A top Novartis executive says the $225 billion drug giant is planning for a 'doomsday scenario' in cancer treatment

  • Swiss drug giant Novartis is developing drugs that could prevent cancer before patients get it.
  • Jay Bradner, who heads up Novartis’s drug research and discovery, says that in a “doomsday” scenario, this may end up being the only cure for cancer.
  • But health insurers might not want to pay for preventative cancer drugs because they won’t benefit from future savings, Bradner said.
  • Bradner spoke with Business Insider at the World Economic Forum in Davos, Switzerland this week.

DAVOS, Switzerland – Cancer drugs today work to fight off the most serious forms of the disease.

But Swiss drug giant Novartis is prepping for what one of its top executives calls a “doomsday” scenario: That, once a patient has cancer, the devastating disease is hard or impossible to cure – and “that the cure for cancer is never having it at all.”

Jay Bradner heads up Novartis’s drug research and discovery, as president of the Novartis Institutes for BioMedical Research. Novartis has a market value of about $US225 billion, and currently makes drugs like the heart failure drug Entresto and the skin treatment Cosentyx, as well as cancer therapies.

During an interview at the World Economic Forum in Davos, Switzerland, this week, Bradner said that Novartis is taking a “forward-thinking,” preventative approach in developing cancer drugs – but most rival drugmakers aren’t.

“What type of medicines would we make if prevention was the purpose of the drug discovery process?” Bradner asked. “You might target very different mechanisms.”


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Bradner knows what he’s talking about. Before he joined Novartis in 2016, he was a cancer doctor and star Harvard researcher.

Novartis is following this approach, Bradner said, by developing drugs that target pathways that lead to cancer. Those same pathways, by contrast, might not be as important once someone has cancer, he said.

But getting health insurers to pay for these types of oncology drugs could be a challenge, he said.

“It’s hard to imagine as a payer, how [one] might get excited about supporting access to a medicine for a patient at age 20 who’s going to be off your plan, benefiting at age 55,” Bradner said.


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Novartis’s approach represents a major change from the rest of the industry.

Take the drug tamoxifen, for example, which treats breast cancer but is also used in women who don’t have the cancer, but do have high risk of getting the disease.

Drugs like tamoxifen start off being studied in advanced cancer and are then “marched dutifully” into early-stage cancers, Bradner said.

Eventually, only after a number of pieces fall into place, are they studied in prevention, he said, work that’s usually funded by a foundation or the federal government.

Meetings at Davos have been “productive in surprising ways,” Bradner said, including because they have sparked conversations with health insurers about this very topic.

Because Bradner works to discover and develop drugs for Novartis, health insurers “are often not at the table, and surely should be,” he said.

“If we’re – to skate to where the puck is going – innovating medicines for the next decade, when new ideas from our labs will ultimately reach patients from around the world, we should be,” he said. “We must be very thoughtful about the environment into which they will be born.”

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