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Travere Therapeutics, Inc. (TVTX)·Q4 2024 Earnings Summary
Executive Summary
- Q4 delivered accelerating top-line with total revenue of $74.79M, up 19% QoQ and 66% YoY, led by FILSPARI net sales of $49.64M; revenue modestly beat external consensus, but GAAP EPS of -$0.73 missed, driven by ongoing SG&A/R&D investment and lower other income vs prior year .
- Commercial KPIs inflected: 693 FILSPARI patient start forms (PSFs) in Q4 vs 505 in Q3 (+37%), reflecting full-approval tailwinds and broader label utilization; FILSPARI full-year sales reached $132.2M .
- 2025 catalysts: sNDA for FSGS targeted around end of Q1 (first potential approval in FSGS), PDUFA Aug 28, 2025 for REMS liver monitoring modification (monthly→quarterly year 1), European full approval conversion for FILSPARI with expected $17.5M milestone; management expects continued IGAN sales growth in 2025, albeit with higher gross-to-net (high-teens to low-20s) .
- Balance sheet strengthened by November equity raise (gross $125M; net proceeds ~$134.7M included in year-end cash/marketables of $370.7M), supporting launch and pipeline priorities; pegtibatinase Phase 3 HARMONY enrollment restart now targeted for 2026 after process improvements .
What Went Well and What Went Wrong
What Went Well
- Strong commercial execution: “we received 693 new patient start forms… a 37% increase from the prior quarter,” with FILSPARI Q4 net sales ~$50M and continued high compliance/persistence, reinforcing adoption breadth and depth .
- Label expansion tailwind and payer traction: full approval enabled broader use (removal of 1.5 g/g threshold) and “excellent coverage,” with formularies updating authorization criteria to reflect the broader label, easing access for patients with lower proteinuria .
- Strategic pipeline momentum: Type C meeting completed; sNDA for FSGS planned near end of Q1 2025, potentially first-ever FDA approval in FSGS; KDIGO final guidelines and REMS-modification PDUFA could further de-risk adoption .
Selected quotes
- “We saw a meaningful inflection in demand following full approval” .
- “We received 693 new patient start forms… 37% increase from the prior quarter” .
- “We plan to submit our sNDA… for FSGS around the end of the first quarter of twenty twenty five” .
What Went Wrong
- EPS miss and persistent losses: GAAP EPS -$0.73 vs external consensus -$0.58 amid continued operating loss and lower other income; non-GAAP EPS -$0.47; total other income fell to $0.4M vs $5.7M in prior year quarter .
- Tiopronin (Thiola) headwinds: Q4 Tiopronin net sales declined modestly YoY (-5.2% YoY) with management highlighting generic dynamics and expecting further headwinds in 2025 for this smaller segment .
- Gross-to-net pressure outlook: CFO guides to higher 2025 gross-to-net (high-teens to low-20s), front-loaded early in the year—this will temper net revenue realization despite demand growth .
Financial Results
Headline P&L vs Prior Periods and External Estimates
Notes: Gross margin calculated as (Revenue-COGS)/Revenue using reported totals (see citations).
Segment/Line-Item Breakdown
KPIs and Balance Sheet
Guidance Changes
Earnings Call Themes & Trends
Management Commentary
- CEO on demand inflection: “In the fourth quarter, net sales [of FILSPARI] grew by nearly 40% compared to the third quarter and we saw a meaningful inflection in demand following full approval” .
- CCO on access and label: “We continue to have excellent coverage… updates of authorization criteria reflecting the broader… label… will further ease access for patients with lower proteinuria levels” .
- CMO on foundational role: “Foundational treatment is defined as non immunosuppressive, kidney targeted and nephroprotective… with efficacy based on superior kidney function preservation from a head to head comparison” .
- CFO on 2025 setup: “We believe net product sales of [FILSPARI]… will grow significantly in 2025… [but] expect a moderate increase in gross to net… high teens to low 20s, greatest impact early in the year” .
- Program update: “On track to submit an sNDA for an FSGS indication around the end of the first quarter of 2025” .
Q&A Highlights
- Competitive landscape: Management emphasized FILSPARI’s dual pathway blockade and head-to-head superiority vs irbesartan, noting likely segmentation for new entrants and confidence in dosing flexibility and payer positioning .
- REMS path: First step targeted is monthly→quarterly liver monitoring in year 1; agency has discussed ~3,000 patients over two years exposure before considering full removal .
- PSF conversion and persistence: Company reports strong fulfillment and high compliance/persistence; improved REMS process has reduced leakage, aiding revenue conversion .
- FSGS launch readiness and pricing: ~80% prescriber overlap with IgAN; preparation focused on physician education and value story; pricing strategy to ensure broad access, with doubled dose potentially implying higher regimen cost though details TBD .
- Gross-to-net framework: Expect GTN in high-teens/low-20s in 2025, front-loaded in Q1, then more even through the year .
Estimates Context
- S&P Global consensus via our SPGI feed was unavailable at the time of analysis (tool limit). Values retrieved from S&P Global were unavailable.
- External consensus (Zacks/Nasdaq): Revenue $73.44M; EPS -$0.58. Actual Q4 revenue $74.79M (beat), GAAP EPS -$0.73 (miss). Segment beats: FILSPARI $49.64M vs ~$45.31M external; Tiopronin $23.90M vs ~$24.03M .
Key Takeaways for Investors
- FILSPARI demand and breadth accelerated post-full approval (PSFs +37% QoQ), with ~$50M Q4 sales; adoption into lower-proteinuria patients and payer alignment support continued growth into 2025 .
- 2025 IGAN revenue growth should remain strong, but model a higher gross-to-net (high-teens/low-20s), especially weighted to Q1 seasonality .
- Multiple near-term catalysts could unlock value: FSGS sNDA filing (end of Q1), REMS-mod PDUFA (Aug 28), EU full approval conversion ($17.5M milestone), and KDIGO finalization—all pointing to reduced friction and greater access .
- Tiopronin is a manageable headwind amid generics and is a shrinking percent of mix; the story is increasingly FILSPARI-driven .
- Liquidity is solid post-November raise (year-end cash/marketables $370.7M); management expects operating cash use to decline over time as revenues scale and milestone inflows arrive .
- Watch competitive ERA entries and complement/B-cell agents: Management frames combinations as likely, with FILSPARI as the foundational nephroprotective agent; payer positioning and pricing strategy appear prepared for evolving combination paradigms .
- Execution risk remains on regulatory (FSGS endpoint acceptance, REMS changes) and manufacturing (pegtibatinase scale-up to 2026 restart), but core commercial trajectory and guideline tailwinds are supportive .