Core Viewpoint - Novo Nordisk A/S has agreed to acquire Akero Therapeutics, Inc. for a total value of approximately $4.7 billion, focusing on treatments for metabolic diseases [1][2]. Transaction Terms - Novo Nordisk will pay $54 per share in cash, totaling $4.7 billion at closing [2]. - Akero shareholders will also receive a non-transferable contingent value right (CVR) for a potential additional payment of $6 per share, amounting to $0.5 billion, contingent upon U.S. regulatory approval of EFX for treating compensated cirrhosis due to MASH [2]. Strategic and Portfolio Fit - The acquisition aligns with Novo Nordisk's long-term strategy to develop innovative medicines for diabetes, obesity, and related comorbidities [3]. - Akero's EFX is a promising treatment for metabolic dysfunction-associated steatohepatitis (MASH) [3]. Clinical Development - EFX is currently being evaluated in the phase 3 SYNCHRONY program, which includes three clinical trials aimed at supporting regulatory approval for treating pre-cirrhotic (F2-F3) MASH and compensated cirrhosis (F4) due to MASH [4]. - Previous phase 2b trials showed significant improvements in liver fibrosis, with reductions of 49% and 29% in fibrosis for the HARMONY and SYMMETRY trials, respectively, compared to placebo groups [5]. Financial Implications - The acquisition is not expected to affect Novo Nordisk's operating profit outlook for 2025, although it will negatively impact free cash flow by approximately $4 billion [6]. - For 2026, increased research and development costs are anticipated, leading to a projected three percentage point decrease in full-year operating profit growth [7]. - The transaction will primarily be financed through debt [7].