AstraZeneca H1 results: growth holds up despite pipeline setbacks

AstraZeneca keeps its growth story moving

AstraZeneca's half-year results delivered a solid combination of revenue growth, higher core earnings and further regulatory approvals. The pharmaceutical group also reconfirmed its full-year guidance and said it remains on track for its ambition of $80 billion in Total Revenue in 2030.

That does not mean the update was spotless. Reported profitability grew more slowly than the adjusted figures, operating cash flow declined, net debt increased and several Phase III trials failed to meet their primary endpoints.

The broad message is that AstraZeneca's established medicines and pipeline continue to produce growth, but the cost of supporting that expansion is becoming increasingly visible.

The headline numbers

AstraZeneca generated Total Revenue of $30.672 billion in the first half of 2026, an increase of 9% at actual exchange rates and 6% at constant exchange rates, or CER. CER removes the effect of currency movements to show the underlying change in performance.

H1 2026 measure	Result	Actual change	CER change
Total Revenue	$30.672 billion	9%	6%
Product Revenue	$30.595 billion	9%	6%
Reported operating profit	$7.410 billion	3%	2%
Core operating profit	$10.510 billion	12%	11%
Reported EPS	$3.60	4%	3%
Core EPS	$5.21	12%	11%

Core measures exclude items including intangible asset amortisation and impairment, legal settlements and restructuring charges. They can help investors compare operating trends, but the reported numbers still show the costs ultimately passing through the accounts.

The distinction was particularly clear in the second quarter. Q2 Total Revenue rose 6% to $15.384 billion, while core earnings per share increased 21% to $2.63. Reported earnings per share rose by a more modest 2% to $1.61, or declined 2% at CER.

Reported Q2 operating profit fell 10% to $3.164 billion. Core operating profit, meanwhile, increased 12% to $5.158 billion.

Oncology remains the main growth engine

Oncology delivered H1 revenue of $14.124 billion, representing 46% of group revenue. It grew 18% at actual rates and 15% at CER.

Several major medicines contributed:

• Imfinzi revenue increased 31% to $3.548 billion.
• Enhertu revenue rose 36% to $1.719 billion.
• Calquence revenue increased 19% to $1.944 billion.
• Tagrisso revenue grew 8% to $3.775 billion.
• Truqap revenue increased 43% to $431 million.

Rare Disease also performed well, with revenue rising 13% to $4.911 billion. Strensiq was the standout, growing 41% to $1.053 billion, while Ultomiris increased 16% to $2.584 billion.

Respiratory and Immunology revenue climbed 12% to $4.750 billion. Tezspire grew 43% to $694 million, while Breztri and Fasenra increased by 20% and 14% respectively.

This spread matters. AstraZeneca is not relying on one medicine for growth, and strength across Oncology, Rare Disease and Respiratory and Immunology helped offset weakness elsewhere.

Farxiga and China remain meaningful headwinds

Cardiovascular, Renal and Metabolism revenue fell 8% to $6.089 billion, or 12% at CER.

Farxiga revenue declined 6% to $4.042 billion as generic competition followed its US loss of exclusivity. Loss of exclusivity means the expiry of patent or regulatory protection, allowing cheaper generic alternatives to enter the market.

Farxiga's US revenue fell 17%, with multiple generics launched during Q2. The medicine was also affected by generic competition and volume-based procurement in China. Volume-based procurement is a system under which large medicine orders are negotiated centrally, typically creating pricing pressure.

China group revenue was flat at actual rates and declined 5% at CER during H1. The second-quarter picture was weaker, with revenue down 7% at actual rates and 13% at CER.

Other areas under pressure included Brilinta, down 64%, and Soliris, down 20%. AstraZeneca said the latter reflected patient conversion to Ultomiris and competitive pressure.

Pipeline progress came with genuine setbacks

AstraZeneca reported 30 approvals in major regions since its previous full-year results, alongside six key positive Phase III programmes and eight first approvals in major markets.

Notable approvals included Baxfendy for hypertension in the US, new Enhertu uses in breast cancer and solid tumours, and additional indications for Imfinzi, Truqap and Fasenra.

However, drug development remains unpredictable. The CARDIO-TTRansform trial of Wainua in ATTR-CM did not meet its primary efficacy endpoint. The EMERALD-2 trial involving Imfinzi also missed its primary endpoint, as did an adult and adolescent Ultomiris trial in HSCT-TMA.

AstraZeneca nevertheless expects more than 20 high-value trial readouts over the next 18 months. That provides plenty of potential catalysts, but it also creates scope for further disappointments alongside successes.

Investment is supporting growth but weighing on cash

Reported research and development expense increased 12% to $7.545 billion. Core R&D expense rose 9% to $7.123 billion, reflecting more trials, investment in new technologies and projects added through business development.

Selling, general and administrative expense rose 13% to $10.571 billion as AstraZeneca invested in current and future launches.

Operating cash flow was less encouraging. Net cash inflow from operating activities declined by $875 million to $6.224 billion, due mainly to working-capital movements, higher tax payments and foreign exchange effects.

Net debt increased by $3.538 billion during the half to $26.912 billion. Capital expenditure also rose to $1.513 billion, and AstraZeneca expects full-year expenditure on property, plant, equipment and software-related intangible assets to increase by approximately a third.

The company is also pursuing further pipeline deals. It agreed a $600 million upfront payment for worldwide rights to Zegfrovy, with potential additional payments of up to $900 million. A separate respiratory agreement includes a $200 million upfront payment and potential milestones of up to $1.9 billion.

These investments could support future growth, but they add to the importance of cash generation and disciplined capital allocation.

Guidance and dividend offer reassurance

AstraZeneca reconfirmed its 2026 guidance at CER:

• Total Revenue is expected to increase by a mid-to-high single-digit percentage.
• Core EPS is expected to increase by a low double-digit percentage.
• The core tax rate is expected to be between 18% and 22%.

The interim dividend increased by 3 cents to $1.06 per share, equivalent to 79.5 pence. AstraZeneca intends to raise the annual dividend declared for 2026 to $3.30 per share.

What investors should watch next

The strongest features of the update were double-digit Oncology and Rare Disease growth, rising core margins, a higher dividend and unchanged guidance. Those provide support for AstraZeneca's long-term revenue ambition.

The counterweight is a widening gap between core and reported performance, weaker operating cash flow, rising net debt and continued pressure from generic competition and Chinese pricing. The mixed clinical results are also a reminder that even a broad pipeline cannot remove development risk.

Attention now turns to whether newer approvals can maintain commercial momentum, how quickly the Farxiga decline develops and whether upcoming pipeline readouts justify AstraZeneca's heavy investment. The next scheduled update is its nine-month and third-quarter results on 30 October 2026.