Novartis has flagged that 2026 profit will likely fall for the first time in years as patents for major drugs near expiration, including Entresto and Xolair. The company projects generic competition could create roughly a $4 billion negative impact on earnings. The update spotlights the near-term earnings cliff facing large-cap pharma as portfolios reach the end of exclusivity for revenue-critical franchises. It also increases pressure to fund late-stage pipeline progress and offset losses with new launches or acquisitions. In the background, investors will watch how quickly Novartis can ramp substitutes across cardiometabolic and respiratory/immunology franchises once competition begins.