Alnylam Pharma (DUL) Q3 2026 Earnings Report

The call was broadly positive, with strong product and TTR revenue growth, expanding AMVUTTRA adoption, broad patient access, encouraging brezosiran data, a growing pipeline, profitability, and substantial cash generation. However, management acknowledged that AMVUTTRA demand growth and conversion of physician engagement into patient starts are slower than expected, while 340B policy uncertainty, Medicare Advantage access changes, lower collaboration revenue, lower gross margin, and the need to enlarge the TRITON-CM study remain challenges.

For 2026, Alnylam expects TTR product sales to land at the low end of its $4.2 billion-$4.5 billion range, with no material top-line contribution from its field expansion, and achieving $4.2 billion in total TTR revenues would represent nearly 70% growth versus last year or $1.7 billion in growth on a dollar basis; Q4 is expected to face inventory and price headwinds in the U.S., potential Q4 ordering volatility related to the final 340B rule, and an expected impact from more restrictive first-line AMVUTTRA access in Medicare Advantage, while the company does not expect acceleration of growth in Q4 2026. Alnylam will not provide 2027 product revenue guidance at JPMorgan, will provide preliminary fourth quarter and full year 2026 revenue at JPMorgan in January, and expects to provide 2027 guidance in mid-February; it continues to target a 25%+ total revenue CAGR throughout year-end 2030, approximately 2030 ATTR cardiomyopathy launch timing for nucresiran, a pivotal brezosiran study in 2027, about 75,000 treated ATTR cardiomyopathy patients in the U.S. by 2030, and a third of U.S. category TRX.