Ardelyx, Inc.

Total product revenue in Q2 2026 was $118 million versus $90 million in Q2 2025, up 31% year over year. IBSRELA revenue was $86.2 million, up 33% year over year, and XPHOZAH revenue was $31.9 million, up 27% year over year. R&D expense was $26.1 million versus $15.7 million a year ago; SG&A was $101.4 million versus $84 million; and net loss was $16.7 million versus $19.1 million. The company ended the quarter with $281.8 million in cash, cash equivalents, and short-term investments, and it drew down $50 million from its SLR facility during the quarter. For 2026, IBSRELA guidance was cut to $350 million to $370 million, XPHOZAH guidance was reiterated at $110 million to $120 million, and OPEX was revised to below $500 million. Management also said it still expects sequential IBSRELA revenue growth in the second half, with Q4 the highest revenue quarter of the year, and expects profitability in 2027.

Mike Raab framed the quarter as a record revenue milestone, but he stressed that performance fell short of expectations because payer hurdles slowed IBSRELA access. He said the long-term view for IBSRELA remains intact, including the goal of $1 billion in revenue, and emphasized a set of actions to improve access, fulfillment, and patient awareness. He also highlighted Ardelyx’s two commercial products, its expanding pipeline, and a belief that the company is moving toward sustained profitability in 2027 and beyond.

Sue Hohenleitner emphasized that Ardelyx is using its revenue base to fund commercial operations and the pipeline while keeping a disciplined capital allocation posture. She cited $118 million in total product revenue, $86.2 million from IBSRELA, $31.9 million from XPHOZAH, $26.1 million in R&D, $101.4 million in SG&A, and a $16.7 million net loss, noting that the loss narrowed from both last year and Q1. She also said the company ended with $281.8 million in liquidity, drew $50 million from SLR for general corporate purposes and flexibility, lowered IBSRELA guidance to $350 million to $370 million, kept XPHOZAH at $110 million to $120 million, and cut OPEX guidance to below $500 million. She reiterated that management expects to be income positive in 2027.

Analysts focused heavily on IBSRELA access, asking whether demand was still intact but scripts were getting blocked or slowed. Management said the main issues were more step edits and stricter prior authorizations, which are slowing new patient starts rather than completely blocking them, and said the expanded field reimbursement team and IBSRELA Pharmacy Network are helping with approvals, resubmissions, and fulfillment. Questions also covered whether payer pushback is broader across IBS-C and whether any ANDA challenges have surfaced; management said payer friction is meaningful across enough plans to affect the business, but declined to comment specifically on challenges, while noting the product’s non-absorbed profile, FDA requirements, and expanding patent estate as barriers. On XPHOZAH, management explained that the $750 million target was pulled because TDAPA is ending and the post-TDAPA reimbursement environment, including a proposed phosphorus quality measure, is still uncertain.