With a Phase 3 failure denting the rare disease drug’s prospects, AstraZeneca has little room for error as it plots a path toward its ambitious 2030 sales target.
As AstraZeneca exited the first quarter, initially skeptical analysts were coming around to the potential for the drugmaker to hit its goal of growing sales to $80 billion by 2030. But less than three months later, the shocking Phase 3 failure of rare disease drug Wainua has left the company needing wins in two high-risk readouts to maintain its trajectory toward the towering target.
The FDA approved Wainua, an antisense oligonucleotide inhibitor, in December 2023 for the treatment of transthyretin amyloidosis (ATTR) with polyneuropathy. Months later, AstraZeneca named Wainua as one of the drugs underpinning its belief that it could grow sales to $80 billion by 2030. At the time, the consensus estimate of analysts put AstraZeneca’s 2030 sales at $66.8 billion.
Wainua has yet to contribute significantly to AstraZeneca’s path to $80 billion, with sales totaling just $212 million last year. But the drugmaker was predicting peak revenues in excess of $5 billion until the Phase 3 flop derailed plans to expand Wainua’s label to cover ATTR cardiomyopathy (ATTR-CM).
AstraZeneca still thinks it can hit $80 billion, though. Before that disappointing readout, the company-sponsored consensus projected 2030 sales of $82.7 billion, Leerink Partners analysts said in a July 9 note to investors. Removing ATTR-CM reduced that forecast to $80.8 billion, reflecting about $1.9 billion in Wainua sales in 2030. AstraZeneca’s management acknowledged that the setback “decreases headroom” but is still confident the company can achieve the 2030 goal, the analysts said.
Plotting a path to $80B
The coming months will feature readouts that could intensify questions about whether AstraZeneca can hit its target. This year, the company is scheduled to report data from SERENA-4 and AVANZAR, late-phase clinical trials that Leerink analysts called binary events subject to “prior investor uncertainty.”
SERENA-4 is testing the investigational oral SERD camizestrant in first-line, HR-positive breast cancer. AVANZAR is assessing the antibody-drug conjugate Datroway, already marketed for second-line non-small cell lung cancer (NSCLC) and forms of breast cancer, in first-line NSCLC. Leerink analysts predicted that SERENA-4 could add non–risk adjusted peak sales of $2.8 billion for camizestrant and that AVANZAR could boost Datroway sales by $2.2 billion. AstraZeneca, which won its first FDA approval for Datroway in January 2025, reported sales of ¥47.6 billion (~$293 million) and $43 million in the first quarter of 2026.
The analysts see the trials as risky, putting the probability of success at 20% for SERENA-4 and at 50% for AVANZAR. Skepticism about the chances of the studies succeeding extends beyond Leerink, with analysts at Guggenheim Securities characterizing investor expectations as “very low.”
The failure of the trials would remove rungs from the ladder that AstraZeneca climbs toward its $80 billion target. AstraZeneca has tipped each drug to generate peak sales of $5 billion or more. SERENA-4 and AVANZAR are central to the blockbuster forecasts. Camizestrant is awaiting approval in another indication, but in a May 8 note to investors Guggenheim analysts called that commercial opportunity “limited.”
Analysts have generally been less confident in the 2030 aim than AstraZeneca itself seems to be. Although the Guggenheim team said the consensus of its peers did reach $80 billion in December, the firm’s own estimate was lower, at $76.4 billion. It raised that number to $79.6 billion in April, based on developments including Phase 3 data on the chronic obstructive pulmonary disease prospect tozorakimab, but following the Wainua setback, Guggenheim’s 2030 forecast for the company fell back down to $78 billion.
The analysts now foresee Wainua sales of $500 million, down from $2 billion before the Phase 3 flop. Removing the ATTR-CM opportunity from the Leerink model similarly resulted in a drop in risk-adjusted 2030 total revenues, from $79.5 billion to $78.6 billion.
Fallback options
AstraZeneca has options if setbacks to SERENA-4 and AVANZAR impede its pursuit of the 2030 sales goal. The $80 billion objective “was on an organic basis, and that does not assume any M&A of any size and scale,” AstraZeneca CFO Aradhana Sarin said on the company’s earnings call in February.
While AstraZeneca is aiming to hit its 2030 target without M&A, Sarin said the company has “substantial firepower” for deals. AstraZeneca will “remain very disciplined in terms of what type of assets we bring in,” partly because it requires “substantial investments in R&D” to create shareholder value after buying a drug candidate, Sarin said.
Organically, AstraZeneca could smooth its path to $80 billion by beating sales expectations for its existing growth drivers and planned launches or by lessening the impact of loss of exclusivity on drugs such as Lynparza and Farxiga. Guggenheim analysts said elecoglipron, an oral GLP-1 asset, is “underappreciated,” but with the small molecule entering Phase 3 this year, it is not on AstraZeneca’s roadmap to $80 billion.
The roadmap features assets including the cancer medicines Imfinzi and Imjudo, blood pressure drug Baxfendy and rare disease candidate efzimfotase alfa. Guggenheim analysts foresee a “standard, slow [cardiovascular disease] ramp” for Baxfendy, with Medicare Part D reimbursement negotiations expected in 2027 or 2028.
If the pipeline stutters, AstraZeneca’s ability to squeeze more sales from existing assets could be key to hitting its 2030 target. The company’s commercial teams have impressed recently, helping to power sales past analyst expectations in the third and fourth quarters of 2025 and the first quarter of 2026. AstraZeneca plans to release its second-quarter earnings results on July 27.
