NEW YORK – During a call Friday to discuss Novartis' fourth quarter and full-year 2024 financial results, executives boasted that the company last year delivered "one of the strongest performances" in its history, highlighting in particular the uptake of precision medicine products like Kisqali (ribociclib) and Pluvicto (lutetium Lu 177 vipivotide tetraxetan).
Novartis in Q4 2024 reported net sales of $13.15 billion, a 15 percent increase compared to $11.42 billion in Q4 2023. Net sales increased 16 percent in constant currency and beat analysts' consensus revenue expectation of $12.81 billion.
Sales of Novartis' top 20 pharmaceutical brands — including Kisqali, Pluvicto, and other precision medicine products such as the combination of Tafinlar (dabrafenib) and Mekinist (trametinib), Lutathera (lutetium Lu 177 dotatate), Scemblix (asciminib), and Zolgensma (onasemnogene abeparvovec) — contributed $10.64 billion to Q4 2024 revenue, a 19 percent increase over the year-ago quarter. With these innovative medicines in Novartis' portfolio, the company is in a growth trajectory through the end of the decade, Novartis CEO Vas Narasimhan said during the call.
In Q4 2024, sales for Kisqali, a drug sold for early-stage and advanced hormone receptor (HR)-positive, HER2-negative breast cancer, grew 48 percent to $902 million compared to the prior year's fourth quarter. Last fall, the US Food and Drug Administration approved the CDK4/6 inhibitor, which was already marketed for HR-positive HER2-negative metastatic breast cancer, as an option for patients with stage II and III early breast cancer who are at high risk of recurrence. The National Comprehensive Cancer Network also recommended Kisqali as a category 1 preferred medicine in the adjuvant breast cancer setting. These events drove up sales of the drug by 65 percent in the US in Q4, Narasimhan highlighted.
Pluvicto, Novartis' radiopharmaceutical for PSMA-positive metastatic castration-resistant prostate cancer (mCRPC), recorded sales of $351 million in Q4 2024, a 29 percent increase over the year-ago quarter. Narasimhan noted that Pluvicto is now available in more than 20 countries, and Novartis is laying the foundation to bring the radiopharmaceutical to PSMA-positive mCRPC patients who have not received prior taxane chemotherapy, based on data from the PSMAfore study.
If the company garners FDA approval in the first half of this year, as it expects, the company has said it could triple the eligible population for Pluvicto. Narasimhan said Novartis is ready for this approval and has opened approximately 590 clinical sites that can provide Pluvicto and approximately 350 sites that are actively ordering it for patients. "Every month, every week, we're adding more sites," he said. "We're getting more sites to actively order [the drug]. We're getting further into community oncology, which will set us up not only for Pluvicto but our broader [radiopharmaceutical] pipeline over time."
Novartis is seeking approval for Pluvicto in China for treating PSMA-positive mCRPC in the post-taxane setting and in Japan in both the pre- and post-taxane settings. The company is also evaluating Pluvicto with standard-of-care treatment in metastatic hormone-sensitive prostate cancer in the PSMAddition study and expects a readout from the trial in the second half of 2025.
Sales for Lutathera, another radiopharmaceutical in Novartis' portfolio for treating SSTR-positive gastroenteropancreatic neuroendocrine tumors, grew 29 percent to $190 million. The firm is also developing Ac-PSMA-617, an investigational targeted alpha therapy, in PSMA-positive prostate cancer and plans to initiate a Phase III trial this year.
Revenue for Tafinlar plus Mekinist, used to treat various BRAF-mutated cancers, increased 8 percent to $527 million. And Scemblix, used to treat Philadelphia chromosome-positive chronic myelogenous leukemia, recorded $207 million in revenue in Q4 2024, a 66 percent growth compared to Q4 2023.
In Q4 2024, sales of Zolgensma, Novartis' spinal muscular atrophy (SMA) gene therapy, decreased 8 percent to $262 million compared to Q4 2023. The gene therapy is designed to deliver a functional SMN1 gene, which is abnormal in SMA patients.
Novartis closed out 2024 with the announcement that the Phase III STEER study of intrathecal Zolgensma met its primary endpoint and showed that the gene therapy can increase patients' Hammersmith Functional Motor Scale-Expanded (HFMSE) scores from baseline. HFMSE is a gold standard measurement of motor ability and disease progression in SMA patients. The company is planning to seek approval this year for intrathecal Zolgensma broadly across children and young adults based on this data.
Narasimhan noted that the company inked a global license and collaboration agreement with PTC Therapeutics to develop PTC518, an mRNA splice modulator designed to reduce expression of the HTT gene, mutations in which cause the inherited, fatal neurodegenerative disease Huntington's disease. The company is hoping PTC518 will become the first oral disease-modifying therapy for Huntington's and plans to take over its development, manufacturing, and commercialization after the placebo-controlled portion of the Phase II PIVOT-HD study ends in the first half of this year.
Novartis posted net income of $2.82 billion in Q4 2024, or $1.42 per share, compared to $2.64 billion in Q4 2023, or $1.29 per share. Core EPS was $1.98, higher than the consensus Wall Street estimate of $1.81.
Full-year financial performance
From 2023 to 2024, Novartis' net sales increased by 11 percent, or 12 percent in constant currency, from $45.44 billion to $50.32 billion and beat the $50.47 billion that analysts on average had projected. The company's top 20 pharmaceutical brands contributed $40.24 billion, an 18 percent increase from 2023.
Over the same period, Kisqali sales increased 46 percent to $3.03 billion; revenue for Tafinlar plus Mekinist grew 7 percent to $2.06 billion; Pluvicto reached blockbuster status with $1.39 billion in revenue, a 42 percent growth; Lutathera sales grew 20 percent to $724 million; Scemblix sales increased 67 percent to $689 million; and Zolgensma sales were flat at $1.21 billion.
During 2024, Novartis posted net income of $11.94 billion, or $5.92 per share, compared to $8.57 billion, or $4.13 per share, in 2023. Core EPS was $7.81.
In 2025, Novartis expects net sales to grow in the mid- to high-single digits.