Agios Pharmaceuticals, Inc.

Agios reported Q2 2026 total Mitapivat net revenue of $44.7 million, including $40.9 million in the U.S. and $3.8 million outside the U.S. Cost of sales was $3 million. R&D expense was $100.8 million versus $91.9 million in Q2 2025, and SG&A was $51.5 million versus $45.9 million in the prior-year period. Net loss improved to $100.7 million from $112 million a year ago. Management ended the quarter with approximately $1 billion in cash, cash equivalents and marketable securities. For 2026, the company still expects approximately $45 million to $50 million from PK deficiency revenues in the U.S. and said operating expenses should be approximately flat versus 2025, excluding the $25 million cevidoplenib upfront payment and including sickle cell launch prep. Management also said any potential sickle cell launch would not be a material contributor to 2026 full-year revenues given the November 1 PDUFA date.

Brian Goff framed the quarter as evidence that Agios is executing across three pillars: commercial launch, pipeline expansion, and disciplined capital allocation. He emphasized the company’s goal of building a multibillion-dollar rare disease business and highlighted AQVESME, the sickle cell filing, cevidoplenib, AG-236, and AG-181 as key value drivers. His tone was confident and forward-looking, with repeated focus on the company’s financial flexibility and long-term growth runway.

Cecilia Jones focused on the numbers: $44.7 million in Mitapivat revenue, $100.8 million of R&D, $51.5 million of SG&A, and a $100.7 million net loss. She said R&D rose mainly because of a $25 million upfront payment tied to the Oscotec agreement, while SG&A increased due to AQVESME commercial launch activity. She also reiterated approximately $1 billion in cash and said full-year operating expenses should be roughly flat versus 2025, excluding the cevidoplenib upfront payment, while the company continues to expect $45 million to $50 million of 2026 U.S. PK deficiency revenue.

Analysts pressed management on AQVESME persistence, the pace of new patient starts, how much of the current prescription volume is still an early-launch bolus, and whether the company is seeing repeat prescriptions and refills. Management said continuation looks strong, pointed to clinical trial/open-label data as the best proxy for persistence so far, and said refills are coming in as expected. Another major topic was the sickle cell label and REMS: management said the clinical data did not show the hepatocellular injury seen in sickle cell patients, so a REMS may not be required, but final decisions on branding, pricing, and launch details will come at approval. Analysts also asked about gross-to-net and payer mix; management said sickle cell would likely carry a higher gross-to-net burden because of its higher Medicaid mix and the 23% mandatory rebate.