Novartis Just Lost a Potential $6 Billion Drug

Novartis may have just lost a drug that analysts thought could generate up to $6 billion a year. 

On September 4, 2026, Novartis announced that pelacarsen, its experimental cardiovascular drug, failed a major phase 3 trial. The drug was intended to lower lipoprotein(a), a genetically determined risk factor for heart disease that affects roughly one in five people worldwide. 

This wasn’t just an opportunity for medicine. From a financial perspective, the commercial stakes were enormous.

Analysts had estimated that pelacarsen could generate between $3 billion and $6 billion in peak annual sales. Additionally, Novartis’s current blockbuster heart-failure drug, Entresto, has been facing increased competition. Pelacarsen, therefore, was a major factor that investors believed could drive Novartis’s next phase of growth.  

But the phase 3 clinical trial may have destroyed that outlook. 

The study included more than 8,000 patients, and while Pelacarsen successfully lowered lipoprotein(a), it failed to significantly reduce the catastrophic events that make heart disease so deadly—heart attacks, strokes, and cardiovascular deaths.

For investors, this distinction is extremely important. A drug’s success isn’t just determined by whether it reduces a biomarker(lipoprotein(a). Whether or not it can actually translate that change into a strong clinical benefit will dictate whether it gets approved and generates sales. 

When markets reopened on September 7, 2026, Novartis shares fell about 3.2%. But the financial impact could stretch beyond Novartis. 

Amgen and Eli Lilly are currently working on their own drugs that could lower Lp(a). Before pelacarsen’s failure, investors viewed these programs as competitors in a potentially massive and lucrative cardiovascular market. However, because pelacarsen showed that lowering Lp(a) may not prevent cardiovascular events at all, there's much more doubt surrounding whether or not these drugs have any chance of working at all. 

That creates what investors call a read-through. Bad clinical data from one company can force the market to reassess the value of similar drugs at completely different companies. 

Nevertheless, if one of those competitors succeeds, it could inherit a multibillion-dollar market with Novartis potentially being out of the way. 

But if they fall short like Novartis, the pharmaceutical industry may have wasted years chasing a market that never really existed.