Focused Spend Is What Investors Have Wanted, With Catalyst Rich H2/2027

Research evidence excerpt

Focused Spend Is What Investors Have Wanted, With Catalyst Rich H2/2027

TD Cowen BioCryst Pharmaceuticals

Global Research June 29, 2026

For additional insight into Q1 patient numbers, we estimate that there are ~1,430 paid patients

on Orladeyo in the U.S., or roughly -2% Q/Q patient growth from ~1,460 in Q4. We estimate ~

$143MM in US Orladeyo sales, assuming $5MM of ROW sales contributing to Q1 ~$148MM total

sales. Patient numbers are roughly calculated using Q1 U.S. sales of $143MM, divided by the net

quarterly cost of ~$100K and assuming 81% of patients are receiving paid drug for a full quarter.

This implies that ~1,765 patients are on treatment (vs. estimated 1,802 in Q4). For Q2, to achieve

our U.S. Orladeyo sales expectations (~$155MM, +8% Q/Q), BioCryst would need to have ~1,550

patients on paid drug for the quarter.

Given the sales performance, we model $615MM in 2026 US Orladeyo sales, which implies

~1,538 patients treated for the full year (assuming net pricing of $400K). We believe this is

achievable/could be exceeded given BioCryst reported 1,600 patients on Orladeyo exiting 2025,

and guidance to add ~150+ annual net patients yearly. Correspondingly, we model $635MM

(+6% Y/Y, +13% excluding EU sales) in global Orladeyo sales, at the midpoint of the company's

2026 revenue guidance ($625-645MM, +13% Y/Y). Recall long term BioCryst has suggested

“the same pattern based on patient growth trends and insurance seasonality.” For Orladeyo's

quarterly cadence we expect Q2 sales to grow following the Q1 deductible resets/managed

care reauthorizations, followed by steady growth through H2 (pediatric expansion). We model

$155MM (roughly +8% Q/Q) in Q2.

As for the pediatric launch, management highlighted a manufacturing delay due to a problem

in batch specifications.