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Roche’s diversified approach ranges from oncology to ophthalmology
Roche’s focus spans oncology, immunology, neuroscience, and cardiovascular diseases. The company’s oncology portfolio stands out with candidates such as inavolisib and giredestrant that target novel mechanisms in breast cancer. Additionally, Inavolisib, a PI3K inhibitor, targets the PI3Kα isoform, involved in the pathways that drive cell growth and survival. It shows potential not only in breast cancer but also in other solid tumors.
Furthermore, giredestrant is a selective estrogen receptor degrader (SERD) that targets and binds to estrogen receptors, inducing their degradation. This mechanism disrupts estrogen receptor-mediated signaling, crucial for the growth of estrogen receptor-positive (ER+) breast cancer, aiming to provide a potent new treatment option. Additionally, Roche is exploring tiragolumab, which is designed for use in combination therapies, showing potential in treating various solid tumors. Outside of oncology, Roche’s neuroscience and ophthalmology pipelines also highlight the company’s diversified approach with drugs like Evrysdi for spinal muscular atrophy and Vabysmo for retinal vein occlusion.
Novartis slows down to speed up
While Novartis has a robust pipeline, the company has strategically streamlined by about 10% to focus on core areas like cardiovascular and kidney diseases. This shift, along with the spin-off of Sandoz, signals a sharpened focus that could position Novartis for accelerated success in the long run. This strategic focus is further highlighted by their acquisition of Chinook Therapeutics, bolstering its pipeline with late-stage candidates for complex kidney diseases.
Novartis is actively seeking to expand indications for existing drugs. For example, Lutathera, already FDA-approved for specific tumors (GEP-NETs), is the subject of the phase 3 NETTER-2 study that tests Lutathera as a first-line treatment option for patients with Grade 2 and Grade 3 advanced GEP-NETs.
Similarly, Pluvicto, approved for advanced prostate cancer (mCRPC), is being investigated for potential use in earlier stages of the disease.
First approved in late 2021, Novartis’ Inclisiran (Leqvio) continues to gain wider use for managing high LDL cholesterol. In 2023, it received an expanded FDA indication for adults at increased cardiovascular risk, even without prior events. This status allows for earlier use of Leqvio as an adjunctive therapy with diet and statin therapy in patients with heightened cardiovascular risk.
Cosentyx, already approved for psoriasis, psoriatic arthritis, and ankylosing spondylitis, holds promise for treating other autoimmune diseases. This potential expansion aligns with Novartis’ focus on diverse patient needs, as seen with Aimovig for migraine prevention and Mayzent for multiple sclerosis.
Beyond its core focus areas, Novartis is actively developing therapies to address global health needs. KAE609 (cipargamin) for malaria is a notable example.
Pipeline size and R&D spending are not the only metrics of success
While Roche and Novartis lead in terms of pipeline size and R&D spending, these benchmarks alone do not confer a strategic advantage. Less is sometimes more. Novo Nordisk, despite having a more modest R&D budget ($2.6 billion in 2022; $4.7 billion in 2023) and fewer pipeline drugs compared to its peers, has emerged as the fastest-growing Big Pharma firm from 2020 to 2023. A targeted therapeutic area strategy can drive outperformance and reshape the landscape. Novo Nordisk’s (along with Lilly’s) growing success in metabolic disease has served up as a wake-up call for R&D organizations that frequently focused narrowly on oncology and immunology.
In the evolving landscape of the pharmaceutical industry, companies must measure success not merely by R&D numbers and pipeline updates, but by impact. The cases of Merck & Co., Pfizer, J&J, and AbbVie from 2020-2023 underscore the need for a strategic shift in R&D approaches. Ultimately, sustainable leadership will hinge on Big Pharma’s ability to pivot from the conventional pipeline breadth model to one centered on a data-driven strategic focus, novel partnerships, and disruptive technologies. This shift should not just target areas of dire patient need but also continually push the boundaries of scientific possibility.
Filed Under: Drug Discovery, Metabolic disease/endicrinology, Oncology
