Group performance

Novartis delivered a solid financial performance in 2021, supported by sales growth in key products and increased margins. These factors helped counter the impact of the COVID-19 pandemic in some therapeutic areas and a challenging environment for our generics business.

Strong sales of key products continued to underpin our financial performance in 2021. Novartis full-year net sales were USD 51.6 billion, up 4% from the prior year when measured in constant currencies (cc) to remove the impact of exchange rate movements, and up 6% when measured in US dollar terms. The COVID-19 pandemic continued to impact some therapeutic areas – most notably oncology and our generics business.

In 2021, our growth products contributed USD 21.6 billion, or 52% of Innovative Medicines net sales. This was led by our heart failure medicine Entresto, which grew 40% (cc) to USD 3.5 billion, driven by increased patient share across major markets. In 2021, Entresto received approval in the US for an expanded indication in chronic heart failure.

Cosentyx, our treatment for psoriasis and other autoimmune diseases, also continued to grow strongly. Sales rose 17% (cc) from the prior year to USD 4.7 billion, driven by demand in the US and Europe as well as strong volume growth in China. Meanwhile, Zolgensma, our gene therapy for children with spinal muscular atrophy, delivered sales of USD 1.4 billion, up 46% (cc), reaching blockbuster status for the first time.

Recently launched products also progressed well. Kesimpta, a treatment for relapsing multiple sclerosis that was approved in Europe in 2021, had sales of USD 372 million, driven by launch uptake, strong access and increased demand.

Our oncology products also contributed to the solid performance. Promacta, a treatment for blood disorders that is known as Revolade outside the US, grew 15% (cc) to USD 2.0 billion. Kisqali, a breast cancer treatment, had sales of USD 937 million, up 36% (cc). Jakavi, a treatment for blood disorders and cancers, grew 16% (cc) to USD 1.6 billion, showing double-digit growth across all regions.

Sales of Sandoz biopharmaceuticals continued to be a bright spot, with a 7% (cc) increase to USD 2.1 billion. However, that was countered by price competition and softer retail demand, including the impact of a weak cough and cold season, leading to an overall decline (-2%¹ cc; 0% in US dollar terms) in Sandoz Division net sales.

Novartis Group sales in Europe, our largest market, grew 5% (cc). Sales in the US rose 2%. Sales in emerging growth markets grew 11% (cc), led by a double-digit increase in China.

Operating income was USD 11.7 billion, up 13% (cc) from the prior year, mainly driven by higher sales and lower legal expenses, partly offset by increased investments in marketing and sales and in research and development, and higher amortization. Net income was USD 24.0 billion, benefiting from the USD 14.6 billion gain from the divestment of our investment in Roche. Earnings per share were USD 10.71.

To help people understand our underlying performance, we also present our core results, which exclude the impact of amortization, restructurings, acquisitions and other significant items. Core operating income of USD 16.6 billion rose 6% (cc). Core net income of USD 14.1 billion rose 5% (cc). Core earnings per share were USD 6.29, up 7% (cc). Free cash flow of USD 13.3 billion was up 14%, driven by higher operating income adjusted for non-cash items and lower payments for legal provisions, partly offset by a USD 650 million upfront payment to in-license tislelizumab from an affiliate of BeiGene, Ltd.

2021 net sales by division

(in USD millions, % growth in constant currencies, and divisional or business unit share of net sales)

2021 net sales by geographical region

(% of net sales and in USD millions)

¹ FY sales growth for Sandoz includes +1% impact from a reclassification of contract manufacturing from other revenue to sales