Alnylam CEO Says Company Is 'Not Yet Satisfied' With Amvutra Demand, Sees No Fourth-Quarter Acceleration
Alnylam expects TTR sales at the low end of its $4.2 billion to $4.5 billion range as its larger field team has not yet lifted patient starts.
Alnylam Pharmaceuticals, which develops RNA interference medicines, has a $1.3 billion quarter to show for the third quarter and a blunt message on its main growth drug. CEO Yvonne Greenstreet said on the company's earnings call Thursday that "we're not yet satisfied with the underlying demand growth we have observed" for Amvutra, and that she does not expect growth to accelerate in the fourth quarter.
Low end of the range
CFO Jeff Poulton said the company reiterated its 2026 guidance but now expects sales of its transthyretin amyloidosis (TTR) medicines to land at the low end of the $4.2 billion to $4.5 billion range. He said it is prudent to assume no material top-line contribution from the expanded field force this year.
Poulton cited two further drags on fourth-quarter demand: hospital customers may order unevenly while they wait for a final federal rule on 340B drug-discount reimbursement, and UnitedHealth tightened first-line access to Amvutra in its Medicare Advantage plans on October 1. He added that inventory and price, which helped third-quarter reported revenue, will be headwinds to reported growth in the fourth quarter.
He noted that reaching $4.2 billion in TTR revenue would still be nearly 70% growth from last year. Shares of Alnylam fell about 15% to $197.72 in Thursday trading.
More meetings, slower patient starts
Alnylam expanded its customer-facing teams to reach the roughly two-thirds of active prescribers who have not yet prescribed Amvutra. Chief Commercialization Officer Tolga Tanguler said about a third have, and that more than 2,000 new unique prescribers have written it since the U.S. cardiomyopathy launch. His summary: "trial begets preference."
Answering a Barclays analyst, Greenstreet said converting engagement into patient starts is "taking longer" than the company had hoped. She said newer prescribers see fewer cardiomyopathy patients and have more entrenched habits. Tanguler pointed to non-clinical hurdles such as prior authorization and coordinating care outside the office.
The quarter itself was strong. Product revenue rose 52% from a year earlier to $1.29 billion, and TTR revenue reached $1.15 billion, up 59%. U.S. TTR revenue grew about $100 million from the second quarter, with an $81 million rise in demand and a $17 million inventory benefit.
Pipeline and the 2027 guide
Alnylam is adding 500 patients to its late-stage Triton-CM trial of nucresiran, to about 2,250, and says the launch timeline of about 2030 is unchanged. Chief Research and Development Officer Pushkal Garg said the aim is adequate events and statistical power.
Because the 340B rule is expected in the coming weeks, Poulton said the company will give 2027 product revenue guidance with fourth-quarter results in mid-February instead of at the January J.P. Morgan conference.
Phase 2 data for ALN6400 in HHT and Phase 1 obesity data for ALN2232 are due on that February call, alongside the 2027 outlook.
Sources
- Alnylam: Q3 Earnings Snapshot — Associated Press
- Alnylam: Q3 Earnings Snapshot – WTOP News — wtop.com
- Alnylam Pharmaceuticals Q3 2026 Earnings Preview (NASDAQ:ALNY) | Seeking Alpha — seekingalpha.com
- Alnylam (ALNY) Q3 Earnings on the Horizon: Analysts' Insights on Key Performance Measures — Yahoo Finance
- What Alnylam Pharmaceuticals (ALNY)'s Huntingtons Drug Trial Results Mean For Shareholders — Yahoo Finance
