Morgan Stanley: US drug prescription growth rebounds year over year; new-product sales forecasts have differing prescription hurdles

Does the year-over-year rebound in the US prescription market mean demand is accelerating across the board?

In the week ended 30 October, US total prescriptions (TRx) grew 5.2% year over year, up from 4.4% the previous week; year-over-year growth over rolling 4-week and 12-week periods was 4.3% and 2.6%, respectively. But prescriptions fell 0.4% week over week, after rising 0.3% the previous week: improved year-over-year momentum did not translate into a continued weekly strengthening.
Morgan Stanley noted that growth in expanded unit prescriptions (EUTRx) was below TRx for the week. Standard TRx counts both 30-day and 90-day prescriptions as one prescription, while expanded-unit data takes prescription quantity or duration into account, so the two metrics do not present demand in exactly the same way.

Gilead's Yeztugo, used for PrEP, had about 2,100 total prescriptions for the week, unchanged from the previous week; injectable prescriptions were about 1,350, also unchanged. Morgan Stanley forecasts US sales of 1.046 billion dollars in 2026, above the Visible Alpha consensus of 1.023 billion dollars; global sales are forecast at 1.085 billion dollars, above consensus of 992 million dollars.
Support for the forecast includes a persistence rate above 70% and payer coverage of 95%; the company's US sales guidance is about 1 billion dollars. However, prescriptions have not increased this week, and the firm says early post-launch sales visibility is limited. Prescription changes therefore remain an important reference point for assessing whether the forecast will be realized.

Merck's Lipfendra had about 3,430 prescriptions for the week, up from 3,110 the previous week. Most prescriptions came from patients already using other cholesterol-lowering drugs, rather than switching from injectable PCSK9 drugs. Management said penetration of existing therapies in the relevant market is about 5%, but also expects the cholesterol-lowering market to ramp gradually because of medication inertia. At an institution-estimated net price of about 239 dollars per prescription, about 102 thousand prescriptions would be needed to reach the 24 million dollars consensus for the fourth quarter of 2026; because the consensus does not break out regions, the firm uses global sales as an approximation for US sales.
Johnson & Johnson's Icotyde had about 2,140 prescriptions for the week, up from about 2,010 the previous week. Morgan Stanley estimates that about 24 thousand to 32 thousand prescriptions would be needed over the full year to reach the 201 million dollars US consensus for 2026, assuming a monthly list price of 8,285 dollars and a gross-to-net discount rate of 0–25%. IQVIA's capture rate for the drug's prescriptions rose from about 25%–30% in the second quarter to about 30%–40% in the third quarter. As recently obtained commercial insurance coverage takes effect, early prescription data may still understate prescribing.

Bristol Myers Squibb's Cobenfy had about 3,200 prescriptions for the week, down from about 3,400 the previous week. At an institution-assumed net price of about 1,435 dollars per prescription, about 161 thousand prescriptions would be needed to reach the 237 million dollars consensus for 2026; this makes the distance between the week's prescription change and the full-year target more tangible.
Vertex's Journavx had about 41,400 prescriptions for the week, up from about 39,700 the previous week. Based on an average prescription duration of 11 days, about 3 million prescriptions would be needed to reach the 216 million dollars consensus for 2026 if the gross-to-net discount rate is 80%, or about 2 million prescriptions if it is 70%; the firm estimates the gross-to-net discount rate was about 77% in the two most recent quarters. In addition, IQVIA does not cover hospital prescriptions, while hospital and retail channels accounted for 45% and 55% of Journavx sales in 2025, respectively, so IQVIA prescriptions alone cannot represent performance across all channels.