アムニール・ファーマシューティカルズ(AMRX)2026年第3四半期決算説明会:業績予想を引き上げ
アムニール・ファーマシューティカルズの2026年第3四半期は、売上高が前年同期比10%増の8億6,300万ドル、調整後EBITDAが同30%増の2億700万ドルと好調な業績を記録した。これを受け経営陣は2026年通期の売上高および利益ガイダンスを引き上げた。アフォーダブル・メディスン部門とスペシャリティ部門が成長を牽引したほか、Kashiv買収によるバイオシミラープラットフォームの構築が完了した。さらに、ランレオチドやイオヘキソールの展開、ファイザーとのGLP-1に関する提携を進め、2030年の売上高目標に向けた持続的な成長基盤を強化している。
要点
- アムニール・ファーマシューティカルズ(AMRX)が発表した2026年第3四半期の売上高は前年同期比10%増の8億6,300万ドルとなった。調整後EBITDAは30%増の2億700万ドル、調整後EPSは53%増の0.26ドルに上昇した。
- アフォーダブル・メディスン部門の売上高は、ウィメンズヘルス向け経皮吸収型パッチ、新製品投入による5,400万ドル、ならびに大型バイオシミラー顧客からの注文時期が好適であったことによる約4,000万ドルの寄与に支えられ、前年同期比19%増の5億4,700万ドルとなった。
- スペシャリティ部門の売上高は、CREXONT、BREKIYA自己注射器、UNITHROIDが牽引し、前年同期比20%増の1億5,000万ドルに増加した。AvKARE部門の売上高は、前年同期に大型製品の導入があった反動で17%減の1億6,500万ドルとなった。
- 経営陣は2026年通期の売上高、調整後EBITDA、調整後EPSの見通し(ガイダンス)を引き上げた。新たな予想範囲はそれぞれ31億5,000万〜32億5,000万ドル、8億〜8億1,500万ドル、1.04〜1.08ドルとなっている。
- 同社はKashivの買収を完了し、開発、製造から商業化までを網羅する統合型バイオシミラープラットフォームを構築した。経営陣は、2030年の売上高見通しである43億〜45億ドルに向けた成長の最大のシェアをバイオシミラーが占めると見込んでいる。
- 9月下旬に発売されたランレオチドは約700万ドルの売上高を記録した。経営陣は第4四半期の売上高が数倍に拡大すると予想しており、将来的には30%〜40%の市場シェア獲得を目指している。
主要財務実績
| 指標 | 2026年第3四半期 | 前年同期比 | 主な背景 |
|---|---|---|---|
| 売上高 | 8億6,300万ドル | +10% | アフォーダブル・メディスン部門およびスペシャリティ部門が成長を牽引 |
| 調整後EBITDA | 2億700万ドル | +30% | 売上高の増加と規律ある費用管理 |
| 調整後EPS | 0.26ドル | +53% | 調整後EBITDAの増加と支払利息の減少 |
| 調整後売上総利益率 | 43.2% | +50ベーシスポイント | 好適な製品ミックス |
| アフォーダブル・メディスン部門の売上高 | 5億4,700万ドル | +19% | 貼付剤、新製品投入、バイオシミラーの注文時期 |
| スペシャリティ部門の売上高 | 1億5,000万ドル | +20% | CREXONT、BREKIYA、UNITHROID |
| AvKARE部門の売上高 | 1億6,500万ドル | -17% | 前年同期比較に大型製品導入が含まれていたこと |
年初来(第3四半期累計)では、売上高が8%増、調整後EBITDAが20%増、調整後EPSが34%増となった。
事業および業績の動向
アフォーダブル・メディスン部門が最大の成長寄与となった。新製品が四半期売上高を5,400万ドル押し上げたほか、大型バイオシミラー顧客からの注文時期が好適であったことにより約4,000万ドル寄与した。ウィメンズヘルス向け経皮吸収型パッチも引き続き主要な牽引役となっており、経営陣は需要に対応するため生産能力を追加していると述べた。
ランレオチドは9月下旬に発売されたため、第3四半期業績への寄与はごくわずかにとどまった。同社は初期の普及状況が好調であるとし、今後の四半期でより大きな寄与を見込んでいる。アムニールは2026年第4四半期中に60ミリグラムおよび90ミリグラム規格の承認後変更申請を提出する予定で、経営陣は2027年後半の発売を目指している。経営陣によると、現在承認されている120ミリグラム規格が、規格別市場の約90%を占めている。
アムニールはイオヘキソール(iohexol)のポートフォリオも拡大した。同社は全SKUの申請を完了し、生産能力を増強するとともに、製品のサプライチェーンを強化したと説明した。経営陣はイオヘキソールが2027年の主要な成長ドライバーになると期待している。
スペシャリティ部門では、CREXONTの新規処方医師数が毎月約400人ペースで増加し続けた。経営陣は、処方数の伸びが長期予想の中央値から上限付近を支援していると述べた。BREKIYAの動向は同社の2026年当初予想の約2倍で推移しており、経営陣は2027年の業績が2026年水準の倍近くに達する可能性があると述べた。
経営陣によると、Kashivの統合は順調に進展している。アムニールは現在、ランレオチドの利益の100%を享受しており、ニュージャージー州経済開発局から6,000万ドルの税額控除を獲得した。同社は、利益分配義務の解消および税制上のインセンティブ獲得により、4億〜5億ドルの財務上の利益が見込まれることを改めて表明した。
ファイザーとの提携に向けたGLP-1原薬および製剤専用施設の建設は、2028年の稼働に向けて予定通り進んでいる。アムニールは、この提携に18市場での独占的アクセス権が含まれており、両社が将来の共同販売取り決めについて検討中であると明かした。
業績見通し(ガイダンス)
| 2026年通期指標 | 更新後のガイダンス | 中間値の変更 |
|---|---|---|
| 売上高 | 31億5,000万〜32億5,000万ドル | 5,000万ドルの上方修正 |
| 調整後EBITDA | 8億〜8億1,500万ドル | 4,300万ドルの上方修正 |
| 調整後EPS | 1.04〜1.08ドル | 0.05ドルの上方修正 |
| 営業キャッシュフロー | 3億2,500万〜3億7,500万ドル | 2,500万ドルの下方修正 |
経営陣は、営業キャッシュフロー見通しの引き下げについて、需要に対応するために必要な製品在庫の増加と、売掛金回収の時期が2027年第1四半期にズレ込む見込みとなったためであると説明した。
Kashiv買収後の第3四半期末時点における純有利子負債倍率(ネットレバレッジ)は調整後EBITDAの3.5倍であった。経営陣は2026年末時点で3.6倍になると予想しており、2028年までに同比率を3倍未満に引き下げられるとの自信を維持している。
経営陣は、2026年の約31億〜32億ドルに対し、2030年の売上高見通しを43億〜45億ドルとする数値を再確認した。同社は、追加的な成長の大部分がバイオシミラーを牽引役とするアフォーダブル・メディスン部門からもたらされると見込んでいる。また経営陣は、バイオシミラーや高難度ジェネリックの構成比向上、Kashivの収益性の完全受容、および運営効率化を通じて、売上総利益率が改善すると見込んでいる。
リスクと注目点
- 第3四半期のアフォーダブル・メディスン部門の売上高のうち約4,000万ドルは、大型バイオシミラー顧客からの注文時期が好適であったことを反映している。
- 営業キャッシュフローの見通しは、在庫投資および売掛金回収時期の2027年第1四半期へのズレ込みにより引き下げられた。
- AvKARE部門の売上高は、低粗利の卸売事業の優先度を下げた決定の影響を引き続き受けているが、経営陣は第3四半期の調整後EBITDAが2桁の伸びを示したと述べている。
- アムニールのゾレア(XOLAIR)バイオシミラーの発売時期は、特許和解交渉の状況に左右される。経営陣は現在、2027年下半期の終盤頃の発売を見込んでいる。
- Kashiv買収に伴い純有利子負債倍率が上昇しており、調整後EBITDAの3倍未満へのレバレッジ解消は即座ではなく2028年を目標としている。
アナリスト質疑応答のハイライト
経営陣は、アムニールのゾレアバイオシミラーがセルトリオン製品に次いで米国市場で2番目の製品になると見込んでおり、2027年下半期後半に発売される可能性がある。同社は英国での承認も取得しており、欧州医薬品庁(EMA)から肯定的な見解を得たと報告、欧州での最終承認は2026年11月下旬を見込んでいる。
ランレオチドについて、アムニールは将来的には30%〜40%の市場シェアを目標としている。同社は欧州でも同製品を申請済みであり、2027年第3四半期に規制当局の判断が行われる見通しで、米欧双方の需要に対応できるよう生産能力が設計されている。
経営陣は、2030年までの売上高成長の最大のシェアをバイオシミラーが創出するはずだと述べた。その他の寄与要因としては、ウィメンズヘルス製品、無菌注射剤、持続性注射剤プログラム、吸入剤、眼科製品、スペシャリティ部門、およびAvKAREの政府チャネル拡大が含まれると期待されている。
決算説明会全文文字起こし
決算説明会の完全なトランスクリプト
経営陣による説明
Operator
Good morning, and welcome to the Amneal Pharmaceuticals' Third Quarter 2026 Earnings Call.
I will now turn the call over to Amneal's Head of Investor Relations, Tony DiMeo.
Anthony DiMeo
Good morning. And thank you for joining Amneal Pharmaceuticals' third quarter 2026 earnings call.
Today, we issued a press release reporting Q3 results. The earnings press release and presentation are available on the IR page of amneal.com.
Certain statements made on this call regarding matters that are not historical facts, including, but not limited to, management's outlook or predictions are forward-looking statements that are based solely on information that is now available to us. Please see the sections entitled Cautionary Statements on Forward-Looking Statements in our press release and presentation for factors that may impact future performance.
We also discuss non-GAAP measures. Information on use of these measures and reconciliations to GAAP are in the earnings release and presentation.
On the call today are Chirag and Chintu Patel, Co-Founders and Co-CEOs; Tasos Konidaris, CFO; Joe Renda for Specialty; and Jason Daly, Chief Legal Officer.
I will now hand the call over to Chirag.
Chirag Patel
Thank you, Tony. Good morning, everyone.
Today, Amneal is a stronger, more diversified company than ever before with a portfolio focused on high-value products designed to drive durable growth. We have expanded across specialty, biosimilars and complex products while building the capabilities and capacity to drive these businesses long term.
2026 marks our seventh consecutive year of top and bottom line growth, a track record that stands out in the industry. Our third quarter performance reflects that progress with revenue of $863 million, up 10%; adjusted EBITDA of $207 million, up 30%; and adjusted EPS of $0.26, up 53%. The breadth of our portfolio and the depth of our pipeline give us confidence that we are still early in realizing Amneal's full potential.
Let me highlight the progress across our key growth areas. First, in biosimilars, we closed the Kashiv transaction in Q3. Amneal now has the end-to-end capabilities to succeed in biosimilars, R&D, manufacturing and commercial in-house. Now it is all about execution.
From a macro perspective, we have access to a large and growing biosimilar market with approximately $234 billion of U.S. biologic sales losing exclusivity over the next decade. At the same time, streamlined regulatory pathways, new commercial models such as private label and accelerating market adoption are creating a major inflection point for the U.S. biosimilar industry. Against this backdrop, our portfolio strategy is deliberately differentiated, balancing targeted lower competition molecules with a select number of broader biologic opportunities.
We believe this approach positions Amneal to capture attractive economics and sustain long-term value creation, for Amneal biosimilars are a natural extension of our purpose, making key medicines more accessible and affordable while building a durable growth platform.
Biologics accounts for more than half of U.S. drug spending, yet represents only 5% of total prescriptions, highlighting the significant affordability and access challenge. We believe we can help address that gap and create value for patients.
Second, complex generics remains a core strength with a proven track record of execution. We have an expanding, diversified portfolio of high-demand complex therapies, including Women's Health, transdermal patches and important new injectable products approvals such as lanreotide, romidepsin and iohexol. Across dosage forms, these are significant opportunities for sustained growth. We have strategically evolved our portfolio toward high-value complex products where our science manufacturing capabilities and capacity, reliable supply and customer relationships set us apart.
Third, in Specialty, our key brands are performing very well. 2 years after launch, CREXONT for Parkinson's disease continues to gain share. This is being driven by positive patient experience and compelling clinical evidence with more than 3 additional hours of Good On time per day versus other therapies. BREKIYA is also gaining strong traction in migraine and cluster headache, performing ahead of our expectations this year. We see our Specialty segment becoming considerably large over time.
Fourth, AvKARE remains an important aspect of our business that provides diversification and access to government and institutional channels for our high-value products, including biosimilars in the future.
Fifth, we are advancing our GLP-1 collaboration with Pfizer as construction of our new dedicated GLP-1 manufacturing facilities for both drug substance and drug product remain on track for 2028.
Taken together, Amneal has a fundamentally stronger and more diversified growth profile than ever before. With more growth engines, more innovation and more opportunities ahead, our focus is on the execution, delivering across each of these areas, converting that potential into results. We believe the momentum of 2026 positions us very well for continued high growth in 2027 and beyond.
With that, I'll turn it over to Chintu.
Chintu Patel
Thank you, Chirag, and good morning, everyone. I want to thank the entire Amneal team, which continues to execute at a high level. Their strong performance enable us to pursue increasingly ambitious opportunities while continuing to deliver across our existing businesses. Since our last call, we closed the Kashiv transaction in August. The combined team is working as one across development, manufacturing and commercialization to build our biosimilar business.
Also, as we shared on our Q2 call, one of our India facilities experienced flooding back in late July. The team worked tirelessly to limit the impact, and we are pleased to share that operations have fully resumed. In addition, in September, we received FDA approval for lanreotide, a high-value complex injectable.
Let me focus on 4 areas. First, integrating Kashiv and advancing our biosimilar pipeline; second, our global operational strategy; third, our R&D portfolio; and fourth, growing our specialty business.
First, in biosimilar, we now have the end-to-end capabilities from cell line and clone development through clinical execution, regulatory expertise, biologics manufacturing and commercialization. Kashiv brings the science, development and biologics manufacturing, while Amneal brings commercial scale, channel expertise and customer relationships. Together, we can move faster, run effectively and capture more value, reinforcing biosimilars as a key long-term growth pillar for Amneal. The combined platform is designed to make disciplined portfolio decisions, advance multiple molecules in parallel and create a repeatable path from R&D to commercialization.
Our biosimilars manufacturing footprint in New Jersey and India is expanding, which enable us to work on a growing number of biosimilar R&D programs and also meet commercial demand. Our biosimilars pipeline is focused on early-to-market global opportunities where we are targeting being first or second to launch. We built this playbook and executed it well in complex generics, and we are now applying it to biosimilars.
Second, in operations, our priorities remain clear: quality, reliability and resiliency. Across our global manufacturing and supply chain network, we continue to deepen our capabilities and capacity in complex generics, sterile injectables, and biosimilars.
Our facilities have transformed in recent years through digitization, automation, and AI-enabled tools. We are advancing our manufacturing capabilities and quality while improving efficiency. At the same time, we are scaling capacity for our key growth areas, including significant expansion for women's health transdermal patches this year, new U.S. sterile injectable capabilities by 2028, expanding our complex injectable capacity for key programs like lanreotide and risperidone, building out our 2 new GLP-1 facilities and increasing biosimilar capacity to support our pipeline. These initiatives are designed to meet increasing market demand and drive meaningful new growth.
This broad operational platform is differentiated in the industry. Our large manufacturing footprint across 20 global facilities and technical expertise position Amneal well to deliver reliable supply, address important market needs and pursue new growth opportunities at the same time.
Third, turning to our complex generics pipeline. We continue to convert many years of R&D hard work into significant commercial products. Complex generics build this company, and we are not slowing down. That strategy is visible in the differentiated portfolio, spanning injectables, ophthalmics, inhalation, transdermal drug-device combinations, 505(b)(2) products and other dosage forms.
Recent approvals are important proof points. Recent approvals include key complex generics and 505(b)(2) products such as lanreotide, romidepsin RTU, sodium bicarbonate IV bag and additional strength and presentations of iohexol. These products expand our portfolio into large attractive markets and demonstrate our ability to develop, manufacture and commercialize increasingly complex medicines in-house.
Looking ahead, we are advancing a deep pipeline of long-acting injectable 505(b)(2) and inhalation programs. We continue to have the most CGT approvals in the U.S. pharmaceutical industry.
One year ago, on our Q3 call, we highlighted 20 key launches across 2025 and 2026 that we believe would propel our Affordable Medicines business to a new level. Today, almost all are now approved and launched. Looking forward, we see a next wave of new product launch opportunities between 2027 and 2029, particularly new sterile injectable and bag products. This gives us high confidence that growth in Affordable Medicines will continue to stay elevated in the years ahead.
Importantly, this is not a onetime launch cycle. It reflects the innovation engine we have built over many years and the steady conversion of those programs into successful commercial launches.
Specifically, innovation is a new growth platform that we have been building. Last year, we received our first 2 approvals ProAir and QVAR. Looking ahead, we are targeting additional MDI and soft mist approvals over the next 3 years. We see innovation as a new vector of growth for the business.
Fourth, in Specialty, we are very pleased with the continued performance of CREXONT and BREKIYA. The strength is visible not only in higher revenues, but also in prescription trends, physician adoption and the growing number of patients benefiting from these impactful therapies.
For CREXONT, we continue to build on the clinical and real-world evidence supporting its differentiated profile in Parkinson's treatment landscape. We are pursuing second Phase IV study evaluating its effect on disease progression as awareness and physician experience expand, the opportunity clearly to expand CREXONT's reach among the 700,000 patients in the U.S. on carbidopa/levodopa therapy. Beyond CREXONT and BREKIYA, we are advancing additional 505(b)(2) and novel R&D programs to build a broader specialty platform focused on differentiated medicines that improve patient outcomes.
Across our businesses, our formula remains the same: strong science, quality first, robust planning, care for customers and patients and disciplined execution. The progress made in 2026 and the catalysts ahead gives us very strong confidence heading into 2027.
With that, I will turn it over to Tasos.
Anastasios Konidaris
Thank you, Chintu. And good morning, everyone.
I'm very pleased to share our third quarter exceptional financial results, which are a testament to our strategic choices and strength of execution. Revenue of $863 million increased 10%, adjusted EBITDA of $207 million increased 30% and adjusted EPS of $0.26 increased 53%.
Our growth profile remains very strong due to the relevancy and complexity of our growth product portfolio as well as the fact that we play in large and growing markets. As a result, we're very pleased to once again increase our 2026 financial guidance and expect strong momentum in 2027 and beyond.
In the third quarter, Affordable Medicines delivered revenue of $547 million and grew 19%. This reflects growth across our 3 channels of retail, injectables and government.
From a product perspective, growth was mainly driven by women's health transdermal patches, new product launches, which added $54 million in the quarter and favorable timing of a large biosimilar customer order, which added about $40 million. It is worth noting that lanreotide made a very small contribution in Q3 as we launched in late September. However, we're already seeing terrific uptake and expect much larger contribution of lanreotide in subsequent quarters as we fulfill substantial market demand.
Specialty revenue was $150 million, up 20%, driven by continued growth across CREXONT, BREKIYA autoinjector and UNITHROID. Strong underlying trends and smart execution across these 3 brands support continued growth into future years.
AvKare revenue was $165 million, down 17% as expected due to the nonrepeating nature of a large product introduction in the third quarter of last year, where revenue grew 25%. Putting this one factor aside, AvKare revenue in the quarter was stable, while adjusted EBITDA was up double digits as our team continues to prioritize profitability over simple revenue growth.
Moving down the P&L. Q3 adjusted gross margin was 43.2%, up 50 basis points year-over-year, reflecting favorable mix. Adjusted EBITDA grew 30% due to strong revenue growth and disciplined expense management. Q3 adjusted EPS grew 53%, reflecting higher adjusted EBITDA and lower interest expense.
It is important to note that our year-to-date financial performance is also extremely strong with revenues up 8%, adjusted EBITDA up 20% and adjusted EPS up 34%.
As a result, we're very pleased to update our full year 2026 guidance. Revenues increased by $50 million at the midpoint of the new range of $3.15 billion to $3.25 billion. Adjusted EBITDA is increased by $43 million at the midpoint of the new range between $800 million and $815 million. Adjusted EPS is also increased by $0.05 at the midpoint of the new range of $1.04 and $1.08.
Finally, operating cash flow is slightly down by $25 million at the midpoint of the new range of $325 million to $375 million. The operating cash flow adjustment is driven by timing and reflects our decision to increase internal finished goods inventory to satisfy strong revenue demand and timing of some collections being pushed to Q1 of 2027.
From a balance sheet perspective, net leverage was 3.5x adjusted EBITDA as of Q3, reflective of closing the Kashiv acquisition. We expect to finish 2026 at 3.6x adjusted EBITDA, in line with year-end 2025 and continue to feel confident of being below 3x adjusted EBITDA by 2028.
Let me now finish with our Kashiv acquisition, where the integration is progressing very well. As you may recall, in addition to the large market opportunity this deal represented, we also highlighted $400 million to $500 million in expected financial benefits driven by elimination of profit-sharing obligations and various tax incentives.
We feel very confident about capturing these benefits, and I'm happy to share 2 recent proof points. First, our newly launched product, lanreotide, was originated at Kashiv. And as a result of the acquisition, Amneal now gets to keep 100% of this product's profits. Second, last week, we secured $60 million in tax credits from the New Jersey Economic Development Authority. Large part of these benefits relates to the manufacturing expansion in support of the Kashiv acquisition and the future biosimilars product road map.
In summary, we're extremely pleased with our strong results, increased financial outlook for 2026 and the strong momentum for continued growth in 2027 and beyond.
With that, I'll turn the call back to Chirag.
Chirag Patel
Thank you, Tasos.
Our Q3 results reflect the breadth and depth of Amneal. We are executing well across our growth pillars, complex generics, biosimilars, specialty and health care with GLP-1 continue to advance very well.
Since our last call, we closed the Kashiv transaction to create an integrated biosimilars platform. We received important approvals, including lanreotide and our specialty brands, CREXONT and BREKIYA continue to drive uptake. These are tangible achievements, and there is more ahead. The strength we are delivering in 2026, combined with our upcoming catalysts and pipeline gives us confidence in continued strong growth in 2027 and beyond.
Our goal remains clear: to become America's #1 affordable medicines company and a leading provider of essential medicines globally.
With that, let's open the call for Q&A.
Operator
We will now begin the question-and-answer session. [Operator Instructions] Your first question is from Les Zalewski with Oppenheimer.
質疑応答
Unknown Analyst
This is [ Jean ] on for Les.
Could you clarify the revenue book for lanreotide in 3Q? And what are you seeing on early metrics from initial stocking versus patient demand?
And then as a follow-up, I think the FDA only approved the 120-milligram syringe. Are the 60- and 90-milligram strengths filed? And when could they be approved?
Anastasios Konidaris
This is Tasos. Number one is we launched lanreotide in Q3 actually, very late in September. The revenue was very small, about $7 million, right? You can expect multiple times of that in Q4. And as we think about kind of continued growth of the product throughout next year and beyond, our team is aiming at about 30% to 40% market share.
With that, let me pass it on to Chintu for part 2.
Chintu Patel
Yes. Thank you.
So on other 2 strengths, 60 and 90, our post-approval supplement is ready, and we will be filing both the strengths in this quarter and expect the launch in the second half of next year.
Anastasios Konidaris
So most of the cells in these strengths.
Chintu Patel
Yes, the 90% of the strengths are in the 120-milligram strength.
Operator
Your next question is from David Amsellem with Piper Sandler.
David Amsellem
So on XOLAIR, can you talk about when in '27 you think you'll be in a position to launch? And just remind us what has to happen in order to be in a position to launch?
And then secondly, on XOLAIR, how are you thinking about competitive dynamics and how impactful it could be in '27 to the extent that you, say, one or 2 biosimilars on the market?
And then just another quick question on BREKIYA that seems to be ramping nicely. Can you talk about access dynamics and how you're thinking about the trajectory of that product going forward?
Chirag Patel
XOLAIR, we have a goal date early next year, and we are in active discussion, which I cannot give you more detail on the patent settlement than a date, but we expect to launch in second half next year towards late and we on the competition side, as you know, Celltrion is in the market. We expect to be the second. And then Teva has filed the product as well.
It's an excellent molecule, large demand. We're already working with customer channels on various customer channels to maximize our opportunity there for years to come as well as we have the approval in MHRA and a positive opinion from EMA for XOLAIR, which we expect the final approval in late November and launch again according to the patent settlement, which we'll let you know when we strike. So very excited about XOLAIR.
Let's talk about BREKIYA. So BREKIYA, we're getting good 50%, 60% conversion, and it's a much needed drug. We're not getting too many payers blocked yet, so let the uptake happen and then we'll worry about the coverage. But right now, it's going through fine.
Operator
Your next question is from Chris Schott with JPMorgan.
Ekaterina Knyazkova
This is Ekaterina on for Chris.
So on your 2030 outlook, it seems like you're expecting very healthy top line growth. Just how much of that is coming from Affordable Medicines versus Specialty and AvKARE? And then can you help us also bridge from the top line to your EPS number? Just any key assumptions in terms of margins or anything like that that you're kind of embedding in that 2030 outlook?
And then second question is around [indiscernible] Women's Health. Just latest trends you're seeing for the product and your expectations for '27. How big can this become once you have some of the additional kind of capacity come online?
Anastasios Konidaris
I may have to repeat a couple of those questions. I'm fast, but you're even faster than me.
As we think about 2030, just to kind of ground everyone, what we said was we expect the revenue to go from about $3.1 billion this year, right, $3.1 billion to $3.2 billion to about $4.3 billion to $4.5 billion. So that's an incremental over $1 billion of growth. The majority of that growth is going to come from our Affordable Medicines space and primarily from Biosimilars, okay? That was a key impetus for the Kashiv acquisition
Now since we announced the biggest majority of that calling, as I said before, is going to come from Affordable Medicines. And within Affordable Medicines, biggest chunk biosimilars, but also you heard us a lot about the growing businesses such as women's health care transdermal patches that are growing as well around our injectable business. So those are the other components within Affordable Medicines that we expect to grow.
AvKARE, we expect that will continue to grow. I think we had this year a little bit of a reset from a revenue perspective as we deprioritize our low-margin distribution channel, but adjusted EBITDA is up 26% this year, just to kind of give you a flavor. So we continue to see a huge runway of AvKARE primarily as they enter play bigger player within the government channel and passing through more biosimilar products. So we're working closely with them about developing a strategic road map of biosimilars within the government channel. And that road map obviously is going to include Amneal products as well as other third parties. So I think that covers the revenue.
Can you just tell me what will be the other question around margins and maybe bottom line growth?
Ekaterina Knyazkova
Yes. Just kind of what are you embedding in just in terms of gross margins and any other kind of key assumptions as you kind of think about bridging from the revenue to the EPS?
Anastasios Konidaris
So great question. So one of the things that we have done over the last few years is focus on increasing our gross margins. So as an example, you can see our gross -- year-to-date as an example, Affordable gross margins are up 300 basis points as an example. And gross margin for the business this year, we're probably going to be -- total Amneal probably at about 46.5% compared to about 45.5% last year. So solid growth rate in terms of gross margins.
As we think about 2030, gross margins will improve further. And they're going to improve further for a number of different reasons. Number one is as biosimilars in general, have a higher gross margin than the rest of our business, and with the acquisition of Kashiv, now we're able to keep all 100% of those economics. So that acquisition and Biosimilars being a key growth driver bodes well from a mix perspective, number one.
Number two, for many years now, we continue to focus on our complex generics for the Women's Health. So part of the reason we did that was, number one, is we saw a big market opportunity, number one; simply the competitive dynamics in that space is better; and number three, the average price point and profitability for those products is higher than what will be for a typical oral generic.
And the third thing is our teams work day and night to continue to drive operating efficiencies. So everyone is busy kind of doing more with less and increasing our efficiency rates, and there is a lot of internal effort that our CEOs are leading in terms of embedding AI more and more in our day-to-day operations.
So over the course of time, as we think about 2030, we see revenue growth accelerating, margins continue to improve, and this is what's going to drive substantial bottom line growth rates as well as reducing debt over the course of time.
Chirag Patel
This is Chirag. I'm going to add a couple of things. So since we are talking about now to 2030, and I think for the overall for all the questions, I guess, this is very important. So our base business is growing actually. So we are very excited due to the women's health HRT, we have built out the capacity, we're building out even more capacity. We are completely in the know of the demand. We're working with HHS and FDA as well. And we would provide you more details in our February call, but it's a significant opportunity. And we are fulfilling a key need out there on Women's Health.
So day and night work has been done by our Piscataway, New Jersey team and expansion has already happened and more is coming. So significant opportunity in the base business, which we never had it before. If you can refer to the Slide 5 in our presentation that shows you that $1.2 billion of revenue on a base business in 2019 has only gone down by $200 million to $1 billion this year.
So there is no such thing as leaky buckets on these products. These are needed products. Some goes down, some go up, 300 products portfolio. Now we're predicting that our base business will grow.
Second, we have the next wave, as my brother mentioned on his script, next wave of launches, which are all in Complex Gx. We're building out a sterile manufacturing facility in New York. We got a PreCheck program. We are converting the compounded drug into approved products, such a big need for the hospitals. And we're a purpose-driven company, correct? So we are partnering with hospitals to solve that supply from India and Brookhaven, New York.
Long-acting depot injections continue to gain traction. Risperidone, octreotide is coming, inhalation, we mentioned 2 approved, more are coming, ophthalmics ramping up. So no shortage of small molecule drugs coming up in next 4 years. Biosimilars on top of that are also coming. Excited about launching denosumab, both presentation in mid next year, then XOLAIR and then continue to -- we have disclosed some of the pipeline assets that are fantastic and expect us to do more and more in Biosimilars.
Specialty is also growing because of continued growth of CREXONT. I mean we're probably not even halfway there, right? We keep growing the scripts.
And then AvKARE is growing on where it needs to grow high-growth areas such as Biosimilars, Specialty and Complex Gx, taking full advantage of our U.S. manufacturing capabilities.
And international grows because of the Biosimilars partnership internationally, we'll be doing more. India, we have launched our own label. Small business today will grow in the future. And we're further partnering in South America, Europe, Middle East, Canada, so international, which today is only $40 million, $50 million business, expect to grow significantly as well. So we're extremely excited about from now to 2030.
Operator
Your next question is from Ash Verma with UBS.
Unknown Analyst
This is [ Bea ] on behalf of Ash. So one question from us.
For the iohexol, can you help us understand the overall opportunities and how that contributes to your '26 and '27 sales? And do you need the full SKU portfolio on the different dosing to maximize this launch? And then how is the conversation going with the IND on the contracting?
Chintu Patel
So on iohexol we now have filed all the SKUs and will be covering the entire breadth of the iohexol product. It is a complex product. Still, we are the only generic. We work very hard to increase our capacity and the cost efficiency. So going into 2027, we feel pretty good about iohexol as being a key growth driver. And our commercial teams are working with hospitals and other channels to increase our market share with having the full basket.
So iohexol would be a good product for us as we have the more capacity, all the SKUs, and we have strong resilient supply chain now on iohexol.
Operator
Your next question is from Matt Dellatorre from Goldman Sachs.
Matthew Dellatorre
Congrats on the progress. Maybe on the Pfizer partnership, could you just give us an update on the status of that and share any more color on development progress, manufacturing preparedness and then also just how meaningful of an opportunity you think this could be to Amneal long-term?
And then on the Specialty side, I know you've pointed in the past to higher confidence in maybe the higher end of your long-term CREXONT and BREKIYA guidance. So just curious what your latest thinking was there.
Chintu Patel
Pfizer, excellent partnership going really well. Both teams are doing fantastic. They just had 12 people visiting our facilities, which are under construction. They are awestruck by how awesome it is, fully digitized, AI-based. The capacity is huge, obviously. It is latest and and greatest lines, fully automated through the packaging inspection. It's amazing site, amazing partnership.
We will complete the construction in late '28 to '29, we should start commercialize for Pfizer in all territories basically. And we are working through the final touches of how the future partnership would look like on our co-marketing. We have given access to 18 markets exclusively. So we're evaluating how do we market that with now Pfizer. We're interested in marketing a brand, not generic.
So that is where the Pfizer partnership and also those 2 sites we are building, we'll be able to take other business from other big pharma or even from Amneal Biologics, Kashiv's products, wherever it comes from amazing sites. So we're very excited to have this big potential, and we'll share more detail as we make great progress.
Chirag Patel
CREXONT and BREKIYA.
Chintu Patel
CREXONT and BREKIYA, Joey, would you like to chime in?
Joe Renda
Yes, absolutely. We're really, really pleased, Matt, with the response we've seen in the market with CREXONT. We continue to add new prescribers every month, around 400 or so we're adding monthly, and our TRxs are continuing to grow at a substantial pace. So we're very confident in the guidance we've given longer term, probably to the middle part, maybe even the higher end of that guidance based on our current trends. So we're very confident there.
And BREKIYA autoinjector, as we talked about earlier, the expansion that we did earlier this year has really enabled that product to really grow. We've already doubled the expectations for tracking of how we're performing this year. We anticipate next year to probably also come close to doubling our performance from this year. So the response from the market for BREKIYA autoinjector has been very positive. And the expansion, as I mentioned, that we did enables us to get into more of the key headache prescribers that have been very, very responsive so far.
And the per patient carton use also has also been a very substantial part of that accelerated growth with autoinjector. So we actually are very confident in that probably going beyond what our current expectations are from a guidance standpoint.
Operator
Your next question is from Daniel Clark with Leerink Partners.
Daniel Christopher Clark
Just wanted to ask how you're thinking about the lanreotide opportunity in Europe here. I believe you have a pending approval. But just curious if you could frame next steps and potentially how that could impact results?
Chintu Patel
Yes, we have filed our product in Europe, and we are expecting action in the third quarter next year. And we have built capacity to address both the U.S. demand and Europe. It is a substantial product and volume in Europe. So we are very excited about the European opportunity also.
Operator
There are no further questions at this time, and we have reached the end of the Q&A Session. I will now turn the call back to Chirag Patel for closing remarks.
Chirag Patel
Well, thank you, everybody, for listening. Have a great day. Thank you.
Chintu Patel
Thank you.
Anthony DiMeo
Thanks everyone.
Operator
This concludes today's call. Thank you so much for attending. You may now disconnect.
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