Novartis’ present technique could be traced again to October 2023, when the Swiss pharma accomplished the spin-off of Sandoz, its generics and biosimilars enterprise. The corporate described the transfer because the completion of a strategic transformation into a centered modern medicines firm, whereas chief govt officer (CEO) Vas Narasimhan stated it allowed Novartis to “absolutely deal with high-value modern medicines.”
Novartis says it’s concentrating on 4 core therapeutic areas: cardiovascular, renal and metabolic ailments, oncology, immunology, and neuroscience, supported by expertise platforms together with xRNA, radioligand remedy, and gene and cell remedy.
On the similar time, within the first quarter of 2026, generic competitors hit a number of older merchandise: Entresto gross sales fell 42%, Promacta 66%, and Tasigna 59%, partly offset by progress from newer medicines together with Kisqali and Pluvicto. Reuters described this as Novartis navigating its most extreme interval of patent expiries, led by Entresto, which accounted for 14% of gross sales the earlier yr.
Regardless of this powerful time, Novartis has been spending closely to strengthen the following era of its pipeline. Current offers embody the acquisition of Avidity Biosciences to broaden its xRNA and late-stage neuroscience pipeline, the acquisition of Tourmaline Bio so as to add the anti-IL-6 antibody pacibekitug in atherosclerotic heart problems, and continued funding in radioligand remedy, which Novartis described in its 2025 annual report as one in every of its market-leading superior expertise platforms.
Novartis: a story about focus
Novartis was created in 1996 by way of the merger of Ciba-Geigy and Sandoz, bringing collectively companies with roots in chemical compounds, prescription drugs and broader healthcare. Novartis didn’t start because the centered modern medicines firm it’s at present; it was constructed from a much wider industrial and healthcare base.
In 2015, Novartis mixed its shopper healthcare enterprise with GSK’s in a three way partnership, and three years later, it offered its 36.5% stake to GSK for $13 billion, ending its participation in shopper well being. Novartis described that sale as a part of its portfolio transformation and a transfer to deal with strategic priorities.
The identical logic utilized to eye care, when in 2019, Novartis spun off Alcon as a separate firm. On the time, Novartis stated the transaction would enable it to focus capital allocation and administration consideration on medicines, whereas giving the group a monetary profile nearer to pharmaceutical friends, together with greater margins.
Lastly, in October 2023, Novartis accomplished the spin-off of Sandoz, its generics and biosimilars enterprise. Novartis framed the transfer because the completion of its strategic transformation right into a centered modern medicines firm.
Shopper well being, eye care and generics every had completely different economics, progress profiles and administration calls for. Eradicating them left Novartis with a cleaner pipeline technique: allocate capital and deal with analysis and growth (R&D).
The problem: patent lapse and generics
The corporate entered 2026 with a transparent strategic profile, but additionally with a visual income downside. In its Q1 2026 outcomes, Novartis stated internet gross sales declined 5%, with the primary stress coming from three older merchandise: Entresto, whose U.S. generics entered the market in Q3 2025, and Tasigna and Promacta, which confronted U.S. generics from Q2 2025.
Probably the most vital is Entresto, Novartis’ coronary heart failure drugs and one of many firm’s largest merchandise. In 2025, Entresto generated $7.75 billion in gross sales, making it Novartis’ largest-selling drugs forward of Cosentyx and Kisqali. However by the primary quarter of 2026, Entresto gross sales fell 42% yr on yr to $1.3 billion. Promacta, utilized in blood problems, fell 66% to $184 million, whereas Tasigna, an older most cancers remedy, fell 59% to $155 million. Novartis stated generic competitors negatively affected all three merchandise, partly offset by robust progress from newer medicines together with Kisqali, Pluvicto, Kesimpta, Scemblix and Leqvio.
Novartis’ present progress engines, together with Cosentyx, Kisqali and Kesimpta, are nonetheless increasing, however they too will ultimately mature and face their very own lifecycle questions. Reuters reported that Cosentyx, Kesimpta and Kisqali are anticipated to lose patent safety within the early 2030s, which implies Novartis is already making an attempt to construct the expansion layer after the present one.
Nevertheless, Novartis just isn’t presenting 2026 as a disaster yr and reaffirmed its full-year steering in Q1 2026, at the same time as gross sales and core working earnings declined, pointing to robust progress from precedence manufacturers. That’s the context by which Novartis’ dealmaking must be interpreted.
Constructing Novartis’ pipeline round 4 pillars
Novartis’ current dealmaking appears broad, however it isn’t random. Many of the offers map onto the 4 therapeutic areas the corporate says outline its enterprise: cardiovascular-renal-metabolic, oncology, neuroscience and immunology. Novartis has additionally stated these areas are supported by expertise platforms together with radioligand remedy and xRNA, which helps clarify why most of the offers should not simply product acquisitions however functionality acquisitions.
Novartis cardiovascular pipeline: from Entresto to prevention, irritation and RNA
Heart problems stays central to Novartis, at the same time as Entresto loses exclusivity. Novartis’s newer cardiovascular technique appears broader than merely changing one coronary heart failure drug with one other: lipid decreasing, thrombosis prevention, irritation and RNA-based approaches.
Leqvio is a component of that cardiovascular pipeline. The siRNA drugs, used to decrease LDL ldl cholesterol, provides Novartis a cardiovascular asset constructed round long-acting RNA interference. In 2025, Leqvio gross sales reached $1.24 billion, up 73%, and in Q1 2026 gross sales grew 69%, with Novartis pointing to robust progress in China.
The Anthos acquisition provides one other layer to the technique. Novartis agreed to purchase Anthos for $925 million upfront, gaining abelacimab, a part 3 Issue XI inhibitor being developed for prevention of stroke and systemic embolism in sufferers with atrial fibrillation. That strikes Novartis right into a next-generation anticoagulation house, the place corporations try to scale back clotting threat with out reproducing the bleeding burden of older anticoagulants.
Tourmaline Bio pushes the technique towards irritation in cardiovascular illness. The $1.4 billion acquisition provides Novartis pacibekitug, an anti-IL-6 antibody being developed for atherosclerotic heart problems (ASCVD). Novartis stated the deal complemented its cardiovascular pipeline, with a part 3-ready candidate concentrating on systemic irritation in ASCVD.
Novartis aso signed a licensing and choices settlement value as much as $5.2 billion with Argo for cardiovascular siRNA candidates, together with a mid-stage program for elevated blood lipids and choices on further candidates addressing cholesterol-related illness drivers.
The Novartis cardiovascular story doesn’t finish with Entresto’s patent expiry, and the pipeline now appears extra stratified.
Novartis oncology technique: focus round progress manufacturers and differentiated modalities
Novartis can be nonetheless closely dedicated to oncology. In 2025, Kisqali, the corporate’s industrial anchor, generated $4.78 billion in gross sales, up 57%, and in Q1 2026 it grew 55% to $1.52 billion, helped by momentum in early breast most cancers and metastatic breast most cancers.
Then there’s Pluvicto; past a prostate most cancers drug, it’s the clearest industrial take a look at of Novartis’ radioligand remedy (RLT) technique. In Q1 2026, Pluvicto gross sales grew 70% to $642 million, pushed by demand in pre-taxane metastatic castration-resistant prostate most cancers within the U.S. and entry enlargement exterior the U.S.
The Mariana Oncology acquisition again in 2024 exhibits how Novartis is making an attempt to deepen that place. Mariana introduced a portfolio of preclinical radioligand remedy packages throughout strong tumors, together with areas reminiscent of breast, prostate, and lung most cancers. Novartis framed the deal as a method to strengthen its RLT pipeline and develop next-generation most cancers remedies.
Novartis is inserting heavier emphasis on areas the place it has both a powerful progress model, reminiscent of Kisqali, or a expertise platform that might generate a number of merchandise — radioligand remedy.
Novartis neuroscience pipeline: rebuilding by way of supply and RNA capabilities
Novartis’ current strikes recommend a broader effort past Alzheimer’s to rebuild the neuroscience pipeline by way of applied sciences that may attain troublesome tissues or troublesome biology.
The biggest instance is Avidity Biosciences. Novartis accomplished the acquisition earlier this yr in February, including Avidity’s antibody-oligonucleotide conjugate platform and three late-stage neuromuscular packages.
There may be additionally the Arrowhead licensing deal bringing an RNA angle into the Novartis neuroscience pipeline. The corporate licensed ARO-SNCA, a preclinical siRNA remedy designed to scale back alpha-synuclein, with Novartis gaining world rights in a deal value as much as $2 billion. The goal locations this system in synucleinopathies, together with Parkinson’s illness, however strategically the deal additionally provides Novartis one other route into RNA-based neuroscience.
Novartis additionally appeared into supply with BioArctic. The collaboration combines BioArctic’s BrainTransporter expertise with a Novartis proprietary antibody, with the goal of producing a drug candidate for extreme neurological circumstances. BioArctic stated Novartis would take over world growth and commercialization if it workouts its choice.
Novartis immunology technique: defending Cosentyx whereas shifting into new mechanisms
Immunology is one other space the place the technique combines lifecycle administration with new mechanisms.
Cosentyx stays the established franchise with $6.67 billion in gross sales in 2025, making it Novartis’ second-largest drugs after Entresto. However Novartis can be making an attempt to broaden immunology past the IL-17 franchise.
The FDA accepted Rhapsido in September 2025 for power spontaneous urticaria in sufferers who stay symptomatic after antihistamines. The drug is an oral focused BTK inhibitor, with a security profile that requires no lab monitoring in line with Novartis. The European Fee approval adopted in April 2026.
The Monte Rosa deal is an earlier-stage, extra platform-driven immunology technique. Novartis and Monte Rosa expanded their collaboration in 2025 to develop molecular glue degraders for immune-mediated ailments, following an earlier settlement round VAV1 degraders together with MRT-6160. Monte Rosa stated the collaboration is meant to speed up degrader growth in opposition to difficult-to-drug immune targets.
From merchandise to platforms
Novartis is doing greater than changing one blockbuster with one other. It’s investing in applied sciences that might generate a number of merchandise throughout its therapeutic areas. Radioligand remedy extends past Pluvicto by way of the Mariana acquisition, whereas current offers in RNA therapeutics, protein degradation and drug supply present capabilities that might assist future packages. Novartis itself describes xRNA, radioligand remedy, and gene and cell remedy as superior expertise platforms supposed to supply sustained scalability throughout its pipeline.
By concentrating sources on 4 therapeutic areas, Novartis can deepen scientific experience, simplify capital allocation and strengthen positions in applied sciences the place manufacturing know-how and specialised infrastructure are aggressive benefits. That is notably the case in radioligand remedy, the place success relies upon additionally on securing isotope provide, manufacturing capability and therapy networks. In its 2025 annual report, Novartis highlighted continued funding in increasing its radioligand manufacturing footprint and supply community to assist future progress.
A extra centered firm, nevertheless, additionally turns into extra depending on the success of its chosen applied sciences. Lots of Novartis’ current acquisitions stay in scientific growth, whereas newer modalities reminiscent of RNA therapeutics and focused protein degradation have but to supply giant numbers of economic medicines. The corporate has lowered the complexity of its portfolio, however in doing so it has concentrated execution threat round a smaller variety of bets. The subsequent problem is proving {that a} extra centered Novartis can be a extra resilient one.
