Chiesi pays $1.9B for KalVista to bet on oral rare disease treatment
What's the deal? Italy's Chiesi GroupDealroom has a profile for this one. Try Dealroom →, a family-owned pharmaceutical company based in Parma, has agreed to acquire US-listed KalVista Pharmaceuticals for approximately $1.9B in an all-cash deal — the largest acquisition in Chiesi's history.
It will launch a tender offer to buy all outstanding KalVista shares at $27 each, representing a 40% premium to KalVista's closing price on April 28, 2026. KalVista's shares rose 39% on the day of the announcement. The deal has been unanimously approved by both boards and is expected to close in Q3 2026.
The acquisition centres on EKTERLY (sebetralstat), KalVista's oral on-demand treatment for hereditary angioedema (HAE) — a rare genetic condition that causes sudden. EKTERLY received US regulatory approval in July 2025 and is the first oral, on-demand treatment for HAE, offering an alternative to injectable therapies that have long dominated the market. Chiesi said the drug would meaningfully contribute to its target of reaching €6B in revenue by 2030, up from €3.6B in 2025.
Why now? Chiesi has been building its rare disease franchise for several years and sees immunology as a core growth area. HAE is a commercially attractive rare disease category: the patient population is small but well-identified, treatment is lifelong, and the shift from injectable to oral therapies is a major clinical and commercial opportunity. EKTERLY's approval gives KalVista a first-mover advantage in the oral on-demand segment that Chiesi is acquiring before competitors can close the gap.
The deal also reflects Chiesi's broader ambition to expand its US commercial footprint — a market where its presence has been more limited than in Europe.
What could go wrong? EKTERLY is a recently approved drug with a limited commercial track record. Translating regulatory approval into sustained revenue growth requires significant investment in market access, physician education, and patient support — all of which take time and carry execution risk, particularly in the competitive HAE market where established injectable therapies from companies including TakedaDealroom has a profile for this one. Try Dealroom → and BioCryst are well entrenched.
At $1.9B, Chiesi is paying a significant premium for a single commercial asset. The deal will be financed with a mix of cash and debt, which adds leverage to a company that, while well-capitalised, is privately held and has less financial flexibility than a publicly listed peer.
The signal: The deal is the latest in a string of large acquisitions in the rare disease space, where a combination of favourable pricing, well-defined patient populations, and regulatory incentives continues to attract premium valuations. For Chiesi, it is a statement of strategic intent — a family-owned European pharma company making its biggest bet yet on building a globally competitive rare disease franchise.
The oral vs injectable dynamic in HAE also reflects a broader shift across rare diseases: patients and physicians are increasingly demanding more convenient treatment options, and the companies that can deliver them are commanding acquisition premiums that reflect both the clinical value and the commercial opportunity.
Sources:
Chiesi
KalVista
Reuters
Bloomberg
BioPharma Dive
Fierce Pharma
BioSpace
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