Billionaire Healthcare Investor Alex Denner’s Hedge Fund Has 75% of Its Assets in These 3 Stocks 

If you work in the biotech industry, you might know the name Alex Denner. If not, his name probably doesn’t ring a bell. 

Denner is the CEO and CIO of Sarissa Capital Management, a Greenwich-based hedge fund that invests exclusively in healthcare companies. Founded in 2013, Sarissa Capital finished 2024 with $927 million in assets under management and $323 million in Q4 2024 13F assets. 

I can’t say whether Denner was the first activist healthcare investor, but he certainly has become one of the better known in the sector. 

Before founding Sarissa, he worked for Carl Icahn, handling healthcare portfolio management for the iconic investor, investing in well-known names such as Biogen (NASDAQ:BIIB) and Forest Laboratories, which was acquired by Allergan in 2014, itself acquired by AbbVie (NYSE:ABBV) in 2020.

He has been involved in some of the biggest healthcare transactions in the past two decades. These three stocks account for 75% of his hedge fund’s $323 million in assets. 

Here’s why. 

Key Points About This Article:

• Billionaire healthcare investor Alex Denner’s Sarissa Capital Management owns just eight stocks. Three of them account for 75% of its portfolio. 
• The hedge fund’s largest holding is healthcare royalty company Innoviva (NASDAQ:INVA). 
• Denner’s two other largest positions account for an additional 36% of his firm’s assets.  
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The Biggest of 8 Holdings

Sarissa Capital finished the fourth quarter with just eight holdings, an average of $40.4 million per stock. 

Considering some billionaire investor hedge funds, that’s not a massive amount. Chase Coleman III’s Tiger Global Management’s average per stock at the end of December was $540 million, 13 times larger.  

However, the largest of the eight, Innoviva (NASDAQ:INVA), a healthcare royalty investor, accounted for 39.11% of the hedge fund’s portfolio as of Dec. 31. Its 7.28 million shares represented an ownership stake in Innoviva of 11.62%. As of April 18, 2024, Sarissa Capital was the second-largest shareholder in the royalty business, behind only BlackRock (NYSE:BLK), at 16.2%. 

Denner first invested in Innoviva stock in Q3 2016. WhaleWisdom.com estimates that Sarissa Capital paid an average price of $13.07. However, when a hedge fund owns a stock for seven years, there is usually movement in and out of the stock to book profits.

For example, it owned 6.61 million shares two years ago, adding more over the subsequent quarters. Go back five years, and it owned 6.24 million shares. 

Denner’s latest move came after the close of the fourth quarter. The hedge fund sold 2.04 million shares in the first week of March at prices between $17.52 and $17.69, generating proceeds of approximately $36 million. The share sale reduced Sarissa Capital’s ownership in Innoviva to 8.36% and its contribution to the hedge fund’s assets to 31.91%, 720 basis points lower. 

However, Sarissa Capital’s largest stake remains 676 basis points higher than second-largest holding, Ironwood Pharmaceuticals (NASDAQ:IRWD).

Ironwood Is a Much Bigger Risk

The beauty of royalty businesses such as Innoviva is that they generate relatively consistent revenue and income streams from funding healthcare product developers. They receive capital to continue investing in R&D, and in return, Innoviva receives an agreed-upon percentage of future revenues. In 2024, Innoviva’s revenue increased 16% to $358.7 million.

Ironwood, on the other hand, is a penny stock currently trading below $1.50. Its 52-week high of $9.23 was a year ago. It focuses on developing and commercializing therapies to treat gastrointestinal (GI) issues and other rare diseases. 

Its claim to fame is Linzess, the company’s product to treat adults with irritable bowel syndrome with constipation (IBS-C) or chronic idiopathic constipation (CIC). It’s not a glamorous product but definitely a lifesaver for those suffering from IBS.

Although its share of Linzess sales in the U.S. fell 21% in 2024 to $340.4 million, it could still generate $5.9 million in non-GAAP profits, considerably better than a year earlier. 

However, in late January, the company announced that it was laying off half its employees to reduce costs and focus on getting its new drug for treating SBS (short bowel syndrome) approved by the FDA (Food and Drug Administration). In 2023, it paid $1 billion for the late-stage R&D on liraglutide. 

At the same time, it ended the development of apraglutide for the treatment of GvHD (graft-versus-host disease). Investors didn’t like the news. Ironwood shares are down 70% in 2025. 

As of March 7, 13D, Sarissa Capital’s Ironwood accounted for 22.49% of its assets. The hedge fund first acquired shares in Q4 2017. Sarissa Capital owns 10.24% of the company.

The Third-Largest Holding Is Much Newer

The final of the hedge fund’s most significant holdings is Neurocrine Biosciences (NASDAQ:NBIX). 

It owns 309,116 shares of the drug development company Neurocrine. It specializes in “discovering and developing life-changing treatments for patients with debilitating neurological, neuroendocrine, and neuropsychiatric disorders.” 

It is also the most profitable. 

In 2024, it earned $656.3 million ($6.33 a share) from $2.36 billion in revenue, 40% higher than the previous year. Almost all of its product sales were from Ingrezza, a drug that treats tardive dyskinesia, a disorder characterized by involuntary repetitive body movements. 

Other treatments are also in the approval pipeline. Not surprisingly, it has 3,223 Stocktwits followers, a decent amount for a niche healthcare business. 

Sarissa Capital sold off about 25% of its holdings in the fourth quarter, when prices were in the $130s, well above their current levels.

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