Vertex Raises 2026 Revenue Outlook as Q3 Sales Rise 12%

Vertex Pharmaceuticals (Nasdaq: VRTX) raised its full-year 2026 revenue guidance after third-quarter sales increased 12% year over year, supported by continued cystic fibrosis growth, expanding contributions from newer products and the first month of revenue from its Crinetics Pharmaceuticals acquisition. Higher operating expenses, including acquisition-related costs and continued pipeline investment, weighed on GAAP and non-GAAP profitability.

The company now expects 2026 revenue of $13.15 billion to $13.25 billion, compared with its previous range of $13.1 billion to $13.2 billion. The forecast includes continued growth in cystic fibrosis, at least $500 million in combined revenue from CASGEVY and JOURNAVX, and $40 million to $50 million from PALSONIFY for the September-to-December post-acquisition period.

Third-quarter total revenue reached $3.44 billion, up from $3.08 billion a year earlier. Cystic fibrosis product revenue rose to $3.27 billion from $3.04 billion, remaining the company’s largest source of sales. ALYFTREK revenue increased to $706 million from $247 million, while TRIKAFTA/KAFTRIO revenue declined to $2.44 billion from $2.65 billion, reflecting the growing contribution from Vertex’s newer once-daily CF therapy. ALYFTREK sales exceeded $1 billion for the first nine months of 2026, and more than 18,000 patients worldwide were receiving the treatment at quarter-end.

Revenue outside the CF franchise also expanded. CASGEVY generated $99 million, compared with $17 million in the prior-year period, while JOURNAVX revenue rose to $58 million from $20 million. PALSONIFY contributed $10 million for September following the September 1 closing of the Crinetics acquisition.

Profitability reflects higher investment and acquisition costs

Vertex reported third-quarter GAAP operating income of $710 million, down from $1.19 billion a year earlier, as its GAAP operating margin narrowed to 21% from 39%. GAAP net income fell to $650 million, or $2.56 per diluted share, from $1.08 billion, or $4.20 per share.

On a non-GAAP basis, operating income was $1.41 billion, compared with $1.38 billion in the year-earlier quarter. The non-GAAP operating margin declined to 41% from 45%, while non-GAAP net income was $1.21 billion, or $4.76 per diluted share, compared with $1.24 billion, or $4.80 per share.

Combined non-GAAP research and development, acquired in-process R&D, and selling, general and administrative expenses increased to $1.53 billion from $1.28 billion. The quarter included about $60 million of Crinetics operating and integration costs. Vertex ended the period with $9.8 billion in cash, cash equivalents and marketable securities.

The company raised its full-year combined GAAP R&D, acquired IPR&D and SG&A expense forecast to $7.15 billion to $7.2 billion from $6.3 billion to $6.45 billion. It now expects approximately $6 billion of combined non-GAAP expenses, above its previous range of $5.65 billion to $5.75 billion. The updated outlook incorporates about $250 million of Crinetics operating expenses and roughly $100 million of currently anticipated acquired IPR&D costs. Vertex maintained its non-GAAP effective tax-rate forecast of 19.5% to 20.5%.

New products broaden the commercial base

Vertex said CASGEVY completed more than twice as many patient infusions during the first nine months of 2026 as in all of 2025. The therapy received expanded pediatric labeling for patients ages 2 to under 12 in the U.S., Bahrain and the United Arab Emirates, and for ages 5 to under 12 in the U.K.

JOURNAVX recorded more than 750,000 prescriptions during the third quarter and has been used to treat more than 1.6 million patients since launch. About 80,000 physicians were prescribing the treatment, up from roughly 70,000 previously. Vertex expects both JOURNAVX prescriptions and revenue to grow by more than threefold in 2026 compared with 2025. Its patient support program is expected to remain in place through 2026, with gross-to-net revenue expected to normalize around mid-2027.

For PALSONIFY, Vertex reported broad payer access covering about 80% of U.S. lives and approximately 500 repeat healthcare-provider prescribers. Management plans to expand the U.S. patient and prescriber base and begin a European launch in the second half of 2027.

Kidney portfolio approaches regulatory and clinical milestones

Povetacicept is under U.S. priority review for accelerated approval in IgA nephropathy, with a target action date of November 30, 2026. Vertex said it is commercially prepared for a potential launch, with a trained field team and patient-onboarding infrastructure in place.

In the Phase 3 RAINIER interim analysis, povetacicept produced a 52% reduction from baseline in 24-hour urine protein-to-creatinine ratio at week 36. The treatment effect versus placebo was 49.8%, and 42.2% of treated participants reached a proteinuria level below 0.5 grams per gram. The company said the therapy was generally safe and well tolerated, with serious infections balanced between the treatment and placebo groups.

Vertex has also fully enrolled the pivotal AMPLITUDE trial of inaxaplin in APOL1-mediated kidney disease with severe proteinuria. An interim analysis is planned for early 2027. The company said positive results could support a potential accelerated-approval application in the U.S. Earlier AMPLIFIED data showed reductions in albuminuria and proteinuria in patients with modest proteinuria, including a cohort with type 2 diabetes, though confidence intervals in the diabetic cohort included no effect.

Other planned milestones include data from a Phase 2 povetacicept study in generalized myasthenia gravis in the first half of 2027 and results from the VX-407 Phase 2 study in autosomal dominant polycystic kidney disease during 2027.

Vertex is also advancing VX-017 as its lead islet-cell therapy for type 1 diabetes. Enrollment and dosing are underway in a Phase 1/2 study that accepts patients of all blood types, expanding the company’s estimated target population to about 120,000 from roughly 60,000. Vertex is targeting the start of pivotal development in 2027.

The company cautioned that regulatory decisions and clinical readouts may not occur on expected timelines, trial data may not support registration or further development, and eligible patient populations could be smaller than anticipated. Commercial launches and product uptake may also fall short of expectations, while the company may not realize the anticipated benefits of acquisitions, including Crinetics.