Novartis (NVS, Financials) is investing $23 billion over the next five years to expand its manufacturing and research footprint in the United States, aiming to make all key medicines for American patients domestically.

The Swiss drugmaker said Thursday the plan includes 10 sites—seven of them new—and is expected to add about 1,000 Novartis jobs and 4,000 more across the U.S. The investment also covers a new $1.1 billion research hub in San Diego, California, set to open between 2028 and 2029.

The company said it will build four new manufacturing plants in yet-to-be-named states and two radioligand therapy facilities in Florida and Texas, while expanding existing sites in New Jersey, Indiana and California. The effort will boost Novartis' capacity to produce active ingredients, biologics and finished medicines within the U.S.

Novartis said the move will also bring production of its small interfering RNA (siRNA) technology to the U.S. for the first time. It's part of a broader push to localize manufacturing across core areas like oncology, immunology and cardiovascular disease.

CEO Vas Narasimhan said the company is responding to a supportive U.S. policy environment and preparing for changes in global supply chains. He reaffirmed Novartis' outlook through 2029, including a goal to surpass a 40% core margin by 2027.

Altogether, Novartis expects its U.S. investment to approach $50 billion over five years, underscoring its long-term commitment to the market.