Novo Nordisk Seeks to Expand Liver Disease Treatments in $5.2B Deal for Bay Area Biotech

Novo Nordisk has reshaped countless waistlines. Now the Ozempic maker is aiming a little higher in the abdomen.

The Danish pharma giant announced Thursday that it will acquire San Francisco-based Akero Therapeutics for $5.2 billion, adding a promising liver-treatment candidate to its pipeline as new CEO Mike Doustdar tries to revive once meteoric growth that has come crashing down to earth this year.

Metabolic Reset

Novo Nordisk became a household name because of Ozempic, its multi-billion-dollar weight loss and diabetes treatment that’s also marketed as Wegovy. Its cultural cache is such that Golden Globes host Nikki Glaser jokingly dubbed the Hollywood ceremony “Ozempic’s biggest night” back in January. In the months since, however, talk about Novo has centered on its plunging shares. After all, investors want stocks forever bulking, not slimming down. Novo has shed 33% of its value in 2025 amid heightened competition from rival Eli Lilly and a wave of copycat drugmakers. Wall Street is worried about cuts to sales forecasts amid an increasingly crowded weight-loss drug market, and last month, Novo announced 9,000 layoffs.

Doustdar took over in July after his predecessor stepped down under pressure from the board. A month later, Wegovy became the first GLP-1 drug to get the US Food and Drug Administration’s accelerated approval for treatment of metabolic dysfunction-associated steatohepatitis, or MASH. Formerly known as fatty liver disease, it occurs when fat builds up in the liver and causes scarring, known as fibrosis. The condition can be treated with drugs that help curb metabolic risk factors, such as blood sugar, body fat and insulin sensitivity. With about 5% of adults affected by the disease, it’s a huge market opportunity. Which is where Akero Therapeutics comes in: The Bay Area biotech is testing its drug efruxifermin on MASH, and it’s considered a potentially “transformational” breakthrough:

• MASH can eventually lead to permanent liver damage called cirrhosis, at which point patients typically need a liver transplant. Efruxifermin, which is currently in Phase 3 trials, is the only treatment to have shown a significant decrease in fibrosis levels in patients with cirrhosis.
• Combined with Wegovy, which can treat lower levels of MASH, Doustdar said efruxifermin will form “an important building block” of Novo’s turnaround efforts. BMO Capital said, in a note to clients, that it views the deal “positively as Doustdar works to bring the ship back on course.”

The Fine Print: Novo will acquire Akero for $54 per share, representing an upfront payout of $4.7 billion. A $6-per-share contingent value is payable if efruxifermin wins FDA approval to treat compensated cirrhosis resulting from MASH by 2031, which would bring the full payout up to $5.2 billion. Akero shares rose 16% after the announcement, something investors no doubt hope will wear off on the soon-to-be parent firm, whose shares slimmed down another 1.5% on Thursday.