Vos Narasimon is the CEO of Novartist, a major Swiss based pharmaceutical company. Born in the United States the Indian immigrant parents, he was educated at Harvard Medical School, but chose not to practice medicine. Instead, he chose to go into the pharmaceutical industry and is now leading the transformation of Novartists to one of the most important pharmaceutical companies in the world. Had a chance to sit down with Vos in New York recently to talk about this transformation. So many people know the names of the drugs that they use, but they don't know the names of the drug companies or pharmaceutical companies that produce them. So for people who may not know much about Nevardists, tell us what drugs or pharmaceutical products as are produced that people would have heard of.

Vos Narasimon is the CEO of Novartist, a major Swiss based pharmaceutical company. Born in the United States the Indian immigrant parents, he was educated at Harvard Medical School, but chose not to practice medicine. Instead, he chose to go into the pharmaceutical industry and is now leading the transformation of Novartists to one of the most important pharmaceutical companies in the world. Had a chance to sit down with Vos in New York recently to talk about this transformation. So many people know the names of the drugs that they use, but they don't know the names of the drug companies or pharmaceutical companies that produce them. So for people who may not know much about Nevardists, tell us what drugs or pharmaceutical products as are produced that people would have heard of.

There's a couple of major drugs we have right now, and Trusto is a medicine for heart failure. Another drug Couthentics for a whole range of immunology indications. We have a drug called Kiskali for breast cancer. As you know, these names are not always tying to what the drugs actually do. But yeah, we have a pretty broad portfolio of medicines over fifteen medicines, over a billion dollars of sales.

There's a couple of major drugs we have right now, and Trusto is a medicine for heart failure. Another drug Couthentics for a whole range of immunology indications. We have a drug called Kiskali for breast cancer. As you know, these names are not always tying to what the drugs actually do. But yeah, we have a pretty broad portfolio of medicines over fifteen medicines, over a billion dollars of sales.

By the way, speaking of their brand names, who comes up with these brand names? Because they there are names that I can't pronounce. Sometimes you don't know what they mean. Do you have a team of people.

By the way, speaking of their brand names, who comes up with these brand names? Because they there are names that I can't pronounce. Sometimes you don't know what they mean. Do you have a team of people.

That came up.

That came up.

It's a whole industry.

It's a whole industry.

Maybe private equity even interested to get into it, but there's a whole industry of people who basically try to find word permutations that might tie to the drug, and then you have to send it to the regulators and they have to be sure that this word will not be confused in any number of different languages for some other medicine or something else.

Maybe private equity even interested to get into it, but there's a whole industry of people who basically try to find word permutations that might tie to the drug, and then you have to send it to the regulators and they have to be sure that this word will not be confused in any number of different languages for some other medicine or something else.

People who don't follow this industry carefully may not recognize it. But the way the industry works, as I understand it is that large pharmaceutical companies either develop internally or through an acquisition a drug or pharmaceutical product that they can sell, and it's patented, and the patents last for seventeen years, seventeen years, seventeen years, and after seventeen years it becomes what's known as a generic, which means that it's not patent. Can get it for presumably a lower price. So is that a good way to make a business? You have you build products in seventeen years they're kind of gone.

People who don't follow this industry carefully may not recognize it. But the way the industry works, as I understand it is that large pharmaceutical companies either develop internally or through an acquisition a drug or pharmaceutical product that they can sell, and it's patented, and the patents last for seventeen years, seventeen years, seventeen years, and after seventeen years it becomes what's known as a generic, which means that it's not patent. Can get it for presumably a lower price. So is that a good way to make a business? You have you build products in seventeen years they're kind of gone.

It's a tough way to make a business, for sure. It means you're on a constant treadmill and you have to constantly have the innovation capacity to have what we call replacement power. You have to replace your sales with the next medicines, the next innovation. So the only winners in the long run are companies that have the R and D firepower, R and D capacity to keep inventing medicines to rejuvenate almost their entire portfolio. So you think of a company like US forty five billion dollars in sales every year. We can have anywhere from two to eight billion dollars plus going off patent, and we have to generate enough sales to replace that and grow on top. And that's why you have a relatively limited number of very large by pharma companies.

It's a tough way to make a business, for sure. It means you're on a constant treadmill and you have to constantly have the innovation capacity to have what we call replacement power. You have to replace your sales with the next medicines, the next innovation. So the only winners in the long run are companies that have the R and D firepower, R and D capacity to keep inventing medicines to rejuvenate almost their entire portfolio. So you think of a company like US forty five billion dollars in sales every year. We can have anywhere from two to eight billion dollars plus going off patent, and we have to generate enough sales to replace that and grow on top. And that's why you have a relatively limited number of very large by pharma companies.

When somebody develops a drug or pharmaceutical product in a company like you, do you have a big lab. I assume is it all over the world or you have it in Switzerland.

When somebody develops a drug or pharmaceutical product in a company like you, do you have a big lab. I assume is it all over the world or you have it in Switzerland.

We invest about nine and a half billion dollars a year in our and DA research headquarters are in Cambridge, Massachusetts, and bossles it so on.

We invest about nine and a half billion dollars a year in our and DA research headquarters are in Cambridge, Massachusetts, and bossles it so on.

So when you get the product and what do you do?

So when you get the product and what do you do?

You test it first on animals, and then you test it on small subset of humans and then a large subset of humans.

You test it first on animals, and then you test it on small subset of humans and then a large subset of humans.

Is that how it works?

Is that how it works?

Roughly, that's how it works, and it's a long journey. First thing we have to do is we have to discover or find what we call a target in the human body that we want a drug. We think this target has some ability to impact human health and.

Roughly, that's how it works, and it's a long journey. First thing we have to do is we have to discover or find what we call a target in the human body that we want a drug. We think this target has some ability to impact human health and.

A disease we're interested in.

A disease we're interested in.

Then we have to design a drug to either inhibit or promote that target, and that takes some time. AI might help us do that faster, we'll see. And then once we have that target drug optimized, we take it into animals, make sure it doesn't cause any preclinical safety signals, and then we finally move into humans. And from the time we move into humans to when we get it to people, it's usually around nine years.

Then we have to design a drug to either inhibit or promote that target, and that takes some time. AI might help us do that faster, we'll see. And then once we have that target drug optimized, we take it into animals, make sure it doesn't cause any preclinical safety signals, and then we finally move into humans. And from the time we move into humans to when we get it to people, it's usually around nine years.

Last year twenty twenty three, we saw an enormous increase in drugs being taken that reduce your weight, and they seem to work quite well. There are two drug companies United States and one in Europe that seem to dominate that business.

Last year twenty twenty three, we saw an enormous increase in drugs being taken that reduce your weight, and they seem to work quite well. There are two drug companies United States and one in Europe that seem to dominate that business.

Are you going to get into that business? And why not? It seems to be extremely profitable.

Are you going to get into that business? And why not? It seems to be extremely profitable.

It is a business we're interested in.

It is a business we're interested in.

We're working on really the next wave of medicines because I think these GLP one medicines that you're talking about are very well serviced by the current companies. It's a fascinating story goes back actually to the early nineteen nineties. It took us almost twenty five years to realize the potent effect that these types of drugs would have on obesity. But we think there's opportunity to improve on them, and we hope it'll be It's very early stage within nov Artists, but can we come up with drugs that better preserve muscle, are maybe easier to take and more infrequently taken. One area of where Novartis is one of the leaders is in what are called small interfering RNA therapies.

We're working on really the next wave of medicines because I think these GLP one medicines that you're talking about are very well serviced by the current companies. It's a fascinating story goes back actually to the early nineteen nineties. It took us almost twenty five years to realize the potent effect that these types of drugs would have on obesity. But we think there's opportunity to improve on them, and we hope it'll be It's very early stage within nov Artists, but can we come up with drugs that better preserve muscle, are maybe easier to take and more infrequently taken. One area of where Novartis is one of the leaders is in what are called small interfering RNA therapies.

It sounds like a fancy.

It sounds like a fancy.

Word, but really what it allows you to do is take drugs that you normally would take every single day and make them drugs you only have to take twice a year. So in cholesterol lowering, we have a medicine that you only have to take twice a year to lower cholesterol sixty percent. We're working on similar medicines for hypertensions, high blood pressure, other risk factors for cardiovascular disease. And the idea is can you get to very infrequently dosed medicines because most people don't stay on the drugs.

Word, but really what it allows you to do is take drugs that you normally would take every single day and make them drugs you only have to take twice a year. So in cholesterol lowering, we have a medicine that you only have to take twice a year to lower cholesterol sixty percent. We're working on similar medicines for hypertensions, high blood pressure, other risk factors for cardiovascular disease. And the idea is can you get to very infrequently dosed medicines because most people don't stay on the drugs.

As I get older, the drug that I'm most interested in is one that deals with Alzheimer's or dementia, because I'm always wondering am I going to be getting this disease?

As I get older, the drug that I'm most interested in is one that deals with Alzheimer's or dementia, because I'm always wondering am I going to be getting this disease?

What are you doing in that area?

What are you doing in that area?

So we're active and I think what we're really interested in is again the next wave of what might be effective therapies for Alzheimer's disease. Today there are two one drug license, another drug coming targeting the plaques in the brain anti amyloid that drugs as they are called.

So we're active and I think what we're really interested in is again the next wave of what might be effective therapies for Alzheimer's disease. Today there are two one drug license, another drug coming targeting the plaques in the brain anti amyloid that drugs as they are called.

But we think the next generation.

But we think the next generation.

Opportunities are going to be to target other elements that accumulate in the brain. One is called TAO. There are other targets as well. But I would say Alzheimer's is a really tough space. I mean, one of the things that's very hard is you need to intervene very early because it's a very slowly progressing disease, and identifying which patients to intervene on and then figuring out what to treat them the patients with is really really difficult.

Opportunities are going to be to target other elements that accumulate in the brain. One is called TAO. There are other targets as well. But I would say Alzheimer's is a really tough space. I mean, one of the things that's very hard is you need to intervene very early because it's a very slowly progressing disease, and identifying which patients to intervene on and then figuring out what to treat them the patients with is really really difficult.

On cancer related drugs, there are some cancer related drugs, and I guess you have some as well, but.

On cancer related drugs, there are some cancer related drugs, and I guess you have some as well, but.

They tend to deal with cancer.

They tend to deal with cancer.

Once you have cancer, they try to ameliorate the side effects of it or the effects of it. What about something that prevents cancer? Is that realistic in my lifetime?

Once you have cancer, they try to ameliorate the side effects of it or the effects of it. What about something that prevents cancer? Is that realistic in my lifetime?

That is something that's a heavy interest of the field, and also at our company, we actually just got great data on a breast cancer drug which can be given to women who have had their breast cancer but resected, but then to prevent it recurring. Now where there's a lot of interest right now is can you identify things in the blood and things are circulating so circulating tumor DNA that would show that the cancer is starting to happen in the body, but well before it would be detectable in any kind of scan. If we can get those tests up to an adequate level of precision and start to treat patients well before the cancer shows up, that would be the big opportunity, but that's still some time away.

That is something that's a heavy interest of the field, and also at our company, we actually just got great data on a breast cancer drug which can be given to women who have had their breast cancer but resected, but then to prevent it recurring. Now where there's a lot of interest right now is can you identify things in the blood and things are circulating so circulating tumor DNA that would show that the cancer is starting to happen in the body, but well before it would be detectable in any kind of scan. If we can get those tests up to an adequate level of precision and start to treat patients well before the cancer shows up, that would be the big opportunity, but that's still some time away.

So you produce medicines that presumably help people with their lives the better and live longer and so forth. Why aren't you a more popular industry? You know, the private equ industry has its attractors, have no doubt, but the pharmaceutical industry is not right too far behind us.

So you produce medicines that presumably help people with their lives the better and live longer and so forth. Why aren't you a more popular industry? You know, the private equ industry has its attractors, have no doubt, but the pharmaceutical industry is not right too far behind us.

Why do people not love you for the drugs you're producing.

Why do people not love you for the drugs you're producing.

Yeah, it's a long story in terms of the history of this industry. Even if you go back to the seventies or eighties, we were a much more popular sector. I think one of the things that happened is as we brought more and more medicines forward and patients got on more and more therapies. The one thing we weren't watching carefully enough as an industry was what was happening at the pharmacy counter. There's a lot of focus in congressional hearings and other places on list prices, but list prices mean very little in the sector because you have pharmacy benefit managers, you have retail pharmacies, you have wholesalers. But what really matters is at the end of the day, when somebody comes to the pharmacy counter. Can they afford their medicines? And we're starting to address that. Some recent legislation addresses that. We're thinking a lot about it. But that's what we've got to figure out how to solve.

Yeah, it's a long story in terms of the history of this industry. Even if you go back to the seventies or eighties, we were a much more popular sector. I think one of the things that happened is as we brought more and more medicines forward and patients got on more and more therapies. The one thing we weren't watching carefully enough as an industry was what was happening at the pharmacy counter. There's a lot of focus in congressional hearings and other places on list prices, but list prices mean very little in the sector because you have pharmacy benefit managers, you have retail pharmacies, you have wholesalers. But what really matters is at the end of the day, when somebody comes to the pharmacy counter. Can they afford their medicines? And we're starting to address that. Some recent legislation addresses that. We're thinking a lot about it. But that's what we've got to figure out how to solve.

Let's talk about your background. So your parents came from where.

Let's talk about your background. So your parents came from where.

They came from Tumbil Nadu in southern India.

They came from Tumbil Nadu in southern India.

And when did they come to the United States.

And when did they come to the United States.

They came in the late sixties and early seventies.

They came in the late sixties and early seventies.

And were they educated?

And were they educated?

They were they actually, you know, my father was alongside his brothers were some of the first people in our family to go to college in India. Father did his PhD in India. I was able to work his way up and then it was one of the first people to come to the United States.

They were they actually, you know, my father was alongside his brothers were some of the first people in our family to go to college in India. Father did his PhD in India. I was able to work his way up and then it was one of the first people to come to the United States.

My mother came to Carnegie Mellon. She did a.

My mother came to Carnegie Mellon. She did a.

Degree in nuclear and becoming a nuclear engineer. And yeah, it was I think a pretty extraordinary story and that they were able to come from relatively modest beginnings, so beginning with my grandparents in relatively small places in India and ultimately find a way to the United States.

Degree in nuclear and becoming a nuclear engineer. And yeah, it was I think a pretty extraordinary story and that they were able to come from relatively modest beginnings, so beginning with my grandparents in relatively small places in India and ultimately find a way to the United States.

So you grew up in the Pittsburgh area.

So you grew up in the Pittsburgh area.

I grew up a Pittsburgh Steelers fan.

I grew up a Pittsburgh Steelers fan.

Indeed, And I assume you did well in high.

Indeed, And I assume you did well in high.

School, did well, did well?

School, did well, did well?

So you went to univer Chicago, went to the University of chicag And why did you go there as opposed to other good schools.

So you went to univer Chicago, went to the University of chicag And why did you go there as opposed to other good schools.

Well, it's an interesting story.

Well, it's an interesting story.

I actually applied to all of the ivs and applied to a number of schools, and I didn't get in anywhere. Actually, the one school that I did admit me was a University of Chicago, and it ended up being such an incredible gift in the end, because the University of Chicago, I would still credit, perhaps more than any other educational experience, taught me how to think, how to synthesize, how to be relentlessly curious.

I actually applied to all of the ivs and applied to a number of schools, and I didn't get in anywhere. Actually, the one school that I did admit me was a University of Chicago, and it ended up being such an incredible gift in the end, because the University of Chicago, I would still credit, perhaps more than any other educational experience, taught me how to think, how to synthesize, how to be relentlessly curious.

It was really positive.

It was really positive.

Okay, So Harvard recognized and gets a mistake from before, admitted view to the medical school, right, they did. And so you went to Harvard Medical School. I assume your immigrant parents were saying, great, my son is going to be a doctor. Yes, So when you told them you weren't going to be a practicing doctor, what did they say?

Okay, So Harvard recognized and gets a mistake from before, admitted view to the medical school, right, they did. And so you went to Harvard Medical School. I assume your immigrant parents were saying, great, my son is going to be a doctor. Yes, So when you told them you weren't going to be a practicing doctor, what did they say?

They were very confused. They were very very confused. I you know, I had this idea in my mind, I did a lot of work in public health. I had some great mentors at Harvard, and I really wanted to see how could I have a bigger impact beyond an individual patient care, and so I wanted to I first went to the World Health Organization, then I went to McKinsey. But all of this time, I certainly think my parents were assuming I was going to go back and do a residency and become a cardiologist and kind of finish the journey, and it never actually worked out that well.

They were very confused. They were very very confused. I you know, I had this idea in my mind, I did a lot of work in public health. I had some great mentors at Harvard, and I really wanted to see how could I have a bigger impact beyond an individual patient care, and so I wanted to I first went to the World Health Organization, then I went to McKinsey. But all of this time, I certainly think my parents were assuming I was going to go back and do a residency and become a cardiologist and kind of finish the journey, and it never actually worked out that well.

For a while, you were, I guess, a protege of Paul Farmer, the famous doctor who was at Harvard for a while, among other places. And you then did other things to help people in India. You went back working with street children in India.

For a while, you were, I guess, a protege of Paul Farmer, the famous doctor who was at Harvard for a while, among other places. And you then did other things to help people in India. You went back working with street children in India.

That's right.

That's right.

So did your parents say, you have a Harvard Medical School degree and you're making no money in India is a great country, but why don't you go practice medicine?

So did your parents say, you have a Harvard Medical School degree and you're making no money in India is a great country, but why don't you go practice medicine?

Say that my father would ask, I worked so hard to get out of these places, why are you working so hard to go back to them? Was certainly a confusion he had in his mind. But overall my parents were very supportive of this public health goal.

Say that my father would ask, I worked so hard to get out of these places, why are you working so hard to go back to them? Was certainly a confusion he had in his mind. But overall my parents were very supportive of this public health goal.

I had okay, So you ultimately came to McKenzie after some public health work and why did you not stay at McKenzie.

I had okay, So you ultimately came to McKenzie after some public health work and why did you not stay at McKenzie.

Yeah, McKenzie was a great training ground for a physician who didn't know anything about a P and L, a balance sheet, knew nothing about M and A or evaluation. I learned a lot very quickly, but I just felt like it was a little bit detached from the real action. And I had an opportunity presented to me to join Novartists Pharmaceuticals to really try to look at our R and D strategy at Novartists at the time, and it was a little bit of a whim sort of a gamble to try to see how that would work out.

Yeah, McKenzie was a great training ground for a physician who didn't know anything about a P and L, a balance sheet, knew nothing about M and A or evaluation. I learned a lot very quickly, but I just felt like it was a little bit detached from the real action. And I had an opportunity presented to me to join Novartists Pharmaceuticals to really try to look at our R and D strategy at Novartists at the time, and it was a little bit of a whim sort of a gamble to try to see how that would work out.

I would have never imagined it would have unfolded the way it did, but it was really great.

I would have never imagined it would have unfolded the way it did, but it was really great.

So you work your way up and then at the age of forty, somebody at Nevarda says, we have a forty year old who didn't go to business school, is not from Switzerland, and he's a medical doctor who's never practiced medicine.

So you work your way up and then at the age of forty, somebody at Nevarda says, we have a forty year old who didn't go to business school, is not from Switzerland, and he's a medical doctor who's never practiced medicine.

Let's make him the CEO. It's right, So were you're surprised?

Let's make him the CEO. It's right, So were you're surprised?

I was shocked.

I was shocked.

I was shocked when they first asked me that to even be part of it. I mean I had been a head of drug development. I had the opportunity to do so many different roles at Novartists in developing vaccines.

I was shocked when they first asked me that to even be part of it. I mean I had been a head of drug development. I had the opportunity to do so many different roles at Novartists in developing vaccines.

I worked in our vaccines.

I worked in our vaccines.

Division, leading a little bit of our generics unit, working in drug development for many, many years. And I think part of the reason they were interested is because I had gotten a background in R and D. But I think it was also not only my age, but also the fact that I think no other major pharmaceutical company had an R and D head, our development head as their CEO.

Division, leading a little bit of our generics unit, working in drug development for many, many years. And I think part of the reason they were interested is because I had gotten a background in R and D. But I think it was also not only my age, but also the fact that I think no other major pharmaceutical company had an R and D head, our development head as their CEO.

Your strategy has been different than the strategy you inherited, and the artist was in many different areas. They had a generic drug business and you sold that. Yes, so why did you get out of that business? It seems to be a recently profitable business.

Your strategy has been different than the strategy you inherited, and the artist was in many different areas. They had a generic drug business and you sold that. Yes, so why did you get out of that business? It seems to be a recently profitable business.

Yeah.

Yeah.

As you know, when we have these conglomerates, you have to ask is there value in the conglomerate? Is their value in building all these different businesses together? And then the question is what are we really great at? And when I came into the role as CEO, I looked we were in consumer health, we were in I care devices, we were in generics. We had a broad range, broad portfolio, and I think what our company's really great at is discovering these novel breakthroughs and then getting access to over two hundred and eighty million patients, which is our reach today, largest we believe of any pharma company to all of these patients. And so in order to do that well, I didn't think we could allocate capital successfully across all of these different businesses. So we spun al Con, the largest public market spin in recent memory in Europe. We spun out Sandos, We sold our consumer health business. It's about one hundred and thirty billion dollars of transactions. Later, we come out as a pure play medicines company, which I think we're a best positioned for the long run.

As you know, when we have these conglomerates, you have to ask is there value in the conglomerate? Is their value in building all these different businesses together? And then the question is what are we really great at? And when I came into the role as CEO, I looked we were in consumer health, we were in I care devices, we were in generics. We had a broad range, broad portfolio, and I think what our company's really great at is discovering these novel breakthroughs and then getting access to over two hundred and eighty million patients, which is our reach today, largest we believe of any pharma company to all of these patients. And so in order to do that well, I didn't think we could allocate capital successfully across all of these different businesses. So we spun al Con, the largest public market spin in recent memory in Europe. We spun out Sandos, We sold our consumer health business. It's about one hundred and thirty billion dollars of transactions. Later, we come out as a pure play medicines company, which I think we're a best positioned for the long run.

Soh you're the CEO and you go to the board and say, you know, we've been in the generics business, we're in the consumer drug business, and we're going to get out of all these except we're going to be in the one business that we were now in. Did they say, you know, you weren't qualified to make that judgment or what did they say?

Soh you're the CEO and you go to the board and say, you know, we've been in the generics business, we're in the consumer drug business, and we're going to get out of all these except we're going to be in the one business that we were now in. Did they say, you know, you weren't qualified to make that judgment or what did they say?

Well?

Well?

I think they went along, and I think they generally were aligned. But I think it also was a step wise journey. I mean, first we did consumer health and we saw how that went, and then two years a year later we did al Con, Then the pandemic came, then we did did Santos. Because I think the fear comes back from what we discussed earlier. When you have a business in innovative medicines and you have these patent cliffs, if you have these other businesses which are much more stable, there's a feeling like you can offset your risk. You have stable businesses and you have this one business where you face these cliffs every fifteen to seventeen years.

I think they went along, and I think they generally were aligned. But I think it also was a step wise journey. I mean, first we did consumer health and we saw how that went, and then two years a year later we did al Con, Then the pandemic came, then we did did Santos. Because I think the fear comes back from what we discussed earlier. When you have a business in innovative medicines and you have these patent cliffs, if you have these other businesses which are much more stable, there's a feeling like you can offset your risk. You have stable businesses and you have this one business where you face these cliffs every fifteen to seventeen years.

I take the view that the only way you're going to generate.

I take the view that the only way you're going to generate.

Enough medicines to keep growing as you focus your capital on innovation.

Enough medicines to keep growing as you focus your capital on innovation.

So last week, as we're talking now, last week you made another acquisition, I think for roughly five billion dollars. You bought a company that is dealing with blood cancer. So why was that a good acquisition? And how does it as long does it take you to make an assessment of whether an acquisition is good or not? And do you come up with the ideas yourself, or does some investment banker come along and tell you it's a great idea.

So last week, as we're talking now, last week you made another acquisition, I think for roughly five billion dollars. You bought a company that is dealing with blood cancer. So why was that a good acquisition? And how does it as long does it take you to make an assessment of whether an acquisition is good or not? And do you come up with the ideas yourself, or does some investment banker come along and tell you it's a great idea.

We limit our use of investment bankers. In general.

We limit our use of investment bankers. In general.

What we try to look at is in the therapeutic areas we're in. So we're in blood cancers. We've been in blood cancers for over twenty years. Some of the most pioneering drugs and blood cancers have come from our research labs, and we say, if this is an area we're in we have deep understanding, therefore this makes sense to actually add another medicine to that portfolio, and so we.

What we try to look at is in the therapeutic areas we're in. So we're in blood cancers. We've been in blood cancers for over twenty years. Some of the most pioneering drugs and blood cancers have come from our research labs, and we say, if this is an area we're in we have deep understanding, therefore this makes sense to actually add another medicine to that portfolio, and so we.

Make that assessment.

Make that assessment.

If it's a good strategic fit, in this case a good financial fit, we'll make the bet. One of the things we've tried to be much more disciplined on is to try to go at the lower end of the range to under five billion dollars for acquisitions and really ensure that they're in areas we have deep understanding. Generally, when we've gone too far away from our core, the value creation hasn't been there.

If it's a good strategic fit, in this case a good financial fit, we'll make the bet. One of the things we've tried to be much more disciplined on is to try to go at the lower end of the range to under five billion dollars for acquisitions and really ensure that they're in areas we have deep understanding. Generally, when we've gone too far away from our core, the value creation hasn't been there.

In twenty twenty three, AI burst onto the scene. Everybody is now excited about AI. How is AI affecting your company and do you think it's going to help your company?

In twenty twenty three, AI burst onto the scene. Everybody is now excited about AI. How is AI affecting your company and do you think it's going to help your company?

I think a it's going to have a big impact, but I think it's going to take more time than most people expect. I think first in productivity areas, AI has media applications, and I feel like in productivity we can use AI for document management, document generations, not really sexy areas, but things that really tractable in our sector. Most uniquely, the big question is can you speed up or increase the efficiency of drug R and D? And there we're doing a couple of things, working on clinical trials and optimizing our clinical trials. But the big bets we've made are with Palenteer, Microsoft Research Labs, Google deep Mind, and a few other partners to say, could you really discover novel drugs that maybe weren't discoverable without AI? Can you optimize drugs much more quickly? And this is all building on the pioneering work that Google Deep Minded on a technology called Alpha fold. There's a huge opportunity here, But I think we also have to acknowledge that we only understand about five to ten percent of what is going on in the human body. So to expect AI to use that five to ten percent to extrapolate and come up with big discoveries is going to take time.

I think a it's going to have a big impact, but I think it's going to take more time than most people expect. I think first in productivity areas, AI has media applications, and I feel like in productivity we can use AI for document management, document generations, not really sexy areas, but things that really tractable in our sector. Most uniquely, the big question is can you speed up or increase the efficiency of drug R and D? And there we're doing a couple of things, working on clinical trials and optimizing our clinical trials. But the big bets we've made are with Palenteer, Microsoft Research Labs, Google deep Mind, and a few other partners to say, could you really discover novel drugs that maybe weren't discoverable without AI? Can you optimize drugs much more quickly? And this is all building on the pioneering work that Google Deep Minded on a technology called Alpha fold. There's a huge opportunity here, But I think we also have to acknowledge that we only understand about five to ten percent of what is going on in the human body. So to expect AI to use that five to ten percent to extrapolate and come up with big discoveries is going to take time.

So other than AI, what medical technologies do you think are coming along that in the next one, two or three years are likely to change what you do or change the medical world.

So other than AI, what medical technologies do you think are coming along that in the next one, two or three years are likely to change what you do or change the medical world.

I think a couple of things.

I think a couple of things.

One RNA therapeutics as I mentioned earlier in the broadcast, or RNA therapeutics sRNAs.

One RNA therapeutics as I mentioned earlier in the broadcast, or RNA therapeutics sRNAs.

These are really coming to life now.

These are really coming to life now.

What this allows you to do is treat diseases that were not treatable or treat them with very infrequent drug dosing. And if you could imagine if we could take on blood pressure and cholesterol with once year dosing, hugely transformative.

What this allows you to do is treat diseases that were not treatable or treat them with very infrequent drug dosing. And if you could imagine if we could take on blood pressure and cholesterol with once year dosing, hugely transformative.

Another one is sell therapy for immune diseases.

Another one is sell therapy for immune diseases.

We've seen extraordinary results in early phase studies that if you can reset somebody's immune system there are autoimmune disease actually goes away, and we'll see if this is sustains. But these are some of the most impressive results that we've ever seen in early stage clinical studies. And then the last is we're very big in an area of cancer called radio ligend therapy. This is the idea that can you bring nuclear particles right next to a cancer in the body and deliver the radiation very locally, and this has the opportunity to treat a whole range of solid tumors in ways that we couldn't afford.

We've seen extraordinary results in early phase studies that if you can reset somebody's immune system there are autoimmune disease actually goes away, and we'll see if this is sustains. But these are some of the most impressive results that we've ever seen in early stage clinical studies. And then the last is we're very big in an area of cancer called radio ligend therapy. This is the idea that can you bring nuclear particles right next to a cancer in the body and deliver the radiation very locally, and this has the opportunity to treat a whole range of solid tumors in ways that we couldn't afford.

What do you do to kind of lower your global footprint carbon footprint? What do you do?

What do you do to kind of lower your global footprint carbon footprint? What do you do?

Our big topic on sustainability is much more on access to medicines, and so we have a big effort on global access to medicines, trying to make sure our innovations are accessible. The work we do in areas like malaria, on leprosy, sickle cell disease to ensure populations around the world can get access to these medicines.

Our big topic on sustainability is much more on access to medicines, and so we have a big effort on global access to medicines, trying to make sure our innovations are accessible. The work we do in areas like malaria, on leprosy, sickle cell disease to ensure populations around the world can get access to these medicines.

How do you pay for that?

How do you pay for that?

So it's all part of our sustainability efforts and we view it as part of our core mission to deliver these global health therapies to patients around the globe. So we have a huge effort in global health R and DST two hundred and fifty million dollars actually in trying to discover the next wave of medicines to treat these global health conditions.

So it's all part of our sustainability efforts and we view it as part of our core mission to deliver these global health therapies to patients around the globe. So we have a huge effort in global health R and DST two hundred and fifty million dollars actually in trying to discover the next wave of medicines to treat these global health conditions.

What about DEID We're on a good track here.

What about DEID We're on a good track here.

We've actually about forty eight percent women in management media and pay for women and of artists is higher than for men.

We've actually about forty eight percent women in management media and pay for women and of artists is higher than for men.

So we have more work to do at the upper levels of the company. But we're overall doing really well.

So we have more work to do at the upper levels of the company. But we're overall doing really well.

I think, what skill set do you think somebody should develop in order to rise up to be a CEO?

I think, what skill set do you think somebody should develop in order to rise up to be a CEO?

I think the biggest thing I think about is curiosity, just relentless, relentless curiosity. I think whatever position I was put in at Novartis, it was usually a place where I didn't know anything, had to learn teach myself, be relentlessly curious and then apply it and having experiences in a range of different parts of the business world is going to be a huge success.

I think the biggest thing I think about is curiosity, just relentless, relentless curiosity. I think whatever position I was put in at Novartis, it was usually a place where I didn't know anything, had to learn teach myself, be relentlessly curious and then apply it and having experiences in a range of different parts of the business world is going to be a huge success.

How many employees does Novardis have now?

How many employees does Novardis have now?

Seventy six thousand.

Seventy six thousand.

Seventy six thousand.

Seventy six thousand.

It's a lot of employees, so you frequently get a chance to meet them in some organizations somewhere or some meeting.

It's a lot of employees, so you frequently get a chance to meet them in some organizations somewhere or some meeting.

How do you deal with all those employees?

How do you deal with all those employees?

I think the most valuable thing I find in my job is to go around the world and meet these meet our people, be able to have town halls and interactions. It used to be before we spun off all these businesses one hundred and thirty five thousand people, so we've definitely slimmed down. But I think there's nothing that can replace showing up face to face and describing why.

I think the most valuable thing I find in my job is to go around the world and meet these meet our people, be able to have town halls and interactions. It used to be before we spun off all these businesses one hundred and thirty five thousand people, so we've definitely slimmed down. But I think there's nothing that can replace showing up face to face and describing why.

We do what we do.

We do what we do.

So, as the CEO of the artists, you tell your subordinates these are the areas that I think we should work on and see if you can come up with a pharmaceutical product in that area. Or do they come to you and say, we have a prospect here and you bless this. How does that work?

So, as the CEO of the artists, you tell your subordinates these are the areas that I think we should work on and see if you can come up with a pharmaceutical product in that area. Or do they come to you and say, we have a prospect here and you bless this. How does that work?

Well?

Well?

In general, I have a philosophy that we call in our culture unbost and we try to unboss our people. We want our people to actually bring the ideas up and then we of course have to challenge them, but then we make the call. So I really believe that in our sector where some of our scientists are world class, many of our scientists are world class, they should be bringing up the ideas and we have to curate them. But certainly, I'm not sitting on some mountain here knowing what the right thing to do is.

In general, I have a philosophy that we call in our culture unbost and we try to unboss our people. We want our people to actually bring the ideas up and then we of course have to challenge them, but then we make the call. So I really believe that in our sector where some of our scientists are world class, many of our scientists are world class, they should be bringing up the ideas and we have to curate them. But certainly, I'm not sitting on some mountain here knowing what the right thing to do is.

Certainly so, if.

Certainly so, if.

Somebody is saying, I'm graduating from college or graduate school the next year or so, and I want a nice career, why should somebody want to be in the pharmaceutical industry. Why not go into something sexy like private equity or investment banking or something like that.

Somebody is saying, I'm graduating from college or graduate school the next year or so, and I want a nice career, why should somebody want to be in the pharmaceutical industry. Why not go into something sexy like private equity or investment banking or something like that.

You know, despite some of the things people have, concepts people have about our industry. In the end, what we do is we create these miracles that fit in the palm of your hand, these little medicines that can transform a human beings life. And if you look at the arc of history, in the last one hundred and thirty years, we've been able to move through the power of medicine life expectancy from thirty years to eighty years. We're now able to cure diseases. We're able to give people, you know, with debilitating disease their lives back.

You know, despite some of the things people have, concepts people have about our industry. In the end, what we do is we create these miracles that fit in the palm of your hand, these little medicines that can transform a human beings life. And if you look at the arc of history, in the last one hundred and thirty years, we've been able to move through the power of medicine life expectancy from thirty years to eighty years. We're now able to cure diseases. We're able to give people, you know, with debilitating disease their lives back.

So if you're part of.

So if you're part of.

That kind of enterprise, you can get up every day knowing you're moving the needle for society, you're moving the needle for mankind. I think we do reimagine medicine with the medicines we create, and I think that's a pretty inspiring way to spend your time.

That kind of enterprise, you can get up every day knowing you're moving the needle for society, you're moving the needle for mankind. I think we do reimagine medicine with the medicines we create, and I think that's a pretty inspiring way to spend your time.

So suppose a president came along to you and said, I know you're living in Switzerland, but it'd be great to be the Secretary of Health and Human Services or head of FDA or something.

So suppose a president came along to you and said, I know you're living in Switzerland, but it'd be great to be the Secretary of Health and Human Services or head of FDA or something.

What would you say?

What would you say?

I would think hard about it.

I would think hard about it.

At the moment, it would feel like a really daunting task given the politics.

At the moment, it would feel like a really daunting task given the politics.

But on the flip side, I do think public.

But on the flip side, I do think public.

Service, of course, has so much power, and I think if you're in the right context, you could do a lot of good for good for the world. But I think it's very context dependent. As you know, it can be a very short time in some of these roles with some of the recent recent cabinet members.

Service, of course, has so much power, and I think if you're in the right context, you could do a lot of good for good for the world. But I think it's very context dependent. As you know, it can be a very short time in some of these roles with some of the recent recent cabinet members.

Suppose I said, I'm a stock market picker and I want to be buying good stocks and companies that are going to grow and so forth. Why should I want to invest in the pharmaceutical industry? Is it going to continue to grow as it did last year? And what about your own company?

Suppose I said, I'm a stock market picker and I want to be buying good stocks and companies that are going to grow and so forth. Why should I want to invest in the pharmaceutical industry? Is it going to continue to grow as it did last year? And what about your own company?

Do you think it's going to have good growth prospects over the next couple of years. We do.

Do you think it's going to have good growth prospects over the next couple of years. We do.

We've signed up for a five percent plus growth, forty percent plus margins, and very consistent growth over time. I think the reason to invest in the sector is the science. I mean, when you look again, if I go back into the history, for most of the last century, we were only giving people pills and.

We've signed up for a five percent plus growth, forty percent plus margins, and very consistent growth over time. I think the reason to invest in the sector is the science. I mean, when you look again, if I go back into the history, for most of the last century, we were only giving people pills and.

Small, small molecule drugs.

Small, small molecule drugs.

Then we discovered that we had this whole world of biologics and we could treat diseases with biologicals. More recently, we've discovered that we can reprogram yourselves, we can edit the genome, we can use these RNA therapeutics to completely transform areas of medicine. Those technology areas are at their very nascent stage, and what we're going to find is they're going to open up whole new areas of growth from our business standpoint and a human health impact standpoint. And so to get in now, as that's happening, and you've seen how the obesity companies have cleared five hundred billion market cap, we hope that as we work in our areas like cell therapy and RNA therapeutics, we will also be able to climb to a whole other level of market cap over time.

Then we discovered that we had this whole world of biologics and we could treat diseases with biologicals. More recently, we've discovered that we can reprogram yourselves, we can edit the genome, we can use these RNA therapeutics to completely transform areas of medicine. Those technology areas are at their very nascent stage, and what we're going to find is they're going to open up whole new areas of growth from our business standpoint and a human health impact standpoint. And so to get in now, as that's happening, and you've seen how the obesity companies have cleared five hundred billion market cap, we hope that as we work in our areas like cell therapy and RNA therapeutics, we will also be able to climb to a whole other level of market cap over time.

So as you look back on your career and are still very early in the career relative to many other people, I often talk to any regrets about going this route or not becoming a medical doctor and working on patients, No, I have to say.

So as you look back on your career and are still very early in the career relative to many other people, I often talk to any regrets about going this route or not becoming a medical doctor and working on patients, No, I have to say.

I mean, when I look at the reach of our medicines and the impact they have, I'll just go back to my time with Paul Farmer just to say that who unfortunately passed away, but it was an incredible mentor and inspiring mentor. I always told him, I want to have this big impact on public health. He of course did it, working with patients and some of the poorest communities in the world. Today, Novartis are malaria drug Coartem. Coartem is almost ninety nine percent effective when it's given on time to.

I mean, when I look at the reach of our medicines and the impact they have, I'll just go back to my time with Paul Farmer just to say that who unfortunately passed away, but it was an incredible mentor and inspiring mentor. I always told him, I want to have this big impact on public health. He of course did it, working with patients and some of the poorest communities in the world. Today, Novartis are malaria drug Coartem. Coartem is almost ninety nine percent effective when it's given on time to.

Treat a malaria patient.

Treat a malaria patient.

Over four hundred million children treated with our malaria medicines and the biggest malaria pipeline, so even from a public health standpoint, the opportunity to have an impact at scale has really been fulfilled.

Over four hundred million children treated with our malaria medicines and the biggest malaria pipeline, so even from a public health standpoint, the opportunity to have an impact at scale has really been fulfilled.

With this role.

With this role.

Thanks for listening to hear more of my interviews. You can subscribe and download my podcast on Spotify, Apple, or wherever you Lisien

Thanks for listening to hear more of my interviews. You can subscribe and download my podcast on Spotify, Apple, or wherever you Lisien