Novartis is rapidly expanding its US manufacturing footprint with a $23 billion investment commitment while CEO Vas Narasimhan warns that potential Trump administration drug pricing controls could devastate the pharmaceutical industry.
Speaking on the company's earnings calls, Narasimhan expressed confidence in navigating potential tariff impacts but highlighted the "Most Favored Nations" rule as a far greater threat. The policy, which Trump unsuccessfully attempted to implement in his first term, would match US drug prices to lower international levels.
"The 'Most Favored Nations' rule would be devastating to the industry," Narasimhan said during the first quarter earnings call. He warned that if the US adopts international pricing, pharmaceutical companies would have to "relook at their long-term, medium- to long-term outlook."
Manufacturing Strategy Accelerates
The company is "moving as fast as possible" to ensure domestic production of key medicines within the next few years, Narasimhan announced during the second quarter earnings presentation. The $23 billion commitment includes a recently signed lease agreement for a large-scale research facility in San Diego and construction of another radioligand therapy facility.
"Our goal in the coming years is to have 100% of our key US products fully produced, end to end, in the US, and we're on track to do that," Narasimhan told investors.
The CEO acknowledged that Novartis could have boosted its US operations sooner, calling it a strategic decision recognizing that "the US is our most important single market from a growth and revenue standpoint."
Tariff Concerns and Timeline Challenges
With Trump indicating that pharmaceutical tariffs could reach as high as 200% and potentially begin as soon as August 1, Narasimhan described the potential impact as "significant" for Novartis' business. However, he noted that moving production of "most medicines" from one location to another typically involves a "3- to 4-year horizon."
The company is hopeful that the administration will provide consideration for companies making investments to move production to the US, especially given Trump's previous indication of a grace period of "about a year, a year and a half" for supply chain adjustments.
Strong Financial Performance
Novartis reported robust second quarter earnings with 11% year-on-year growth, bringing in just over $14 billion for the quarter. The heart failure drug Entresto remained the company's top-selling asset with nearly $2.34 billion in Q2 sales.
Key growth drivers included the breast cancer drug Kisqali, which jumped 64% to hit sales of nearly $1.18 billion, and the leukemia drug Scemblix, which surged 79% to earn almost $300 million. Leqvio, for treating hyperlipidemia, saw 61% year-on-year growth and reached nearly $300 million in sales.
Pipeline Setbacks and Outlook
The company disclosed that its investigational antibody ianalumab failed a Phase II study for the dermatological condition hidradenitis suppurativa, leading to discontinuation of the program.
Despite pipeline challenges, Novartis raised its 2025 outlook, now expecting net sales to grow in the high single-digit range and core operating income to grow in the low-teens range.
Policy Advocacy Efforts
Narasimhan has been actively advocating against importing European price controls to the US, co-authoring a letter with Sanofi CEO Paul Hudson urging the EU to raise drug prices to better reward innovation. "It's really important that we keep advocating that the United States should not import European price controls and the European anti-innovation environment into the United States," he emphasized.
The full impact of potential pricing controls would depend on program breadth, with scenarios ranging from Medicare Part D applications to potential spillover into Medicaid 340B pricing controls and private markets.
