The ambitions of Pascal Soriot for Anglo-Swedish medicines giant AstraZeneca have no bounds. Given this shift towards the US, an attempt to pull off a deal with American pharma behemoth Bristol Myers Squibb doesn’t entirely come as a shock. However, the sense of merging with a lower-valued, less innovative pharma group is highly questionable. A deal with Bristol Myers, valued at $133.4billion – considerably more than Britain’s other drug giant GlaxoSmithKline at £77billion– would signal American dominance. But there are questions as to whether healthcare systems in the US and the UK would find such dominance acceptable.