Vertex's Q2 2026 revenue rose 12% to $3.33B as ALYFTREK took over from TRIKAFTA in cystic fibrosis, but a 37% jump in launch spending held EPS growth to 8% ($4.31); 2026 revenue guidance was raised to $13.1–13.2B ahead of the ~$10B Crinetics deal.
Revenue
$3.3B
+12.5% YoY
Net income
$1.1B
+6.5% YoY
Diluted EPS
$4.31
+8.0% YoY
Operating margin
37.4%
How VRTX compares with Health Care peers
Figure
VRTX
Peer median
Rank
Revenue growth (YoY)
+12.5%
+7.3%
14th of 53
Operating margin
37.4%
15.1%
3rd of 53
EPS growth (YoY)
+8.0%
+15.1%
34th of 48
Rank 1 = fastest revenue growth, highest operating margin, fastest EPS growth. Peers are the other Health Care companies with a 2026 report on this site, each at its latest period we've analyzed; fiscal calendars differ, so periods are not always the same months.
Vertex's newer cystic fibrosis pill drove Q2, and spending on the next launches is catching up with revenue
Vertex Pharmaceuticals' total revenue rose 12% to $3.33 billion in the quarter ended June 30, 2026. Almost all of the extra money came from its cystic fibrosis (CF) medicines, mainly ALYFTREK, the once-daily successor to TRIKAFTA. ALYFTREK sales rose to $573.6 million from $156.8 million a year earlier. TRIKAFTA/KAFTRIO slipped 2% at the same time, so part of ALYFTREK's growth is patients moving over from TRIKAFTA. The two newer non-CF launches, the gene-edited sickle cell therapy CASGEVY and the non-opioid painkiller JOURNAVX, grew fast but are still small: $126 million between them, under 4% of sales. Profit grew more slowly than revenue. Operating expenses rose 15%, led by a 37% jump in sales and marketing costs for JOURNAVX and the expected povetacicept kidney-disease launch. Net income rose 6.5% to $1.10 billion, or $4.31 per diluted share (up 8.0%). Management raised its full-year revenue guidance to $13.1–13.2 billion. After the quarter closed, Vertex agreed to buy Crinetics Pharmaceuticals for about $10 billion in cash.
At a glance
CF revenue +10.6% to $3.21 billion. CF medicines are still 96% of product sales, and they still grow at double digits. That growth comes from ALYFTREK's rollout (reimbursed in 25 countries), higher U.S. net prices and currency, and it does not rely on the new launches.
Operating margin 37.4%, down from 38.8%. Vertex is spending ahead of revenue it doesn't book yet: SG&A (selling, general and administrative costs) rose $157.6 million year over year, while the two non-CF launches added $83.6 million of revenue.
$13.6 billion of cash and marketable securities, up from $12.3 billion at year-end. That cushion matters because the Crinetics deal will spend much of it. The deal will be paid with cash on hand plus a new $4.5 billion term loan.
The numbers
Metric
Q2 2026
Q2 2025
YoY Change
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Year-to-date (six months): revenue $6,320.8M (+10.2%), net income $2,131.2M (+26.9%), diluted EPS $8.33 vs $6.48. The large YTD profit jump reflects a one-time $379.0 million write-off in Q1 2025, not faster underlying growth (see below).
Inside the CF franchise: a switch, not just growth
The CF line is where the quarter was actually decided, and the table shows two things happening at once:
ALYFTREK is taking over from TRIKAFTA. ALYFTREK added $416.8 million of revenue year over year. TRIKAFTA/KAFTRIO lost $53.9 million and the older CF drugs lost another $56.6 million. The net CF gain was $306.3 million. In the U.S., the 10-Q credits growth to "continued strong patient demand, including from new initiations of ALYFTREK, and higher realized net prices in CF." Outside the U.S., it cites "ALYFTREK uptake" and "favorable impacts from foreign exchange". The company's full-year guidance assumes currency adds about 1.5 percentage points to growth.
The switch matters for margins because of royalties. Vertex pays royalties on CF sales to the Cystic Fibrosis Foundation's assignee, Royalty Pharma. The 10-Q puts the TRIKAFTA royalty at 9.33% and says Vertex's position is that ALYFTREK's is 4%. That lower royalty is why the filing says a "lower blended royalty rate" partly offset mix pressure on cost of sales. Royalty Pharma disputes the 4%, however (see below).
Cost of sales still rose from 13.8% to 14.7% of product revenue. The filing attributes this to "changes in product mix". CASGEVY, a one-time cell therapy, and JOURNAVX are more expensive to produce per dollar of sales than CF pills.
The new launches: fast growth from a small base
CASGEVY (a one-time CRISPR gene-editing treatment for severe sickle cell disease and transfusion-dependent beta thalassemia): $76.4 million, up 151% year over year and 78% from Q1's $42.9 million. The FDA recently extended approval to children aged 2 and up. The company says that makes about 5,500 more patients eligible. Germany also agreed reimbursement for patients 12 and older in May.
JOURNAVX (suzetrigine, a non-opioid pill for moderate-to-severe acute pain): $49.6 million, up from $12.0 million a year ago and 71% from Q1's $29.0 million. About 535,000 prescriptions were filled in the quarter. Three of the four major Medicare Part D pharmacy benefit managers now cover it, and Vertex says about 260 million Americans have reimbursed access.
Together, the two brought in $197.9 million in the first half. Guidance calls for $500 million or more of non-CF revenue for 2026. The second half therefore needs at least about $302 million, roughly 50% above the first-half pace. Q2 alone ($126.0 million, annualizing to ~$504 million) suggests that is reachable if sequential growth continues. Most of the target is still ahead, though.
What the headline numbers hide
Cash conversion is strong, partly because of timing. First-half operating cash flow was $2,553.5 million against net income of $2,131.2 million, about 1.2x. The 10-Q attributes the jump from $1,892.0 million a year ago partly to "the timing of income tax payments, and reduced purchases of inventory". Some of that improvement will not repeat. After $245.6 million of capital spending, first-half free cash flow was about $2.3 billion. Receivables grew 4.0% and inventory 4.6% since December, both slower than sales, so the quarter shows no sign of pulling revenue forward.
Prior-year one-offs flatter the year-to-date comparison. Q1 2025 included a $379.0 million impairment (a write-off of the value previously assigned to a drug candidate) after Vertex dropped its VX-264 type 1 diabetes program. That is why six-month net income is up 26.9% while Q2 alone is up only 6.5%. Within Q2, last year's revenue also included a $20.6 million upfront payment from partner Ono Pharmaceutical, with nothing similar this year. Product revenue growth (13.2%) is therefore the cleaner measure than total revenue growth (12.5%).
A small investment gain helped this quarter. Other income of $24.3 million included a $37.2 million gain on a strategic equity investment. Vertex strips that out of its non-GAAP figures. Acquired in-process R&D (upfront and milestone payments to license or buy outside drug programs, expensed immediately) was $21.4 million versus $2.2 million, too small to change the picture.
Where EPS growth came from. Operating income grew 8.3%. A higher tax rate (21.0% vs 19.5%) cut net income growth to 6.5%. Buybacks then added back roughly 1.5 points: diluted shares fell 1.4% to 255.2 million after Vertex repurchased 1.8 million shares for $799.5 million in the first half. So the 8.0% EPS growth came mostly from operations, with buybacks roughly offsetting the tax headwind. On the company's non-GAAP basis, which excludes stock compensation ($170.2 million) and investment gains, EPS grew only 4.6%. That is a better guide to how much the launch spending is squeezing underlying profit.
R&D is flat; the cost growth is commercial. R&D rose just 1.6%. The 10-Q says outsourced trial spending fell "due to the discontinuation of certain clinical programs during 2025", while headcount went into povetacicept, type 1 diabetes, neuropathic pain and kidney programs. The 37% SG&A increase is the cost of launching JOURNAVX and preparing for povetacicept.
An open royalty dispute. In October 2025 Royalty Pharma started a confidential arbitration claiming ALYFTREK's royalty is about 8%, not the 4% Vertex pays, and seeking unpaid royalties. Vertex says the claim is "contrary to the plain terms" of the agreement. The stakes grow as ALYFTREK grows: at ALYFTREK's first-half 2026 sales of $998.0 million, a 4-point difference is about $40 million, before any claim on past periods.
Guidance moved up on revenue only. Revenue guidance rose to $13.1–13.2 billion from $12.95–13.1 billion. Guidance for combined R&D, acquired R&D and SG&A was left at $6.3–6.45 billion GAAP ($5.65–5.75 billion non-GAAP). First-half GAAP spending in those lines was $3,053.2 million. Reaching the range means second-half spending of roughly $3.25–3.40 billion, a step up from the first half. Margins are unlikely to widen in H2.
Takeaway: Vertex is funding its new-product build-out almost entirely from CF, and CF still grows about 10% a year as patients move to ALYFTREK, which carries a lower royalty if Vertex wins the arbitration. The real test is not this quarter's beat. It is whether CASGEVY, JOURNAVX and (if approved) povetacicept can grow fast enough to justify SG&A rising three times faster than revenue, and the ~$10 billion Crinetics purchase on top.
The Crinetics deal
On July 6, 2026, Vertex agreed to buy Crinetics Pharmaceuticals for $85.00 per share in cash. That is a total equity value of about $10.0 billion, or about $8.8 billion net of Crinetics' cash. Crinetics sells PALSONIFY for acromegaly (a hormone disorder that causes excess growth) and is developing atumelnant for congenital adrenal hyperplasia (CAH). Vertex calls rare endocrine diseases its "fifth pillar". The 10-Q says the deal will be paid for with cash on hand plus a new $4.5 billion term loan, with $1.0 billion due on the loan's first anniversary. It also warns that net interest income ($120.6 million this quarter) will fall. In its deal announcement, Vertex said it expects the acquisition to add to non-GAAP operating income starting in 2029. Until then it adds costs and interest expense. Vertex expected the deal to close in Q3 2026. Current 2026 guidance excludes Crinetics, and management will reissue guidance after closing.
Outlook and catalysts
Management's 2026 guidance: revenue of $13.1–13.2 billion (raised); $500 million or more from non-CF products; combined GAAP R&D, AIPR&D and SG&A of $6.3–6.45 billion; and a non-GAAP tax rate of 19.5–20.5%. First-half revenue was $6.32 billion, so the guidance implies about $3.39–3.44 billion per quarter in H2. That is a modest step up from Q2's $3.33 billion.
Dated events from the filing to watch:
November 30, 2026: FDA decision (PDUFA date) on povetacicept for IgA nephropathy, an immune-driven kidney disease, under accelerated approval. It would be Vertex's first kidney-disease product. The SG&A build-out is already being paid for.
Fall 2026: data from the AMPLIFIED Phase 2 study of inaxaplin in APOL1-mediated kidney disease. Interim data from the larger AMPLITUDE study are due in early 2027.
H2 2026: first patient data for VX-828, the first of Vertex's next-generation ("3.0") CF correctors, and results from the VX-670 myotonic dystrophy trial.
Later in 2026: updated timelines for the type 1 diabetes cell therapies zimislecel and VX-017, and CF data at the North American Cystic Fibrosis Conference in October.
Our read: the CF base looks secure in the near term. The ALYFTREK switch is adding net revenue, not just replacing TRIKAFTA. The risk is on the cost side. Operating margin has already slipped 1.4 points. The Crinetics debt and lower interest income will weigh on 2026–2028 earnings. Povetacicept's approval and early launch will show whether the extra SG&A pays off. Watch Q3 for three things: non-CF revenue above ~$150 million (the pace the $500 million target needs), any ruling in the Royalty Pharma arbitration, and the post-Crinetics guidance reset.
Source: Vertex Pharmaceuticals Form 10-Q for the quarter ended June 30, 2026 (filed August 4, 2026), plus the company's Q2 2026 earnings release (Form 8-K, August 3, 2026) for guidance and product highlights and the July 6, 2026 Form 8-K for Crinetics deal terms.