NGI-226

Novartis said further generic erosion of three blockbuster medicines, including its top-selling heart failure drug Entresto, will leave a $4 billion hole in its sales this year. Generic competition started to make a mark in the fourth quarter, as Entresto sales plummeted 45% from the year-earlier period in constant currencies to $1.25 billion. Sales of thrombocytopenia treatment Promacta plunged 63% to $226 million, while blood cancer drug Tasigna declined 58% to $179 million. Even with the three generic rivals entering the market around mid-2025, Novartis was able to produce total fourth-quarter sales of $13.3 billion, relatively steady compared to the previous year. As for the coming full year, the company is predicting an increase in the low-single digits. “We expect to grow in 2026 through the largest patent expiries in Novartis history,” CEO Vas Narasimhan told the media. “This demonstrates the strength of our growth drivers and the strength of our pipeline.” Novartis’ revenue forecast suggests 2026 sales of $56.2 billion to $57.9 billion, Jefferies analysts wrote in a same-day note. At the same time, Novartis foresees core operating income declining by low-single digits, according to its latest earnings report . Full-year 2025 sales were up 8% from the year before, at $54.5 billion, supported by two products that passed the $1 billion mark for the first time. Blood cancer drug Scemblix pulled in $1.29 billion in 2025, up 85% from 2024. And sales of cholesterol medicine Leqvio grew 57% to hit $1.19 billion. Investors seemed to be reassured by these figures. The company’s share price remained flat on the Swiss exchange early Wednesday. On the pipeline side, Novartis discontinued several early- to mid-stage programs following a review. The majority of culled candidates were in Phase 1 development for cancer, namely: Novartis also dropped a candidate for tendinopathy called NGI226 that was in Phase 2 development. A company spokesperson wrote in an email that the cuts were “balanced by the addition of new projects entering our pipeline.” Novartis also slightly delayed some of its highly anticipated R&D milestones. It now expects to report Phase 3 data for pelacarsen in this year’s second half, as opposed to the first half, according to an earnings presentation . The drug is for certain patients who have elevated levels of lipoprotein(a). The company also said Phase 3 data for its rare kidney disease drug zigakibart would come in the first half of 2027, instead of this year. Novartis amended the protocol of a trial in IgA nephropathy so that kidney biomarker data would come at the same time as results on the primary endpoint of proteinuria, which is considered a more robust marker of kidney function. Elsewhere, Narasimhan said Novartis was still “very active” when it came to deals in China. Last month, it spent $50 million upfront to license a radiopharmaceutical candidate from Zonsen PepLib Biotech. Oncology will be a core focus for Novartis’ M&A deals going forward, Narasimhan told analysts on a separate earnings call. On the media call, the CEO described China’s biotech environment as “very important” and “exciting,” adding that US and European regulators could take lessons from some of the ways China has “streamlined regulatory oversight” and “modernized its clinical trial enrollment approach.” Novartis isn’t the first company to double down on its interest in China. Last month, AstraZeneca announced it would spend $15 billion on manufacturing and R&D projects in China through 2030. In December, Novartis said it had reached a deal with President Donald Trump’s administration to lower drug prices in the US. That deal included an agreement to launch future medicines with “comparable prices” across high-income countries. Narasimhan told analysts the company is “working through strategies” for anticipated launches, including its Sjögren’s disease candidate ianalumab, which is expected to launch in the G7 countries next year. Editor’s note: This article was updated to add comments from Novartis’ analyst call.