Bristol-Myers Squibb Company (BMY) Earnings Call Transcript & Summary

July 30, 2026

NYSE US Health Care Pharmaceuticals earnings 64 min

What were the key takeaways from Bristol-Myers Squibb Company's July 30, 2026 earnings call?

In Q2 2026, Bristol-Myers Squibb (BMY) reported total revenue of approximately $13 billion, reflecting a 5% year-over-year increase, driven primarily by a 14% rise in its growth portfolio. Adjusted diluted EPS was $2.04, and the company raised its full-year guidance for both revenue and adjusted EPS, citing strong performance and momentum in key products. The guidance revision includes an expected 20% to 25% growth in Eliquis revenue, offsetting a projected decline in the legacy portfolio.

What topics did Bristol-Myers Squibb Company cover?

  • Revenue Growth Acceleration: Bristol-Myers Squibb's total revenue increased 5% year-over-year to approximately $13 billion, with the growth portfolio contributing $7.6 billion, up 14%. Management stated, "Our growth portfolio continued its strong performance with sales up 14%", highlighting the strength of key products like Reblozyl and Breyanzi.
  • Guidance Increase: Management raised full-year 2026 revenue and adjusted EPS guidance due to strong first-half results. David Elkins noted, "Based on this first half momentum and confidence in our second half outlook, we are raising our full year guidance for both revenue and adjusted diluted EPS."
  • Pipeline Developments: Bristol-Myers Squibb is advancing a differentiated pipeline with multiple pivotal readouts expected by year-end. The company anticipates significant opportunities from drugs like Iberdomide and Mezigdomide, with PDUFA dates set for August 17, 2026, and May 13, 2027, respectively.
  • Eliquis Performance: Eliquis revenue grew by 21%, driven by strong demand and market share gains. David Elkins stated, "Eliquis delivered demand-driven growth of 21%, which nearly offset declines from generic entry across the remainder of the legacy portfolio."
  • Cobenfy and Milvexian Delays: Delays in the Cobenfy and Milvexian studies were discussed, with management emphasizing that these were due to enrollment pace and quality concerns rather than execution issues. Cristian Massacesi remarked, "The pace of events is lower than predicted" for Milvexian, which is now expected to read out in Q1 2027.

What were Bristol-Myers Squibb Company's July 30, 2026 results?

  • Total Revenue: $13B (vs $12.4B est, +5% YoY)
  • Growth Portfolio Revenue: $7.6B (up 14% YoY)
  • Adjusted EPS: $2.04 (beat by $0.12)
  • Eliquis Revenue: $4.5B (up 21% YoY)
  • Reblozyl Growth: 29% (reflecting strong uptake in first-line MDS associated anemia)
  • Breyanzi Growth: 41% (driven by strong demand across indications)

Bristol-Myers Squibb's solid Q2 performance and raised guidance reflect a strong growth trajectory, bolstered by key product performance and a promising pipeline. However, the delays in Milvexian and Cobenfy studies present risks that investors should monitor closely. Future catalysts include upcoming PDUFA dates and pivotal trial readouts, which could significantly influence stock performance.

Earnings Call Speaker Segments

Operator

operator
#1

Welcome to the Bristol-Myers Squibb Second Quarter 2026 Earnings Conference Call. [Operator Instructions] Please note, this event is being recorded. I would now like to turn the conference over to Chuck Triano, Senior Vice President and Head of Investor Relations. Please go ahead.

Charles Triano

executive
#2

Thank you, and good morning, everyone. We appreciate you joining our second quarter 2026 earnings call. With me this morning with prepared remarks are Chris Boerner, our Board Chair and Chief Executive Officer; and David Elkins, our Chief Financial Officer. Also participating in today's call is Adam Lenkowsky, our Chief Commercialization Officer; and Cristian Massacesi, our Chief Medical Officer and Head of Global Drug Development. Earlier this morning, we posted our quarterly slide presentation to bms.com that you can use to follow along with Chris and David's remarks. Before we get started, I'll remind everybody that during this call, we will make statements about the company's future plans and prospects that constitute forward-looking statements. Actual results may differ materially from those indicated by those forward-looking statements as a result of various important factors, including those discussed in the company's SEC filings. These forward-looking statements represent our estimates as of today and should not be relied upon as representing our estimates as of any future date, and we specifically disclaim any obligation to update forward-looking statements even if our estimates change. We'll also focus our comments on our non-GAAP financial measures, which are adjusted to exclude certain specified items. Reconciliations of certain non-GAAP financial measures to the most comparable GAAP measures are available at bms.com. Finally, unless otherwise stated, all comparisons are made from the same period in 2025 and sales growth rates will be discussed on an underlying basis, which excludes the impact of foreign exchange. All references to our P&L are on a non-GAAP basis. And with that, I'll hand it over to Chris.

Christopher Boerner

executive
#3

Thanks, Chuck. Good morning, everyone, and thank you for joining our Q2 2026 earnings call. We delivered another excellent quarter, driven by disciplined execution across the business. Our progress towards transitioning the portfolio to fuel durable long-term growth is reflected in our growth portfolio strong Q2 performance. At the same time, we're delivering strong performance from our existing business. We're also advancing a broad and differentiated pipeline while maintaining financial flexibility to invest in the highest value opportunities for patients and shareholders. Together, these efforts continue to strengthen the foundation we're building and increase our confidence in our ability to grow the company as we exit the decade. Let me walk you through some of the highlights of our performance, beginning with our Q2 results on Slide 4. Our growth portfolio continued its strong performance with sales up 14%. Key assets, including Reblozyl, Breyanzi, Camzyos, Opdualag and Qvantig continued to perform well, with 10 products in our overall portfolio achieving double-digit growth. This performance demonstrates both the value creation of our portfolio and the continued execution of our commercial organization. Based on the strength of our results, we are increasing our full year 2026 revenue and adjusted EPS guidance. David will provide additional details shortly. Building on our in-market performance, our pipeline of differentiated assets is an important driver of our long-term growth, and we're making significant progress there as well. We had an exciting ASCO in June, where we shared data that reinforces the breadth of innovation across our leading oncology franchise. To highlight a few examples. In hematology, we presented positive Phase III data from the Mezigdomide SUCCESSOR-2 study evaluating MeziKd for patients with relapsed or refractory multiple myeloma. The study showed a statistically significant and clinically meaningful improvement in progression-free survival. This further strengthens our confidence in the CELMoD class and its potential to drive the advancement of future myeloma treatment. In solid tumors, we saw encouraging Phase III data from 2 iza-bren studies, supporting our strategy of building differentiated ADC capabilities across multiple difficult-to-treat solid tumors. We are also initiating our fourth global Phase III study in first-line EGFR mutant non-small cell lung cancer. For Pumitamig, we shared encouraging early Phase II global data in combination with chemotherapy for first-line non-small cell lung cancer. And in terms of our expanding development program, we are initiating a new Phase II novel, novel study combining pumitamig with imzokitug, our CCR8 antibody. These programs reinforce the power of our innovation engine and support our strategy of combining different modalities to deliver transformational medicines and improve patient outcomes. Turning now to our near-term pipeline milestones we anticipate during the remainder of 2026 on Slide 5. We've talked about our ambition to translate a data-rich pipeline into durable long-term growth drivers, and we continue to expect pivotal readouts across our therapeutic areas by the end of this year. These near-term readouts represent compelling opportunities including Admilparant, a potential first-in-class medicine that could redefine the standard of care in pulmonary fibrosis, Arlo-cel in relapsed or refractory multiple myeloma, Iberdomide progression-free survival data, Milvexian in secondary stroke prevention, RYZ101 in GEP-NETs and Sotyktu in lupus, a disease affecting millions of patients with very limited treatment options. Each of these pipeline opportunities carries the potential to redefine treatment standards addressing large underserved patient populations and helping to accelerate our long-term growth trajectory. Together, they represent multibillion-dollar peak sales potential and reflect the full depth and breadth of what we're building. For Milvexian, we now expect the atrial fibrillation study to read out in the first quarter of 2027. This is an event-driven study, and the updated timing from late 2026 reflects the pace of events. As a reminder, the study is being monitored by an independent data monitoring committee, which continues to endorse the study. And with the passage of time, as the study progresses, we are increasingly encouraged about Milvexian's potential and look forward to seeing the results of this important study. With respect to the Cobenfy development program in Alzheimer's psychosis, based on the pace of enrollment in the ADEPT 2 and 4 studies and relapse events accruing more slowly than projected in ADEPT 1, we now anticipate top line data readouts from the ADEPT program to begin in early 2027 and be spread across the year with the potential interim analysis for ADEPT 1 later this year. While we await those readouts look forward to sharing safety and efficacy data later this year from the open-label lead-in portion of ADEPT 1 as well as data from ADEPT 3 which is the open-label rollover study for patients who have already completed the ADEPT 1, 2 and 4 studies. These data reinforce our continued confidence in the potential for this medicine in Alzheimer's psychosis. Finally, our Phase III BALSAM-1 and 2 studies evaluating Cobenfy and Bipolar-I disorder continue to enroll well, and we anticipate reading out in the first half of 2027. In addition to these upcoming data readouts, we're also beginning to see the next stage of our pipeline strategy coming to focus as recent clinical progress translates into regulatory decisions. We are awaiting the August 17 PDUFA date for Iberdomide and are ready for the launch of this important medicine, which has the potential to be the first commercialized CELMoD. This would represent a brand-new class of treatment for myeloma, a historically difficult-to-treat illness with a patient population that could significantly benefit from new innovative options. And we're pleased that the FDA accepted our NDA for Mezigdomide with a PDUFA date of May 13, 2027. Together, Iberdomide and Mezigdomide continue to reinforce our confidence in the long-term potential of our protein degradation platform. The FDA also recently accepted our supplemental NDA for Camzyos in adolescents with obstructive hypertrophy cardiomyopathy and assigned a September 30 PDUFA date. At the same time, we continue to actively plan our previously announced Phase III study evaluating Camzyos in patients with nonobstructive hypertrophic cardiomyopathy and expect to initiate the study by the end of the year. I want to step back for a moment and take stock of where we are and why I'm energized by what's to come. Our growth portfolio is delivering today and our differentiated pipeline is on the verge of multiple pivotal readouts with the potential to introduce more than 10 new medicines by the end of the decade, including Iberdomide and Mezigdomide, both of which have upcoming PDUFA dates. In addition, we also anticipate over 30 meaningful life cycle management opportunities during that same period. Our priorities are clear: continue executing with discipline and translate differentiated science into transformational medicines for patients. Turning to Slide 6. We continue to evolve how we operate as a company. Over the past few years, we made a significant progress rewiring BMS into a more agile, focused and efficient organization. This includes expanding the use of AI to help our teams move faster, execute better and operate more effectively. Over the past several years, BMS has embedded AI across its research and enterprise operations and demand for compute has grown alongside the scale and maturity of our AI capabilities. In support of this expansion, we've recently announced partnership agreements with both Anthropic and NVIDIA. Concretely, this will help our scientists do 3 things: understand disease biology more deeply, design and test candidate molecules faster and make earlier, better informed decisions about which programs to move forward. At the same time, we remain disciplined in how we manage our resources. Our focus on productivity continues to generate meaningful savings. When combined with our strong free cash flow generation and balance sheet, these efforts continue to fortify the company's financial foundation. Before I turn the call over to David, I'll emphasize that the strong financial foundation we've built provides us with the optionality and flexibility to continue investing in growth drivers, pursuing business development opportunities and returning cash to shareholders. And with that, David, over to you.

David Elkins

executive
#4

Thank you, Chris, and good morning, everyone. We delivered another strong quarter with the results continuing to highlight the underlying strength of our growth portfolio comprised of many products that are early in their life cycles. Our performance is also supported by disciplined investment in growth-oriented initiatives. Results were further bolstered by Eliquis. Based on this first half momentum and confidence in our second half outlook, we are raising our full year guidance for both revenue and adjusted diluted EPS. Let me begin with a review of our second quarter results. Starting with Slide 8. Total revenue in the second quarter increased 5% year-over-year to approximately $13 billion with strong performance of our growth portfolio, offsetting legacy portfolio decline. Growth portfolio revenue rose 14% to $7.6 billion, now representing nearly 60% of total revenue. As Chris referenced, multiple products contributed to this growth as this portfolio continues to emerge as a broadening foundation for durable long-term growth, further supported by the broad pipeline. Within the legacy portfolio, Eliquis delivered demand-driven growth of 21%, which nearly offset declines from generic entry across the remainder of the legacy portfolio. Despite full generic availability in the U.S., Revlimid revenue remains more resilient. Turning to product performance on Slide 9, starting with oncology. Qvantig continued its strong launch trajectory with revenue of $261 million and is now annualizing at over $1 billion. For Opdivo, revenue decreased 4% to approximately $2.5 billion, primarily driven by continued conversion to Qvantig in the U.S. In the quarter, we saw some inventory build at the wholesale level, reversing some of the drawdown we referenced in the first quarter. Opdualag delivered another quarter of strong double-digit growth which continues to be driven by demand globally and its leading position as a standard of care in first-line melanoma in the U.S. Turning to Slide 10. Reblozyl grew 29%, reflecting solid uptake in first-line MDS associated anemia, continued strength in the second-line setting and further penetration in the first-line RS-negative population. Breyanzi posted 41% growth in the second quarter, driven by its best-in-class profile and strong demand across proved indications in both the U.S. and international markets. As in prior years, we anticipate the typical summer demand patterns to moderate growth in the third quarter. Moving to cardiovascular immunology on Slide 11. Eliquis revenue was approximately $4.5 billion, up 21%, driven by strong demand through continued market share gains. As a result of the price decrease implemented at the start of the year, U.S. second half sales are expected to benefit from the elimination of the accumulated CPI penalty in certain government channels. Camzyos revenues increased 59% to $416 million, reflecting continued promotional efforts, new patient prescriber additions and deeper penetration into the community setting. Now moving to immunology. Global revenue for Sotyktu grew 23%. We are supporting the recent indication for psoriatic arthritis in adults, and we look forward to the Phase III readouts in lupus later this year. I will wrap up our product performance review on Slide 12 with neuroscience. Cobenfy grew 81% to $63 million in revenue in the quarter, reflecting continued steady progress in the schizophrenia market. Let's now move to the P&L on Slide 13. Gross margin in the second quarter was 71.4%, reflecting product mix. Operating expenses for the second quarter were $4.1 billion. We continue to benefit from our strategic productivity initiative, which provides us both the ability to reduce expenses in identified areas as well as the flexibility to invest in multiple growth-oriented opportunities. Our effective tax rate in the quarter was 16.5%, reflecting jurisdictional earnings mix. Overall, diluted earnings per share were $2.04 for the quarter. Now turning to the balance sheet and capital allocation highlights on Slide 14. We remain in a strong financial position with approximately $11.5 billion in cash equivalents and marketable securities as of June 30. In the second quarter, we generated approximately $3.4 billion in operating cash flow and paid down an additional $1.2 billion in debt. In terms of capital allocation, we maintain a strategic and balanced approach to deploying our strong cash flows. Business development remains a priority, and we are regularly evaluating opportunities in the therapeutic areas we know best, while continuing to return cash to shareholders through our commitment to the dividend. Moving to guidance on Slide 15. We are increasing our full year 2026 financial guidance for both revenue and adjusted diluted EPS based upon our strong first half results and our current projections for the balance of the year while maintaining our projections for gross margin, other income and expense and our tax rate. Incorporating into these revisions are projected higher Eliquis revenue growth of 20% to 25%. In a less pronounced total legacy portfolio revenue decrease now expected to be between 4% and 6%. We have slightly increased our projected operating expenses for the year to account for accelerated prelaunch activities supporting our CELMoDs, iberdomide and mezigdomide, the expanding pumitamig development program and opportunities to further support the growth portfolio. And to reiterate Chris' comment, our strategy remains focused on driving execution across the organization to build momentum in our growth portfolio and advance our pipeline while maintaining financial flexibility to balance investment in future growth with disciplined, shareholder-friendly capital allocation. In closing, our strong performance in the quarter reinforces our confidence to deliver long-term value for our patients and shareholders. And with that, I'll now turn the call back over to Chuck for Q&A.

Charles Triano

executive
#5

Thanks, David. Everybody, if you could please help us post questions, operator, and we'll get started with the Q&A session.

Operator

operator
#6

[Operator Instructions] The first question today comes from Geoff Meacham with Citi bank.

Geoffrey Meacham

analyst
#7

Congrats on the quarter. Chris or Cristian, I guess I just wanted to talk about the depth in Milvexian studies going into 2027. I know they're event-driven, but maybe can you talk a little bit about what this means relative to your initial assumptions? Is there something in the patient population, maybe that has changed or that is perhaps different than what you guys initially assumed? Just wanted to get a little bit more context for both of those.

Christopher Boerner

executive
#8

Geoff, thanks for the question. Cristian?

Cristian Massacesi

executive
#9

Geoff, thanks for the question. Let me start with Cobenfy with ADEPT. First, let me explain the reasons for the delay. Chris highlighted in his opening remarks, let me dig into it. ADEPT 1, we are recruiting events, psychotic relapses. And we are having now a lower pace of how we are recruiting these events than predicted. So this is -- can be seen overall as a positive way. And anyway, ADEPT 1 will be the first interim analysis without by the end of this year or beginning next year. ADEPT 2 and ADEPT 4 is different because like for the rest of Cobenfy program, the first priority has been to ensure the highest quality in terms of the patients we are including in the trial, the conduction of the study. If you think about it, this is one of the best ways to ensure for these trials, the highest chance of success and then this is very important also to support the registration. So this scrutiny in preserving quality and increasing quality impacted the enrollment pace. The second point I want to make is about where we are now. I think we have implemented now several measures to accelerate this enrollment. And I think the pace and the projections on time lines are solid. Finally, related to your question on a debt program overall, there has been no change in any way in our confidence in both the underlying science, the scientific rationale and also the study designs that we are implementing in a debt program. We continue to believe that [indiscernible] can provide a substantial benefit to patients with [indiscernible] disease and psychosis. And actually, this is the main reasons we decided to share the open-label data of ADEPT 1 and the rollover ADEPT 3 data in one of the next meeting of forms later this year. Moving to Milvexian. As you said and Chris said, first of all, we remain blinded. But this shifting into first quarter '27 of [indiscernible] is, again, simply a reflection of the way the pace we are recruiting events. It is lower than predicted. DMC continue to oversee the study in a regular way and continue to endorse the conduction of the study. I see favorably this delay because actually gave us more confidence that we are targeting for both the primary endpoint, noninferiority and the secondary endpoint of superiority of bleedings. I remain very excited. Milvexian can be the first [ Factor XI ] drug to be at parity on efficacy with Eliquis, not beating Eliquis on bleedings.

Operator

operator
#10

The next question comes from Chris Schott with JPMorgan.

Christopher Schott

analyst
#11

Just following up on Milvexian. I guess beyond just the noninferiority primary endpoint, I think there's a debate on the street, what type of hazard ratio you need to see for this drug to get broad adoption cannibalizing sizable pieces of Eliquis versus just targeting maybe an underserved segment of the AF market. Can you just help frame out what you think you'd need to see from that study for this to be a very large opportunity for Bristol versus what would be maybe more as an incremental new product for the company just in terms of how strong that data has to be? And if I just throw a second one and really quickly. On the guidance increase, can you just talk a little bit about the drivers of the upside for the growth portfolio is implied in the guidance? I guess is there any standout assets that are driving that upside?

Christopher Boerner

executive
#12

Thanks for the question, Chris. I'll ask Adam to start and then David, you can jump in on guidance.

Adam Lenkowsky

executive
#13

Great. Thank you, Chris. So Milvexian represents a significant commercial opportunity, and we know there is a need for a medicine that has low bleeding risk, lower than Eliquis and can play across both AFib and SSP. As far as the atrial fibrillation opportunity, this is a very large market. There are approximately 10 million patients diagnosed and treated in the U.S. We know this market well. We know the customers well, and we know what it takes to compete and win. [indiscernible] bleeding continues to be the main reason why clinicians continue to hold back from using more Factor Xas in more patients. And despite what we see today with Eliquis, there's still roughly 40% of patients who should be anticoagulated, who are undertreated, they're underdosed with discontinued treatment, and that's driven largely by physician concerns around bleeding risk. And so I don't think it makes sense to speculate on hazard ratio. But what I can say is our study, as Christian mentioned, was designed to demonstrate a superior bleeding profile compared to Eliquis with comparable efficacy. And so patients with bleeding liability, risk factors are more likely to experience HCP hesitation today for anticoagulation treatment. So for example, patients who are elderly, low body weight represent a high unmet need, patients who have renal impairment. And Milvexian has the potential not just to unlock those patients but also, we expect milvexian to shift first-line decision-making over time, allowing physicians to initiate and maintain milvexian treatment more confidently than we can even do today by using Eliquis.

David Elkins

executive
#14

And on guidance, Chris, look, it was -- you saw in the results, it was pretty pervasive across the growth portfolio. We saw really strong growth. Opdualag was up 22%; Reblozyl, 29%. Breyanzi, we continue to see great growth there, 41% and Camzyos was at 59%. And as we also talked about, the Qvantig now, we have 15% share. So well on our way to about 30% to 40%. It's now annualizing over $1 billion. So if you look at Qvantig and Opdivo together, we're really pleased with the progress of that franchise. So it really is the underlying business, coupled with the strong performance of -- from a demand perspective on Eliquis, that gives us confidence in our guidance for the year.

Operator

operator
#15

The next question comes from Evan Seigerman with BMO Capital Markets.

Evan Seigerman

analyst
#16

I'm going to not ask one on milvexian or the ADEPT program. But taking a step back, you've been clear that BD remains a really important part of your long-term growth strategy. Can you just walk me through what excites you in biotech these days and kind of where you would look? I know you're not going to give specifics, but what type of technologies or therapeutic areas do you think would best fit within Bristol's portfolio?

Christopher Boerner

executive
#17

So maybe I'll start and then I'll ask Christian to chime in. Look, thanks for the question, Evan. Business development, as you know, and as we've discussed repeatedly, continues to be a top allocation priority. The way I think about BD just at a macro level is we've got a very strong late-stage pipeline. You see that in the commentary that we've made just this morning. We certainly don't feel any compulsion to taste deals. But as we've said consistently, if there's an opportunity that we can find that has a few things that are important to us, notably, they're in therapeutic areas that we know well. There are areas where the science is compelling. And of course, we need to be able to make a compelling case financially that we can drive value to the company and to shareholders. If those things come together and ideally continue to enable us to derisk our near-term growth profile we certainly have the financial flexibility and the capabilities to be in the mix. And so that's been our guiding philosophy around business development for some time now, and it continues to be our focus. But Cristian, are there particular areas you would highlight?

Cristian Massacesi

executive
#18

Thanks, Evan, for the question. There are -- I would frame in 2 way. I'm excited by what is new, what is innovative in terms of new targets, but also the way you deliver your drugs against that target, the modalities. I think this is where I think internally also looking external innovation is very, very -- continue to be very important. I want to give you some concrete examples. We know better and better the biology of the diseases where we are operating, I think cancer, I think neuroscience, cardiovascular. Now it's identifying targets that are becoming more and more relevant, and then the way we deliver against that. I want to give an example of an internal product that is our CELMoD BCL-6 is coming from our protein degradation platform. BCL-6 is a key target in lymphomas, drive lymphomas. But because it's the scripting factor, we were unable to inhibit them. Now with the degrader we can. This is just an example. Imagine the potential in neuroscience. We are building up our Alzheimer portfolio and we start to understand more and more on the biology of Alzheimer. Now the question is, how can we deliver against amyloid, against [indiscernible], against new targets and how we can have better drugs to get into the brain. The [indiscernible] is an example. So these are the kind of -- I hope I give you concrete examples on what I think innovation can look like, especially looking then at the development path that ultimately is our job.

Operator

operator
#19

The next question comes from Emily Field with Barclays.

Unknown Analyst

analyst
#20

Question on Cobenfy in the approved schizophrenia indication. You've talked about one of the drags on sales being that clinicians aren't titrating up quickly enough to the therapeutic dose. So I was just wondering if you could give us an update on how the educational efforts on optimizing that are going and when perhaps we could see that reflected in the sales trajectory? And if I could just sneak in another one on Sotyktu in lupus. Obviously, a lot of readouts coming in the lupus space over the next couple of years. So I was just wondering if you could highlight your confidence in the Sotyktu MOA and this obviously notoriously difficult space?

Christopher Boerner

executive
#21

So Adam, maybe you could start and Cristian, you can chime in as well.

Adam Lenkowsky

executive
#22

Sure. Emily, let me just take the first part of your question about Cobenfy. Cobenfy continues to deliver steady growth. And we see significant upside coming from future label expansions. What we're seeing today in schizophrenia is a number of positive leading indicators for the brand that continues to give us confidence. We're encouraged by the positive trends in total script volumes. In fact, in the quarter, we saw roughly a 15% growth in TRxs quarter-over-quarter. We're driving consistent increases in new prescribers and physician feedback continues to be positive. That said, we have areas where we need to make further progress. We need to accelerate new patient starts as well as improve repeat prescribing. As we shared before, this is disease state that prescribing behavior is deeply entrenched and Cobenfy will continue to grow by building more positive experiences in the market. As far as dosing, we have been educating physicians on the importance of rapidly titrating Cobenfy to the effective dose of 125 milligrams as we see far too many patients that remain on either the 50 or 100-milligram dose. What we have seen though is an increase in 125-milligram prescribing since introducing our Phase IV SWITCH study, which will both help maximize efficacy but we need to see further increases in the dose shift towards the 125 milligrams. But taken together, we have a meaningful opportunity to continue to build confidence and bring clarity on how to maximize Cobenfy use and overall, we do expect Cobenfy to grow consistently throughout the year with significant upside through a very broad LCM program. As far as Sotyktu in lupus, look, this is a market that is very different than the PSL market. Sotyktu remains really a strategically important asset, which we believe could see renewed momentum with our new indications. SLE, which will read out this year, and [indiscernible] will be out next year. In particular, a real need exists for more effective treatments. Those include treatments that reduce steroid dependence that includes treatments that are associated with fewer side effects. And what we saw in our Phase II study gives us a lot of confidence. That study was one of the largest and most compelling in SLE to date, having met both the primary and key secondary efficacy endpoints. So we believe we have a real opportunity to differentiate Sotyktu based on overall clinical responses, efficacy in skin and joint involvement, the ability to reduce steroid dependence and also associated toxicity. So we very much look forward to our SLE data readout this year as this could really catalyze growth for the brand.

Cristian Massacesi

executive
#23

Thanks, Adam, and thanks, Emily, for asking about these important readouts that will happen this year, both studies. As Adam said, the confidence stays on the Phase II. Adam explained very well why the Phase II were positive and positive for primary or secondary endpoints. It's not very typical in this space. Now what I'm pleased is on the fact that we have been able to mimic the Phase II study into the Phase III studies. This is very important because when I look at patient demographics, disease characteristics, trial management end points, everything is very matching. And there are in immunology, you have some kind of risks, sometimes related to placebo response. I think our teams investigators did a very good job in managing that risk in terms of checking carefully [indiscernible] and actually monitoring the primary endpoint. So really looking forward on the results this year, and I think, as Adam said, this can be a very important overall drug to bring in these patients.

Operator

operator
#24

The next question comes from Asad Haider with Goldman Sachs.

Asad Haider

analyst
#25

Congratulations on the quarter. Maybe for Cristian on [indiscernible]. This now seems to be becoming the key clinical events for the balance of the year given the updates that you guys just described. So just -- perhaps just level set us on expectations as we sharpen our pencils ahead of this readout. Can you contextualize whether it fits into the IPF landscape if the clinical benefit turns out to be in line with currently available drugs, which have improved FVC by roughly 40% to 50%. What would be the use case for adding it in? And then on the PPF side, is that trial still tracking to read out closely after IPF? And then anything you can tell us on the [indiscernible] strategy?

Christopher Boerner

executive
#26

Thanks, Asad. I'll start with Cristian and then maybe, Adam, you can chime in as well. .

Cristian Massacesi

executive
#27

Thanks, Asad, for the question. You're right. This is becoming a very important readout and guided by the end of this year. Let me start with the mechanism of action. LPA1 is a very important novel target because it's not working only on the fibrotic and inflammatory pathway, but also potentially on the [indiscernible]. This is novel. We believe that [indiscernible] can be first and best-in-class against LPA1. And the conviction on the Phase III, again, sits on the Phase II results, both in IPF and PPF. You know the results were very positive for [indiscernible] primary end point. What we did, and we were able to do also in this setting was ensure consistency as we run the Phase II into the Phase III, again, in terms of endpoints, population, overall criteria. It is an important aspect I want to highlight. In Phase III, we have 2 shots on goal in each of the studies, IPF and PPF because we are testing 2 doses, 60 milligrams, it is the dose that emerged from the Phase II, but also 120-milligram that was introduced later. We know there is a dose relation activity. And this gives us more chances with both doses, also looking overall the study conduction and how the blinded data emerging on the safety side very well. Overall, I have to say I'm really looking forward to these readouts because the profile of this drug can be very [indiscernible] for patients with both IPF and PPS. IPF guided this year, PPF -- to the second part of your question will be, just a few months after, so very, very same ballpark time lines beginning next year. Adam, you want to speak about the positioning?

Adam Lenkowsky

executive
#28

Yes. No, thanks for the question, Asad. [indiscernible] has the potential to play a truly meaningful role in both IPF and PPF as we expect improved efficacy and tolerability profile. There is still a significant unmet need for new and improved therapies that slow disease progression, potentially even halting disease progression that are well tolerated and ultimately help patients better manage their disease. Remember, GI tolerability remains a significant challenge with current agents in the market. And in fact, 50% to 60% of IPF patients continue to stop their medications by 12 months, and that's with current standard of care. And what you've seen in the most recent launch, it clearly validates the market opportunity, that there is an opportunity to gain significant share as better tolerated and more effective new treatment options emerge. And so what we're seeing happen in the market today is the emergence of a large second line add-on and switch market for the first time. We're seeing that with [indiscernible] over 50% of their starts are coming after generics. So today, this is a roughly $4 billion market. We expect this market to grow significantly with improved treatment that could maybe double to $8 billion to $10 billion by the middle of the 2030s with improved treatment options. And we believe that [indiscernible] truly has the potential to be foundational as a first branded option with the versatility of being used in combination. And so we very much look forward to the readout in the back half of this year.

Operator

operator
#29

The next question comes from Seamus Fernandez with Guggenheim Securities.

Seamus Fernandez

analyst
#30

So I wanted to drill in a little bit on the CELMoDs. We've got 2 assets that are either filed or fileable with the agency. Just wanted to get a better sense of how in, let's say, 2028 to 2030, how you see the CELMoDs actually contributing to the growth revenue for the company? This does seem like a multibillion dollar perhaps even a double-digit $1 billion potential opportunity if the earlier-stage studies read out positively. But even in the existing indications that you see today, what kind of contribution do you see coming from your CELMoD portfolio?

Christopher Boerner

executive
#31

Thanks, Seamus. Great question. And obviously, we're quite excited about the platform and both [indiscernible], but Adam, you can chime in?

Adam Lenkowsky

executive
#32

Yes. No, thank you, Seamus, for the question. So clearly, CELMoDs represent a significant commercial opportunity. And we're confident that both iberdomide and mezigdomide will deliver very strong growth for the company. And we're very much looking forward to iberdomide's PDUFA date which is just a few weeks away, and our commercial teams are launch ready. We're also pleased to have a PDUFA date set for mezigdomide as you have heard earlier on the call, which will come in May of next year. Let me just step back. We call it 70% to 80% of patients are treated with [indiscernible] myeloma in the community. And both iber and mezi are able to provide a balance of high potency, be able to provide a manageable and very familiar toxicity profile that are able to provide a better experience for patients with the convenience of an oral treatment that fits within the workflow of their practice. So iber will replace [ POMALYST ] and [ REVLIMID ] in the leading triplet regimens in second line and combined with [indiscernible] and we'll amplify the efficacy of current IMiD-based regimens. Our goal is to make iber and mezi foundational myeloma, replacing rev and [indiscernible] in second line over time. We do expect strong adoption in the community and PFS data should be available within just a few months after our approval, which will certainly help accelerate uptake as some physicians are going to want to see PFS data before adopting. But we are ready to launch. We know the work we need to do to establish both iber and mezi in the market. So we're also excited about the upcoming readouts for [indiscernible], which will be the third CELMoD in the market that has the opportunity to really revolutionize first-line and also play a significant role in second-line follicular lymphoma. So we're excited to bring these important medicines to patients, and we know these 3 drugs will provide meaningful contributions to growth for the company.

Operator

operator
#33

The next question comes from Michael Yee with UBS.

Michael Yee

analyst
#34

Two questions, both for Cristian. On IPF, can you just talk a little bit about the 120 dose that you're using and how you feel about how much more efficacy that could add and what exposure analysis data you might have seen there in the context of also blood pressure questions and how you feel about the risk benefit of the 120? And then just perhaps a clarification on milvexian. I know that everyone's asking about hazard ratios, but just so that you could confirm I would assume that the noninferiority study, you expect the hazard ratios certainly in the upper bound to be well above 1.0. But as long as it's not inferior, that is a win for you? Just wanted to clarify and confirm.

Christopher Boerner

executive
#35

And Cristian, you can start and then Adam, you can just chime in with any additional detail on milvexian.

Cristian Massacesi

executive
#36

Thank you, Mike, for the question on [indiscernible]. As I said, we introduced 120-milligram dose based on some work coming and modeling work showing that there was a dose relation. You remember, in the Phase II, we tested 30-milligram and 60-milligram, 60-milligram was the dose showing better and higher benefit and this is what we brought in Phase III. Then at the start of the Phase III, that was randomized running introducing 120 [indiscernible] data and clear that dose. We believe that there is a dose relation. The real -- as you mentioned, the real unknown for the [indiscernible] was 120 safety profile in terms of high potentials. What I can tell you is that DMC is monitoring regulated study. We completed the recruitment and we are waiting the readout, and there was in a blinded way, very reassuring events, safety profile rate. So this increases the confidence that we have to [indiscernible] and the studies are fully powered for both doses. And related to milvexian, again, we remain blinded and you're right, the margins on noninferiority are range around that is [indiscernible] the study is fully design and power to show another [indiscernible]. This is what we expect milvexian being as good as Eliquis terms of stroke and systemic [indiscernible] and then [indiscernible] being better on bleedings.

Adam Lenkowsky

executive
#37

Yes. Just as far as what we're hearing from our positions, I think, number one, physicians, payers, as we meet with them, they're not anchored on a specific percentage threshold. What they're looking for, though, is clinically meaningful reduction in major bleeding that translates into fewer events, fewer hospitalizations and ultimately, a lower cost in treating AFib patients. It's why Eliquis continues to play such a prominent role in the marketplace. Our customers focus on whether treatment enables them to have broader and more confident use of anticoagulation preserving stroke production while improving the safety margin has a potential to really meaningfully reshape the treatment dynamics that we see today. And we believe that the profile that we have described and we fully expect will drive significant demand and will be important for payers, patients and providers.

Operator

operator
#38

The next question comes from Jason Gerberry with Bank of America.

Jason Gerberry

analyst
#39

Another one on IPF and maybe for Adam. Just given the really strong launch of just [indiscernible], does this impact the bar for success in your view? Does it elevate maybe the commercial bar for success? Or is it potentially winning and differentiating versus just [indiscernible] mainly on tolerability. And do you see the market potentially moving to polypharmacy, much like markets like pulmonary hypertension. So I just wanted to get your perspective on some of those market considerations.

Unknown Executive

executive
#40

Jason, thanks for the question. As we said, Cristian and I've all shared, IPF PPF remains a market with significant unmet needs, and those needs are in both efficacy and tolerability improvement. At [indiscernible] as the first ever LPA1 antagonist has the potential to play a real significant role, and we expect both improved efficacy and improved tolerability. Specifically as it relates to GI toxicity, which even what we see today with some of the most recently approved products has an overall rate of diarrhea of 40%, over 60% in combination. And what we've seen with [indiscernible] in our Phase II studies is a side effect profile that is comparable to placebo. I think what you're getting at is, right, [indiscernible] launch validates the market opportunity and shows there's an opportunity to gain significant share as better tolerated and effective new treatment options emerge. And that's what we're seeing. We're seeing the creation of a second line add-on market for the first time ever. It has over 50% of new [indiscernible] starts are coming after generic [indiscernible] switch or add-on treatments. And we'll see this part of the market grow substantially after generic use. So clearly, we'll see a big market in [indiscernible] pharmacy, we're going to switch and add-on. As I talked about, this is a market that we think could double in size over time with improved treatment options. And [indiscernible] certainly has the potential to be foundational both as a first branded option in monotherapy with the versatility of being used in combination, given what we expect to be really exciting efficacy profile and tolerability profile.

Operator

operator
#41

The next question comes from David Amsellem with Piper Sandler.

David Amsellem

analyst
#42

So I had a question about your [indiscernible] program with the data coming next year. Just with the recent data from Biogen, [indiscernible] and just given the body of data for the A-beta therapy, I just wanted to get a better sense from you on what we'd like to see from CDR [indiscernible] and just the totality of the data that you get next year for [indiscernible] in order to justify moving forward? And then also what you're seeing with that molecule that potentially differentiates it from [indiscernible]?

Cristian Massacesi

executive
#43

Thank you for the question, David. The -- our anti-tau antibody, [indiscernible] is a very potential best-in-class important antimicrotubule binding region tau. I want to -- I'm specific on this because -- there are many antibodies out there, but I think banking R1 and R3 domains in the MTRBin the microtuble region is believed to be very important because it is a critical area that lead to formation and spread of the [indiscernible]. So the job of the drug is blocking this spread from one to another. We did the Phase I and the Phase I was very assuring in terms of safety and tolerability of the product, and now we completed the recruitment of Phase II. The readout of the Phase II is going to be next year. As you said, it's an exciting moment because what is emerging is that tau clearance is impacting cognition in Alzheimer's patient with mild impairment and cognitive impairment. And this can translate maybe into clinical benefit. So as you can imagine, our Phase II study will assess tau clearance will assess also some end points related to condition and potential [indiscernible] benefit. This will give us the way forward for the next stage of the development. I'm very excited about this space in general. We have now a second mechanism validated tau on top of amyloid. And I think now started to emerge also the discussion how we sequence this [indiscernible] drug how we combine them and for us it's an entry because, of course, we are very much into this space and developing the next generation of assets that are shuttled to increase the brand penetration. But very excited about [indiscernible] and see the data next year.

Operator

operator
#44

The next question comes from Luisa Hector with Berenberg.

Luisa Hector

analyst
#45

I wanted to just check on milvexian a little bit around how nimble you can be around launch costs. Do you need to pull back on any investment due to this delay? Or is it just a matter of a quarter is not a big deal. And with that in mind, could you remind us the setup. I mean, Eliquis, you have the sales force, you've had the rebate, but you've had some changes there with and pricing. So as we think about the future, Eliquis and then Milvexian hopefully launching, are there any constraints in that partnership with Pfizer on Eliquis that make things more difficult when you launch milvexian. Is there anything we should think about there or your sales force and your rebate are kind of transferable?

Unknown Executive

executive
#46

Adam, do you want to take that?

Adam Lenkowsky

executive
#47

Sure. Luisa, thanks for the question. As we said, my vaccine represents a significant commercial opportunity. What's great about milvexian is we have the infrastructure that has been established now for many years. with Eliquis. So we have that in place today covering virtually all of the physicians in atrial fibrillation is also a high overlap with SSP as well, say for some -- a small number of stroke neurologists that we'll be able to cover in the market today with our current [indiscernible] team. So we really have the full infrastructure commercially set, and we're very much looking forward to launching. As far as the interplay with Eliquis, Eliquis LOE, as you're aware, is April of 2028, and this lines up very nicely with the filing and launch time lines of milvexian. So we expect that Eliquis LOE to lead directly into the successful launch of milvexian.

Christopher Boerner

executive
#48

And just to follow up, there would be no constraints with respect to the relationship that we have with Pfizer in terms of our ability to successfully launch and commercialize milvexian.

Operator

operator
#49

The next question comes from David Risinger with Leerink Partners.

David Risinger

analyst
#50

So Chris, regarding milvexian and an atrial fibrillation, you had stated in your prepared remarks, "an independent data monitoring committee continues to [indiscernible] the study and with the passage of time as the study progresses, we are increasingly encouraged about milvexian". So can you please comment further on the endorsement including how you're interpreting study continuation as a positive signal when the DMC is evaluating both efficacy and bleeding I ask because it's already known and clear that milvexian is associated with much lower bleeding risk in Eliquis. So that is not any surprise that lower bleeding would be positive in the trial. So I'm more interested in your interpretation on the primary endpoint of efficacy with respect to your observations.

Christopher Boerner

executive
#51

Sure. Thanks, David. Maybe I'll start and then Cristian, you can continue to chime in or extend upon your earlier comments. Look, we continue to see, on a routine basis, the DMC looking, as you note, at both safety and efficacy. And if you look not only at the most recent reviews, but really just look at this over time, we've continued to see on this program a slowing of event rates, along with the continued view that the efficacy continues to be in line with expectations to continue the study, the safety, as you point out, we had a lot of confidence in. But in the backdrop of this broader program from a competitive standpoint, the fact that we continue to see DMC reviews and that as we look at the blinded data and see the event rate profile we continue to gain confidence that this program has significant potential to read out in a way that would be a competitive product relative to the position that we have with Eliquis. But Cristian, do you want to comment further?

Cristian Massacesi

executive
#52

Yes, David, let me use an analog in the same disease [indiscernible] with the same class drug. One study was in recent time stopped by the DMC based on [indiscernible] data review because the events were going in a different direction. So there was actually a potential detriment on the primary end point on stocks and embolisms in the investigational arm versus the comparator arm Eliquis. So the DMC stopped that study because that was becoming a problem. So having DMC continues to assess the efficacy and safety data, as you say, and giving us very much closer to the final readout, the reassurance that the study can progress as planned is a good thing. It's a good thing because at least we are sure that we are not bringing some anything that goes against the patients [indiscernible] to the patient on efficacy. Remember that this study is to show noninferiority, needs to be as good as Eliquis on strokes. And considering the number of events that we recruited so far the pace of defense and the DMC continues [indiscernible], this is -- this looks good. And then as you said, the bleeding probably milvexian is going to be better than [indiscernible] expectations.

Christopher Boerner

executive
#53

So if you just step back in this program, generally, David, what I would say is that you continue to have very strong scientific rationale. We know the strong Phase II data that we had. As you've highlighted, we know the safety and on efficacy given the event profile and how it's evolving in a blinded fashion and DMCs continue to endorse the continuation of the study. You add all of that up, we feel very good about this program.

Operator

operator
#54

The next question comes from Steve Scala with TD Cowen.

Steve Scala

analyst
#55

I have 2 questions. First, how will the increased growth of Eliquis in 2026 impact sales in 2027 and beyond. Is it a tailwind, a headwind or neither in '27? And is any portion of those revenues in '26 sustainable? Secondly, after a number of Phase III setbacks in recent years, Bristol actively addressed study conduct deficiencies. Curious where you stand relative to resolving them? And are milvexian and Cobenfy delays completely unrelated to any lingering study conduct issues, such as maybe assessment of primary events?

Christopher Boerner

executive
#56

So thanks for the question, Steve. Maybe, Adam, do you want to start with Eliquis, and then Cristian, you can address the second part of the question. .

Adam Lenkowsky

executive
#57

Yes. Steve, thanks for the question. Eliquis continues to deliver strong demand growth back in the U.S. new-to-brand share is approaching 80%. As we said, coming into this year, we would see the benefit of the WACC reduction taken January 1 in the second half of the year. And thus, sales in the U.S. in the second half would be higher than in the first half of the year. And as we talked about -- David talked about is sales this year are anticipated to grow roughly 20% to 25% year-over-year. Now we still expect the $1.5 billion to $2 billion step-down in 2027 that we referenced on the Q1 call. We'll clearly provide any appropriate update in conjunction with our 2027 guidance when issued. But the U.S. sales certainly would carry forward to next year, offset by the patent expiry of Eliquis in Europe in mid-Q4. Cristian?

Cristian Massacesi

executive
#58

Thank you, Steve, for the question. Very broad one. Let me tell you that -- let me start with the general concept. The Phase III trial can fail if the science doesn't hold, you cannot do a lot on that. But most of the time, fails because also execution can be related to the execution. Execution means that not only how you run the [indiscernible], also the study, the statistical assumptions, the comparator performance and so on. So what we did as a general way of working was to identify in any of the ongoing studies, potential risks and mitigate that. Because this is with [indiscernible], it's impossible to have 100% [indiscernible] in any of the registrational studies. But you can get -- you want to get as close as possible to that. And this is what now we are working, integrating high technology data and everything to have for each program this TTS improvement. Milvexian and Cobenfy delays are unrelated in a certain way because milvexian is event-driven. And actually, the event is slowing down favorably because of being us on what we were expecting. And for Cobenfy, quality is another potential aspect of -- that can lead to failure of studies and the preserving quality is capital to increase access. And this is one of the reasons for ADEPT 2 and ADEPT 4, of the delay, ADEPT 1 again is then driven and actually [indiscernible] is lower, can be a good sign.

Christopher Boerner

executive
#59

Steve, let me just weigh in on maybe that last comment. So Cristian's approaching his 1-year anniversary at the company. And I just want to say I'm incredibly pleased with the progress that he and the team have made. He has been consistently focusing on making sure we have the right scientific talents and expertise across therapeutic areas. He's brought an incredible focus on being great operationally. We've made good progress on ensuring we've got the right infrastructure and ways of working. And at the end of the day, we continue to make sure that we're investing in the right areas of science where the company can be successful and if you add all of that up, I feel very good that the R&D engine that he's helping to build is going to sustain the growth of this enterprise.

Unknown Executive

executive
#60

Great. And operator, if we could please take our last question.

Operator

operator
#61

The last question today will come from Akash Tewari with Jefferies.

Akash Tewari

analyst
#62

Just a clarification on milvexian. You previously mentioned both the leading events and [indiscernible] events need to mature for the trial to stop. Are both bleeding [indiscernible] tracking slower than expected? Or have we already reached the required number of events for bleeding events already?

Cristian Massacesi

executive
#63

Thank you, Akash. The -- I don't drive on the number of events. What I can tell you because this is -- we disclosed this, we need to recruit 430 events for primary endpoint, [indiscernible] and 503 event for bleedings. We want to achieve both numbers before locking the database and have [indiscernible] because the primary point is very important. And also then how we test the [indiscernible] bleeding is also very important. So we are on track for this and this will happen first quarter '27.

Christopher Boerner

executive
#64

Thanks, Cristian. So let me just say in closing that I just want to reiterate that the big focus of the team has been to drive what we call a say-to-do ratio. And I think what you're seeing in the performance for the quarter is that -- we're doing what we said we will do -- we would do. Today's results really underscore the impact of what we see as a multiyear strategy to reshape our business and drive sustainable growth. We're delivering very strong commercial execution across our growth portfolio. We're advancing a broad and differentiated pipeline while being very disciplined in maintaining the financial flexibility that we need to invest in future growth while also, of course, returning capital to shareholders. We continue to see the company through focused execution. We continue to strengthen rather the company through focused execution, and we're very confident in the long-term trajectory of the business. So finally, I'd like to just thank our colleagues around the world for their continued dedication to the mission that we have and to their focus on serving our patients. So thank you all for joining us today. And as always, we'll be available for any follow-up questions. Thanks.

Operator

operator
#65

The conference has now concluded. Thank you for attending today's presentation. You may now disconnect.

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