BridgeBio Pharma, Inc. Q1 FY2025 earnings call

• Attruby Launch: Strong early uptake with 2,072 unique patients receiving prescriptions and 756 unique healthcare providers writing prescriptions by April 25. Driven by strong clinical endpoints (early separation from placebo, 42% relative risk reduction in cardiovascular hospitalization and mortality at 30 months, 50% reduction in cardiovascular hospitalization) and transparent patient-first support programs.
• Pipeline Progress: Three Phase 3 readouts expected in the next year, including trials in limb-girdle muscular dystrophy 2I, achondroplasia, and ADH1. Encouraging progress in hypochondroplasia trial enrollment and encaleret's potential in hypoparathyroidism. Continued development of other programs like BBP-418 and BBP-812.
• Business Measurement Framework: Focus on NPV, considering time value of money, revenue uptake, study successes, and cost of capital. Constraints include beautiful science, best-in-class status, and NPV positivity.

Attruby generated $36.7 million in net product revenue in Q1 2025. License and services revenue was $79.9 million, driven by recognition of a $75 million regulatory amount related to Beyonttra’s EU approval and anticipation of a $30 million milestone in Q2 for Beyonttra's Japan approval. Attruby's revenue contribution was significant, while license and services revenue stemmed from regulatory milestones.

• Attruby: Expect continued growth and aim for 30%-40% market share in ATTR-CM.
• Pipeline: Anticipate top-line data from Phase 3 programs (ADH1 and LGMD2I in H2 2025, achondroplasia in early 2026).
• Beyonttra: Expect $30 million milestone in Q2 from Japan approval.

Minimal impact from tariffs, close to negligible effect on NPV. Potential challenges from new entrants in the ATTR-CM market, though Attruby's clinical data and pricing are competitive.

Q: Granularity on tailwinds driving Attruby's success?

A: Neil Kumar mentioned differentiated clinical efficacy, market growth, and access programs as key tailwinds.

Q: Quantify paid conversion rate and inventory?

A: Matt Outten stated conversion is ahead of historical launches, with a limited distribution network for just-in-time inventory.

Q: Filability of biomarker for limb-girdle?

A: Neil Kumar believes FDA inclination is positive toward using glycosylation of aDG as an approvable endpoint.

Q: Resonance with HCP and gross to net?

A: Matt Outten discussed positive feedback on clinical data and outcomes, Tom Trimarchi noted gross to net trended slightly favorable with Part D redesign impact minimal.

Q: New patient starts for ATTR-CM?

A: Neil Kumar mentioned continued growth due to market education and increasing diagnosis from high-volume clinics.

Q: IP and royalty implications?

A: Tom Trimarchi noted minor tariff impact as Attruby is made in the US with IP domiciled here.

Q: Hypoparathyroidism opportunity?

A: Ananth Sridhar discussed positive POC data for encaleret in hypoparathyroidism, noting a larger market than ADH1.

Q: Commercial trends since AMVUTTRA approval?

A: Matt Outten noted AMVUTTRA has limited uptake outside mixed phenotype due to pricing and lack of significant variant data.

Q: Switch patient impact on Attruby?

A: Chinmay Shukla and Matt Outten stated focus on treatment-naive patients with switch share evolving as competition increases.