Novartis Faces Board Pressure After Del-Desiran Miss And Pelacarsen Failure, Testing Its Post-2030 Plan

Novartis started September with a cluster of readouts that Guggenheim Securities had identified as important to confidence in the company’s mid- to long-term sales potential. The run began with a win: remibrutinib, already approved last September as Rhapsido for chronic spontaneous urticaria, lowered annualized relapse rates in two Phase 3 multiple sclerosis trials. That momentum did not last. Within days, Novartis said pelacarsen showed no significant benefit on cardiovascular risk and del-desiran failed a study in myotonic dystrophy type 1.

The back-to-back disappointments have expanded a debate that was already forming around how Novartis is allocating capital. Del-desiran came from the company’s $12 billion acquisition of Avidity Biosciences last year, and a major shareholder is now pushing for tighter board-level scrutiny of dealmaking. In reporting cited by both sources, David Samra of Artisan Partners said CEO Vasant Narasimhan has done a "very good job" running Novartis, but argued the board has not properly scrutinized acquisitions.

The Data

Ahead of the readouts, Guggenheim analysts had called pelacarsen, remibrutinib and del-desiran major clinical catalysts and, in a July 21 note, described them as "critical" to Novartis’ post-2030 growth. The reason those studies mattered was not simply near-term sentiment. They were part of the company’s argument that its pipeline can replace revenue from current blockbusters as patent protection fades.

Remibrutinib delivered a positive result in multiple sclerosis, giving Novartis one clear success from the group. But pelacarsen, an Lp(a) program Novartis obtained in 2023 by paying Ionis $60 million upfront cash, failed to show a significant benefit in secondary prevention of cardiovascular disease. Del-desiran, meanwhile, failed in a rare muscle-wasting disease study in myotonic dystrophy type 1.

The del-desiran result hit especially hard because the drug was the centerpiece of the Avidity acquisition. Fierce Biotech reported that investors sent Novartis shares down more than 10%, erasing nearly $30 billion from its market cap. BioSpace framed the same event less through the stock move than through the increase in pressure on leadership’s acquisition strategy.

The Commercial Picture

The timing of the failures matters because Novartis is heading toward a period in which several of its largest products face U.S. patent expirations. BioSpace said Cosentyx, Kisqali and Kesimpta, Novartis’ three best-selling drugs in the first half of 2026, are scheduled to lose patent protection from 2029 to 2031 and together accounted for almost 38% of total sales. The company’s fourth best-selling product, Entresto, has already lost exclusivity; its sales halved in the second quarter but still reached $1.2 billion in that three-month period.

That backdrop explains why these trial outcomes carry more weight than a normal late-stage miss. Guggenheim’s focus on the post-2030 period reflects a simple strategic problem: Novartis needs enough new growth drivers to offset erosion in products that currently anchor the business. A positive remibrutinib readout helps, but two failures in the same sequence leave a larger hole in that bridge.

Novartis told Fierce it continues to take a "disciplined and shareholder-friendly approach to capital allocation," citing investments in its existing business, bolt-on deals, dividends and share buybacks. The company also said its pipeline is broad and that its sales guidance for both the pre-2030 and post-2030 periods remains unchanged.

The Road Here

Samra’s criticism goes beyond one study failure. He pointed to the Avidity acquisition and also to Novartis’ $2.9 billion purchase of MorphoSys in 2024. According to BioSpace, between acquiring a controlling stake in MorphoSys in May and closing the deal in October, Novartis recorded an $800 million impairment tied to an assessment of the biotech’s data. Fierce added that one of MorphoSys’ key assets, pelabresib, has carried a safety signal since the acquisition and that Novartis in 2024 said an FDA filing plan was delayed because of an imbalance in malignant transformations.

The Avidity deal also stood out because it broke with management’s stated preference for bolt-on acquisitions often described as around or below $5 billion. Fierce noted that before Avidity, Novartis’ dealmaking had largely stayed within that range, with The Medicines Company in 2019 at $9.7 billion being the prior exception.

There is also a counterargument embedded in the reporting. BioSpace noted that the current leadership team has navigated earlier exclusivity challenges successfully, with CFO Mukul Mehta recently calling the current loss-of-exclusivity period the largest the company has ever faced even as sales have risen this year. The immediate question, then, is not whether Novartis can operate through patent cliffs at all. It is whether recent acquisitions and late-stage programs are strong enough to support the next cycle.

For investors, the signal is that Novartis’ pipeline debate has shifted from individual trial volatility to governance. When expensive external bets fail close together, the issue becomes not only scientific execution but whether the board is filtering risk consistently enough before it writes multibillion-dollar checks.