Ironwood Pharmaceuticals, Inc.

Q2 total revenue was $113 million, GAAP net income was $51 million, and adjusted EBITDA was $83 million. LINZESS U.S. net sales were $282.3 million, up 14% year over year, and first-half LINZESS U.S. net sales were $555 million, up 44% year over year. For full-year 2026, Ironwood raised guidance to LINZESS U.S. net sales of $1.15 billion to $1.20 billion, revenue of $460 million to $485 million, and adjusted EBITDA of greater than $310 million. Management said LINZESS demand is tracking to mid-single-digit growth for the full year, and fourth quarter is expected to be the strongest quarter of 2026 for net sales.

Tom McCourt framed 2026 around three priorities: maximizing LINZESS, advancing apraglutide, and delivering sustained profitability and cash flow. He emphasized that LINZESS is showing exceptional strength, now positioned to grow more than 30% year over year and return to blockbuster status, while also highlighting the FDA pediatric functional constipation approval as a meaningful expansion. On apraglutide, he said STARS-2 is a key priority and expressed confidence in the program’s differentiated profile and in the team’s ability to execute the confirmatory trial.

Ron Silver said Q2 financial performance was strong, with $113 million of total revenue, $51 million of GAAP net income, and $83 million of adjusted EBITDA. He noted quarter-end cash and cash equivalents of $79 million and collaboration receivables of $113 million, and said Ironwood repaid its $200 million convertible notes at maturity in June. Looking ahead, he expects operating cash flows to continue reducing debt, with less than $300 million of gross debt outstanding by year-end and adjusted EBITDA guidance of greater than $310 million for 2026.

Analysts focused on whether the LINZESS price increase might hurt demand, especially in Medicaid, and management said it is not seeing the dramatic Medicaid volume reduction it had feared. Tammi Gaskins said demand is tracking to 5% year-to-date EUTRx volume growth and that state-level work with partners has helped preserve access across channels. Questions also centered on STARS-2 enrollment and whether prior dosing issues could recur; management said site activation is underway, more U.S. sites are being added, and the kit and process have been substantially improved based on root-cause analysis and human factors studies, giving them confidence the dosing error will not repeat.