Behind The Buyout: Dispatches From The Dealmaking Table

As pharmaceutical industry observers know, the last two years have not been kind to companies seeking financing. Venture capital firms have grown increasingly risk-averse, forcing biotech companies to pivot. Business development deals are proving a vital lifeline.

During Q1 2025, a total of 164 biopharma partnerships were signed, together worth $60.8bn in potential deal value (PDV). Of the 72 deals with disclosed values, 21 reached or surpassed a billion dollars. Big pharma companies penned 44 alliances in all during Q1, accounting for about 26% of the quarter’s deal volume. Twenty seven partnerships involving biopharma start-ups were signed during the quarter, 13 of which had disclosed potential deal values and four of which had PDVs exceeding $1bn.

During the first quarter of 2025, six biopharma start-up acquisitions were signed, but in the pharma industry, deals are more than financial transactions, they are inflection points that define careers, reshape pipelines and determine whether promising medicines ever reach patients.

While these numbers are encouraging in the current climate, especially for small biotech looking to make a deal, a 2024 report by LEK Consulting found that approximately 50-55% of pharma transactions produce less than expected results.

In nearly $1tn invested across 195 deals since 2010, it found that the lead assets acquired in these deals underperform by about 40% compared to pre-deal sales forecasts within just three years of launch.

For executives steering a company through a buy-side acquisition or preparing their own organization for sale, leading the deal is a high-wire act balancing strategic vision, operational discipline and human leadership.

In Vivo spoke to four industry leaders with extensive M&A experience -- Fred Hassan, Sean A. MacDonald, Elizabeth Holt and Cora Griffin -- about what it really takes to lead a successful deal. From billion-dollar buyouts to transcontinental licensing partnerships, they reveal that the path to value is rarely linear and never purely rational. The best deals, they agree, are built on a foundation of purpose, trust and relentless execution.

Define The “Why”: Strategy Before Structure

Every deal begins with a motive. And getting that motive right is, in many ways, half the battle.

“The ‘why’ is everything,” said Sean A. MacDonald, CEO of Domain Therapeutics. “You can do a deal for a hundred different reasons, to replace pipeline gaps, scale up revenues, acquire novel tech or even buy time. But unless everyone, from the CEO to the board to the team, agrees on why you’re doing it, you’re just shopping without a list. You’ll get distracted and overpay, or worse, buy something you don’t need.”

“You can do a deal for a hundred different reasons...But unless everyone, from the CEO to the board to the team, agrees on why you’re doing it, you’re just shopping without a list.”

Sean A. MacDonald, CEO, Domain Therapeutics

MacDonald has a strong market history of acquisitions, having served as head of business development for Cosmo Pharmaceuticals, CEO of Corbin Therapeutics, and vice president of corporate and business development at Pharmascience.

Dealmaking veteran Fred Hassan, whose acquisition resume includes leading Schering-Plough’s $16bn purchase of Organon and overseeing the $60bn+ sale of Pharmacia to Pfizer, puts it even more bluntly: “Avoid the treadmill trap. Too many CEOs are trying to satisfy Wall Street with arbitrary EPS growth promises. Focus instead on building long-term value rooted in vision and culture. Once that’s anchored, acquisition becomes an extension of strategy, not a distraction from it,” he said.

Cora Griffin, co-founder of the RSV biotech ReViral, which Pfizer acquired for $525m in 2022, reflects on how strategic alignment guided every step of the journey: “We were laser-focused on RSV, and we knew Pfizer had the commercial scale and global infrastructure to take it to patients faster than we could alone. That clarity helped us recognize when the right offer was in front of us.”

Execution Wins Or Loses The Deal

The best strategic logic in the world can fall apart without crisp execution. MacDonald recalls the one that got away, a deal that lingered for 13 months before collapsing after a management reshuffle at the acquirer.

“We kept tweaking, trying to get more value, and then a new CSO came in and froze all deals. It died right there. That’s why I always say: Don’t let great be the enemy of good. If your deal is within range -- between your worst-case and best-case scenario -- take it. Close it. Move on.”

Speed matters. But so does momentum, said Liz Holt, who helped guide Gyroscope and Aiolos Bio through acquisitions by Novartis and GSK, respectively. “You’ve got to keep people motivated during what’s often a draining, ambiguous period. With Gyroscope, we were doing back-to-back diligence meetings and integration planning, it was exhausting. But the energy you bring as a leader is contagious. If you fade, your team fades.”

"With Gyroscope, we were doing back-to-back diligence meetings and integration planning, it was exhausting. But the energy you bring as a leader is contagious. If you fade, your team fades.”

Elizabeth Holt, CBO, iOnctura

Holt’s point is echoed by Griffin, who remembers working until 3 am finalizing due diligence with Pfizer: “Momentum gets deals done. We kept up constant, clear communication across both sides. That’s what pulled us through. You can’t allow silence to grow. Silence becomes doubt.”

Trust Is The True Currency

Ask any of these leaders what made a difference in the success of their deals, and one word comes up again and again: trust.

“In both of our deals, we were handing over something we loved, assets we had built from scratch,” said Holt. “Yes, there’s the financial upside. But emotionally, it’s like giving away your child. So, we had to trust the buyer would do right by it. And they had to trust us to share everything warts and all.”

Holt describes how GSK built that trust during the acquisition of Aiolos Bio, a respiratory-focused startup: “They didn’t just come in and start issuing orders. They assigned buddy roles, spent time with our teams, and were very transparent about roles and structure. It made the transition feel respectful, not hostile.”

I met executive teams in person and said, ‘Help us make this work, even if your own role changes.’ I asked them to be role models. People needed to see unity. That’s what calms the storm.”

Fred Hassan, former CEO, Schering-Plough

Fred Hassan believes building trust starts well before day one. “After we announced deals; Organon, Monsanto, Cynamid and Robins, I immediately visited their main sites. I met executive teams in person and said, ‘Help us make this work, even if your own role changes.’ I asked them to be role models. People needed to see unity. That’s what calms the storm.”

Trust also matters when negotiations get tense. Holt recalls negotiating a licensing deal with a Chinese biotech while at Aiolos Bio. “We didn’t speak the same language, culturally or literally. But we walked through Shanghai in the rain together. That walk was everything. When the tough clauses came, that relationship helped us ask not just ‘what do you want?’ but ‘why do you want it?’ That unlocked solutions.”

Culture Fit Is Non-Negotiable

Most pharma executives agree that financial, scientific and strategic alignment are table stakes. What’s harder, but often more critical, is cultural fit.

Hassan warns against “acquirer arrogance,” a common trap after a deal closes: “You’ve paid the price, you’ve got the asset and now you think you know best. That’s where value gets destroyed. The best acquirers stay humble. They integrate fast where it matters, like accounting and HR, but they go deliberately where innovation lives, like R&D.”

“When you’re being acquired, the cultural tone of the buyer sets everything.”

Cora Griffin, head of business development, Curve Therapeutics

Hassan’s team at Schering-Plough allowed Organon’s R&D leader, David Nicholson, to continue as number two in the combined R&D organization. That continuity helped preserve a promising pipeline project, now known as Keytruda (pembrolizumab). Now a $27bn blockbuster for Merck, it might have been cut into a less thoughtful integration.

Griffin added, “When you’re being acquired, the cultural tone of the buyer sets everything. Pfizer was transparent and collaborative. That helped us keep our team engaged and excited, even as they were technically being absorbed.”

Lessons From Both Sides Of The Table

Hassan has lived both roles—as acquirer and seller. He believes that dignity, empathy and clarity are the three essentials for a divesting CEO.

“At Pharmacia, once we agreed to sell to Pfizer, I told my team: ‘Keep your heads up. Stay focused. This is good for patients, good for shareholders, and maybe even good for your careers.’ We kept pushing, we got FDA approval for the blockbuster antibiotic linezolid during the waiting period. That showed pride and purpose.”

MacDonald, too, reflected on how leadership differs when you’re managing stakeholder expectations internally. “If you’re a junior exec executing a deal, stay close to your internal champion. Don’t let daylight open between you and them. The deal will evolve. If you’re out ahead of their thinking, you’ll create confusion and false expectations on the other side.”

And when the deal doesn’t go through? “Learn from it,” said Griffin. “Honestly assess what worked and what didn’t. And move forward without bitterness.”

All four leaders are adamant: a deal isn’t successful until it’s integrated successfully.

“Integration planning must start during due diligence,” said Griffin, who joined Pfizer post-acquisition to support that transition. “If you don’t know how people, processes and data will move, you’ll lose months or more. That’s time you’re not helping patients or hitting milestones.”

Town halls, joint integration officers and SPOCs (single points of contact) were some of the mechanisms Hassan used to drive integration. “The people side is everything. If you don’t address uncertainty quickly, rumors fill the vacuum. That’s where morale dips and productivity craters.”

Emotional Intelligence Is Your Greatest Tool

Perhaps the most underrated leadership quality in dealmaking? Emotional intelligence.

“This stuff is personal,” said Holt. “These aren’t widgets. We’re dealing with life-saving therapies and people who’ve sacrificed years. Leaders need to show up, and not just with spreadsheets, but with heart.”

Griffin agreed: “You have to be aware of the grief that comes with letting go. You might not cry about it. But you feel it. Your team feels it. Honor that.”

MacDonald, a veteran of deals across North America and Europe, says humility matters most: “You’re never the hero. You’re just trying to balance competing needs and get something important done. If everyone is a little bit happy and a little bit unhappy, that’s probably a good deal.”

Lead With Purpose, Not Ego

So what does it take to lead a deal well?

“Clarity, courage and communication,” Griffin said. “Discipline and decisiveness,” added MacDonald. “Trust, empathy, and vision,” said Hassan. And for Holt? “Curiosity. Never assume you know best. Ask questions. Listen. Learn.”

The landscape of biopharma is littered with deals that looked good on paper but failed to deliver. But when led with emotional intelligence, strategic clarity and operational discipline, the right deal can change everything, and not just for shareholders, but for patients as well.