Ardelyx Q2 2026 Earnings Call Transcript

Ardelyx (NASDAQ: ARDX ) released second-quarter financial results and hosted an earnings call on Thursday. Read the complete transcript below. This transcript is brought to you APIs. For real-time access to our entire catalog, please visit for a consultation.

View the webcast at Summary Ardelyx reported a record quarterly revenue of $118 million for Q2 2026, up 31% year-over-year, driven by strong performance from IBSRELA and XPHOZAH. IBSRELA revenue grew 33% year-over-year, but payer hurdles impacted patient access, prompting strategic initiatives to improve access and increase demand. XPHOZAH generated a 27% revenue increase year-over-year, with plans to maintain growth despite potential market challenges after a legal decision regarding phosphate-lowering drugs. The company revised its 2026 guidance for IBSRELA to $350-$370 million due to access challenges, while maintaining XPHOZAH's guidance at $110-$120 million.

Ardelyx plans to achieve sustained profitability by 2027, emphasizing disciplined expense management and strategic investments in R&D and SG&A. Full Transcript OPERATOR Welcome to the Ardelyx second quarter 2026 earnings call. All participants will be in a listen-only mode. I would now like to turn the conference over to Lisa Caparelli, Senior Vice President of Investor Relations and Corporate Communications.

Lisa, you may begin. Lisa Caparelli, Senior Vice President of Investor Relations and Corporate Communications Thank you, Jen. Good afternoon everyone and welcome to our second quarter 2026 financial results and business update call. Earlier today we issued our earnings release, which can be found on the investor section of our website at Ardelyx.

Slides that accompany today's call will also be found on our website. On today's call I am joined by Mike Raab, President and CEO of Ardelyx, Eric Foster, Chief Commercial Officer, and Sue Hohenleitner, our Chief Financial Officer. Before we begin, I'd like to remind you that some of the statements made during the call today are forward-looking statements within the meaning of the Private Securities Litigation Reform Act of 1995.

These statements involve a number of risks and uncertainties that may cause our actual results to differ materially from those expressed or implied, including those described in our annual report on Form 10-K, our quarterly report on Form 10-Q which was filed today, and from time to time in other documents filed with the SEC. These forward-looking statements speak only as of today's date and while we may elect to update these forward-looking statements in the future, we specifically disclaim any obligation to do so even if our views change. I will now pass the call over to Mike. Mike Raab, President & CEO Thank you, Lisa.

Good afternoon everyone and thank you for joining us today. This afternoon we issued a press release announcing our Q2 financial results and a revision to our guidance. I'd like to share my perspectives on our results, drivers of those results and how we're positioning the business for future growth. Before I turn the call over to Eric and Sue to cover the performance in detail in Q2, IBSRELA and XPHOZAH generated combined revenue of $118 million, up 31% year over year, the largest quarterly revenue in our company's history.

This is a meaningful milestone and it is important to acknowledge growth in the second quarter was robust and yet performance fell short of our expectations. To be clear, IBSRELA demand is strong, prescriber confidence remains, and our view of the long-term opportunity has not wavered, including achieving a billion dollars in revenue. As we anticipated with the establishment of the IBSRELA Pharmacy Network, our investment in the field reimbursement team and with IBSRELA's continued success, payers have implemented significant hurdles that impacted new patient starts and access to IBSRELA. Eric will provide further details in his commentary.

The fundamentals of the IBSRELA business remain strong and by staying focused on execution, improving patient access and partnering closely with providers, we are positioned to drive continued adoption and create meaningful value for both patients and shareholders. Now on XPHOZAH, the team had an excellent quarter. Growth continues to be driven by patient need, physician adoption and a differentiated clinical profile. C.

Circuit Court of Appeals affirmed the District Court's dismissal of our lawsuit against CMS. As a result, oral-only phosphate-lowering drugs remain in the bundle. With this decision, we have determined that we will no longer pursue further litigation on this matter. Now, while our strategy remains, we recognize the market dynamics ahead of us present challenges to navigate.

As we have always done, we remain committed to ensuring patients in need have access to XPHOZAH. Now taking a step back, we operate in a complex business with significant external pressures and with new ones that emerge almost daily. Even so, we are in an enviable position. We have two first-in-class commercial products, both differentiated, growing quarter over quarter and year over year.

Our strengthening balance sheet is driven by top line growth, disciplined expense management and a thoughtful capital allocation strategy. We have built a solid foundation, are investing in our future by advancing tenapanor and our next generation NHE3 inhibitor, and we are continuing business development activities to further expand our pipeline. We are building a robust patent estate for tenapanor anchored by multiple Orange Book-listed patents including our 299 patent. We are a well-funded, self-sustaining, high-growth company on the path to sustained profitability in 2027 and beyond.

Our enthusiasm and belief in our business, our competitive position, our strategy and the long-term value we are creating has not changed. Now with that I'll turn the call over to Eric. Eric Foster, Chief Commercial Officer Thank you, Mike. IBSRELA revenue grew 33% year over year and, as Mike noted, we experienced significant payer hurdles that had a direct impact on access to IBSRELA.

While new patient starts have been slowed by these hurdles, we continue to see strong growth in refills and total prescriptions, reaching our highest demand quarter to date. We understand the ongoing market dynamics IBSRELA is facing and are confident that the following four actions will position IBSRELA for future growth by addressing increasing payer hurdles and accelerating IBSRELA demand. 1) Leveraging our dedicated field reimbursement team, which we doubled in size in the first half of this year and we've all been in the field as of July 1st, to help navigate HCPs' cumbersome paperwork and burdensome step edits.

2) Reinforcing our continued efforts to drive more prescriptions through the IBSRELA Pharmacy Network, or IPN, to increase fulfillment rates and improve adherence. We deployed additional resources along with our FRMs and salesforce to provide patient-focused, high-touch support that improves the patient experience. Our data shows that when a prescription goes through the IPN it results in higher fulfillment rates, faster fills, and in one additional refill per patient on an annual basis. 3) Increasing the frequency of engagement with our target HCPs is one of the most important drivers of demand.

In Q2 we implemented initiatives to expand our sales organization to 144 representatives to increase the frequency of engagement with our targeted high-writing HCPs. With this expanded sales force along with our FRMs, we expect to see continued direct and measurable impact and, while early, we are encouraged by the results. 4) We are expanding our patient awareness and engagement initiatives. Alongside our partnership with the LPGA and ongoing omnichannel and digital efforts, we are initiating new direct-to-consumer activities during the second half of the year.

Our consumer-facing messaging is expected to increase brand awareness among our targeted patient population, leading to important conversations with healthcare providers, which our experience tells us leads to an IBSRELA prescription. The unmet need remains high for IBS-C patients and highlights the important role IBSRELA plays for patients seeking treatment options. Last year nearly 7 million prescriptions were written for IBS-C—indicated drugs, reflecting both the large number of patients seeking relief despite existing therapies and the significant patient burden that still exists.

Although multiple treatment options are available, our internal research indicates that as many as 77% of patients on a secretagogue continue to experience persistent symptoms. The patient need is demonstrated by record highs in Q2 demand, total writers, total prescriptions per writer and market share since launch, and further supports our conviction in IBSRELA reaching 1 billion in revenue. As we continue to work to execute on the four initiatives I just outlined, I am confident that these efforts will address the barriers identified, accelerate adoption and enable more patients to receive the treatment they need.

Moving on to XPHOZAH, we are impressed by the resilience of XPHOZAH as we saw strong momentum in Q2. , approximately 80% are treated with phosphate-lowering therapies in an effort to achieve and maintain target phosphorus levels. As the number of patients treated with XPHOZAH grows, our conviction in its value is reinforced. Our priority remains clear: ensuring XPHOZAH is available to patients who need it.

In Q2, XPHOZAH generated 27% revenue growth year over year. We saw solid growth across key metrics, with notable increases in total dispenses of 33% and in paid prescriptions of 25% compared to the same quarter in 2025. In addition, XPHOZAH reached its highest total writers and prescriptions per writer since Q1 2025. While we are encouraged by XPHOZAH's performance, we continue to recognize and assess the challenges ahead of us.

Our focus remains on enhancing the effectiveness of our commercial approach by refining salesforce deployment and strengthening engagement with healthcare providers and dialysis organizations. These initiatives are designed to ensure we're reaching the physicians treating the patients most likely to benefit from XPHOZAH while continuing to build awareness across the nephrology community. I'm confident in the team's ability to drive demand for both medicines by overcoming the access challenges for IBSRELA and maintaining disciplined execution with XPHOZAH in the second half of this year.

Patients need our differentiated products as indicated by the growing demand for both IBSRELA and XPHOZAH, and helping more patients with our medicine is our top priority. I will now turn it over to Sue Hohenleitner, Chief Financial Officer Thank you, Eric. Our second quarter 2026 financial results reflect the ongoing transformation of Ardelyx into a financially strong organization that allows us to leverage our revenue base to fund both our current commercial operations and our R&D pipeline. This quarter we maintained our focus of turning disciplined capital allocation into a clear strategic advantage.

In the second quarter our total product revenue was $118 million compared to $90 million in the same period last year, representing 31% growth and demonstrating the need for our differentiated products. IBSRELA is our primary growth engine. 2 million increased 33% compared to Q2 of 2025. We are expecting sequential revenue growth in the second half of 2026, with the fourth quarter delivering the highest revenue of the year.

XPHOZAH continues to demonstrate resilience. 9 million, an increase of 27% compared to the second quarter of 2025, driven by strong demand. Our financial strategy remains focused on driving towards sustainable profitability, which we are now projecting in 2027. We are a well-funded company investing in our growth accelerators, our commercial operations and our pipeline, all of which require high-impact investments in R&D and SG&A.

7 million for the same period in 2025. This increase primarily reflects development activities and patient enrollment costs for the ongoing EXCEL Phase 3 clinical trial in CIC. 4 million for the quarter compared to $84 million for the same period in 2025. This increase reflects deliberate investments to address the access barriers and drive future adoption of IBSRELA.

1 million for the same period in 2025. 7 million for the same period in 2025. 8 million in cash, cash equivalents and short-term investments, and our liquidity remains robust. As previously announced, during the second quarter we drew down $50 million from our existing arrangement with FLR for general corporate purposes and to enhance flexibility to support our ongoing strategic initiatives, all in line with our capital allocation strategy.

Now turning to guidance, we issue guidance based on a high degree of confidence in our ability to deliver, and if things meaningfully change, we are committed to updating those projections. Starting with 2026 for IBSRELA, taking into consideration the current environment and our proactive initiatives to increase access and fulfillment, we have made the prudent decision to lower our full-year 2026 guidance for IBSRELA to a range of $350 to $370 million. This revised guidance represents annual growth of more than 30% at the midpoint.

This would suggest back-half sales would be roughly 60% of the full year, acknowledging increased sequential revenue growth in the upcoming quarters and in line with prior years' growth patterns. Now turning to XPHOZAH, we are reiterating our full-year 2026 revenue guidance to be between $110 and $120 million. Now moving on to OPEX, with the decision to modify our guidance for IBSRELA revenue, we have proactively taken additional efforts to manage spending and are revising our 2026 OPEX guidance to be below $500 million. We are managing the business with discipline as evidenced by these actions.

Moving on to our longer-term guidance, a few things. First, let me be clear. We are still on a path to achieve a billion dollars in revenue for IBSRELA. However, with the 2026 revenue revision, we are evaluating the evolving market dynamics and the impact on the timing of this achievement.

For XPHOZAH, we have been assessing market dynamics as well as future growth projections in a period of uncertainty. Therefore, it is prudent to revisit our internal assumptions and pull our $750 million revenue guidance. We believe these are the right decisions and at this time are the right actions to take to ensure that any forward view we provide reflects the current reality as we are on the cusp of profitability and transition into a more steady and measurable cash flow positivity in the near future.

Our financial strategy is guided by our three capital allocation priorities which remain unchanged: accelerating IBSRELA growth, actively progressing our pipeline, and maintaining financial strength. In closing, we are funding our own operations and pipeline from our revenue base and we remain disciplined in our spending, aggressive in our commercial pursuits, and committed to delivering value for both patients and shareholders. With that, I will hand it back to Mike. Mike Raab, President & CEO Thank you, Sue.

The demand for our medicines is evident. We do understand the challenges that we are facing and we've taken decisive action to address them. We remain focused on executing on our 2026 priorities, including growing IBSRELA demand by improving patient access, maintaining XPHOZAH's momentum, building, expanding our pipeline and delivering strong financial results. I have tremendous confidence in our team, our strategy and our ability to execute.

We are committed to our patients and creating long-term value for our shareholders. And thank you for your continued support. With that, we'll open the call for questions. Operator.

OPERATOR Thank you. If you would like to ask a question, please press star one on your telephone keypad now and you'll be placed into the queue in the order received. In the interest of time, we ask that you limit yourself to one question. Once again, if you have a question, please press star one on your phone now.

And our first question today will come from Roanna Ruiz with Leerink Partners. Ryan, Analyst at Leerink Partners Hey guys, you have Ryan on for Roanna. Thanks for taking our question. Maybe can you just talk about the underlying demand metrics that you guys are tracking as you exit Q2 and through July and how that gives you confidence heading into, you know, your revised full-year guidance.

And then maybe just quickly, can you also just talk about the pushes and pulls that are baked into this new guidance for IBSRELA? Mike Raab, President & CEO Sure. And so it's all from IBSRELA, not XPHOZAH, correct? Yes, correct.

Eric. Eric Foster, Chief Commercial Officer Yeah. Hey, Ryan. Thanks for this question.

So as we look at performance right now, as we talked about, you know, we continue to see really strong refills and total prescriptions, so we'll continue to take a look at that. Clearly we're excited about the highest demand quarter that we've had to date, so we're going to continue to make sure that we focus on that as well as prescriptions. Going into the IBSRELA Pharmacy Network, we know when that happens, we get higher fulfillment rates, faster fills, and on average, one more refill on an annual basis per patient.