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This is the first of a two-case series (IMD-3-1088 and IMD-3-1089). Consolidations and paradigm shifts in the pharmaceutical industry in the 1990s induced Astra and Zeneca to review potential merger partners. Both companies were confident of surviving on their own, banking on organic growth. However, escalating costs in research and development, and sales and marketing, patent expiries, benefits of scale, and pressure on prices made this increasingly difficult to sustain. After 6 months of discussion, Astra and Zeneca announced a ''merger of equals'' in December 1998. Case (A) looks at some of the ''black box issues'', how they were negotiated to ensure that this was indeed a merger of equals and the final outcome of the negotiations. A video ''IMD-3-1088-V'' is available to accompany the case series.