Bristol Myers Squibb executives faced sharp questions from an analyst on Thursday regarding the slow commercial launch pace of its highly touted Cobenfy.
The schizophrenia medicine’s performance was relatively underwhelming for the second quarter in a row. Despite a 30% sales bump compared to the same time last year, the $57 million in sales for the third quarter missed analyst estimates by $11 million.
It doesn’t help that the drug came on the market with incredible hype. BMS acquired the therapy in 2024 for $14 billion and gained FDA approval the same year, sending expectations soaring over the first schizophrenia treatment with a novel mechanism of action in three decades. Some analysts projected $300 million sales in its first year.
In reality, the drug made a more subdued debut with $155 million in sales in 2025. Since its launch, analysts have cut the drug’s revenue predictions through 2030 by roughly 40%.
On Thursday's earnings call, BMS’ chief commercialization officer, Adam Lenkowsky, noted that total prescription volume for Cobenfy increased by 3% to 4% for the quarter. But prescribing behaviors and side effects, alongside inventory issues specific to the third quarter, is weighing on the drug’s performance, he said.
“We need to accelerate new patient starts. We need to improve repeat prescribing. I think one of the bigger challenges that we’ve seen is we’ve been educating physicians on the importance of rapidly titrating Cobenfy to the effective dose of 125 mg,” Lenkowsky said on the earnings call.
According to Lenkowsky, far too many patients remain on the suboptimal 50 and 100-mg dose of Cobenfy due to the nausea and vomiting side effects during the initiation period. The better course of action, BMS said, is to titrate patients up to the full 125 mg and give antiemetics to manage the gastrointestinal issues.
“When patients are on the effective dose and the GI toxicity is managed appropriately, we have truly seen remarkable results for this product,” Lenkowsky said.
Cobenfy’s slow burn in schizophrenia has created apprehension around BMS’ closely watched phase 3 readouts in Alzheimer’s disease psychosis slated for next year.
At 7 million patients in the U.S., Alzheimer’s represents a much bigger market. And about 30% to 50% of those patients experience psychosis, for which Cobenfy could be the first FDA-approved treatment if the clinical trials go as hoped.
But BMS has already had to push back the readouts on two occasions: In December 2025, it delayed Adept-2 readouts because of site irregularities, and this summer, it delayed readouts of the Adept trials, citing slower-than-expected enrollment.
The long-awaited results are set to come out just around the new year, and BMS needs positive results from two out of the three trials to approach the FDA. But even if the trials are a success, there’s skepticism about Cobenfy’s commercial potential and tolerability in the older Alzheimer’s population.
To its advantage, Cobenfy is not associated with the boxed warnings that come with many of the existing antipsychotics, like sedation, cognitive impairment, and movement disorders. “But that said, we will take the learnings from schizophrenia, and we’re going to need to set up expectations with patients and physicians, build confidence around managing the nausea and vomiting with Cobenfy,” he said.
Beyond Cobenfy, BMS produced a strong quarter with a 7% increase in total revenue compared to the same time of 2025. William Blair analysts said the performance was largely driven by better-than-expected performance from the legacy portfolio, especially BMS’ blood cancer drug, Revlimid, which generated $303 million in Q3, well above analysts' estimates of $236 million. The company’s aging blood thinner, Eliquis, also saw a 25% jump in sales.
BMS raised its revenue guidance for the year to $49.75 billion to $50.25 billion and assured that key readouts for milvexian—widely seen as BMS’ successor to Eliquis—and Cobenfy are still on track.