Revenues Top One Billion: Record AMVUTTRA Adoption Drives Growth (ALNY Q1 2026 Earnings Call)

By Dr. Graph | Updated on May 26, 2026 | earnings

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Alnylam crossed a historic threshold in the first quarter of fiscal 2026 as robust global demand for its core transthyretin amyloidosis franchise drove record net product sales. The company achieved its first-ever quarter exceeding one billion dollars in product revenues while maintaining consecutive profitability.

Net Product Sales Cross One Billion Dollars as Operating Income Quadruples

Alnylam recorded a historic milestone as net product revenues climbed to $1.036 billion in the first quarter of fiscal 2026. This performance represents a 121% increase year-over-year and a 4% sequential expansion compared to the prior quarter. Robust global demand for core therapies drove the record top line, helping the company secure its third consecutive quarter of profitability. Non-GAAP operating income reached $339 million, representing a more than four-fold increase compared with the prior-year period.

Reiterated Revenue Outlook Prepares for Substantial Commercial Acceleration

Management reconfirmed its full-year financial targets, expressing strong confidence in its long-term portfolio expansion. Jeffrey Poulton reconfirmed the TTR franchise product sales guidance of $4.4 billion to $4.7 billion. He stated: "our guidance continues to reflect an assumption of significantly higher quarter-on-quarter revenue growth for the balance of the year." To support its scientific goals, Pushkal Garg clarified that the company aims to invest approximately 30% of its revenues in non-GAAP R&D to advance its clinical pipeline.

Core Amyloidosis Franchise Anchors Expansion While Rare Disease Segment Grows

The transthyretin amyloidosis franchise remains the primary commercial engine, with global TTR net revenues reaching $910 million, which represents a 153% year-over-year increase driven by strong adoption of AMVUTTRA. Meanwhile, the rare disease segment generated $126 million in net revenue from rising patient demand. Outside the United States, revenues declined by $7 million sequentially, which was primarily driven by expected pricing adjustments in Germany following the ATTR-CM launch.

Robust Patient Adherence and Strategic Prescribing Patterns Drive Demand

Tolga Tanguler explained that initial utilization of AMVUTTRA by new prescribers is balanced between first and second lines of therapy, with first-line adoption accelerating with physician experience. In the U.S., TTR revenue grew 9% sequentially, translating to a $59 million increase that was achieved despite a calendar headwind of 12 shipping Wednesdays compared to 14 in the prior quarter. Additionally, Pushkal Garg noted that HELIOS-B results validate the therapeutic benefit of adding silencers to stabilizer regimens, which will be further evaluated in the ongoing TRITON outcomes study.

Frequently Asked Questions

Why did Alnylam expand the enrollment of the TRITON-CM Phase III study for nucresiran?

Alnylam utilized a prespecified protocol option to expand enrollment by 500 patients, raising the total from 1,250 to 1,750. This expansion protects the event-driven study against low event rates due to enrolling patients with milder disease on average, while keeping the projected drug launch on track for 2030.

What do real-world studies show regarding patient adherence and prescriber adoption for AMVUTTRA in the United States?

A retrospective cohort study of approximately four years of real-world data showed that 93% of patients achieved high adherence to vutrisiran, with the vast majority remaining on therapy for over a year. Additionally, the company added more than 1,200 unique new U.S. prescribers since March of the previous year.

What caused the decline in Alnylam's collaboration revenues during the first quarter of fiscal 2026?

Collaboration revenue was $82 million, representing a 17% year-over-year decrease. This decline was primarily driven by a high comparison baseline from the prior-year quarter, which included a non-recurring $30 million milestone payment received from Vir.

What factors influenced Alnylam's product gross margin and royalty revenues in Q1 2026?

Royalty revenue rose 85% year-over-year to $49 million, driven by higher global sales of Leqvio. However, product gross margin declined to 80% due to higher average royalty rate obligations to Sanofi for Amvuttra, which reset each calendar year.