{"schema_version":"1.0","type":"article","title":"Entresto Sinks 38%; Novartis Bets on Leqvio","url":"https://drugnews.com.tw/articles/2026-11-03-novartis-entresto-generic-leqvio-orion4-heart-bet-en.html","markdown_url":"https://drugnews.com.tw/articles/2026-11-03-novartis-entresto-generic-leqvio-orion4-heart-bet-en.md","lang":"en","date":"2026-11-03","publish_at":"2026-11-03T08:00:00+08:00","updated_at":"2026-11-03","category":"製藥巨頭系列","topic":"製藥巨頭系列","tags":["Novartis","Entresto","Leqvio","inclisiran","Lp(a)"],"summary":"Generics cut Entresto's Q3 sales 38%. Both Novartis succession bets failed in one September week. Leqvio's ORION-4 trial will succeed this winter because PCSK9 is a proven target, but it cannot fill Entresto's hole.","key_points":["Novartis's Leqvio (inclisiran) will report a successful ORION-4 cardiovascular outcomes trial by March 31, 2027, with a significant cut in major cardiovascular events of at least the 15% Amgen's Repatha showed in FOURIER, because its PCSK9 target was already proven in FOURIER's 27,564 patients.","Novartis reported on October 27, 2026 that Entresto sold $1.165 billion in Q3 2026, down 38% at constant currency, and $3.651 billion in the first nine months versus $6.495 billion a year earlier, after US generics launched on July 22, 2025.","Two Novartis succession bets failed within one week of September 2026: pelacarsen's 8,323-patient Lp(a)HORIZON trial missed its primary endpoint on September 4 and will not be filed in the US, and del-desiran failed HARBOR on September 8, leading to a $1.9 billion impairment in Q3."],"facts":[{"claim":"Entresto net sales, Q3 2026","value":1165,"unit":"USD million","as_of":"2026-10-27","source":"https://www.sec.gov/Archives/edgar/data/0001114448/000111444826000014/a261027-99_2.htm"},{"claim":"Entresto sales change, Q3 2026 (constant currency)","value":"-38","unit":"%","as_of":"2026-10-27","source":"https://www.sec.gov/Archives/edgar/data/0001114448/000111444826000014/a261027-99_2.htm"},{"claim":"Entresto net sales, first nine months of 2026","value":3651,"unit":"USD million","as_of":"2026-10-27","source":"https://www.sec.gov/Archives/edgar/data/0001114448/000111444826000014/a261027-99_2.htm"},{"claim":"Entresto net sales, first nine months of 2025","value":6495,"unit":"USD million","as_of":"2026-10-27","source":"https://www.sec.gov/Archives/edgar/data/0001114448/000111444826000014/a261027-99_2.htm"},{"claim":"Entresto net sales, full year 2024","value":7822,"unit":"USD million","as_of":"2025-01-31","source":"https://www.sec.gov/Archives/edgar/data/1114448/000137036825000008/a250131-99_2.pdf"},{"claim":"FDA approval date of Entresto","value":"2015-07-07","unit":"date","as_of":"2015-07-07","source":"https://www.novartis.com/news/media-releases/novartis-new-heart-failure-medicine-lcz696-now-called-entrestotm-approved-fda-reduce-risk-cardiovascular-death-and-heart-failure-hospitalization"},{"claim":"PARADIGM-HF enrollment","value":8442,"unit":"patients","as_of":"2015-07-07","source":"https://www.novartis.com/news/media-releases/novartis-new-heart-failure-medicine-lcz696-now-called-entrestotm-approved-fda-reduce-risk-cardiovascular-death-and-heart-failure-hospitalization"},{"claim":"First US generic Entresto launch (Novadoz/MSN)","value":"2025-07-22","unit":"date","as_of":"2025-07-30","source":"https://business.optum.com/en/support/professionalrx-resources/newgeneric-entresto-073025.html"},{"claim":"Novartis group net sales, Q3 2026","value":14.5,"unit":"USD billion","as_of":"2026-10-27","source":"https://www.sec.gov/Archives/edgar/data/0001114448/000111444826000014/a261027-99_2.htm"},{"claim":"Kisqali net sales, Q3 2026","value":1821,"unit":"USD million","as_of":"2026-10-27","source":"https://www.sec.gov/Archives/edgar/data/0001114448/000111444826000014/a261027-99_2.htm"},{"claim":"Kisqali net sales, first nine months of 2026","value":5032,"unit":"USD million","as_of":"2026-10-27","source":"https://www.sec.gov/Archives/edgar/data/0001114448/000111444826000014/a261027-99_2.htm"},{"claim":"Cosentyx net sales, Q3 2026","value":1857,"unit":"USD million","as_of":"2026-10-27","source":"https://www.sec.gov/Archives/edgar/data/0001114448/000111444826000014/a261027-99_2.htm"},{"claim":"Leqvio net sales, Q3 2026","value":506,"unit":"USD million","as_of":"2026-10-27","source":"https://www.sec.gov/Archives/edgar/data/0001114448/000111444826000014/a261027-99_2.htm"},{"claim":"Leqvio sales growth, Q3 2026","value":64,"unit":"%","as_of":"2026-10-27","source":"https://www.sec.gov/Archives/edgar/data/0001114448/000111444826000014/a261027-99_2.htm"},{"claim":"Impairment on del-desiran IPR&D, Q3 2026","value":1.9,"unit":"USD billion","as_of":"2026-10-27","source":"https://www.sec.gov/Archives/edgar/data/0001114448/000111444826000014/a261027-99_2.htm"},{"claim":"Del-desiran carrying value after impairment","value":5.5,"unit":"USD billion","as_of":"2026-10-27","source":"https://www.sec.gov/Archives/edgar/data/0001114448/000111444826000014/a261027-99_2.htm"},{"claim":"Lp(a)HORIZON enrollment","value":8323,"unit":"patients","as_of":"2026-09-04","source":"https://ir.ionis.com/news-releases/news-release-details/ionis-partner-novartis-announces-lpahorizon-phase-3-topline"},{"claim":"Equity value of Novartis acquisition of Avidity","value":12,"unit":"USD billion","as_of":"2025-10-26","source":"https://www.sec.gov/Archives/edgar/data/1599901/000119312525250696/d25008dex991.htm"},{"claim":"Leqvio LDL-C reduction vs placebo (up to)","value":52,"unit":"%","as_of":"2021-12-22","source":"https://www.sec.gov/Archives/edgar/data/1114448/000117184321008671/f6k_122221.htm"},{"claim":"ORION-4 planned enrollment","value":15000,"unit":"patients","as_of":"2026-10-28","source":"https://www.hra.nhs.uk/planning-and-improving-research/application-summaries/research-summaries/orion-4/"},{"claim":"FOURIER enrollment","value":27564,"unit":"patients","as_of":"2017-03-17","source":"https://acc.org/Latest-in-Cardiology/Articles/2017/03/10/19/18/Fri-9am-FOURIER-Further-CV-Outcomes-Research-With-PCSK9-Inhibition-in-Elevated-Risk-Patients-acc-2017"},{"claim":"FOURIER relative reduction in primary major cardiovascular events","value":15,"unit":"%","as_of":"2017-03-17","source":"https://acc.org/Latest-in-Cardiology/Articles/2017/03/10/19/18/Fri-9am-FOURIER-Further-CV-Outcomes-Research-With-PCSK9-Inhibition-in-Elevated-Risk-Patients-acc-2017"},{"claim":"Expected year of Amgen olpasiran outcomes readout","value":2028,"unit":"year","as_of":"2026-09-08","source":"https://www.biospace.com/drug-development/novartis-cholesterol-lowering-medicine-fails-phase-3-clouding-lpa-horizons"},{"claim":"Expected year of Lilly lepodisiran outcomes readout","value":2029,"unit":"year","as_of":"2026-09-08","source":"https://www.biospace.com/drug-development/novartis-cholesterol-lowering-medicine-fails-phase-3-clouding-lpa-horizons"},{"claim":"Leqvio peak sales guidance (more than)","value":4,"unit":"USD billion","as_of":"2026-10-27","source":"https://www.investing.com/news/transcripts/earnings-call-transcript-novartis-beats-q3-2026-eps-forecast-lifts-profit-outlook-93CH-4975830"},{"claim":"Leqvio net sales, Q3 2025","value":308,"unit":"USD million","as_of":"2026-10-27","source":"https://www.sec.gov/Archives/edgar/data/0001114448/000111444826000014/a261027-99_2.htm"}],"sections":["01 | A ten-year blockbuster, halved in one summer","02 | Two succession bets, both lost in one week of September","03 | Two RNA drugs, one proven target","04 | After the readout: how big a hole can Leqvio fill?","References"],"references":[{"title":"Novartis Q3 2026 interim financial report (Form 6-K","source":"Novartis／SEC","date":"2026-10-27","url":"https://www.sec.gov/Archives/edgar/data/0001114448/000111444826000014/a261027-99_2.htm"},{"title":"Novartis Q3 2026 investor presentation","source":"Novartis","date":"2026-10-27","url":"https://www.novartis.com/sites/novartis_com/files/q3-2026-investor-presentation.pdf"},{"title":"Novartis faces $1.9B hit from Avidity fail but maintains confidence in $12B buy","source":"BioSpace","date":"2026-10-27","url":"https://www.biospace.com/business/novartis-faces-1-9b-hit-from-avidity-fail-but-maintains-confidence-in-12b-buy"},{"title":"Earnings call transcript: Novartis beats Q3 2026 EPS forecast, lifts profit 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LCZ696, now called Entresto, approved by FDA","source":"Novartis","date":"2015-07-07","url":"https://www.novartis.com/news/media-releases/novartis-new-heart-failure-medicine-lcz696-now-called-entrestotm-approved-fda-reduce-risk-cardiovascular-death-and-heart-failure-hospitalization"},{"title":"New generic: Entresto","source":"Optum Rx","date":"2025-07-30","url":"https://business.optum.com/en/support/professionalrx-resources/newgeneric-entresto-073025.html"},{"title":"Novartis Q4 and full year 2024 financial results (Form 6-K","source":"Novartis／SEC","date":"2025-01-31","url":"https://www.sec.gov/Archives/edgar/data/1114448/000137036825000008/a250131-99_2.pdf"},{"title":"FDA approves Novartis Leqvio, first-in-class siRNA to lower cholesterol (Form 6-K","source":"Novartis／SEC","date":"2021-12-22","url":"https://www.sec.gov/Archives/edgar/data/1114448/000117184321008671/f6k_122221.htm"},{"title":"ORION-4 research summary","source":"NHS Health Research Authority","date":"2026-10-28","url":"https://www.hra.nhs.uk/planning-and-improving-research/application-summaries/research-summaries/orion-4/"},{"title":"FOURIER: Evolocumab significantly reduces risk of cardiovascular events","source":"American College of Cardiology","date":"2017-03-17","url":"https://acc.org/Latest-in-Cardiology/Articles/2017/03/10/19/18/Fri-9am-FOURIER-Further-CV-Outcomes-Research-With-PCSK9-Inhibition-in-Elevated-Risk-Patients-acc-2017"},{"title":"Novartis to acquire Avidity Biosciences (Exhibit 99.1, Form 8-K","source":"Avidity Biosciences／SEC","date":"2025-10-26","url":"https://www.sec.gov/Archives/edgar/data/1599901/000119312525250696/d25008dex991.htm"},{"title":"Novartis heart drug sales halve: can new drugs take over in time? (Chinese","source":"Drugnews","date":"2026-10-06","url":"https://drugnews.com.tw/articles/2026-10-06-novartis-growth-succession-capital-allocation.html"}],"images":[],"cover_image":"https://drugnews.com.tw/assets/articles/novartis-entresto-generic-leqvio-orion4-heart-bet-en/default-brand.png","publisher":{"name":"Drugnews｜藥時事","url":"https://drugnews.com.tw/","profile":"https://drugnews.com.tw/brand-profile.json"},"citation":"Drugnews｜藥時事（2026-11-03）。Entresto Sinks 38%; Novartis Bets on Leqvio。https://drugnews.com.tw/articles/2026-11-03-novartis-entresto-generic-leqvio-orion4-heart-bet-en.html","disclaimer":"This article is intended for industry research and knowledge sharing only. It does not constitute investment, medical, fundraising, or individual stock advice.","translations":{},"relationship":"independent_editorial","disclosure_url":"https://drugnews.com.tw/policy/"}