AstraZeneca has held merger talks with Bristol Myers Squibb over recent months on a deal that would create a combined pharmaceutical company worth roughly $400 billion, the Financial Times reported. AstraZeneca shares fell as much as 7% following the news.

AstraZeneca currently carries a market value near $263 billion against Bristol Myers Squibb's roughly $133 billion. A combined entity would become the world's fourth-largest drugmaker by market capitalization and would dwarf AstraZeneca's previous largest acquisition, the $39 billion purchase of Alexion in 2021. No deal structure has been finalized, and talks could still stall or collapse.

The rationale cuts both ways: AstraZeneca wants deeper US commercialization muscle to help hit its $80 billion revenue target by 2030, while Bristol Myers Squibb needs a stronger pipeline to offset looming patent expirations on drugs like Eliquis and Opdivo. Both companies lean heavily on oncology revenue, which analysts say could draw antitrust scrutiny given overlapping cancer drugs such as Opdivo and Imfinzi.