Press Release: Novartis delivered strong growth -3-

(4 weeks after the end of study treatment, p = 0.057)

and at Week 132 (at the end of treatment, nominal

p = 0.039). Safety was consistent with previous findings.

Novartis plans to submit these data for traditional

approval in H1 2026.

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Pluvicto Real--world analyses from the Novartis PRECISION platform

(lutetium Lu177 vipivotide tetraxetan) showed that Pluvicto achieved a median progression--free

survival (PFS) of 13.5 months in men with PSMA+ mCRPC

who were taxane--naïve and had received at least

one androgen receptor pathway inhibitor (ARPI). Longer

median PFS was observed when Pluvicto was initiated

after one prior ARPI compared with use after multiple

ARPIs. Data were presented at the ASCO-GU Symposium.

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Cosentyx In a matched adjusted indirect comparison analysis

(secukinumab) of efficacy and safety from Phase III trials in HS,

including SUNSHINE and SUNRISE, Cosentyx showed greater

flare prevention and a lower risk of Candida infections

compared with bimekizumab through Week 48, while maintaining

similar HiSCR50 responses. Data were presented at

AAD.

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Del-zota One--year data from the Phase I/II EXPLORE44 and EXPLORE44--OLE

studies evaluating del-zota in individuals with Duchenne

muscular dystrophy amenable to exon 44 skipping (DMD44)

showed sustained reductions in serum creatine kinase

levels, significant increases in dystrophin, and improvements

in multiple functional measures. Safety profile observed

to date is consistent with earlier findings. Data

were presented at MDA.

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Del-desiran Final results from the Phase I/II MARINA study of

del-desiran in adults with myotonic dystrophy type

1 (DM1), published in The New England Journal of Medicine,

showed effective delivery to muscle and a reduction

in DMPK mRNA, and improvements across multiple functional

measures. Safety profile observed to date is consistent

with earlier findings. Del--desiran is currently being

evaluated in the Phase III HARBOR study in DM1, with

readout anticipated in H2 2026.

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Selected transactions Novartis successfully completed the acquisition of

Avidity Biosciences, strengthening its late-stage

neuroscience pipeline and advancing its xRNA strategy.

Novartis entered into an agreement with Synnovation

Therapeutics to acquire SNV4818, a pan--mutant selective

PI3K inhibitor currently in Phase I/II for

patients with HR+/HER2-- breast cancer and other advanced

solid tumors. The program aligns with Novartis' strategy

in breast cancer, and fits naturally alongside CDK

inhibitors as well as endocrine (hormonal) therapies

as part of a potential combination regimen. The transaction

is expected to close in H1 2026, subject to customary

closing conditions.

Novartis entered into an agreement to acquire Excellergy,

including Exl-111, a half-life extended, high-affinity

anti-IgE antibody in Phase I, with a differentiated

mechanism designed to dissociate receptor-bound IgE

and drive faster and deeper Fc RI downregulation.

This acquisition builds on deep Novartis expertise

in IgE biology and allergic disease, with the potential

to offer earlier symptom relief, stronger disease

control and more convenient dosing. The transaction

is expected to close in H2 2026, subject to customary

closing conditions.

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Capital structure and net debt

Retaining a good balance between investment in the business, a strong capital structure, and attractive shareholder returns remains a priority.

In Q1 2026, Novartis repurchased a total of 10.4 million shares for USD 1.6 billion on the SIX Swiss Exchange second trading line under the up-to USD 10 billion share buyback announced in July 2025 (with up to USD 6.1 billion still to be executed). In addition, 2.0 million shares (equity value of USD 0.3 billion) were repurchased from employees. In the same period, 12.3 million shares (equity value of USD 0.3 billion) were delivered to employees related to equity-based compensation plans. Novartis aims to offset the 2026 dilution related to equity-based compensation plans of employees over the remainder of the year, in addition to the share repurchases under the up-to USD 10 billion share buyback. Consequently, the total number of shares outstanding decreased by 0.1 million versus December 31, 2025. These treasury share transactions resulted in an equity decrease of USD 1.6 billion and a cash outflow of USD 1.9 billion.

Net debt increased to USD 38.1 billion at March 31, 2026, compared to USD 21.9 billion at December 31, 2025. The increase was mainly due to the free cash flow of USD 3.3 billion being more than offset by the net cash outflow for M&A and intangible asset transactions of USD 12.5 billion, the USD 6.2 billion annual net dividend payment in March (which is the gross dividend of USD 9.1 billion reduced by the USD 2.9 billion Swiss withholding tax paid in April 2026, according to its due date), and cash outflows for treasury share transactions of USD 1.9 billion.

As of Q1 2026, the long-term credit rating for the company is Aa3 with Moody's Ratings and AA- with S&P Global Ratings.

2026 outlook

Barring unforeseen events; growth vs. prior year in

cc

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Net sales Expected to grow low single-digit

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Core operating income Expected to decline low single-digit

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Foreign exchange impact

If late-April exchange rates prevail for the remainder of 2026, the foreign exchange impact for the year would be positive 2 percentage points on net sales and positive 1 percentage point on core operating income. The estimated impact of exchange rates on our results is provided monthly on our website.

Key figures(1)

Q1 2026 Q1 2025 % change

USD m(2) USD m(2) USD cc

-------- -------- ---- ----

Net sales 13 113 13 233 -1 -5

-------- -------- ---- ----

Operating income 4 235 4 663 -9 -11

-------- -------- ---- ----

As a % of sales 32.3 35.2

----------------------------------------- -------- --------

Net income 3 156 3 609 -13 -13

-------- -------- ---- ----

EPS (USD) 1.65 1.83 -10 -11

-------- -------- ---- ----

Net cash flows from operating activities 3 676 3 645 1

-------- -------- ----

Non-IFRS measures

Free cash flow 3 330 3 391 -2

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April 28, 2026 01:00 ET (05:00 GMT)