Vertex Pharmaceuticals NASDAQ: VRTX reported first-quarter 2026 total revenue of $2.99 billion, up 8% year over year, as growth in its cystic fibrosis (CF) franchise and contributions from newer launches helped drive results. CEO and President Dr. Reshma Kewalramani said the company is “off to a terrific start in 2026,” describing the year as “defined by execution,” with newer products contributing roughly a quarter of product revenue growth.
Quarter highlights: CF growth and traction in new launches
Kewalramani said total product revenue in the quarter was $2.99 billion, reflecting 8% year-over-year growth. She highlighted commercial milestones across newer products through the end of the quarter, including ALYFTREK surpassing $1 billion in cumulative revenue, more than 500 people initiating the CASGEVY treatment journey, and more than 1 million prescriptions written for JOURNAVX.
Chief Commercial Officer Duncan McKechnie said CF revenue increased 6% globally, with U.S. CF growth of 5% and international growth of 8% in the quarter. He attributed ALYFTREK’s continued uptake to its once-daily dosing and improved sweat chloride profile, and said Vertex signed reimbursement agreements in 11 countries for ALYFTREK during the quarter.
McKechnie also said recent U.S. label expansions for ALYFTREK and TRIKAFTA represent an incremental commercial opportunity of approximately 800 newly eligible people with CF in the U.S.
Pipeline and regulatory progress: Povi momentum and CF updates
On research and development, Kewalramani pointed to multiple regulatory submissions and clinical progress, with a focus on the company’s emerging renal franchise and continued work in CF.
Kewalramani highlighted interim phase III RAINIER study results for povotacicept (Povi) in IgA nephropathy (IgAN), calling the data “sparkling from top to bottom.” She said Vertex submitted a biologics license application (BLA) for Povi in IgAN 27 days after database lock, which she described as the fastest submission in company history.
According to Kewalramani, Povi achieved statistically significant and clinically meaningful results across primary and secondary endpoints at the interim analysis, including:
- Proteinuria: 52% reduction from baseline by 24-hour UPCR (49.8% reduction versus placebo)
- Serum Gd-IgA1: 77.4% reduction from baseline (79.3% reduction versus placebo)
- Hematuria resolution: 85.1% of Povi-treated patients with hematuria at baseline achieved resolution (61.7% reduction versus placebo)
- Exploratory endpoint: 42.2% of patients reached 24-hour UPCR < 0.5 g/g after 36 weeks of treatment
She said Povi was generally safe and well-tolerated, with most adverse events mild to moderate, no serious adverse events related to Povi, no opportunistic infections, and serious infections occurring at a 0.5% rate in both placebo and Povi groups. Anti-drug antibodies were observed but had “no impact on Povi’s efficacy or risk profile,” she said.
Vertex also provided updates for Povi in additional indications. Kewalramani said enrollment is complete in the phase II portion of the OLYMPUS phase II/III study in primary membranous nephropathy (PMN), and the company has initiated the phase III portion ahead of its previously stated mid-2026 goal. She also said a 30-patient phase II proof-of-concept study of Povi in generalized myasthenia gravis is underway.
In CF, Kewalramani said the company reached a “significant milestone” with U.S. label expansions for ALYFTREK and TRIKAFTA that broaden coverage to patients with a clinical diagnosis of CF and at least one CFTR variant responsive based on clinical and/or in vitro data, which she said expands eligibility to about 95% of people with CF, including those with rare genotypes. She said Vertex plans to submit for ALYFTREK in children ages 2 to 5 and for TRIKAFTA in children ages 1 to 2 “in the near term.”
Vertex’s next-generation 3.0 CFTR modulator VX-828 is currently in a study of patients with CF, with results expected in the second half of 2026. Kewalramani said VX-581 and VX-272 are in phase I healthy volunteer studies.
However, Vertex discontinued VX-522, an mRNA therapy for patients who cannot benefit from CFTR modulators, due to tolerability issues the company was unable to overcome. In response to a question, Kewalramani said the issue related to “lung inflammation,” likely an inflammatory response to the lipid nanoparticle delivery system. She said the company will return “back to the drawing board” on modalities and that delivery remains the key challenge for the remaining patients who require nucleic acid therapy.
Commercial update: CASGEVY and JOURNAVX build
McKechnie said CASGEVY’s rollout is gaining momentum across three regions, with over 500 patients initiating the treatment journey. Vertex reported $43 million in CASGEVY revenue in the first quarter. McKechnie said the company secured a pricing agreement in Germany during the quarter and is working through implementation steps, which he described as a “historic moment.” He noted quarterly variability due to patient timing for infusion, but said the company has “very strong visibility” for the rest of 2026 and expects CASGEVY to contribute meaningfully toward a goal of more than $500 million in non-CF revenue this year.
For JOURNAVX in moderate-to-severe acute pain, McKechnie said more than 350,000 prescriptions were filled in the quarter, compared to approximately 550,000 in all of 2025. JOURNAVX generated $29 million in revenue in Q1, which he said was in line with expectations, though the quarter reflected “some normal inventory destocking.” He said prescriptions remained roughly split 50/50 between hospital and retail channels.
McKechnie said payer coverage reached 240 million lives and Vertex secured coverage with at least one major Medicare Part D plan effective May 1. Later in the Q&A, he added that Vertex had secured coverage at two of the four large Medicare Part D plans and was close to securing a third, with coverage starting between May 1 and July 1. He also said Vertex doubled its field force to 300 representatives ahead of plan and launched its first direct-to-patient telehealth platform, Informed Pain Care, accessible via genavix.com.
Financial results and outlook
Chief Operating Officer and Chief Financial Officer Charlie Wagner said total revenue rose 8% year over year to $2.99 billion, with CF global revenue up 6% and contributions from CASGEVY ($43 million) and JOURNAVX ($29 million). U.S. revenue grew 7%, while international revenue grew 9%, which Wagner said included a benefit from year-over-year foreign exchange changes.
Vertex reported combined non-GAAP R&D, acquired IP R&D, and SG&A expenses of $1.29 billion, up 5% from the prior year. Wagner said non-GAAP R&D expenses declined 2% year over year due in part to clinical trial timing and mix, while non-GAAP SG&A increased 30% primarily due to commercial investments, with roughly 40% of the increase attributable to JOURNAVX and about one-third to renal launch programs.
Non-GAAP operating income was $1.31 billion versus $1.18 billion a year ago, and non-GAAP EPS was $4.47 compared with $4.06 in the prior-year quarter. Vertex ended the quarter with $13 billion in cash and investments after repurchasing $344 million of shares, or more than 741,000 shares, during the quarter, Wagner said.
Wagner reiterated full-year 2026 guidance, including total revenue of $12.95 billion to $13.1 billion (8% to 9% growth), gross margin “just under 86%,” combined non-GAAP operating expenses of $5.65 billion to $5.75 billion, and a non-GAAP effective tax rate of 19.5% to 20.5%. He said the company does not expect tariffs to have a material impact to the 2026 income statement.
About Vertex Pharmaceuticals NASDAQ: VRTX
Vertex Pharmaceuticals Inc is a Boston-based biotechnology company focused on the discovery, development and commercialization of therapies for serious diseases. Founded in 1989, Vertex built its reputation on research-driven drug development and is best known for its work in cystic fibrosis (CF), where its portfolio of small-molecule CFTR modulators transformed standards of care for many people with the disease. The company operates research and development, manufacturing and commercial organizations and serves patients and healthcare systems in multiple international markets.
Vertex's marketed products center on CFTR modulators that target the underlying cause of cystic fibrosis rather than just treating symptoms.
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