Lantheus (LNTH) Q3 2026 earnings review
Lantheus wins key drug approvals, but regulators extend buyout review
Lantheus, a maker of radioactive imaging agents and cancer therapies, grew its continuing operations while clearing three regulatory milestones before its planned buyout by Curium. Reported revenue edged up 2% to $390 million because the company sold its older SPECT imaging unit in January, but sales from continuing businesses rose 9% by our math as the Neuraceq Alzheimer's scan reached $46 million. Lower production costs lifted profit per share excluding one-offs by 32%, while a $31 million research write-down and deal fees pushed GAAP profit down.
| Sales from businesses owned a year ago (ex-SPECT) | +9.4% reported revenue: $389.9M (+1.5%) |
|---|---|
| Profit per share, excluding one-offs | $1.68 +32% from a year ago (GAAP: $0.33, -20%) |
| Neuraceq brain scan revenue | $45.6M +15% from last quarter |
| Full-year outlook | Suspended pending up to $8.0B Curium buyout |
⚖️ Verdict: ⚪ Neutral
The story is unchanged because the agreed cash buyout of $102.50 per share plus up to $12 in milestone payouts still governs the outcome, though the pieces moved in opposite directions. FDA approvals for the BRAVNETSA tumor therapy and TAUKLARIFY brain scan, alongside Medicare payment backing for PYLARIFY TruVu, improve the odds of hitting those future sales goals, but the Federal Trade Commission extended its antitrust review of the merger on October 21.
The question now is whether the Curium merger clears antitrust review on time and how much of the $12 milestone payout shareholders will collect. Either regulators clear the deal quickly while the newly approved drugs build sales toward the targets, or antitrust hurdles and PYLARIFY price pressure slow both the closing and the payouts. The upcoming third-quarter 10-Q filing and merger proxy will show the antitrust details and milestone rules.
🐂 Bull Case
Neuraceq Sales Top $45 Million as Footprint Grows
Neuraceq is Lantheus's injectable imaging agent used with positron emission tomography (PET) scans to detect amyloid plaques in the brains of patients evaluated for Alzheimer's disease. The medical imaging maker bought the product in July 2025 and has been adding manufacturing sites across the country to brew and deliver the short-lived radioactive doses to more hospitals.
Sales of the brain imaging agent reached $45.6 million this quarter, up 15.0% from the second quarter and 123.0% from last year's partial third quarter. The $6.0 million quarterly increase beat the roughly $4 million sequential pace seen in the first half of 2026. That steady climb brought nine-month sales to $120.6 million, showing that new production sites are turning directly into hospital orders and lifting underlying sales excluding divested businesses by 9.4% by our math.
What to watch: fourth-quarter Neuraceq revenue in the annual report. A reading above $45.6 million will show whether new manufacturing sites still drive sequential gains now that the acquisition is over a year old.
FDA Clears Two Drugs and Medicare Backs TruVu
Lantheus spent 2026 preparing three regulatory milestones to restart growth in 2027 and earn up to $12.00 per share in Contingent Value Rights (CVRs, extra cash payouts tied to future sales goals through 2030 under the Curium buyout). In the third quarter, the company cleared all three regulatory hurdles.
- PYLARIFY TruVu (next-generation prostate cancer scan): Medicare granted Transitional Pass-Through payment status and a permanent billing code effective October 1, 2026.
- BRAVNETSA (targeted radiation therapy for gut tumors): won final FDA approval on September 22, 2026 as the only bioequivalent version of rival drug Lutathera.
- TAUKLARIFY (tau brain imaging agent for Alzheimer's disease, formerly MK-6240): won FDA approval on August 14, 2026.
These approvals matter because Medicare pass-through status lets hospitals claim separate reimbursement for TruVu, while Lantheus is "preparing for a thoughtful commercial launch to support reliable supply and broad patient access" for BRAVNETSA. What to watch: site-by-site FDA manufacturing approvals for TruVu in the annual filing, which will determine how fast hospitals can switch to the new formula.
Lower Production Costs Lift Operating Margin
Lantheus shed its older single-photon emission computerized tomography (SPECT) imaging business at the start of 2026 to focus on higher-margin PET diagnostics. This quarter also lapped inventory write-offs from a year ago, lifting profitability excluding one-offs.
Operating margin excluding one-offs rose 8.2 percentage points from a year ago to 39.3%, and rose 2.7 percentage points from the second quarter. By our math, cost of goods sold—the direct cost of making and delivering imaging doses—fell 4.5 percentage points of revenue to 37.6%, while general and administrative overhead fell 3.3 percentage points to 18.1%. Those savings drove profit per share excluding one-offs up 32.3% to $1.68.
What to watch: cost of goods sold as a share of revenue in the fourth quarter. Holding that line near 38% will show that leaving the older SPECT business permanently improved manufacturing margins.
🐻 Bear Case
FTC Extends Antitrust Review of Curium Buyout
On August 3, 2026, Lantheus agreed to sell itself to Curium US Holdings for $102.50 per share in cash plus up to $12.00 per share in milestone payouts, valuing the deal at up to $8.0 billion. Curium already licenses and sells Lantheus's flagship prostate cancer imaging agent in Europe, making the buyer a close industry peer.
In the fine print of the release, Lantheus disclosed that the antitrust waiting period under the Hart-Scott-Rodino Act remains open, "which was extended on October 21, 2026 by the Federal Trade Commission". An extension beyond the initial review window means federal regulators are taking a closer look at overlapping radiopharmaceutical operations before letting the buyout proceed.
This matters because closing the sale requires clearing antitrust reviews in the US and abroad, and the company has already suspended its financial outlook and stopped holding investor calls while it waits. What to watch: disclosures in the third-quarter 10-Q filing on whether the FTC extension involved a formal Second Request for documents, which would test the target of closing in the first half of 2027.
R&D Write-Downs and Deal Fees Cut GAAP Profit
While Lantheus highlighted a 28.1% jump in operating profit excluding one-offs, its reported GAAP operating income fell 26.2% from a year ago to $32.2 million. Research and development expenses nearly doubled to $92.8 million, climbing 11.3 percentage points of revenue to 23.8% by our math.
- Intangible asset write-down: $31.0 million charge in the third quarter.
- Acquisition, integration and divestiture items: $46.2 million in operating expenses.
- Equity investment mark-down: $12.2 million net loss below the operating line.
These charges cut against management's past framing of 2025 acquisitions as smooth growth drivers, because writing down $31.0 million of intangible assets right after lowering acquisition earn-out liabilities in the second quarter shows that acquired pipeline programs lost value. What to watch: the intangible asset footnote in the 10-Q filing, which will name the impaired drug candidate and show if further research assets remain at risk.
PYLARIFY Sales Dip Ahead of Fourth-Quarter Price Test
PYLARIFY, Lantheus's PET imaging agent for finding prostate cancer spread, brings in 61% of total company revenue. After price cuts hurt sales in 2025, quarterly revenue stabilized around $240 million during the first half of 2026.
In the third quarter, PYLARIFY sales edged down 0.7% from a year ago and 0.6% from the second quarter to $238.9 million. Because the company no longer hosts earnings calls, it did not disclose whether US dose volumes kept rising or if net prices slipped further. That leaves the flagship product slightly shrinking right as a rival imaging agent lost its temporary Medicare payment status on October 1, an event management previously warned could renew hospital price pressure.
What to watch: fourth-quarter PYLARIFY and TruVu combined revenue, plus any volume commentary in the 10-Q filing. A sequential drop below $235 million would show that rival price cuts hurt PYLARIFY faster than hospitals switched to TruVu.
Risks this quarter didn't answer
Because Lantheus cancelled its conference call due to the pending Curium buyout, five standing risks got no detailed operational update in the earnings release.
- CVR payout rules: the release mentions up to $12.00 per share for commercial milestones through 2030, but only the merger proxy will show the exact sales targets.
- BRAVNETSA patent appeal and supply: rival ADACAP is appealing the patent ruling to the Federal Circuit, and Lantheus relies on third-party manufacturer POINT Biopharma for drug supply.
- LNTH-2501 manufacturing delay: the company has not yet resolved the third-party factory inspection issues cited in the FDA's June 26 rejection letter.
- Alzheimer's blood tests and TAUKLARIFY rollout: the release gave no comment on blood biomarkers replacing brain scans, stating only that Lantheus is "assessing the appropriate path toward broader commercial availability" for TAUKLARIFY.
- Leadership and lawsuits: stockholder lawsuits over the buyout and prior periods remain pending alongside interim executive leadership.
💲 Other KPIs
Free cash flow—operating cash left after capital spending—rose 5.6% from a year ago and 11.2% from the second quarter to $99.9 million, as capital spending fell to $2.0 million. That cash generation lifted total cash to $683.6 million against $571.7 million of total debt, leaving $111.9 million in net cash by our math.
Sales of DEFINITY, an injectable contrast agent for heart ultrasound scans, grew 4.8% from a year ago to $85.7 million, keeping its steady mid-single-digit pace. Revenue from strategic partnerships—supplying brain imaging agents for drugmakers' clinical trials—climbed 44.0% from a year ago to $19.7 million.
Weighted average diluted shares rose 1.1% from a year ago and 1.3% from the second quarter to 68.4 million. The radiopharmaceutical group paused stock buybacks in 2026 and kept financing cash outflows near zero at $0.5 million this quarter ahead of the all-cash acquisition.
❓ Key Questions
Which drug candidate triggered the $31 million impairment?
Lantheus recorded a $31.0 million intangible asset impairment inside research and development expenses this quarter. Investors need the 10-Q footnote to see whether the write-down hit the delayed LNTH-2501 diagnostic kit or one of the radiotherapeutic assets slated for partnering.
Why did the FTC extend the merger review?
The Federal Trade Commission extended the antitrust waiting period for the Curium merger on October 21, 2026. Because Curium already sells PYLARIFY in Europe, shareholders need to know if regulators issued a full Second Request and whether divestitures will be required.
What are the exact sales targets for the $12 CVR?
Up to $12.00 per share of the buyout price sits in Contingent Value Rights tied to commercial milestones through 2030. Without the specific revenue thresholds for TruVu, Neuraceq and BRAVNETSA, shareholders cannot judge how much of that extra payout is reachable.
How did PYLARIFY dose volumes and net prices move?
PYLARIFY revenue dipped 0.7% from a year ago to $238.9 million, and the cancelled conference call removed the usual disclosure of US dose volume growth. Knowing the split between volume and price shows how much hospital demand Lantheus is carrying into the TruVu transition.