News|Articles|September 10, 2026

Pharmaceutical Executive Daily: David Samra Calls For Novartis Board Shake-Up

Key Takeaways

Governance pressure is intensifying at Novartis, with calls to penalize dealmakers for failed M&A and align executive pay with GAAP-economic outcomes rather than adjusted metrics excluding write-downs.
Clinical setbacks in a muscle-wasting program linked to Avidity and in pelacarsen catalyzed rapid market-cap erosion, while operational execution is distinguished from board-level oversight accountability.
Caspian Therapeutics is advancing KO-7246 to inhibit menin-mediated suppression of beta-cell proliferation, aiming for durable increases in insulin-producing capacity across Type 1 and Type 2 diabetes models.
A $50 million financing syndicate led by BVF Partners, including Eli Lilly and the T1D Fund, signals growing cross-over interest in disease-modifying cardiometabolic mechanisms beyond glycemic control.
Payers are tightening orphan access by demanding meaningful incremental benefit, expanding step therapy, enforcing tighter-than-label criteria, and increasing reauthorization denials, elevating the importance of unmet-need strategy during pivotal design.

Artisan Partners' David Samra calls for a board shake-up at Novartis after costly deal failures, Kura Oncology spins out Caspian Therapeutics to pursue menin inhibition for diabetes, and Ira Studin examines how payers are redefining unmet need for orphan products.

Welcome to Pharmaceutical Executive Daily, your quick briefing on the top news shaping the pharmaceutical and life sciences industry.

In today's Pharmaceutical Executive Daily, Artisan Partners' David Samra calls for a board and compensation overhaul at Novartis following the failure of its $12 billion Avidity acquisition and disappointing pelacarsen trial results, Kura Oncology spins out Caspian Therapeutics with $50 million in financing to test menin inhibition as a disease-modifying approach to diabetes, and Ira Studin, PhD, argues that payers are narrowing the definition of unmet need for orphan products in ways that will reshape access and pricing.

David Samra, managing director at Artisan Partners and one of Novartis' 20 largest shareholders, calls for an overhaul of the company's board and compensation structure after back-to-back trial failures wipe out nearly $30 billion in market value in two days, including the collapse of a muscle-wasting drug from the $12 billion Avidity acquisition and weak results for the heart drug pelacarsen. Samra argues that executives behind failed deals should be penalized and that pay metrics should reflect real economic outcomes rather than adjusted figures that exclude write-downs, while crediting chief executive officer Vas Narasimhan's operational performance and placing the blame on board oversight.

Kura Oncology spins out Caspian Therapeutics, a separately financed subsidiary advancing menin inhibitors as a disease-modifying approach to diabetes and cardiometabolic disease, backed by $50 million in financing led by BVF Partners with participation from Eli Lilly, the T1D Fund, and other investors. The company's lead compound, KO-7246, works by blocking menin's role as a brake on pancreatic beta-cell proliferation, with preclinical data showing durable increases in insulin-producing capacity across both Type 1 and Type 2 diabetes models.

Finally, Ira Studin, PhD, president of Stellar Managed Care Consulting, argues that payers are narrowing how they define unmet need for orphan products, increasingly requiring meaningful rather than marginal clinical improvement over standard care before granting coverage. Studin points to expanding step therapy requirements, tighter-than-label coverage restrictions, and more rigorous reauthorization denials as emerging tools payers are using to limit access, and contends that manufacturers who build a strong clinical case for unmet need during pivotal trial planning will be better positioned for launch access and pricing.

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