BP
BridgeBio Pharma, Inc. (BBIO)·Q4 2024 Earnings Summary
Executive Summary
- Q4 2024 revenue was $5.9M, up from $1.7M in Q4 2023, driven by the first U.S. sales of Attruby; GAAP net loss per share was $1.40 vs $0.96 YoY .
- Attruby FDA approval on Nov 22 enabled $2.9M of net product revenue in Q4; EU approval on Feb 10 triggered a $75M milestone and tiered royalties beginning in the low-thirties percent, supporting near‑term cash inflows .
- Year-end cash, cash equivalents, and short-term restricted cash were $681M; management expects $105M in regulatory milestone receipts in 1H 2025 (Europe, Japan) .
- Consensus EPS and revenue estimates for Q4 were unavailable at time of query due to S&P Global API limits; no estimate comparisons are included (S&P Global data not retrieved).
What Went Well and What Went Wrong
What Went Well
- U.S. and EU approvals and early commercial traction: “As of February 17, 2025, 1,028 unique patient prescriptions for Attruby have been written by 516 unique prescribers since FDA approval,” with category‑leading clinical results highlighted by the CCO .
- Strong clinical differentiation: Attruby demonstrated earliest known time to separation (3 months) and substantial reductions in ACM/CVH (42% at 30 months; 46–48% reductions in composite ACM and recurrent CVH in OLE at 36–42 months) .
- Advancing late-stage pipeline: FORTIFY (LGMD2I/R9), CALIBRATE (ADH1), and PROPEL 3 (achondroplasia) are fully enrolled with last participant–last visit expected before end of 2025 .
What Went Wrong
- Elevated operating spend: Q4 operating costs and expenses rose to $231.9M (vs $179.2M YoY), primarily SG&A ramp for Attruby commercialization; quarterly loss from operations widened to $(226.0)M .
- Higher financing burden: Q4 total other expense was $(40.2)M vs $7.1M in Q4 2023, reflecting increased interest expense and equity method losses .
- Continued GAAP net losses: Q4 net loss to common shareholders was $(265.1)M vs $(168.1)M YoY, highlighting the transition-phase economics of launch amid scale-up costs .
Financial Results
Quarterly financials vs prior periods (oldest → newest)
Revenue breakdown (Q4 2024)
KPIs
Guidance Changes
Earnings Call Themes & Trends
Management Commentary
- CEO perspective on market resonance and access: “It is exciting to see patients, physicians, and payers resonate with our message that the greater levels of TTR stabilization that Attruby delivers can be of benefit… and that the TTR protein is clinically important, not toxic.” — Neil Kumar, Ph.D., Founder & CEO .
- CCO on clinical differentiation and launch traction: “Attruby's category-leading results - time to separation of just three months, along with a 42% reduction in all-cause mortality and recurrent hospitalizations and a 50% reduction in cardiovascular hospitalizations at 30 months - set it apart…” — Matt Outten, CCO .
- CFO on Q3 pre-launch readiness: “We are prepared to launch acoramidis in the U.S., upon approval by the FDA, at the end of 2024 as well as to read out our three ongoing Phase 3 studies in 2025.” — Brian Stephenson, Ph.D., CFA .
Q&A Highlights
- Launch breadth and prescriber mix: Early scripts were broadly distributed beyond centers of excellence, reflecting activation across heart failure practices (10k+ HFpEF practices), with 430 scripts and 250+ prescribers within weeks post-approval (updated metrics later exceeded in Feb) .
- Go-to-market message: Emphasis on 3-month separation and 42% composite reduction resonating with clinicians; aim for parity access to ensure a clinical sale vs price-driven dynamics .
- Market access cadence: Achieved ~77% parity coverage early, aided by hospitalization reductions that matter to payers; expectation to continue gaining parity across plans .
- Timeline for investor communications: Management expects first formal earnings calls starting April/May 2025, with metrics on patients, prescribers, and payers to gauge launch health .
Note: A formal Q4 2024 earnings call transcript was not available; management’s January 13, 2025 JPM presentation and Q&A are used as the closest primary source .
Estimates Context
- S&P Global consensus estimates for Q4 2024 EPS and revenue were unavailable at time of query due to API daily limit; press release and 8‑K did not disclose Street comparisons. Values retrieved from S&P Global were not available; thus, no beat/miss analysis vs consensus is included.
- Given launch-phase dynamics and absence of numerical guidance, we expect Street models to emphasize Attruby uptake (scripts, prescribers), payer parity progress, and EU/Japan milestone timing (including $105M in 1H 2025) .
Key Takeaways for Investors
- Launch traction and clinical differentiation are the near-term stock drivers: early script and prescriber breadth plus clear outcome benefits (3-month separation; 42–50% reductions) should support adoption and payer parity .
- Cash runway strengthened by milestones and royalties: YE cash $681M with $75M EU milestone received and $105M regulatory milestones expected in 1H 2025; royalty tier begins in low‑thirties percent, de‑risking near‑term liquidity .
- Operating leverage to watch: SG&A ramp was substantial in Q4 to support launch; monitor cost discipline vs revenue scale-up and any nonrecurring items (e.g., deal-related costs cited for FY) .
- Pipeline optionality in 2025: Three fully enrolled Phase 3 programs (LGMD2I/R9, ADH1, achondroplasia) with LPLV expected before end of 2025 provide multiple catalysts beyond Attruby .
- Market access parity is key: Management targets clinical sale and parity access rather than pricing battles; hospitalization reductions bolster payer rationale, smoothing reimbursement path .
- Near-term communications: Expect first earnings calls in April/May 2025 with more detailed launch KPIs (patients, prescribers, payer metrics), providing clearer visibility into revenue trajectory .
- EU approval achieved; Japan next: EU commercialization (via Bayer) and Japan approval in 1H 2025 are incremental geographic growth and cash flow catalysts .
Appendix: Additional Press Releases Relevant to Q4
- FDA approval of Attruby (Nov 22, 2024): first and only near-complete TTR stabilizer with label specifying ≥90% stabilization; clinical outcomes detailed; patient access programs launched .
- OLE outcomes (Nov 18, 2024): sustained benefit with 36% ACM reduction at Month 36 and 46–48% composite ACM/CVH reductions at Months 36–42; published in Circulation .
- CHMP positive opinion (Dec 13, 2024): EU recommendation ahead of EC approval; benefits consistent with ATTRibute-CM .
- Q3 financials and business update (Nov 12, 2024): pre-launch readiness, TRACE‑AI collaboration, and financial trends .