Bristol-Myers Squibb (BMY) reported fourth quarter 2025 total revenue of approximately $12.5 billion, flat year-over-year, as a 15% increase in the Growth Portfolio to $7.4 billion offset declines in the Legacy portfolio. For the full year, the Growth Portfolio grew 17%, nearly offsetting a roughly $4 billion decline in Legacy products, driven by strong performances from Reblozyl (up 21% in Q4), Breyanzi (up 47%), and Camzyos (up 57%). The company achieved $1 billion in cost savings in 2025 and ended the year with $11 billion in cash. Looking ahead, BMY provided 2026 revenue guidance of $46.0 to $47.5 billion with non-GAAP EPS of $6.05 to $6.35, projecting Eliquis growth of 10-15% despite a 40% WAC price reduction. Management highlighted a 'data-rich' 2026 with six anticipated product readouts, reinforcing their strategy to rewire the company for long-term growth through new product launches and disciplined capital allocation.
| Metric | Value | Change |
|---|---|---|
| Q4 Total Revenue | $12.5 billion | Flat year-over-year |
| Q4 Growth Portfolio Revenue | $7.4 billion | +15% year-over-year |
| Full Year Growth Portfolio Growth | N/A | +17% year-over-year |
| Q4 Eliquis Revenue | $3.5 billion | +6% year-over-year |
| Q4 Breyanzi Revenue Growth | N/A | +47% year-over-year |
| Q4 Camzyos Revenue | $353 million | +57% year-over-year |
| Q4 Reblozyl Growth | N/A | +21% year-over-year |
| Q4 CoBinfy Revenue | $51 million | Steady uptake |
| Full Year 2025 EPS | $6.15 | N/A |
| 2026 Revenue Guidance | $46.0 - $47.5 billion | N/A |
| 2026 EPS Guidance | $6.05 - $6.35 | N/A |
| Cost Savings Achieved (2025) | $1.0 billion | Target achieved |
Management emphasized the successful 'rewiring' of the company, evidenced by the Growth Portfolio growing 17% year-over-year and nearly offsetting the $4 billion decline in the Legacy portfolio. This shift is critical as it demonstrates the company's ability to replace lost revenue from Revlimid and Pomalyst with new assets like Reblozyl, Breyanzi, and Camzyos. The strategic focus is now on sustaining this momentum, with the Growth Portfolio representing nearly 60% of total revenue in Q4.
A major strategic highlight is the 'data-rich' pipeline scheduled for 2026, with top-line registrational data expected for six potential new products, including Nilvexian, Admilarent, and Iberdomide. Management views this as a pivotal year to define the long-term growth profile, with over 10 Phase 3 readouts anticipated. This signals a transition from a company dependent on legacy assets to one driven by innovation and new molecular entities.
BMY is adapting its pricing strategy in response to the Inflation Reduction Act (IRA) by implementing a 40% WAC reduction for Eliquis. This strategic move eliminates CPI penalties and expands patient access, which management believes will drive 10-15% growth in 2026 despite the price cut. This highlights a pragmatic approach to maximizing revenue lifecycle under new regulatory constraints while maintaining market share dominance.
The company is actively reallocating capital, having achieved $1 billion in cost savings in 2025 and targeting another $1 billion by 2027. These savings are being reinvested into high-growth areas, specifically business development (e.g., Orbital Therapeutics, Karuna) and commercialization efforts for new launches. This disciplined capital deployment supports the 'multiyear plan to rewire Bristol-Myers Squibb Company for long-term growth.'
The most significant red flag is the explicit guidance regarding Eliquis in 2027, where management expects a 'step down in the range of $1.5 to $2 billion' due to EU patent expiry. While 2026 looks strong with 10-15% growth, the looming 2027 cliff represents a massive revenue headwind that the pipeline must successfully address to maintain the company's growth trajectory.
Gross margin declined 210 basis points in the fourth quarter to 71.9% and is guided to be between 69-70% for 2026. This pressure is driven by product mix, specifically the growth of lower-margin Eliquis and the decline of high-margin Revlimid. Persistent margin compression could limit operating leverage even as revenue grows.
While the Growth Portfolio is expanding, the Legacy Portfolio is declining rapidly, with a projected 12-16% decrease in 2026. The fact that the $4 billion decline in Legacy was 'nearly offset' by Growth Portfolio gains suggests a tight race where any slowdown in new product uptake could result in overall revenue stagnation or decline.
Adoption of CoBinfy, while steady, remains modest at $51 million in Q4 revenue. Analysts probed the lack of an inflection point, and while management cites positive feedback and access expansion, the commercial performance of this key neuroscience asset requires monitoring to ensure it reaches its 'blockbuster' potential.
Overall: Management exhibited a high level of confidence and discipline throughout the call, emphasizing 'focused execution' and a strong 'say-to-do ratio.' Christopher Boerner and David Elkins were direct and transparent regarding the 2027 Eliquis patent cliff while remaining bullish on the near-term growth trajectory and pipeline potential. The tone shifted from defensive in previous years about patent cliffs to proactive, highlighting the successful pivot to the growth portfolio.
Confidence: HIGH - Management provided specific guidance ranges for 2026, detailed cost savings achievements, and spoke with certainty about upcoming data readouts. Phrases like 'we remain very much on target' and 'I am very, very confident' regarding clinical trials underscored their assurance.
Management guided to revenue in the range of $46.0 to $47.5 billion. This reflects continued strong performance from the growth portfolio and a projected revenue decline for the legacy portfolio of 12-16% due to loss of exclusivity (LOE) impacts.
The company expects adjusted diluted earnings per share to be between $6.05 and $6.35. This assumes an effective tax rate of approximately 18% and total operating expenses declining to approximately $16.3 billion.
Eliquis is projected to grow in the range of 10% to 15% in 2026. This is driven by global demand growth and a recent 40% WAC price reduction intended to expand access and eliminate inflation penalties.
Looking ahead to 2027, management expects a 'step down in the range of $1.5 to $2 billion' in Eliquis sales compared to 2026. This is primarily attributed to EU patent expiry and subsequent generic entry.
Hedging & Uncertainty: Management generally used confident language ('we expect,' 'we anticipate') but employed hedging when discussing specific clinical trial outcomes and the 2027 Eliquis cliff. For example, regarding the Milvexian trial, Cristian Massacesi stated, 'We remain blinded to the study... but what the DMC is telling us... give us confidence,' indicating reliance on interim data rather than final results. Regarding 2027 guidance, David Elkins used broad assumptions: 'We've made broad-based assumptions about generic entry,' acknowledging the uncertainty of litigation outcomes. This hedging reveals management's awareness of binary clinical events and legal risks while maintaining a confident public stance.
Data-rich period - Christopher Boerner, CEO
Rewire Bristol-Myers Squibb Company for long-term growth - Christopher Boerner, CEO
Say-to-do ratio - Christopher Boerner, CEO
Step down - David Elkins, CFO
Position of strength - David Elkins, CFO
Standard of care - Adam Lenkowsky, CCO
On target - Cristian Massacesi, CMO
Breadth and depth - Christopher Boerner, CEO
Analyst Sentiment: Analysts were generally inquisitive and focused on the sustainability of growth, specifically drilling down into the 2027 Eliquis cliff and the commercial uptake of CoBinfy. There was skepticism regarding the sudden drop in Eliquis from 2026 to 2027, with analysts like Stephen Scala pressing for clarity on the pricing mechanics. Questions from Seamus Fernandez and Terence Flynn highlighted enthusiasm for the pipeline but sought to prioritize the most impactful assets.
Management Responses: Management responses were detailed and transparent, particularly from David Elkins regarding the financial mechanics of the Eliquis cliff and Christopher Boerner regarding business development priorities. They did not deflect questions about the 2027 headwinds but rather framed them as known quantities being managed. Clinical leaders (Massacesi) provided robust technical defenses for pipeline assets like Milvexian and Admilarent.
The 2027 Eliquis Cliff was a dominant topic, with analysts seeking to understand why the drug grows double-digits in 2026 only to drop $1.5-$2B in 2027. Management clarified this is due to EU patent expiry and the specific timing of the 40% WAC price cut benefits in 2026.
Pipeline Prioritization and Catalysts: Analysts asked management to rank the upcoming data readouts (CELMoDs, Milvexian, Admilarent). Management emphasized the breadth of opportunities but highlighted the 'best-in-class' potential of Milvexian and the transformative nature of the IPF data.
CoBinfy Commercial Trajectory: Analysts questioned the lack of an inflection point in CoBinfy sales. Management defended the launch, citing record prescription volumes compared to analogs and high access rates, while noting that new indications are needed for significant acceleration.
Business Development Strategy: Questions focused on whether BMY would enter the metabolic/obesity space. Management clarified they are prioritizing 'breadth and depth' in existing therapeutic areas (Neuro, CV, Oncology) rather than chasing hot new sectors outside their expertise.
Bristol-Myers Squibb is successfully executing a complex turnaround strategy, transitioning from a company reliant on legacy hematological drugs to a diversified growth engine. The Q4 results prove that the new Growth Portfolio (Reblozyl, Breyanzi, Camzyos) is generating enough momentum (17% full-year growth) to substantially offset the steep declines in Revlimid and Pomalyst. The 2026 guidance for revenue ($46-47.5B) and EPS ($6.05-6.35) suggests stability and modest growth, driven by the Eliquis pricing strategy which cleverly navigates IRA headwinds to drive volume. The investment thesis rests heavily on the upcoming 'data-rich' year; successful readouts for Milvexian (AFib/Stroke), Admilarent (IPF), and the CELMoDs (Iberdomide) are critical to bridging the 2027 Eliquis patent cliff. While the 2027 projected $1.5-2B drop in Eliquis is a valid concern, management's transparency and the strong balance sheet ($11B cash, debt paid down) provide confidence in their ability to navigate this hurdle. The shift in business mix toward higher-growth oncology and immunology assets, combined with disciplined cost control ($2B productivity initiative), positions BMY for sustainable growth into the next decade. The risk/reward is attractive at current levels, assuming the pipeline delivers on its promise in 2026.
The transcript reveals a significant adaptation by Big Pharma to the Inflation Reduction Act (IRA). BMY's decision to cut Eliquis WAC by 40% to eliminate CPI penalties indicates a strategic pivot where companies are willing to lower list prices to maximize net revenue and avoid government penalties. This suggests a broader industry trend where 'gross-to-net' bubbles are being managed through aggressive price resets rather than just relying on rebates.
The 'data-rich' environment described by BMY, with over 30 meaningful launch opportunities by 2030, signals a robust innovation cycle in the pharmaceutical sector. The specific focus on difficult-to-treat areas like IPF (Admilarent) and Triple-Negative Breast Cancer (Pemigatinib) highlights an industry-wide push into high-unmet-need medical areas, suggesting continued high R&D productivity and investment in transformative therapies.