Who is this relevant for?
- Hospitals managing supply risk
- Distributors monitoring sourcing opportunities
- Manufacturers evaluating UK market entry
Chiesi agreed to buy KalVista for $1.9bn, adding Ekterly (sebetralstat), the first oral therapy for attacks in hereditary angioedema (HAE). The deal, expected to close in Q3 2026, is the largest in Chiesi's history.
Ekterly was approved by the FDA in July 2025 for on-demand treatment of HAE attacks in patients 12 and older. Through end-2025, it generated $49M in sales, with 1,700 patients starting therapy. Most revenue came from refills in Q4, suggesting repeat use. The drug is also rolling out in Germany, Japan (via Kaken), and approved in EU, UK, Switzerland, Australia, Singapore.
For pharma operators, the shift from injectable to oral on-demand therapy changes logistics. Hospitals and distributors accustomed to cold chain or injection supplies for products like Firazyr, Kalbitor, Ruconest, or Berinert now face demand for a stable oral alternative. Manufacturers eyeing the UK or EU markets can note the regulatory approvals already in place.
Chiesi expects Ekterly to meaningfully contribute to its 2030 revenue goal of €6B+, from €3.6B in 2025. The company also runs trials in children aged 2–11, which could expand the addressable population.
Analysts project peak sales around $500M annually in US and Europe, based on the oral convenience advantage.
The acquisition underscores Chiesi's commitment to rare diseases, following its $1.25B Amryt buy in 2023. For supply chain and market access teams, the arrival of an oral HAE attack treatment introduces a new sourcing and stocking dynamic.