When Pfizer acquired Wyeth after an eternity of stone cold silence in health care M & A, people got so worked-up they became tongue-tied trying to spread the news.

But then Merck bought The Plough, Roche sealed the deal with G-Tech and Gilead Sciences signed a definitive agreement to acquire CV Therapeutics and just like that, it is raining deals in Big Pharmaworld.

Gilead offered $20 per share or $1.4 billion in cash for CVT. That topped by 25% a hostile offer made 2 weeks ago by Astellas Pharma.

Gilead is best known for a trio of HIV drugs, but it’s got a dollar on darusentan which is in phase III trials for refractory hypertension. And its eyes are on CVT’s prize, which is Ranexa, a drug just recently approved as a first line agent for the management of angina pectoris. 

“The acquisition of CV Therapeutics represents a unique opportunity to complement and strengthen our growing cardiovascular portfolio,” Gilead chairman CEO John Martin said.

Last year, Ranexa did $109 million in sales. That’s a vanishingly small percentage of the market for chronic angina, a condition afflicting nearly 10 million Americans.

The FDA had approved Ranexa in 2006, but only in patients that had failed therapy with beta blockers, calcium channel blockers and nitrates, on grounds that it increased the risk of potentially life-threatening arrhythmias.

CVTs internal research had actually suggested that the drug may prevent arrhythmias, and a large randomized trial published in 2007 eventually supported the company’s view.

Safe though Ranexa may be, Gilead’s still got a major problem on its hands trying to squeeze big dollars out of Ranexa when so many different, effective angina drugs are available in generic form.