Covis Pharma is owned by private equity and, if past deals are anything to go by, run by executives more focused on cash flows than R&D. Thus the acquisition of Amag seems something of a departure, considering that the main draw is a project that still requires substantial development. Ciraparantag is a reversal agent believed to be active against heparin as well as the novel, oral anticoagulants Pradaxa, Eliquis, Xarelto and Savaysa. There is a need here: Andexxa, now owned by Alexion after its $1.4bn Portola takeover, is approved against Eliquis and Xarelto, but carries black box warnings; Boehringer Ingelheim’s Praxbind only reverses that company’s Pradaxa. As a small molecule ciraparantag could offer a more convenient, safer and faster-acting option, Amag argued – although this still needs to be proven in phase III. Step forward Covis, which this week agreed to pay almost $500m for Amag, net of debt. Perhaps the hope is that Daiichi Sankyo, which sells Savaysa, will step in as a development partner; the Japanese group previously co-sponsored an earlier trial. The sellside estimates launch in 2023 and sales of $10m by 2026, according to EvaluatePharma. Covis is surely hoping for much more.