AstraZeneca PLC (NYSE: AZN) reported total revenue of $15.3bn for the three months ended 31 March 2026, a 13% increase on an actual exchange rate basis and 8% at constant exchange rates (CER), as growth in oncology and rare disease offset a decline in the cardiovascular, renal and metabolism segment.
The Cambridge, UK-based biopharmaceutical company competes directly with Merck, Roche, and Johnson & Johnson in oncology and with Novartis in rare disease. AstraZeneca has reported consistent double-digit oncology revenue growth over recent quarters, supported by a pipeline of medicines across multiple cancer types.
#Oncology and Rare Disease Drive Quarter
Oncology product revenue reached $6.8bn in Q1 2026, up 16% at CER, with Imfinzi contributing $1.7bn, up 30% at CER, and Enhertu contributing $831m, up 34% at CER across AstraZeneca's recorded share. Rare disease product revenue totalled $2.4bn, up 15% at CER, with Strensiq rising 43% at CER to $517m and Ultomiris adding $1.3bn, up 18% at CER.
The cardiovascular, renal and metabolism segment reported product revenue of $3.2bn, flat on an actual basis and down 7% at CER. Farxiga contributed $2.2bn, up 7% on an actual basis but down 2% at CER, as generic competition and volume-based procurement in China reduced growth. Brilinta declined 67% at CER following generic entry in the US and Europe in Q2 2025.
#Tozorakimab Meets Primary Endpoints in Three COPD Trials
Since the Q4 2025 results announcement, AstraZeneca reported positive Phase III data from four programmes. Tozorakimab, an investigational IL-33 inhibitor, met its primary endpoint in three COPD trials — OBERON, TITANIA and MIRANDA — demonstrating reductions in annualised rates of moderate-to-severe exacerbations versus placebo across former and current smokers. A fourth COPD trial, PROSPERO, a long-term extension study, showed a numerical but not statistically significant reduction in the annualised rate of severe exacerbations in former smokers, the primary endpoint.
Efzimfotase alfa met its primary endpoint in the MULBERRY trial in children aged two to under twelve with hypophosphatasia who had not previously received Strensiq, demonstrating improvement in bone health compared to placebo at week 25. A companion trial in adolescents and adults, HICKORY, did not meet its primary endpoint.
"We delivered strong growth in Q1 2026, with Total Revenue above $15 billion, demonstrating our consistent commercial execution," Pascal Soriot, Chief Executive Officer of AstraZeneca, said in the earnings release. He added that the company is preparing for multiple launches and remains on track to achieve its 2030 targets.
On 30 April 2026, the FDA's Oncologic Drugs Advisory Committee voted 6 to 3 that AstraZeneca had not demonstrated clinically meaningful benefit for camizestrant, an oral selective estrogen receptor degrader, in the first-line treatment of hormone receptor-positive, HER2-negative advanced breast cancer upon detection of an ESR1 mutation. The committee's concerns centred on the trial design of the SERENA-6 Phase III study and the absence of mature overall survival data, despite SERENA-6 showing a 56% reduction in the risk of disease progression or death versus standard of care. The FDA is not bound by the committee's recommendation and AstraZeneca said it would continue working with the agency as it completes its review. The FDA's final decision on the application is pending.
#Guidance Reconfirmed; CSPC Deal Closed
AstraZeneca reconfirmed its full-year 2026 guidance, projecting total revenue growth of a mid-to-high single-digit percentage at CER and core earnings per share growth of a low double-digit percentage at CER. The company recorded a core tax rate of 21% in Q1 2026, compared with 14% in Q1 2025, as the prior period benefited from the release of tax liabilities following settlements with tax authorities. Core EPS rose 5% at CER to $2.58.
In April 2026, AstraZeneca closed a collaboration agreement with CSPC Pharmaceuticals covering obesity and type 2 diabetes programmes, paying a $1.2bn upfront fee. CSPC is eligible to receive development and regulatory milestones of up to $3.5bn, plus commercialisation milestones and tiered royalties. The company also exercised an option to license PTX-299, a bispecific antibody degrader targeting EGFR, from Pinetree Therapeutics, triggering a $25m payment.
Alongside the earnings release, AstraZeneca announced it would revive a £300m ($405m) investment programme in the UK that it had suspended in September 2025 following a dispute over NHS drug pricing. The package includes £200m to complete the Rosalind Franklin Building at its Cambridge Biomedical Campus and £100m for its Macclesfield site, which the company said would become a facility using digital and data tools to advance drug development. The reversal followed a US-UK trade arrangement that raised NHS payments for new medicines by 25% and reduced the rebate rate payable by drugmakers from 22.9% to 14.5% in 2026. Prime Minister Keir Starmer announced the investment in parliament, describing it as a vote of confidence in the UK. Soriot said in the earnings call that both policy changes were directly linked to the company's decision to resume the projects.
Net debt increased by $2.6bn in the quarter to $25.9bn at 31 March 2026, reflecting the issue of $1.99bn in new long-term loans and $2.4bn in commercial paper. AstraZeneca intends to increase its annual dividend to $3.30 per share in FY 2026.
The company attributed projected revenue and earnings growth to its oncology pipeline and multiple planned product launches. Risks to the outlook include generic competition in key markets, pricing pressure from government procurement programmes, currency movements, patent challenges, and the outcome of ongoing legal proceedings including US government investigations and antitrust litigation.