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Heart failure drug Entresto could be Novartis' largest growth driver, but its launch has been somewhat disappointing. In a clinical outcome study, it reduced patient risk of heart failure hospitalizations and cardiovascular death by at least 20% compared with the standard ACE inhibitor, enalapril.With millions of heart failure patients eligible for treatment, peak annual sales estimates top out at around $10 billion. Unfortunately, end payers haven't been too thrilled about replacing cheap, generic ACE inhibitors with Entresto, which costs around $4,600 per year.However, more than a year following its launch, U.S. sales of Entresto appear to be accelerating, and Novartis expects the drug to contribute about $200 million to total 2016 revenue. Further out, planned filings for three new entities, three biosimilars , and five label expansions for commercial-stage drugs this year alone give Novartis a solid chance of offsetting future losses to generic competition. In the numbers Although Exelixis is still losing money, rapid uptake of Cabometyx in the second-line RCC setting is largely expected to push the bottom line into positive territory this year. The company's recent market cap of around $5.3 billion, though, is around 16.5 times this year's average revenue estimate. An eventual expansion to frontline RCC treatment would probably lead to long-term gains from recent prices, but it's important to remember that nearly all of the company's chips are riding on one drug right now. So far Cabometyx's launch has exceeded expectations, but any signs of sputtering in the quarters ahead could make owning this stock a nerve-racking experience. Image source: Getty Images.


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