Eli Lil­ly may not have dis­cov­ered orex­ins, but the phar­ma’s lat­est ac­qui­si­tion marks in­creas­ing mo­men­tum for a drug class that’s ma­tur­ing af­ter years of fine-tun­ing.

The big ques­tion on the minds of Wall Street is whether orex­in­s' po­ten­tial is ful­ly known.

Lil­ly an­nounced last week that it was buy­ing Centes­sa Phar­ma­ceu­ti­cals for $6.3 bil­lion up­front, its largest ac­qui­si­tion since it bought Loxo On­col­o­gy in 2019, should the deal close. The move gives Lil­ly ac­cess to a pipeline of orex­in re­cep­tor 2 ag­o­nists, pri­mar­i­ly in de­vel­op­ment to treat sleep dis­or­ders like nar­colep­sy.

But what if nar­colep­sy is just scratch­ing the sur­face? In­ter­views with Wall Street an­a­lysts sug­gest that’s a pos­si­bil­i­ty, and with Lil­ly in con­trol, a lot more mon­ey could be poured in­to widen­ing the drugs’ de­vel­op­ment scope — specif­i­cal­ly, test­ing whether they broad­ly help with fo­cus or fa­tigue.

The White House this week be­gan of­fer­ing a $950-per-month ver­sion of Ab­b­Vie's megablock­buster Hu­mi­ra on TrumpRx, even as the drug dis­count web­site al­so of­fers two Hu­mi­ra biosim­i­lars from Pfiz­er and Am­gen that both cost less than $300 per month.

It re­mains un­clear who would pur­chase brand-name Hu­mi­ra through TrumpRx. The cash-pay gov­ern­ment web­site does­n't ac­cept in­sur­ance, and those on Hu­mi­ra with cov­er­age can pay as lit­tle as $5. Those on Medicare have seen their out-of-pock­et ex­pens­es capped at $2,000 per year. Its in­clu­sion was part of Ab­b­Vie's "most fa­vored na­tion" deal with the White House in Jan­u­ary.

Di­a­betes pa­tients in Medicare spent sig­nif­i­cant­ly less on in­sulin in the first year af­ter a $35 month­ly cap was put in place in 2023 — and more of them ap­peared to ad­here to treat­ment.

A new study pub­lished Mon­day in JA­MA In­ter­nal Med­i­cine looked at med­ical records from 4.8 mil­lion type 2 di­a­betes pa­tients be­fore and af­ter the cap took ef­fect. The re­sults pro­vide ear­ly ev­i­dence that the new pric­ing pol­i­cy, en­act­ed un­der the In­fla­tion Re­duc­tion Act, may be linked to in­creased ac­cess to in­sulin.

“Our study re­al­ly does get at the ques­tion of: Did this have a pop­u­la­tion-wide ben­e­fit in terms of peo­ple hav­ing more ac­cess to in­sulin and there­fore hav­ing bet­ter health out­comes?” said Ben Rome, an as­sis­tant pro­fes­sor at Har­vard Med­ical School and an au­thor of the study. “There seems to be some trends in that di­rec­tion.”

Al­though Mer­ck and Terns Phar­ma­ceu­ti­cals are part of biotech's M&A surge, the $6.7 bil­lion deal did­n't near­ly play out the way ei­ther an­tic­i­pat­ed.

Mer­ck de­cid­ed to sig­nif­i­cant­ly low­er its of­fer for the biotech by about 13% af­ter see­ing up­dat­ed clin­i­cal da­ta that changed the out­look for Tern­s' in­ves­ti­ga­tion­al on­col­o­gy drug, called TERN-701, ac­cord­ing to SEC fil­ings on Tues­day. The doc­u­ments show one of the rare in­stances in which a com­pa­ny drops its of­fer price dur­ing ne­go­ti­a­tions.

The New Jer­sey phar­ma gi­ant will gain ac­cess to an ex­per­i­men­tal chron­ic myeloid leukemia (CML) med­i­cine that could one day com­pete with No­var­tis' block­buster treat­ment Scem­blix. But the da­ta led an­oth­er po­ten­tial ac­quir­er, an un­named "large phar­ma­ceu­ti­cal com­pa­ny" re­ferred to as "Par­ty C," to back out of deal talks. Pri­or to this, a few oth­er com­pa­nies — Par­ties A, B, D and E — had told Terns that they weren't in­ter­est­ed in a deal, ac­cord­ing to the reg­u­la­to­ry pa­per­work.

In its third ac­qui­si­tion of 2026, Gilead is spend­ing $3.15 bil­lion up­front to snag a next-gen­er­a­tion an­ti­body-drug con­ju­gate plat­form from Ger­man start­up Tubu­lis.

The Cal­i­for­nia bio­phar­ma could pay out an­oth­er $1.85 bil­lion down the road to Tubu­lis share­hold­ers if all goes well with the ac­qui­si­tion, which was an­nounced Tues­day morn­ing. Tubu­lis raised a $401 mil­lion Se­ries C last year, had its sights on a