Darwin's Our Take: Gilead announces third acquisition of 2026

Gilead announces third acquisition of 2026: Next-gen ADC developer Tubulis for up to $5 billion

Gilead Sciences has entered into a definitive agreement to acquire Tubulis GmbH, a private biotech based in Munich that develops next-generation antibody-drug conjugates (ADCs), for as much as $5 billion.

The acquisition will expand Gilead’s ADC capabilities and build out the company’s oncology pipeline with next-gen assets and platforms.

Tubulis’ lead asset, TUB-040, is in Phase Ib/II development as a potential treatment for platinum-resistant ovarian cancer and non-small cell lung cancer. Another candidate, TUB-030, in the same stage of development, has shown encouraging data across multiple solid tumor types, according to Gilead’s announcement.

Tubulis’ pipeline includes five other investigational candidates either in the discovery or preclinical stage of development.

Daniel O’Day, Gilead’s CEO, said, “Today’s agreement follows a two-year collaboration with Tubulis, which has given us strong conviction in their programs and research capabilities. Bringing this potential into Gilead would further expand what is already the strongest and most diverse pipeline in our company’s history.”

O’Day was referring to a collaboration established between Gilead and Tubulis in December 2024. In that transaction, Gilead paid $20 million up front to collaboratively discover and develop TUB-040.

Through that partnership, Tubulis was eligible to receive another $30 million if Gilead exercised an option included in the agreement, as well as $415 million in potential development and commercialization milestone payments.

The year before Gilead entered into its collaboration with Tubulis, Bristol Myers Squibb established a partnership with the German biotech. BMS paid $22.8 million up front to access Tubulis’ technology for a selected number of ADCs to treat solid tumors and agreed to pay more than $1 billion in milestones.

Tubulis’ technology platform is designed to increase stability, allowing more of the drug to reach its target by preventing premature payload loss. It also produces ADCs with a high drug-to-antibody ratio, which increases efficacy.

Under the new acquisition agreement, Gilead will pay $3.15 billion for the outstanding equity of Tubulis at closing, and possibly up to $1.85 billion in unspecified milestone payments.

The deal is expected to close this quarter, subject to expiration or termination of certain regulatory filings and other customary conditions, Gilead noted. Once the acquisition has been completed, Tubulis will operate as a dedicated ADC research organization within Gilead.

OUR TAKE: Having specialized in HIV and hepatitis treatments for decades, Gilead is spending billions to diversify its drug development portfolio. As its main franchises mature, the company is shifting some of its growth strategy from virology to oncology and immunology.

In 2020, Gilead stunned analysts when it spent a whopping $21 billion to acquire Immunomedics. That deal handed Gilead Trodelvy (sacituzumab govitecan-hziy), a first-in-class, Trop-2-directed ADC the FDA approved earlier that year on an accelerated basis as a treatment for metastatic triple-negative breast cancer.

The FDA approved Trodelvy in 2023 for a second breast cancer indication — metastatic HR-positive, HER2-negative breast cancer. That same year, annual sales of Trodelvy surpassed $1 billion, making it a blockbuster.

In February of this year, Gilead agreed to acquire Arcellx in a deal with an equity value of $7.8 billion. Gilead and Arcellx have been collaborating since 2022 on developing an investigational BCMA-directed CAR T-cell therapy known as anitocabtagene autoleucel, or anito-cel, as a treatment for multiple myeloma. The FDA is set to make an approval decision on anito-cel by Dec. 23.

And then last month, Gilead agreed to acquire Ouro Medicines for approximately $1.7 billion in cash up front and potentially another $500 million in milestone payments. Ouro’s lead asset, gamgertamig, a T cell engager that targets the immune cell proteins BCMA and CD3, is being evaluated in early-stage studies as a treatment for autoimmune hemolytic anemia, immune thrombocytopenia, and other diseases.

Regarding the Tubulis acquisition, Daina Graybosch, an analyst with Leerink Partners, wrote in a research note that is it “more than an oncology bolt-on; we see real platform value in application of Tubulis’ ADC technologies to other therapeutic areas, namely virology.”

What else you need to know

Neurocrine Biosciences plans to acquire Soleno Therapeutics in a deal valued at $2.9 billion. With the acquisition, Neurocrine will add Soleno’s lead product, Vykat XR (diazoxide choline), a first-in-class, once-daily oral therapy the FDA approved a year ago as a treatment for hyperphagia (persistent hunger) associated with Prader-Willi syndrome in patients age 4 and older. Under the terms of the definitive agreement, Neurocrine will pay Soon shareholders $53 per share. The boards of both California-based companies have approved the acquisition. If regulatory approval is granted and other customary closing conditions are met, the companies anticipate closing the deal within 90 days of when the agreement was announced on April 6.

Jefferson Health is suing Aetna, claiming a Medicare Advantage “downcoding” payment policy the CVS Health-owned insurer recently implemented violates reimbursement contracts as well as CMS’ two-midnight rule. That rule requires Medicare to cover hospital stays as inpatient in cases where the patient is expected to need care for at least two midnights; MA plans are required to comply with the rule. Aetna’s policy applies to urgent or emergent hospital admissions and involves a two-tier rate system based on what Aetna calls “level of severity.”

For hospital admissions lasting between one and fewer than five midnights, if Aetna decides patients are low severity, the company typically pays a lower, “observation-level” rate — even when patients are admitted on an inpatient basis. According to Healthcare Dive, Aetna pays the negotiated inpatient rate for these shorter stays only if the company determines that claims meet internal guidelines. Stays that last at least five midnights are paid at the higher rate. A spokesperson for Aetna said the company disagrees with the allegations.  

Orlando Health plans to increase its footprint in Alabama by acquiring RMC Health System, a not-for-profit health system based in, and owned by, the city of Anniston. It serves the northeastern part of the state with a 375-bed medical center, outpatient facilities, specialty practices, more than 1,800 team members, and over 200 physicians, according to a press release. Orlando Health said it has committed to investing “significant resources” in RMC Health over the five years ahead, including the implementation of an electronic health record system. The deal is expected to be finalized in the fall. In October 2024, Orlando Health acquired a 70% ownership stake in Birmingham-based Baptist Health from Tenet Healthcare. Currently, Orlando Health, a private nonprofit, operates 25 hospitals and has four more in development.

Providence continues to carry out its strategic restructuring initiative through divestitures and by paring services. Last month, the Renton, Wash.-based health system disclosed that it is considering selling its insurance business, Providence Health Plan. More recently, Becker’s Hospital Review reported that Providence intends to sell Queen of the Valley Medical Center in Napa, Calif., and that acute care and emergency services will be phased out at Providence Mission Hospital Laguna Beach. Providence has divested non-core assets as well, including MedPearl, its clinical decision support tool; Tegria Services Group, its health IT consulting business; and 10 skilled nursing facilities in several states. The health system also transitioned its home health and hospice unit to a joint venture with Compassus.  

Oregon Health & Science University’s recently hired CEO of OHSU Health, Tarek Salaway, is no longer with the Portland-based health system. Salaway took on the role of CEO in mid-December; before that, the health system went without a permanent CEO for nearly two years. No reason was provided for Salaway’s departure. Dr. Renee Edwards, chief medical officer at OHSU, will serve as acting CEO of OHSU Health until an interim CEO is named.  

Brentwood, Tenn.-based Lifepoint Health agreed to acquire eight acute care hospitals from ScionHealth, a health system based in Louisville, Ky., that serves communities in 26 states. LifePoint said in a news release that the two organizations are pursing the required legal and regulatory steps, and they expect to finalize the acquisition within the next couple of months. Lifepoint noted that all of the hospitals would retain their current employees and providers, and all existing services would remain available.

What we’re reading

One woman, three autoimmune diseases: CAR-T therapy vanquishes ultra-rare disease trio. Nature, 4.9.26

Levels, Growth, And Semantics: The Role Of Prices In Driving Health Care Spending. Health Affairs, 4.9.26

Smart contact lens monitors eye pressure and delivers glaucoma drugs in early tests. STAT, 4.8.26

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