Swiss drugmaker Novartis today announced a multi-billion dollar revamp, swapping assets with GlaxoSmithKline and selling its animal health arm.
The moves come as the company aims to simplify its business and increase its focus on high-margin cancer medicines.
The overhaul is part of a major realignment in the global pharmaceuticals industry as it strives to cope with a clampdown in health spending by cash-strapped governments.
"The transactions mark a transformative process for us," said Novartis chief executive Joe Jimenez, who has been undertaking a strategic review of the once-sprawling business.
"They also improve our financial strength, and are expected to add to our growth rates and margins immediately," he added.
Novartis said it had agreed to buy GlaxoSmithKline's oncology products for $14.5 billion, while selling to GSK its vaccines, excluding flu, for $7.1 billion plus royalties and creating a joint venture with GSK in consumer healthcare.
Novartis also said it had agreed to sell its animal health arm to Eli Lilly for approximately $5.4 billion.
The global pharmaceuticals sector has seen a flurry of deal-making recently as large companies seek to focus on a small number of leading businesses, while smaller speciality and generic producers seek greater scale.
Cancer is a particular focus for some drugmakers, thanks to novel medicines that show promise by boosting the body's immune system. The deal will see Novartis strengthen its world second biggest position in cancer behind cross-town rival Roche.
A desire to boost its oncology business is seen as a key factor behind Pfizer's reported interest in AstraZeneca.
A weekend newspaper said Pfizer, which has also been spinning off assets such as animal health and baby food, had made a £60 billion bid approach that had been rebuffed by the British firm.
As well as strengthening its vaccines business, GSK will take the lead in running a future consumer health business worth about $10 billion in annual revenue with Novartis. The British drugmaker will return £4 billion to shareholders as well.
Novartis's Jimenez said the deals would result in slightly lower overall sales for the Swiss group, but higher profit as it swaps lower-margin vaccines business for higher-margin oncology drugs.
Novartis said it would start a separate sale process for its flu business immediately, which was not part of the GSK deal.
Eli Lilly will have the world's second biggest animal health business by revenue in the wake of its deal with Novartis. It said it would fund the transaction with $3.4 billion of cash and $2 billion of loans and expected cost savings of about $200m a year within three years of closing the deal.