AstraZeneca PLC Earnings - Q4 2025 Analysis & Highlights
AstraZeneca reported strong financial performance in 2025 with robust pipeline momentum, significant revenue growth across all business segments, and ambitious guidance for 2026 despite anticipated patent expirations and pricing pressures in key markets. The company is advancing multiple transformational technologies including ADCs, cell therapy, and weight management solutions to support growth through 2030 and beyond.
Key Financial Results
Total revenue increased 8% in 2025, with product revenue growing 10% driven by continued global demand for innovative medicines.
Core earnings per share (EPS) grew 11% in 2025, in line with full year guidance.
The company had 16 blockbuster medicines in 2025, with 17 medicines growing at double digits.
Core gross margin landed at 82% in 2025, in line with expectations set out at the start of the year.
Operating profit increased by 9%, with operating leverage continuing to be a key focus.
Strong cash flow from operating activities increased by 23% to $14.6 billion in 2025.
Capital expenditures increased by $1.1 billion to $3.3 billion, in line with expectations.
Total deal payments in 2025 amounted to $4.2 billion, of which around $3 billion were payments relating to past deals.
Business Segment Results
Oncology delivered total revenues of $25.6 billion, an increase of 14% on the prior year or 17% excluding the 2024 Lynparza sales milestone.
Tagrisso achieved over $7 billion in full year revenues, Imfinzi over $6 billion, Calquence over $3.5 billion, and Enhertu over $2.5 billion in AstraZeneca revenues.
BioPharmaceuticals medicines delivered total revenue up 5% to $23 billion, with growth medicines substantially outpacing the impact of generic entry.
Respiratory & Immunology (R&I) revenues were up 10% in the fourth quarter, with revenue from growth medicines having increased by 27%.
Cardiovascular, Renal & Metabolic (CVRM) revenues were 6% down on the prior year, with generic competition slowing Farxiga's growth to 2%.
Rare Disease delivered total revenue of $9.1 billion in 2025, up 4% over the prior year, driven by growth in neurology indications and continued global expansion.
Ultomiris grew 15% in the quarter, driven by patient demand across indications including the competitive gMG and PNH markets.
Growth across Oncology and R&I was 17% and 12%, respectively, while CVRM was impacted by patent expiry of Brilinta and Farxiga in the UK.
Emerging markets outside of China grew 22%, while China grew 4% despite losing Pulmicort to generics.
Europe grew 7% and the US grew 10%.
Capital Allocation
A second interim dividend of $2.17 per share was confirmed, resulting in a full year 2025 declared dividend of $3.20 per share.
In 2026, the company intends to increase the annual declared dividend to $3.30 per share, in line with the progressive dividend policy.
The company currently has interest-bearing debt of close to $30 billion, which is a level they are comfortable with.
Net debt to EBITDA ratio currently sits at 1.2 times.
CapEx investment is anticipated to increase by approximately one-third versus 2025 in 2026, as the company expands capacity to support future growth.
This includes recently announced US and China investments and previously announced investments in the ADC facility in Singapore, all of which are multiyear projects.
In 2026, success-based milestones and sales payments relating to past deals are anticipated to total around $2.5 billion.
Industry Trends and Dynamics
The company secured 43 approvals for medicines across major regions in the last 12 months, helping sustain growth into 2026.
Biologic medicines continue to gain share among severe asthma patients, with AstraZeneca medicines now making up more than half of the new-to-brand prescriptions for the severe asthma biologic segment in several markets.
The company is seeing strong demand for medicines across all regions, with particular momentum in emerging markets outside of China.
There is increasing demand for innovative medicines addressing cardiometabolic diseases, with obesity and related conditions representing a significant unmet medical need.
Competitive Landscape
The company maintains class leadership position in multiple therapeutic areas, including BTK inhibitors with Calquence and IL-5 medicines with Fasenra for severe eosinophilic asthma.
Breztri is the fastest-growing medicine within the expanding fixed-dose triple class treating COPD, with the company being the clear market leader in China and gaining share in most other major markets.
Enhertu is seeing share gains both in HER2-positive and HER2-low metastatic breast cancer across all regions.
The company has a differentiated portfolio with diversification across products and geographies, which provides resilience to regional disruptions and reduces concentration risk.
In the US, the company now believes Truqap is at peak with further incremental growth to be driven by other markets.
The company is the largest pharma company in China despite losing Pulmicort to generics.
Macroeconomic Environment
The company faces known headwinds in 2026, including Value-Based Procurement (VBP) in China this quarter for Farxiga, Lynparza, and roxadustat.
Farxiga will face loss of exclusivity in the US in April 2026, with US Farxiga generating $1.7 billion or 21% of global revenues in 2025.
In Europe, patent protections for Farxiga across EU markets extend to 2028.
The company anticipates a low-single-digit positive FX impact on total revenue and neutral impact on core EPS based on January average exchange rates.
Growth Opportunities and Strategies
The company has the potential to reach 25 blockbuster medicines by 2030, up from 12 blockbusters at the time of the $80 billion revenue target announcement in May 2024.
The company had 16 positive Phase III trial readouts in 2025, with a combined peak year sales potential of $10 billion.
The company now has more than 100 Phase III trials ongoing, with 20 Phase III readouts expected in 2026 that should collectively drive more than $10 billion of peak revenue.
The pipeline in 2027 should deliver a similar number of Phase III readouts, actually slightly higher than 2026.
Five prioritized technologies for investment include: weight management and cardiovascular risk factors, ADCs and radioconjugates, next-generation IO bispecifics, cell therapy and T-cell engagers, and gene therapy programs.
The company has two products in Phase III for weight management and cardiovascular risk factors, including an oral PCSK9 with data expected in 2027 and an oral GLP-1 moved into Phase III.
The company announced a partnership with CSPC to develop long-acting weight management injectables, moving from weekly to monthly dosing.
The company now has eight ADCs from its own pipeline, with three in Phase III, and will get data in the first half of 2026 for sone-ve.
Cell therapy programs include AZD0120 entering Phase III this year with encouraging Phase I data, and surovatamig also moving into Phase III.
The company is working on multiple approaches to CAR-T, including allogeneic projects with some entering the clinic this year, and in-vivo approaches.
Wainua (antisense oligonucleotide) is expected to deliver CARDIO-TTRansform readout in ATTR cardiomyopathy in the second half of 2026, with the trial enrolling more than 1,400 patients.
Tozorakimab, a differentiated IL-33 biologic for COPD, has three Phase III trials (OBERON, TITANIA, MIRANDA) expected to read out in the first half of 2026.
Elecoglipron, an oral GLP-1 receptor agonist, met primary endpoints in both VISTA and SOLSTICE Phase IIb trials and is progressing into Phase III development in 2026.
The company is advancing a selective amylin receptor agonist (AZD6234) as monotherapy and in combination with a dual GLP-1/glucagon receptor agonist (AZD9550), both expected to deliver first Phase II data in 2026.
Datroway (TROP2 ADC) demonstrated a five-month improvement in overall survival versus standard of care chemotherapy in triple-negative breast cancer, with TROPION-Breast02 accepted for FDA priority review.
AVANZAR trial will evaluate Datroway as first-line lung cancer treatment and will be the first trial to validate the QCS TROP2-NMR biomarker.
Camizestrant (next-generation oral SERD) showed transformational SERENA-6 results in first-line hormone receptor-positive disease with emerging ESR1 mutations, with SERENA-4 expected to read out in the second half of 2026.
Imfinzi combinations are expected to deliver data in 2026 for multiple indications, including EMERALD-3 in hepatocellular carcinoma and VOLGA in muscle invasive bladder cancer.
Enhertu is expected to expand into three new settings in 2026, including first-line metastatic breast cancer following DESTINY-Breast09 approval and early breast cancer settings.
Calquence expects the imminent US launch of the AMPLIFY finite therapy regimen to be an important driver of growth.
Tagrisso is anticipated to have strong performance in 2026 driven by further adoption of LAURA and ADAURA in early disease and sustained leadership in first-line metastatic disease.
Fasenra is expected to continue positive momentum in 2026 with growth in emerging markets accelerating following inclusion in China's National Reimbursement Drug List.
Tezspire has made rapid market share gains in severe asthma and growth potential has been enhanced by recent approvals for chronic rhinosinusitis with nasal polyps.
Breztri regulatory reviews are underway for asthma based on KALOS and LOGOS trials, with first approvals anticipated in the first half of 2026.
Saphnelo subcutaneous formulation was recently approved in Europe and further approvals are expected in other regions including the United States and Japan in the first half of 2026.
Lokelma is expected to continue strong growth in 2026, driven by market leadership within the growing potassium binder class.
Baxdrostat is being prepared for launch in uncontrolled and treatment-resistant hypertension, with US approval anticipated to broadly coincide with generic dapagliflozin entry, and peak revenues expected to exceed $5 billion.
Dapagliflozin fixed-dose combinations have the potential to unlock new waves of medicines, with three combinations in Phase III development and the first two Phase III trials due to read out in 2027.
Ultomiris is expected to continue growth driven by neurology indications, with peak year sales indicated to be above $5 billion.
Strensiq is expected to continue adoption supported by hypophosphatasia guidelines, with efzimfotase alfa readout anticipated in the first half of 2026.
Koselugo growth is expected to be driven by patient demand and geographic expansion in pediatric patients, in addition to recent approval in adult patients.
Anselamimab demonstrated highly clinically meaningful improvement in all-cause mortality and cardiovascular hospitalization in kappa light chain amyloidosis subgroup, with global regulatory reviews and submissions underway.
The company expanded collaboration with Neurimmune to include NI009, a fibril-depleting antibody for lambda light chain amyloidosis, representing 80% of the light chain population.
Cliramitug, a first collaboration with Neurimmune, is now in Phase III for ATTR cardiomyopathy, with the DepleTTR trial completing enrollment a full year ahead of plan with more than 1,000 patients recruited.
The company plans to initiate a Phase IIb of Wainua with cliramitug, with the combination having the potential to deliver a new standard of care for ATTR cardiomyopathy patients.
The company is investing in AI and multimodal foundation models through a joint venture with Tempus to improve the probability of success in clinical studies and better shape trial designs.
Laroprovstat, an oral PCSK9 inhibitor, is expected to deliver first data in 2027 with potentially $5 billion plus peak revenue potential.
The combination of zibotentan with dapagliflozin has a sales potential between $3 billion and $5 billion.
Tozorakimab is positioned as a potentially high medical need opportunity in COPD with multibillion-dollar potential if the product hits its target product profile.
Financial Guidance and Outlook
Total revenue is anticipated to grow by a mid- to high-single-digit percentage in 2026, driven by strong underlying momentum in the business.
The company anticipates a broadly flat to slightly higher core gross margin in 2026, driven by backing out the royalty buyout and product sales mix.
A core tax rate between 18% and 22% is expected in 2026.
Core EPS growth of low-double-digit percentage at constant exchange rates is anticipated in 2026.
R&D expenses are anticipated to be at the upper end of the low-20s percentage range of total revenue in 2026.
The company continues to target a mid-30s operating margin in 2026, with priority remaining to drive absolute profit growth and long-term value for shareholders.
A step-up in core net finance expense for 2026 is anticipated, driven by higher lease expenses and lower interest income.
The company remains comfortable with its current level of gross debt at close to $30 billion.
The company anticipates very strong financial performance in 2025 to continue in 2026.
The company is entering an unprecedented catalyst-rich period with significant high-value Phase III trials that can read out and support growth to 2
