On January 12, 2026, Novartis wrote a large cheque for a problem that sounds almost too basic for modern biotech: delivery. The Swiss drugmaker signed a licensing and collaboration deal worth up to $1.7bn with privately held SciNeuro Pharmaceuticals to develop antibody treatments for Alzheimer’s disease — built around SciNeuro’s “shuttle” technology designed to move drugs across the blood–brain barrier.
If this feels like plumbing rather than science, that is the point. Alzheimer’s research has spent decades hunting the “right” target — amyloid, tau, inflammation, synapses, metabolism — and has mostly returned disappointment. Even now, with two amyloid-clearing antibodies approved in the US, the field is learning a blunt lesson: it is hard to treat the brain if you cannot reliably reach it.
The deal, in plain numbers
SciNeuro will receive $165mn upfront, plus research funding, and could earn up to $1.5bn in development, regulatory and commercial milestones — and tiered royalties if a product makes it to market. Novartis will work with SciNeuro in early development and then take over global development and commercialisation. The deal is expected to close in the first half of 2026, subject to customary conditions.
This is not Novartis dabbling. It is a clear signal that big pharma increasingly sees blood–brain barrier engineering as a platform worth owning — a potential “moat” that could outlast any single Alzheimer’s molecule.
Why the blood–brain barrier is suddenly centre stage
The blood–brain barrier (BBB) is the brain’s security system: tightly packed cells lining blood vessels that block most large and many small molecules from entering brain tissue. It keeps pathogens and toxins out, but it also blocks many drugs.
For biologics, the challenge is extreme. A 2025 review notes that only about 0.1% of intravenously injected monoclonal antibodies reach the human Alzheimer’s brain, with estimates in animals often in the 0.01%–0.1% range.
That tiny fraction has huge downstream consequences. If only one-thousandth of your antibody reaches the brain, you may be tempted to raise the dose — which can increase systemic exposure and side effects. And in Alzheimer’s, side effects are not theoretical.
The approved drugs proved a point — and exposed the limits
The arrival of anti-amyloid antibodies has changed the conversation from “nothing works” to “some things work, modestly, in the right patients — at a cost.”
- Leqembi (lecanemab) has a US list price of $26,500 per year, according to Eisai.
- Kisunla (donanemab) has been priced in the US at $695.65 per vial, with an annualised 12-month cost often framed around $32,000.
Uptake has been slower than early hype implied. One snapshot: Q1 2025 global sales reported by Fierce Pharma put Leqembi at $96mn versus Kisunla at $21.5mn.
And BioArctic (which receives royalties via Eisai) said preliminary global revenue for Leqembi reached JPY 18bn in Q3 2025.
Cost is only one part. The bigger friction is operational complexity — infusions, diagnostic confirmation, and repeat brain imaging — plus safety monitoring. In the pivotal CLARITY-AD trial, lecanemab’s incidence of ARIA-E (brain swelling) was 12.6% and ARIA-H (microbleeds/hemorrhage) was 17.3%.
For donanemab, a JAMA Neurology paper reports ARIA-edema/effusions occurring in the ~20%–24% range (study details vary by analysis and timeframe).
These are not rare nuisances. They shape who gets treated, how aggressively, and how comfortable clinicians feel about expanding use beyond narrow labels.
Which brings us back to delivery.
What a “brain shuttle” actually is
The phrase sounds like marketing, but the principle is straightforward: hitchhike on a transport system the BBB already uses.
One commonly used strategy is receptor-mediated transport (also called receptor-mediated transcytosis). The idea is to engineer a therapeutic — often an antibody — to bind to a receptor on BBB cells (for example, the transferrin receptor, which normally helps move iron-related cargo). The drug is then carried across the barrier in a controlled way.
BioArctic, for instance, describes its BrainTransporter platform as using transferrin receptor-mediated transport, and has claimed up to 70-fold higher penetration of antibodies over the BBB in its presented data.
SciNeuro’s announcement is less specific in public, but it says its Alzheimer antibody programme incorporates a proprietary BBB shuttle technology to enhance brain delivery — positioned as a differentiator versus existing amyloid-beta antibodies.
The logic is seductive: if you can get more drug into the brain at a lower dose, you might improve efficacy, reduce side effects, or both. And if the delivery system is modular, you might use it across multiple targets — amyloid today, tau tomorrow, perhaps inflammation or synaptic pathways later.
The Roche shadow: trontinemab and the “delivery arms race”
Novartis is not alone in this thinking. Roche has been pushing a similar concept with trontinemab, an amyloid antibody linked to its Brainshuttle technology.
In July 2025, Roche said its Phase Ib/IIa Brainshuttle AD study showed rapid amyloid clearance, with 91% of treated participants becoming amyloid PET negative and ARIA-E below 5%, and it outlined Phase III programmes (TRONTIER 1 and 2) planned to start in 2025.
That claim, if it holds up in Phase III, matters for two reasons.
First, it hints at a future where amyloid clearance could be achieved with lower systemic exposure, potentially improving safety and convenience — two of the biggest bottlenecks in the current generation.
Second, it suggests that “better amyloid drugs” may not just mean better binding or better biology. They may mean better logistics inside the body.
Novartis is building a BBB portfolio, not a one-off experiment
The SciNeuro deal looks even more deliberate when you place it alongside Novartis’s recent BBB moves.
- In July 2025, Sironax said Novartis signed an agreement to evaluate its Brain Delivery Module platform, with Sironax eligible for up to $175mn in upfront and near-term payments and Novartis holding an option to acquire full global rights to the platform.
- In August 2025, BioArctic announced an option, collaboration and license agreement with Novartis using its BrainTransporter technology, including an upfront payment of $30mn plus milestones and royalties.
- Now, in January 2026, SciNeuro adds another approach — again focused on the BBB, again linked to Alzheimer’s, and again with Novartis taking global control after early-stage work.
Seen together, this looks less like enthusiasm for one promising antibody, and more like a strategic grab for delivery infrastructure.
If Alzheimer’s becomes a long-term market — and demographics suggest it will — platform advantages could be worth more than a single “best-in-class” molecule.
Why delivery could be the real “moat” in Alzheimer’s
The Alzheimer’s burden is staggering and rising.
The WHO estimates more than 55mn people live with dementia globally, projected to reach 78mn by 2030 and 139mn by 2050.
The global cost was estimated at $1.3tn in 2019, with projections that it could reach $1.7tn by 2030 — or $2.8tn if adjusted for increasing care costs.
Those numbers explain why pharma keeps coming back, despite the failures.
But the market also punishes marginal gains. If your drug is only modestly better, or only modestly safer, health systems will ask hard questions. So will families.
Delivery platforms can change the calculus by doing something less glamorous than inventing a new mechanism: they can make existing mechanisms workable. A brain shuttle could:
- Improve brain exposure of antibodies and other biologics, potentially raising efficacy without raising the dose.
- Lower systemic dosing, which could — in theory — reduce peripheral side effects and perhaps some safety risks tied to exposure. (This is a hypothesis, not a guarantee.)
- Enable new targets that have been abandoned because they could not be delivered effectively.
- Create a reusable platform: once the delivery module is validated, it becomes a multiplier across multiple programmes.
In other words, delivery is not just about getting one drug across the BBB. It is about turning the BBB from a scientific obstacle into a defensible business asset.
What could go wrong: brain shuttles are not magic
The BBB has humbled many clever ideas, and shuttles come with their own constraints.
First, biology changes with age and disease. Many shuttle strategies rely on receptors such as transferrin receptor (TfR). But receptor expression and transport capacity can vary with age and pathology — exactly the settings relevant to Alzheimer’s.
Second, the body is full of “off-ramps.” A shuttle that binds a widely expressed receptor may be taken up by other organs, changing biodistribution and sometimes creating new safety questions. Even in controlled studies, transport vehicles can show complex organ localisation patterns.
Third, the engineering has trade-offs. Bind too strongly and the therapeutic may get stuck at the barrier. Bind too weakly and transport may not improve. The “sweet spot” can be hard to reproduce across species — and Alzheimer’s has a long history of mouse success failing in humans.
Finally, regulators and payers will care about outcomes, not PET scans. Amyloid clearance is becoming easier to show; meaningful cognitive benefit is harder — and slower — to prove. A better delivery system must translate into real-world improvement, not just prettier biomarker charts.
The bigger shift: from single targets to systems thinking
The SciNeuro deal lands in a moment when the Alzheimer’s field is moving toward the view that the disease is not one pathway gone wrong, but multiple pathways interacting — a lesson oncology learned decades ago.
If that is true, then delivery matters even more. Combination approaches and multi-target strategies will only be practical if drugs can reach the brain reliably, safely, and at scale.
That makes Novartis’s $1.7bn bet look less like a gamble on “another amyloid antibody” and more like a wager on how Alzheimer’s drug development will be done in the next decade: less like a single miracle molecule, more like a layered stack of biology, diagnostics, and — yes — transport.
In Alzheimer’s, the next leap may not come from finding a smarter weapon. It may come from finally building a better way to get that weapon to where it needs to be.
