Excluding Roche investment impacts2						Reported
		Q4 2022 USD m		Q4 2021 USD m		% change USD		% change cc 1		Q4 2021 USD m		% change USD		% change cc 1
Net sales to third parties		12 690		13 229		-4		3		13 229		-4		3
Divisional operating income		2 218		2 854		-22		-13		2 854		-22		-13
Corporate income and expense, net		-269		-292		8		2		-292		8		2
Operating income		1 949		2 562		-24		-14		2 562		-24		-14
As % of net sales		15.4		19.4						19.4
(Loss)/income from associated companies		-3		2		nm		nm		14 621		nm		nm
Interest expense		-219		-206		-6		-8		-206		–  6		-8
Other financial income and expense		14		-42		nm		nm		-26		nm		nm
Income taxes		-275		-645		57		50		-645		57		50
Net income		1 466		1 671		-12		2		16 306		-91		-90
Basic earnings per share (USD)		0.69		0.75		-8		7		7.29		-91		-89
Net cash flows from operating activities		4 111		3 884		6				3 884		6
Free cash flow 1		3 552		3 027		17				3 027		17
Core 1
Core operating income		4 030		3 819		6		15		3 819		6		15
As % of net sales		31.8		28.9						28.9
Core net income		3 251		3 044		7		17		3 135		4		14
Core basic earnings per share (USD)		1.52		1.36		12		23		1.40		9		19
1  Constant currencies (cc), core results and free cash flow are non-IFRS measures. An explanation of non-IFRS measures can be found on page 50. Unless otherwise noted, all growth rates in this release refer to same period in prior year.
2  A reconciliation of 2021 IFRS results and non-IFRS measures core results and free cash flow to exclude the impacts of the 2021 divestment of our Roche investment can be found on page 58 of the Condensed Financial Report. The free cash flow impact represents the dividend received in Q1 2021 from Roche in relation to the distribution of its 2020 net income.
nm = not meaningful

				Excluding Roche investment impacts2						Reported
		FY 2022 USD m		FY 2021 USD m		% change USD		% change cc 1		FY 2021 USD m		% change USD		% change cc 1
Net sales to third parties		50 545		51 626		-2		4		51 626		–  2		4
Divisional operating income		10 234		12 288		-17		-8		12 288		-17		-8
Corporate income and expense, net		-1 037		-599		-73		-84		-599		-73		-84
Operating income		9 197		11 689		-21		-13		11 689		-21		-13
As % of net sales		18.2		22.6						22.6
(Loss)/income from associated companies		-9		-2		nm		nm		15 339		nm		nm
Interest expense		-837		-811		-3		-5		-811		–  3		-5
Other financial income and expense		20		-96		nm		nm		-80		nm		nm
Income taxes		-1 416		-2 119		33		25		-2 119		33		25
Net income		6 955		8 661		-20		-9		24 018		-71		-67
Basic earnings per share (USD)		3.19		3.86		-17		-7		10.71		-70		-66
Net cash flows from operating activities		14 236		14 549		-2				15 071		-6
Free cash flow 1		11 945		12 760		-6				13 282		-10
Core 1
Core operating income		16 665		16 588		0		8		16 588		0		8
As % of net sales		33.0		32.1						32.1
Core net income		13 352		13 099		2		11		14 094		-5		3
Core basic earnings per share (USD)		6.12		5.84		5		14		6.29		-3		6
1  Constant currencies (cc), core results and free cash flow are non-IFRS measures. An explanation of non-IFRS measures can be found on page 50. Unless otherwise noted, all growth rates in this release refer to same period in prior year.
2  A reconciliation of 2021 IFRS results and non-IFRS measures core results and free cash flow to exclude the impacts of the 2021 divestment of our Roche investment can be found on page 58 of the Condensed Financial Report. The free cash flow impact represents the dividend received in Q1 2021 from Roche in relation to the distribution of its 2020 net income.
nm = not meaningful

During 2022, Novartis unveiled a new focused strategy with our transformation into a “pure-play” Innovative Medicines business. We have a clear focus on five core therapeutic areas (cardiovascular, immunology, neuroscience, solid tumors and hematology), with multiple significant in-market and pipeline assets in each of these areas, that address high disease burden and have substantial growth potential. In addition to two established technology platforms (chemistry and biotherapeutics), three emerging platforms (gene & cell therapy, radioligand therapy, and xRNA) are being prioritized for continued investment into new R&D capabilities and manufacturing scale. Geographically, we are focused on growing in our priority geographies - the US, China, Germany and Japan.

1. Accelerate growth: Renewed attention to deliver high-value medicines (NMEs) and focus on launch excellence, with a rich pipeline across our core therapeutic areas.

2. Deliver returns: Continuing to embed operational excellence and deliver improved financials. Novartis remains disciplined and shareholder-focused in our approach to capital allocation, with substantial cash generation and a strong capital structure supporting continued flexibility.

3. Strengthening foundations: Unleashing the power of our people, scaling data science and technology and continuing to build trust with society.

The planned spin-off remains on track for H2 2023. Completion of the transaction is subject to certain conditions, including consultation with works councils and employee representatives (as required), general market conditions, tax rulings and opinions, final Board of Directors endorsement and shareholder approval in line with Swiss corporate law. The transaction is expected to be tax neutral to Novartis.

Net sales were USD 12.7 billion (-4%, +3% cc) in the fourth quarter driven by volume growth of 10 percentage points, partly offset by price erosion of 3 percentage points and the negative impact from generic competition of 4 percentage points.

Corporate income and expense, which includes the cost of Group headquarter and coordination functions, amounted to an expense of USD 269 million compared to an expense of USD 292 million in the fourth quarter of 2021, mainly driven by prior year adjustments to provisions on M&A transactions partly offset by higher restructuring costs and lower contributions from the Novartis Venture Fund.

Operating income was USD 1.9 billion (-24%, -14% cc), mainly due to higher restructuring costs (USD 0.6 billion), primarily related to the implementation of the previously announced streamlined organizational model. Operating income margin was 15.4% of net sales, decreasing by 4.0 percentage points (-3.2 percentage points cc).

Core operating income was USD 4.0 billion (+6%, +15% cc) driven by higher sales and productivity, including initial savings from the previously announced streamlined organizational model. Core operating income margin was 31.8% of net sales, increasing by 2.9 percentage points (+3.5 percentage points cc).

Income from associated companies was a loss of USD 3 million in the fourth quarter compared to an income of USD 14.6 billion in prior year and core income from associated companies was a loss of USD 3 million in the fourth quarter compared to an income of USD 93 million in prior year. These decreases were due to the divestment of our investment in Roche that closed in the fourth quarter of 2021 where a gain of USD 14.6 billion was recognized.

Interest expense amounted to USD 219 million and was broadly in line with the prior year. Other financial income and expense amounted to an income of USD 14 million compared to an expense of USD 26 million in the prior year and core other financial income and expense amounted to an income of USD 54 million compared to an expense of USD 24 million in the prior year quarter, as higher interest income was only partly offset by currency losses.

The tax rate in the fourth quarter was 15.8% compared to 3.8% in the prior year. The current and the prior year fourth quarter tax rate include a favorable adjustment to true-up to the estimated full year tax rate, which was lower than previously estimated. The prior year quarter’s tax rate decreased due to the impact of the divestment gain recognized on the sale of our investment in Roche, partly offset by uncertain tax positions and prior year items.

For comparability, excluding these impacts, the prior year rate would have been 15.9%, broadly in line with 15.8% in the current year.

The core tax rate (core taxes as a percentage of core income before tax) was 15.8% compared to 14.9% in the prior year. The current and prior year core tax rates were both favorably impacted by the effect of adjusting to the full year core tax rate, which was less than previously estimated.

Net income was USD 1.5 billion (-91%, -90% cc), impacted by Roche income in the prior year of USD 14.6 billion. Excluding the impact of Roche income, net income grew +2% (cc). EPS was USD 0.69 (-91%, -89% cc). Excluding the impact of Roche income, EPS grew +7% (cc).

Core net income was USD 3.3 billion (+4%, +14% cc), mainly driven by growth in core operating income, partly offset by the loss of Roche core income. Excluding the impact of Roche core income, core net income grew +17% (cc). Core EPS was USD 1.52 (+9%, +19% cc), benefiting from lower weighted average number of shares outstanding. Excluding the impact of Roche core income, core EPS grew +23% (cc).

Free cash flow amounted to USD 3.6 billion (+17% USD), mainly driven by higher net cash flows from operating activities and lower purchases of intangible assets.

Net sales were USD 50.5 billion (-2%, +4% cc) in the full year, driven by volume growth of 11 percentage points, partly offset by price erosion of 4 percentage points and the negative impact from generic competition of 3 percentage points.

Corporate income and expense, which includes the cost of Group headquarter and coordination functions, amounted to an expense of USD 1.0 billion, compared to an expense of USD 599 million in 2021, mainly driven by higher restructuring costs, lower contributions from the Novartis Venture Fund and prior year income from a fair value adjustment on contingent receivables related to intellectual property rights, partly offset by prior year adjustments to provisions on M&A transactions.

Operating income was USD 9.2 billion (-21%, -13% cc), mainly due to higher restructuring (USD 1.2 billion) primarily related to the implementation of the previously announced streamlined organizational model, higher impairments (USD 1.0 billion) and lower divestment gains (USD 0.6 billion). Operating income margin was 18.2% of net sales, decreasing by 4.4 percentage points (-3.8 percentage points cc).

Core operating income was USD 16.7 billion (0%, +8% cc) benefiting from higher sales, partly offset by higher R&D investments. Core operating income margin was 33.0% of net sales, increasing by 0.9 percentage points (+1.3 percentage points cc).

Income from associated companies was a loss of USD 9 million compared to an income of USD 15.3 billion in prior year and core income from associated companies was a loss of USD 9 million compared to an income of USD 993 million in prior year. These decreases were due to the divestment of our investment in Roche that closed in the fourth quarter of 2021 where a gain of USD 14.6 billion was recognized.

Interest expense amounted to USD 837 million and was broadly in line with the prior year. Other financial income and expense amounted to an income of USD 20 million compared to an expense of USD 80 million in the prior year, as higher interest income was partly offset by financial expenses and currency losses. Core other financial income and expense amounted to an income of USD 141 million compared to an expense of USD 41 million in the prior year as higher interest income was only partly offset by currency losses.

The tax rate was 16.9% compared to 8.1% in the prior year. In the prior year, the tax rate was impacted by the Roche income from associated companies (including the divestment gain recognized on the sale of our investment in Roche in December 2021), the impact of increases in uncertain tax positions and prior year items.

For comparability, excluding these impacts, the prior year tax rate would have been 16.8%, broadly in line with 16.9% in the current year.

The core tax rate (core taxes as a percentage of core income before tax) was 16.3% compared to 15.8% in the prior year. For comparability, excluding Roche Income from associated companies (divested in December 2021), the prior year core tax rate would have been 16.7% compared to 16.3% in the current year, decreasing mainly the result of a change in core profit mix.

Net income was USD 7.0 billion (-71%, -67% cc), impacted by Roche income in the prior year. Excluding the impact of Roche income, net income declined -9% (cc). EPS was USD 3.19 (-70%, -66% cc). Excluding the impact of Roche income, EPS declined -7% (cc).

Core net income was USD 13.4 billion (-5%, +3% cc) as growth in core operating income was partly offset by the loss of Roche core income. Excluding the impact of Roche core income, core net income grew +11% (cc). Core EPS was USD 6.12 (-3%, +6% cc), benefiting from lower weighted average number of shares outstanding. Excluding the impact of Roche core income, core EPS grew +14% (cc).

Free cash flow amounted to USD 11.9 billion (-10% USD), mainly due to a decrease in net cash flows from operating activities and lower divestment proceeds, partly offset by lower purchases of property, plant and equipment.

		Q4 2022 USD m		Q4 2021 USD m		% change USD		% change cc		FY 2022 USD m		FY 2021 USD m		% change USD		% change cc
Net sales		10 360		10 704		-3		3		41 296		41 995		–  2		4
Operating income		1 945		2 468		-21		-12		8 786		10 688		-18		-9
As % of net sales		18.8		23.1						21.3		25.5
Core operating income		3 768		3 596		5		14		15 237		15 215		0		8
As % of net sales		36.4		33.6						36.9		36.2

Net sales were USD 10.4 billion (-3%, +3% cc) with volume contributing 11 percentage points to growth. Generic competition had a negative impact of 5 percentage points. Pricing had a negative impact of 3 percentage points, including approximately 1 percentage point impact from a revenue deduction true-up for Cosentyx in the US, which was related to prior quarters in 2022. Sales growth for the quarter was also negatively impacted by the prior year reclassification of contract manufacturing from other revenues to sales. Excluding the contract manufacturing reclassification impact, sales would have grown +4% (cc). Sales in the US were USD 4.2 billion (+7%) and in the rest of the world USD 6.2 billion (-9%, +1% cc).

Sales growth was mainly driven by continued strong performance from Entresto (USD 1.3 billion, +36%, +44% cc), Kesimpta (USD 369 million, +151%, +157% cc), Pluvicto (USD 179 million) and Kisqali (USD 357 million, +25%, +33% cc), partly offset by generic competition mainly for Gilenya, Exjade and Afinitor and the Cosentyx US revenue deduction true-up.

In the US (USD 4.2 billion, +7%), sales growth was mainly driven by Kesimpta, Entresto and Pluvicto, partly offset by the impact of generic competition mainly on Gilenya. In Europe (USD 3.4 billion, -10%, -1% cc), sales decline was driven by increased generic competition for Gilenya and Exjade, partly offset by growth for Entresto and Kesimpta. Emerging Growth Markets grew +7% (cc, -2% USD), with China sales USD 0.6 billion (-9%, +1% cc) in which Entresto growth was offset by Volume-Based Procurement impact on Diovan and Exforge.

Operating income was USD 1.9 billion (-21%, -12% cc), driven by higher restructuring and impairments, partly offset by higher gross margin and lower SG&A investments. Operating income margin was 18.8% of net sales, decreasing 4.3 percentage points (-3.4 percentage points in cc).

Core adjustments were USD 1.8 billion, mainly due to amortization, restructuring and impairments, compared to USD 1.1 billion in prior year. Core adjustments increased compared to prior year, mainly due to higher restructuring and impairments, partly offset by contingent consideration adjustment.

Core operating income was USD 3.8 billion (+5%, +14% cc), mainly driven by higher gross margin and lower SG&A investments. Core operating income margin was 36.4% of net sales, increasing 2.8 percentage points (+3.5 percentage points cc). Other revenue as a percentage of sales increased by 0.5 percentage points (cc). Core cost of goods sold as a percentage of sales decreased by 0.5 percentage points (cc). Core R&D expenses as a percentage of net sales decreased by 0.2 percentage points (cc). Core SG&A expenses as a percentage of net sales decreased by 2.0 percentage points (cc). Core other income and expense as a percentage of net sales increased the margin by 0.3 percentage points (cc).

Net sales were USD 41.3 billion (-2%, +4% cc) with volume contributing 12 percentage points to growth. Generic competition had a negative impact of 4 percentage points. Pricing had a negative impact of 4 percentage points. Sales in the US were USD 15.9 billion (+6%) and in the rest of the world USD 25.4 billion (-6%, +3% cc).

Sales growth was mainly driven by continued strong growth from Entresto (USD 4.6 billion, +31%, +37% cc), Kesimpta (USD 1.1 billion, +194%, +200% cc), Kisqali (USD 1.2 billion, +31%, +38% cc), Pluvicto (USD 271 million) and Cosentyx

(USD 4.8 billion, +1%, +5% cc), partly offset by generic competition mainly for Gilenya, Afinitor/Votubia and Gleevec/Glivec.

In the US (USD 15.9 billion +6%), sales growth was mainly driven by Entresto, Kesimpta and Pluvicto, partly offset by the impact of generic competition on Afinitor/Votubia and Gilenya. In Europe (USD 13.6 billion, -9%, +1% cc) sales growth was driven by Entresto, Kisqali and Kesimpta, partly offset by increased generic competition for Gilenya. Emerging Growth Markets grew +2% (+9% cc), with China sales USD 2.9 billion (+3%, +7% cc) driven by Cosentyx.

Operating income was USD 8.8 billion (-18%, -9% cc), driven by higher impairments, restructuring, lower divestment gains and higher R&D expenses, partly offset by higher gross margin. Operating income margin was 21.3% of net sales, decreasing 4.2 percentage points (-3.4 percentage points in cc).

Core adjustments were USD 6.5 billion, mainly due to amortization, impairments and restructuring, compared to USD 4.5 billion in prior year. Core adjustments increased compared to prior year, mainly due to higher impairments and restructuring.

Core operating income was USD 15.2 billion (0%, +8% cc), mainly driven by higher gross margin, partly offset by higher R&D investments. Core operating income margin was 36.9% of net sales, increasing 0.7 percentage points (+1.3 percentage points cc). Revenues as a percentage of sales increased by 0.1 percentage points (cc). Core cost of goods sold as a percentage of sales was in-line with the prior year. Core R&D expenses as a percentage of net sales increased by 0.2 percentage points (cc). Core SG&A expenses as a percentage of net sales decreased by 1.4 percentage points (cc). Core other income and expense as a percentage of net sales was in-line with the prior year.

		Q4 2022		Q4 2021		% change		% change		FY 2022		FY 2021		% change		% change
		USD m		USD m		USD		cc		USD m		USD m		USD		cc
Cardiovascular
Entresto		1 291		949		36		44		4 644		3 548		31		37
Leqvio		42		4		nm		nm		112		12		nm		nm
Total Cardiovascular		1 333		953		40		47		4 756		3 560		34		40
nm = not meaningful

Entresto (USD 1,291 million, +36%, +44% cc) sustained robust demand-led growth, with increased patient share across all geographies. Guidelines position Entresto as the first choice RASi versus ACEi/ARB in patients with HFrEF. Entresto benefits from the adoption of guideline-directed medical therapy for these patients in all geographies. In the US, Entresto benefits from being added to guidelines for patients with HFpEF (with LVEF below normal). In China and Japan, Entresto volume growth is fueled by increased penetration in hypertension in addition to growth in heart failure. It is estimated that around 10 million patients are on treatment with Entresto. In the US, Novartis is in ANDA litigation with generic manufacturers.

Leqvio (USD 42 million) launch in the US and other markets is ongoing, with focus on patient on-boarding, removing access hurdles and enhancing medical education. In the US, Leqvio is covered at or near label for 76% of patients eleven months after launch. Leqvio in the US has been assigned a unique Healthcare Common Procedure Coding System code (J-code) and average sales price. Leqvio is the first and only small interfering RNA (siRNA) therapy to lower LDL cholesterol approved in the US. Leqvio is now approved in 70 countries. Novartis obtained global rights to develop, manufacture and commercialize Leqvio under a license and collaboration agreement with Alnylam Pharmaceuticals.

		Q4 2022		Q4 2021		% change		% change		FY 2022		FY 2021		% change		% change
		USD m		USD m		USD		cc		USD m		USD m		USD		cc
Immunology
Cosentyx		1 080		1 243		-13		-9		4 788		4 718		1		5
Xolair		323		373		-13		-3		1 365		1 428		-4		6
Ilaris		301		284		6		14		1 133		1 059		7		15
Other										1				nm		nm
Total Immunology		1 704		1 900		-10		-5		7 287		7 205		1		7
Net sales reflect Xolair sales for all indications.
nm = not meaningful

Cosentyx (USD 1,080 million, -13%, -9% cc) continued volume growth across key geographies, offset by a revenue deduction true-up in the US (mainly due to higher than expected Medicaid patient mix), which was related to prior quarters in 2022. Ex-US sales grew +5% (cc). Since initial approval in 2015, Cosentyx has proven its sustained efficacy and consistent safety profile across five systemic inflammatory conditions and has treated more than 960,000 patients worldwide. For the full year, Cosentyx grew +5% (cc) worldwide.

Xolair (USD 323 million, -13%, -3% cc) sales declined, with growth in Emerging Growth Markets offset by lower sales in other markets. Novartis co-promotes Xolair with Genentech in the US and shares a portion of revenue as operating income but does not record any US sales.

Ilaris (USD 301 million, +6%, +14% cc) showed continued growth across all geographies. Contributors to growth include the adult-onset Still’s disease indication, together with the other adult rheumatology indications in the US and Europe, as well as strong performance for the Periodic Fevers Syndrome indications in Japan.

		Q4 2022		Q4 2021		% change		% change		FY 2022		FY 2021		% change		% change
		USD m		USD m		USD		cc		USD m		USD m		USD		cc
Neuroscience
Gilenya		346		656		-47		-44		2 013		2 787		-28		-24
Zolgensma		309		342		-10		-5		1 370		1 351		1		5
Kesimpta		369		147		151		157		1 092		372		194		200
Mayzent		99		81		22		28		357		281		27		32
Aimovig		59		59		0		9		218		215		1		11
Other				1		nm		nm		1		1		0		nm
Total Neuroscience		1 182		1 286		-8		-4		5 051		5 007		1		5
nm = not meaningful

Gilenya (USD 346 million, -47%, -44% cc) sales declined due to generic pressure mainly in the US and Europe. Novartis is in litigation in the US on the method of treatment patent, and in Europe on the dosing regimen patent, against generic manufacturers. In June 2022, an appeals court held the Gilenya US dosing regimen patent invalid. Novartis has filed a petition seeking further review with the US Supreme Court.

Zolgensma (USD 309 million, -10%, -5% cc) sales declined due to timing of access and reimbursement decisions, as well as timing of prior year patient bolus in certain markets. Quarter on quarter sales are relatively stable reflecting that the addressable market is now mainly incident patients, having launched in most major markets. Zolgensma is now approved in 47 countries.

Kesimpta (USD 369 million, +151%, +157% cc) sales growth was driven by strong launch uptake, access and increased demand. Kesimpta is a targeted B-cell therapy that can deliver powerful and sustained high efficacy, with a favorable safety and tolerability profile and the flexibility of an at home self-administration for a broad population of RMS patients. Kesimpta is now approved in 80 countries with more than 36,000 patients treated.

Mayzent (USD 99 million, +22%, +28% cc) sales grew across key geographies. Sales continued to grow in patients with multiple sclerosis showing signs of progression despite being on other treatments. Mayzent is the first and

only oral disease-modifying therapy studied and proven to delay disease progression in a broad SPMS patient population.

Aimovig (USD 59 million, ex-US, ex-Japan 0%, +9% cc) sales grew (cc) in Europe and Emerging Growth Markets. Aimovig is reimbursed in 32 markets and has been prescribed to over 759,000 patients worldwide. Novartis reached an agreement in Germany by which Aimovig is reimbursed as a 1st line prophylactic migraine treatment based on the HER-MES trial.

		Q4 2022		Q4 2021		% change		% change		FY 2022		FY 2021		% change		% change
		USD m		USD m		USD		cc		USD m		USD m		USD		cc
Solid Tumors
Tafinlar + Mekinist 1		465		458		2		8		1 770		1 693		5		11
Kisqali		357		285		25		33		1 231		937		31		38
Votrient		103		139		-26		-21		474		577		-18		-13
Lutathera		128		115		11		15		471		475		-1		3
Piqray		112		87		29		30		373		329		13		14
Pluvicto		179				nm		nm		271				nm		nm
Tabrecta		36		27		33		35		133		90		48		48
Total Solid Tumors		1 380		1 111		24		30		4 723		4 101		15		21
1  Majority of sales for Mekinist and Tafinlar are combination, but both can be used as monotherapy
nm = not meaningful

Tafinlar + Mekinist (USD 465 million, +2%, +8% cc) sales grew across all geographies, driven by demand in BRAF+ adjuvant melanoma and NSCLC indications, while maintaining demand in the highly competitive BRAF+ metastatic melanoma market. Tafinlar + Mekinist remains the worldwide targeted therapy leader in BRAF+ melanoma.

Kisqali (USD 357 million, +25%, +33% cc) sales grew strongly across all geographies, based on increasing recognition of its overall survival and quality of life benefits in HR+/HER2- advanced breast cancer. Kisqali has proven overall survival benefit across all three Phase III trials of the MONALEESA program regardless of menopausal status, line of therapy, site or number of metastases, endocrine resistance, or endocrine partner. Novartis is in US ANDA litigation with generic manufacturers.

Votrient (USD 103 million, -26%, -21% cc) sales declined due to increased competition, especially from immuno-oncology agents in metastatic renal cell carcinoma.

Lutathera (USD 128 million, +11%, +15% cc) sales grew across all geographies, with approximately 500 centers actively treating patients globally.

Piqray (USD 112 million, +29%, +30% cc) sales grew mainly in the US, benefiting from indication expansion into PIK3CA-related overgrowth spectrum (PROS). Piqray is the first and only therapy specifically developed for the approximately 40% of HR+/HER2- advanced breast cancer patients who have a PIK3CA mutation, which is associated with a worse prognosis.

Pluvicto (USD 179 million) strong US launch performance, with more than 160 active centers. Pluvicto is the first and only radioligand therapy approved by the FDA for the treatment of progressive, PSMA-positive metastatic castration-resistant prostate cancer, who have already been treated with other anticancer treatments (ARPI and taxane-based chemotherapy).

Tabrecta (USD 36 million, +33%, +35% cc) sales grew mainly in the US and Europe, as the first therapy approved by the FDA to specifically target metastatic NSCLC with a mutation that leads to MET exon 14 skipping (METex14).

		Q4 2022		Q4 2021		% change		% change		FY 2022		FY 2021		% change		% change
		USD m		USD m		USD		cc		USD m		USD m		USD		cc
Hematology
Promacta/Revolade		540		518		4		11		2 088		2 016		4		9
Tasigna		475		508		-6		0		1 923		2 060		-7		-1
Jakavi		388		408		-5		8		1 561		1 595		-2		9
Kymriah		139		143		-3		5		536		587		-9		-2
Adakveo		51		43		19		19		194		164		18		19
Scemblix		52		7		nm		nm		149		7		nm		nm
Other										1		1		0		nm
Total Hematology		1 645		1 627		1		9		6 452		6 430		0		7
nm = not meaningful

Promacta/Revolade (USD 540 million, +4%, +11% cc) showed growth across most geographies, driven by increased use in second-line persistent and chronic immune thrombocytopenia and as first-line and/or second-line treatment for severe aplastic anemia.

Tasigna (USD 475 million, -6%, 0% cc) sales were stable (cc), with decline in the US, Europe and Japan, offset by growth in Emerging Growth Markets.

Jakavi (USD 388 million, -5%, +8% cc) sales grew (cc) mainly in Europe, Emerging Growth Markets and Japan, driven by strong demand in both the myelofibrosis and polycythemia vera indications.

Kymriah (USD 139 million, -3%, +5% cc) sales grew (cc) in Emerging Growth Markets and Japan, partly offset by decline in the US and Europe, due to lower DLBCL demand, mainly driven by competitive entry into earlier line of treatment.

Adakveo (USD 51 million, +19%, +19% cc) continued to grow worldwide, reaching more than 11,800 patients with vaso-occlusive crises caused by sickle cell disease to date.

Scemblix (USD 52 million) continued its strong launch uptake demonstrating the high unmet need in CML, particularly patients previously treated with 2 or more tyrosine kinase inhibitors, or with the T315I mutation. In October 2022, US FDA converted the accelerated approval of Scemblix to a full approval, confirming the clinical benefit after longer exposure.

		Q4 2022		Q4 2021		% change		% change		FY 2022		FY 2021		% change		% change
		USD m		USD m		USD		cc		USD m		USD m		USD		cc
Other Promoted Brands
Lucentis		398		508		-22		-12		1 874		2 160		-13		-4
Xiidra		145		134		8		8		487		468		4		4
Ultibro Group		113		148		-24		-13		479		584		-18		-9
Beovu		49		51		-4		7		203		186		9		18
Other respiratory		26		16		63		69		84		53		58		79
Total Other Promoted Brands		731		857		-15		-6		3 127		3 451		-9		-1
Total Promoted Brands 1		7 975		7 734		3		10		31 396		29 754		6		12
1  Total Promoted Brands refer to the sum of Total Other Promoted Brands and all Therapeutic Areas brands (Hematology, Solid Tumors, Immunology, Neuroscience and Cardiovascular).

Lucentis (USD 398 million, -22%, -12% cc) sales declined in Europe, Japan and Emerging Growth Markets mainly due to competition.

Xiidra (USD 145 million, +8%, +8% cc) sales grew mainly in the US due to favorable revenue deductions. In the US, Novartis is in ANDA litigation with generic manufacturers.

Ultibro Group (USD 113 million, -24%, -13% cc) sales declined mainly in Europe, Emerging Growth Markets due to competition. Ultibro Group consists of Ultibro Breezhaler, Seebri Breezhaler and Onbrez Breezhaler.

Beovu (USD 49 million, -4%, +7% cc) sales grew (cc) in Europe, Emerging Growth Markets and Japan, partly offset by decline in the US.

		Q4 2022		Q4 2021		% change		% change		FY 2022		FY 2021		% change		% change
		USD m		USD m		USD		cc		USD m		USD m		USD		cc
Established Brands
Sandostatin		305		345		-12		-8		1 238		1 413		-12		-10
Galvus Group		209		278		-25		-16		859		1 092		-21		-12
Gleevec/Glivec		175		233		-25		-18		745		1 024		-27		-22
Exforge Group		159		197		-19		-12		743		901		-18		-12
Diovan Group		142		189		-25		-16		652		773		-16		-9
Afinitor/Votubia		106		174		-39		-32		512		938		-45		-41
Voltaren/Cataflam		81		97		-16		-4		334		373		-10		0
Zortress/Certican		80		110		-27		-18		329		431		-24		-14
Exjade/Jadenu		61		129		-53		-48		323		563		-43		-38
Neoral/Sandimmun(e)		74		89		-17		-6		310		368		-16		-8
Contract manufacturing		82		108		-24		-23		214		108		98		110
Other		911		1 021		-11		-6		3 641		4 257		-14		-9
Total Established Brands		2 385		2 970		-20		-13		9 900		12 241		-19		-13

Sandostatin (USD 305 million, -12%, -8% cc) declined across all geographies due to ongoing competitive pressure, including generic competition ex-US.

Galvus Group (USD 209 million, -25%, -16% cc) declined in Europe, Japan and Emerging Growth Markets.

Gleevec/Glivec (USD 175 million, -25%, -18% cc) declined due to increased generic competition.

Exforge Group (USD 159 million, -19%, -12% cc) declined across all geographies.

Diovan Group (USD 142 million, -25%, -16% cc) declined in Emerging Growth Markets, Europe and Japan due to generic competition.

Afinitor/Votubia (USD 106 million, -39%, -32% cc) declined in the US and Europe driven by generic competition.

Voltaren/Cataflam (USD 81 million, -16%, -4% cc) declined in Emerging Growth Markets.

Zortress/Certican (USD 80 million, -27%, -18% cc) declined in the US and Japan.

Exjade/Jadenu (USD 61 million, -53%, -48% cc) declined due to pressure from generic competition.

Neoral/Sandimmun(e) (USD 74 million, -17%, -6% cc) declined mainly in Japan and Europe.

		Q4 2022 USD m		Q4 2021 USD m		% change USD		% change cc		FY 2022 USD m		FY 2021 USD m		% change USD		% change cc
Net sales		2 330		2 525		-8		0		9 249		9 631		-4		4
Operating income		273		386		-29		-20		1 448		1 600		-10		-2
As % of net sales		11.7		15.3						15.7		16.6
Core operating income		391		528		-26		-18		1 903		2 064		-8		-1
As % of net sales		16.8		20.9						20.6		21.4

Sandoz net sales were USD 2.3 billion (-8%, 0% cc), with volume contributing 5 percentage points to growth. Pricing had a negative impact of 5 percentage points. Sales were negatively impacted by a prior year biopharmaceuticals contract manufacturing revenue reclassification. Excluding this impact, overall Sandoz sales would have grown +1% (cc).

Sales in Europe were USD 1.3 billion (-7%, +3% cc), in the US USD 429 million (-10%), in Asia / Africa / Australasia USD 387 million (-14%, -4% cc) and in Canada and Latin America USD 225 million (+4%, +10% cc). Ex-US sales grew +3% (cc).

Retail sales were USD 1.7 billion (-9%, -1% cc). Total Anti-Infectives sales were USD 329 million (-2%, +5% cc).

Global sales of Biopharmaceuticals grew to USD 517 million (-7%, +3% cc), with growth in Europe, Canada and Latin America.

Operating income was USD 273 million (-29%, -20% cc), with the decline mainly due to higher SG&A and lower gross margin from inflationary pressures on input costs and the impact of prior year milestone income. Operating income margin was 11.7% of net sales, decreasing 3.6 percentage points (-3.0 percentage points in cc).

Core adjustments were USD 118 million, including USD 54 million of amortization. Prior year core adjustments were USD 142 million including USD 61 million of amortization. The change in core adjustments compared to prior year was mainly driven by lower impacts from manufacturing footprint changes.

Core operating income was USD 391 million (-26%, -18% cc), with the decline mainly due to higher SG&A and lower gross margin from inflationary pressures on input costs and the impact of prior year milestone income as well as lower divestment income. Core operating margin was 16.8% of net sales, decreasing by 4.1 percentage points (-3.8 percentage points cc). Core gross margin as a percentage of sales decreased by 1.5 percentage points (cc). Core R&D expenses as a percentage of net sales increased by 0.2 percentage points (cc). Core SG&A expenses as a percentage of net sales increased by 1.6 percentage points (cc). Core other income and expense decreased the margin by 0.5 percentage points (cc), mainly due to lower divestment income.

Sandoz net sales were USD 9.2 billion (-4%, +4% cc) with volume contributing 10 percentage points to growth. Pricing had a negative impact of 6 percentage points.

Sales in Europe were USD 4.9 billion (-7%, +4% cc), in the US USD 1.8 billion (-4%) in Asia / Africa / Australasia USD 1.6 billion (-3%, +6% cc) and in Canada and Latin America USD 969 million (+11%, +15% cc) driven by volume increases and tender wins.

Retail sales were USD 6.8 billion (-4%, +4% cc), growing across all regions ex-US. Total Anti-Infectives sales were USD 1.2 billion (+2%, +10% cc).

Global sales of Biopharmaceuticals grew to USD 2.1 billion (-1%, +9% cc), growing across all regions.

Operating income was USD 1.4 billion (-10%, -2% cc), with the decline mainly due to higher SG&A investments to drive higher sales and inflationary pressures on input costs, which were partly offset by higher sales. Operating income margin was 15.7% of net sales, decreasing by 0.9 percentage points (-1.0 percentage points in cc).

Core adjustments were USD 455 million, including USD 221 million of amortization. Prior year core adjustments were USD 464 million, including USD 236 million of amortization.

Core operating income was USD 1.9 billion (-8%, -1% cc), with the decline mainly due to higher SG&A, partly offset by higher sales. Core operating margin was 20.6% of net sales, decreasing by 0.8 percentage points (-1.1 percentage points cc). Core gross margin as a percentage of sales decreased by 0.3 percentage points (cc), due to higher inflation and input costs. Core R&D expenses as a percentage of net sales decreased by 0.5 percentage points (cc). Core SG&A expenses increased by 0.9 percentage points (cc). Core other income and expense decreased margin by 0.4 percentage points (cc).

Net cash flows from operating activities amounted to USD 4.1 billion, compared with USD 3.9 billion in the prior year quarter. This increase was mainly driven by lower income taxes paid and lower payments out of provisions, partly offset by unfavorable changes in working capital.

Net cash outflows used in investing activities amounted to USD 1.5 billion, compared with USD 4.6 billion net cash inflows in the prior year quarter.

The current year quarter cash outflows were driven by USD 0.9 billion for net purchases of marketable securities, commodities and time deposits; USD 0.4 billion for purchases of property, plant and equipment; and USD 0.3 billion for purchases of intangible assets. These cash outflows were partly offset by cash inflows of USD 0.1 billion from the sale of intangible assets.

In the prior year quarter, net cash inflows from investing activities of USD 4.6 billion were driven by proceeds of USD 20.7 billion from the divestment of our investment in Roche; USD 0.7 billion from the sale of marketable securities, commodities and time deposits; and USD 0.2 billion from the sale of intangible assets, financial assets and property, plant and equipment. These cash inflows were partly offset mainly by USD 15.6 billion cash outflows for purchases of marketable securities and time deposits, mainly due to the investment of a portion of the proceeds from the divestment of our investment in Roche; USD 0.3 billion for acquisitions and divestments of businesses, net (including the acquisition of GSK’s cephalosporin antibiotics business for USD 351 million); and USD 1.0 billion for purchases of intangible assets, financial assets and of property, plant and equipment.

Net cash outflows used in financing activities amounted to USD 4.0 billion, compared with USD 3.3 billion in the prior year quarter.

The current year quarter cash outflows were driven by USD 2.7 billion for net treasury share transactions and USD 1.2 billion from the net decrease in current financial debts. Payments of lease liabilities and other financing cash flows resulted in a net cash outflow of USD 0.1 billion.

In the prior year quarter, net cash outflows used in financing activities of USD 3.3 billion were driven by USD 2.4 billion net decrease in current financial debts; USD 0.7 billion for the repayment of a bond denominated in euro (notional amount of EUR 0.6 billion) at maturity; and USD 0.1 billion for net treasury share transactions. Payments of lease liabilities amounted to USD 0.1 billion.

Free cash flow amounted to USD 3.6 billion (+17% USD), compared with USD 3.0 billion in the prior year quarter, mainly driven by higher net cash flows from operating activities and lower purchases of intangible assets.

Net cash flows from operating activities amounted to USD 14.2 billion, compared with USD 15.1 billion in 2021. This decrease was mainly due to unfavorable changes in working capital and lower dividends from associated companies (2021 included the USD 0.5 billion dividends received from our investment in Roche, which was divested in the fourth quarter of 2021), partly offset by lower income taxes paid and favorable hedging results.

Net cash inflows from investing activities amounted to USD 1.5 billion, compared with USD 4.2 billion in 2021.

The current year cash inflows were driven by net proceeds of USD 4.7 billion from the sale of marketable securities, commodities and time deposits; USD 0.5 billion from the sale of intangible assets, financial assets and property, plant and equipment. These cash inflows were partly offset by cash outflows of USD 1.5 billion for purchases of intangible assets; USD 1.2 billion for purchases of property, plant and equipment; USD 0.1 billion for purchases of financial assets; and USD 0.9 billion for acquisitions and divestments of businesses, net (primarily the acquisition of Gyroscope Therapeutics Holdings plc for USD 0.8 billion).

In 2021, net cash inflows from investing activities of USD 4.2 billion were driven by proceeds of USD 20.7 billion from the divestment of our investment in Roche; USD 2.3 billion from the sale of marketable securities, commodities and time deposits; and USD 1.4 billion from the sale of intangible assets, financial assets and property, plant and equipment. These cash inflows were partly offset by USD 16.4 billion cash outflows for purchases of marketable securities and time deposits, mainly due to the investment of a portion of the proceeds from the divestment of our

investment in Roche; USD 1.6 billion for purchases of intangible assets (including the upfront payment to in-license tislelizumab from an affiliate of BeiGene, Ltd); USD 1.4 billion for purchases of property, plant and equipment; USD 0.6 billion for acquisitions and divestments of businesses, net (including the acquisition of GSK’s cephalosporin antibiotics business for USD 351 million); and USD 0.2 billion for purchases of financial assets.

Net cash outflows used in financing activities amounted to USD 20.6 billion, compared with USD 16.3 billion in 2021.

The current year cash outflows were mainly driven by USD 10.6 billion for net treasury share transactions; USD 7.5 billion for the dividend payment; USD 2.5 billion in aggregate for the repayment of two US dollar bonds; and USD 0.3 billion payments of lease liabilities. These cash outflows were partly offset by cash inflows of USD 0.3 billion from the net increase in current financial debts.

In 2021, net cash outflows used in financing activities of USD 16.3 billion were driven by USD 7.4 billion for the dividend payment; USD 3.0 billion for net treasury share transactions; USD 3.5 billion net decrease in current financial debts; and USD 2.2 billion for the repayment of two bonds denominated in euro (notional amount of EUR 1.25 billion and of EUR 0.6 billion) at maturity. Payments of lease liabilities and other financing cash flows resulted in a net cash outflow of USD 0.2 billion.

Free cash flow amounted to USD 11.9 billion (-10% USD), compared with USD 13.3 billion in 2021, mainly due to a decrease in net cash flows from operating activities and lower divestment proceeds, partly offset by lower purchases of property, plant and equipment.

Total non-current assets of USD 80.5 billion decreased by USD 5.5 billion compared to December 31, 2021.

Intangible assets other than goodwill decreased by USD 2.5 billion as additions (including from the acquisition of Gyroscope Therapeutics Holdings plc) were more than offset by amortization, impairments and unfavorable currency translation adjustments.

Goodwill decreased by USD 0.3 billion, mainly due to unfavorable currency translation adjustments.

Property, plant and equipment decreased by USD 0.8 billion as net additions were more than offset by depreciation, unfavorable currency translation adjustments and impairments.

Financial assets decreased by USD 0.6 billion, driven mainly by fair value losses on listed equity and fund investments.

Other non-current assets decreased by USD 1.1 billion driven by the decrease of the prepaid post-employment benefit plans of USD 0.9 billion, resulting mainly from the pension accounting effects from increases in actuarial discount rates.

Right-of-use assets, investments in associated companies and deferred tax assets were broadly in line with December 31, 2021.

Total current assets of USD 36.9 billion at December 31, 2022 decreased by USD 8.8 billion compared to December 31, 2021.

Cash and cash equivalents decreased by USD 4.9 billion, mainly due to the dividend payment, the purchase of treasury shares and net repayments of financial debt, partly offset by the cash generated from operating activities and from investing activities, which includes the net proceeds from the sales of marketable securities, commodities and, time deposits.

Marketable securities, commodities, time deposits and derivative financial instruments decreased by USD 4.5 billion mainly driven by the net sales of marketable securities, commodities and time deposits.

Inventories increased by USD 0.5 billion and trade receivables, income tax receivables and other current assets were broadly in line with December 31, 2021.

Total non-current liabilities of USD 29.4 billion decreased by USD 4.4 billion compared to December 31, 2021.

Non-current financial debts decreased by USD 2.7 billion, mainly due to the reclassification of USD 2.3 billion from non-current to current financial debts of two EUR denominated bonds with notional amounts of EUR 750 million and EUR 1.25 billion maturing in 2023 and favorable foreign currency translation adjustments of USD 0.4 billion.

Provisions and other non-current liabilities decreased by USD 1.3 billion, mainly driven by decreases in accrued liabilities for employee benefits of USD 1.2 billion (primarily due to a decrease in accrued liabilities for defined benefit pension plans of USD 0.9 billion, resulting from the pension accounting effects from increases in actuarial discount rates), and in contingent consideration of USD 0.3 billion, a reclassification of non-current legal matters provisions to current portion of USD 0.2 billion, partly offset by the increase in other non-current liabilities of USD 0.4 billion.

Deferred tax liabilities decreased by USD 0.4 billion and non-current lease liabilities were broadly in line with December 31, 2021.

Total current liabilities of USD 28.7 billion decreased by USD 1.6 billion compared to December 31, 2021.

Provisions and other current liabilities decreased by USD 0.9 billion, mainly driven by the decrease in the commitment for repurchase of own shares liability of USD 2.8 billion, partly offset by increases in restructuring provisions of USD 0.8 billion (primarily due to the initiative announced in April 2022 to implement a new streamlined organizational model), in provisions for legal matters of USD 0.5 billion, including a USD 0.2 billion reclassification from non-current provisions for legal matters, and in provisions for revenue deductions of USD 0.3 billion.

Current financial debts and derivative financial instruments decreased by USD 0.4 billion, mainly due to the repayment of two US dollar bonds of USD 1.0 billion and USD 1.5 billion, the closure during the third quarter of 2022 of the interest-bearing accounts of employees payable on demand, which amounted to USD 1.8 billion at December 31, 2021, and favorable currency translation adjustments, partly offset by the reclassification from non-current to current financial debts of USD 2.3 billion and an increase of USD 1.9 billion in commercial paper.

Trade payables decreased by USD 0.4 billion and current lease liabilities and current income tax liabilities were broadly in line with December 31, 2021.

The Group’s equity decreased by USD 8.4 billion to USD 59.4 billion at December 31, 2022 compared to December 31, 2021.

This decrease was mainly due to the cash-dividend payment of USD 7.5 billion, purchase of treasury shares of USD 10.9 billion, unfavorable currency translation differences of USD 0.5 billion and fair value adjustments on equity securities of USD 0.4 billion. This was partially offset by the net income of USD 7.0 billion, decrease of the treasury share repurchase obligation of USD 2.8 billion, and equity-based compensation of USD 0.9 billion.

The Group’s liquidity amounted to USD 18.9 billion at December 31, 2022, compared to USD 28.3 billion at December 31, 2021. Total non-current and current financial debts, including derivatives, amounted to USD 26.2 billion at December 31, 2022 compared to USD 29.2 billion at December 31, 2021.

The debt/equity ratio increased to 0.44:1 at December 31, 2022 compared to 0.43:1 at December 31, 2021. As of December 31, 2022 the net debt was USD 7.2 billion, compared to USD 0.9 billion at December 31, 2021.

Benefiting from our continued focus on innovation, Novartis has one of the industry’s most innovative and inventive pipelines with ~150 projects in clinical development.

Product		Active ingredient/ Descriptor		Indication		Region
Pluvicto		lutetium (177Lu) vipivotide tetraxetan		Metastatic castration-resistant prostate cancer, post-taxane		EU - Dec

				Completed submissions
Product		Indication		US		EU		Japan		News update
Cosentyx		300mg auto-injector and pre-filled syringe		Q4 2022		Approved		Approved		– US resubmission
Cosentyx		Intravenous formulation for psoriatic arthritis (PsA), ankylosing spondylitis (AS), and non-radiographic axial SpA (nr-axSpA)		Q4 2022
Cosentyx		Hidradenitis suppurativa		Q3 2022		Q2 2022
Jakavi		Acute graft-versus-host disease (GvHD)				Approved		Q1 2021		– US filing by Incyte
		Chronic GvHD				Approved		Q1 2021		– US filing by Incyte
SEG101 (crizanlizumab)		Sickle cell disease, pediatrics								– Results from the ongoing global Ph3 STAND study did not show superiority compared to placebo; health authorities have been informed
VDT482 (tislelizumab)		2L Esophageal cancer (ESCC)		Q3 2021		Q1 2022				– FDA deferred action pending completion of required inspections
		NSCLC				Q1 2022

Compound/ product		Potential indication/ Disease area		First planned submissions		Current Phase		News update
Aimovig		Migraine, pediatrics		≥2026		3
AVXS-101 (OAV101)		Spinal muscular atrophy (IT formulation)		2025		3
Beovu		Diabetic retinopathy		2025		3
CFZ533 (iscalimab)		Sjögren's syndrome		≥2026		2
Coartem		Malaria, uncomplicated (<5 kg patients)		2024		3		– Submission will use the MAGHP procedure in Switzerland to facilitate rapid approval in developing countries
Cosentyx		Giant cell arteritis		2025		3
		Lupus nephritis		≥2026		3

Compound/ product		Potential indication/ Disease area		First planned submissions		Current Phase		News update
JDQ443		Non-small cell lung cancer, 2/3L		2024		3
		Non-small cell lung cancer (combos)		≥2026		2
KAE609 (cipargamin)		Malaria, uncomplicated		≥2026		2
		Malaria, severe		≥2026		2
KAF156 (ganaplacide)		Malaria, uncomplicated		≥2026		2		– FDA Orphan Drug designation – FDA Fast Track designation for the ganaplacide-containing combination therapy
Kisqali + endocrine therapy		Hormone receptor-positive (HR+)/human epidermal growth factor receptor 2-negative (HER2-) early breast cancer (adjuvant)		2023		3
Leqvio		Secondary prevention of cardiovascular events in patients with elevated levels of LDL-C		≥2026		3
LMI070 (branaplam)		Huntington’s disease				2		– Program discontinued based on an overall assessment of potential benefit-risk from the Ph2b VIBRANT-HD study
LNA043		Osteoarthritis		≥2026		2		– FDA Fast Track designation
LNP023 (iptacopan)		Paroxysmal nocturnal hemoglobinuria		2023		3		– FDA, EU Orphan Drug designation – FDA Breakthrough Therapy designation – Ph3 APPLY-PNH full data presentation at ASH – Ph3 APPOINT-PNH trial met primary endpoint
		IgA nephropathy		2024		3		– EU Orphan Drug designation – Few months submission delay but readout confirmed for 2023 (Slightly slower recruitment than planned)
		C3 glomerulopathy		2024		3		– EU Orphan Drug designation – EU PRIME designation – FDA Rare Pediatric designation – China Breakthrough Therapy designation – Few months submission delay but readout confirmed for 2023 (Slightly slower recruitment than planned)
		Membranous nephropathy				2		– Program discontinued (uncompelling competitive profile)
		IC-MPGN		≥2026		3		– Ph3 start planned in H2 2023
		Atypical haemolytic uraemic syndrome		≥2026		3		– Recruitment slower than anticipated
LOU064 (remibrutinib)		Chronic spontaneous urticaria		2024		3
		Multiple sclerosis		≥2026		3
		Sjögren's syndrome		≥2026		2
Lutathera		Gastroenteropancreatic neuroendocrine tumors, 1L in G2/3 tumors		2023		3
177Lu-NeoB		Multiple solid tumors		≥2026		1
LXE408		Visceral leishmaniasis		≥2026		2
MBG453 (sabatolimab)		Myelodysplastic syndrome		2024		3		– FDA Fast Track designation – EU Orphan Drug designation
		Unfit acute myeloid leukemia		≥2026		2
MIJ821 (onfasprodil)		Depression		≥2026		2
NIS793		1L Pancreatic cancer		2025		3		– FDA Orphan Drug designation
Piqray		Triple negative breast cancer				3		– Project will be discontinued to prioritize other key programs in portfolio
		Human epidermal growth factor receptor 2-positive (HER2+) advanced breast cancer				3		– Project will be discontinued to prioritize other key programs in portfolio
		Ovarian cancer		2023		3
Pluvicto		Metastatic castration-resistant prostate cancer pre-taxane		2023		3		– Ph3 PSMAfore trial met primary endpoint
		Metastatic hormone sensitive prostate cancer		2024		3
PPY988 (GT005)		Geographic atrophy		≥2026		2		– Gyroscope acquisition

Compound/ product		Potential indication/ Disease area		First planned submissions		Current Phase		News update
QGE031 (ligelizumab)		Food allergy		≥2026		3		– Optimized clinical program strategy to maximize potential
SAF312 (libvatrep)		Chronic ocular surface pain		≥2026		2
Scemblix		1L Chronic myeloid leukemia		2025		3		– Ph3 ASC4FIRST trial completed enrollment
TQJ230 (pelacarsen)		Secondary prevention of cardiovascular events in patients with elevated levels of lipoprotein(a)		2025		3		– FDA Fast Track designation – China Breakthrough Therapy designation
VAY736 (ianalumab)		Auto-immune hepatitis		≥2026		2
		Sjögren’s syndrome		≥2026		3		– FDA Fast Track designation
		Lupus nephritis		≥2026		3
		Systemic lupus erythematosus		≥2026		2
		1L Immune thrombocytopenia		≥2026		3		– Ph3 study VAYHIT1 initiating
		2L Immune thrombocytopenia		≥2026		3		– Ph3 study VAYHIT2 initiating
		warm Autoimmune hemolytic anemia		≥2026		3		– Ph3 study VAYHIA initiated
VDT482 (tislelizumab)		1L Nasopharyngeal carcinoma		2023		3		– FDA Orphan designation
		1L Gastric cancer		2023		3
		1L ESCC		2023		3
		Localized ESCC		2024		3		– Protocol amendment
		1L Hepatocellular carcinoma		2023		3
		1L Small cell lung cancer		2024		3
		1L Urothelial cell carcinoma		≥2026		3
		Adj/Neo adj. NSCLC		≥2026		3
VPM087 (gevokizumab)		Colorectal cancer, 1L		≥2026		1
Xolair		Food allergy		2023		3
YTB323		1L High-risk large B-cell lymphoma		≥2026		2		– Development plan update
XXB750		Hypertension		≥2026		2		– Ph2b initiated

Project/ Compound		Potential indication/ Disease area		News update
GP2411 (denosumab)		Osteoporosis (same as originator)		– In Ph3
SOK583 (aflibercept)		Ophthalmology (same as originator)		– In Ph3
Insulin glargine, lispro, aspart		Diabetes		– Collaboration with Gan & Lee
Natalizumab		Multiple sclerosis and Crohn’s disease		– Collaboration Polpharma Biologics – In registration
Trastuzumab		HER2-positive cancer tumors		– Collaboration EirGenix – In registration
Bevacizumab		Solid tumors		– Collaboration Bio-Thera Solutions – In registration

Fourth quarter (unaudited)

(USD millions unless indicated otherwise)		Note		Q4 2022		Q4 2021
Net sales to third parties		11		12 690		13 229
Other revenues		11		397		293
Cost of goods sold				-4 073		-3 976
Gross profit				9 014		9 546
Selling, general and administration				-3 747		-3 985
Research and development				-2 442		-2 409
Other income				172		371
Other expense				-1 048		-961
Operating income				1 949		2 562
(Loss)/income from associated companies		3		-3		14 621
Interest expense				-219		-206
Other financial income and expense				14		-26
Income before taxes				1 741		16 951
Income taxes				-275		-645
Net income				1 466		16 306
Attributable to:
Shareholders of Novartis AG				1 466		16 308
Non-controlling interests				0		-2
Weighted average number of shares outstanding – Basic (million)				2 135		2 237
Basic earnings per share (USD) 1				0.69		7.29
Weighted average number of shares outstanding – Diluted (million)				2 150		2 253
Diluted earnings per share (USD) 1				0.68		7.24
1  Earnings per share (EPS) is calculated on the amount of net income attributable to shareholders of Novartis AG.

Full year (audited)

(USD millions unless indicated otherwise)		Note		FY 2022		FY 2021
Net sales to third parties		11		50 545		51 626
Other revenues		11		1 283		1 251
Cost of goods sold				-15 486		-15 867
Gross profit				36 342		37 010
Selling, general and administration				-14 253		-14 886
Research and development				-9 996		-9 540
Other income				805		1 852
Other expense				-3 701		-2 747
Operating income				9 197		11 689
(Loss)/income from associated companies		3		-9		15 339
Interest expense				-837		-811
Other financial income and expense				20		-80
Income before taxes				8 371		26 137
Income taxes				-1 416		-2 119
Net income				6 955		24 018
Attributable to:
Shareholders of Novartis AG				6 955		24 021
Non-controlling interests				0		-3
Weighted average number of shares outstanding – Basic (million)				2 181		2 243
Basic earnings per share (USD) 1				3.19		10.71
Weighted average number of shares outstanding – Diluted (million)				2 197		2 260
Diluted earnings per share (USD) 1				3.17		10.63
1  Earnings per share (EPS) is calculated on the amount of net income attributable to shareholders of Novartis AG.

Fourth quarter (unaudited)

(USD millions)		Q4 2022		Q4 2021
Net income		1 466		16 306
Other comprehensive income
Items that are or may be recycled into the consolidated income statement
Novartis share of other comprehensive income recognized by associated companies, net of taxes				3
Net investment hedge, net of taxes		-118		89
Currency translation effects, net of taxes		1 652		-2 699
Total of items that are or may be recycled		1 534		-2 607
Items that will never be recycled into the consolidated income statement
Actuarial (losses)/gains from defined benefit plans, net of taxes		-1 920		6
Fair value adjustments on equity securities, net of taxes		-97		-48
Total of items that will never be recycled		-2 017		-42
Total comprehensive income		983		13 657
Attributable to:
Shareholders of Novartis AG		980		13 660
Non-controlling interests		3		-3

Full year (audited)

(USD millions)		FY 2022		FY 2021
Net income		6 955		24 018
Other comprehensive income
Items that are or may be recycled into the consolidated income statement
Novartis share of other comprehensive income recognized by associated companies, net of taxes				46
Net investment hedge, net of taxes		91		216
Currency translation effects, net of taxes		-450		-4 762
Total of items that are or may be recycled		-359		-4 500
Items that will never be recycled into the consolidated income statement
Actuarial (losses)/gains from defined benefit plans, net of taxes		-103		1 809
Fair value adjustments on equity securities, net of taxes		-382		194
Total of items that will never be recycled		-485		2 003
Total comprehensive income		6 111		21 521
Attributable to:
Shareholders of Novartis AG		6 116		21 528
Non-controlling interests		-5		-7

(USD millions)		Note		Dec 31, 2022 (audited)		Dec 31, 2021 (audited)
Assets
Non-current assets
Property, plant and equipment		11		10 764		11 545
Right-of-use assets				1 431		1 561
Goodwill		11		29 301		29 595
Intangible assets other than goodwill		11		31 644		34 182
Investments in associated companies				143		205
Deferred tax assets				3 739		3 743
Financial assets				2 411		3 036
Other non-current assets		4		1 110		2 210
Total non-current assets				80 543		86 077
Current assets
Inventories				7 175		6 666
Trade receivables				8 066		8 005
Income tax receivables				268		278
Marketable securities, commodities, time deposits and derivative financial instruments				11 413		15 922
Cash and cash equivalents				7 517		12 407
Other current assets				2 471		2 440
Total current assets				36 910		45 718
Total assets				117 453		131 795
Equity and liabilities
Equity
Share capital				890		901
Treasury shares				-92		-48
Reserves				58 544		66 802
Equity attributable to Novartis AG shareholders				59 342		67 655
Non-controlling interests				81		167
Total equity				59 423		67 822
Liabilities
Non-current liabilities
Financial debts				20 244		22 902
Lease liabilities				1 538		1 621
Deferred tax liabilities				2 686		3 070
Provisions and other non-current liabilities				4 906		6 172
Total non-current liabilities				29 374		33 765
Current liabilities
Trade payables				5 146		5 553
Financial debts and derivative financial instruments		5		5 931		6 295
Lease liabilities				251		275
Current income tax liabilities				2 533		2 415
Provisions and other current liabilities				14 795		15 670
Total current liabilities				28 656		30 208
Total liabilities				58 030		63 973
Total equity and liabilities				117 453		131 795