Lantheus Holdings, Inc.

First-quarter revenue was $377.3 million, up 1.2% year over year, and up 8.6% excluding $25.2 million of prior-year spec revenue that was divested. GAAP diluted EPS was $1.80 and adjusted EPS was $1.46, down 4.6% from the prior year period; reported net income was $118.4 million and adjusted profit was $95.8 million, down 12.5%. Gross profit margin was 67.0%, flat year over year. By segment, oncology revenue (PYLARIFY) was $240.9 million, down 6.5%; neurology revenue (NEURACEQ) was $35.4 million; cardiology revenue (DEFINITY) was $84.6 million, up 6.8%; and strategic partnerships and other revenue was $16.3 million, up 52.1%. Operating cash flow was $125.1 million, free cash flow was $121.9 million, and cash and cash equivalents net of restricted cash were $498.6 million at quarter-end. For 2026, the company reiterated revenue guidance of $1.4 billion to $1.45 billion and adjusted EPS guidance of $5 to $5.25.

Mary Heino described the quarter as a strong start and repeatedly stressed that 2026 is a year of commercial execution and regulatory progress, with growth acceleration expected to begin in 2027. Her strategic focus was on protecting the PSMA PET franchise, executing a seamless transition from PYLARIFY to PYLARIFY TRUVU, building NEURACEQ through deeper account penetration and expanded manufacturing footprint, and advancing late-stage pipeline assets. Her tone was confident and disciplined, but also cautious about timing launches and capital deployment.

Bob Marshall said the quarter came in solidly across the portfolio, with revenue up 1.2% year over year and gross margin at 67.0%, which he said is likely to trend toward the high end of the earlier 65% to 66% range. He pointed to the main margin drivers as the spec divestiture, PYLARIFY and DEFINITY volumes, and DEFINITY price, partly offset by lower PYLARIFY net price, Evergreen inclusion, and NEURACEQ ramp-related dilution. He also highlighted cash generation of $125.1 million in operating cash flow, $121.9 million in free cash flow, $498.6 million in cash and equivalents, $200 million remaining on buybacks, and access to a $750 million undrawn revolver. On guidance, he said the company still expects full-year 2026 revenue of $1.4 billion to $1.45 billion and EPS of $5 to $5.25, while keeping an eye on competitive dynamics and cost discipline.

Analysts focused heavily on whether the company’s full-year guidance implied a step-down after a strong Q1, and management said it was being prudent rather than signaling a deterioration. They cited ongoing competitive monitoring, the timing of pass-through changes, and the upcoming CEO transition as reasons to hold guidance steady. Questions on TRUVU centered on contracting, customer readiness, pricing, and the switch from PYLARIFY; management said conversions will be site-by-site, begin in Q4, and only occur once coding, coverage, and reimbursement systems are ready. On PNT2003, management explained that tentative approval means the FDA review is substantively complete, but final approval still depends on Hatch-Waxman timing and related legal proceedings, and Bob Marshall said it is not embedded in 2026 guidance.