BridgeBio 药

BridgeBio reported $244 million in total revenue in the second quarter, up 120% year over year, of which Attruby contributed $222 million. BridgeBio recorded a net loss of $152 million in the second quarter. Shares were trading flat on Aug. 11.

Why it matters: Alongside Attruby's strong 23% sequential sales growth, BridgeBio now has three late-stage candidates in active regulatory review: BBP-418 (for limb-girdle muscular dystrophy), encaleret (for ADH1, a rare genetic disorder), and infigratinib (for achondroplasia). Management will need to run three concurrent launches across distinct physician specialties while continuing to grow Attruby's share in the competitive ATTR-CM market. We assign a 90% probability of approval to each candidate and expect launches in early to mid-2027. Attruby's growth is increasingly driven by newly diagnosed patients rather than patients switching therapies, suggesting durable share gains. This momentum is further supported by the expansion of the overall ATTR-CM market as diagnosis and treatment rates continue to rise.

The bottom line: We maintain our fair value estimate of $85 per share for no-moat BridgeBio, and shares are trading in 3-star, fairly valued territory. We continue to have a positive outlook and forecast a three-year compound annual revenue growth rate exceeding 66%. We raised our 2026 Attruby sales forecast to just over $1 billion due to strong patient uptake, though elevated expenses associated with the three upcoming launches are offsetting much of this benefit, with operating expenses up 43% year over year in the second quarter. BridgeBio shoulders nearly all commercial execution risk as both BBP-418 and encaleret are wholly owned and the firm controls infigratinib commercialization outside Japan. While this structure maximizes long-term economics if launches succeed, it also leaves BridgeBio fully exposed to any commercial setbacks. We maintain our Very High Uncertainty Rating.

We maintain our fair value estimate of $85 per share for no-moat BridgeBio. We assign a 90% probability of approval to infigratinib, and we have a positive outlook for this achondroplasia candidate based on positive phase 3 trial results. Bridgebio submitted regulatory filings in the US and anticipates a launch in mid-2027. Management plans to submit a Marketing Authorization Application for achondroplasia to the European Medicines Agency in the fourth quarter of 2026.

Our valuation largely rests on the commercial success of Attruby. We estimate this drug could generate global revenue of approximately $4.5 billion by 2035, with the US accounting for $3.6 billion in sales. Attruby is at the centerpiece of the firm’s growth strategy, so it is crucial for it to achieve strong patient uptake.

Other drugs in BridgeBio’s late-stage pipeline also have strong growth potential. We model that encaleret could achieve peak sales of nearly $600 million by 2035, assuming it captures around 20% of the patient market. For BBP-418 and low-dose infigratinib, which we anticipate could launch commercially in 2027, we estimate probability-weighted 2035 sales of nearly $300 million and $1.2 billion, respectively. Overall, on a probability-weighted basis, the company’s pipeline could contribute roughly $2.1 billion in revenue by 2035.

We anticipate that product costs will be roughly 10% of total revenue, resulting in a gross margin of about 90%. As the company’s pipeline advances into late-stage trials, we anticipate its R&D costs will continue to grow, and selling, general, and administrative expenses are expected to increase as drug candidates approach commercialization. As revenue grows over our 10-year forecast period, R&D expenses and SG&A expenses will scale as a percentage of sales. We assume a 9% cost of equity for BridgeBio, which is consistent with the other emerging biotech companies.

We don’t believe BridgeBio has an economic moat. The company’s key drug is Attruby (for the treatment of cardiomyopathy of wild-type or variant transthyretin-mediated amyloidosis, or ATTR-CM). The rest of its pipeline remains unapproved, and Attruby’s own commercial trajectory is still relatively early in a crowded ATTR-CM market. BridgeBio’s focus on high unmet medical needs and its recent strategic partnerships are positive indicators, but we need to see maintained cash flow and successful commercialization across multiple products before considering a narrow moat rating.

Through its 2021 merger with Eidos Therapeutics, BridgeBio gained full rights to acoramidis (Attruby), a potential best-in-class therapy for transthyretin amyloidosis, a rare heart disease caused by misfolded TTR protein accumulating in the heart muscle. Bayer holds European rights, and AstraZeneca holds Japanese rights, while BridgeBio retains the US opportunity. Attruby is central to our valuation, accounting for nearly 70% of our 2035 revenue forecast, so any long-term safety issues or superior competitor data would significantly impair the firm’s value. This concentration risk, and the threat of substantial value destruction it implies, drives our no moat rating.

BridgeBio's main competitor in ATTR amyloidosis is Pfizer's Vyndaqel/Vyndamax (tafamidis), the only other approved TTR stabilizer. Both tafamidis and acoramidis (Attruby) bind and stabilize the TTR protein, preventing it from forming amyloid deposits and slowing disease progression. Their safety profiles appear similar, but in the phase 3 ATTRibute-CM trial, acoramidis achieved higher serum TTR levels, a marker associated with lower mortality and hospitalization risk in ATTR-CM. This is a cross-trial comparison, since the two drugs have not been tested head-to-head.

A newer class, TTR silencers, reduces TTR production rather than stabilizing the protein. Alnylam's Amvuttra (vutrisiran) is the key approved entrant. However, because acoramidis reached the market first as a lower-cost stabilizer with strong efficacy, we think silencers will struggle to displace stabilizers as the standard of care. Combining a stabilizer with a silencer will likely remain cost-prohibitive at least until Vyndaqel's patent expires in 2031.

Given these dynamics and a growing pool of diagnosed patients, driven by greater disease awareness and noninvasive diagnostics, we believe Attruby could capture significant share among newly diagnosed and inadequately managed patients.

A key risk to Attruby’s market share gains is generic entry once Pfizer’s Vyndaqel/Vyndamax patents expire, in 2026 in Europe and 2031 in the United States. BridgeBio appears to be positioning itself to build patient loyalty ahead of and during the interim period before generics become available.

BridgeBio is also advancing other late-stage pipeline candidates. Encaleret, an investigational oral therapy for ADH1, would compete with Ascendis’ injectable Yorvipath, with oral administration as its main advantage. BridgeBio’s low-dose infigratinib targets FGFR-driven conditions including achondroplasia and hypochondroplasia. In February 2026, BridgeBio reported positive phase 3 top-line results, and if approved, it would compete with BioMarin’s Voxzogo, the first approved achondroplasia drug, with oral dosing as its key differentiator against Voxzogo’s daily injections. BridgeBio’s BBP-418 could become the first oral therapy for LGMD2I/R9, a rare muscle-degeneration disorder, and faces minimal competition given how early-stage alternative treatments remain.

A critical factor in BridgeBio’s valuation is its ability to advance pipeline drugs to market. Nulibry, approved in 2021 for the rare disorder molybdenum cofactor deficiency type A, had its global rights sold to Sentynl in 2022 for a modest $10 million upfront; BridgeBio now earns only tiered royalties and milestones on it, illustrating how commercial execution of pipeline candidates remains essential to the firm’s growth and market position.

We are also concerned about BridgeBio’s heavy dependence on strategic collaborations for the marketing and commercialization of its product candidates, as demonstrated by the issues with Truseltiq. Despite receiving FDA approval in 2021 for bile duct cancer, Truseltiq was discontinued after pharmaceutical company Helsinn terminated its commercialization agreement. The FDA approval was also withdrawn because BridgeBio was unable to fund and complete the required postmarketing studies to verify the clinical benefits of the drug. Similarly, the success of Attruby is closely tied to BridgeBio's collaboration with Bayer, a German pharmaceutical company. According to their recent agreement, Bayer has been granted an exclusive license to commercialize Attruby as a treatment for ATTR-CM in Europe. While this partnership offers BridgeBio a lucrative deal, including up to $310 million in upfront and near-term milestone payments and royalty percentages starting in the low 30s, the ultimate success of Attruby in Europe will be contingent upon Bayer’s ability to effectively market and sell the drug.

Overall, we think the company has several promising candidates that could one day support a moat, but the uncertainty around their development is too high to warrant a narrow moat at this time. We currently give the company's late-stage clinical drug candidates probabilities of approval of 90%, with these therapies estimated to reach the market in 2027.

The successful commercialization of Attruby could establish BridgeBio as a key player in the ATTR-CM market, significantly improving its path to profitability.

BridgeBio’s pipeline targets high unmet patient needs, positioning the company’s products for strong market adoption upon receiving regulatory approval.

Partnerships with pharmaceutical companies provide milestone payments and economic benefits, offsetting clinical development costs and supporting BridgeBio’s financial stability and market entry.

BridgeBio has historically faced challenges in developing pipeline candidates and bringing them to market.

BridgeBio's valuation relies on the commercialization of Attruby, but the drug's full potential may be undermined by tafamidis’ patent extension, introduction of generic alternatives, and other branded competition.

While BridgeBio targets several rare genetic disorders—including amyloidosis, achondroplasia, and ADH1—it faces competition from other companies advancing next-generation therapies in these disease areas.