Novartis CEO Vas Narasimhan saw his realized compensation swell by 30% in 2025, reaching 24.9 million Swiss francs ($32.4 million) as the Swiss pharma giant exceeded its long-term financial and innovation targets.
The significant jump in compensation was primarily fueled by high payouts from Novartis’ long-term performance plan, which were triggered as the company's shares reached new highs, and key brands such as Entresto, Kisqali and Kesimpta delivered sales “well above expectations,” according to the company’s latest annual report (PDF).
Specifically, payouts from Novartis’ long-term performance plan, which runs in three-year cycles, increased by 4.8 million Swiss francs to reach 17.3 million Swiss francs.
The 2023-25 cycle vested at 188% of its target—the highest level since Narasimhan became CEO in 2018. This windfall was further amplified by a 64% surge in Novartis’ stock price during the three-year period, the report notes.
As of early 2026, Novartis’ U.S. shares are now nearing $160 apiece, compared with about $90 per share at the close of 2022.
Combining those share gains with dividends, Narasimhan scored maximum payouts for his company's total shareholder return (TSR) metric as Novartis' 84% TSR over the cycle ranked No. 2 among a group of 15 global healthcare peer companies, the annual report shows.
The peer roster includes Eli Lilly, which saw its shares nearly triple in value over the three-year period thanks to the massive success of its obesity and diabetes drug tirzepatide, plus the potential of its newer offerings.
Over at Lilly rival Novo Nordisk, also in Novartis’ peer group for exec pay benchmark, Maziar Mike Doustdar—who took over the CEO baton from Lars Fruergaard Jørgensen in August—got a pay package worth 20.7 million Danish kroner ($3.3 million) for his work in 2025, according to Novo’s annual remuneration report (PDF).
Meanwhile, Narasimhan’s pay package further benefited from a 14% increase in performance-based annual incentive, which reached 5.1 million Swiss francs for 2025 as a result of a 180% payment of target.
With $54.5 billion in 2025 sales, Novartis met the sales target the board set for its CEO annual bonus scorecard, while the company came in above its core operating income and free cash flow goals.
Breast cancer drug Kisqali outperformed its 2025 sales target by 9%, while a portfolio of recent launches that includes radioligand therapy Pluvicto, kidney disease drugs Fabhalta and Vanrafia, and oral BTK inhibitor Rhapsido exceeded its collective goal by 14%.
For four strategic objectives, Novartis performed “significantly above” on three. On pipeline advancement, Novartis counted 18 key approvals versus a target of 10, made 13 regulatory filings when the target was seven and moved 17 compounds into late-stage clinical development compared with an original plan of six.
Last year, Novartis’ core margin reached 40.1% of net sales, meeting a public target two years ahead of plan. The company is now projecting lower profit margins for 2026 as it digests its $12 billion buyout of Avidity Biosciences and invests in the San Diego biotech’s pipeline of antibody-oligonucleotide conjugates.
A lower margin is only one of the challenges that Narasimhan will need to navigate this year. His exec team also needs to show that Novartis can grow through the largest patent expiry in its corporate history. In 2026, Novartis expects a $4 billion revenue hole following the entry of U.S. generic rivals to its heart failure treatment Entresto, blood disorder drug Promacta and cancer therapy Tasigna last year.
For Narasimhan, his 2025 compensation at grant value—a category that’s often highlighted by U.S. companies in their exec pay reports—was 15.2 million Swiss francs, versus 14.2 million Swiss francs the prior year. Within this package is 7.6 million Swiss francs worth of long-term stock options tied to the company’s performance in the 2025-27 cycle.
Giovanni Caforio, M.D., the former Bristol Myers Squibb CEO who became Novartis’ board chair last year, netted 2.9 million Swiss francs in compensation in his first year at the new position.
Narasimhan’s pay also topped the 10.2 million Swiss francs that his counterpart at Roche, Thomas Schinecker, received (PDF) for 2025.