Core Insights - Novartis reported strong performance in 2025 with high single-digit sales growth and core margin expansion despite facing significant US generic competition [3] - Key growth drivers included Kisqali, Kesimpta, Pluvicto, Scemblix, and Cosentyx, which continued their strong trajectory [3] - The company advanced several potential multi-blockbusters in its pipeline with FDA approvals and positive Phase III readouts [3] - Novartis expects to grow through the largest patent expiry in its history in 2026, indicating the strength of its business [3] Financial Performance - Q4 2025 net sales reached USD 13.3 billion, a 1% increase year-over-year, while full-year net sales were USD 54.5 billion, reflecting an 8% increase [4][13] - Operating income for Q4 was USD 3.6 billion, up 2%, and for the full year, it was USD 17.6 billion, a 21% increase [10][13] - Net income for Q4 was USD 2.4 billion, down 15%, while full-year net income was USD 14.0 billion, up 17% [10][14] - Core operating income for Q4 was USD 4.9 billion, a 1% increase, and for the full year, it was USD 21.9 billion, a 12% increase [11][16] - Free cash flow for Q4 was USD 1.7 billion, down 54%, while for the full year, it was USD 17.6 billion, an 8% increase [12][17] Key Growth Drivers - Priority brands showed strong performance in Q4, with Kisqali sales growing 44%, Kesimpta 27%, Pluvicto 70%, Scemblix 87%, and Cosentyx 11% [18] - The top 20 brands contributed to a total of USD 10.8 billion in Q4 sales, with a slight increase of 2% year-over-year [19] R&D and Innovation - Novartis received FDA approval for Itvisma, the first gene replacement therapy for a broad SMA population, and expanded indications for Scemblix [21] - Pluvicto's FDA submission for metastatic hormone-sensitive prostate cancer was completed based on Phase III data [22] - Ongoing trials for ianalumab showed significant benefits in Sjögren's disease and primary immune thrombocytopenia [23][24] Strategic Initiatives - Novartis announced a proposed acquisition of Avidity Biosciences, expected to close in the first half of 2026, enhancing its pipeline in neuroscience [25] - The company reached an agreement with the US government to lower drug prices, which will impact its 2026 guidance [32] Capital Structure - Novartis repurchased 77.6 million shares for USD 8.9 billion in 2025, reducing the total number of shares outstanding by 66.9 million [27] - Net debt increased to USD 21.9 billion by the end of 2025, primarily due to cash outflows for share repurchases and dividends [28] 2026 Guidance - For 2026, Novartis expects low single-digit growth in net sales and a decline in core operating income [30]