Novartis shares fall after weak Q1 hit by Entresto competition

Novartis reported first-quarter core operating profit and sales below market expectations, as generic competition for its top-selling heart drug Entresto weighed on results.

Shares of the Swiss drugmaker declined about 3% in premarket trading on Tuesday following the earnings release.

Quarterly group operating income, adjusted for special items, fell 12% to $4.9 billion.

This was below analyst expectations of about $5.1 billion, according to data cited by Visible Alpha.

Total net sales for the quarter came in at $13.11 billion, also missing expectations of $13.40 billion.

Entresto generic competition hits sales

The company is navigating its largest patent expiry cycle in two decades.

This includes Entresto, which accounted for 14% of total net sales last year.

Entresto sales dropped sharply in the first quarter.

Revenue from the drug fell 42% to $1.31 billion after US patents expired and generic versions entered the market.

Analysts had expected Entresto sales of $1.37 billion for the quarter ended March 31.

The pressure is expected to continue.

Entresto is set to face patent expiries in Europe starting in November, further intensifying competition.

CFO comments on outlook

CFO Mukul Mehta addressed the earnings performance during a call with reporters.

He said the results were in line with the company’s internal expectations.

"We do expect growth to return back to our P&L in second half of this year," Mehta said, as cited in a Reuters report.

Broader generic pressure on portfolio

Apart from Entresto, other key drugs are also facing competition from generics.

Blood disorder treatment Promacta and leukemia drug Tasigna are under similar pressure.

This adds to the challenge for Novartis, which now needs to rely on newer medicines to drive growth.

The company has already indicated that it expects sales to decline by $4 billion this year due to generic competition impacting Entresto and the other two drugs.

Full-year guidance unchanged

Despite the weak first-quarter performance, Novartis maintained its full-year outlook.

The Basel-based company expects a low single-digit percentage decline in core operating income for the year, excluding currency fluctuations.

The company also indicated that it is looking toward its drug pipeline to support future growth, even as near-term earnings remain under pressure.

Stock performance

Novartis shares were trading around CHF 110.96 as of April 28, 2026.

The stock was down during the day, reflecting investor concerns following the earnings miss.

The company’s 52-week range stands between CHF 87.89 and CHF 131.00.

Long-term growth expectations remain

Despite current headwinds, Novartis signalled confidence in its long-term growth trajectory.

The company expects growth to improve later in the year and may adjust its outlook depending on upcoming clinical trial results.

However, near-term performance is likely to remain impacted by ongoing generic competition across key products.

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