I. M&A and DealmakingThe M&A environment has proven strong in 2026. Total M&A volume across the period, including smaller deals, comes to an estimated $160 billion to $165 billion, he says. Annualized, that puts the biopharma and services M&A market on pace to clear $300 billion, a level van den Akker calls, by historical standard, "very, very active." Van den Akker's read is that the data has largely borne that out, though he's also watching newer, less-anticipated structures take shape alongside it. Van den Akker points to a stronger IPO market in the second quarter than the first, with healthier valuations and larger ticket sizes, alongside a rising biotech sentiment index.