AMRX Amneal Pharmaceuticals, Inc.
$20.44
Amneal Pharmaceuticals, Inc. Q3 F2026 Earnings Call Transcript
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Operator
Good morning and welcome to the Amneal Pharmaceuticals third quarter 2026 earnings call. I will now turn the call over to Amneal's head of investor relations, Tony DiMeo.
Tony DiMeo
Head of Investor Relations
Good morning and thank you for joining Amneal Pharmaceuticals third quarter 2026 earnings call. Today we issued a press release reporting Q3 results. The earnings press release and presentation are available on the IR page of amneal.com. Certain statements made on this call regarding matters that are not historical facts, including but not limited to management's outlook or predictions, are forward-looking statements that are based solely on information that is now available to us. Please see the sections entitled Cautionary Statements on Forward-Looking Statements in our press release and presentation for factors that may impact future performance. We also discuss non-GAAP measures. Information on use of these measures and reconciliations to GAAP are in the earnings release and presentation. On the call today are Chirag and Chintu Patel, co-founders and co-CEOs, Tasos Konidaris, CFO, Joe Renda for Specialty, and Jason Daly, Chief Legal Officer. I will now hand the call over to Chirag. Thank you, Tony.
Chirag Patel
Co-Founder and Co-Chief Executive Officer
Good morning, everyone. Today, Emneal is a stronger, more diversified company than ever before, with a portfolio focused on high-value products designed to drive durable growth. We've expanded across specialty biosimilars and complex products while building the capabilities and capacity to drive these businesses long term. 2026 marks our seventh consecutive year of top and bottom line growth, a track record that stands out in the industry. Our third quarter performance reflects that progress. with revenue of 863 million, up 10%, adjusted EBITDA of 207 million, up 30%, and adjusted EPS of 26 cents, up 53%. The breadth of our portfolio and the depth of our pipeline give us confidence that we are still early in realizing MNU's full potential. Let me highlight the progress across our key growth areas. First, in biosimilars, we closed the Kashif transaction in Q3. MNIL now has the end-to-end capabilities to succeed in biosimilars, R&D, manufacturing, and commercial in-house. Now it is all about execution. From a macro perspective, We have access to a large and growing biosimilar market with approximately 234 billion of U.S. biologic cells losing exclusivity over the next decade. At the same time, streamlined regulatory pathways, new commercial models such as private labels and accelerating market adoption are creating a major inflection point for the U.S. biosimilar industry. Against this backdrop, our portfolio strategy is deliberately differentiated, balancing targeted, lower competition molecules with a select number of broader biologic opportunities. We believe this approach positions MNIL to capture attractive economics and sustain long-term value creation. From M-Neal for M-Neal biosimilars are a natural extension of our purpose, making key medicines more accessible and affordable while building a durable growth platform. Biologics accounts for more than half of U.S. drug spending, yet represents only 5% of total prescriptions, highlighting the significant affordability and access challenge. We believe we can help address that gap and create value for patients. Second, complex genetics remains a core strength with a proven track record of execution. We have an expanding diversified portfolio of high-demand complex therapies, including women's health, transdermal patches, and important new injectable products approvals such as Landreotide, Bromidepsin and Iohexol. Across dosage forms, these are significant opportunities for sustained growth. We have strategically evolved our portfolio toward high value complex products, where our science, manufacturing capabilities and capacity, Reliable supply and customer relationships set us apart. Third, in specialty, our key brands are performing very well. Two years after launch, Trexon for Parkinson's disease continues to gain share. This is being driven by positive patient experience and compelling clinical evidence with more than three additional hours of good on time per day. and many more. Healthcare remains important aspect of our business that provides diversification and access to government and institutional channels for our high-value products, including biosimilars in the future. Fifth, we are advancing our GLP-1 collaboration with Pfizer as construction of our new dedicated GLP-1 manufacturing facilities for both drug substance and drug product remain on track for 2028. Taken together, MNIL has a fundamentally stronger and more diversified growth profile than ever before. With more growth engines, more innovation, and more opportunities ahead, our focus is on the execution. delivering across each of these areas, converting that potential into results. We believe the momentum of 2026 positions us very well for continued high growth in 2027 and beyond. With that, I'll turn it over to Chintu.
Chintu Patel
Co-Founder and Co-Chief Executive Officer
Thank you, Chirag, and good morning, everyone. I want to thank the entire MNIL team which continues to execute at a high level. Their strong performance enables us to pursue increasingly ambitious opportunities while continuing to deliver across our existing businesses. Since our last call, we closed the Kashif transaction in August. The combined team is working as one across development, Manufacturing and Commercialization to build our biosimilar business. Also, as we shared on our Q2 call, one of our India facilities experienced flooding back in late July. The team worked tirelessly to limit the impact, and we are pleased to share that operations have fully resumed. In addition, in September, we received FD approval for Landreotide, a high-value complex injectable. Let me focus on four areas. First, integrating Kashif and advancing our biosimilar pipeline. Second, our global operational strategy. Third, our R&D portfolio. And fourth, growing our specialty business. First, in biosimilar. We now have the end-to-end capabilities from cell line and clone development through clinical execution, regulatory expertise, biologics manufacturing, and commercialization. Kashif brings the science, development, and biologics manufacturing, while MNIL brings commercial scale, channel expertise, and customer relationships. Together, we can move faster, plan effectively, and capture more value, reinforcing biosimilars as a key long-term growth pillar for MNIL. The combined platform is designed to make disciplined portfolio decisions, advance multiple molecules in parallel, and create a repeatable path from R&D through commercialization. Our biosimilars manufacturing footprint in New Jersey and India is expanding, which enables us to work on a growing number of biosimilar R&D programs and also meet commercial demand. Our biosimilars pipeline is focused on early-to-market global opportunities where we are targeting being first or second to launch. We built this playbook and executed it well in complex generics and we are now applying it to biosimilars. Second in operations, our priorities remain clear. Quality, reliability, and resiliency. Across our global manufacturing and supply chain network, we continue to deepen our capabilities and capacity in complex generics, sterile injectables, and biosimilars. Our facilities have transformed in recent years through digitization, automation, and AI-enabled tools. We are advancing our manufacturing capabilities and quality while improving efficiency. At the same time, we are scaling capacity for our key growth areas, including significant expansion for women's health trans-thermal patches this year, new US-serine injectable capabilities by 2028, Expanding our complex injectable capacity for key programs like Landreotide and Respiradone Building out our two new GLP-1 facilities and increasing biosimilar capacity to support our pipeline These initiatives are designed to meet increasing market demand and drive meaningful new growth This broad operational platform is differentiated in the industry Our large manufacturing footprint across 20 global facilities and technical expertise position MNIL well to deliver reliable supplies, address important market needs, and pursue new growth opportunities at the same time. Third, turning to our complex generics pipeline, we continue to convert many years of R&D hard work into significant commercial products. Complex generics and we are not slowing down. That strategy is visible in the differentiated portfolio spanning injectables, ophthalmics, inhalation, transdermal, drug device combinations, 55B2 products and other dosage forms. Recent approvals are important Group Points. Recent approvals include key complex generics and 5-5-E2 products, such as Landiotide, Rumidefsen RTU, Sodium Bicarbonate IV bag, and additional strength and presentations of Iohexol. These products expand our portfolio into large, attractive markets and demonstrate our ability to develop, manufacture, and commercialize increasingly complex medicines in-house. Looking ahead, we are advancing a deep pipeline of long-acting injectable 55E2 and inhalation programs. We continue to have the most CGT approvals in the U.S. pharmaceutical industry. One year ago, on our Q3 call, we highlighted 20 key launches across 2025 and 2026 that we believed would propel our affordable medicines business to a new level. Today, almost all are now approved and launched. Looking forward, we see a next wave of new product launch opportunities between 2027 and 2029, particularly new sterile injectable and bag products. This gives us high confidence that growth in affordable medicine will continue to stay elevated in the years ahead. Importantly, this is not a one-time launch cycle. It reflects the innovation engine we have built over many years and the steady conversion of those programs into successful commercial launches. Specifically, inhalation is a new growth platform that we have been building. Last year, we received our first two approvals, ProAir and QR. Looking ahead, we are targeting five additional MDI and soft mist approvals over the next three years. We see inhalation as a new vector of growth for the business. Fourth in specialty, we are very pleased with the continued performance of Kraxon and Raykia. The strength is visible not only in high revenues, but also in prescription trends, physician adoption, and the growing number of patients benefiting from these impactful therapies. For Kraxon, we continue to build on the clinical and real-world evidence supporting its differentiated profile in Parkinson's treatment landscape. We are pursuing second phase four study, evaluating its effect on disease progression. As awareness and physician experience expand, the opportunity remains clear to expand Craxon's reach among the 700,000 patients in the U.S. on carbidopa-leuropa therapy. Beyond Traxon and Brachia, we are advancing additional 55B2 and novel R&D programs to build a broader specialty platform focused on differentiated medicines that can improve patient outcomes. Across our businesses, our formula remains the same. Strong science, quality first, robust planning, care for customers and patients, and disciplined execution. The progress made in 2026 and the catalyst ahead gives us very strong confidence heading into 2027. With that, I will turn it over to Tasim.
Tasos Konidaris
Chief Financial Officer
Thank you, Chintu, and good morning, everyone. I'm very pleased to share our third quarter exceptional financial results, which are a testament to our strategic choices and strength of execution. Revenue of $863 million increased 10%, adjusted EBITDA, of 207 million increased 30%, and adjusted EPS of 26 cents increased 53%. Our growth profile remains very strong due to the relevancy and complexity of our broad product portfolio, as well as the fact that we play in large and growing markets. As a result, we're very pleased to once again increase our 2026 financial guidance and expect strong momentum in 2027 and beyond. In the third quarter, Affordable Medicines delivered revenue of $547 million and grew 19%. This reflects growth across our three channels of retail, injectables, and government. From a product perspective, growth was mainly driven by our women's health transdermal patches, new product launches which added $54 million in the quarter, and favorable timing of a large biosimilar customer order, which added about 40 million. It is worth noting that Landreotide made a very small contribution in Q3 as we launched in late September. However, we're already seeing terrific uptake and expect much larger contribution of Landreotide in subsequent quarters as we fulfill substantial market demand. Specialty revenue was $150 million, up 20%, driven by continued growth across Crexan, Prakia Autoinjector, and Unitroid. Strong underlying trends and smart execution across these three brands support continued growth into future years. Upcare revenue was $165 million, down 17%, as expected, due to the non-repeating nature of a large product introduction in the third quarter of last year where revenue grew 25%. Putting this one factor aside, Avcare revenue in the quarter was stable while adjusted EBITDA was up double digits as our team continues to prioritize profitability over simple revenue growth. Moving down the P&L. Q3 adjusted gross margin was 43.2% up 50 basis points year-over-year, reflecting favorable mix. Adjusted EBITDA grew 30% due to strong revenue growth and disciplined expense management. Q3 adjusted EPS grew 53%, reflecting higher adjusted EBITDA and lower interest expense. It is important to note that our year-to-date financial performance is also extremely strong with revenues up 8%, adjusted EBITDA up 20%, and adjusted EPS up 34%. As a result, we're very pleased to update our full year 2026 guidance. Revenues increased by 50 million at the midpoint of the new range of 3.15 to 3.25 billion. Adjusted EBITDA is increased by 43 million at the midpoint of the new range between 800 and 815 million. Adjusted EPS is also increased by 5 cents at the midpoint of the new range of $1.04 and $1.08. Finally, operating cash flow is slightly down by 25 million at the midpoint of the new range of 325 to 375 million. The operating cash flow adjustment is driven by timing and reflects our decision to increase internal finished goods inventory to satisfy strong revenue demand and timing of some collections being pushed to Q1 of 2027. From a balance sheet perspective, net leverage was three point times adjusted EBITDA as of Q3, reflective of closing the KASIVA acquisition. We expect to finish 2026 at 3.6 times adjusted EBITDA in line with year-end 2025 and continue to feel confident of being below three times adjusted EBITDA by 2028. Let me now finish with our KASIVA acquisition where the integration is progressing very well. As you may recall, in addition to the large market opportunity this deal represented, we also highlighted 400 to 500 million in expected financial benefits driven by elimination of profit-sharing obligations and various tax incentives. We feel very confident about capturing these benefits, and I'm happy to share two recent proof points. Our newly launched product, Lanreotide, was originated at KASIB, and as a result of the acquisition, MNEL now gets to keep 100% of this product's profits. Second, last week, we secured $60 million in tax credits from the New Jersey Economic Development Authority. A large part of these benefits relates to the manufacturing expansion in support of the KASIB acquisition and the future biosimilars product roadmap. In summary, we're extremely pleased with our strong results, increased financial outlook for 2026, and the strong momentum for continued growth in 2027 and beyond. With that, I'll turn the call back to Chirag.
Chirag Patel
Co-Founder and Co-Chief Executive Officer
Thank you, Tasos. Our Q3 results reflect the breadth and depth of MNEO. We are executing well across our growth pillars, complex generics, biosimilars, specialty, and healthcare. With GLP-1, continue to advance very well. Since our last call, we closed the Kashif transaction to create an integrated biosimilars platform. We received important approvals, including LandrioTide. and our specialty brands Crexon and Brachia continue to drive uptake. These are tangible achievements and there is more ahead. The strength we are delivering in 2026 combined with our upcoming catalyst and pipeline gives us confidence in continued strong growth in 2027 and beyond. Our goal remains clear. to become America's number one affordable medicines company and leading provider of essential medicines globally. With that, let's open the call for Q&A.
Conference Operator
Operator
We will now begin the question and answer session. Please limit yourself to one question and one follow up. If you would like to ask a question, please press star one to raise your hand. To withdraw your question, press star one again. We ask that you pick up your handset when asking a question to allow for optimum sound quality. If you are muted locally, please remember to unmute your device. Please stand by while we compile the Q&A roster. Your first question is from Les Zalewski with Oppenheimer. Your line is now open. Please go ahead.
Jeevan
Analyst, on behalf of Les Zalewski at Oppenheimer
Hey, this is Jeevan on for Les. Thanks for taking our questions. Could you clarify the revenue book for Lanyotide and 3Q? And, you know, what are you seeing on early metrics from initial stocking versus patient demand? And then as a follow-up, I think the FDA only approved the 120 milligram syringe. Are the 60 and 90 milligram strengths filed, and when could they be approved? Thank you.
Tasos Konidaris
Chief Financial Officer
Adrian, this is Tarsos. Welcome. Number one is we launched Latrina or Landreotide in Q3, actually, very late in September. The revenue was very small, about $7 million, right? You can expect multiple times of that in Q4. and as we think about continued growth of the product throughout next year and beyond, our team is aiming at about 30 to 40% market share. With that, let me pass it on to Chintu for part two. Yeah, thank you.
Chintu Patel
Co-Founder and Co-Chief Executive Officer
So on other two strengths, 60 and 90, our post-approval supplement is ready and we will be filing both the strengths in this quarter. and expect the launch in the second half of next year. Most of the cells in this strength? Yeah, 90% of the cells are in the 120mg strength. Thank you, Chintu. Thank you.
Conference Operator
Operator
Your next question is from David Amsalem with Piper Sandler. Your line is now open. Please go ahead.
David Amsellem
Analyst, Piper Sandler
Hey, thanks. So on Zolaire, can you talk about When in 2027 you think you'll be in a position to launch and just remind us what has to happen in order to be in a position to launch? And then secondly, on Zoeller, how are you thinking about competitive dynamics and how impactful it could be in 2027 to the extent that you say one or two biosimilars on the market? and then just another quick question on Breccia that seems to be ramping nicely. Can you talk about access dynamics and how you're thinking about the trajectory of that product going forward? Thanks.
Chirag Patel
Co-Founder and Co-Chief Executive Officer
David, good morning. Zola, we have a goal date early next year, and we are in active discussion, which I cannot give you more detail on a patent settlement and a date, but we expect to launch in second half next year towards late. And we, on a competition side, as you know, Seltrion is in the market. We expect to be the second. and then Teva has filed the product as well. It's an excellent molecule, large demand. We're already working with customer channels on various customer channels to maximize our opportunity here for years to come, as well as we have the approval in MHRA and a positive opinion from EMA for Zolaire, which we expect the final approval in late November. and launch again according to the patent settlement, which we'll let you know when we strike. So very excited about Zola. Let's talk about Brachia. So Brachia, we're getting good 50-60% conversion and it's a much needed drug. We're not getting too many pairs blocked yet. So let the uptake happen and then we'll worry about the coverage. But right now it's going through fine. Thank you.
Conference Operator
Operator
Your next question is from Chris Schott with J.B. Morgan. Your line is now open. Please go ahead.
Katarina
Analyst, on behalf of Chris Schott at J.P. Morgan
Thanks so much. This is Katarina on for Chris. So on your 2030 outlook, you know, seems like you're expecting very healthy top line growth. You know, just how much of that is coming from affordable medicines versus specialty and healthcare? And then can you help us also bridge from the top line to your EPS number? Any key assumptions in terms of, you know, margins or Anything like that that you're kind of embedding in that 2030 outlook. And then second question is around Dodi and women's health. You know, just latest trends you're seeing for the product and your expectations for 27. You know, how big can this become once you have some of the additional kind of capacity come online? Thanks.
Tasos Konidaris
Chief Financial Officer
Good morning. You may have to repeat a couple of those questions. I'm fast, but you're even faster than me. As we think about 2030, just to kind of ground everyone, what we said was will expect the revenue to go from about $3.1 billion this year, right, 3.1 to 3.2, to about 4.3 to 4.5. So that's an incremental over a billion dollars of growth. The majority of that growth is going to come from the affordable medicines space and primarily from biosimilars, okay? That was a key impetus for us to kind of, for the CASEV acquisitions. Now, since we are now, so the biggest majority of that calling, as I said before, is going to come from affordable medicines and within affordable medicines, biggest chunk biosimilars. But also, you know, you heard us a lot about the growing businesses such as women's health care, Transdermal Patches that are growing as well around our injectable business. So those are the other components within affordable medicines that we expect to grow. Abcare, we expect Abcare to continue to grow. I think we had this year a little bit of a reset from a revenue perspective as we deprioritize our low margin distribution channel. and Anastasios Konidaris. primarily as they enter, play bigger player within the government channel and passing through more biosimilar products. So we're working closely with them about developing a strategic roadmap of biosimilars within the government channel. And that roadmap obviously is going to include MNL products as well as other third parties. So I think that covers the revenue. Can you just tell me What would be the other question around margins and maybe bottom line growth?
Katarina
Analyst, on behalf of Chris Schott at J.P. Morgan
Yeah, just kind of what are you embedding just in terms of gross margins and any other kind of key assumptions as you kind of think about bridging from the revenue to the EPS?
Tasos Konidaris
Chief Financial Officer
Great, great, great, great. So, great question. So, one of the things that we have done over the last few years is focus on increasing our gross margins. So, as an example, you can see our year-to-date, as an example, affordable gross margins are up 300 basis points, as an example. And gross margin for the business this year, we're probably going to be total annual probably at about 46.5 compared to about 45.5 last year. So solid growth rate in terms of gross margins. As we think about 2030, gross margins will improve further. And they're going to improve further for a number of different reasons. Number one is, as biosimilars in general, have a higher gross margin than the rest of our business. And with the acquisition of AdCare, I'm sorry, the acquisition of Kashi, now we're able to keep all 100% of those economics intact. So that acquisition and biosimilars being a key growth driver bodes well from a mixed perspective, number one. Number two, for many years now, we continue to focus on our complex generics, affordable medicines. So part of the reason we did that was, number one, is we saw a big market opportunity, number one. Simply the comparative dynamics in that space is better. And number three, the average price point and profitability for those products is higher than what will be for a typical oral generic. and the third thing is our teams work day and night to continue to drive operating efficiencies. So everyone is busy kind of doing more with less and increasing our efficiency rates. And there is a lot of internal effort that our CEOs are leading in terms of embedding AI more and more in our day-to-day operations. So over the course of time, as we think about 2030, we see revenue growth accelerating, margins continue to improve, and this is what's going to drive substantial bottom-line growth rates as well as reducing debt over the course of time.
Chirag Patel
Co-Founder and Co-Chief Executive Officer
Greg Tassos, Chirag, I'm going to add a couple of things. So since we are talking about now to 2030, then I think for the overall, for all the questions, I guess, this is very important. So our base business is growing, actually. So we are very excited due to the Women's Healthcare HRT, we have built out capacity. We're building out even more capacity. We are completely in the know of the demand. Anastasios Konidaris, Chintu Patel, Anastasios Konidaris, Chintu Patel, Anastasios Konidaris, Anastasios Konidaris, Chintu Patel, Anastasios Konidaris, Chintu Patel, Anastasios Konidaris, Chintu Patel, Some goes down, some go up, 300 products portfolio. Now, we're predicting that our base business will grow. Second, we have next wave, as my brother mentioned on his script, next wave of launches, which are all in complex CX. We're building out a sterile manufacturing facility in New York. We got a pre-check program. We are converting the compounded drug into approved products. Such a big need for the hospitals. And we're a purpose-driven company, correct? And so we are partnering with hospitals to solve that supply from India and Brookhaven, New York. Long-acting depo injections continue to gain traction. Respiradone, octretides coming. Inhalation, we mentioned two approved, more are coming. Ophthalmics ramping up. So no shortage of small molecule drugs coming up in next four years. Biosimilars on top of that are also coming. Excited about the launching Dinosumab. Both presentation in mid-next year. and then Zola and then continue to, we have disclosed some of the pipeline assets. They're fantastic and expect us to do more and more in biosimilars. Specialty is also growing because of continued growth of Crexon. We're not even, I mean, we're probably not even halfway there, Joe, right? We'll keep growing the scripts. And then Avcare is growing on where it needs to grow, high growth areas such as biosimilar specialty and complex GX, taking full advantage of our U.S. manufacturing capabilities. And international growth because of the biosimilars partnership internationally will be doing more. India, we have launched our own label. Small business today will grow in the future. and we're further partnering in South America, Europe, Middle East, Canada. So international, which today is only a $40-$50 million business, expect to grow significantly as well. So we're extremely excited about from now to 2030.
Conference Operator
Operator
Your next question is from Ash Verma with UBS. Your line is now open. Please go ahead.
Dee
Analyst, on behalf of Ash Verma at UBS
Hey, good morning. This is Dee on behalf of Ash. So one question from us. For the ILXO, can you help us understand the overall opportunities and how that contributes to your 26 and 27 sales? And do you need the full SKU portfolio on the different dosing to maximize this launch and then How's the conversation going with the IND on the contracting? Thank you.
Chintu Patel
Co-Founder and Co-Chief Executive Officer
So on IOHAG soil, We now have filed all the SKUs and we'll be covering the entire breadth of the Iohexol product. It is a complex product. Still, we are the only generic. We work very hard to increase our capacity and cost efficiency. So going into 2027, we feel pretty good about Iohexol as being a key road driver and our commercial teams are working with hospitals and other channels to increase our market share with having the full basket. So the IronXR would be a good product for us going as we have the more capacity, all the SKUs, and we have strong, resilient supply chain now on IronXR.
Conference Operator
Operator
Your next question is from Matt De La Torre from Goldman Sachs. Your line is now open. Please go ahead.
Matt De La Torre
Analyst, Goldman Sachs
Great. Thanks for the questions and congrats on the progress. Maybe on the Pfizer partnership, could you just give us an update on the status of that and share any more color on development progress, manufacturing preparedness? and then also how meaningful of an opportunity this could be to AMEO long-term. And then on the specialty side, I know you've pointed in the past to higher confidence and maybe the higher end of your long-term Crexon and Brexia guidance.
Chirag Patel
Co-Founder and Co-Chief Executive Officer
Good morning, Matt. How are you? Pfizer, excellent partnership, going really well. Both teams are doing fantastic. They just had 12 people visiting our facilities, which are under construction. They are awestruck at how awesome it is, fully digitized, AI-based. The The capacity is huge, obviously. It's latest and greatest lines, fully automated through the packaging inspection. It's an amazing site, amazing partnership. We will complete the construction in late 28 to 29. We should start commercialize for and all territories, basically. And we're working through the final touches of how the future partnership would look like on our co-marketing. We have given access to 18 markets exclusively, so we're evaluating how do we market that with now Pfizer. We're interested in marketing a brand, not genetics. So that is where the Pfizer partnership and also those two sites we're building will be able to take other business from other big pharma or even from MNIL Biologics, Kashif's products, wherever it comes from. Amazing sites. So we're very excited to have this big potential and we'll share more detail as we make great progress. What was it?
Joe Renda
Specialty
Crexon and Brachia.
Chirag Patel
Co-Founder and Co-Chief Executive Officer
Crexon and Brachia. Joey, would you like to chime in?
Joe Renda
Specialty
Yeah, absolutely. We're really, really pleased, Matt, with the response we've seen in the market with Crexon. We continue to add new prescribers every month. Around 400 or so, we're adding it monthly. And our TRXs are continuing to grow at a substantial pace. So we're very confident in the guidance we've given longer term, probably to the middle part, maybe even the higher end of that guidance based on our current trends. So we're very confident there. And Brachia Auto Injector, as we talked about earlier, the expansion that we did earlier this year has really enabled that product to really grow. We've already doubled the expectations for the tracking of how we're performing this year. We anticipate next year to probably also come close to doubling our performance from this year. So the response from the market for Brachia Auto Injector has been very positive and and the expansion, as I mentioned, that we did enables us to get into more of the key headache prescribers that have been very, very responsive so far. And the per-patient carton use also has also been a very substantial part of that accelerated growth with per-key autoinjectors. So we actually are very confident in that probably going beyond what our current expectations are from a guidance standpoint.
Matt De La Torre
Analyst, Goldman Sachs
Great. Thanks for all the comment. Appreciate it.
Conference Operator
Operator
Thank you, Ben. Your next question is from Daniel Clark with Lee Rink Partners. Your line is now open. Please go ahead.
Daniel Clark
Analyst, Leerink Partners
Great. Thank you. Good morning. Just wanted to ask how you're thinking about the Lanyard Tide opportunity in Europe here. I believe you have a pending approval. So just curious if you could frame, you know, next steps and potentially what, you know, like how that can impact results. Thank you.
Chintu Patel
Co-Founder and Co-Chief Executive Officer
Hi, Daniel. Good morning. Yes, we have filed our product in Europe, and we are expecting action in the third quarter next year. And we have real capacity to address both the U.S. demand and Europe. It is a substantial product and volume in Europe, so we are very excited about the European opportunity also.
Conference Operator
Operator
There are no further questions at this time, and we have reached the end of the Q&A session. I will now turn the call back to Chirag Patel for closing remarks.
Chirag Patel
Co-Founder and Co-Chief Executive Officer
Well, thank you, everybody, for listening. Have a great day. Thank you.
Conference Operator
Operator
This concludes today's call. Thank you so much for attending. You may now disconnect.