BioCryst Q1 2026: Orladeyo Revenue Slows to 11% Reported Growth, but Ex-Europe, 21%

What happened

BioCryst reported Q1 2026 ORLADEYO net revenue of $148.3 million, up 11% year-over-year, marking a deceleration from the 37% growth in 2025. Excluding the European business divested in late 2025, comparable growth was 21%, indicating the core U.S. business remains healthy. The Q1 result annualizes to roughly $593 million, below the 2026 guidance range of $625–645 million, but seasonality and timing of shipments may narrow the gap through rest of year. Management did not update guidance with this release, so the market must wait for the Q2 call to assess if the deceleration is temporary or a signal of competitive and payer headwinds. The equity already trades at a high EV/EBITDA multiple that leaves no room for even modest growth disappointments, reinforcing the need for cautious position sizing.

Implication

The Q1 revenue trend does not break the base case, but it narrows the margin of safety. Investors should demand a lower entry or clearer confirmation of accelerating growth later in 2026 before adding to positions. Continue to monitor Q2 trends and any guidance revisions closely.

Thesis delta

The Q1 report confirms Orladeyo is still growing, but at a slower pace than the heroic 37% in 2025. Adjusting for Europe, 21% growth is solid but still a step down. This does not invalidate the WAIT rating, but it shifts the burden of proof toward management to deliver the high end of guidance and demonstrate that growth is not inflecting downward. The thesis now leans more heavily on the latter half of 2026 for acceleration, increasing execution risk.