Novo Nordisk and biotech startup Orbis Medicines have struck a drug discovery and licensing deal worth up to $1.4 billion, aiming to develop oral therapies for cardiometabolic diseases that are currently only available as injectables. The partnership will tap into Orbis' AI-enabled nGen platform to identify macrocycles — a class of ring-shaped molecules with the potential to reach disease targets that traditional small-molecule drugs struggle to access. Novo will also make an undisclosed strategic investment in Orbis as part of the agreement.

Macrocycles are gaining serious momentum in pharma. Johnson & Johnson won FDA approval in March for Icotyde, an oral macrocyclic peptide for plaque psoriasis, and Merck followed in July with Lipfendra, an oral macrocyclic peptide for cholesterol reduction. Novo's collaboration builds on its existing oral peptide absorption technology (SNAC), acquired with Emisphere Technologies in 2020.

By the Numbers:

• Up to $1.4 billion in upfront payments, milestones, and tiered royalties
• Orbis' synthetic macrocycles achieved up to 18% oral bioavailability in preclinical studies
• Novo acquired SNAC technology via a $1.8 billion deal for Emisphere in 2020

Why it matters: If successful, converting injectable cardiometabolic treatments into oral drugs could dramatically improve patient adherence and expand access — a major shift in how conditions like diabetes and obesity are managed at scale.