Sanofi Just Fired Its CEO. The Replacement Is a Familiar Face.

After leaving Sanofi, she climbed the ranks at Merck KGaA. She became CEO in May 2021, making her the first woman to lead a DAX40 company in Germany. At Merck KGaA, she steered the company through the tail end of the pandemic, executed what the company called a "string-of-pearls" strategy of targeted acquisitions and divestitures, and shifted the healthcare portfolio toward oncology and immunology.

Her track record suggests she's a builder, not a dreamer. Board Chairman Frédéric Oudéa praised her "strategic vision, execution rigor, and transformation skills." Translation: she finishes what she starts.

When she officially takes the helm after Sanofi's Annual General Meeting on April 29, she'll become the company's first female CEO and one of only two women running a major large-cap pharma company globally.

The Awkward In-Between

From February 17 until Garijo's official start, Sanofi has an interim CEO: Olivier Charmeil, the company's Executive Vice President of General Medicines and an executive committee member since 2011. It's a caretaker arrangement; keep the lights on, don't redecorate.

But the real question isn't about the transition period. It's about what happens after.

What Changes Under Garijo?

Sanofi's pipeline has over 80 clinical-stage projects, with 34 in Phase 3 or regulatory submission. The rare disease portfolio alone has more than 20 clinical-stage drugs, including treatments for Gaucher disease, Fabry disease, and achondroplasia. That's a deep bench.

The worry is whether Garijo shifts the company's center of gravity. At Merck KGaA, she reorganized R&D, forged global alliances, and expanded into high-growth markets like the US and Japan. She diversified. She went bigger. If she brings that same playbook to Sanofi, it could mean more emphasis on higher-volume diseases (think oncology, immunology, and potentially even obesity) and less focus on the rare disease heritage that defines the company's identity.

There's no announcement yet about an obesity push, and Sanofi's rare disease pipeline looks stable for now. But pipelines change when CEOs change. That's just how pharma works.

Garijo's mandate from the board is clear: boost R&D productivity, tighten governance, and drive innovation. In plain English, that means she needs to find the drugs that will replace Dupixent's revenue before the patent cliff arrives. She has roughly five years to do it.

A Broader Pattern

Sanofi isn't the only pharma giant swapping captains. GSK's Emma Walmsley stepped down after nine years, replaced by Luke Miels in January 2026. CSL ousted its CEO the same month as Sanofi. Even Pfizer faced activist pressure from Starboard Value in 2024, though CEO Albert Bourla kept his job while his chief science officer did not.

The pattern is unmistakable: pharma boards are losing patience faster than ever. Patent cliffs are looming across the industry. Blockbusters are aging out. And shareholders want CEOs who can deliver the next generation of drugs, not just ride the last one's coattails.

Hudson got six years. The generation before him might have gotten ten. Garijo should take note.

The Bottom Line

Sanofi's board made a calculated bet. They swapped a CEO who grew sales but couldn't diversify the pipeline for one who's already proven she can restructure R&D, integrate acquisitions, and navigate complexity at scale.

Garijo knows Sanofi's DNA — she helped build part of it. She knows rare disease, she knows immunology, and she knows what it takes to transform a sprawling organization. The question is whether she'll preserve what makes Sanofi special or reshape it into something more conventional.

Either way, the clock is ticking. Dupixent's patents won't wait for anyone, not even Sanofi's first female CEO.

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