CNS drug development has had a significant revival. Anti-amyloid agents like Leqembi have shown meaningful slowing of Alzheimer’s progression, and Cobenfy’s 2024 approval marked the first non-dopaminergic schizophrenia treatment in over 30 years. A therapeutic area that saw multiple big pharma exits just a decade ago is attracting capital again. We cover the full picture in the new Evaluate Spotlight CNS episode which is available here.

The M&A data reflects that renewed confidence. Deal volume has risen from around 35 transactions per year pre-pandemic to over 50 annually since, and median deal size has climbed to around $500m. The BMS acquisition of Karuna for Cobenfy and J&J’s $14.6bn purchase of Intra-Cellular Therapeutics, which brought Caplyta across schizophrenia, bipolar disorder, and depression, are the headline examples. Acquirers are active and willing to move on well-differentiated, clinically validated assets.

Licensing is a rather different story. Volume spiked during the low-interest-rate years, then contracted sharply. Median deal size has held, though, which we believe reflects a focus on higher standards rather than smaller budgets. Human proof-of-concept data is now table stakes and a compelling mechanism with inconclusive early data no longer draws serious interest.

One thing that we discuss in the webinar is that M&A and licensing are focusing on different indications. Acquisitions cluster in commercially established categories like pain, depression, Parkinson’s and Alzheimer’s, while licensing leans toward neurodegeneration, where licensees will take on more scientific risk for a novel mechanism. The split reflects different risk appetites.

We also discuss the modalities that are drawing the most forward-looking interest. RNAi, brain-shuttle technologies, and oligonucleotides are all areas where the science is well ahead of the commercial playbook. Psychedelics, which is particular area of Emma’s expertise remain a wait-and-see area. Two psilocybin compounds could reach the FDA soon, but the care burden has slowed uptake and the commercial case remains unproven.

The full Evaluate Spotlight CNS webinar and report go deeper (though the webinar is just 20 minutes), covering deal-structure trends, indication-level data, and where the next wave of assets is coming from.

If you’re looking for data and insight to support your CNS strategy, or need guidance on your best next steps, get in touch to chat to our team. You can also find detailed reports on many indications within CNS in Datamonitor Healthcare.