Novartis is navigating its largest patent-expiry period with a differentiated group of growth medicines and an increasingly broad late-stage pipeline. Q2 returned to 1% constant-currency sales growth as Kisqali, Kesimpta, Scemblix, Pluvicto and Leqvio expanded rapidly, while Entresto declined 51%. The new Pluvicto metastatic hormone-sensitive prostate-cancer indication nearly doubles its eligible population, and the completed Avidity acquisition adds a late-stage muscle-directed RNA platform. These strengths are balanced by severe generic erosion, lower first-half core operating income and materially higher net debt after acquisitions and the annual dividend.