Cosentyx's first $1B quarter marred by COVID-19 drag, but Novartis still chalks up gains

Novartis headquarters
Novartis reported third-quarter sales of $12.3 billion, flat compared with last year and 2% shy of analyst expectations. (Novartis)

Novartis was hit hard by COVID-19-related slowdowns in the second quarter. While the Swiss drugmaker has since turned for the better, its skin and eye businesses are still feeling the burn.

Cosentyx, Novartis’ top-selling drug, just celebrated its first blockbuster quarter, with sales of $1.01 billion, up from $944 million in the second quarter.

However, the IL-17A inhibitor came in below industry watchers’ expectations, and its 7% year-over-year growth rate marked a further decline from the second quarter’s 12% at constant currencies.

To hear Novartis’ pharma chief Marie-France Tschudin tell it, though, Cosentyx suffered from a general slowdown in dermatology during COVID-19. Even today, only an estimated 70% to 90% of pre-COVID-19 target patients have returned to see their doctors, she said during a conference call Tuesday. The company expects Cosentyx to return to double-digit growth in the fourth quarter.

Cosentyx was one of the key growth drivers Novartis cited for keeping its overall sales flat over last year’s level despite the pandemic, an improvement from a 4% year-over-year decline in the second quarter.

Zolgensma was another contributor. The spinal muscular atrophy (SMA) gene therapy brought in $291 million in third-quarter sales, up from $205 million in the second quarter and 8% above analysts’ consensus.

RELATED: Novartis' Zolgensma expansion hits FDA roadblock, giving Biogen and Roche a reprieve

Novartis attributed Zolgensma’s growth to geographic expansion and increased SMA screening among newborns. In the U.S., Zolgensma appeared to have rebounded from a second-quarter low and relatively stabilized, while the ex-U.S. market contributed $169 million to the total haul.

SMA screening rates continue to rise. In the U.S., about 74% of newborns are screened for the genetic disease, versus 60% as of the second quarter, CEO Vas Narasimhan said during the call. As a result, the drug’s patient make-up has shifted from symptomatic patients who switch from other therapies to newborns. In the third quarter, newborns made up 83% of U.S. sales, versus 34% during the same time the prior year, he said.

Novartis was previously aiming to reach older SMA patients in 2021 with a new Zolgensma formulation that’s infused into the spinal fluid rather than intravenously. But the FDA effectively pushed that timeline off by at least two years by requiring Novartis to run a phase 3 study to clear concerns about a safety signal observed in animal studies.

The company’s working with the FDA to design that confirmatory study, and “our hope is that we can come up with a lean program to move extremely quickly,” Narasimhan said, adding that it’s premature for the company to offer an updated timeline at this point.

RELATED: Novartis gets a green light to challenge Roche, Sanofi with delayed MS med Kesimpta

Also in neuroscience, Novartis in August got the FDA green light for Kesimpta—sold as Arzerra in leukemia—in relapsing forms of multiple sclerosis (MS). The drug goes after CD20-expressing B cells to control neuroinflammation, the same target used by Roche’s blockbuster Ocrevus. The Novartis drug boasts a convenience edge because it's an under-the-skin injection patients can give themselves, while Ocrevus requires infusion by a healthcare professional.

“For us, it’s key to have broad HCP engagement and have this translate into adoption,” Tschudin said. Novartis’ field force has reached 90% of the 5,800-plus MS prescribers it's targeting, according to Tschudin. After eight weeks on the market, the drug has snagged 2.5% new-to-brand share in the U.S.

Overall, Novartis’ third-quarter sales of $12.3 billion were 2% shy of consensus. The company maintained its full-year sales outlook of growth in the mid-single-digit percentage range, which was originally dialed down in the second quarter. It slightly lifted operating profit guidance, now expecting it to increase in the low-double digits to mid-teens, from its previous expectations of a low-double-digit boost.