Patent losses hit Novartis hard, but CEO has a plan

The loss of market exclusivity for a trio of big-selling drugs in the last quarter of 2025 dragged down Novartis sales, but chief executive Vas Narasimhan says the company is equipped to ride out "the largest patent expiry in Novartis history."

The cumulative impact of losing protection for heart failure drug Entresto (sacubitril/valsartan), cancer therapy Tasigna (nilotinib), and platelet booster Promacta/Revolade (eltrombopag) meant that Novartis' fourth-quarter sales fell 1% to $13.3 billion.

The hangover will continue through 2026 as well, with the Swiss group now predicting a fall in its operating profit this year and low single-digit sales growth. However, Narasimhan is confident that growth brands like Kisqali (ribociclib) for breast cancer, multiple sclerosis therapy Kesimpta (ofatumumab), and radiopharmaceutical Pluvicto – along with an expanding pipeline – mean that it will emerge stronger from this challenging period

He said that despite a $4 billion hit to sales in 2026 from the patent losses, the company "remains well on track to deliver our mid-term guidance." The company is modelling 5% to 6% annual sales growth from 2027 to 2030.

Novartis has been splashing out on a series of bolt-on deals to build out its pipeline, $30 billion in 2025 alone, and is poised to complete a $12 billion takeover of RNA drug developer Avidity Biosciences in the next few months.

Among its current growth brands, leukaemia drug Scemblix (asciminib) and cholesterol-lowerer Leqvio (inclisiran) crossed the $1 billion sales threshold for the first time last year, coming in at $1.3 billion and $1.2 billion, respectively, while Pluvicto passed the $2 billion mark.

There were also encouraging uptake signs for Novartis' IgA nephropathy (IgAN) portfolio – led by Vanrafia and Fabhalta with third candidate zigakibart following after in late-stage development – as well as chronic spontaneous urticaria (CSU) therapy Rhapsido (remibrutinib), which has a long list of other potential indications and "multi-blockbuster potential," according to Novartis.

Narasimhan said the company is expecting seven pivotal trial readouts this year and 28 regulatory filings or approvals involving new drugs like immunology therapy ianalumab, Ionis-partnered cardiovascular drug pelacarsen, and Avidity's antibody-oligonucleotide conjugate (AOC) delpacibart zotadirsen (del-zota) for Duchenne muscular dystrophy (DMD).

Novartis needs that pipeline to deliver as it faces another big patent expiry – for $6.7 billion immunology drug Cosentyx (secukinumab) – around the end of the decade.