Change is afoot in the Japanese pharmaceutical industry. Long protected by regulatory guidelines that maintained its somewhat insular existence, the lowering of these barriers is forcing this industry to enter the global fray. The guidelines that were designed to prevent foreign companies entering the Japanese market were relaxed in 2006, and while there has been no major buyout of any of the big Japanese players yet, there is growing acquisition threat and increased competition from global pharmas. Further changes in the domestic market are also forcing shake-ups, and with many Japanese companies sitting on healthy cash reserves, deal making is on the cards. The acquisition of the US company, MGI PHARMA, by Eisai in December 2007 is symptomatic of these recent changes, and represents the largest ever overseas acquisition by a Japanese pharmaceutical company. Here we look at the rationale for the deal in the context of Eisai#8217;s fifth mid-term strategic #8216;Dramatic Leap Plan#8217;.