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The a16z Show

Novartis CEO Vasant Narasimhan on Transforming a 250-Year-Old Company

The a16z Show

a16z

Culture, Business, Science, Disruption, Technology, Software Eating The World, Entrepreneurship, Innovation

4.21.2K Ratings

🗓️ 16 February 2026

⏱️ 58 minutes

🧾️ Download transcript

Summary

a16z general partner Jorge Conde talks with Vasant Narasimhan, CEO of Novartis International, about transforming a 250-year-old conglomerate into a pure play medicines company and unlocking $180 billion of value in the process. They cover Novartis's platform technologies: cell and gene therapies, RNA medicines, and radioligand therapies. They also discuss AI in drug discovery, the rise of China as a biotech competitor, and what Vasant looks for when evaluating startup partnerships, including his advice on the killer experiments and CMC work that can make or break a deal.

Transcript

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0:00.0

We unlocked almost $180 billion of value.

0:04.0

Took this company that was a conglomerate and we turned it into four companies.

0:07.8

We had these other businesses, but it was never really the core of kind of who we are.

0:11.7

We were misallocating capital.

0:13.3

Spitting off companies sounds easy in retrospect.

0:16.3

Actually, spitting off three public companies is a massive, massive undertaking.

0:20.6

You can rewind a disease or completely, in some cases, almost create a functional cure for patients.

0:26.6

One of our sentinel patients was an individual in bed all the time, receives our cell therapy.

0:32.6

Six months later, no sign of disease.

0:35.6

I mean, this is extraordinary.

0:36.6

Cell therapy is an immunology, alongside immune reset by mean, this is extraordinary. Cell therapies and immunology,

0:38.9

alongside immune reset by specific, tri-specific.

0:41.5

That is going to be a whole renaissance for cell therapy.

0:45.0

When Vassant Narasimhan became CEO of Novartis in 2018,

0:49.5

he inherited a conglomerate, consumer health, animal health, vaccines, generics, devices. Over six years,

0:56.7

he spun off three public companies and unlocked almost $180 billion of value. Today, Novartis

1:02.7

is focused on four disease areas and three platform technologies, cell and gene therapies,

1:08.4

RNA medicines, and radiolagin therapies. One of their gene therapies, Z medicines, and radioligan therapies.

1:16.0

One of their gene therapies, Zolgensma, treats children with spinal muscular atrophy,

1:18.9

a disease that would otherwise be fatal by age two.

1:23.5

It costs over $2 million, and it's reimbursed in 48 countries.

1:29.1

Basin started his career doing public health work on tuberculosis in Peru with Paul Farmer and Jim Kim.

...

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