Business

Chiesi Group acquires KalVista for USD 1.9b, expanding rare disease portfolio with Ekterly

Edited by Robert McTiernan··3 min read

Italy-based Chiesi Group has agreed to acquire Framingham, Massachusetts-based KalVista Pharmaceuticals (Nasdaq: KALV) for USD 27.00 per share in cash, representing total equity consideration of approximately USD 1.9 billion, in what constitutes the largest acquisition in Chiesi's history by transaction value. The deal centers on Ekterly (sebetralstat), the first approved oral on-demand plasma kallikrein inhibitor for hereditary angioedema, and is structured to expand Chiesi's rare immunology commercial footprint, particularly in the United States.

Chiesi will conduct a tender offer through its wholly owned Delaware subsidiary, Skyline Merger Sub, Inc., to acquire all outstanding shares of KalVista at USD 27.00 per share in cash, representing a 36% premium to KalVista's 30-day volume-weighted average share price as of April 28, 2026. The transaction carries no financing condition. The transaction was unanimously approved by the boards of both companies and is expected to close in the third quarter of 2026, subject to customary closing conditions including the tender of at least a majority of outstanding KalVista shares and receipt of regulatory approvals.

The KalVista Asset Profile

The transaction is driven by a single commercial asset. Ekterly (sebetralstat) is an oral, small-molecule inhibitor of plasma kallikrein, the serine protease responsible for bradykinin generation in the kallikrein-kinin system. In hereditary angioedema, deficiency or dysfunction of C1 esterase inhibitor leads to uncontrolled kallikrein activation, producing recurrent episodes of subcutaneous and submucosal swelling that can be life-threatening when affecting the larynx. Sebetralstat is approved in the United States, European Union, United Kingdom, Switzerland, Australia, Singapore, and Japan for on-demand treatment of acute HAE attacks in patients aged 12 years and older, and is the first oral agent in this class to reach approval for acute attack management. A US regulatory filing to expand the indication to children aged 2 to 11 is planned for 2026, with the KONFIDENT-KID trial registered as NCT06467084 supporting that submission. Following its US commercial launch in July 2025, sebetralstat generated USD 49 million in 2025 sales.

Upon closing, Chiesi will assume responsibility for pre-existing regional licensing arrangements that KalVista had established prior to the transaction, including exclusive rights held by Kaken Pharmaceutical in Japan, Pendopharm in Canada, and Multicare Pharmaceuticals across Latin America. The acquisition conveys worldwide rights to sebetralstat and KalVista's full intellectual property estate by virtue of the whole-company structure.

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Competitive Landscape

The KalVista Pharmaceuticals acquisition takes place against a backdrop of consolidation activity in the HAE plasma kallikrein inhibitor space. In October 2025, BioCryst Pharmaceuticals acquired Astria Therapeutics, whose lead asset navenibart is a long-acting injectable monoclonal antibody targeting plasma kallikrein for HAE prophylaxis, in a transaction implying an enterprise value of approximately USD 700 million. The approximately 2.7-fold premium in the Chiesi deal relative to the BioCryst transaction reflects the distinction between an asset already generating commercial revenue — sebetralstat recorded USD 49 million in its first partial year on the US market — and a Phase III-stage prophylactic program yet to reach approval.

For Chiesi, which operates its rare disease activities through the Chiesi Global Rare Diseases business unit, the USD 1.9 billion acquisition provides an already-commercialized rare disease pharmaceutical asset with multi-regional approval and an active US revenue base, directly supporting the company's stated EUR 6 billion 2030 strategic revenue target. The all-cash, no-contingency structure reflects the de-risked profile of an approved and launched product rather than a development-stage bet, and positions Chiesi to deploy its existing rare immunology infrastructure against a patient population where oral on-demand therapy represents a differentiated treatment option relative to the injectable standard of care.

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