Alnylam Pharmaceuticals (ALNY) Stock Forecast & Price Target

Alnylam Pharmaceuticals is viewed favorably because its ATTR-CM franchise remains the core growth engine, with AMVUTTRA leadership, less anticipated competition after CARDIO-TTRansform failed, and management-backed estimates implying peak annual revenues of $9.55 billion in 2029E for AMVUTTRA and over $20.5 billion for the broader TTR franchise by 2040. Its RNAi platform also offers durable pipeline optionality, including nucresiran with a larger long-term revenue opportunity and better economics, while zilebesiran could become a second major cardiovascular franchise if ZENITH confirms clinically meaningful MACE reduction. Even with pricing normalization, demand remains strong in a materially underdiagnosed market with more than 80% of an estimated 200,000 U.S. ATTR-CM patients untreated and prescription growth accelerating to a ~77% CAGR from December 2024–December 2025.

Alnylam Pharmaceuticals is facing a more fragile investment case because its valuation rests heavily on pipeline assets with only partial probability of success, while the RNAi platform’s revenue build is still modeled to emerge in the late 2020s and therefore contributes only a modest present value. The core commercial concern is that ZENITH may not capture the differentiated “quality of control” thesis if time in target range, ambulatory monitoring, and variability analyses are not prespecified, leaving a positive result to be framed mainly by mean systolic blood pressure. In addition, the company faces meaningful execution and profitability risks from a subpoena tied to government price reporting and distributor fee and discount arrangements, plus safety and commercialization questions around zilebesiran despite 889 patients exposed and mostly mild adverse events.