
Entresto is owned by Novartis AG, a publicly traded Swiss pharmaceutical company listed on the SIX Swiss Exchange (NOVN) and NASDAQ (NVS). Entresto generated $7.7 billion in sales for Novartis in 2025 before facing generic competition after its July 2025 patent expiry. Novartis CEO Vas Narasimhan called it the largest patent expiry in company history. The drug is approved for heart failure with reduced ejection fraction.
| Brand | Parent Company | Ownership Type |
|---|---|---|
| Entresto | Novartis | Brand division |
Entresto (sacubitril/valsartan) was developed by Novartis as a first-in-class angiotensin receptor neprilysin inhibitor (ARNI). The drug combines two active ingredients: sacubitril, a neprilysin inhibitor, and valsartan, an angiotensin II receptor blocker. This combination targets two pathways involved in heart failure progression.
The clinical development program was built on the PARADIGM-HF trial, a large-scale cardiovascular outcomes trial that enrolled over 8,400 patients. The trial was stopped early in 2014 by the Data Monitoring Committee because Entresto demonstrated a clear survival benefit compared to enalapril, the standard treatment at the time. Patients taking Entresto had a 20 percent reduction in cardiovascular death and a 21 percent reduction in heart failure hospitalizations compared to enalapril.
The FDA approved Entresto in July 2015 under priority review for heart failure with reduced ejection fraction. The European Medicines Agency approved it in November 2015. The drug received Breakthrough Therapy designation from the FDA, reflecting its potential to substantially improve outcomes for heart failure patients.
After approval, Entresto adoption was initially slower than Novartis expected. Physicians were cautious about switching patients from existing therapies. Novartis invested heavily in physician education and clinical evidence generation, publishing additional trial data and real-world evidence studies. The PIONEER-HF trial, published in 2018, demonstrated that initiating Entresto in stabilized acute heart failure patients reduced natriuretic peptide levels more than enalapril.
Entresto's sales grew steadily. By 2019, the drug had reached $1.8 billion in annual revenue. Sales accelerated after the 2021 FDA approval for heart failure with preserved ejection fraction (HFpEF), expanding the eligible patient population. By 2023, Entresto was Novartis's top-selling product, generating $6.0 billion. In 2024, sales reached $7.0 billion. In 2025, full-year sales were $7.7 billion, making Entresto one of the highest-revenue cardiovascular drugs in pharmaceutical history.
The primary U.S. composition of matter patent expired in July 2025. The FDA approved the first generic versions of Entresto in July 2025, manufactured by MSN Laboratories. Novartis filed a lawsuit against the FDA claiming the approval was unlawful, and submitted a Citizen Petition seeking to block generic entry until February 2026. The FDA rejected the petition, stating that generic manufacturers could avoid patent infringement by adjusting their labels. A federal appeals court ruled against Novartis, allowing generic Entresto to remain on the market.
Following generic entry, Entresto sales declined sharply. Q4 2025 revenue fell approximately 45 percent year-over-year. Novartis CEO Vas Narasimhan described the Entresto patent expiry as the largest in the company's history during an earnings call. Despite the revenue decline, Entresto remains on the market as a branded product, with Novartis continuing to promote its clinical benefits over generic alternatives.
Entresto is also subject to government price negotiation under the U.S. Inflation Reduction Act. Negotiated prices are scheduled to be published in September 2026 and would take effect in 2027. Narasimhan has described the initial impact of drug pricing negotiations as manageable.
What does Novartis own?
Novartis owns a portfolio of innovative prescription medicines across oncology, immunology, cardiovascular, neuroscience, and ophthalmology. Key products include Cosentyx (inflammatory diseases), Entresto (heart failure), Kisqali (breast cancer), Kesimpta (multiple sclerosis), Leqvio (cholesterol), Zolgensma (gene therapy for spinal muscular atrophy), Pluvicto (prostate cancer radioligand therapy), and Kymriah (CAR-T cell therapy). Novartis spun off its Sandoz generics division in 2023 and its Alcon eye care division in 2019, both of which are now independent publicly listed companies.
Is Novartis publicly traded?
Yes, Novartis AG is listed on the SIX Swiss Exchange under ticker NOVN and on the New York Stock Exchange under ticker NVS (as American Depositary Receipts). The company has a broad institutional and retail shareholder base with no single controlling shareholder. Major institutional shareholders include Vanguard Group, BlackRock, and Norges Bank Investment Management. The Novartis Foundation for Employee Participation also holds a significant stake.
What is Novartis's revenue?
Novartis reported FY2025 net sales of $50.3 billion, up 12% year over year (17% in constant currencies). Core operating income grew 15% (19% in constant currencies). For 2026, the company guides net sales growth of high single digits and core operating income growth of low double digits. The long-term outlook through 2030 calls for 5% net sales growth and 7% core operating income growth. Revenue is primarily generated from prescription medicine sales in more than 140 countries.
Who founded Novartis?
Novartis was formed in 1996 through the merger of Ciba-Geigy and Sandoz, two of Switzerland's oldest pharmaceutical companies. Ciba-Geigy itself was formed through the 1970 merger of Ciba (founded 1859) and Geigy (founded 1758), both based in Basel. Sandoz was founded in 1886 in Basel. The 1996 merger, valued at approximately $63 billion, was one of the largest corporate mergers in history at the time. The name Novartis comes from the Latin "novae artes," meaning "new skills."
Where is Novartis headquartered?
Novartis AG is headquartered in Basel, Switzerland. Basel has been the center of the Swiss pharmaceutical industry for more than a century, and both Novartis and Roche, another major pharmaceutical company, are headquartered in the city. Novartis operates manufacturing and research facilities in Switzerland, the United States, Germany, Spain, Italy, Japan, China, India, Singapore, and Brazil, and sells products in more than 140 countries worldwide.
Who is the CEO of Novartis?
Vas Narasimhan has served as CEO of Novartis since February 2018. He is a physician by training and has emphasized data science, digital health, and a focused innovative medicines strategy during his tenure. Under his leadership, Novartis spun off Sandoz (2023) and Alcon (2019), transforming the company from a diversified healthcare conglomerate into a focused innovative medicines company. Joerg Reinhardt chairs the board of directors.
What is Novartis's market position?
Novartis is one of the world's largest pharmaceutical companies by revenue, with FY2025 net sales of $50.3 billion. The company competes against Roche, Pfizer, AbbVie, Johnson & Johnson, AstraZeneca, Bristol-Myers Squibb, Merck, and Eli Lilly. Its FY2025 constant-currency sales growth of 17% outpaced many large-cap pharmaceutical peers. The company's long-term outlook of 5% net sales growth through 2030 positions it among the faster-growing companies in the large-cap pharmaceutical sector.
Entresto's sustainability profile is tied to Novartis's corporate ESG framework. Novartis has committed to achieving net zero greenhouse gas emissions across its value chain by 2040, with interim science-based targets validated by the Science Based Targets initiative. The company aims to reduce Scope 1 and 2 emissions by 50 percent by 2030 compared to a 2019 baseline.
Novartis's manufacturing sites that produce Entresto are included in the company's environmental management system, certified to ISO 14001 standards. The company reports on water consumption, waste generation, and energy use at its manufacturing facilities annually in its ESG report.
On access to medicine, Novartis participates in the Access to Medicine Foundation's rankings. The company has tiered pricing arrangements for Entresto in certain middle-income countries. However, the drug's high cost in the U.S. market (approximately $600 per month before generics) has been a point of criticism from patient advocacy groups and policymakers.
The Inflation Reduction Act's drug price negotiation provision applies to Entresto. Novartis has publicly stated that it is engaging with the CMS negotiation process. The negotiated maximum fair price is scheduled for publication in September 2026, with implementation in 2027.
Entresto has not been subject to any product safety recalls. The controversies surrounding the drug are related to patent litigation, generic competition, and drug pricing policy.
Patent Litigation and FDA Lawsuit (2025): In July 2025, Novartis filed a lawsuit against the FDA claiming that the regulator's approval of a generic Entresto from MSN Laboratories was unlawful. Novartis argued that the generic version infringed patents expiring in 2033 and 2036. The FDA rejected Novartis's Citizen Petition, which sought to block generic approvals until February 2026, stating that generic manufacturers could avoid infringement by adjusting their labels. A federal appeals court subsequently ruled against Novartis, allowing the generic to remain on the market. This case is resolved: generic Entresto is available in the U.S. market.
Revenue Impact of Generic Erosion: Entresto sales declined approximately 45 percent in Q4 2025 year-over-year following generic entry. This represents one of the steepest revenue declines for a major pharmaceutical product facing generic competition. Novartis CEO Vas Narasimhan called it the largest patent expiry in company history.
Inflation Reduction Act Price Negotiation: Entresto is among the drugs selected for government-negotiated pricing under the U.S. Inflation Reduction Act. The negotiated price will be published in September 2026 and take effect in 2027. Novartis has described the impact as manageable but has also expressed concern about the long-term effects of price negotiation on pharmaceutical innovation incentives.
Pricing Criticism: At approximately $600 per month in the U.S. before generics, Entresto was significantly more expensive than older heart failure medications. Patient advocacy groups raised concerns about access and affordability, particularly for Medicare patients. The introduction of generic versions at lower prices has partially addressed this concern.
These competing brands operate in the same categories and provide similar products or services. Compare key attributes to understand market positioning and competitive landscape.
| Brand | Parent Company | Country | Founded | Market Position | Primary Market | Gender Target |
|---|---|---|---|---|---|---|
| Novartis | Switzerland | 2010 | Declining branded | Global | All-consumers | |
| Viatris | USA | 1996 | Premium | Global | All-ages | |
| Pfizer | USA | 1987 | Mass market | Global | All-ages | |
| Sanofi | France | 1997 | Mass market | Global | All Genders | |
| Bausch Health | Canada | 1987 | Mass market | United states | All Genders |
Healthcare PharmaceuticalsOwned by Novartis
Prescription oral medication for relapsing-remitting multiple sclerosis (RRMS) and secondary progressive MS. Developed and marketed by Novartis. FDA-approved in 2010 as the first oral disease-modifying therapy for MS. Generic fingolimod entered the US market in 2024 after patent expiration.
Healthcare PharmaceuticalsOwned by Viatris Inc.
Brand name for atorvastatin, the world's best-selling prescription drug from 1996 to 2012, generating over $125 billion in cumulative sales. Originally developed by Parke-Davis and acquired by Pfizer in 2000. Now owned by Viatris Inc. (NASDAQ: VTRS) since November 2020. FY2025 net sales of $1.55 billion.
Healthcare PharmaceuticalsOwned by Pfizer Inc.
Prescription calcium channel blocker medication for treating high blood pressure and angina, manufactured and marketed by Pfizer.
Healthcare PharmaceuticalsOwned by Sanofi
Clopidogrel antiplatelet medication co-developed by Sanofi and Bristol-Myers Squibb, FDA approved in 1997, that became the world's second best-selling drug before its patent expired in May 2012.
Healthcare PharmaceuticalsOwned by Bausch Health Companies Inc.
Prescription combination medication for hypertension containing enalapril and hydrochlorothiazide, originally developed by Merck and now distributed by Bausch Health.
Market Positioning: Entresto competes with 5 brands in the same categories, ranging from mass market to luxury positioning.
Geographic Distribution: Competitors are headquartered across multiple regions, indicating global competition in this market segment.
Brand Heritage: Competitor brands range from established heritage brands to newer market entrants, with founding years spanning several decades.
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Healthcare PharmaceuticalsOwned by Chempro Chemists
Australian online pharmacy operated by Chempro Chemists from Molendinar, Queensland. Offers prescription medications, health products, and wellness items through digital platforms and mail-order delivery.
Pharmacy Direct is privately owned, unlike Entresto which is under a publicly traded parent company.
Healthcare PharmaceuticalsOwned by EKR Therapeutics, Inc.
Retavase (reteplase) is a prescription thrombolytic medication indicated for acute ST-elevation myocardial infarction. Administered as two 10-unit intravenous bolus injections 30 minutes apart. Currently marketed by Chiesi USA.
Retavase is privately owned, unlike Entresto which is under a publicly traded parent company.
Healthcare PharmaceuticalsOwned by IBSA Institut Biochimique S.A.
IBSA Institut Biochimique SA's branded levothyroxine softgel capsule (Tirosint) and liquid solution (Tirosint-SOL), FDA approved for hypothyroidism, formulated without dyes, gluten, lactose, alcohol, or sugar, providing an excipient-free alternative to conventional levothyroxine tablets for patients with sensitivities or absorption issues.
Tirosint is privately owned, unlike Entresto which is under a publicly traded parent company.
Healthcare PharmaceuticalsOwned by Alcon Inc.
Independent publicly traded global eye care company headquartered in Geneva, Switzerland, specializing in surgical equipment, contact lenses, and ophthalmic products. Spun off from Novartis in April 2019.
Alcon operates independently without a large parent corporation.
Healthcare PharmaceuticalsOwned by Bausch + Lomb Corporation
Global eye health company and contact lens manufacturer founded in 1853, known for ULTRA, Biotrue One Day, and INFUSE lens lines. Public on NYSE and TSX under BLCO.
Bausch + Lomb operates independently without a large parent corporation.
Healthcare PharmaceuticalsOwned by GE HealthCare Technologies Inc.
Independent publicly traded healthcare technology company spun off from General Electric in January 2023, providing medical imaging, diagnostics, and healthcare IT solutions globally.
GE HealthCare operates independently without a large parent corporation.
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