Swiss pharmaceutical giant Novartis has blamed a 45% drop in fourth-quarter profits on its poor performance in the US.
Total earnings dropped to $904m in the three months to 31 December, from $1.65bn in the same period a year earlier.
But group profits for the whole of 2007 totalled $11.95bn, up from $7.2bn in 2006.
Strong performance around the world was affected by weak sales in the States, where turnover fell 15% to $3.07bn.
It comes after its bowel drug Zelnorm (tegaserod maleate) was withdrawn from the market, and generic manufacturers targeted hypertension drug Lotrel (amlodipine besylate and benazepril HCl).
The company has also suffered from regulatory issues in America after the Food and Drug Administration asked for more trials on its diabetes drug Galvus (vildagliptin).
This prompted the firm to warn that it may not be resubmitted for approval before 2010.
But now chief executive Daniel Vasella has hinted the treatment may never go back before the FDA.
“We have 140 projects in the pipeline, so we have choices to make and priorities to make,” he said.
But the company claims it will continue discussion with the regulator over painkiller Prexige (lumiracoxib), even though it was pulled from shelves in Europe and rejected by the FDA last year because some patients suffered severe complications.
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