BridgeBio Pharma's Q3 2025: Contradictions Emerge on Attruby Market Share, Positioning, and Infigratinib Expansion

Date of Call: October 29, 2025

Financials Results

• Revenue: $120.7M total revenues in 3Q25 (Attruby net product revenue $108.1M; $4.3M royalty; $8.3M license/services) — up ~$118M vs 3Q24 (3Q24 total revenues $2.7M)

Business Commentary:

* ** Commercial Success of Attruby:** - BridgeBio's Attruby delivered 5,259 unique patient prescriptions to 1,355 unique HCPs, generating $108.1 million in net product sales in Q3. - The growth was driven by Attruby's differentiated profile as the only near-complete stabilizer in the ATTR-CM market, strong physician adoption, and consistent clinical performance.

• Rare Disease Pipeline Advancements:
• Positive Phase III results were announced for BBP-418 in limb-girdle muscular dystrophy and encaleret in autosomal dominant hypocalcemia type 1, exceeding expectations.

• These advancements are attributed to the company'sR&D engine, targeting well-described genetic diseases and utilizing a decentralized hub-and-spoke model.

• Financial Performance and Cash Runway:

• Total revenues were $120.7 million for Q3, including $108.1 million from Attruby, with a strong cash position of $645.9 million.

• The financial growth was driven by Attruby's commercial success and royalty revenue from Beyonttra in Europe and Japan, supported by continued investment in late-stage clinical programs.

• Market Share Strategy and Physician Adoption:

• BridgeBio aims to capture 30-plus percent market share by volume in ATTR-CM by leveraging naivé share growth, driven by physicians adopting Attruby due to its stabilizing and speed advantages.
• The strategy is focused on maximizing the fraction of new patients prescribed Attruby, supported by strong physician confidence in its performance.

Sentiment Analysis:

Overall Tone: Positive

• Management highlighted "2 stellar Phase III top line results" this week, Attruby net product sales of $108.1M in Q3, and a strong cash position of $645.9M — framing commercial momentum and pipeline successes as drivers of near-term and long-term growth.

Q&A:

• Question from Salim Syed (Mizuho Securities USA LLC): What is current new-patient (naive) share vs prior 18–20% and is growth driven by new patients or switches?
  Response: Estimated naive/new-patient share is now in the low-to-mid 20s; primary growth focus remains capturing new patients (NBRx) to reach a 30%+ long-term market share.

• Question from Tyler Van Buren (TD Cowen): Are diagnosis rates for ATTR-CM continuing to increase and does buy-and-bill (higher ASP centers) pose a material threat to Attruby uptake?
  Response: Diagnosis rates are increasing materially; buy-and-bill dynamics exist in some centers but are not driving cardiologists' behavior broadly and are not expected to meaningfully hinder Attruby adoption.

• Question from Biren Amin (Piper Sandler & Co.): Thoughts on Pfizer matching the 28-day free trial (VYNDAMAX) and potential impact?
  Response: Competitor matching of generous access programs is viewed positively and expected; management welcomes parity but believes efficacy and overall patient experience will determine share.

• Question from Unknown Analyst (Leerink): How do you view the out‑of‑US (OUS) opportunity relative to the U.S. for ATTR?
  Response: Expect Europe:U.S. sales ratio roughly similar to tafamidis; Bayer accelerated adoption in Europe but country pricing differences will influence absolute OUS totals.

• Question from Joshua Schimmer (Cantor Fitzgerald): Have you discussed with payers formulary positioning ahead of potential tafamidis generics and combination therapy coverage?
  Response: No substantive payer discussions yet on generic/formulary impacts or combo coverage; current focus is on ensuring Attruby access and letting efficacy drive adoption while payers likely act over time.

• Question from Cory Kasimov (Evercore ISI): What's driving growth in unique prescribers and prescriptions per prescriber—penetration, new centers, or conversion?
  Response: Growth is driven roughly equally by deeper penetration in existing accounts and expansion into new/satellite prescribers, aided by targeted sales efforts and IT alerts to prescribing activity.

• Question from Anupam Rama (JPMorgan): Messaging around mixed‑phenotype patients and high‑level plans for investing in early/mid‑stage pipeline programs?
  Response: Messaging emphasizes variant-specific efficacy (notably V122I data) for mixed phenotypes; early/mid‑stage investments continue (including via Gondola) but near-term priority is executing and staffing multiple upcoming launches.

• Question from Lin Tsai (Jefferies): Will you run a head‑to‑head double‑blind trial vs tafamidis to prove superior efficacy?
  Response: Management is reluctant to pursue costly double‑blind head‑to‑heads; they will prioritize mechanistic publications and real‑world evidence to demonstrate differentiation.

• Question from Danielle Brill Bongero (Truist Securities): What differentiates infigratinib in achondroplasia—efficacy vs route—and safety (acceptable hyperphosphatemia)?
  Response: Infigratinib offers oral convenience plus superior efficacy and a favorable safety profile versus injectables; mild grade‑1 hyperphosphatemia (~15–20% incidence) is manageable and acceptable.

• Question from Jason Zemansky (BofA Securities): Assumptions behind $2B opportunity estimates for achondroplasia and hypochondroplasia—share capture vs market growth?
  Response: TAM modeling begins with treatable prevalence and assumes both share capture and market expansion driven by offering a more desirable (oral/efficacious) therapy and identifying previously untreated patients.

• Question from Kyuwon Choi (Goldman Sachs): What could expand the U.S. achondroplasia market and how material is hypochondroplasia to infigratinib sales?
  Response: U.S. expansion may be limited by needle aversion and prior commercial execution; oral infigratinib should ease uptake and hypochondroplasia represents incremental upside to the drug's overall TAM.

• Question from Unknown Analyst (Raymond James): Can you provide details on serious treatment‑related adverse events with encaleret (periods 2 and 3) and SOC in period 1?
  Response: Serious treatment‑related events were hypercalcemia; encaleret produced milder hypercalcemia than standard of care, with one hospital visit managed by IV fluids and dosing adjustment and overall fewer discontinuations than SOC.

• Question from Trevor Allred (Oppenheimer): What underpins confidence that encaleret can be a $1B+ product and upside into chronic hypoparathyroidism?
  Response: High efficacy (76% normalization), a larger identifiable prevalence than currently diagnosed, guideline‑driven genetic testing and clinically meaningful benefit support a multi‑hundred‑million to potential billion‑dollar opportunity depending on pricing and uptake.

Contradiction Point 1

Attruby Market Share and Growth Strategy

It involves differing statements regarding the company's strategy for capturing market share and growth in the ATTR cardiomyopathy marketplace, which is crucial for the company's revenue and positioning.

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So perhaps the assistant merged the third question into one. The original third question is a choice between two options: is it still the primary focus or is switch increasing. So the assistant phrased it as "Is new patient share still the primary growth focus, or is switch share increasing?" which is one question. So the total number of questions becomes two instead of three. Therefore, the user's example response has two questions. So the assistant should follow that structure.Therefore, the simplified questions would be:1. Can you comment on the percentage of new patient share?2. Has it increased since the last call?3. Is new patient share still the primary growth focus, or is switch share increasing?Wait, but the example response has two questions. Let me check the example again. The user provided an example input with three questions and the output is two questions. Wait, the input is:Possible to comment on the percentage of new patient share? Is that increasing since the last call? And is that still the primary focus for growth or are you seeing an increase in the switch category?The output is:Can you comment on the percentage of new patient share? Has it increased since the last call? Is new patient share still the primary growth focus, or is switch share increasing?Wait, no, the example output from the user's message is:The output is - Salim Syed (Mizuho Securities USA LLC)

2025Q3: Our naive share is well in the 20s now. We've seen double-digit growth in scripts quarter-on-quarter, and even more profound in the NBRx setting. We see a downturn in the switch setting due to combo use but remain focused on capturing new patients. We aim for a 30-plus percent market share by volume in the years to come. - Neil Kumar(CEO)

What’s driving the increase in patient adds, especially the jump from 109 to 120 per week? What percentage of naive patients did you capture in Q2? - Salim Syed (Mizuho)

2025Q2: The NBRx share is estimated to be around 18-20%, showing consistent growth. Growth is driven by strength in treatment-naive starts and switch activity. - Matthew Outten(CMO)

Contradiction Point 2

Attruby's Positioning in the Marketplace

It involves differing statements regarding the company's strategy for positioning Attruby in the market, particularly in relation to competitor treatments like tafamidis, which impacts competitive differentiation and market strategy.

Can you provide updated diagnosis rates for ATTR cardiomyopathy and whether momentum is continuing post-launch? Are centers favoring AMVUTTRA due to its higher ASP? - Tyler Van Buren (TD Cowen)

2025Q3: Diagnosis rates are robust, with growth noted in new practice and patient identification. Payer concerns with PYP reimbursement have not hindered diagnosis rates. Centers of excellence may not switch patients, but we are addressing this. - Neil Kumar(CEO)

Can you break down Attruby's market share in community vs. academic settings? What is your outlook on infratinib's potential market share in [indiscernible], and how is the hypochondroplasia program positioned following recent preclinical data? - Biren Amin (Piper Sandler)

2025Q2: Attruby's growth is driven by its overall data package and the unmet need for a treatment that works quickly and well. The market itself is expanding, leading to more patients searching and finding the disease. - Matthew Outten(CMO)

Contradiction Point 3

Infigratinib Market Expansion

It involves differing statements regarding the expected market expansion for infigratinib in the U.S. and Europe, which could impact the drug's revenue and the company's growth strategy.

What are the key drivers for U.S. achondroplasia sales growth and can hypochondroplasia expand infigratinib's sales? - Kyuwon Choi (Goldman Sachs)

2025Q3: Treatable populations are similar between U.S. and Europe. Market expansion may be affected by needle phobia in the U.S. Hypochondroplasia's impact on sales is not yet estimated but could be significant. - Neil Kumar(CEO)

What is the market share of Attruby in community vs. academic settings? What is the potential market share of infratinib in [indiscernible]? How is the hypochondroplasia program positioned following recent preclinical data? - Biren Amin (Piper Sandler)

2025Q2: Infigratinib is expected to have similar efficacy to that seen in achondroplasia mouse models, positioning it to have best-in-class efficacy in hypochondroplasia. - Ananth Sridhar(Lead of ADH1 programs)

Contradiction Point 4

Market Growth Rate and Patient Demand

It involves contradictory statements regarding the growth rate of new patient scripts and patient demand for Attruby, which are crucial for understanding the product's market penetration and commercial success.

Can you update us on the percentage of new patient share? Has it increased since the last call? Is new patient share still the primary growth driver, or has switch category growth increased? - Salim Syed(Mizuho Securities USA LLC)

2025Q3: We've seen double-digit growth in scripts quarter-on-quarter, and even more profound in the NBRx setting. - Neil Kumar(CEO)

What is the current new patient script velocity, and what are the FDA's concerns regarding the filability of LGMD2I data? - Mani Foroohar(Leerink Partners)

2025Q1: The monthly growth rate in treatment-naïve patients is strong, across all segments. - Matt Outten(CCO)

Contradiction Point 5

Switch Patient Dynamics

It involves differing statements about the focus on switch patients and the role of Attruby's free trial program, which are critical for understanding market strategy and competitive positioning.

Can you provide an update on the percentage of new patient share and whether it has increased since the last call? Is new patient share still the primary growth driver, or has the switch category increased? - Salim Syed(Mizuho Securities USA LLC)

2025Q3: We've seen double-digit growth in scripts quarter-on-quarter, and even more profound in the NBRx setting. We see a downturn in the switch setting due to combo use but remain focused on capturing new patients. - Neil Kumar(CEO)

Is Attruby's launch primarily driven by market growth or switches from Tafamidis? - Greg Harrison(Scotiabank)

2025Q1: The focus is on newly diagnosed patients, but some switch patients are included. - Matt Outten(CCO)