Vas Narasimhan (the CEO, Novartis) has named it directly: becoming the number one partner in the technology ecosystem is one of Novartis’s four digital strategic pillars. That is not aspirational language dropped into an investor deck. It is explicit ecosystem intent at CEO level, and it is rare in global pharma.

Novartis has acted on it. Two remarkable architectures now exist inside the company, each sophisticated enough to be a case study on its own.

I took a look at Novatis and its intent though a different approach here, exploring the results from the Intelligent Integrated Business Ecosystem (IIBE) and raising some fairly important Ecosystem building questions on Novartis, based on my analysis as part of the Healthcare research undertaken

So these two remarkable architectures seem to have so much value left on the table. There seems much to do on taking these to a very different level

The first is the AI partnership stack — Isomorphic Labs, with its $1.2 billion commitment doubled in 2025, alongside Generate:Biomedicines, Microsoft, Schrödinger, and Deciphex. It is built to produce discovery science Novartis could not generate alone, and the “Lego blocks” architecture behind it — modular, swappable, plug-and-play — is a genuinely adaptive piece of design.

The second is the Radioligand Therapy network: five US manufacturing sites by 2028, coast-to-coast delivery, hospital-readiness programmes across more than thirty European countries, and better than 99% on-time delivery of individually prepared, time-critical cancer treatments. Novartis is the only pharmaceutical company with a dedicated commercial RLT portfolio, and the moat this creates — manufacturing scale, isotope supply relationships, regulatory depth, delivery expertise — is arguably the most durable in oncology.

Both are described, accurately, as ecosystems. And that is precisely where the greater opportunity is being left on the table in my opinion.

Integration is not orchestration

Narasimhan has called the RLT network a “fully integrated ecosystem.” He’s right that it’s integrated — the manufacturing, delivery, clinical, and discovery components inside it are coherent and well run. But integration describes how the parts of one architecture fit together. Orchestration describes something different: whether intelligence flows between architectures, compounding at each point of contact rather than stopping at it. That makes it truly valuable.

Right now, it stops.

Isomorphic’s discovery work does not connect to the RLT hospital network. Generate:Biomedicines’ outputs do not automatically route into the clinical delivery architecture. The research coming out of MD Anderson and Roswell Park does not flow back to the AI partners positioned to act on it. Each relationship is real, deep, and well managed — bilaterally. None of them talk to each other through Novartis.

This matters most in the RLT network’s operational data, which may be the least understood strategic asset the company holds. Every readiness assessment, every delivery-constraint pattern, every outcome across five manufacturing sites and thirty-plus country programmes is a signal about where the next generation of precision oncology should go. Today, that intelligence is used to optimise delivery. It is not yet reaching the discovery partners who could design against it. That gap — not a strategy gap, an architecture gap — is where the company’s most significant uncaptured value currently sits.

Why this is a CEO-level question, not an operating one

Product moats erode on schedule. Novartis knows this better than most companies in the industry right now: Entresto down 42%, Promacta down 66%, Tasigna down 59% in Q1 2026, all from expected generic entry. It’s a managed cycle, and the growth from Kisqali and Pluvicto is absorbing it. But loss-of-exclusivity pressure sharpens a different question, one that sits above any single product line: what is the next architecture of value, and does it erode the same way?

Intelligence orchestration moats don’t erode the way product moats do. They compound. A governed network that gets smarter every time RLT delivery data meets AI discovery capability, every time a partner’s output becomes another partner’s input, builds an advantage that isn’t tied to any one molecule’s patent life. No competitor can replicate bilateral partner depth as strong as Novartis has already built. But depth between Novartis and each partner isn’t the next competitive frontier — governing the space between the partners is.

That is not a call for a new strategy. Novartis already has two of the best ecosystem architectures in the industry. It is a call to connect what already exists — through what IIBE terms a Living Bridge function: a sensing and routing layer that lets capability move to where the network is learning it’s needed, rather than waiting for Novartis to notice and broker it bilaterally each time.

The specific gap, in diagnostic terms

Running Novartis through the IIBE nine-dimension ecosystem diagnostic puts the company at 70/100 — a strong score, ahead of Bayer and in the same tier as GE HealthCare, just behind Roche. The strengths cluster exactly where you’d expect: strategic intent (8/10), data intelligence (8/10), resilience (8/10), and moat architecture (8/10) are all genuine strengths.

The two weak dimensions tell the real story. Partner and actor orchestration scores 5/10 — partners create value for Novartis, but not yet for each other through Novartis infrastructure. And dynamic orchestration and evolution capacity scores 4/10, the lowest single dimension in the assessment: there is no visible sensing layer for signals emerging from the partner network, and no feedback loop routing RLT outcomes back into AI discovery. Novartis adapts to its ecosystem. The ecosystem does not yet adapt through Novartis.

That is a precise, addressable gap — not a critique of what has been built, but a description of the one layer still missing above it that has greater potential.

The question worth sitting with

Novartis’s strategy already sees the ecosystem in two dimensions — AI discovery and physical delivery. The IIBE argument is that there’s a third: the governed layer that connects them, where the compounding actually happens.

The company that first builds a genuine orchestration layer across AI discovery and physical delivery in oncology will hold an advantage no competitor can copy by building a better version of either piece alone.

Novartis is closer to that position than any other pharmaceutical company today — because it is the only one that has already built both halves.

The only question is whether the two halves get connected on purpose, or discovered to be connectable only after a competitor gets there first.

Dedicated conversations structured through a comprehensive Ecosystem architecture builds out awareness and recognition.

Perhaps Novartis needs help. Presumptuous perhaps, I don’t think so. My job is to prompt and open up options, their job is to decide. I am only a train ride away, living in Locarno – the other end of Switzerland -and it has been a while since I first visited their campus. Even better setting up a call to see where a conversation can go.

Vas Narasimhan would it make sense?

Paul Hobcraft is the developer of the Intelligent Integrated Business Ecosystem (IIBE) framework, working through Agility Innovation and Ecosystems4Innovating from Locarno, Switzerland. Full diagnostic scoring and dimension-by-dimension detail available on request.