Pharmaceutical Executive Daily: Novartis Shareholders Raise Concerns over M&A Strategy

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, Novartis shareholders intensify pressure on the company's dealmaking strategy after the failure of its del-desiran muscle-wasting drug wipes out nearly $30 billion in market value, Michelle Carnahan contends that health care's fragmentation problem calls for an orchestration layer rather than more point solutions, and Nacho Quinones and Aisling O'Loughlin make the case for AI-powered synthetic advisory boards as a tool for biopharma decision-making.

Novartis shareholders intensify pressure on the company's dealmaking strategy after the failure of its del-desiran muscle-wasting drug triggers an 11% single-day stock plunge and erases roughly $30 billion in market value. Investors including Gillian Hollenstein of Point Capital Navigator Fund and Michael Hannig of DJE Kapital argue Novartis should favor smaller, $5 billion to $10 billion bolt-on deals for late-stage assets over large bets like the $12 billion Avidity acquisition, while Arctic Asset Management's Daniel Bolanowski points to a "deeper trust issue" around business development. Chief executive officer Vas Narasimhan's job appears secure, with shares still up 60% since he took over in 2018, though shareholders are pushing for improved board oversight.

Michelle Carnahan, co-founder and chief executive officer of Arbiter, argues that health care's fragmentation problem stems not from a shortage of tools but from the lack of an "execution layer" to coordinate care across disconnected systems. Carnahan points to an industry that has poured $100 billion into point solutions that don't talk to each other, leaving only half of the more than 100 million annual specialist referrals completed and costing health systems $150 billion a year in no-shows. She calls for a unified patient record, clearer action-tracking, and incentives that reward coordination over activity volume.

Finally, Nacho Quinones, PhD, and Aisling O'Loughlin, PhD, authors of an IQVIA white paper, make the case for synthetic advisory boards, simulated discussions run by AI-powered digital personas built to represent specific health care stakeholder archetypes. They contend the boards, which can run in minutes rather than weeks, should precede traditional live advisory boards to pre-test hypotheses and sharpen questions, provided outputs remain grounded in transparent, traceable source data.

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