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Richard Saynor’s journey to becoming a self-described patent destroyer was largely by accident. Saynor has been CEO of Sandoz since 2019, but he started his career as a pharmacist before finding the job frustrating and leaving. He eventually became a sales rep in the drug industry, working his way up the ranks in a 35-year career to lead one of the world’s largest generics businesses. In a wide-ranging interview with Endpoints News , Saynor shared his views on President Donald Trump’s impact on the industry, preparing for the launch of generic GLP-1s, and whether Mark Cuban Cost Plus Drug Company actually competes with generic drugmakers. Generics may seem like a boring, if vital, part of the drug business. But Saynor is a colorful, outspoken leader who seemingly enjoys the role of pharma’s heel. (When it comes to the industry’s concerns over the US proposal for most favored nation pricing, he quipped: “Sell a few jets and have a little less art.”) More importantly, Wall Street is buying what he’s selling. Since Sandoz spun out of Novartis in October 2023, its share price is up over 80%, meaning the company is valuing at over $22 billion. Even as other legacy generic manufacturers like Teva have invested more in branded drug R&D, Saynor has kept Sandoz focused on generics and biosimilars. This conversation has been edited for length and clarity. Andrew Dunn: Before returning to Sandoz, you were at GSK for nearly nine years. What drew you back to generics? Richard Saynor: I even got hired at GSK to set up a generics company. That was what, 15 years ago, when it was fashionable for originators to set up generics companies. It was an unmitigated disaster. Like most originator companies, they’re not very good at running generics companies. I learned a lot of different things, more about leading across big, complicated organizations. And then I literally got a phone call on a Monday from [Novartis CEO] Vas [Narasimhan], saying, “Would you like to come back?” I met him on a Tuesday or Wednesday, and I had a contract signed on the Friday. It was literally Monday to Friday — soup to nuts. Dunn: Why are pharmas so lousy at running generics? Saynor: There’s a natural tension. My job is to destroy patents. I’m not saying I don’t support patents. Patents are vital to drive innovation, but ultimately, we need to challenge and bring our products to market as soon as possible. Also, the speed of execution. This is much more like an FMCG [fast-moving consumer goods] business. The margins are thinner. Things happen much more quickly. Whereas if you’re an originator, you know 15 years from now when your patents are going to expire. Your train crashes tend to be coming at you very slowly and that drives a different kind of cultural behavior. The pharma industry is in constant pursuit of perfection, no matter how many McKinsey or BCG consultants. They have the luxury of time and resource. For a lot of our time, 80% is good enough. I’m not talking about quality, but in terms of business decisions, it’s a very different kind of beast. Dunn: You plan to potentially launch a generic GLP-1 in Canada and Brazil in 2026. What do you expect for the biosimilar market, both there and eventually in the US? Saynor: Canada, we filed and are waiting for approval once the data exclusivity expires sometime in Q1 next year. Interesting market. Novo never filed a patent in Canada. Never know why. I’m sure someone’s lost their job, but never mind. It’s the second-largest semaglutide market in the world. Dunn: That’s pretty remarkable. Saynor: You gotta ask why. I don’t think Canadians are disproportionately large. There’s clearly a dynamic, like insulin, with cross-border business. It’s going to be interesting how that evolves. But, look, I’ve got no idea. In my 35 years, I’ve never launched a product where the originator can’t meet the demand. In Brazil, the biggest prescribers are dentists. Everyone says, “Why dentists?” They do aesthetic work, and then you have your Botox, and then you want a bikini body. It’s behaving like an OTC consumer brand. Imagine selling this, rather than $300, at $50. Anybody over the age of 40 in Brazil will probably want to be on that. I’ve got no idea how the US will evolve. To be fair, we’re talking 2032, 2033, once we’ve had the patent fight and the usual games we have to play. This is really at least a 10-year journey, of which the start of the experiment is Canada. I’ve not given any guidance. I quite honestly have no idea how to forecast this. Dunn: I’m curious what you make of the Mark Cuban Cost Plus Drug Company. They’re very publicly undercutting the market price for generic drugs. Is that serious competition for Sandoz? Saynor : No. It’s not the market price of the manufacturers. It’s the market price of the distributors and the PBMs [pharmacy benefit managers]. If I sell a pack of antibiotics at 15 cents, you’ll pay $1.00. Someone else is making 85 cents on my 15 cents. What he’s trying to do is not expose what the generic industry is charging because, quite frankly, this is one of the worst markets in the world for small molecule generics. But what he’s exposing is the distortion and the power of the GPOs [group purchasing organizations] and the PBMs and their ability in terms of how they price. Dunn: Why can’t Sandoz do something similar? It seems like there are benefits in rebuilding some public trust with transparency and clarity on what it costs to make and exactly what one pays for a medicine. Saynor: It’s a good question. That’s one no one has ever asked me. It would have been impossible to do that under Novartis for all sorts of reasons. I don’t think they would have wanted a spotlight shined in that space. And now, to make that move, I’m biting the hand that feeds me. My biggest customers, unfortunately, are CVS, Optum, etc. I have a complicated relationship. On one hand, I can see the distortion that they have. On the other hand, I’ve got to run a business. Dunn: In December, you said you were “quite optimistic” about the incoming Trump administration. You said that “potentially more change will happen for our industry, and that is a good thing.” Were you wrong in your optimism? And do you think the Trump administration is doing the right kind of disrupting? Saynor: I wouldn’t say I’m wrong. I’m still optimistic. The top five branded drugs cost US patients more than all of the generics and biosimilars put together. We’re part of the solution, not part of the problem. To the administration’s credit, access has been pretty good. Keren Haruvi, who leads our US business — she’s chairwoman for the [Association for Accessible Medicines]. She’s been talking to the administration pretty much weekly over the last few months. I think what [Trump] wants to do is put out relatively simplistic messages and then force change. We will see. On tariffs, sticks will not change our behavior. We make next to no money. So why would I invest hundreds or billions of dollars to make even less money by onshoring? We’re the only antibiotic manufacturer in the Western world. It would cost me $2 billion to $3 billion and maybe three to five years to build a new factory in the US. Yet I would still be undercut by Asian players who sell at cents on the dollar. Unless there’s a structural benefit, my board is never going to approve that kind of spending on capital. You need, then, to start talking about carrots. Reinforce Hatch-Waxman. Reward me for challenging patents and bringing products to the marketplace. Look at restricting patent abuse. But if it’s just a tariff, two things will happen: Either we’ll try and put the price up. And if we can’t put the price up, and we’re losing money, we’ll withdraw the product. It’s that simple. Dunn: Former FDA head Scott Gottlieb recently wrote about his concerns over the dismissal of a generic drug policy group at the agency. Do you share his concern about the impact of those FDA cuts? Saynor: I’m concerned. I was talking to the US team, and there’s something like 2,000 assessors currently recused because they’re looking for other jobs. They’ve got rid of a lot of people, but even the people who stayed all want to leave. That’s a huge problem. You’ll see delays, and that can’t be good for the innovator. And it also clearly isn’t good for the generics and biosimilars industry. Either policy won’t help us clarify what we need to do to get a product approved or products won’t get approved in time, which means patients will be paying a premium for longer than they have to. Dunn: Is that impacting you today? Saynor: No. Not today. But it’s like going bankrupt. It happens slowly until it happens quickly. You’ll start seeing approvals start taking a little bit longer. Am I worried as a company? No, because the US is a relatively modest component of our total business. But I think it’s a shame for US patients.

Since Bernard Ravina’s medical training in neurology in the 1990s, there have been few new therapies that treat a movement disorder known as dystonia. “Nothing fundamentally has changed for these patients since then,” the drug development executive said. About two years ago, Ravina joined Atlas Venture as an entrepreneur-in-residence to help fix that. And now the company he helped found — Vima Therapeutics — has raised a $60 million Series A and expects to be in Phase 2 by the end of this year, he exclusively told Endpoints News . A handful of neurotoxins like AbbVie’s Botox are approved for certain forms of dystonia, which impairs muscles and causes them to unexpectedly contract. Other treatments include brain surgery or deep brain stimulation, but “very few people want that,” the Vima CEO said. Using Botox or other neurotoxins requires repeat injections and can only address specific muscles, but dystonia can affect multiple areas of the body. Tremors, voice issues and difficulty chewing are some signs of the chronic neurological disorder. Severe cases can lead to joint dislocations and fractures, Ravina said. Vima aims to deliver an oral treatment with VIM0423, which is currently in Phase 1. The experimental once-a-day drug targets the brain’s muscarinic cholinergic receptors. “You’ve seen the renaissance of muscarinic cholinergic receptor-targeted drugs in psychiatry with Karuna,” Ravina said, referring to the company that Bristol Myers Squibb acquired for its schizophrenia medicine Cobenfy. “There’s a role for those same areas of the brain involved in movement disorders. People have tried to drug this class. In psychiatry, you’re agonizing, enhancing the activity of muscarinic receptors. For movement disorders, it’s antagonizing, inhibiting that activity.” Muscarinic-targeting drugs have been used for movement disorders for decades. In 1949, the FDA approved a muscarinic antagonist known as trihexyphenidyl to treat certain forms of Parkinson’s disease. But most of these drugs have tolerability issues. “What we’ve been able to achieve is a way to selectively target the right muscarinic cholinergic receptors to drive efficacy but to really minimize those safety concerns [and] enhance tolerability,” Ravina said. The upcoming Phase 2 will enroll patients with severe dystonia that affects multiple parts of their bodies. The trial will likely implement three or more months of treatment since it takes about that length of time “for the full benefit to be seen,” according to Ravina. The therapy should work in both adults and children, he said, noting the company is deciding “the right timing” for bringing children into clinical studies of VIM0423. The initial $60 million comes from Atlas Venture, Access Industries and Canaan, which are “committed to making sure that we have capital for completing the Phase 2,” he said. Atlas, one of the main biotech incubation venture firms, just had success in neurology this month. Vigil Neuroscience, one of the companies it founded to work on experimental medicines from Amgen, is being bought by Sanofi for $470 million. Ravina joined Atlas in late 2022 after stints as chief medical officer at neuro biotechs Praxis Precision Medicines and Voyager Therapeutics. “Why hasn’t anybody done this before? And my answer to the team at Atlas was, when was the last time you had a movement disorders doc come and be an entrepreneur-in-residence at a venture capital firm?” Bernard said. “It just doesn’t happen a lot.” Ravina hired Judith Dunn, a former president of R&D at Fulcrum Therapeutics and global head of clinical development at Roche, to lead R&D at Vima. The team may explore dystonia manifestations in other conditions down the road, with Ravina pointing out that about 50% of children with cerebral palsy have a dystonic phenotype. Like other biotechs working through the current funding environment, the 15-employee startup plans to take it one step at a time, just as its Greek name suggests. Vima means “step” or “pursuit” in Greek. It took about six to eight drives between Boston and New York for Ravina and his wife to come up with the biotech’s name. “And a whole lot of scrap paper in the glove compartment,” he said.