The key portfolio decisions that life sciences companies are contemplating today come at a time of contrasts. Big pharma is cash-rich enough to snap up hundreds of small to mid-cap biotech companies.1 And, access to cash for biotech is compressing. Yet the mega mergers that occurred during the comparatively robust M&A era of the 2010s slowed significantly at the beginning of the current decade. Only recently have acquirers closed a handful of sizable deals, suggesting a potential uptick in M&A value in 2023