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Friday, August 7, 2026

Ardelyx cuts 2026 IBSRELA revenue outlook on payer hurdles, maintains 2027 profitability goal

 

Ardelyx cuts 2026 IBSRELA revenue outlook on payer hurdles, maintains 2027 profitability goal

  • Q2 2026 non-GAAP EPS -$0.07 on revenue $120.9M, missing both EPS and revenue estimates.
  • Record Q2 revenue grew 31% YoY, but IBSRELA underperformed internal expectations due to access frictions.
  • Full-year 2026 IBSRELA revenue guidance cut to $350–370M; XPHOZAH outlook of $110–120M reiterated.
  • Company pulled XPHOZAH’s $750M long-term target amid post-TDAPA and reimbursement uncertainty.
  • Operating expenses now guided to < $500M in 2026; management still expects profitability starting in 2027.
  • Payers have added step edits and stricter prior auths, slowing new IBSRELA starts despite strong underlying demand.
  • XPHOZAH demand solid with 27% revenue growth and strong script trends despite CMS bundle headwinds.
  • Cash and investments of $281.8M plus $50M new debt draw support continued commercial and pipeline investment.
  • IBSRELA gross-to-net headwind remains in low-to-mid 30% range, including potential higher discounts and coupons.
  • Management remains committed to $1B IBSRELA opportunity but is reassessing timing given revised 2026 base.
  • Main investor focus: durability of IBSRELA growth under payer pressure and XPHOZAH’s post-TDAPA economics.
  • Main concern: escalating payer access restrictions on IBSRELA and post-TDAPA uncertainty for XPHOZAH.
  • Mixed quarter, driven by strong demand but increased payer hurdles forcing a cut to IBSRELA guidance.

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