Roivant Sciences and subsidiaries
In 2014, Ramaswamy founded the biotechnology firm Roivant Sciences; the "Roi" in the company's name refers to return on investment. The company was incorporated in Bermuda, a tax haven, and received almost $100 million in start-up capital from QVT and other investors, including RA Capital Management, Visium Asset Management, and the hedge fund managers D. E. Shaw & Co. and Falcon Edge Capital. Roivant's strategy was to purchase patents from larger pharmaceutical companies for drugs that had not yet been successfully developed, and then bring them to the market. The company created numerous subsidiaries, including Dermavant (focused on dermatology), Urovant (focused on urological disease), and China-based Sinovant and Cytovant, both focused on the Asian market.
In 2015, Ramaswamy raised $360 million for the Roivant subsidiary Axovant Sciences in an attempt to market intepirdine as a drug for Alzheimer's disease. In December 2014, Axovant purchased the patent for intepirdine from GlaxoSmithKline (where the drug had failed four previous clinical trials) for $5 million, a small sum in the industry. Ramaswamy appeared on the cover of Forbes in 2015, and said his company would "be the highest return on investment endeavor ever taken up in the pharmaceutical industry." Before new clinical trials began, he engineered Axovant's initial public offering (IPO); it became a "Wall Street darling" and raised $315 million. The company's market value initially soared to almost $3 billion, although at the time it only had eight employees, including Ramaswamy's brother and mother. Ramaswamy took a massive payout after selling a portion of his shares in Roivant to Viking Global Investors. He claimed more than $37 million in capital gains in 2015. Ramaswamy said his company would be the "Berkshire Hathaway of drug development" and touted the drug as a "tremendous" opportunity that "could help millions" of patients, prompting some criticism that he was overpromising.
In September 2017, the company announced that intepirdine had failed in its large clinical trial. The company's value plunged; it lost 75% in one day and continued to decline afterward. Shareholders who lost money included various institutional investors, such as the pension fund of the California State Teachers' Retirement System. Ramaswamy was insulated from much of Axovant's losses because he held his stake through Roivant. The company abandoned intepirdine. In 2018, Ramaswamy said he had no regrets about how the company handled the drug. In subsequent years, he said he regretted the outcome but was annoyed by criticism of the company. Axovant thereafter attempted to reinvent itself as a gene therapy company, and dissolved in 2023.
In 2017, Roivant partnered with CITIC Private Equity of the Chinese state-owned CITIC Group to form Sinovant. In 2017, Ramaswamy struck a deal with Masayoshi Son in which SoftBank invested $1.1 billion in Roivant. In 2019, Roivant sold its stake in five subsidiaries (or "vants"), including Enzyvant, to Sumitomo Dainippon Pharma; Ramaswamy made $175 million in capital gains from the sale. The deal also gave Sumitomo Dainippon a 10% stake in Roivant.
While campaigning for the presidency, Ramaswamy called himself a "scientist" and said, "I developed a number of medicines."
In January 2021, Ramaswamy stepped down as CEO of Roivant Sciences and assumed the role of executive chairman. In 2021, after he resigned as CEO, Roivant was listed on the Nasdaq via a reverse merger with Montes Archimedes Acquisition Corp, a special purpose acquisition vehicle. In February 2023, Ramaswamy stepped down as chair of Roivant to focus on his presidential campaign.
Ramaswamy remains the sixth-largest shareholder of Roivant, retaining a 7.17% stake. During Ramaswamy's time running Roivant the company had never been profitable.