NVS HOLD Conviction: 3/5 $215B

Novartis AG

Current: $105 · PT: $115
Investment Thesis
Global pharma leader with strong positions in cardiovascular, immunology, neuroscience, and oncology. Achieved 40% core margin in 2025. Navigating Entresto patent cliff in 2026 with diversified growth drivers.
Bull Case
Entresto LOE better than feared with strong branded retention. Kisqali and Kesimpta accelerate above expectations. Pluvicto supply constraints resolved, captures mCRPC market. Pipeline delivers with Ianalumab and Pelabresib approvals.
Bear Case
Entresto generics erode faster than expected. Cosentyx faces biosimilar pressure earlier. Pluvicto manufacturing issues persist. Pipeline setbacks in radioligand or immunology programs.
Drug Portfolio (24)
Lutathera APPROVED
100% ownership
Oncology Radioligand therapy IV
Mayzent APPROVED
100% ownership
Neurology Small molecule Oral
Kesimpta APPROVED
100% ownership
Neurology Antibody SC
Entresto APPROVED
100% ownership
CVRM Small molecule Oral
Cosentyx APPROVED
100% ownership
Immunology Antibody SC
Kisqali APPROVED
100% ownership
Oncology Small molecule Oral
Pluvicto APPROVED
100% ownership
Oncology Radioligand therapy IV
Scemblix APPROVED
100% ownership
Oncology Small molecule Oral
Fabhalta APPROVED
100% ownership
Immunology Small molecule Oral
Zolgensma APPROVED
100% ownership
Neurology Gene therapy IV
Jakavi APPROVED
100% ownership
Oncology Small molecule Oral
Tasigna APPROVED
100% ownership
Oncology Small molecule Oral
Tafinlar + Mekinist APPROVED
100% ownership
Oncology Small molecule Oral
Promacta APPROVED
100% ownership
Immunology Small molecule Oral
Ilaris APPROVED
100% ownership
Immunology Antibody SC
Pelabresib PHASE3
100% ownership
Oncology Small molecule Oral
Remibrutinib FILED
100% ownership
Immunology Small molecule Oral
Ianalumab PHASE3
100% ownership
Immunology Antibody SC
225Ac-PSMA-617 PHASE3
100% ownership
Oncology Radioligand therapy IV
Pelacarsen PHASE3 LICENSEE
100% ownership
CVRM Antisense oligonucleotide SC
Lucentis APPROVED CO_DEVELOPER
50% ownership
Ophthalmology Antibody fragment Intravitreal
Xolair APPROVED CO_DEVELOPER
50% ownership
Immunology Antibody SC
Leqvio APPROVED
100% ownership
CVRM siRNA SC
DrugStageRoleOwnershipAreaModality
AimovigAPPROVEDCO_DEVELOPER50%NeurologyAntibody
Financials (USD)
PeriodRevenue ($M)Gross MarginR&DSG&AOp IncomeOp MarginNet IncomeEPS
2023A$45,40075.0%$9,080$11,350$13,62030.0%$10,900$5.32
2024A$50,30076.0%$10,060$12,070$16,10032.0%$13,330$6.49
2025A$54,00076.5%$10,800$12,960$17,55032.5%$14,660$7.15
2026E$57,50077.0%$11,500$13,800$18,97533.0%$15,800$7.70
2027E$61,00077.0%$12,200$14,640$20,13033.0%$16,750$8.17
2028E$64,00077.0%$12,800$15,360$21,12033.0%$17,550$8.56
2029E$66,50077.0%$13,300$15,960$21,94533.0%$18,250$8.90
2030E$68,50077.0%$13,700$16,440$22,60533.0%$18,800$9.17
Recent Quarters
QuarterRevenue ($M)Gross MarginOp MarginEPS
Q4 2026E$15,00077.0%33.0%$2.01
Q4 2025$14,10076.5%32.5%$1.86
Q4 2024$13,14076.0%32.0%$1.61
Q3 2026E$14,70077.0%33.0%$1.97
Q3 2025$13,70076.5%32.5%$1.82
Q3 2024$12,82076.0%32.0%$1.69
Catalysts (15)
Pluvicto - Pre-Chemo mCRPC - FDA Approval
REGULATORY SM
Novartis PSMAfore PR, FDA filing 2025 Q1 2026
NVS - Avidity Biosciences Acquisition Close
CORPORATE
Novartis PR Jan 13, 2026 H1 2026
Entresto - Generic Competition Impact
COMPETITIVE SM
Novartis Q4 2025 Earnings 2026
Leqvio - Commercial Uptake Updates
COMMERCIAL
Novartis Q4 2025 Earnings 2026
225Ac-PSMA-617 - mCRPC - Ph3 - Start
CLINICAL
Novartis JPM 2026 Presentation 2026
Pelabresib - Myelofibrosis - EU Filing/Approval
REGULATORY SM
Novartis Q4 2025 Earnings, FDA CRL 2026
Pelabresib - Myelofibrosis - Ph3 - Start (MANIFEST-3)
CLINICAL
Novartis Q4 2025 Earnings 2026
Scemblix - 1L CML - FDA Approval
REGULATORY SM
Novartis ASC4FIRST PR, JPM 2026 H1 2026
Pelacarsen - Lp(a) CV Prevention - Ph3 - Topline (HORIZON)
CLINICAL SM
ClinicalTrials.gov NCT04023552, Novartis JPM 2026 H1 2026
Fabhalta - IgAN - Full Approval Data
CLINICAL
ClinicalTrials.gov NCT04578834 H2 2026
Remibrutinib - Hidradenitis Suppurativa - Ph3 - Topline
CLINICAL SM
Novartis JPM 2026 Pipeline H2 2026
Remibrutinib - CIndU - Ph3 - Topline
CLINICAL
Novartis JPM 2026 Pipeline H2 2026
Ianalumab - SLE - Ph3 - Topline (SIRIUS-SLE)
CLINICAL SM
ClinicalTrials.gov, Novartis JPM 2026 H2 2026
Cosentyx - Biosimilar Competition Timeline
COMPETITIVE
Novartis investor presentations Ongoing
Ianalumab - Sjogren's - Ph3 - Topline
CLINICAL SM
Novartis JPM 2026 Pipeline 2027
Open Debates (2)
Underappreciated Growth Driver: Fabhalta (iptacopan) — First Oral Complement Inhibitor
Bull
Fabhalta is the first oral complement factor B inhibitor — approved for PNH, in development for C3G, IgAN. In PNH, it competes with Soliris/Ultomiris (both IV/SubQ, $6B+ combined). Oral convenience is a massive differentiator for a chronic disease requiring lifelong treatment. $420M in early launch suggests strong physician interest. If IgAN data is positive, the TAM expands to $3-5B. Novartis guides to $3B peak — could exceed if oral convenience drives switch from injectables.
Bear
PNH is small (~15K patients in US). Soliris/Ultomiris are deeply entrenched with proven long-term outcomes. Physicians are cautious about switching complement inhibition. Factor B inhibition may not provide equivalent protection vs C5 inhibition.
Conviction: 5/5
Underappreciated Risk: Entresto Patent Cliff — Immediate and Large
Bull
Novartis has guided for better-than-feared erosion with strong branded retention. Heart failure patients and physicians prefer known brands. Kissqali, Kesimpta, and pipeline will offset.
Bear
Entresto is $7.1B — the largest single drug. Generic sacubitril/valsartan will launch in 2026. Heart failure is a primary care market where generics dominate aggressively. Entresto erosion could reach 50%+ within 18 months — a $3.5B revenue hole. Novartis's 40% core margin was achieved WITH Entresto's high-margin contribution. Post-cliff, margins will compress. The pipeline is strong but none of the assets individually replace $7B.
Conviction: 5/5
Data from Supabase · Updated 2026-03-24