Despite the high unmet medical need in the cardiovascular and metabolic indications, companies are increasingly reluctant to make deals in the sector. But unique therapeutic approaches to diseases could bring new life.

As statins go generic, a host of companies are hunting out new treatments for cholesterol control. They're not put off by recent setbacks, given the huge remaining unmet need and commercial opportunity. Many new companies are still trying to lower LDL and/or raise HDL, but anti-inflammatory approaches are increasingly popular too, as scientists better understand the nature and process of plaque formation.

Borean aims to leverage the trimeric properties of one human protein, tetranectin, to develop second-generation protein therapeutics to treat autoimmune disease and cancer. Its first candidate is a TNF-alpha antagonist in preclinical testing for autoimmune diseases, but the company also has ongoing early work on several undisclosed oncology targets.

In May 2005 Kos Pharmaceuticals took over three of Biovail Corp's hypertension drugs plus most of its associated sales force, paying just 1.4 times 2004 sales-or roughly a fifth of what Biovail had paid for the same products less than five years ago. The deal draws attention to why the two mid-cap companies--similarly sized, and, until recently, with a similar business model--have fared so differently in primary care.