Name: ARDELYX, INC. Q2 2025 Earnings Call
Start: 2025-08-04T20:30:00.000Z

Executive Summary

Q2 2025 revenue was $97.7M (+33% y/y; +32% q/q), driven by IBSRELA and XPHOZAH; GAAP diluted EPS was $(0.08) .
IBSRELA net sales were $65.0M (record quarter), and management raised 2025 IBSRELA U.S. net sales guidance to $250–$260M from $240–$250M; XPHOZAH net sales were $25.0M, up 27% q/q excluding a Q1 returns reserve release .
Versus S&P Global consensus, Q2 beat on revenue ($97.7M vs $81.1M est*) and EPS (−$0.08 vs −$0.137 est*); Q1 had missed both revenue ($74.1M vs $79.4M est*) and EPS (−$0.17 vs −$0.075 est*)* .
Balance sheet flexibility increased: company drew $50M at SOFR+4% (floor 4.7%) and gained an option for an additional $100M; CFOO transition announced (to depart by Dec-31-2025 or upon successor start) .

What Went Well and What Went Wrong

What Went Well

IBSRELA delivered a record quarter with $65.0M net sales (+84% y/y; +46% q/q); management raised full-year IBSRELA guidance to $250–$260M (from $240–$250M) .
- “IBSRELA recorded its highest revenue quarter, with growth across all key demand indicators.” — Mike Raab, CEO .
XPHOZAH showed sequential demand strength: $25.0M, +7% q/q; +27% q/q excluding Q1 returns reserve release; paid prescriptions have grown month-over-month since March, with roughly 50/50 Medicaid vs commercial mix .
Cash and investments ended Q2 at $238.5M; the company also drew $48.7M net proceeds under its term loan in June to bolster liquidity .

What Went Wrong

XPHOZAH declined y/y ($25.0M vs $37.1M) due to the loss of Medicare coverage after Jan 1, 2025 bundling; payer mix now leans to non-Medicare segments .
Profitability remains a headwind: Q2 GAAP net loss of $(19.1)M (vs $(16.5)M y/y); SG&A at $84.0M reflecting commercial investments; R&D at $15.7M .
Policy/legal overhang persists: CMS-related litigation remains unresolved; oral arguments set for Sep 25 (no statutory timeline for decision), maintaining uncertainty around XPHOZAH’s Medicare coverage path .

Financial Results

Metric	Q4 2024	Q1 2025	Q2 2025
Total Revenue ($M)	$116.1	$74.114	$97.662
Diluted EPS ($)	$0.02	$(0.17)	$(0.08)
Loss from Operations ($M)	N/A	$(36.349)	$(14.395)
Operating Margin % (calc.)	N/A	−49.0% (calc. from )	−14.7% (calc. from )
R&D Expense ($M)	$13.7	$14.938	$15.666
SG&A Expense ($M)	$76.1	$83.222	$83.988

Note: Operating margin calculated as Loss from operations / Total revenue using cited figures.

Segment/Product Net Sales

Metric	Q4 2024	Q1 2025	Q2 2025
IBSRELA Net Sales ($M)	$53.8	$44.403	$65.045
XPHOZAH Net Sales ($M)	$57.2	$23.411	$25.032

KPIs and Balance Sheet

KPI	Q4 2024	Q1 2025	Q2 2025
Cash, Cash Equivalents & ST Investments ($M)	$250.1	$214.0	$238.5
IBSRELA Gross-to-Net Deduction %	28.5%	34.8%	~32.2%
XPHOZAH Gross-to-Net Deduction %	20.3%	~32% (ex returns release)	~29%
Long-term Debt ($M)	$150.853	$151.301	$201.446

Guidance Changes

Metric	Period	Previous Guidance	Current Guidance	Change
IBSRELA U.S. Net Sales	FY 2025	$240–$250M	$250–$260M	Raised
SG&A Run-Rate	FY 2025	Increase by ~$10M/qtr vs Q4 to ~ $90M by year-end	~ $90M per quarter for remainder of year	Maintained/clarified
XPHOZAH Revenue	FY 2025	No formal guidance	No formal guidance	Maintained
Peak Sales – IBSRELA	Long-term	>$1B (reaffirmed)	>$1B (reaffirmed)	Maintained
Peak Sales – XPHOZAH	Long-term	$750M (non-Medicare TAM)	$750M (non-Medicare TAM)	Maintained

Earnings Call Themes & Trends

Topic	Previous Mentions (Q4’24 and Q1’25)	Current Period (Q2’25)	Trend
IBSRELA growth and execution	Accelerating demand, field force expansion, omnichannel/patient pull-through focus	Record $65.0M; breadth/depth of prescribers, improved pull-through; guidance raised	Positive momentum
XPHOZAH access post-Medicare changes	Message: “prescribe as usual”; PAP for Medicare; non-Medicare focus; guidance withheld	+27% q/q ex-reserve; paid Rx growing MoM since March; ~50/50 Medicaid/commercial; still no guidance	Stabilizing and rebuilding ex-Medicare
Gross-to-net dynamics	Expect less favorable XPHOZAH GtN in 2025 vs 2024; IBSRELA GtN seasonal	Q2 IBSRELA ~32.2%; XPHOZAH ~29%; improvements tied to co-pay dynamics and mix	Normalizing within ~30% band
Balance sheet & debt	$250.1M cash YE; SLR draw in Oct-24	Drew remaining $50M at SOFR+4% (floor 4.7%); option for additional $100M	Increased flexibility
BD/pipeline & leadership	Building pipeline; CBO hire; patient officer	CMO and CTOO appointments; CFOO transition announced	Organizational build-out
Regulatory/legal	KIDNEY PATIENT Act as “free call option”	CMS appeal arguments 9/25, timing uncertain	Ongoing policy risk

Management Commentary

“Ardelyx delivered an outstanding second quarter of 2025, generating nearly $100 million in total revenue… Our confidence in IBSRELA continues to grow, and we are raising our 2025 revenue expectations to $250–$260 million.” — Mike Raab, CEO .
“We have grown the total number of paid prescriptions month over month since March, and we are focused on continuing that steady and consistent growth for the remainder of the year [for XPHOZAH].” — Eric Foster, CCO .
“We finished the second quarter with… approximately 32.2% [IBSRELA gross-to-net].… We satisfied our $75 million total royalty obligation to AstraZeneca during the second quarter.” — Justin Renz, CFOO .
“With a total available market of 220,000 patients… substantively less than 100,000 patients gets you to that $750 million [XPHOZAH]” — Mike Raab, CEO .

Q&A Highlights

IBSRELA guidance raised despite seasonality; management remains “thoughtful and deliberate,” with potential for further updates later in the year .
Gross-to-net: IBSRELA ~32.2% in Q2; XPHOZAH ~29%, with outlook in the ~29–31% range given mix and co-pay trends .
XPHOZAH payer mix/access: ~50/50 Medicaid vs commercial; physicians urged to prescribe as before; ArdelyxAssist adjudicates access; sequential growth expected .
Balance sheet optionality: $50M debt draw at favorable rates to enhance flexibility; option for an additional $100M remains open .
CMS litigation: oral arguments set for Sep 25; outcome timing uncertain .

Estimates Context

Metric	Q1 2025 Est.*	Q1 2025 Actual	Q2 2025 Est.*	Q2 2025 Actual
Revenue ($M)	$79.44*	$74.11	$81.08*	$97.66
Primary EPS ($)	$(0.075)*	$(0.17)	$(0.1369)*	$(0.08)

Q2 beat revenue and EPS; Q1 missed both metrics versus S&P Global consensus*.
Street now looks for Q3 2025 revenue ~$100.54M* and EPS ~$(0.0675), with Q4 2025 revenue ~$118.81M (context for 2H cadence).*

Values retrieved from S&P Global.

Key Takeaways for Investors

Clear fundamental beat in Q2 (revenue and EPS) amid strong IBSRELA momentum and raised FY guidance for that brand .
XPHOZAH is stabilizing ex-Medicare; sequential growth and MoM paid Rx gains indicate the access strategy is working even without formal guidance .
Operating leverage improved sequentially; loss from operations narrowed materially q/q as revenue scaled (+32% q/q) .
Balance sheet flexibility increased with a favorable debt draw and additional $100M option; cash/investments of $238.5M provide runway for commercial execution and BD .
Leadership transitions/hires (CMO, CTOO; CFOO transition) align resources with next growth phase; watch for continuity of execution .
Policy risk remains (CMS appeal timing; reimbursement dynamics), but non-Medicare TAM supports the $750M XPHOZAH peak framework; KIDNEY PATIENT Act remains a free call option .
Near-term stock catalysts: sustained IBSRELA outperformance vs consensus*, visibility on XPHOZAH sequential growth, and any updates on CMS/legal or commercial coverage expansions*.