Good day, and thank you for standing by. Welcome to the BioCryst third quarter 2026 earnings call. At this time, all participants are in a listen-only mode. After the speaker's presentation, there will be a question-and-answer session. To ask a question during the session, you will need to press star one one on your telephone. You will then hear an automated message advising your hand is raised. To withdraw your question, please press star one pne again. Please be advised that today's conference is being recorded. I would now like to hand the conference over to your first speaker today, Nick Wilder with BioCryst. Nick, go ahead.
Good morning, and welcome to BioCryst's third quarter 2026 corporate update and financial results conference call. Participating with me today are President and CEO Charlie Gayer, Chief Financial Officer Babar Ghias, and Chief R&D Officer Dr. Sandeep Menon. A press release and slide presentation about today's news are available on our investor relations website. Today's call contains forward-looking statements, including statements regarding future results, unaudited and forward-looking financial information, as well as the company's future performance and/or achievements. These statements are subject to known and unknown risks and uncertainties, which may cause our actual results, performance, or achievements to be materially different from any future results or performance expressed or implied in this presentation. For additional information, including a detailed discussion of these risks, please refer to slide two of the presentation. In addition, today's conference call includes non-GAAP financial measures.
For a reconciliation of these non-GAAP financial measures against the most directly comparable GAAP financial measure, please refer to the earnings press release available on our investor relations website. I'd now like to turn the call over to Charlie.
Thanks, Nick. The third quarter was significant for BioCryst as we continued to deliver strong execution during a time of strategic evolution. On the HAE front, new patient prescriptions for ORLADEYO continued at the same high level that we have seen all year. We again added new prescribers at a rate above the average of the past several years, and the total base of treated patients grew at a healthy rate in the quarter. We were thrilled to launch ORLADEYO pellets to kids in August, and early signs of performance continue to be promising. Children of all ages across the two to 11 range have started on ORLADEYO pellets, and the mix of kids switching from other prophy and acute only, as well as those who were treatment naive, has been balanced. This suggests the pediatric market may grow beyond the 500 patients that we have previously described.
We are also looking forward to launching the recently approved 150 mg ORLADEYO pellets at the upcoming American College of Allergy, Asthma, and Immunology meeting this month. This new formulation for ages 12 and up provides an option for kids who started on pellets, for adolescents and adults who have difficulty swallowing a capsule, or for anyone who simply prefers the pellet formulation. We are looking forward to generating real-world evidence to track the progress and patterns of use for all patients treated with ORLADEYO pellets. During the third quarter, we also implemented the transition to CareMed as our sole source pharmacy partner for shipments to patients. We switched to CareMed because the volume of patients on ORLADEYO has grown to the point where operational excellence at the pharmacy level can have a significant impact on the growth in treated patients and the shipment in paid product.
We are working closely with CareMed to integrate best practices within our Empower Patient Services program and are encouraged by the early signs we are seeing in the partnership. We believe CareMed can scale with us as our portfolio of HAE prophy offerings continues to grow. Turning to our pipeline, as we have previously announced, the pivotal trial for navenibart fully enrolled in June, and we remain on track to announce top-line data through 12 months of therapy in the third quarter of next year. Our team is working diligently on the BLA file, as well as launch planning for when we add this potentially transformative product to our HAE portfolio. Continuing on the theme of strong execution, we have enrolled part four of our trial of BCX17725 for Netherton syndrome patients and are on track to have early clinical data by the end of this year.
There are no treatments approved for this devastating skin condition that we believe includes at least 3,000 patients in the U.S. alone. Once the data reads out, we will review the data in totality, which includes key efficacy endpoints like IASI, the Ichthyosis Area and Severity Index score, as well as safety and tolerability to inform potential next steps in the program. Finally, we are excited about our strategic shift toward building our pipeline through external innovation. We recently announced a Scientific Advisory Board of leading biotech industry experts who will partner with us to deliver on our strategy. These esteemed advisors, with a successful track record, did not join us just for the honor of being on the board. They joined us because they believe that BioCryst's profitability, discipline, and strong execution position the company for success in our rare disease strategy.
With that, I'll turn it over to Babar to describe our increasingly strong financial position.
Thanks, Charlie. We are pleased to share the results of a very strong third quarter, which included not only the important accomplishments just described, but also continued financial excellence. The intentional, proactive steps we have taken throughout the year to position BioCryst for durable growth and increasing profitability continue to be reflected in our financial performance. In my remarks today, I will refer to certain non-GAAP financial measures, which adjust for revenues and expenses associated with our former European ORLADEYO business, stock-based comp, Birmingham site closure, and organizational restructuring costs, and expenses associated with the Astria acquisition. Additional information regarding these adjustments is included in today's press release. We believe these non-GAAP measures provide investors with a useful view of the underlying performance of the ongoing business. Now, turning first to revenue. ORLADEYO net revenue was $174.8 million for the quarter, with more than 95% coming from the U.S. business.
On a comparable basis, excluding European revenue, ORLADEYO revenue increased 20% year-over-year. ORLADEYO revenues benefited this quarter from the CareMed transition. One of the benefits of switching to a larger specialty pharmacy is that they maintain a level of inventory at multiple sites and broader set of working operation hours that facilitate timely fulfillment to efficiently respond to patient demand. The inventory they hold typically ranges from one to three weeks of product. As part of the transition to this model, CareMed built an inventory level towards the lower end of this range during the third quarter, resulting in a revenue contribution in the upper teens of millions of dollars in the quarter. Since we expect their inventory level to remain in this lower end, revenue should more closely reflect underlying patient demand going forward.
While a transition of this nature naturally creates some temporary operational complexity as systems and processes are implemented, we are very pleased with the progress to date. Although it is still early, we are already seeing an improvement in days to first shipment for new patients, an important measure of the patient experience. Despite the transition, even when removing the impact of the inventory build, ORLADEYO revenue, excluding Europe, grew year-over-year. This is evidence of the continued favorable patient dynamics across the approved population. Throughout this process, our priority has remained the same, maintaining a high-quality patient experience and uninterrupted access to ORLADEYO. Before turning to operating expenses, let me briefly provide some context around the GAAP to non-GAAP adjustments this quarter. These adjustments primarily relate to the closure of our Birmingham facility and associated organizational restructuring activities that remain on track to be substantially completed by year-end.
Of the approximately $19 million in restructuring-related expenses in the quarter, only $10 million are real cash costs. Non-cash charges primarily reflected accounting adjustments to assets that no longer will have economic use following the closure. The most important takeaway today is the structural benefit to our cost base. The actions we have taken are expected to generate approximately $30 million-$35 million of annualized savings once fully realized, with the potential for additional savings as certain programs are wound down. As we look toward 2027, the business as it exists today is positioned for continued revenue growth alongside a lower operating cost base than in 2026. We will provide formal 2027 guidance at the appropriate time, but the combination should support continued expansion in profitability. Turning now over to operating expenses. Non-GAAP operating expenses were slightly lower year-over-year, consistent with the financial discipline we have been emphasizing.
We are actively investing in the phase III development program for navenibart, which is naturally an important driver of R&D spending. At the same time, we are taking a disciplined, data-driven approach to capital allocation across the rest of the pipeline. BCX17725 is a good example. Our approach has been to generate early clinical data in patients first, and let that data prospectively inform the appropriate level of future investment. We remain on track to share those data before year-end. Sales and marketing expenses were modestly higher year-over-year, driven primarily by the transition-related fees associated with the specialty pharmacy arrangement. G&A expense has remained essentially flat. This operating leverage from the trends is increasingly visible in our results.
Non-GAAP operating profit for the quarter was $86 million, an increase of 70% year-over-year, while non-GAAP net income of $71 million more than doubled from the prior year period. As profitability continues to grow, we also expect to benefit from our substantial net operating loss carryforwards, which should help limit cash taxes over the medium term, subject to applicable tax rules and limitations. That creates the potential for strong growth not only in earnings, but also in cash generation. Our liquidity position remains strong, with cash and equivalents of $376 million. As we have discussed, we have made a deliberate pivot toward external innovation, but we are going to remain disciplined in how we build the pipeline. For us, the priority is not adding programs simply to increase the size of the pipeline.
It is identifying opportunities where we believe BioCryst can create meaningful value for patients and shareholders. At the same time, we will always continue to evaluate opportunities to strengthen the balance sheet and return capital, while maintaining the financial flexibility to invest in compelling innovation. Turning finally to our 2026 financial guidance. When we established our ORLADEYO revenue guidance, we did not assume a benefit from the initial specialty pharmacy inventory build. Given that we still remain relatively early in the CareMed transition implementation, we are not changing ORLADEYO revenue guidance at this time. We are encouraged by the progress we are seeing, but we also recognize that we are transitioning six years of launch experience, systems, and operating knowledge from one partner to another on an accelerated timeline. Importantly, we view this as a finite transition and not a long-term operating dynamic.
Underlying patient demands and trends remain strong, and we are excited about the opportunity to expand the pediatric launch while also offering the newly approved oral pellet formulation for patients with HAE 12 years and older, providing a continuum of oral treatment options. On the other hand, we are increasing our total revenue guidance to $715 million-$730 million, reflecting higher realized licensing revenue and international RAPIVAB orders from our partner. To emphasize, RAPIVAB is not a strategic core asset for us and is mostly a pass-through business with low margins. On expenses, we are again tightening our full-year operating expense guidance now to $415 million-$425 million for 2026. When we realize the full-year benefit of the actions we have taken in 2026, we expect operating expenses in 2027 to decline further while the underlying business continues to grow.
To close, this was a very strong third quarter and strong first nine months of 2026. We have one quarter remaining, and our focus is on finishing the year well and entering 2027 from a position of considerable strength. With growing revenue and increasingly efficient cost structure, expanding profitability, strong liquidity, and important pipeline catalysts ahead, we believe we have the opportunity to make 2027 a transformational year for BioCryst. The entire organization is focused on executing against the opportunity, and I am very grateful to our colleagues across BioCryst for everything they have accomplished this year. With that, operator, we are now ready to take questions.
Thank you. At this time, we will conduct the question-and-answer session. As a reminder, to ask a question, you will need to press star one one on your telephone and wait for your name to be announced. To withdraw your question, please press star one one again. Please stand by while we compile the Q&A roster. Our first question comes from the line of Gavin Clark-Gartner with Evercore ISI. Go ahead.
Hey, guys. Great to see the progress, and thanks for taking the question. I guess, first, just to clarify on the inventory. So there was upper teens contribution from the CareMed inventory build. How should we expect that to trend next quarter? Will there be a reversal of a similar amount? Is there some level of inventory build still to happen here? What should we think about next quarter?
Yeah, thanks for the question, Gavin. So I think your intuition is correct. It's a one-time inventory build that they have for dispensing. Our expectation is that, as I mentioned in the call, that typically they hold 7-21 days of inventory. In this quarter, we were on the lower side of that range, and we expect that to remain in the lower side. So you are not going to expect a one-time benefit or, I guess, a recurring benefit of inventory every quarter from this point onwards. There may be, in the nearer term, in another quarter, there may be small fluctuations, but as it gets smoothed out, it should reflect patient demand. To summarize, it was really a one-time benefit of this order of magnitude, and that should be the expectation.
Okay, great. That's helpful. Just quickly, quick follow-up. What was the pediatric prescriptions that you saw this quarter?
We're not going to get into the specific numbers, Gavin, but it continued to be strong. We had announced at the end, I think it was at the end of July, we had 47. That was well ahead of our expectations for the year. We continue ahead of our expectations. The pediatric revenue we generate is still going to be a very small part of this year's revenue, but it's a good sign for the future. Like I mentioned, we're looking forward to starting to collect real-world evidence in this population, so I think we'll have more to report out in the future as a little more time passes
Perfect. Thanks, guys.
One moment for our next question. Our next question comes from the line of Laura Chico at Wedbush. Your line is live.
Good morning. Thanks very much for taking the question. I guess I wanted to ask one more strategic. Could you expand on your commentary around the 2033 and beyond outlook for the HAE franchise? If I am looking at the slides correctly, it looks like you are describing it as a range from about $1.4 billion to $2.0 billion in 2033. I think before you talked about this as a $1.8 billion plus opportunity. So I guess, help us understand some of the dynamics there that go into the lower and upper bounds. What needs to go right? I guess, has anything changed to shift your outlook? Thank you.
Thanks, Laura. The range that we provide is actually based on sell-side analyst views of the portfolio, and we put it out there because directionally, we agree with the two products with the most established oral at that point, the market-leading oral prophy, and then what we think will be really a transformative product with every three and six-month dosing with Navenibart. It really allows us to hit both big segments of the market, those who prefer oral prophy, those who prefer injectable prophy. The things that need to go right for that to happen, obviously, is continued growth of ORLADEYO, which we expect, and all of our forward-looking research metrics tell us that that will continue. Then a strong launch that we are preparing for Navenibart.
What we see in our research with doctors and patients is that that three and six-month dosing with high efficacy and with a convenient administration is something that gets their attention and will encourage patients to switch. So the real key is going to be how many of the patients who are on other injectable PROFIs want to take advantage of this longer-term dosing and switch. That will be the key driver of kind of the pace of our revenue growth and kind of the ultimate peak of where we get with Navenibart.
Thanks, Charlie.
Thanks.
One moment for our next question. Our next question comes from the line of Steve Seedhouse at Cantor. Go ahead.
Oh, great. Thanks for taking the question. Related to the long-term revenue projections, but specifically as it pertains to ORLADEYO and just the stickiness of that, have you guys done any updated market research post the deucrictibant prophylaxis phase III result, and do you have a sense that that was above, below, or in line with expectations of what you've been modeling really for the past several years? Thanks.
Thanks, Steve. We have not done specific research since the data came out. However, what we did do is our annual large exercise that we do the middle of every year, where we talk to 175 HAE treaters, 100 patients, 50 payers, and run it through a big conjoint exercise and market simulation model. What we put in there for deucrictibant, recall that we always put all of our current and future competition in with their best-case profile. The profile that we put in for deucrictibant was actually slightly better than the actual, what they proved out in the phase III. So comparable, but slightly better. It showed that, yes, that product will gain share, as you would expect, but what it's not going to do is take away the base of ORLADEYO patients.
We continue to see ORLADEYO growing even in the face of future competition in a couple years from deucrictibant.
Terrific. Thank you.
One moment for our next question. Our next question comes from the line of Stacy Ku at TD Cowen. Go ahead.
Hey. Thanks so much for taking our questions. We have a couple of clarifications. First, maybe can you talk about, given your inventory commentary, really appreciate all the detailed thoughts there, your level of confidence in the high end of ORLADEYO guidance that you provided for the year? That is just a follow-up on inventory. Then second, on the pediatric launch, would you characterize it more as steady additions, or are you seeing a bit of a bolus type of dynamic for the pediatric prescriptions? As we look to next year and consensus, I know you will not comment, but does that include what you are seeing for the pediatric launch, or would you look at that as upside? Then third clarification, when we speak to clinicians, they tend to have their patients track very detailed data on their attacks for payer reimbursement and access.
As you are looking at the oral competitive landscape in the next couple of years, do you have a good sense of the percentage of patients that are well-controlled on ORLADEYO, so having really competitive attack rate reductions, as folks try to understand the stickiness of the drug? Thanks so much.
Great. Thanks, Stacy. Maybe I'll take, go through the second question with all those pieces, then we'll come back and Babar can talk about the inventory. On the pediatrics, number one, what we're seeing is kind of steady, strong additions. There was, of course, a bolus at first, particularly because of the supply delay that we had. There was a bolus to start. Those patients have been transitioned to therapy. Then we're seeing continued strong demand that is ahead of what our original expectations are. It's still only been a few months, so we'll have to see how long this continues, but the early signs are very promising. As we kind of look to the future of ORLADEYO, when we give guidance for 2027, pediatrics will be absolutely a part of all of that.
When we have additional data that's, as I've mentioned, real-world evidence, when we generate other evidence that we think is interesting and helpful, we may comment on other pieces of how pediatrics breaks out of the whole bit. As far as patients, the patients who are well-controlled on ORLADEYO, you've heard us talk before about when patients start, 60% of them roughly get to 12 months of therapy. Then those patients are largely the very well-controlled. Those are the ones who are getting down to a median attack rate. We've put out real-world evidence on this, where they're getting down to a median attack rate of about a third of an attack per month. Patients generally are reporting significant reductions in attack rates regardless of where they're coming from, whether they switch from other prophylaxis or were not previously on prophylaxis
We feel like we're holding onto the patients who are doing well. They're getting market-competitive efficacy. Then, Babar, you want to talk about the-
Yeah. Thanks, Stacy, for the question. Allow me to explain a little bit more perspective on the pharmacy. Look, at the end of the day, the progress of any product should be on patient demand and not inventory dynamics. As Charlie mentioned in his remarks, the performance of a pharmacy can actually create a meaningful impact on the progress of the product. When we made that switch, we were getting to a point of scaling the product that we needed to move with a larger partner who can support the vision for ORLADEYO and potentially navenibart when it gets approved. When we think about basically keeping the guidance, at the start of the year, we had a different pharmacy partner, we had a different operating model. It was not necessarily incorporating the dynamics of the inventory.
As I said, what we do not want to do is artificially change the guidance because fundamentally, it should be about patient demand.
We are still in early days of that, so we did not feel the need that at this point in time we need to change the guidance for ORLADEYO just because we have a one-time inventory dynamic. As I said, once we get past this quarter, as you can appreciate, it has only been six weeks that we have actually been fully with CareMed because the implementation started somewhere in the August timeframe, so call it six to eight weeks. We do not even have a full quarter under the belt. As we get past through that, it should really reflect the patient demand. That is why we were being a little bit careful and being conservative in terms of changing guidance at this point in time just because of an inventory dynamic.
Incredibly helpful. Thank you all.
One moment for our next question. Our next question comes from the line of Tazeen Ahmad with Bank of America. Go ahead.
Great. Hi, this is Jeremiah on for Tazeen. Thanks for taking our question. I wanted to ask a question on the Netherton readout that's expected around year-end. I am just wondering what's the benchmark or what level of data you guys are looking for in order to move that program forward? I guess, depending on if the study hits, how quickly could you move to the pivotal stages? Thanks.
Sandeep, you want to take that?
Yeah, I will take that. No, thank you for the question. As you know, Netherton syndrome is a devastating skin disease, and that has got multiple other layers of disease manifestation, including immunity and inflammation. We are getting ready for our data readout in December. What we will be presenting is the primary endpoint and the key secondary endpoints, along with obviously the safety and tolerability of that. What good looks like at this point, these patients don't have any treatment options, and given the severity of the disease, any improvement, which is clinically meaningful, is still better than what patients don't have at this point. So we have talked to the patients and the relevant KOLs, and also in discussions very soon with the FDA to come up with a benchmark, basically
From our perspective, as long as we are able to get 20%-25% in the primary IASI score, I think it should be a pretty good clinically meaningful endpoint based on all the research that we have done internally, talking to the KOLs, and obviously the regulatory discussions are pending as well. So I think we will put it out there for now, and once the data reads out, we will share more.
And obviously within that, we will be looking for consistency in the fact as well. We will look at this a number of different ways. Do you want to just talk about what do we think next will be? Would we go straight to
Yeah, the next basically, we will be reflecting on the totality of the data. At this point, we want to do what is best for the program and for the patients. We are not going to rush into anything that is a pivotal right away. Depending on what the data is, we will talk to the regulators and digest the data. Because this is going to be the first in class, first therapy ever coming for Netherton, we want to be very clear in terms of where we want to take this. But we will be swift in decision-making, and we will move fast. At the same time, we will be very scientifically rigorous and thoughtful in how we take the clinical development forward.
Very helpful. Thanks, guys.
One moment for our next question. Our next question comes from the line of Maury Raycroft with Jefferies. Your line is live.
Hi, good morning. Thanks for taking my questions. I will shift gears and maybe just ask one on BD. I guess with the new scientific advisory board, can you talk more about their mandate and what your latest thinking is related to BD and the type of assets you are looking to in-license?
Yeah. From our, thank you for the question, Maury. Our scientific advisory board, as you can see, it comes with a high pedigree and a very, very successful track record, including with Dr. Tony Manning, who is chairing the SAB. It is a working scientific advisory board, like Charlie mentioned. It is not that people are coming in to get some luxurious seat on the board here. They are working with us, as we are, at least a few times a week. We are rolling our sleeves, looking at multiple assets. As we have shared before, it is going to be early clinical assets, phase I, phase II. Mostly, we will go with very, very clear biology. We are not going to take chances on things that are far-fetched in terms of an inflection point.
We will ensure that this is sticking to our core strengths, because we have a commercial fabric that we are going to take advantage of. That is what we are going to play, and you will see in the next few months, as we have more information, we will be ready to share. The punchline here is the SAB is very, very seasoned. They have been there, done that, and we are working together as a team to get to a place where we have a pipeline that is going to be rich and valuable to our stakeholders
Maury, just to add to that too, we have of course built a very strong internal team for both scientific evaluation and business development. The internal team is generating the ideas, and then when we get excited about something, the SAB helps us really wrestle it to the ground. Is this something that we want to do? We think it is a great partnership. Early days, it is working very well, and we think that this is going to be very supportive to our strategy
Got it. That is helpful. Maybe just a quick follow-up on Netherton. As you guys are thinking about next steps with the program, in the press release, it mentions that expenses were lower related to the program in third quarter. I guess, any specific reasons there? Is it just because the study is enrolled and it is kind of at a status quo, or how should we think about that?
Yeah, I think I will point it back to the financial discipline that we have been instituting across the organization, Maury, and basically taking an evidence-based approach. I will give you an example. Historically, we may have been a little bit aggressive in our sense that we need to do CMC campaign before we have actually seen results. I think what I was basically emphasizing earlier was we are taking a very evidence-based and rigorous scientific approach that, do we first have a product? Do we have the available data that allows us to unlock the next step of development? I think across the organization, we have been instituting that discipline. Netherton, like I said, that was a perfect example where we did not feel that we need to spend dollars at risk on things before we actually can unlock the data.
That was basically the primary reason why you see a declining expense. I think that is going to be a theme, right? That is how we are going to go about and develop on this innovation aspect that we are talking about BD, but also being very committed to delivering strong profitability going forward.
Maury, just to add what Babar nicely summarized, we will ensure that we are still very swift. It is not that we are going to just make it so sequential that we will delay the program, and that is not what it is. Basically, we will get some early data and we will take the right bets that is going to give us scientific and development success.
Got it. Okay. Thanks for taking my questions.
Yeah.
One moment for your next question. The next question comes from the line of Jessica Fye with JPMorgan. Go ahead.
Hi, this is Silvia on for Jess Fye. Thanks for taking our question. To confirm, with the prior model pre-CareMed, was there any inventory sitting elsewhere that needs to be worked down that maybe leads to the hesitation to update the ORLADEYO guide? As a follow-up, and appreciate the conservatism so soon after the specialty pharmacy shift, but if the high teens inventory benefit was not contemplated in the fundamental ORLADEYO guidance you laid out and are maintaining, would it be wrong for investors to expect full-year ORLADEYO revenue landing in the $650 million-$655 million range, which is just the midpoint of the fundamental guidance plus $15 million-$20 million? Thanks.
Thanks, Silvia. First of all, from inventory from the prior pharmacy, the billing model was different there. There, it was a flash sale for every pack that went out, so there basically was no inventory. With CareMed, it's a little bit more traditional pharmacy model where they buy some inventory, as Babar described. It's at a relatively low level, about a week's worth of inventory. No, from the guidance perspective, with everything we see at this point and with the changes that, as we're saying, we still haven't worked through completely, we see the range of $625 million-$645 million is still the right guidance for the year.
One moment for our next question. Our next question comes from the line of Serge Belanger. Your line is live.
Hi. Good morning, everyone. This is John on for Serge today. Thanks for taking our questions. Just a couple on ORLADEYO. First, curious if you could provide an update on the paid Rx rate exiting the third quarter, and if your outlook has changed on where this could reach considering the efficiencies yielded from the CareMed partnership. Then second, on the pediatric side of things, you highlighted the launch is progressing ahead of expectations. Just curious how you view the overall opportunity now versus the original 500-patient pool. Thanks.
Thanks, John. As far as the paid rate, just recall what typically happens in the second half of the year is our paid rate typically peaks in the second quarter after going through all the reauthorizations in the first part of the year. Then in the second half of the year, it starts to gradually tick down, mainly because the rate is driven more by new patients coming on, and new patients don't get to the 80%+ paid rate that we had in the overall population as quickly. So, we're seeing that same dynamic right in line with our expectations. I think we ended the quarter somewhere around 82%, 83% paid
To your question around CareMed, we do think with their capabilities working with our team, it gives us the opportunity to meet and potentially exceed our long-term goal of getting to 85% paid rate as kind of a steady state. So, we think we're on track for that. I'll note that with pediatrics too, we're seeing excellent early paid rates. Pediatrics, as you would expect, is basically a commercial plus Medicaid business, so a little bit different dynamic than our overall population. But the early signs are we're getting these kids at a high rate to pay, and I expect that to continue. Then as far as the overall opportunity for peds, yeah, we're cautiously optimistic that it could end up being bigger than we originally expected. It certainly is turning out to be that this year.
I think we need a couple quarters in addition, at least, to see what the steady state in terms of demand. There are still physicians out there who are still learning about this indication and have not acted yet. I think there is likely a lot more opportunity than the 500 diagnosed and treated patients that we have previously prescribed.
One moment for our next question. Our next question comes from the line of John Wolleben at Citizens. Your line is live.
Hi, this is Catherine on for John. I just have a quick clarification question about the number of patient adds. I know you said that the patient adds have been kind of tracking along the average from quarter by quarter. I just want to provide a little bit more color on how that is tracking and what your expectations are for the fourth quarter based on your revenue guidance. Thank you.
Thanks, Catherine. What we described is that new patient prescriptions coming in has been very much in line, and the net patient adds in the third quarter were quite healthy. We expect, particularly with our transition to CareMed, with the continued demand, with the strong demand in Peds, that we would expect another good quarter in the fourth quarter, and that this trend will largely continue into 2027.
Perfect. Thank you.
One moment for our next question. Our next question comes from the line of Brian Abrahams at RBC Capital Markets. Your line is live.
Hi there. Good morning. Thanks for taking our question. I am curious, are you seeing any effects on ORLADEYO use patterns from the recent launch of oral on-demand or other long-acting injectable therapies for prophylaxis? Then, I guess, secondarily, curious what your market research tells you about the potential opportunity differences if navenibart can demonstrate every six-month dosing versus every three months. Thanks.
Thanks, Brian. We have said before, and at this point, it has been over a year since the oral acute came onto the market, and then also the two new prophies that came on last summer. We are really not seeing any impact from the oral acute patients. Some ORLADEYO patients are using it. We are certainly not seeing any negative trends, nor would I say it is anything particularly positive. It just has not had that much of an impact on our business. The oral, or sorry, the other longer-acting injectables, what we are really seeing there is that when a patient ORLADEYO does not work out for them, instead of moving preferentially to TAKHZYRO, more of those patients are going either to ANDEMBRY or DAWNZERA, and that is what you would expect.
With navenibart, what we're seeing, again, in all the research that we've done, three months is really a transformative. Every three months dosing is really transformative. Having the ability to have three months and six months as an option makes the whole package even better. We expect to get both doses in our label, certainly based on the phase II data that we've seen with both doses having very durable reduction in attacks. To have that option, and we don't know yet which dosage form would be which frequency would be most used. I think that's something we'll learn more about. But to have both really makes navenibart a very strong option for patients and physicians. Very, really, really intriguing to them.
Thank you.
This concludes the question-and-answer session. I would now like to turn it back to Charlie Gayer for closing remarks.
Thank you. As we've described here, another really strong quarter from BioCryst as we've gone through a year of transformation, both in leadership, in strategy, in how we run the business. I'd also like to thank everybody, all our colleagues at BioCryst who've worked so hard during this year of transition. I think we've set ourselves up for a really great 2027 and beyond. Thank you, everyone.
Thank you for your participation in today's conference. This does conclude the program. You may now disconnect.