Pharma BD Deal Intelligence

Novartis AG / Ionis Pharmaceuticals, Inc. / Akcea Therapeutics, Inc.

2016 · Licensing/Option · $1.4B · Complete

This deal was never an acquisition—Novartis licensed two Ionis/Akcea antisense cardiovascular candidates for $175M upfront in a deal that could have topped $1.35B in milestones, then dropped one asset (APOCIII-LRx) outright in 2019. The surviving candidate, pelacarsen, remains in Phase 3 with no approval or revenue nearly a decade after signing.

WRONG BY 74 POINTS

Not an acquisition at all — a cardiovascular licensing deal where Novartis dropped half the assets and the surviving one (pelacarsen) still has zero approvals or revenue after nearly a decade

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Ranks computed across 828 graded deals (Critic + Outcome Score both present).

The coverage arc

Jan 05, 2017 BioPharma Dive Bullish

Novartis hooked up with Ionis and Akcea to gain access to two Phase 1/2a antisense cardiovascular candidates targeting Lp(a) and ApoCIII, expanding its…

Jan 08, 2019 FierceBiotech Bullish

With positive Phase 2 data showing up to 80% Lp(a) reduction, Akcea and Ionis stood to receive $150M as Novartis exercised the option to license…

Feb 08, 2019 BioPharma Dive Bullish

Novartis paid $150M to license the lead Lp(a) candidate, signaling confidence in pelacarsen as a potential first-in-class Lp(a)-lowering therapy heading into…

Source summaries from our enrichment pipeline; follow links for originals.

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Novartis entered a worldwide option and collaboration agreement with Ionis Pharmaceuticals and its Akcea Therapeutics subsidiary on two Phase 1/2a antisense cardiovascular candidates (AKCEA-APO(a)-LRx and AKCEA-APOCIII-LRx). Near-term payments of $175M total ($75M upfront + $100M equity in Ionis). Up to $600M (APO(a)) and $530M (APOCIII) in development/commercial milestones plus tiered royalties topping 20%. Novartis to fund Phase 3 CV outcomes trial upon option exercise.

Did it work? Outcome assessment

Not an acquisition at all — a cardiovascular licensing deal where Novartis dropped half the assets and the surviving one (pelacarsen) still has zero approvals or revenue after nearly a decade

Strategic verdict
Failed to Achieve

Key facts

Disease & market context

Cardiovascular risk in patients with elevated lipoprotein(a) [Lp(a)] and ApoCIII

Disease Overview

Lipoprotein(a) [Lp(a)] is a genetically determined, causal risk factor for atherosclerotic cardiovascular disease, aortic stenosis, and stroke. Levels are largely unmodifiable by diet, exercise, or statins, leaving an estimated 64 million US adults with elevated Lp(a) without targeted pharmacologic options. Elevated ApoCIII similarly drives triglyceride-rich lipoprotein burden and residual cardiovascular risk in patients on statin therapy.

Competitive Landscape

At the time of the 2016 deal, no therapy had been approved specifically to lower Lp(a). The cardiovascular lipid-lowering market was dominated by statins and the newly launched PCSK9 inhibitors Repatha (evolocumab, Amgen) and Praluent (alirocumab, Sanofi/Regeneron), both approved in 2015 at ~$14,000/year list price but with limited Lp(a) impact (~25-30% reduction at most). The Ionis/Akcea LICA antisense platform offered substantially deeper Lp(a) suppression (up to ~99%) by directly silencing hepatic LPA mRNA, and Novartis was buying optionality on what could become the first targeted Lp(a) drug. The deal positioned Novartis ahead of the eventual competitive set: Amgen's olpasiran (siRNA, ~94% Lp(a) reduction) and Lilly's lepodisiran (siRNA, ~94% reduction) entered Phase 3 only years later. AKCEA-APO(a)-LRx was rebranded pelacarsen (TQJ230) and Novartis exercised the option in 2019. Pelacarsen's Lp(a) HORIZON Phase 3 outcomes trial completed enrollment, with results pivotal to validating the Lp(a) class. Akcea later regained APOCIII-LRx rights (olezarsen) when Novartis declined to exercise that option.

Related deals — scored

DealYearValueOutcome
Novartis AG / Ionis Pharmaceuticals, Inc. / Akcea Therapeutics, Inc. (this deal)2016$1.4B26
Novartis AG / Advanced Accelerator Applications S.A.2017$3.9B98
Novartis AG / Endocyte, Inc.2018$2.1B96
Novartis AG / Lek Pharmaceuticals d.d.2002$876M88
Novartis AG / GlaxoSmithKline plc2014$16.0B81
Novartis AG / PTC Therapeutics Inc.2024$2.9B80
Novartis AG / Chinook Therapeutics Inc.2023$3.5B78

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