Despite initial hype in oncology where business models struggled, cell therapy is finding a major new application in treating autoimmune diseases. By resetting the immune system, it can offer functional cures for debilitating conditions—a powerful and unexpected pivot for the technology platform.
CEO Vasant Narasimhan explains that even successful, diversified businesses within a pharma conglomerate lead to strategic capital misallocation. Focusing on the core competency of discovering novel medicines created far more value than maintaining a diversified portfolio of otherwise healthy businesses.
According to Novartis's CEO, a top reason for rejecting potential biotech partners is their underinvestment in Chemistry, Manufacturing, and Controls (CMC). Startups often neglect this unglamorous work, leading to deal failure because the acquirer can't be sure the drug can be scaled efficiently and safely.
After decades of work, small interfering RNA (siRNA) has overcome delivery challenges to become a mature, "de-risked" platform, primarily for liver-directed targets. This now enables powerful medicines like a once-yearly injection for high cholesterol, representing a major public health breakthrough.
Novartis's CEO views AI not as a single breakthrough technology but as an enabler that creates small efficiencies across the entire R&D value chain. The real impact comes from compounding these small gains to shorten drug development timelines by years and improve overall success rates.
Novartis's CEO highlights a surprising inefficiency: clinical trial nurses often record patient data on paper, which is then manually entered into multiple digital systems. This archaic process creates immense friction, cost, and risk of error, representing a huge, unsolved "boring problem" in biotech.
Novartis's radioligand drugs have a radioactive half-life requiring delivery from factory to patient within 4-5 days. Building and mastering a global supply chain to handle this extreme logistical complexity at 99.9% on-time delivery creates a significant competitive advantage that is difficult for others to replicate.
A key competitive advantage for China's surging biotech industry is regulatory velocity. Its national regulator, the NMPA, approves first-in-human studies in less than a month. This allows Chinese firms to generate crucial clinical data and de-risk assets far faster than their U.S. and European counterparts.
AI is becoming a personal C-suite tool. Vasant Narasimhan uses an AI agent trained on Novartis's historical R&D decisions. This allows him to query past contexts and biases when facing a new decision, leading to more informed, data-driven leadership rather than relying solely on memory.