Pharma Earnings Roundup: Alnylam, Neurocrine, AbbVie, Merck, Roche Miss Expectations

Several drugmakers saw their shares fall after reporting quarterly earnings that missed Wall Street expectations. Alnylam Pharmaceuticals' stock tumbled nearly 30% in late July after it reported $1.01 billion in second-quarter sales for Amvuttra, below consensus estimates, and trimmed its 2026 revenue guidance. Neurocrine Biosciences shares also fell more than 10% after its fourth-quarter report, while AbbVie, Merck, and Roche all posted sales shortfalls for key products.

Amvuttra lowers production of transthyretin, a protein that can misfold and form amyloid deposits. Alnylam cut 2026 revenue guidance for Amvuttra and Onpattro by $200 million, to a $4.2 billion to $4.5 billion range, citing normalizing second-line demand after Amvuttra's 2025 expansion into ATTR cardiomyopathy. The FDA first approved Amvuttra in 2022 for hereditary transthyretin-mediated amyloidosis polyneuropathy, then expanded its use to cardiomyopathy in March 2025. Amvuttra competes in ATTR-CM with Pfizer's Vyndamax and BridgeBio's Attruby; a potential rival, AstraZeneca-Ionis's Wainua, failed a phase 3 trial in July and showed no treatment effect among patients already taking a stabilizer.

In its official fourth-quarter report, Alnylam recorded nearly $3 billion in 2025 product revenue and almost $1 billion in the final three months, up 81% and 121% year over year. Despite the growth, shares slipped around 4%. Amvuttra accounted for nearly 80% of product revenue. For 2026, the company expects net product revenue of $4.9 billion to $5.3 billion, with Amvuttra and Onpattro contributing up to $4.7 billion. Alnylam attributed a roughly 250% jump in fourth-quarter patient demand for Amvuttra to its approval last spring for ATTR cardiovascular problems. The company estimates about 80% of patients with this condition remain undiagnosed, and the number of identified patients has grown 40% annually since 2019.

Beyond Alnylam, AbbVie's Imbruvica generated $532 million in second-quarter global net revenue, narrowly missing the consensus estimate of roughly $533 million, a 29.4% year-over-year decline. The drug faced pressure from Medicare's newly effective negotiated price, set 38% below its 2023 list price, and competition from newer BTK inhibitors such as AstraZeneca's Calquence, BeOne Medicines' Brukinsa, and Eli Lilly's Jaypirca. AbbVie does not expect U.S. generic entry before March 2032.

Merck's chickenpox vaccine Varivax, MMR-II, and combination vaccine ProQuad generated $592 million in Q2, about 2.6% below the $608 million analysts expected and 2.8% below the year-earlier period. Merck attributed the decline primarily to lower U.S. demand, partly offset by higher U.S. net pricing, increased European demand, and favorable private-sector purchasing patterns for MMR-II.

Roche's Vabysmo brought in about $1.27 billion in Q2, 7.1% below consensus and down 1% year over year. The company attributed the shortfall partly to slower retinal-market growth, settling into a 2% to 3% "new normal," and to closures of copay-assistance foundations that contributed to a contraction in the U.S. branded retinal-drug market.

Neurocrine Biosciences' shares fell more than 10%, wiping out more than $1 billion in value, after its fourth-quarter report showed net product sales of $798 million in Q4 and $2.83 billion for 2025, up 29% and 22% year over year, respectively. Ingrezza, a treatment for movement issues associated with Huntington's disease, accounted for more than 80% of sales, with the remainder mostly from Crenessity. Neurocrine expects 2026 Ingrezza net sales of $2.7 billion to $2.8 billion and plans to spend $150 million building sales teams for the two products. Approximately 20,000 people in the U.S. have congenital adrenal hyperplasia; about 2,050 began taking Crenessity in 2025, with the final quarter averaging 431 new starts.

Ascendis Pharma reported fourth-quarter product revenue of 240 million euros (about $279 million) and full-year product revenue of 684 million euros, with 70% coming from Yorvipath.