Novartis Navigates Challenges and Opportunities in Q3 2025

Novartis, the Swiss pharmaceutical giant, reported a mixed bag of results in its third quarter of 2025, showcasing both the challenges faced by its established blockbusters and the promising growth of its newer drugs. Despite headwinds, the company managed to deliver 7% groupwide sales growth, reaching $13.9 billion for the quarter.

Entresto and Cosentyx Face Headwinds

Novartis' top-selling heart therapy, Entresto, experienced its first decline following the entry of generic competition in the U.S. market. Sales of Entresto dropped 1% year-over-year to $1.88 billion in Q3, a significant slowdown from the 22% growth observed in the previous quarter. The impact was particularly pronounced in the U.S., where sales fell 13% to just under $800 million.

Similarly, Cosentyx, Novartis' second-best-selling product for inflammatory and autoimmune diseases, saw a 1% dip in sales to slightly below $1.7 billion. This decline was attributed to a one-time $74 million rebate adjustment in the U.S. and pricing discounts in international markets. Additionally, Cosentyx faces new competition in the hidradenitis suppurativa (HS) market from UCB's Bimzelx, which entered the field in November 2024.

Newer Drugs Drive Growth

Despite setbacks with its established products, Novartis' newer medicines showed impressive growth, offsetting the losses from Entresto and Cosentyx:

1. Kisqali, a breast cancer treatment, led the charge with a 68% year-over-year increase, bringing in $1.33 billion. The drug's success is largely due to its early breast cancer indication, where it holds a 63% new-to-brand share in the U.S.

2. Kesimpta, used in multiple sclerosis treatment, delivered $1.22 billion in sales, marking a 44% increase year-over-year and beating analyst expectations by 9%.

3. Pluvicto, a radioligand therapy, grew 45% year-over-year to $564 million in sales.

4. Leqvio, a PCSK9 cholesterol drug, is on track to achieve blockbuster status with $894 million in sales for the first nine months of 2025, including $308 million in Q3.

Strategic Moves and Future Outlook

Novartis is not resting on its laurels, making strategic moves to secure its future in the evolving pharmaceutical landscape:

1. The company recently agreed to acquire Avidity Biosciences for $12 billion, expanding its presence in RNA therapeutics.

2. Novartis unveiled a $23 billion U.S. investment plan in April, focusing on R&D and manufacturing expansions, partly in response to potential U.S. tariffs on pharmaceuticals.

3. The company is preparing an FDA filing for Pluvicto in metastatic hormone-sensitive prostate cancer, which could potentially double the drug's target patient population.

As the pharmaceutical industry navigates policy changes in the U.S., including "most favored nation" drug pricing deals, Novartis remains actively engaged with the administration to develop solutions. CEO Vas Narasimhan emphasized the importance of focusing on the company's growth drivers, stating, "I would focus much more on the dynamic growth you saw in the quarter on Kisqali, Pluvicto, Scemblix, Kesimpta, all of which, to my eyes, were ahead of consensus. That's where I think the focus should be now looking ahead for the company."