Alnylam hit by wave of analyst cuts after KARDIA-3 miss

Eight analyst firms cut their price targets on ALNY on October 30 alone. Two downgraded. The stock fell 29% on earnings day and is now down 35% over the past month, trading at $165.

The analyst response

Raymond James dropped its rating from Strong Buy to Outperform and cut its target from $420 to $315. Bernstein went further, downgrading to Market Perform and slashing its target from $376 to $199. Goldman Sachs kept its Buy rating but cut from $536 to $320. TD Cowen stayed Buy but trimmed from $482 to $354. UBS, RBC Capital, Morgan Stanley, Wells Fargo and Needham all lowered targets as well.

The breadth is the story. These are not fringe adjustments. The consensus remains Buy, with 15 buys and 8 holds as of October 31. But the target range has collapsed. The Bernstein target of $199 sits 21% below the current price. The Goldman target of $320 implies 94% upside from here.

The central dispute is the KARDIA-3 data. Bears argue the efficacy case rests on an enrichment analysis drawn from just 41% of Cohort A, with wide confidence intervals and a control arm that could intensify over time. Bulls point to the TTR franchise's underpenetrated market and AMVUTTRA's leadership across the full patient spectrum.

Options and the borrow market

Options positioning shifted sharply. The put-call ratio fell to 0.54 on October 30, 3.6 standard deviations below its 20-day mean of 0.65. That is the lowest reading in over a year, against a 52-week range of 0.36 to 0.77. Call buying, relative to puts, picked up even as the stock fell.

Short interest stands at 4.7% of free float, down roughly 8% over the past week. The borrow market is loose. Availability stands at 6,037% of short interest, meaning shares available to lend vastly exceed the existing short position. Cost to borrow is 0.41%, low by any measure. There is no sign of a crowded short here.

Nasdaq-100 watch

ORTEX puts the probability of ALNY being deleted from the Nasdaq-100 at the December 2026 Annual Review at 69%. The stock is currently 24% below the exit line, which sits at $204.64. The market cap now stands at $22.1 billion. The line requires $27.4 billion. If deletion is confirmed, index trackers would need to sell an estimated $1.8 billion worth of shares, equivalent to 6.4 days of normal trading volume. Across 19 similar past deletions, the median move from announcement to effective date was minus 3.5%, and 79% of cases moved in that direction.

Retail attention spikes

Wikipedia pageviews for Alnylam show a retail attention score 1.9 standard deviations above its own 90-day history as of October 30, per the Wikimedia Foundation data tracked by ORTEX. Medicaid reimbursements for the company's drugs were up 39% year-on-year in Q1 2026, with prescriptions up 27% over the same period, according to Centers for Medicare and Medicaid Services data.

The stock closed at $165 on October 30. The next earnings date is February 11, 2027.