ALNY Stock Hits Fresh 52-Week Low On Medicare Access Worries And Pipeline Delays

• CEO Yvonne Greenstreet noted the company is “not yet satisfied with the underlying demand growth” despite expanded sales force efforts.
• CFO Jeff Poulton also flagged potential fourth-quarter ordering volatility as hospitals await a final Centers for Medicare & Medicaid Services (CMS) rule on drug reimbursements. 
• Alnylam also said that its mid-stage data for ALN-6400 in hereditary hemorrhagic telangiectasia and early-stage data for ALN-2232 in obesity are now expected in February.

Shares of Alnylam Pharmaceuticals (ALNY) fell roughly 26% on Thursday after the company signaled slower-than-expected demand growth for its flagship AMVUTTRA therapy, pushed back certain trial results, and highlighted near-term pressures from Medicare Advantage restrictions and proposed drug reimbursement changes.

The stock hit a fresh 52-week low of $172.31 during the session and is on track for its worst day since late July, if the losses hold.

ALNY Flags Concerns

Third-quarter net product revenues rose 52% to about $1.3 billion, driven by total transthyretin (TTR)  franchise sales of $1.15 billion. Yet management said it now expects full-year TTR product sales to land at the low end of its $4.2 billion to $4.5 billion range.

CEO Yvonne Greenstreet noted the company is “not yet satisfied with the underlying demand growth” despite expanded sales force efforts. Chief Commercialization Officer Tolga Tanguler added that increased physician engagement “has not yet translated into increased demand growth,” citing the time needed to shift entrenched prescribing habits among newer community physicians.

On access, Tanguler highlighted a more restrictive first-line AMVUTTRA policy implemented by UnitedHealth in its Medicare Advantage business effective October 1. While existing patients are unaffected and an exception process exists, the change “could create some delays for new patients,” he said.

CFO Jeff Poulton also flagged potential fourth-quarter ordering volatility as hospitals await a final Centers for Medicare & Medicaid Services (CMS) rule on drug reimbursements, which, if finalized as proposed, would substantially cut Medicare payments for drugs acquired through the program, such as Alnylam’s Amvuttra, starting in 2027. The company said it will not issue 2027 product revenue guidance at the January JPMorgan conference and will wait until its fourth-quarter results in mid-February.

Alnylam also said that its mid-stage data for ALN-6400 in hereditary hemorrhagic telangiectasia and early-stage data for ALN-2232 in obesity are now expected in February with fourth-quarter results, a modest delay from prior guidance of the second half of 2026.

Wall Street Weighs In On ALNY

H.C. Wainwright analyst Patrick Trucchio attributed the stock’s selloff to discussion of Medicare Advantage step-therapy restrictions and potential disruption from changes to drug reimbursement rules. However, the firm views the selloff as an overreaction and reiterated a ‘Buy’ rating with a $455 price target. It sees the main risk as slower new starts rather than switching of existing patients, and added that it would not equate provider payment changes to an equivalent cut in Alnylam’s realized selling price.

Stifel downgraded the stock to ‘Hold’ from ‘Buy’ and cut its target to $225 from $318, warning that near-term Amvuttra estimates are likely to come down “probably significantly” and that it is “hard to see a path for the stock with it not being a beat-and-raise story.” Jefferies noted the “slight push” to pipeline catalysts on bleeding and obesity programs and maintains a Hold rating.

How Did ALNY Retail Traders React?

On Stocktwits, retail sentiment around ALNY stock rose from ‘bearish’ to ‘neutral’ territory over the past 24 hours while message volume jumped from ‘normal’ to ‘high’ levels.

A Stocktwits user noted that the stock is now back to 2023 valuations.

ALNY stock has dropped 57% year-to-date. 

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