Two Big Misses by Novartis (NVS) Has Shareholders Pushing for Board Overhaul

Two big misses on acquired or partnered assets and now a large shareholder, Artisan Partners, is pushing for a board overhaul and stronger acquisition oversight.

Novartis has responded by maintaining its 5–6% 2025–30 sales CAGR target, but after removing roughly $5B of risk-adjusted peak sales across the two assets, that target increasingly requires near-flawless execution elsewhere or additional business development.

Summary of the two negative data updates:

Pelacarsen (Lp(a) in cardiovascular disease):

This is effectively a zero after failing to reduce cardiovascular events in >8,000 optimized secondary-prevention patients despite lowering Lp(a), a type of extra sticky lipid that is elevated in some patients.

Pre-failure peak-sales expectations were roughly $4–6B, making it the larger and strategically more damaging loss against Novartis’s patent cliff. The only plausible salvage is a convincing, prespecified signal in patients with very high baseline Lp(a) or exceptionally deep lowering when full data are presented at  a conference; absent that, another large outcomes trial is commercially hard to justify.

Del-desiran (muscular dystrophy):

This should also be zero in the base case after HARBOR missed its 54-week video hand-opening-time (vHOT) endpoint, versus pre-failure peak-sales estimates of $1.5–3.1B; the failure is particularly painful because del-desiran was the lead asset in Novartis’s $12B Avidity acquisition.

A narrower path remains because secondary and exploratory endpoints showed activity and Novartis plans regulator discussions, potentially supporting a new trial using a less-variable functional endpoint or an enriched subgroup, but this is a multiyear reset, not a filing path.