BridgeBio's Attruby Launch Challenges Pfizer's Dominance in ATTR-CM Market

BridgeBio Pharma's recent launch of Attruby (acoramidis) for the treatment of transthyretin amyloid cardiomyopathy (ATTR-CM) has shown promising early results, potentially disrupting Pfizer's stronghold in the market. The pharmaceutical industry is closely watching this development, as it could reshape the landscape for ATTR-CM treatments and impact the projected $15-20 billion annual market.

Impressive Early Prescription Numbers

BridgeBio reported that as of February 17, 2025, 1,028 unique prescriptions for Attruby have been written by 516 different healthcare professionals in the United States. This figure represents a significant increase from the 430 prescriptions by 248 unique prescribers reported at the J.P. Morgan Healthcare Conference on January 13. The rapid uptake has exceeded investor expectations, with Evercore ISI analysts noting that the launch is "off to a great start."

Matt Outten, BridgeBio's chief commercial officer, expressed encouragement about the launch, stating that prescriptions are "being successfully filled across all patient types." The company's stock price has responded positively to these developments, climbing more than 30% since the beginning of the year.

Market Dynamics and Competition

Attruby's entry into the market poses a direct challenge to Pfizer's tafamidis (sold as Vyndaqel and Vyndamax), which generated $5.4 billion in sales in 2024. BridgeBio CEO Neil Kumar has claimed that Attruby will be the "obvious" choice for patients who either don't respond to tafamidis or experience disease progression after treatment.

The ATTR-CM market is expected to grow substantially over the next decade, with analysts projecting annual sales of $15-20 billion. This growth potential has attracted other competitors, including Alnylam Pharmaceuticals, which has a different type of therapy, vutrisiran, under review in the U.S. with a decision date set for March 23, 2025.

Financial Implications and Future Outlook

While BridgeBio recorded only $2.9 million in net product revenue for Attruby through the end of 2024, analysts expect 2025 sales to significantly exceed the current consensus estimate of $86 million. The company finished 2024 with $681 million in cash, up from $393 million the previous year, despite increased operating expenses related to the Attruby launch.

BridgeBio's European approval for Attruby (marketed as Beyonttra) earlier this month triggered a $75 million milestone payment from commercial partner Bayer. The company is set to receive royalties exceeding 30% on European sales.

As BridgeBio continues to establish itself in the ATTR-CM market, the pharmaceutical industry will be watching closely to see how Attruby's launch translates into market share and financial performance in the coming months.