The multimillion-dollar agreement between Cytokinetics and Royalty involves funding for Aficamten's commercial launch alongside new research and development efforts for two additional heart medications.

Royalty also agreed to purchase $50 million in Cytokinetics stock. This is part of a secondary public offering that intends to raise around $500 million for the company.

When considered collectively, the actions point more toward a company getting ready to stay independent than to be acquired.

A report from Mizuho Securities' Salim Syed says that out of 29 investors surveyed, 21 believed that the chance of Cytokinetics being bought was 1-in-5 or lower. Before hearing about the Royalty transaction, Seventeen had placed the likelihood of a buyout at 50% or higher.

Aficamten is the subject of much publicized attention in Cytokinetics since it addresses a disease that thickens the heart muscle. Obstructive hypertrophic cardiomyopathy, also known as HCM, can block blood flow and cause symptoms like irregular heartbeats, difficulty breathing, and chest pain.

Aficamten treatment improved oxygen uptake and self-assessed symptoms, function, and quality of life scores compared to a placebo, as shown in the Sequoia-HCM trial data published in December.

Cytokinetics plans to seek FDA approval for Aficamten in the third quarter. Royalty funds will support preparation, and sales royalties are set at 4.5% up to $5 billion and 1.0% beyond that. The agreement includes financing for a Phase 3 trial of omecamtiv mecarbil.

To fund the trial in patients with heart failure and a low ejection fraction, the biotech will receive $100 million. Cytokinetics will repay Royalty $100 million in installments if omecamtiv mecarbil is approved, plus an additional 2% royalty if successful. Cytokinetics will make fixed quarterly payments to Royalty up to $237.5 million over 4.5 to 5.5 years if the medicine fails to be approved.