Who Owns Bridion?

Bridion (sugammadex) emerged from innovative research at Organon Pharmaceuticals in the early 2000s, focusing on cyclodextrin chemistry to create a selective relaxant binding agent. The compound was specifically designed to encapsulate and inactivate aminosteroid neuromuscular blocking agents like rocuronium and vecuronium through a unique molecular mechanism. After Schering-Plough acquired Organon in 2007, and Merck subsequently acquired Schering-Plough in 2009, Bridion became part of Merck's pharmaceutical portfolio. This series of corporate acquisitions positioned the revolutionary anesthesia agent within one of the world's largest pharmaceutical companies, providing substantial resources for its global commercialization.

Bridion received its first regulatory approval in the European Union in July 2008, followed by approvals in Australia (2009), Japan (2010), and numerous other international markets. The drug encountered a more challenging regulatory pathway in the United States, with the FDA issuing complete response letters in 2008 and 2013 due to concerns about hypersensitivity reactions and potential effects on coagulation. After additional clinical studies and safety data analysis, Bridion finally received FDA approval in December 2015, seven years after its European authorization. This staggered global approval process created significant differences in clinical experience and adoption patterns across regions, with European and Asian anesthesiologists gaining extensive experience with the agent while U.S. practitioners awaited access.

The clinical development program for Bridion was extensive, involving over 30 Phase III trials and more than 2,500 subjects. These studies demonstrated that Bridion could achieve recovery from neuromuscular blockade to a train-of-four ratio of 0.9 (the threshold for adequate recovery) in approximately 2-3 minutes for moderate blockade and 3-5 minutes for deep blockade. This represented a dramatic improvement over neostigmine, which typically required 30-60 minutes for moderate blockade and was often ineffective for deep blockade. Key studies like the STRONGER trial (2009) and the CRYSTAL trial (2011) established Bridion's superior speed and predictability compared to conventional reversal agents, particularly in challenging scenarios such as profound blockade or rapid sequence induction.

Following its introduction, Bridion quickly gained adoption in European and Asian markets, where it transformed anesthesia practice by enabling more precise neuromuscular management. The American Society of Anesthesiologists and European Society of Anaesthesiology updated their guidelines in 2018 and 2020 respectively to recognize selective relaxant binding as the preferred approach for reversal of moderate and deep blockade. By 2022, Bridion had become the standard of care in many health systems worldwide, with global sales reaching $1.5 billion annually, making it one of Merck's fastest-growing hospital products.

The clinical utility of Bridion expanded through the 2020s as research demonstrated additional benefits beyond rapid reversal. The POPULAR study (2021) showed that Bridion was associated with a 34% reduction in postoperative pulmonary complications compared to neostigmine. The STRONGER-PEDS trial (2022) established safety and efficacy in pediatric populations, leading to expanded age-range approvals in most markets by 2023. The SECURE trial (2023) demonstrated Bridion's value in obese patients, where traditional reversal approaches often failed to provide reliable recovery.

A significant milestone occurred in 2024 when Merck received approval for Bridion XR, an extended-release formulation allowing pre-emptive administration at the start of surgery, eliminating the need for reversal timing calculations. This innovation further simplified neuromuscular management and expanded Bridion's clinical applications. By early 2026, Bridion had been used in over 50 million surgical procedures worldwide and had transformed anesthetic practice by enabling precise control over neuromuscular blockade throughout the perioperative period.

Despite its clinical success, Bridion has faced challenges including cost concerns in some healthcare systems and the emergence of rare adverse events such as hypersensitivity reactions (occurring in approximately 0.3% of patients). Merck has addressed these challenges through risk management programs, physician education, and patient selection guidance. The company has also invested in manufacturing efficiencies, reducing production costs by approximately 35% between 2020 and 2025, which has enabled more competitive pricing in price-sensitive markets and contributed to broader global access.