Bristol-Myers Squibb Co Earnings - Q4 2025 Analysis & Highlights
Bristol-Myers Squibb reported strong Q4 2025 execution with robust Growth Portfolio momentum, announced a data-rich 2026 pipeline with multiple Phase 3 readouts expected, provided 2026 revenue guidance of $46-$47.5 billion, and outlined strategic priorities including cost optimization, business development, and pipeline advancement across oncology, cardiovascular, immunology, and neuroscience.
Key Financial Results
Total Q4 2025 revenue was approximately $12.5 billion, flat year-over-year.
Growth Portfolio revenue increased 15% to $7.4 billion in Q4 and represented close to 60% of total revenue in the quarter.
Full-year 2025 Growth Portfolio revenue grew 17% for the full year.
Gross margin declined 210 basis points in Q4 to 71.9%, driven primarily by product mix, notably Eliquis and Revlimid.
Full-year diluted earnings per share came in at $6.15, which includes a net charge related to in-process R&D and licensing income totaling $1.40 per share for the full year.
Q4 diluted earnings per share were $1.26, including a net charge of $0.60 per share in the quarter.
Operating expenses for the full year were $16.6 billion, a decrease of $1.2 billion from 2024.
Cash flow from operations in Q4 was approximately $2 billion.
Business Segment Results
Opdivo delivered solid growth with Q4 revenue up 7% to nearly $2.7 billion, driven by new indications and continued share growth within first-line non-small cell lung cancer.
Opdualag delivered another quarter of strong double-digit growth, driven by demand in the US where it remains a standard of care in first-line melanoma.
Reblozyl delivered 21% growth, with performance reflecting solid uptake across first and second-line MDS-associated anemia patients.
Breyanzi showed impressive growth with Q4 revenue up 47%, driven by its desirable profile and continued strong demand across its approved indications.
Eliquis delivered nearly $3.5 billion in Q4 revenue, an increase of 6%, driven by demand growth and market share gains, with US revenue increasing 4%.
Camzyos revenue in Q4 grew 57% to $353 million, benefiting from continued demand growth globally.
Sotyktu global revenue grew 3%.
Cobenfy revenue in Q4 was $51 million, with continued steady uptake among prescribers and patients.
Qvantig launch continued to progress well with Q4 revenue of $133 million.
Breyanzi received FDA approval in December as the first and only CAR T cell therapy for adults with relapsed or refractory marginal zone lymphoma, now approved across five cancer types.
Capital Allocation
The company completed its targeted $10 billion of debt paydown ahead of schedule.
Cash equivalents and marketable securities totaled approximately $11 billion as of December 31, 2025.
Business development remains a top priority, with the company continuing to pursue high return business development opportunities.
The company maintains a commitment to returning cash to shareholders through its dividend.
The company is investing in growth initiatives including partnerships on pumitamig and the Orbital Therapeutics program.
Industry Trends and Dynamics
The pharmaceutical industry is experiencing significant innovation in oncology, particularly in CAR T cell therapies and bispecific antibodies.
Pulmonary fibrosis remains an aggressive disease with urgent need for new treatment options.
Triple-negative breast cancer remains an aggressive disease where there is an urgent need for new treatment options.
Atrial fibrillation is a very large market with approximately 40% of patients remaining either untreated or undertreated, leaving them at risk for stroke.
Idiopathic pulmonary fibrosis and progressive pulmonary fibrosis have less than 50% five-year overall survival rates, indicating significant need for newer therapies.
Approximately 70% to 80% of multiple myeloma patients are treated in the community setting.
Competitive Landscape
In metastatic melanoma, Bristol-Myers Squibb has over 65% market share when considering the totality of BMS market share, with Opdualag approaching 30% market share.
Eliquis maintains approximately 75% NRx share in the US.
Cobenfy's uptake has surpassed all schizophrenia comparators and relevant analogs in the first year of launch.
The company faces competition from other M4 agonists, M4 positive allosteric modulators, and other M1/M4 inhibitors emerging in the market.
In the multiple myeloma space, the competitive landscape is increasingly complicated with recent data from bispecifics.
Competitor Bayer is running the STROKE study for a Factor XI inhibitor, with results expected to be announced.
Macroeconomic Environment
The company noted broader pricing dynamics for Eliquis starting in 2026, which prompted a reevaluation of pricing strategy.
The Inflation Reduction Act (IRA) price was effectuated January 1, including the removal of Medicare Part D liability in both the initiation and catastrophic phases.
The company finalized a $0 Medicaid agreement with the administration.
A roughly 40% WAC reduction for Eliquis eliminates inflationary penalties or CPI penalties of statutory rebates that had been accumulating over many years.
Growth Opportunities and Strategies
The company is advancing a multi-year plan to rewire Bristol-Myers Squibb for long-term growth.
The company expects to introduce more than 10 new medicines and over 30 meaningful launch opportunities by 2030.
Opdualag, Breyanzi, and Camzyos each contributed over $1 billion in sales for the full year, while Reblozyl delivered over $2 billion.
The company expects to report top line registrational data for six potential new products in 2026: milvexian in atrial fibrillation and secondary stroke prevention, admilparant in idiopathic pulmonary fibrosis, iberdomide in multiple myeloma, mezigdomide and Arlo-cel in relapsed or refractory multiple myeloma, and RYZ101 in second-line-plus GEP-NETs.
The company anticipates meaningful pivotal line extension readouts for Sotyktu in lupus and Cobenfy in Alzheimer's disease psychosis.
The company is pursuing opportunities to build breadth and depth in existing therapeutic areas rather than entering new therapeutic areas like metabolic obesity.
Milvexian has the potential to be the only Factor XI oral therapy in atrial fibrillation, which is a big opportunity.
Admilparant is a potential first-in-class LPA1 product that could redefine the standard of care in pulmonary fibrosis, offering improved efficacy and tolerability profile.
Pumitamig, developed with BioNTech, showed encouraging anti-tumor response and a manageable safety profile in both first and second-line treatment settings for triple-negative breast cancer.
The company has eight registrational studies for pumitamig expected to be underway by year-end, with three additional planned studies recently announced.
Zola-cel, the company's CD19 CAR T, is initiating in patients with active systemic sclerosis in the global Phase 3 study Breakfree-SSc.
Navlimetostat, a potential first-in-class PRMT5 inhibitor, will present first oral data in combination in the pancreatic setting at the ESMO Targeted Anticancer Therapies Conference.
The company delivered on a $2 billion strategic productivity initiative, achieving approximately $1 billion in savings in 2025 and is on track to realize the remaining billion dollars over 2026 and 2027.
The company is expanding the use of AI to help move faster, operate leaner, and reinvest strategically in growth.
Cobenfy has significant lifecycle management programs with studies ongoing in Alzheimer's disease, Alzheimer's disease psychosis, Alzheimer's disease cognition, agitation coupled with bipolar disorder.
Reblozyl continues to drive demand across first-line RS-positive and first-line RS-negative patients, with RS-negative providing the greatest opportunity for growth in the United States.
Opdualag is expected to receive an all-comers indication in Europe in Q2, which will drive significant growth internationally.
The company is studying iberdomide and mezi as partners for TCEs and cell therapy in multiple myeloma.
Financial Guidance and Outlook
The company estimates 2026 revenue to be between $46 billion and $47.5 billion.
The company expects gross margin to be between 69% to 70% in 2026.
The company expects total operating expenses to decline from 2025 levels to approximately $16.3 billion in 2026.
The company expects OI&E expense of approximately $700 million in 2026, which reflects the expiry of the royalty-bearing license of diabetes products at the end of 2025.
The company expects to maintain a tax rate of approximately 18% in 2026.
The company expects to deliver non-GAAP earnings per share in the range of $6.05 to $6.35 in 2026.
The company expects its typical sequential revenue decrease in Q1 2026 due to seasonal inventory destocking.
The company anticipates that Eliquis second half revenue will trend higher than the first half of 2026.
The company expects 2027 Eliquis sales compared to 2026 to show a step-down in the range of $1.5 billion to $2 billion.
The company projects a revenue decline for the Legacy Portfolio of between 12% and 16% in 2026, given ongoing loss of exclusivity impacts.
The company projects Eliquis growth in 2026 to be in the range of 10% to 15%, driven by continued global demand growth and the recent price reduction.
The company expects lower operating expenses compared to 2025, due to the ongoing cost savings program.
The company expects to continue to ensure a strategic and balanced approach to capital allocation.
Pipeline and Clinical Development
The company has at least 10 pivotal readouts expected in 2026 across multiple therapeutic areas.
Iberdomide has already demonstrated significant improvement in MRD-negativity rates, with PFS data expected in 2026.
Mezigdomide is an add-on study with mezi on top of Kd versus Kd, with the company confident in the first readout with this second CELMoD.
Arlo-cel is a Phase 2 registrational study with Phase 3 ongoing in myeloma in patients post-BCMA/GPRC5D CAR T.
Admilparant Phase 3 is conducting and enrolling patients very similar to Phase 2, where the company had a very good reduction of the risk of decline of FVC of 60% in IPF and more than 70% in PPF.
Milvexian in stroke has already been the risk, with no reason to believe there will be a different, if not better outcome than competitor data.
The LIBREXIA-atrial fibrillation study has completed enrollment with more than 20,000 patients, well past the point where a competitor study was terminated by the DMC due to lack of efficacy.
The DMC regularly continues to endorse trial progression for milvexian, checking both efficacy and safety.
The company remains blinded to the milvexian AFib study, but the DMC feedback on blinded bleeding rates gives confidence that the company is on target to achieve the benefit hoped.
The ADEPT program is coming by the end of 2026 as guided, with the company on track.
