Oct 29, 2026 earnings call — BRINSUPRI blockbuster launch and raised guidance
Raised full-year guidance after BRINSUPRI reached $400.1 million in Q3, lifting full-year BRINSUPRI outlook to $1.35 billion-$1.4 billion.
Revenue $0.5B (est $0.5B) · EPS $-0.46 (est $-0.38)
Key quotes
"We have determined that this type of commercial outreach usually has a very high return on investment, and we are excited for its launch next month."
"If even a single-digit percentage of the approximately 32 million patients with COPD or asthma in the U.S. are found to have undiagnosed bronchiectasis, the addressable population for BRINSUPRI could expand to several million patients."
"After enrolling its first patient in December of last year, the study is now more than 35% enrolled, reflecting the medical community's enthusiasm for the strength of TPIP's clinical profile."
Analyst Q&A 10
patient drop-off trends
Q (Yesha Patel · Evercore): Analyst asked how discontinuation trends are evolving as earlier patient cohorts mature and whether newer cohorts track similarly.
A: Management said the metrics are positive and doing better than expected. They noted Symphony TRXs and revenue are the two things to watch and that trends are moving in the right direction.
"I would tell you all of the metrics are positive from my point of view." — Will Lewis (CEO·CHAIR)
guidance and TPIP timing
Q (Jessica Fye · JPMorgan): Analyst asked whether guidance for BRINSUPRI will be given in January like past practice and when top-line data for TPIP ILD and PAH trials might come.
A: Management said they expect to provide guidance around the usual conference next year for BRINSUPRI. They said TPIP enrollment should be completed by the first half of 2028 and that data timing depends on database lock and submission readiness.
"On TPIP, we indicate that the enrollment will be completed by the first half of 2028, no later than that," — Will Lewis (CEO·CHAIR)
seasonal effects on demand
Q (Faisal Khurshid · Jefferies): Analyst asked about seasonal dynamics: how summer shaped up versus fall and implications for fourth quarter planning.
A: Management said it's too early to comment definitively on seasonality and they do not view seasonality as a major force so far. They will watch the cold and flu season and expect to have clearer commentary by spring next year, while noting persistency and launch trends remain strong.
"I think it's too early for us to make commentary about seasonality." — Will Lewis (CEO·CHAIR)
who is prescribing BRINSUPRI
Q (Andrea Newkirk · Goldman Sachs): Analyst asked whether growth is coming from more prescriptions within existing specialists (depth) or from broader community pulmonologists (breadth), and asked about expenses and cash-flow modeling.
A: Management said they are pushing both breadth and depth but are emphasizing depth among physicians already writing the medicine, with centers of excellence offering it widely. On cash flow, finance said revenue margins can improve, they invested in manufacturing for TPIP phase IIIs already, and they feel confident about cash flow positivity next year while continuing appropriate clinical investments.
"At places like National Jewish, almost every patient coming in who has BE is being offered BRINSUPRI." — Will Lewis (CEO·CHAIR)
COPD/asthma comorbidity size
Q (Ritu Baral · TD Cowen): Analyst asked for specifics on awareness of comorbid COPD/asthma patients with bronchiectasis and whether that becomes a tailwind in 2027.
A: Management cited literature showing 4% to 64% comorbidity and said the low end implies 800,000 patients; they believe the true rate is higher and estimate about 20% from KOLs, implying single-digit millions. They plan retrospective CT-scan work and physician outreach to better quantify this over the next year.
"At the low end of that range, that would be 800,000 patients." — Will Lewis (CEO·CHAIR)
severity mix of new starts
Q (Jason Zemansky · BofA): Analyst asked whether new patient starts are still the most severe patients or shifting to less severe, and what that implies for remaining demand.
A: Management said they expect another growth leg as physicians move from treating the most severe patients to treating less severe and moderate patients. They said as that mindset shifts, BRINSUPRI could become a default medicine for bronchiectasis patients rather than only a targeted rescue for severe cases.
"I think we're going to encounter another leg of growth for this drug in this indication as physicians adjust their mindset from treating their most severe patients, which is how they typically start with a new medicine and particularly a new mechanism, and the experience of that being so positive, and they shift to those who are perhaps less severe, more moderate." — Will Lewis (CEO·CHAIR)
branded advertising plans
Q (Joseph Schwartz · Leerink Partners): Analyst asked what lift in new patient starts management assumes from branded marketing, the timing of response, required return to scale spend, and how success will be measured.
A: Management said DTC should work well given positive physician perception and existing success, and they expect demand lift probably in the first half of next year. They noted typical DTC returns of 2x-3x on capital, will watch results closely, and plan additive multi-channel campaigns rather than redirecting other advertising spend.
"Typically, what you see, if you were to do an AI search, is somewhere in the 2x-3x range return on capital." — Will Lewis (CEO·CHAIR)
using AI to find comorbid patients
Q (Maxwell Skor · Morgan Stanley): Analyst asked how AI helps identify comorbid COPD/asthma patients, whether reimbursement could be a challenge, and when better visibility will emerge.
A: Management said they are using AI tools and working with imaging vendors and hospitals to increase detection on high-res CT scans, but turning the system is like steering an oil tanker and will take time. They do not expect reimbursement to be a major friction today and think approvals are high; they expect to begin seeing patient funnel impact in 2027 and more in 2028 and beyond.
"That we'll begin to see, I think, in 2027 and certainly in 2028 and beyond." — Will Lewis (CEO·CHAIR)
long-term real-world study expectations
Q (Leonid Timashev · RBC): Analyst asked whether exacerbation rates in long-term studies like BEST-BE will mirror clinical trials, risks if patients perform worse, and whether results will be published or change labeling.
A: Management said they expect study data will be published and that long-term evidence will help the brand, especially against competitors, and can show potential disease-modifying benefit. They noted known regional differences, including a 68% reduction in Japanese patients, and said long-term studies will help tease out such effects across populations.
"Certainly, we expect that all the data that gets out from these studies will be circulated and in publications, and that always helps a brand or a medicine." — Will Lewis (CEO·CHAIR)
addressable market and TPIP enrollment pace
Q (Olivia Brayer · Cantor Fitzgerald): Analyst asked whether the addressable patient population estimate has changed given the strong launch and whether brensocatib is expanding diagnosis, and asked for monthly enrollment pace updates for TPIP ILD.
A: Management said the addressable market has grown since prior guidance and cited the last guidance of roughly 500,000 or 550,000 diagnosed non-cystic fibrosis bronchiectasis patients in the U.S., noting population growth and awareness from a new medicine drive increases. On TPIP monthly enrollment granularity they declined to provide it, but said new data releases and open-label updates have catalyzed enrollment interest.
"The last time we provided guidance, it was roughly 500,000 or 550,000 overall diagnosed non-cystic fibrosis bronchiectasis patients in the U.S." — Will Lewis (CEO·CHAIR)