AstraZeneca Q4 Earnings Call Highlights

AstraZeneca (NASDAQ:AZN) reported full-year and fourth-quarter 2025 results, highlighting revenue growth, expanding “blockbuster” product breadth, and a busy late-stage pipeline as it issued 2026 guidance that incorporates several known headwinds, including pricing pressure in China and a U.S. loss of exclusivity for Farxiga.

2025 results: revenue up, EPS growth, and expanding blockbuster base

Chief Executive Officer Pascal Soriot said 2025 was “a great year,” pointing to 8% total revenue growth and 10% product revenue growth, driven by global demand for the company’s innovative medicines. Core EPS increased 11%. Soriot said AstraZeneca ended 2025 with 16 blockbuster medicines and said the company sees potential to reach 25 blockbusters by 2030, up from 12 when it set its $80 billion 2030 ambition in May 2024.

On pipeline execution, management said AstraZeneca delivered 16 positive phase III readouts in 2025 with a combined peak-year sales potential of $10 billion, and secured 43 approvals across major regions in the past 12 months to support continued growth into 2026.

Regional and segment performance: oncology strength, CVRM headwinds, emerging markets growth

Soriot emphasized the company’s diversification by therapy area and geography, describing it as reducing concentration risk. He said oncology and respiratory & immunology (R&I) grew 17% and 12%, respectively. CVRM grew 2% despite being impacted by the patent expiry of Brilinta and Farxiga in the U.K., with additional pressure expected in 2026. Rare Disease grew 5% despite biosimilar impact on Soliris, with management saying the transition to Ultomiris is close to complete.

Regionally, the company cited 10% growth in the U.S. and 7% growth in Europe. China grew 4% despite losing Pulmicort to generics, and Soriot said AstraZeneca remains the largest pharmaceutical company in China. Emerging markets outside China grew 22%, which Soriot described as an increasingly important contributor.

Margin, cash flow, and capital allocation

Chief Financial Officer Aradhana Sarin said total revenue increased 8% in 2025 and product revenue increased 10%. Alliance revenue rose 38%, reflecting increased profit-sharing contributions from partnered products including Enhertu, Tezspire, and Beyfortus in regions where partners book sales.

On profitability, Sarin said core gross margin was 82%, in line with expectations. Fourth-quarter gross margin reflected seasonality and $235 million of royalty buyouts for Sotyktu and rilvegostomig recorded in cost of sales. Core R&D expense rose 12%, tied to growing investment opportunities and a trial footprint of more than 300 active trials, including 100+ phase III trials. SG&A rose 3% and fell as a percentage of revenue to 26% from 28% in 2024, which management attributed to operating leverage and cost discipline. Operating profit increased 9%.

Operating cash flow increased 23% to $14.6 billion. Capex increased to $3.3 billion and the company expects 2026 capex to rise by roughly one-third versus 2025, reflecting multi-year projects including newly announced U.S. and China investments and an ADC facility in Singapore. Total deal payments in 2025 were $4.2 billion (about $3 billion related to prior deals). For 2026, Sarin said the company anticipates $2.5 billion of success-based milestones and sales payments tied to past deals.

AstraZeneca ended the year with close to $30 billion in interest-bearing debt and a net debt-to-EBITDA ratio of 1.2x, a level management said it is comfortable with. The company confirmed a second interim dividend of $2.17 per share, taking the full-year 2025 declared dividend to $3.20 per share, and said it intends to increase the annual declared dividend to $3.30 per share in 2026.

2026 guidance: growth outlook despite Farxiga and China pricing headwinds

For 2026 (at constant exchange rates), AstraZeneca guided to mid- to high-single-digit total revenue growth and low double-digit core EPS growth. Sarin said guidance reflects known headwinds, including China’s volume-based procurement (VBP) in the first quarter for Farxiga, Lynparza, and Roxadustat and Farxiga loss of exclusivity in the U.S. in April. She noted U.S. Farxiga generated $1.7 billion in 2025, representing 21% of global Farxiga revenue. Europe accounts for 35% of Farxiga revenue and, according to management, patent protection in EU markets extends to 2028.

Sarin also referenced the “MFN deal” as a 2026 headwind, but said its impact is already factored into guidance. For 2026, the company expects a broadly flat to slightly higher core gross margin, with a core tax rate of 18% to 22%. Based on January average exchange rates, management expects a low single-digit positive FX impact on total revenue and a neutral impact on core EPS.

Commercial highlights and pipeline catalysts

Oncology revenue reached $25.6 billion in 2025, up 14%, with executive Dave Fredrickson citing multi-blockbuster performance including Tagrisso (over $7 billion), Imfinzi (over $6 billion), Calquence (over $3.5 billion), and Enhertu (over $2.5 billion in AstraZeneca revenue). In Q4, oncology revenues exceeded $7 billion for the first time, and Fredrickson noted headwinds from a 20% manufacturer’s liability under Medicare Part D reform.

Management outlined multiple 2026 drivers, including additional Imfinzi opportunities (including Potomac and bladder cancer), three anticipated Enhertu setting expansions in breast cancer, and the “imminent” U.S. launch of Calquence’s AMPLIFY finite therapy regimen. Fredrickson said the company views the trend toward finite therapies as meaningful in hematology and described an opportunity to be first in the U.S. with a BTK inhibitor plus BCL2 combination finite CLL approach.

Executives highlighted several clinical catalysts discussed on the call, including:

• Datopotamab deruxtecan: AVANZAR pivotal readout in first-line lung cancer expected in 2026, and TROPION-Lung15 readout in patients progressed on a TKI; FDA priority review acceptance for TROPION-Breast02.
• Camizestrant: SERENA-4 phase III readout expected in the second half of 2026; management said trial design enriches for endocrine-sensitive patients.
• CMG901 (claudin 18.2 ADC): first phase III data in second-line gastric cancer expected in the first half of 2026.
• Wainua (ATTR cardiomyopathy): CARDIO-TTRansform readout expected in the second half of 2026; management emphasized the trial’s size and hard cardiovascular endpoints.
• Tozorakimab (IL-33 biologic in COPD): phase III program expected to read out in the first half of 2026, with a primary endpoint focused on reduction of moderate-to-severe exacerbations in former smokers.

In weight management, the company said its once-daily oral GLP-1 receptor agonist Eccoglipron met primary endpoints in two phase IIb trials (VISTA and SOLSTICE) and will advance into phase III in 2026, with data to be presented at the American Diabetes Association meeting in June.

In China, executive Iskra Reic cited VBP as a near-term headwind but pointed to expected tailwinds from launches and reimbursement, including NRDL listings for Fasenra and Calquence tablets beginning January 1. Reic said profitability in China remains lower than the group average, citing lower prices, but emphasized volume and unmet need.

Separately, Soriot noted an investor relations leadership transition, thanking Andy Barnett and announcing that Joris will take over the IR role.

About AstraZeneca (NASDAQ:AZN)

AstraZeneca is a global, science-led biopharmaceutical company headquartered in Cambridge, England. Formed through the 1999 merger of Sweden’s Astra AB and the UK’s Zeneca Group, the company researches, develops, manufactures and commercializes prescription medicines across a range of therapeutic areas. AstraZeneca’s operations span research and development, large-scale manufacturing, and commercial distribution, with a presence in developed and emerging markets worldwide.

The company focuses on several core therapy areas including oncology, cardiovascular, renal and metabolism (CVRM), respiratory and immunology, and rare diseases.