"Will the axe fall"? Remember Novartis Pharma US primary goal/duty/mandate is to deliver the numbers mandated by Switzerland. If growth in sales isn't happening due to losartan pressure on Diovan, Aricept generic vs Exelon Patch, total number of prescriptions down for all medicines ( which was the case in 2010), fewer people have insurance due to jobless numbers, Gilenya growth slower than budgeted, on and on, what's left is cutting costs. They will soon, if not already, have enough sales numbers to make decisions on necessary cuts. Rember whether it's via increased sales or cuts; SWITZERLAND ALWAYS GETS THEIRS!