Novartis is planning to buy U.S.-based biotech Excellergy for up to $2 billion, betting on a next-generation allergy treatment that may prove to work faster and better than anything currently on the market, the Swiss pharmaceutical giant said Friday.

The acquisition will add Exl-111, an early-stage drug candidate, to Novartis’ existing allergy portfolio. It is the latest bolt-on deal in the company’s attempt to offset looming patent expirations.

It comes just a week after Novartis announced it is acquiring Synnovation subsidiary Pikavation Therapeutics for up to $3 billion to secure the rights to an experimental breast cancer drug. 

In February, the company completed the acquisition of Avidity Biosciences, adding three late-stage programs to its neuromuscular pipeline, with potential for several launches before 2030. 

Excellergy’s lead asset remains several years away from hitting the market. Novartis said it will pay the smaller biotech in both upfront and milestone payments, and the transaction is expected to close in the first half of 2026, subject to regulatory approvals.

Novartis stock traded sideways in morning trading in Zurich. Palo Alto-based Excellergy is privately held.

Many of the best-selling drugs in the world are facing a loss of exclusivity in key jurisdictions in what the sector calls “the patent cliff.” By the turn of the decade, companies risk losing hundreds of billions in revenue as branded drugs are exposed to generic competition.

Like the second half of 2025, early 2026 has seen a slew of M&A announcements from Big Pharma, including Merck announcing it has reached an agreement to buy Terns Pharmaceuticals for up to $6.7 billion earlier this week. Britain’s GSK and AstraZeneca are also among the companies that have announced several deals over the past months.

GSK’s global head of business development Chris Sheldon told CNBC late last year he is looking for acquisitions often in mid-stage development in the $1 billion to $2 billion range, where the biology is validated biology but the outcome of a drug candidate isn’t yet obvious. Like Novartis and AstraZeneca, GSK looks for so-called bolt-on deals that complement its portfolio and technology.

Novartis warned earlier this year that profits would decline in early 2026 as some of its best-selling drugs, including heart medicine Entresto face generic competition. Its second-best-selling medicine Cosentyx is expected to lose key exclusivities around 2029.

“For the first half of the year, we will have a tough prior year base with Entresto, Promacta and Tasigna generics having entered the U.S. market mid-2025,” said then-incoming CFO Mukul Mehta in a post-earnings call with analysts in February.

Novartis is seeing strong growth in other medicines such as cancer drug Kisqali and multiple sclerosis treatment Kesimpta, but still has to bulk up its pipeline to offset declines. 

CEO Vas Narasimhan has said that the company is in the middle of the biggest patent expiration wave in the company’s history.

“It’s $4 billion that we will absorb over the course of this year across the three medicines,” Narasimhan told CNCB in February.

Four years of war between Russia and Ukraine are beginning to take their toll on the countries’ demographics as the conflict puts women off — or prevents them — from starting or expanding their families.

While the effects of that broad-based hesitancy to have children might not be immediately apparent, a decline in the birth rate can have far-reaching consequences for economies and societies further down the track.

Since Russia’s full-scale invasion of Ukraine began on Feb. 24, 2022, Ukraine’s fertility rate — the average number of births per woman — has plummeted, exacerbated by the war, the loss of partners and spouses in the fighting, and family separation and mass emigration.

In 2021, Ukraine’s total fertility rate stood at 1.22 but this has since dropped to 1.00 in 2025, according to United Nations population data. Some have cited a more dire metric, with the First Lady of Ukraine, Olena Zelenska, warning in December that the fertility rate in the country had plunged to 0.8–0.9 children per woman, with the war and insecurity across Ukraine causing this “critical decline.”

For a society to replace itself from one generation to the next, without relying on migration, a total fertility rate of 2.1 children per woman is necessary.

Russia, too, has also seen a longer-term trend downwards in its fertility rate exacerbated by the war. In 2021, Russia’s fertility rate was 1.51 but by 2025, it had dropped to 1.37 children per woman, down from 1.4 recorded the year before.

But four years of war appear to have played a big part in deterring or preventing women in Ukraine from having children, while in Russia, women seem resistant to repeated calls from the Kremlin, and President Vladimir Putin, to have larger families.

Declining birth rates pose big problems for countries as they have knock-on effects on the economy and society, with few births meaning fewer workers in the labor force in future, as well as lower productivity and economic growth.

That means lower tax receipts for governments and extra strain on pension and healthcare systems as an ageing population grows and becomes dependent on a shrinking working population.

While the declining fertility and birth rate — referring to the number of live births per 1,000 people each year — had been declining before the war, Russia’s invasion made the situation even worse, Iryna Ippolitova, senior researcher at the Kyiv-based Centre for Economic Strategy, told CNBC.

“Of course, in 2022 it got it even worse because of this massive migration and because the majority of those who left Ukraine were people of working age, economically active people,” she noted, adding:

“A lot of women who theoretically could have children left, and for those who stayed, the war and uncertainty meant they were unprepared to give birth in Ukraine, and the number of births is still declining.”

Even if peace talks come to fruition and the war ends, Ippolitova said migration out of Ukraine could continue, while those staying in the country could be put off having families if they fear a repeat invasion by Russia. This, she said, was another reason why Ukraine needed security guarantees as part of any peace deal.

Although fertility trends are notoriously hard to predict, and baby booms are often seen after wars end, Ippolitova said the country’s low fertility rate could still trouble the Ukrainian economy in the future.

Schools and universities were already starting to experience falling numbers of pupils, she said, signaling a smaller working-age population down the line.

“I think that it is a huge problem. We have labor shortages right now, already, and after the war, it will only get worse … In 10 or 15 years when people my age retire, there will be nobody to replace them on the labor market,” Ippolitova said.

The Russian state has introduced incentives for women who have three or more children, including lump-sum payments, tax breaks and state benefits. The Kremlin has even revived the Soviet-era “Mother Heroine” award, giving women a cash reward of 1 million rubles (around $13,000) for having 10 or more children.

Resistance to such incentives remains, however, with Russia recording 1.222 million births in 2024, the lowest annual total since 1999.

In December, Putin said during his year-end press conference that the fertility rate stood at 1.4 in 2025 (the actual figure was 1.374) and suggested Russia needed a baby boom.

“We also have a slight decline [in the fertility rate] — approximately 1.4. We need to achieve at least 2.0,” Putin said during his annual “Direct Line”, telling the public that “we must make the happiness of motherhood and fatherhood fashionable.”

Critics say Putin’s position on the country’s low fertility rate boils down to control rather than demographic concerns.

“I strongly believe that Putin’s regime’s efforts to double down on encouraging births is not related to any kind of demographic trends. This is all about societal control,” Konstantin Sonin, the John Dewey Distinguished Service Professor at the University of Chicago Harris School of Public Policy, told CNBC.

“[Russia’s authorities] want women to be at home, they want women to be with kids. They want men to care about the women, not about politics,” Sonin, a prominent Putin critic, said.

CNBC has contacted the Kremlin for a response to the comments and is awaiting a reply.

Sonin argued that Putin had already shown he did not care about demographics by starting the war against Ukraine, with the conflict causing economic instability, labor market shortages and inflation.

Efforts by the Kremlin to encourage more births had fallen flat, Sonin said, because women in Russia did not feel safe and secure, with the low birth rate direct evidence of that and effectively dispelling positive images of the country and war promoted by Russia and state-run media.

“There are more important things for any woman, for any young family, than just how much money in a direct cash transfer they will receive from the state. What matters for them is the general feeling of safety. And this is not there in Russia,” Sonin said.

“The quality of life has fallen since the beginning of the war. Hundreds of thousands of young people are dead because of the war, so people suddenly feel much less safe than they felt in other circumstances.”