AstraZeneca's shares fell by as much as 7% on Monday following reports of preliminary merger discussions with Bristol Myers Squibb. This potential $400 billion tie-up would create one of the world's largest pharmaceutical companies. The news, initially reported by the Financial Times and confirmed by a Reuters source, led to AstraZeneca's shares dropping 4.8% by 1122 GMT, making it the second-biggest fall on the FTSE 100 index. Conversely, Bristol Myers' shares rose about 5% in U.S. premarket trading.

Analysts and investors largely expressed bewilderment and skepticism regarding the strategic rationale for AstraZeneca. Jefferies analysts noted that AstraZeneca already possesses a strong "growth and innovation profile" and doesn't appear to need "financial engineering." Markus Manns, a portfolio manager at Union Investment and an AstraZeneca shareholder, stated that a combination with Bristol Myers "does not make strategic or financial sense," arguing that many past mega-mergers have destroyed value and such a deal would "deeply disrupt a well-run company with a full pipeline" under CEO Pascal Soriot.

Despite the skepticism, some potential advantages were cited. Sean Conroy, an analyst at Shore Capital, suggested a deal could help AstraZeneca address the "patent cliff" after 2030 and strengthen its oncology business. Lucy Coutts, investment director at JM Finn, mentioned the possibility of accelerating AstraZeneca's U.S. footprint and sales. Lukas Leu, a portfolio manager at ATG Healthcare, noted that cost synergies could boost margins and expand reach in neuroscience and cell therapy. However, concerns were raised about potential antitrust scrutiny due to overlap in cancer immunotherapy drugs like Bristol Myers' Opdivo and AstraZeneca's Imfinzi, and how a combined entity would manage competing products. AstraZeneca declined to comment, while Bristol Myers did not respond to requests for comment.