Swiss pharma giant Novartis AG (NVS Quick QuoteNVS - Free Report) reported first-quarter core earnings per share (excluding one-time charges) of $1.99, which missed the Zacks Consensus Estimate of $2.11. The figure was also down from $2.28 reported a year ago due to lower core net income.

Revenues of $13.1 billion also missed the Zacks Consensus Estimate of $13.6 billion. The top line was down 1% from the year-ago reported figure.

On a constant currency basis, sales decreased 5%. The metric was adversely impacted by generic competition for key drugs Entresto (United States) and Promacta.

Core operating income was down 12% to $4.9 billion due to lower net sales and higher R&D investments.

Core net income was down 15% to $3.8 billion due to lower operating income.

The stock is trading lower in response to first-quarter results.

Shares of Novartis have gained 4.5% year to date against the industry’s decline of 6.5%.

Image Source: Zacks Investment Research

Detailed Performance of Top NVS Drugs in Q1

All growth rates mentioned below are on a year-over-year basis and at constant exchange rates.

Novartis currently focuses on four core therapeutic areas: cardiovascular-renal-metabolic, immunology, neuroscience and oncology.

Cosentyx’s sales (psoriasis, spondylitis and arthritis) declined 2% to $1.57 billion. Sales in the United States declined as demand growth was offset by positive revenue deduction adjustments in the prior-year quarter. Nonetheless, sales continue to grow outside the United States. Cosentyx’s sales missed both the Zacks Consensus Estimate and our model estimate of $1.6 billion.

Kisqali (breast cancer) maintained its stellar performance, with sales surging 55% to $1.52 billion. Sales increased across all regions, driven by continued momentum in the early breast cancer indication as well as leadership in metastatic breast cancer. Kisqali sales beat both the Zacks Consensus Estimate of $1.5 billion and our model estimate of $1.45 billion.

Cardiovascular drug Entresto’s sales plunged 46% year over year to $1.3 billion due to generic competition in the United States. The drug is approved for heart failure globally as well as for hypertension in China and Japan. Nonetheless, ex-U.S. sales continued to grow. Entresto’s sales missed the Zacks Consensus Estimate of $1.4 billion and our model estimate of $1.5 billion.

Kesimpta (multiple sclerosis) sales increased 26% to $1.16 billion. Sales grew across all regions, driven by increased demand and strong access. The figure missed the Zacks Consensus Estimate of $1.2 billion and our model estimate of $1.3 billion.

Pluvicto (prostate cancer) raked in sales of $642 million, surging 70%, driven by strong demand in the U.S. pre-taxane metastatic castration-resistant prostate cancer (mCRPC) setting. Outside the United States, access continued to broaden, with approvals for post-taxane mCRPC in 51 countries and for the pre-taxane setting in nine countries. Sales beat the Zacks Consensus Estimate of $634 million and our estimate of $617 million.

Jakavi (oncology) sales were up 5% to $557 million.

Sales of Tafinlar + Mekinist (oncology) were down 14% to $493 million due to a decline in sales in the United States due to competitive pressure and ex-U.S., mainly due to shipment phasing.

Ilaris sales amounted to $475 million as sales grew across most regions, with continued momentum in the Periodic Fever Syndromes and Still’s disease indications.

Cholesterol drug Leqvio sales surged 69% to $452 million, with growth across all regions. Sales outside the United States accelerated, led by China after its inclusion in the National Reimbursement Drug List in January. The figure beat the Zacks Consensus Estimate of $367 million and our estimate of $368 million.

Novartis holds global rights to develop, make, and market Leqvio through a deal with Alnylam Pharmaceuticals, and is currently involved in U.S. patent litigation with a generic manufacturer.

Scemblix sales skyrocketed 79% to $433 million, driven by broad-based growth across all regions, with continued momentum in the early line setting for chronic myeloid leukemia. Sales beat the Zacks Consensus Estimate of $427 million but missed our model estimate of $451 million.

Xolair (asthma and allergies) sales declined 20% to $388 million. Sales declined in Europe and some emerging markets, mainly due to the launch of a biosimilar in 2025.

Novartis has a collaboration agreement with Roche (RHHBY Quick QuoteRHHBY - Free Report) for Xolair. Novartis and Roche co-promote Xolair in the United States.

Gene therapy Zolgensma (spinal muscular atrophy or SMA) sales of $302 million were down 12%, reflecting a lower incidence of SMA despite continued strong share in the incident population, as well as treatment phasing. The intrathecal formulation is now approved in the United States, UAE, Qatar and Japan, with the first patients treated in the UAE and the United States.

Lutathera (cancer) sales totaled $211 million, up 7%. Sales grew mainly in the United States, Europe and Japan, driven by increased demand.

Promacta (oncology) sales plummeted 68% to $184 million due to generic competition.

Fabhalta sales more than doubled to $169 million, driven by continued launch execution across all markets in paroxysmal nocturnal hemoglobinuria and the launch progress in primary IgA nephropathy and C3 glomerulopathy indications.

Tasigna (leukemia) sales plummeted 61% to $155 million due to generic competition.

Rhapsido (chronic spontaneous urticaria or CSU) to show strong early uptake in the United States, with sales of $37 million, supported by a free drug program to facilitate patient access and increasing coverage.

Novartis Reiterates 2026 Guidance

Net sales are expected to grow in low single digits on a constant currency basis. Core operating income is anticipated to decline in the low single digits

Recent Acquisition Deals by NVS

Novartis acquired Avidity Biosciences, strengthening its late-stage neuroscience pipeline and advancing its xRNA strategy.

The company also agreed to acquire SNV4818 from Synnovation Therapeutics, a pan-mutant selective PI3Kα inhibitor currently in phase I/II for HR+/HER2- breast cancer and other advanced solid tumors. The program aligns with Novartis’ breast cancer strategy and could be combined with CDK inhibitors and endocrine therapies. The deal is expected to close in the first half of 2026, subject to customary conditions.

In addition, Novartis agreed to acquire Excellergy, including Exl-111, a phase I anti-IgE antibody with extended half-life and high affinity. Its differentiated mechanism may enable faster and deeper receptor downregulation, potentially improving symptom control and dosing convenience in allergic diseases. The transaction is expected to close in the second half of 2026, subject to customary conditions.

Pipeline and Other Updates From NVS

The FDA approved Cosentyx for the treatment of moderate to severe hidradenitis suppurativa (HS) in pediatric patients aged 12 years and older, making it the only IL 17A inhibitor approved for this population.

Top-line results from the phase III RemIND trial showed oral remibrutinib met its primary endpoint in chronic inducible urticaria, delivering statistically significant and clinically meaningful complete response rates versus placebo at week 12 across key subtypes.

In a phase II study in IgE-mediated peanut allergy, remibrutinib showed superior, dose-dependent efficacy versus placebo with rapid onset and good tolerability. A phase III program in food allergy is planned to begin in the second half of 2026.

Our Take on NVS’ Q1 Performance

Novartis’ performance in the first quarter was affected by generic competition for its blockbuster drug Entresto in the United States. Generic competition for Promacta also pulled down the top line.

2026 is a pivotal year for Novartis as it navigates the largest patent expiry in its history.

Novartis is now banking on key growth drivers — Kisqali, Kesimpta, Pluvicto, Scemblix and Leqvio — to support top-line growth.

Pipeline progress remained solid, highlighted by positive phase III data for remibrutinib in chronic inducible urticaria and encouraging phase II results in food allergy, underscoring its potential as a pipeline-in-a-pill.

NVS is also focusing on strategic acquisitions to strengthen its pipeline.

The company recently acquired Avidity to strengthen its neuroscience franchise and also announced deals to strengthen its breast cancer and allergic disease portfolios.

NVS’ Zacks Rank & Stocks to Consider

Novartis currently carries a Zacks Rank #3 (Hold).

A couple of top-ranked stocks in the drug/biotech sector are Agenus (AGEN Quick QuoteAGEN - Free Report) and Amarin (AMRN Quick QuoteAMRN - Free Report) , both sporting a Zacks Rank #1 (Strong Buy) at present. You can see the complete list of today’s Zacks #1 Rank stocks here.

Over the past 60 days, estimates for Agenus’ 2026 earnings per share have risen from 54 cents to $1.30, while loss-per-share estimates for 2027 have narrowed from $1.91 to $1.52. AGEN shares have gained 30.2% year to date.

Agenus’ earnings beat estimates in two of the trailing four quarters, while missing the same on the remaining two occasions, with the average surprise being 31.42%.

Over the past 60 days, Amarin's loss-per-share estimates for 2026 have narrowed from $7.32 to $6.36, and the same for 2027 have narrowed from $5.97 to $4.64.

Amarin's earnings beat estimates in three of the trailing four quarters, while missing the same on the remaining occasion, with the average surprise being 51.29%.