BridgeBio Pharma Eyes Four Global Launches by 2027 as Attruby Nears Blockbuster Status

BridgeBio Pharma expects 2027 to be a transformative year as it expands from one commercial product to four globally launched therapies, President and CFO Thomas Trimarchi said during a Bernstein discussion. Trimarchi said the company’s strategy centers on developing medicines for genetic diseases with substantial unmet need, particularly where a genetic mechanism can be directly targeted. He also emphasized capital allocation discipline and net present value considerations as elements of BridgeBio’s operating model. “We are here in this world to help as many patients living with genetic disease as we possibly can in the shortest amount of time,” Trimarchi said. Attruby Launch and New Evidence Trimarchi said Attruby, the company’s treatment for ATTR cardiomyopathy, is annualizing at more than $1 billion globally about six quarters after launch. BridgeBio expects the drug to reach global blockbuster status on a full-year basis by the end of the year, he said. The company estimates that 15,000 to 16,000 patients annually are now reaching the “bottom of the funnel” in the ATTR cardiomyopathy market, compared with an estimated 8,000 patients two years earlier. Trimarchi said Attruby has about 25% share of new patient starts and that share is growing. BridgeBio recently released real-world data comparing acoramidis, the active ingredient in Attruby, with tafamidis. According to Trimarchi, the analysis showed a 34% improvement for acoramidis on a composite measure of diuretic intensification, cardiovascular hospitalizations and all-cause mortality. He said the company also published data suggesting a kidney-protective effect, although the mechanism remains under investigation. Julie Miller Everett, chief operating officer of BridgeBio’s Skeletal Dysplasias Business, said emerging evidence across the category has reinforced the company’s confidence in Attruby’s differentiation. BridgeBio continues to project more than $4 billion in peak-year sales for acoramidis. Trimarchi said the company expects quarterly Attruby revenue increases of approximately $25 million to $30 million for the next several quarters, potentially through late 2027. He attributed the near-term pace partly to normalization in switches from tafamidis and to the changing mix between second-line and treatment-naive patients. BridgeBio is also pursuing lifecycle-management efforts including the ACT-EARLY primary-prevention study in certain asymptomatic variant patients, a cardiac imaging study, further research into the renal findings and a once-daily formulation that Trimarchi said could enter the clinic within 12 to 18 months. Rare-Disease Launches Ahead Among the company’s planned launches, BBP-418 is being developed for Limb-Girdle Muscular Dystrophy Type 2I/R9. Trimarchi described the condition as a progressive disease wit...