Sacubitril/Valsartan

Novartis' CEO remains unfazed by the threat of a newly approved oral PCSK9 inhibitor in Merck & Co.’s Lipfendra , doubling down on the long-term potential of his company's injectable cholesterol drug, Leqvio. Speaking on the company’s Q2 earnings call, Novartis CEO Vas Narasimhan brushed off fears that daily pills could stall Leqvio. As Novartis moves past key patent expirations to deliver a return to top-line growth—partly thanks to strong performance from Leqvio—Narasimhan argued that Leqvio’s twice-yearly dosing offers a unique opportunity. “Even with orals launching, our opportunity remains for driving strong growth in the segment that wants infrequently administered, physician-administered medicines for lipid lowering in the United States, and we see this as an attractive and growing segment that supports our peak sales potential in the U.S. and beyond,” Narasimhan said. Novartis has pegged Leqvio peak sales at above $4 billion, based on the fact that many of the more than 70 million U.S. patients with elevated LDL cholesterol were not able to reach their lipid-lowering targets with older treatments. Initially struggling with a slow launch as doctors got accustomed to the “buy-and-bill” reimbursement model, Leqvio reached blockbuster status in 2025 with $1.2 billion in sales. In this year's second quarter, the small interfering RNA therapy grew sales by 59% at constant currencies, reaching $480 million, landing 5% above analysts’ expectations. In the U.S., Narasimhan highlighted monthly total prescription growth of 49%, as Leqvio “outpaced the advanced lipid-lowering market.” With Medicare Part B use, which the CEO said represents Leqvio’s most important segment, Novartis currently keeps a 23.3% share, up 3.6% year to date. With Lipfendra’s launch, the buy-and-bill pathway for physician-administered drugs now works in Leqvio’s favor, insulating the Novartis med from the potentially brutal price battle between orals and self-injected antibody therapies, Narasimhan noted. Outside the U.S., Narasimhan predicts Leqvio could become Novartis’ largest medicine ever in China, even ahead of the company’s megablockbuster heart failure treatment Entresto. Following its recent inclusion in China’s National Reimbursement Drug List, Leqvio has now doubled its market share, with strong performance in both the hospital setting and other market segments, according to Narasimhan. “We think there’s an opportunity in cardiovascular, hypertension and [cardiovascular] risk reduction for our follow-on siRNAs in China, where there seems to be a high demand for infrequently administered therapies with very clean safety profiles,” Narasimhan said. To potentially further bolster Leqvio’s clinical profile, Novartis is on track to report data from two cardiovascular outcomes studies in 2027. Leqvio is among several new medicines that drove Novartis’ Q2 sales to 1% growth at constant exchange rates, a surprisingly strong showing coming off of a 5% decline in Q1. Entresto, which was once Novartis’ top-selling drug, continued to see significant sales erosion thanks to its U.S. loss of exclusivity. Sales from the drug plummeted 51% in Q2, tumbling below $1.2 billion and missing Wall Street consensus estimates by 9%. In contrast, immunotherapy asset Cosentyx chalked up a 10% increase at an unchanged exchange rate, reaching $1.8 billion. Breast cancer drug Kisqali brought in $1.7 billion in sales in Q2, representing 43% year-over-year growth, and Kesimpta’s $1.4 billion in sales marked a 32% jump. Despite a 5% overall groupwide top-line beat versus consensus, Novartis maintained its full-year sales guidance. As CFO Mukul Mehta noted on Tuesday’s call, the company’s Q2 revenue benefited 1 percentage point from some “one-time phasing items, which will reverse in the second half.”