Bristol-Myers Squibb Co Earnings - Q1 2026 Analysis & Highlights
Bristol-Myers Squibb reported solid Q1 2026 results with strong Growth Portfolio momentum, advancing a diversified pipeline with multiple late-stage readouts expected in late 2026, while maintaining disciplined capital allocation and cost management to support long-term sustainable growth.
Key Financial Results
Total revenue increased 1% year-over-year to approximately $11.5 billion in Q1 2026.
Growth Portfolio revenue increased 9% year-over-year to $6.2 billion, driven by contributions from Reblozyl, Breyanzi, Camzyos, Opdualag, Qvantig, and Cobenfy.
Gross margin declined 280 basis points to 70.3%, primarily driven by product mix.
Operating expenses were $3.9 billion, slightly above the same period last year, with incremental investments in pumitamig, Qvantig, and Cobenfy largely offset by savings from the strategic productivity initiative.
Diluted earnings per share was $1.58 for the quarter, which includes a net charge of $0.03 per share related to in-process R&D and licensing income.
Operating cash flow was approximately $1.1 billion in the first quarter.
Cash equivalents and marketable securities totaled approximately $11 billion as of March 31.
Effective tax rate was 18.3%, reflecting jurisdictional earnings mix.
Business Segment Results
Opdivo revenue decreased 8% to approximately $2.1 billion, with most of the decline coming from the US, primarily driven by an inventory drawdown at the wholesaler level where inventories are at the low end of the typical range.
Qvantig revenues were $163 million, reflecting continued strong launch performance with over 10% conversion from IV to Qvantig in the US in just over a year on the market.
Opdualag delivered strong double-digit growth, driven by demand globally where it remains a standard of care in first-line melanoma.
Reblozyl delivered 15% growth, with performance reflecting solid uptake across first- and second-line MDS-associated anemia.
Breyanzi's first quarter growth was 53%, reflecting its best-in-class profile and continued strong demand across its approved indications in both the US and international markets.
Eliquis revenue was approximately $4.1 billion, an increase of 13%, with continued strong demand and some wholesaler inventory build in the first quarter due to a US price reduction that took effect at the beginning of the year.
Camzyos revenue nearly doubled to $314 million, benefiting from continued demand growth globally.
Sotyktu global revenue grew 20%, with the recent approval in psoriatic arthritis representing a continued presence in rheumatology.
Cobenfy revenue was $56 million in the first quarter, representing continued steady growth.
Capital Allocation
Business development remains a priority, with the company regularly evaluating opportunities in therapeutic areas where it knows best, while continuing to return cash to shareholders through its commitment to the dividend.
The company is size-agnostic on business development deals and has the financial horsepower to pursue multiple size deals.
The company remains on track to deliver the remainder of $2 billion in cost savings from its strategic productivity initiative by the end of 2027.
Cash flow reflects roughly $1.2 billion in lower net cash collections due to Eliquis list price reductions, which is expected to be more than offset later in the year through lower rebate payments.
Industry Trends and Dynamics
The multiple myeloma market is highly competitive and fragmented, but there remains a need for more effective and safe options that can address the majority of patients, particularly those treated in the community setting representing 70% to 80% of patients.
Approximately 40% of patients who should be anticoagulated are either untreated, underdosed, or discontinue treatment, driven largely by concerns around bleeding risk.
Approximately 7 million patients are diagnosed with Alzheimer's disease, with roughly 30% to 50% having psychosis and the vast majority having cognitive impairment.
Approximately 50% to 60% of patients on current standard of care for IPF are discontinuing therapy by 12 months, with diarrhea rates roughly 40% even with the newest approved products.
Fear of bleeding continues to be the main reason why physicians hold back from utilizing Factor Xa inhibitors in more patients.
Competitive Landscape
Camzyos continues to have very good momentum with continued strong new patient starts, high persistency rates, and very low drop-off rates, with approximately 25,000 patients now prescribed Camzyos in the US.
Physicians consistently cite significant and rapid improvement in symptoms with Camzyos, and the company's REMS process is viewed as very clear with established infrastructure and workflow.
The Camzyos dosing and echo regimen at four weeks is preferred, with roughly 90% of patients on the 5-milligram starting dose requiring only one dose titration to 10 milligrams.
Competition for Camzyos has started with some physicians trying one or two patients on competing products, but the competitor is still operationalizing their REMS programs.
Camzyos patients feel better in a matter of weeks, whereas competition requires multiple titration steps to reach an effective dose.
BMS will be the only Factor XI company with a Factor XI inhibitor in atrial fibrillation, with presence also in secondary stroke prevention.
Macroeconomic Environment
The document does not contain specific discussion of macroeconomic factors such as inflation, tariffs, trade, recession, or business cycle conditions.
Growth Opportunities and Strategies
The company's strategy remains grounded in three priorities: focusing R&D on life-threatening diseases; driving strong execution across the organization to build momentum in the Growth Portfolio; and maintaining disciplined, shareholder-friendly capital allocation.
The company aims to deliver more than 10 new medicines and 30 meaningful lifecycle management opportunities by the end of the decade.
The company is improving execution across drug development by upgrading talent, streamlining decision-making, and instituting tighter management of core clinical activities.
The company has set a target to reach lead molecule identification approximately 50% faster, while applying greater rigor so that only the most differentiated molecules advance.
The company expects a 30% reduction in cycle times in late development versus just a few years ago through the use of AI to streamline clinical operations, compress development timelines, and enhance quality oversight.
The company has ongoing partnerships with Faro and Evinova's Cost Optimizer tool to design trials more efficiently.
As the post-LOE growth profile becomes clearer, the company will place greater emphasis on expanding the early- and mid-stage portfolio to support growth into the 2030s.
The company is pursuing a multimodal approach in cell therapy for autoimmune disease with an autologous, allogeneic, and in vivo platform.
Zola-cel, the company's autologous CAR T, has two ongoing pivotal studies in lupus and scleroderma with multiple other indications ongoing.
The company acquired Orbital, an mRNA in vivo platform, where patients produce and manufacture the cells themselves.
Pumitamig strategy is to replace and expand, with the goal to replace PD-1/PD-L1 inhibitors and expand beyond them.
The company announced and delivered seven pivotal studies across indications for pumitamig, all of which are ongoing and recruiting actively.
The company is combining pumitamig with iza-bren ADC, PRMT5 inhibitor navlimetostat, and other drugs to create novel regimens.
The company's goal is to make both iberdomide and mezi foundational in multiple myeloma, replacing Revlimid and Pomalyst in second-line over time in the community.
Cobenfy is being evaluated in multiple indications including Alzheimer's psychosis, bipolar disorder mania, Alzheimer's agitation, and Alzheimer's cognition, with the company having four shots on goal in the Alzheimer's psychosis program.
The company is planning a new, more focused study in non-obstructive HCM based on learnings from the ODYSSEY trial.
Pipeline and Clinical Development
Iberdomide filing for relapsed or refractory multiple myeloma was accepted by the FDA with Breakthrough Therapy Designation and Priority Review, with a PDUFA date of August 17.
Mezigdomide reported positive Phase 3 interim data from the SUCCESSOR-2 study, demonstrating meaningful improvement in progression-free survival in patients with relapsed or refractory multiple myeloma.
Iza-bren shared positive Phase 3 interim top line results in patients with previously treated triple-negative breast cancer based on a study conducted in China.
Sotyktu received approvals in psoriatic arthritis and Opdivo for two new classical Hodgkin lymphoma indications.
Positive Phase 4 switch data was reported for Cobenfy, positive Phase 3 data for Camzyos in adolescents with obstructive HCM, and positive Phase 2 data for Reblozyl in alpha-thalassemia.
Phase 3 readouts expected late in 2026 include milvexian in atrial fibrillation and secondary stroke prevention, Cobenfy in Alzheimer's psychosis, admilparant in IPF, and iberdomide PFS data.
Milvexian AFib and secondary stroke prevention trials are event-driven and recruiting events as planned, with the Data Monitoring Committee regularly reviewing the data and recommending continuation of the studies as planned.
The milvexian AFib study is designed to show non-inferiority versus apixaban with non-inferiority margins ranging from 0.83-0.84 to 1.3, and will then test superiority for bleedings.
The company recruited 20,500 patients for the milvexian AFib study.
Cobenfy ADEPT studies are expected to readout by the end of the year, with ADEPT-1, ADEPT-2, and ADEPT-4 lining up with similar timelines.
The company needs two studies probably for an approval as the base case for a filing in Alzheimer's psychosis.
Admilparant Phase 2 results showed more than 60% improvement versus placebo in lung function decline with a 60 milligram BID dose.
Admilparant is being run in both IPF and PPF studies with two doses at 60 milligram and 120 milligram, with clear dose relationship and benefit of higher dose showing deeper efficacy.
Arlo-cel, the company's GPRC5D CAR T, is expected to have a readout later this year.
Financial Guidance and Outlook
The company is reaffirming its financial guidance for the full year of 2026.
Based upon the first quarter results and current projections, the company sees its financial performance tracking towards the upper end of its established revenue and EPS guidance ranges.
The company sees the business currently tracking towards the upper end of its guidance ranges.
The company will continue to provide updates as the year progresses.
