Financial performance

Novartis maintained its growth momentum in 2022, supported by increased sales of key products across our core therapeutic areas.

2022 highlights

Group performance

Novartis full-year net sales were USD 50.5 billion, up 4% from the prior year when measured in constant currencies (cc) to remove the impact of exchange rate movements, but down 2% when measured in US dollar terms.

Increased sales of key products across our core therapeutic areas continued to underpin our financial performance.

Sales of our heart failure medicine Entresto grew 37% (cc) to USD 4.6 billion, driven by sustained growth and increased patient share across all geographies. Sales of our cholesterol-lowering treatment Leqvio reached USD 112 million following launch in the US and other countries during 2022.

Cosentyx, our treatment for psoriasis and other autoimmune diseases, also continued to grow. Sales rose 5% (cc) from the prior year to USD 4.8 billion, driven primarily by continued volume growth across key markets.

Kesimpta, a treatment for relapsing multiple sclerosis, reached blockbuster status for the first time, with sales growth driven by launch momentum across all geographies. It registered sales of USD 1.1 billion, up 200% (cc) from the prior year.

Kisqali, a treatment for breast cancer, also reached blockbuster status for the first time with sales growth of 38% (cc) to USD 1.2 billion, driven by double-digit growth across all regions. Jakavi, a treatment for blood disorders and cancers, grew 9% (cc) to USD 1.6 billion.

Kesimpta, a treatment for relapsing multiple sclerosis, reached blockbuster status for the first time

Sales of Sandoz biopharmaceuticals continued to perform strongly, with a 9% (cc) increase to USD 2.1 billion. Overall Sandoz Division net sales were USD 9.2 billion, up 4% (cc).

Novartis Group sales in Europe, our largest market, grew 2% (cc). Sales in the US grew by 5%. Sales in emerging growth markets grew 9% (cc), led by a 6% (cc) increase in China.

Operating income was USD 9.2 billion, down 13% (cc) from the prior year, mainly due to higher restructuring costs related to the implementation of our new organizational model and higher impairments.

Net income was USD 7.0 billion, compared with USD 24.0 billion in the prior year, mainly due to the divestment of our stake in Roche in the prior year. Excluding the Roche impact, net income declined by 9% (cc), mainly due to lower operating income. Earnings per share were USD 3.19 compared with USD 10.71 in the prior year. Excluding the Roche impact, EPS declined by 7% (cc).

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 16.7 billion rose 8% (cc). Core net income of USD 13.4 billion rose 3% (cc). Core earnings per share were USD 6.12, up 6% (cc). Free cash flow of USD 11.9 billion was down 10%, mainly due to a decrease in net cash flows from operating activities and lower divestment proceeds, partly offset by lower purchases of property, plant and equipment.

2022 net sales by division

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

2022 net sales by geographical region

(% of net sales and in USD millions)

Innovative Medicines

Our Innovative Medicines Division focuses on our five core therapeutic areas as well as other promoted brands (in the therapeutic areas of ophthalmology and respiratory) and established brands.

The IM Division delivered net sales of USD 41.3 billion in 2022, an increase of 4% (cc) from the prior year.

Six products with multibillion-dollar sales potential - Cosentyx, Entresto, Zolgensma, Kisqali, Kesimpta and Leqvio - contributed 32% of IM net sales in 2022, up from 26% in 2021

Six products with multibillion-dollar sales potential - Cosentyx, Entresto, Zolgensma, Kisqali, Kesimpta and Leqvio - contributed 32% of IM net sales in 2022, up from 26% in 2021. Core operating income for the IM Division was USD 15.2 billion, up 8% (cc).

Innovative Medicines 2022 net sales

(in USD millions, % growth in constant currencies, and therapeutic area share of net sales)

Cardiovascular

Sales were USD 4.8 billion, up 40% (cc). The performance was driven by continued strong growth for Entresto, which registered sales of USD 4.6 billion, up 37% (cc), with increased patient share across all geographies.

Leqvio, our treatment for high cholesterol, registered sales of USD 112 million in its first year after launch. Leqvio is the first and only small interfering RNA (siRNA) therapy to lower low-density lipoprotein cholesterol approved in the US. It is approved in 70 countries. Launch of the product is ongoing, with a focus on patient on-boarding, removing access hurdles and enhancing medical education.

Immunology

Sales reached USD 7.3 billion, up 7% (cc) from the previous year. Cosentyx delivered USD 4.8 billion in sales, up 5% (cc) from the prior year, driven by continued volume growth across key geographies, partly offset by higher US revenue deductions. Since initial approval in 2015, Cosentyx has treated more than 960 000 patients worldwide.

Xolair registered sales of USD 1.4 billion, up 6% (cc). Sales of Ilaris were USD 1.1 billion, up 15% (cc), with continued growth across all regions.

Neuroscience

Sales were USD 5.1 billion, increasing by 5% (cc), mainly driven by sales growth of Kesimpta, but partly offset by a decline in sales of Gilenya. Kesimpta showed strong sales growth, up 200% (cc) to USD 1.1 billion, driven by launch momentum across all geographies. It is now approved in 80 countries with more than 36 000 patients treated. Sales of Zolgensma grew 5% (cc) to USD 1.4 billion.

Gilenya sales were USD 2.0 billion, declining 24% (cc) from the prior year, mainly due to generic pressure in the US and Europe.

Solid Tumors

Sales were USD 4.7 billion, up 21% (cc) from the prior year. Tafinlar + Mekinist grew 11% (cc) to USD 1.8 billion, with growth across all geographies. The combination therapy remains the worldwide targeted therapy leader in BRAF+ melanoma.

Sales of Kisqali grew strongly across all geographies based on increasing recognition of its overall survival and quality of life benefits in HR+/ HER2-advanced breast cancer

Sales of Kisqali grew 38% (cc) to USD 1.2 billion, growing strongly across all geographies based on increasing recognition of its overall survival and quality of life benefits in HR+/ HER2- advanced breast cancer, the most common subtype of breast cancer. Piqray sales grew 14% (cc) to USD 373 million, with a strong performance in the US, benefiting from indication expansion into PIK-3CA-related overgrowth spectrum.

Sales of Pluvicto were USD 271 million as launch in the US in 2022 progressed well. Pluvicto is the first and only radioligand therapy approved by the FDA for the treatment of progressive, PSMA-positive metastatic castration-resistant prostate cancer.

Hematology

Sales were USD 6.5 billion, up 7% (cc) from the prior year. Promacta, which is known as Revolade outside the US, grew 9% (cc) to USD 2.1 billion, driven by increased use in second-line persistent and chronic immune thrombocytopenia and as a first-line and/or second-line treatment for severe aplastic anemia.

Scemblix continued its strong launch uptake with sales of USD 149 million, demonstrating the high unmet need in chronic myeloid leukemia. Jakavi registered sales of USD 1.6 billion, up 9% (cc) from the previous year, driven by strong demand in the myelofibrosis and polycythemia vera indications.

Scemblix continued its strong launch uptake, demonstrating the high unmet need in chronic myeloid leukemia

Other Promoted Brands

Sales were USD 3.1 billion, declining by 1% (cc) from the previous year due to competition for our respiratory and ophthalmology portfolios. Lucentis sales declined 4% (cc) to USD 1.9 billion, mainly in Japan and Europe, due to biosimilar launches. Xiidra sales were USD 487 million, up 4% (cc) from the prior year. Beovu sales grew 18% (cc) to USD 203 million.

Ultibro Group sales declined by 9% (cc) to USD 479 million, mainly in Europe and Emerging Growth Markets, due to competition. Ultibro Group consists of Ultibro Breezhaler, Seebri Breezhaler and Onbrez Breezhaler.

Established Brands

Sales were USD 9.9 billion, down 13% (cc) from the previous year, as sales of established medicines such as Afinitor and Glivec declined due to generic competition.

Sandoz

The Sandoz Division is a global leader in generic pharmaceuticals and biosimilars, and sells products in well over 100 countries. The division has three global franchises: Retail Generics, Biopharmaceuticals and Anti-Infectives.

Sandoz returned to growth in 2022 with a 4% (cc) increase in net sales from the previous year to USD 9.2 billion.

Sandoz returned to growth in 2022 with a 4% (cc) increase in net sales from the previous year

In Retail Generics, Sandoz develops, manufactures and markets finished dosage forms of small molecule pharmaceuticals for sale to third parties across a broad range of therapeutic areas, including finished dosage forms of anti-infectives sold to third parties. Sales in the franchise were USD 6.8 billion, up 4% (cc) from the prior year, growing across all regions apart from the US.

Sales in the Biopharmaceuticals franchise grew 9% (cc) to USD 2.1 billion, driven by growth across all geographies. Sandoz develops, manufactures and markets protein- and other biotechnology-based products, including biosimilars, and provides biotechnology manufacturing services to other companies.

Sales in the Biopharmaceuticals franchise grew 9% (cc), driven by growth across all geographies

In Anti-Infectives, Sandoz manufactures and supplies active pharmaceutical ingredients and intermediates, mainly antibiotics, for use by the Retail Generics franchise and for sale to third-party customers. Total franchise sales to third parties were USD 380 million, a decrease of 5% (cc) from the prior year, mainly due to product discontinuations and supply challenges.

Sandoz 2022 net sales by franchise

(in USD millions, % growth in constant currencies, and franchise share of net sales)