Healthcare deals hit an all-time record in 2018. See the 7 biggest tie-ups that could change how we buy drugs and treat diseases.

Samantha Lee/Business Insider

Healthcare dealmaking hit a record this year, and the transactions could reshape how we pay for our prescriptions and treat diseases.

Big pharma companies, health insurers, and care providers have agreed to about $US421 billion in transactions this year, according to data from Refinitiv. That’s a record high, and amounts to 11 per cent of all M&A this year.

The tally from Refinitiv counts deals when they’re announced, though not all transactions are ultimately completed. The dollar figures include debt held by the target companies.

A few big factors are fuelling the deals frenzy. Interest rates are low, and stock markets climbed for much of the year, providing companies with plenty of cash. Plus, health companies are seeking to partner up with firms that can provide them with new capabilities or new ways of treating disease, as the industry faces pressure to improve its performance, discover new treatments, and lower costs for patients.

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Here are the seven biggest deals of 2018.

The year’s biggest deal? Pharma giant Takeda’s $US77 billion takeover of international drugmaker Shire. The deal will give Japan’s Takeda greater access to the US drug market, and provides it with new prescription products to sell.

The US health insurer Cigna is acquiring Express Scripts in a $US68.5 billion transaction. Express Scripts manages prescription drug benefits for health insurers and companies. The deal will help Cigna offer more comprehensive health benefits to its customers and negotiate better deals with drugmakers.

GlaxoSmithKline agreed to buy out rival pharma giant Novartis’s 36.5% stake in a consumer health joint venture. The $US13 billion deal gives GSK full ownership of the unit, whose products include over-the-counter pills and Sensodyne toothpaste.

Andy Buchanan/WPA Pool via Getty ImagesGlaxoSmithKline CEO Emma Walmsley (L) is seen with First Minister of Scotland Nicola Sturgeon during a visit to a new production building.

Sanofi, based in France, agreed to buy the US biotech Bioverativ in a $US10.9 billion transaction. Bioverativ specialises in treatments for hemophilia, and adds to Sanofi’s efforts to expand in treatments for blood disorders.

The private equity firm KKR deepened its involvement in the industry by acquiring Envision Healthcare in a $US9.5 billion deal. Envision provides physicians to work at hospitals. KKR had previously acquired Envision’s ambulance business.

The biotech Celgene acquired Juno, which specialises in treating cancer, in an $US8.9 billion deal. Juno makes a type of cancer treatments known as CAR-Ts, which are a new way of fighting the disease using the body’s own immune system. Celgene makes other types of cancer drugs, and already had a partnership with Juno.

Wirul Kengthankan/ShutterstockA hospital patient.

Swiss healthcare giant Novartis agreed to acquire the US biotech AveXis in an $US8.1 billion transaction. AveXis focuses on a new field of treatments known as gene therapy, which is being explored for rare diseases. The key drug it’s working on would treat a genetic disease called spinal muscular atrophy.

Forbes/ Victoria EngblomNovartis CEO Vas Narasimhan speaks at the 2018 Forbes Healthcare Summit in New York.

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