Novartis weathers Entresto slump with return to growth

Novartis saw its sales grow 3% in the second quarter, returning to growth after a 1% fall in the first quarter caused by generic competition to heart failure drug Entresto.

Revenues came in at $14.4 billion, with a 50% decline in Entresto (sacubitril/valsartan) sales to $1.2 billion offset by a robust performance for half a dozen growth products, led by breast cancer treatment Kisqali (ribociclib), which grew 43% to almost $1.7 billion thanks to a move into earlier-stage disease.

Chief executive Vas Narasimhan said it was a "solid quarter" for the group, with strong contributions from Kesimpta (ofatumumab) for multiple sclerosis, prostate cancer radiopharmaceutical therapy Pluvicto (177Lu vipivotide tetraxetan), and leukaemia therapy Scemblix (asciminib), which recently moved into the first-line setting.

He also pointed to the "early trajectory" of chronic hives treatment Rhapsido (remibrutinib) and new intrathecal spinal muscular atrophy (SMA) gene therapy Itvisma (onasemnogene abeparvovec), which has expanded the eligible patient population addressed by its original intravenous Zolgensma formulation.

Novartis has previously said that all of the aforementioned products, along with cholesterol-lowering therapy Leqvio (inclisiran) and rare kidney disease therapy Fabhalta (iptacopan), have peak sales potential of between $3 billion and $10 billion.

"We also made meaningful pipeline progress, highlighted by updated Kisqali overall survival data in early breast cancer and the FDA accelerated approval submission for del-zota in [Duchenne muscular dystrophy]," added Narasimhan.

"We are on track for multiple important readouts ahead in the second half, and remain on track to deliver our full-year guidance and mid-term outlook."

The company – whose shares rose almost 3% after the second-quarter announcement – is modelling low single-digit sales and operating profit growth for the full year.

Along with the loss of Entresto market exclusivity, Novartis is also dealing with generic competition to cancer therapy Tasigna (nilotinib) and platelet booster Promacta/Revolade (eltrombopag), both of which were former $2 billion-plus brands.

It will also lose patent protection for Kisqali and immunology and inflammation (I&I) blockbuster Cosentyx (secukinumab) – which grew 10% to $1.82 billion in the second quarter – between now and 2030.

Novartis has been preparing for the continuing patent cliff with a series of acquisitions, completing or agreeing takeover deals for Avidity Biosciences, Pikavation Therapeutics, Excellergy, and Myricx Bio since the start of the year.