Our Global Health & Corporate Responsibility (GH&CR) activities are centered around four key focus areas:
Holding ourselves to the highest ethical standards
Being part of the solution on pricing and access to medicines
Addressing global health challenges
Being a responsible citizen
External recognition for our GH&CR performance
In the past year, Novartis was included in several GH&CR rankings. In 2018, we ranked #2 in the Access to Medicine Index, up from third position in 2016. We maintained our #4 position in the 2018 Dow Jones Sustainability Index (DJSI) World, and were again included in the DJSI Europe Index. We were also recognized as one of the most sustainable corporations (#64) by Corporate Knights and as the third-highest pharmaceutical company in Fortune’s World’s Most Admired Companies 2018. Novartis was included in the FTSE4Good index for 2018.
Novartis won the Sustainability Report of the Year award from Ethical Corporation for its 2017 CR report.
Since 2016, we have adjusted the ratio of fixed to variable total compensation for our sales force to help ensure that the target variable component is a maximum of 35% of total compensation, on average across all countries. For our sales force, in particular, 20% of target variable pay is based on demonstration of our Values and Behaviors. We are in the process of implementing these standards in every country in which Novartis operates. Ultimately, no sales representative will receive the variable compensation unless he or she meets expectations with respect to our Values and Behaviors.
So far, the rollout of the new incentive system has shown positive results. Across divisions, there was a 54% reduction in the number of reported complaints of fraud and professional practices in the sales force in 2018 compared to 2017.
In 2018, we combined our risk management and compliance functions into a single organizational umbrella to provide the businesses with a better view of the risks we face as an organization, and how those risks could impact our ability to deliver on strategic priorities. This is expected to enable more effective risk management and mitigation efforts. We created the role of Chief Ethics, Risk and Compliance Officer to head the combined organization, and elevated this role to the Executive Committee of Novartis (ECN).
In 2018, the Business Practices Office (BPO) investigated 951 cases (454 of higher risk* and 497 of lower risk) relating to misconduct, covering 1 388 allegations. Out of these, 618 allegations (306 of higher risk* and 312 of lower risk) were substantiated and resulted in 311 dismissals or resignations (157 for higher risk* and 154 for lower risk). Starting in January 2019, the BPO Office, renamed the SpeakUp Office, will focus on significant cases while empowering local organizations to handle minor and day-to-day concerns to enable faster resolution.
* Higher risk complaint applies to a senior leader or manager, potentially disruptive reputational impact, sexual harassment, discrimination, retaliation and financial significance.
Being part of the solution on pricing and access
In late 2017, we agreed to systematically integrate access into our business model and committed that all our new product launches will have an access strategy. We established the Novartis Access Principles, built on three pillars: research and development (R&D), affordability, and strengthening healthcare systems. Further, we are taking steps to establish relevant key performance indicators to continually measure our progress. Access is to be a key measure of success for our leaders and employees, and we aim to be transparent in sharing our successes and our learnings.
Assessing our R&D portfolio against unmet needs
We systematically assess our R&D portfolio against the unmet needs of underserved populations and integrate these needs, as appropriate, into our drug discovery and development strategy.
Our innovation process includes adapting existing products for different types of patients or diseases and for diverse environments
We aim to make our products available in countries with the highest burden of the disease
We continue our work to reduce the burden of infectious and tropical diseases
The Novartis Working Group for adaptive R&D, initiated in 2016, spans our innovative, established and generic medicines groups and aims to evaluate and execute adaptive development initiatives that deliver incremental benefit to vulnerable patient populations.
In the first review cycle across all development units, 14 project proposals were endorsed to move forward. They include a new child-friendly formulation of hydroxyurea for sickle cell disease; the use of Entresto in heart failure related to Chagas disease; a project to identify potential differences in the pharmacokinetics of drugs in African patients, where such data are lacking; and a new Coartem formulation to treat malaria in infants below five kilograms of body weight.
Developing effective affordability strategies
We work to make our medicines available by considering both effective affordability strategies and innovative solutions to disease management, as well as off-patent solutions, to complement our innovative medicines portfolio.
We aim to price our medicines responsibly based on the value they deliver to patients, healthcare systems and society
To help improve the affordability of our medicines, we strive to take into account income levels, local affordability barriers and economic realities, while maintaining the sustainability of our business
We plan to conduct regular reviews of prices and affordability strategies as part of our global access strategy reviews to ensure alignment with our Access Principles
Our patient assistance programs and social business models are to be appropriately scaled to expand their reach and impact
In the US, we recently implemented guidelines for limiting average net price increases across our portfolio to the healthcare inflation rate. We also proceeded to proactively adjust prices downward in several low- and lower-middle-income countries.
Novartis was one of the first companies to enter into value-based contracting for our medicines. We already have multiple agreements in place whereby payments are linked to the outcomes our medicines deliver, for example, for our innovative heart failure medicine Entresto.
For Kymriah, our breakthrough treatment for certain types of cancers, we have developed a novel outcome-based contract for the indication of B-cell acute lymphoblastic leukemia. Under the agreement, Novartis does not charge participating treatment centers for the cost of Kymriah when a patient does not achieve a response within one month following infusion.
In 2018, the ECN reviewed plans for key brands in launch phase to assess access strategies targeting underserved populations. For example, Aimovig, our innovative medicine for the treatment of migraine, is supported by programs designed to help accelerate access both before and after reimbursement, as well as to speed up introduction and access in low- and middle-income countries (LMICs).
In LMICs, we have introduced more affordable local brands of many innovative therapies. Overall, we have launched over 60 local brands more than 30 developing markets, reaching more than 220 000 additional patients to date. We have plans to introduce around 50 additional local brands by 2020.
Novartis Social Business (NSB)
NSB comprises several legacy programs (Novartis Access, the Novartis Malaria Initiative, and Novartis Healthy Family). In 2018, NSB reached almost 25 million patients with medicines. In January 2018, NSB assumed full responsibility for the entire Novartis product range in six countries in Africa and Asia (Malawi, Rwanda, Tanzania, Uganda, Laos and Cambodia). It is now also leading the Sandoz business in Burundi, Kenya and India. These countries have been selected as they are large enough for social business models to scale up and be sustainable over time.
Novartis Access comprises a portfolio of 15 on- and off-patent medicines addressing key noncommunicable diseases. This basket of medicines is offered to governments, nongovernmental organizations (NGOs) and other institutional customers at a price of USD 1 per treatment, per month. The program also includes capacity-building activities to strengthen healthcare systems in lower-income countries.
In 2018, the program delivered almost 2.3 million monthly treatments to five countries (Cameroon, Ethiopia, Kenya, Rwanda and Uganda). Further, we signed agreements for implementation in Colombia, El Salvador, Pakistan and Nigeria. Our objective remains to roll out the program in 30 countries in the coming years.
Novartis Healthy Family
The Novartis Healthy Family programs expand access to community education, improved infrastructure and affordable healthcare products for people living at the base of the pyramid – in a way that is sustainable. Programs are active in India, Kenya, and Vietnam. In 2018, the Novartis Healthy Family programs reached 7.8 million people through education, and more than 700 000 patients.
Patient Assistance Programs
In the US, the Novartis Patient Assistance Foundation Inc. (NPAF) provides medicines at no cost to eligible US patients who are experiencing financial hardship and have limited or no prescription drug coverage. In 2018, the foundation provided more than USD 1.9 billion in free medicines to more than 68 000 patients in the US, covering more than 65 medicines from our portfolio. Over the past five years, free medication valued at roughly USD 5.8 billion has been provided to around 273 000 patients.
Through Novartis Oncology Access programs in developing markets – specifically in Asia-Pacific, Latin America and the Middle East – Novartis makes oncology medicines, including Glivec, Tasigna and Exjade, available through copay and shared contribution equitable pricing models.
Since 1999, Novartis has donated high-quality multidrug therapy (MDT) to all leprosy patients in the world through the World Health Organization (WHO), helping treat over 7 million leprosy patients worldwide.
Novartis has also been donating Egaten (triclabendazole) to the WHO for the treatment of fascioliasis, or liver fluke, for over a decade. In 2018, the agreement with the WHO was renewed until 2022. Fascioliasis infects more than 2.4 million people globally.
CMLPath to Care™ connects people living with chronic myeloid leukemia (CML) and their carers with effective treatments, professional medical capabilities, trained physicians and hands-on support. Novartis has committed USD 29 million from 2017 to 2021 in the form of financial support and 150 million tablets to cover treatment for approximately 36 000 patients. The donation program will make Glivec and Tasigna available to patients.
Our generics division, Sandoz, renewed its partnership with World Child Cancer to help improve diagnosis and access to treatment for children with cancer in the developing world. To date 2 468 children have been diagnosed in the Philippines, Ghana, Mexico and Myanmar, and 2 791 healthcare professionals have received training. Sandoz also works with Americares, a leading health-focused relief and development organization. To date, Sandoz has provided more than USD 9 million worth of products to Americares.
Strengthening healthcare systems for maximum impact
A treatment is only as good as the system that delivers it. We therefore seek opportunities to lower local barriers to healthcare delivery, working in collaboration with governments and other partners to support quality patient care in areas where we can have the greatest impact.
We work to empower patients to take ownership of their health and to better understand and manage their disease
We plan to invest in the training and support of healthcare workers to expand their knowledge and improve their ability to help patients
We aim to facilitate programs and collaborations that can aid local research and clinical trial capabilities
We advocate for and support improvements in healthcare policy and healthcare systems design
Inspiring the next generation of scientists
Through the Next Generation Scientist program, we invite talented young scientists and clinicians from LMICs to our Basel, Switzerland, campus for a three-month research internship. In 2018, we welcomed 20 top students from 11 emerging countries. Overall, more than 140 scientists and clinicians from 25 countries have participated in this program developed with the University of Basel.
Tackling cardiovascular health in low-income settings
The Novartis Foundation has two hypertension programs – Communities for Healthy Hearts in Ho Chi Minh City, Vietnam (CH2), and the Community-Based Hypertension Improvement Project (ComHIP) in Ghana – that are working to bring hypertension detection and management closer to local communities by maximizing screening and education opportunities through blood pressure checkpoints in local shops, pharmacies and other businesses.
Further, Better Hearts Better Cities is a health initiative to improve cardiovascular health in urban populations. In 2018, Better Hearts Better Cities covered 1.3 million people across three cities on three continents: Ulaanbaatar in Mongolia, Dakar in Senegal and Sao Paulo in Brazil.
In October, the Novartis Foundation and the Syngenta Foundation for Sustainable Agriculture announced a partnership to address one of the root causes of cardiovascular disease: unhealthy diets. This collaboration aims to help curb cardiovascular disease in low-income urban communities by increasing access to healthy, affordable and nutritious foods.
Leveraging digital technology
With Greenmash, we developed an IT system that registers and notifies patients of their next appointment, tracks medicine dispensing, and provides information to manage medicine stocks. This solution should be operational in Pakistan in 2019.
In the Philippines, we are experimenting with a social business startup, Allied World Healthcare (AWH), to solve common barriers to access. Working with Microsoft, PwC, the National University of Singapore and Singtel, and using expertise and funding from Novartis, AWH has developed a digital platform called Curis. The platform is now operational in one district of the Philippines, with 37 000 patients enrolled. We have started replicating this model in Cambodia.
In India, to address the shortage of qualified doctors in rural areas, the Healthy Family (Arogya Parivar) team set up a digital platform with information technology provider Tech Mahindra to connect patients to secondary care specialists. For the past year, we piloted this platform with Aquarelle, a supplier to apparel company Levi’s, near Bangalore. Health camps were held with workers from one plant, on topics including anemia, menstrual health, hygiene and diarrheal disease. Pilot results show 16% of factory workers were diagnosed as anemic and subsequently treated.
Training community healthcare workers
Recognizing the importance of community health workers (CHWs) in building stronger healthcare systems in developing countries, Novartis supports Last Mile Health, which has established the National Community Health Assistant Program in Liberia. Further, Last Mile Health is developing the world’s first digital education platform, called the Community Health Academy. To help launch this academy, Novartis is donating USD 1 million over three years, in addition to providing input on the program’s curriculum, content and strategic direction.
Reviewing our approach to intellectual property
Novartis does not file or enforce patents in least developed countries or low-income countries. In late 2018, we further reviewed our approach to patent filing in LMICs in an effort to better align it with the local socio-economic circumstances that exist in many of these countries. As a result, effective 2019, we decided to stop filing patent applications in nine LMICs, where Novartis had previously filed. In the remaining LMICs, we will aim to restrict patent filings to those patent applications covering new molecules or new chemical entities.
Addressing global health challenges
Novartis has a long heritage in tackling neglected tropical diseases, with two flagship programs targeting malaria and leprosy. To date, nearly 900 million treatment courses of our antimalarial Coartem, including 370 million pediatric courses of a unique child-friendly formulation, have been delivered without profit and approximately 60 million multidrug therapies for leprosy have been donated through the WHO.
We also have a longstanding investment in research for various infectious and neglected diseases through the Novartis Institute for Tropical Diseases (NITD). Drug discovery efforts at NITD have delivered drug candidates to anticipate the emerging threat of artemisinin resistance. Two drug candidates, KAE609 and KAF156, as well as an innovative formulation of lumefantrine are currently being evaluated in Phase II studies. These programs are conducted with Medicines for Malaria Venture.
In April, we communicated our intention to invest more than USD 100 million over the next five years to advance research and development of new antimalarials, expand access to pediatric antimalarials, and invest in health infrastructure in Africa.
Novartis is a signatory to the London Declaration on Neglected Tropical Diseases, which aims to control, eliminate or eradicate 10 diseases by 2020. In line with our reaffirmed commitment, NITD and the Genomics Institute of the Novartis Research Foundation (GNF) have developed, in partnership with the Wellcome Trust, a promising portfolio of novel drug candidates for the treatment of three kinetoplastid diseases: human African trypanosomiasis (sleeping sickness), leishmaniasis and Chagas disease. Together with our leprosy elimination effort, this strategic focus on kinetoplastid parasitic diseases would address four out of 10 diseases in scope of the London Declaration.
In 2018, the WHO issued revised guidance on the longer regimen to treat multidrug- and rifampicin-resistant tuberculosis, prioritizing oral agents over injectables. Clofazimine is recommended as part of this revised regimen. Novartis has been working to expand the clofazimine label to include this indication; clofazimine is currently only approved in combination with rifampicin and dapsone as a treatment for leprosy.
Helping address the needs of children
Responding to the call from UNICEF to combat childhood pneumonia, Sandoz developed pediatric amoxicillin, today recommended by the WHO as first-line treatment for childhood pneumonia. Over the last three years, Sandoz has supplied more than 3 million pediatric amoxicillin treatment courses to UNICEF and Médecins Sans Frontières. Novartis is now also active in the fight against childhood pneumonia through the Every Breath Counts Coalition, a global network established in 2018.
In September, we announced a partnership with the Global Antibiotic Research & Development Partnership to accelerate the development and availability of generic antibiotics to help reduce child deaths from drug-resistant infections.
Tackling leprosy elimination
Beyond medicines, innovative solutions are required to eliminate leprosy. The Novartis Foundation and Microsoft are partnering to develop a digital health tool, enabled by artificial intelligence, and a Leprosy Intelligent Image Atlas – with local investigators from Oswaldo Cruz Foundation in Brazil. The foundation has also been working with research partners to develop a leprosy diagnostic test.
Partnering on Chagas and sickle cell disease
In Latin America, we launched a new partnership with the World Heart Federation to develop a roadmap for addressing Chagas disease, the second most common cause of chronic heart failure in Latin America, affecting eight million people in 21 countries.
In Africa, we kicked off an effort to establish and strengthen partnerships around sickle cell disease (SCD). Approximately 80% of individuals with SCD globally live in sub-Saharan Africa, and more than half die before age five due to preventable complications.
We plan to launch our commitment to SCD in Africa in early 2019, starting in Ghana. The initiative aims to support the Ministry of Health and Ghana Health Services in establishing 10 SCD centers across Ghana. Additionally, Novartis is supporting the Ghana Sickle Cell Foundation to field test treatment guidelines and to implement a newborn screening program at the national level. In parallel, we submitted hydroxyurea to treat SCD for registration in Ghana and Kenya. In October, the Ghana Food and Drugs Authority approved hydroxyurea for the treatment of SCD.
Addressing drug resistance
Antimicrobial resistance (AMR) is recognized by the WHO as one of the major threats to global public health. It is estimated that AMR could lead to 10 million more deaths annually by 2050.
Sandoz, our generics division, is the world’s largest provider of high-quality affordable antibiotics. It is actively involved in global and local partnerships to help ensure the responsible and appropriate use of existing antibiotics in line with the WHO guidelines.
In October, Novartis announced a licensing and equity agreement with Boston Pharmaceuticals for the development of three novel anti-infective drug candidates in the Novartis portfolio that have the potential to treat antibiotic-resistant infections. In December, as part of our strategy to partner and share data with external innovators committed to developing medicines that address global health challenges, we have contributed data from our anti-bacterial research programs to the Pew Charitable Trusts’ Shared Platform for Antibiotic Research and Knowledge (SPARK).
Being a responsible citizen
Building trust with society requires doing business responsibly wherever we operate. This includes ensuring the safety and well-being of everyone who uses our medicines, supporting and caring for our associates worldwide, respecting human rights, managing risk in our supply chain and minimizing our environmental impact.
Boosting pharmacovigilance efforts and maintaining product quality
Of the total 202 health authority inspections completed in 2018, all but three were deemed good or acceptable (98.5%). Corrective and preventative actions are under preparation and on track.
We also work to boost pharmacovigilance capabilities in low- and middle-income countries. For example, in Egypt, Novartis is working with patient organizations and healthcare professionals to increase understanding of the importance of pharmacovigilance and improve the timely reporting of safety data. Pharmacovigilance training and awareness initiatives have also been introduced in Peru and Ecuador, and in Kenya with Strathmore University.
Combating falsified and counterfeit medicines
Novartis is using a multipronged, companywide strategy to help tackle pharmaceutical crime. We have made significant progress across the board in 2018. We created a new risk function called Novartis Business Assurance & Advisory, reporting to the CEO, to host the anti-counterfeiting program.
We have expanded our in-house forensic capabilities to authenticate suspicious medicines by procuring two additional authentication spectrometric toolkits (i.e., mobile laboratories) covering the Americas and Asia-Pacific in addition to Europe, the Middle East and Africa.
We have also launched a global online market monitoring program using state-of-the-art technology to detect the sale of suspected falsified Novartis medicines on online pharmacies, social media and other commercial platforms.
We investigate all reported cases of falsified and counterfeit Novartis products. Novartis had a very substantial increase in enforcement cases in 2018, with more than 140 successful enforcement cases in 23 countries, compared to 61 reported in 2017.
Working with patients and caregivers
In February, we published our Commitment to Patients and Caregivers, which outlines what patients and caregivers can expect from Novartis. It has four overarching pillars: respecting and understanding the patient community perspective, expanding access to our medicines, conducting responsible clinical trials and recognizing the importance of transparency.
Caring for our people
During 2018, we took major steps to transform our culture. We created a group on our internal social network that brings together more than 120 000 members, with over 94 000 active users and almost 7.3 million messages shared. We launched a new 360-degree assessment to help employees apply the new culture in their daily activities, and improved the process for reviewing employees’ performance, putting more emphasis on conversation. In addition, we launched a program to support employees who are affected as a patient or caregiver by cancer, cardiovascular diseases or neurological diseases.
Diversity and inclusion (D&I)
We have maintained our focus on promoting D&I and were ranked second out of more than 7 000 companies in the 2018 Thomson Reuters D&I Index, up from sixth in 2017. Today, women make up 43% of management, the same as in 2017.
In September, Novartis joined the United Nations Equal Pay International Coalition (EPIC), with a pledge to continue its global practice of conducting regular gender pay analyses and remediating where appropriate. In addition, demonstrating our focus on inclusion, in 2018 Novartis became the first major pharmaceutical company to support the United Nations’ workplace standards protecting the rights of lesbian, gay, bisexual, transgender and intersex people.
The Novartis Corporate Volunteering program operates a virtual platform that matches volunteers with volunteering opportunities. In 2018, the program continued to grow, with nearly 700 associates registered to donate pro-bono skills and time, and 180 new projects initiated. As in previous years, our largest global volunteering activity was our Community Partnership Day. In 2018, 23 900 associates from 58 countries participated, dedicating 191 200 hours to their communities.
Further integrating human rights in our business
Since 2017, we have been publishing a modern slavery statement. In 2018, we put a team in place to lead the development and implementation of our human rights strategy and due diligence program, including human rights impact assessments, awareness raising throughout the company, and development of the necessary internal capabilities to help meet our human rights commitments.
We piloted three human rights assessments in Turkey, China and Malaysia in 2018, in addition to Egypt in 2017. We have identified common risk areas that require follow-up action in 2019. For example, we need more regular and broader engagement and consultation with external stakeholders at the local level; to help ensure formal grievance mechanisms and processes are in place for communities living close to our manufacturing operations; and in some markets, to address risks associated with our outsourced workforce.
Corrective action plans have been developed or are in the process of being developed with the four pilot markets.
Maintaining a responsible supply chain
Responsible procurement is the way we encourage companies that we do business with to meet the standards of ethics, business integrity and environmental practice we expect of them. In 2018, 364 suppliers were identified as posing an elevated risk. Of these, 92 have active follow-up actions, including more information requested, audits or on-site assessments. In 2018, we audited 48 suppliers, representing 52% of those identified as requiring follow-up actions.
We identified the need for an end-to-end model that would be applicable across all divisions and geographies. Continuing our work to implement our new Third-Party Risk Management (TPRM) program, we rolled it out in the first country, Mexico, in October 2018. We expect a phased rollout worldwide in 2019, planned to begin in the Americas (including the US), followed by Asia-Pacific and Europe.
Enhancing our environmental sustainability
We launched a new Environmental Sustainability Strategy with more ambitious targets in 2018.
We aim to become carbon neutral in our own operations (Scope 1 and 2) by 2025, and then reduce our carbon footprint, including that of our supply chain (Scope 1, 2 and 3) by half versus 2016 levels by 2030.
We are also aiming to minimize waste and increase material efficiency, with an ultimate goal of becoming plastic neutral. By 2025, we have committed to eliminate polyvinyl chloride (PVC) in packaging (i.e., secondary and tertiary packaging) and to reduce waste disposal by half versus 2016 levels. By 2030, we are aiming to be completely plastic neutral, with all new products meeting sustainable design principles.
We are also working to achieve water sustainability. Our 2025 goal is to reduce water consumption in our operations by half versus 2016, with no water quality impacts from manufacturing effluents. By 2030, we aim to be water neutral in all areas of our operations.
This presentation contains forward-looking statements within the meaning of the United States Private Securities Litigation Reform Act of 1995, that can generally be identified by words such as “guidance,” “transformation,” “continued,” “potential”, “launches,” “on track” “launched,” “filed,” “launch,” “expected,” “to grow,” “will,” “enter,” “pipeline,” “commitment,” “well positioned,” “future,” “strategy,” “priorities,” “embrace,” “deliver,” “go big,” “build,” “allows,” “expect,” “to be completed,” “closing conditions,” “committed,” “continued,” “growth drivers,” “Priority Review Voucher,” “submissions,” “filings,” “to be presented,” “potentially,” “if approved,” “aims,” “outlook,” “unforeseen,” “forecast,” “may,” “would,” “continues,” “aiming,” “vision,” “priority review,” “PRIME designation,” “Sakigake designation,” “enrollment,” “planned,” “upcoming,” “Fast Track designation,” “Orphan designation,” “scheduled,” or similar expressions, or by express or implied discussions regarding potential new products, potential new indications for existing products, or regarding potential future revenues from any such products; or regarding the potential outcome, or financial or other impact on Novartis, of the spinoff of our Alcon Division, or of the proposed divestiture of certain portions of our Sandoz Division business in the US; or regarding the potential impact of the share buyback plan; or regarding potential future sales or earnings of the Group or any of its divisions or potential shareholder returns; or by discussions of strategy, plans, expectations or intentions. Such forward-looking statements are based on the current beliefs and expectations of management regarding future events, and are subject to significant known and unknown risks and uncertainties. Should one or more of these risks or uncertainties materialize, or should underlying assumptions prove incorrect, actual results may vary materially from those set forth in the forward-looking statements. You should not place undue reliance on these statements. In particular, our expectations could be affected by, among other things: global trends toward healthcare cost containment, including ongoing government, payer and general public pricing and reimbursement pressures and requirements for increased pricing transparency; regulatory actions or delays or government regulation generally, including potential regulatory actions or delays with respect to the proposed transactions or the development of the products described in this presentation; the potential that the strategic benefits, synergies or opportunities expected from the Alcon and Sandoz transactions may not be realized or may be more difficult or take longer to realize than expected; the inherent uncertainties involved in predicting shareholder returns; the uncertainties inherent in the research and development of new healthcare products, including clinical trial results and additional analysis of existing clinical data; our ability to obtain or maintain proprietary intellectual property protection, including the ultimate extent of the impact on Novartis of the loss of patent protection and exclusivity on key products that commenced in prior years and will continue this year; safety, quality or manufacturing issues; uncertainties regarding actual or potential legal proceedings, including, among others, actual or potential litigation with respect to the proposed transactions, product liability litigation, litigation and investigations regarding sales and marketing practices, intellectual property disputes and government investigations generally; uncertainties involved in the development or adoption of potentially transformational technologies and business models; our performance on environmental, social and governance measures; general political, economic and trade conditions, including uncertainties regarding the effects of ongoing instability in various parts of the world; uncertainties regarding future global exchange rates; uncertainties regarding future demand for our products; uncertainties regarding potential significant breaches of data security or data privacy, or disruptions of our information technology systems; and other risks and factors referred to in Novartis AG’s current Form 20-F on file with the US Securities and Exchange Commission. Novartis is providing the information in this presentation as of this date and does not undertake any obligation to update any forward-looking statements as a result of new information, future events or otherwise.
All product names appearing in italics are trademarks owned by or licensed to Novartis Group Companies.