Six months after former FDA senior official Peter Marks joined Eli Lilly, the trillion-dollar pharmaceutical giant has finally made a high-profile return to the infectious disease field.

 

In late May, Lilly posted an announcement on its website declaring that it had acquired three vaccine development companies – Curevo, LimmaTech Biologics, and Vaccine Company – in a single day, with total transaction values reaching up to US$3.8 billion.

 

When the news broke, Wall Street analysts were already impressed by Lilly's "buying spree." With the addition of these three deals, the company's M&A record for the year rose to nine transactions – an average of nearly two deals per month – with total value exceeding US$24.7 billion.

 

Lilly's Chief Scientific Officer, Daniel Skovronsky, stated that these acquisitions reflect a deliberate strategy to prevent diseases at their source rather than merely treating their symptoms.

 

This sounds ambitious, yet it is somewhat nuanced for Lilly. Early-stage entry is not a passing fancy for the company. The establishment of ExploR&D, a division dedicated to early-stage exploration, offers a glimpse of its unique vision. Still, it is undeniable that over the past few decades, Lilly's infectious disease business has been almost dormant.

 

Why has it suddenly returned, even committing to acquiring three companies at once? Moreover, if this acquisition frenzy has not yet ceased, where might it strike next?

 

TONACEA 01: A "Three-Pronged" Acquisition

 

Viewed together, Lilly's vaccine blueprint becomes much clearer.

 

First, acquiring Curevo challenges GSK's shingles vaccine.

 

Lilly's price tag for Curevo is up to US$1.5 billion – including an undisclosed upfront payment and subsequent payments tied to the achievement of specific milestones.

 

Curevo's core product is amezosvatein, an adjuvanted subunit vaccine for preventing shingles in adults. Currently, the global shingles vaccine market is dominated by GSK's Shingrix. In 2025, global sales of this vaccine reached a new high of £3.558 billion, making it an undeniable blockbuster.

 

However, Shingrix has a well-known shortcoming: poor tolerability. Many vaccine recipients experience injection site pain, fever, and other adverse reactions, leading to hesitation about the second dose and overall low vaccination rates.

 

What Lilly sees is precisely Curevo's ability to address this pain point. Amezosvatein utilizes a next-generation synthetic adjuvant. In Phase II clinical trials, it achieved comparable immunogenicity to the existing standard of care across all primary endpoints while significantly improving tolerability.

 

Second, the addition of LimmaTech aims to fill the bacterial vaccine void.

 

With a total consideration of up to US$780 million, Lilly acquired this Swiss company, gaining a pipeline of vaccines targeting bacterial pathogens such as Staphylococcus aureus, gonorrhea, and chlamydia. Among these, the core project LTB-SA7 is in early-stage development, targeting the creation of a vaccine for S. aureus, a leading cause of surgical site infections.

 

Notably, no approved vaccine for S. aureus exists globally. The absence of competition represents a massive unmet clinical need. If LimmaTech's vaccine can be successfully brought to market, it would carve out a new niche in pre-surgical prophylaxis.

 

Third, betting on the long-term value of an Epstein-Barr virus (EBV) vaccine is where Vaccine Company fits in.

 

Lilly acquired Vaccine Company for up to US$1.55 billion. The company's core asset is a vaccine targeting EBV, also known as human herpesvirus type 4.

 

The danger of EBV lies not in acute infection but in its "aftermath." The virus is the cause of infectious mononucleosis and is strongly linked to multiple sclerosis and various malignancies, including nasopharyngeal carcinoma and Hodgkin's lymphoma.

 

No approved EBV vaccine exists globally. This means that if Vaccine Company's technology proves successful, Lilly will gain a first-mover advantage in this untapped area.

 

Overall, Lilly is not putting all its eggs in one basket. However, as Citigroup analyst Geoffrey Meacham noted, the three vaccine developers share a common focus on viral pathogens associated with long-term neurological and oncological risks, which aligns well with Lilly's existing core business.

 

Behind these three transactions is a key figure.

 

In October 2025, Lilly hired Peter Marks, former Director of the FDA's Center for Biologics Evaluation and Research (CBER), as Senior Vice President and Head of its infectious disease division. Marks is one of the most influential figures in vaccine regulation. His joining was widely regarded within the industry as a strong signal of Lilly's return to the infectious disease therapeutic area.

 

Leerink Partners analyst David Risinger commented that these three acquisitions, consistent with the move to hire Marks, demonstrate Lilly's determination to become a vaccine innovator.

 

TONACEA 02: Another Transformation

 

Looking back to the 1940s, it is clear that Lilly is not a "newcomer" to the vaccine field.

 

During World War II, Lilly was one of the first companies in the US to achieve large-scale penicillin production, providing a critical anti-infective weapon for Allied battlefield casualties.

 

In 1955, Jonas Salk developed the world's first inactivated polio vaccine. Lilly was among the first pharmaceutical manufacturers to take on the production and distribution of this vaccine. In an era when polio haunted American society, the company stood on the front lines against infectious disease.

 

However, time changes everything.

 

Over the following decades, Lilly's focus gradually shifted. Diabetes, oncology, immunology, neuroscience – these fields consistently produced blockbuster commercial products, while the infectious disease segment fell into silence.

 

After the outbreak of COVID-19 in 2020, Lilly launched the neutralizing antibody therapies bamlanivimab and etesevimab for the treatment and prevention of the disease in high-risk populations. However, as virus variants evolved, the effectiveness of antibody therapies was challenged, and these products did not yield substantial commercial returns for Lilly.

 

In a sense, COVID-19 served as a "stress test" for Lilly's infectious disease business, and the results were less than ideal. This may be related to the company's response being a short-term reactive measure rather than a long-term strategic layout.

 

What truly signaled a "change of attitude" was Marks's departure to join Lilly in 2025.

 

During his tenure at the FDA, Marks oversaw regulatory activities in vaccines, cell and gene therapies, and blood products. His recruitment indicated that Lilly was seriously considering how to build a complete infectious disease R&D system and elevate its strategic importance.

 

So, why now? The answer may lie in a set of data.

 

In 2025, Lilly's GLP-1/GIP dual agonist tirzepatide achieved global sales of US$36.507 billion, surpassing Merck's Keytruda to claim the title of "global blockbuster king." That same year, the company's annual revenue reached US$65.179 billion, with net profit increasing by 95% year-on-year.

 

In the first quarter of 2026, the company's revenue further grew to US$19.8 billion, a 56% year-on-year increase.

 

Lilly holds a "super check," but how to spend the money has become a more challenging problem than earning it.

 

Strategically, Lilly faces a classic dilemma faced by all companies with a blockbuster product: over-reliance on a single product line. The greater the revenue contribution from a single product, the more the patent cliff becomes a Sword of Damocles hanging over the company's head.

 

Competition in the GLP-1 field is intensifying at an alarming rate. Novo Nordisk's oral semaglutide has been approved for weight loss in the US.

 

AstraZeneca, through a US$18.5 billion collaboration with CSPC Pharmaceutical Group, is aggressively pursuing Chinese GLP-1 innovative assets. Analysts believe competition among GLP-1 class drugs is entering a white-hot phase.

 

Lilly is clearly aware of this. The patent protection period for tirzepatide still has about ten years to run, but company executives have indicated they do not intend to stop there.

 

Another external variable that cannot be ignored is the impact of the US political environment on the vaccine industry.

 

After Robert Francis Kennedy Jr. took over as Secretary of HHS, some government funding and policy support for US vaccine R&D projects were lost. Investing in vaccine development during such a period of "vaccine skepticism" requires additional courage – or, more precisely, additional cash flow.

 

Barclays analyst Emily Field stated that engaging in vaccine-related deals is a "smart move" for Lilly. Here, investor disinterest is primarily influenced by the current US political situation, and political landscapes obviously do not last forever.

 

TONACEA 03: Spending Big

 

The three vaccine acquisitions in late May are just a slice of Lilly's intense expansion in 2026. Since the beginning of the year, Lilly's wallet has hardly stayed closed:

 

• January: Acquired Ventyx Biosciences for up to US$1.2 billion, securing an NLRP3 inflammasome inhibitor to target the intersection of chronic inflammation and metabolic diseases.

• February: Acquired Orna Therapeutics for up to US$2.4 billion, obtaining a circular RNA delivery technology platform for in vivo cell therapy.

• March: Acquired Centessa Pharmaceuticals for up to US$7.8 billion, gaining an orexin receptor 2 agonist pipeline to expand into sleep disorder treatment.

• April: First, acquired CrossBridge Bio (focused on dual-payload ADCs) for US$300 million; then acquired Kelonia Therapeutics for up to US$7 billion, obtaining an engineered lentiviral-based in vivo gene editing delivery platform; followed by the acquisition of Ajax Therapeutics for a first-in-class molecule targeting a Type II JAK2 conformation.

• Along with the three vaccine acquisitions in late May, Lilly's nine M&A deals in the first five months of the year reached US$24.7 billion – exceeding Lilly's total annual acquisition spending for any single year since 2010 and equaling its total acquisition spending for the past three years combined.

 

But more noteworthy than the numbers is the logic behind Lilly's spending.

 

First, Lilly does not choose one over the other; it places simultaneous bets.

 

In the gene therapy field, Lilly is developing both LNP-delivered circular RNA (Orna) and engineered lentiviral-based in vivo gene editing (Kelonia) technology routes. While companies like AstraZeneca, AbbVie, Gilead, and BMS have largely chosen one of these two routes, Lilly has opted for "both."

 

This can be seen as a hedging strategy. As the industry matures, the key to competition among leading players is ensuring they do not bet on the wrong direction. Placing simultaneous bets on both routes means that regardless of which ultimately proves successful, Lilly will have a seat at the table.

 

Second, Lilly values early-stage assets but does not shy away from later-stage products.

 

Jake Van Naarden, Lilly's President of Oncology and Head of Business Development, has publicly explained that the company conducts a significant number of early- and late-stage transactions simultaneously to balance risk and return.

 

The challenge with early-stage deals is that many may "fizzle out," while investing in later-stage products may appear more expensive upfront, but the assets have greater certainty and offer "de-risked" value.

 

Third, Lilly leverages its cash advantage to do what others dare not do.

 

This "blanket" transaction strategy is only feasible for a company with an extremely ample cash position. A total M&A portfolio of nearly US$25 billion is less than the annual sales of tirzepatide alone.

 

"We've made far more offers than you can imagine," Naarden revealed, noting that he and his team evaluate "at least" ten potential transactions each week.

In other words, the US$24.7 billion spent so far this year is just the tip of the iceberg.

 

And China is one of the most important destinations in this "spending campaign."

 

TONACEA 04: Betting Big on China

 

Over the past few years, Lilly's strategic positioning in China has evolved through a three-level progression: from "buying drugs" to "buying technology" to "buying platforms."

 

The most classic example occurred in March 2026. Lilly signed a global pipeline licensing and R&D collaboration agreement with AI pharma company Insilico Medicine valued at up to US$2.75 billion. With an upfront payment of US$115 million plus subsequent milestone payments, the total transaction size approached RMB 20 billion.

 

This represents the highest-value out-licensing deal in the history of Chinese AI pharma.

 

The subject of the deal is a pre-clinical-stage novel oral GLP-1 drug. A telling detail is that Lilly itself is already developing an oral GLP-1 molecule, orforglipron, and has even submitted marketing applications in both the US and China. Yet the company still decided to spend billions of dollars to acquire a similar molecule from a Chinese AI company.

 

This suggests an intriguing trade-off: rather than relying solely on internal R&D, it is more efficient to leverage the high-throughput screening capabilities of an external AI platform – using money to buy time.

 

Insilico Medicine did not emerge overnight. The collaboration between the two parties actually began in 2023, initially with Lilly licensing Insilico's Pharma.AI platform on a software-as-a-service basis. In 2025, the collaboration was upgraded to drug discovery R&D, and Lilly participated as a cornerstone investor in Insilico's IPO on the Hong Kong Stock Exchange.

 

From "buying a shovel" to "securing a position" to "signing a major deal," this trust curve took three years to develop.

 

If Insilico Medicine represents Lilly's bet on AI R&D capabilities, then its seventh collaboration with Innovent Biologics represents the MNC's systematic endorsement of the R&D system of a Chinese innovative drug company.

 

In February, Innovent and Lilly signed a strategic collaboration valued at a potential total of US$8.85 billion. Innovent will lead the R&D for related projects from drug discovery to clinical proof-of-concept in China, while Lilly will obtain exclusive global rights outside Greater China.

 

Innovent's CFO, You Fei, noted that this collaboration extends from commercialization and development phases to the earliest stages of R&D. This means Innovent is not merely participating in global innovation but is beginning to lead it.

 

Lilly's "rooted in China" strategy also extends to manufacturing.

 

In March, Lilly announced a cumulative investment of US$3 billion over the next decade to expand its supply chain capacity in China, focusing on the localized production of oral GLP-1 drugs. The investment adopts an "internal expansion + external partnership" model, leveraging its Suzhou facility and collaborating with local manufacturing partners like Kanglonghua.

 

Lilly has had a presence in Suzhou for nearly 30 years, with cumulative investment reaching RMB 15 billion. On this supply chain, Lilly has integrated China as a core component of its global capacity strategy.

 

These three threads weave together a complete picture of Lilly's "heavy bet on China":

• Supply chain localization to address capacity bottlenecks

• R&D collaboration to fill pipeline gaps

• Equity investment to secure cutting-edge technologies

 

These three elements, interlocking and reinforcing one another, have elevated China from a pure "sales market" to a "strategic resource base."

 

J.P. Morgan analysis shows that the cost for MNCs to access innovative assets of comparable quality in China may be only 30% to 40% of that in the US. This "arbitrage opportunity" endows Chinese innovative drug assets not only with R&D value but also with financial and strategic value.

 

In this sense, Lilly's "increased position" in China can be understood as leveraging China's innovation capabilities and cost advantages to support its global pipeline over the next decade.

 

Based on this analysis, Chinese assets are likely to remain a component of Lilly's transaction options going forward.

 

TONACEA 05: Epilogue

 

Returning to the question posed at the beginning of this article: behind Lilly's acquisition of three vaccine companies in one day, what exactly is the company striving for?

 

On the surface, it is building a "technology investment portfolio" spanning vaccines, gene editing, AI pharma, inflammation, sleep disorders, and other cutting-edge fields.

 

A deeper answer is that this pharmaceutical giant is using its cash advantage to complete a crucial task that every super-company must undertake in response to market and investor expectations: When you have already reached the summit, where do you go next?

 

Looking back through history, many companies have faltered after initial success. Kodak invented the digital camera but got lost in the glory of film; Nokia's dominance in the feature phone era became a burden in the smartphone age. Lilly's CEO, David Ricks, clearly does not want to repeat those stories. Whether the acquisitions will truly help Lilly transcend cycles will be a matter for time to tell.

 

But at the very least, Lilly has taken the first step, and it has done so with enough speed and force that rivals will have to consider how to respond.

 

References:

• Lilly Agrees to Buy Trio of Vaccine Developers

• Lilly to Buy Three Vaccine Developers for Up to $3.8 Billion

• Lilly Goes on $20 Billion Buying Spree as It Seeks Next Act

• Lilly can't stop the dealing, with nearly $21B spent on M&A this year—so far

• Lilly to buy three vaccine developers for nearly $4 billion in infectious disease push

• Eli Lilly Builds Momentum: "A Thousand Gold for a Horse Bone"

• Behind Lilly's billions: Chinese innovative drug companies get a seat at the table

• The trillion-dollar giant: Reshaping early-stage biotech innovation