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Novartis supplies medicines for conditions including cancer, heart disease, immune disorders and neurological disease. Cancer medicines form its largest therapeutic business, including Kisqali for breast cancer; Entresto treats heart failure. Most sales come from the United States and Europe.
Wholesalers, retail chains, governments and other purchasing organizations buy its medicines, while governments, insurers and patients fund treatment. Sales are concentrated among a small number of large buyers. The prices Novartis receives and patients’ access to its medicines depend on payers’ coverage decisions and government pricing rules, not just demand from doctors and patients.
Novartis depends on successful new medicines to replace sales lost when older products face competition. Before selling a new medicine, it must establish safety and effectiveness through testing and obtain regulatory approval; approved uses vary by country. Patents and regulatory exclusivity provide time-limited protection from generic and biosimilar competitors. Entresto has already lost US market exclusivity and faces generic competition, making the development and adoption of replacement products important to the business.
The risk section is the longest, dullest part of the filing. This keeps only what can really hurt you: where it hits, how hard, when it plays out.
Every company claims an edge. Each one is checked against hard numbers like margins and returns: which hold, and which line gives way first.
Novartis’s specialty-medicine growth depends on adoption, clinical results and patent protection; Roche, absent from this list, also matters through its Genentech Xolair partnership and competing multiple-sclerosis medicines.
AstraZeneca competes with Novartis for cancer and cardiovascular medicine sales, including directly for patients with paroxysmal nocturnal haemoglobinuria. Watch their dispute over treatment marketing: Novartis alleged false and misleading statements in an October 2025 lawsuit, which AstraZeneca disclosed as a contingent liability.
AbbVie competes for the inflammatory-disease patients who buy Novartis’s Cosentyx: its Skyrizi and Rinvoq offer competing treatments in major indications, including psoriasis or psoriatic arthritis.
Eli Lilly challenges two Novartis medicine franchises: Verzenio competes with Kisqali for breast-cancer treatment, while Taltz competes with Cosentyx for patients with inflammatory skin and joint diseases.
Pfizer’s Ibrance competes directly with Novartis’s Kisqali for hormone-receptor-positive breast-cancer patients, making this treatment market the relevant overlap rather than Pfizer’s overall drug sales.
Johnson & Johnson competes with Novartis for inflammatory-disease medicine sales through Tremfya and Stelara against Cosentyx; both companies also sell major cancer medicines.
Amgen competes with Novartis for cholesterol-lowering medicine sales through Repatha against Leqvio, but shares the Aimovig business by territory. Amgen holds Aimovig rights in the US and Japan; Novartis sells it elsewhere.
Bristol Myers Squibb competes with Novartis for cancer and multiple-sclerosis medicine sales, with Zeposia competing against Novartis’s medicines for relapsing multiple sclerosis.
Biogen competes with Novartis for neurological-disease treatment sales: its multiple-sclerosis medicines challenge Kesimpta, and Spinraza competes with Novartis’s spinal-muscular-atrophy gene therapies. Tysabri and Spinraza each contributed more than 10% of Biogen’s total revenue in each of 2023, 2024 and 2025, making their sales worth watching.
Sanofi’s Dupixent competes with Novartis’s Xolair and remibrutinib for chronic spontaneous urticaria patients. Dupixent’s progress in this patient group is the relevant signal for Novartis, whose 2025 Xolair growth came mainly from this condition in emerging growth markets.
Regeneron both competes with and earns money from Novartis: its Sanofi-partnered Dupixent challenges Xolair in chronic spontaneous urticaria, while Novartis pays it royalties on Ilaris sales. Those Ilaris royalties were $274.8 million in 2025, a direct link to Novartis’s medicine sales.
Merck competes with Novartis to get oncology providers to adopt their major patented cancer medicines and payers to cover them; treatment adoption and reimbursement are the relevant overlap.
GSK competes with Novartis in specialty medicines for immunology and cancer, but also earns royalties from Novartis’s Kesimpta sales. Kesimpta helped drive GSK’s 2025 royalty-income increase, so that revenue line offers a partial read on demand for Novartis’s multiple-sclerosis medicine.
Incyte and Novartis earn from the same medicine in different markets: Incyte sells ruxolitinib as Jakafi in the US and licenses it to Novartis as Jakavi outside the US, receiving royalties on those sales. Watch Incyte’s Jakavi royalties for the direct link to Novartis, rather than treating US Jakafi sales as Novartis revenue.
Novartis’s Leqvio business rests on global rights licensed from Alnylam to develop, manufacture and sell this RNAi cholesterol medicine. Leqvio sales reached $1.2 billion in 2025, up 59% in US dollars; further account and patient adoption is what Novartis is working to expand.
Takeda competes with Novartis for blood-disease and cancer medicine sales, including Iclusig against Novartis’s Scemblix for chronic myeloid leukemia patients.
Teva competes with Novartis’s off-patent medicines through its broad generic portfolio, while its innovative migraine and multiple-sclerosis medicines also overlap with Novartis treatments.
Genmab’s antibody innovation underlies Novartis’s Kesimpta: Novartis manufactures and sells ofatumumab, and Genmab is entitled to partner royalties. Kesimpta-related royalties are the relevant connection to demand for Novartis’s at-home treatment for relapsing multiple sclerosis.
Novartis funds development of pelacarsen, originated and licensed by Ionis Pharmaceuticals, while Ionis retains milestone and future sales-royalty rights. Watch the global Phase 3 cardiovascular outcomes study for patients with elevated Lp(a) and cardiovascular disease: Novartis conducts and pays for it.
Novartis’s Zolgensma and Itvisma use REGENXBIO’s licensed NAV AAV9 gene-delivery technology, and their sales generate royalties for REGENXBIO. Together the spinal-muscular-atrophy therapies cover different age groups: Zolgensma’s FDA approval is for patients under two, and Itvisma’s is for patients two and older.
Novartis AG earningsThis company
Novartis's report will show whether sales of newer medicines can keep growing enough to offset generic pressure on established brands while protecting its operating margin.
Read growth in net sales from continuing operations alongside operating margin, and compare sales of newer medicines with established brands. Rising sales with a steady or wider margin would show that added volume is doing more than filling the gap from generic competition; slower growth or a narrower margin would show competition, pricing pressure or the cost of growth eroding the business's value.
Biogen Inc. earningsBIIB
Biogen's report will show how its multiple-sclerosis medicines are performing, offering a read on the competition for patients faced by Novartis's Kesimpta.
Watch Biogen's multiple-sclerosis medicine sales and related business commentary. Strength would show that competing treatments are drawing more business, putting greater pressure on Novartis's Kesimpta; weakness would show less momentum for Biogen in that patient contest, but would not by itself establish Kesimpta sales.
GSK plc earningsGSK
GSK's report will show how its royalty income is changing; the Kesimpta-linked portion offers a clue to demand for Novartis's multiple-sclerosis medicine.
Watch GSK's royalty income and any commentary on Kesimpta's contribution. A rising Kesimpta-linked amount would support continued demand growth for Novartis's medicine; a decline would point to a weaker signal. GSK's total royalty line includes other products, so it cannot all be attributed to Kesimpta.
Fed Interest Rate Decision
Novartis’s $28.7 billion of financial debt makes the Fed’s benchmark borrowing rate relevant because higher rates can raise the cost of debt that reprices or is refinanced, while lower rates can ease it.
Expected4.0%Last release4.0%
If it comes in above expectations
Higher-than-expected rates could make Novartis’s repricing or refinancing more expensive, increasing financing costs and leaving less flexibility for other needs.
If it comes in below expectations
Lower-than-expected rates could reduce the cost of Novartis’s repricing or refinanced debt, easing financing costs and preserving more flexibility for other needs.
Incyte Genomics Inc earningsINCY
Incyte's report will show royalty income from Jakavi outside the United States, a direct signal for Novartis's related medicine business.
Look for Incyte's reported Jakavi royalties; US Jakafi sales are Incyte's, not Novartis's. Higher Jakavi royalties would indicate stronger sales outside the United States and more royalty income for Novartis from this business; lower royalties would point to pressure on those-market sales or the associated income.
Regeneron Pharmaceuticals Inc earningsREGN
Regeneron's report will show how its royalties from Novartis's Ilaris sales are changing, a direct link to sales of that Novartis medicine.
Watch Regeneron's reported Ilaris royalties, not its overall results as a proxy for Novartis. Higher royalties would indicate stronger Ilaris sales, but also more royalty expense for Novartis; lower royalties would point to weaker Ilaris sales or related income.
