KORU Medical Systems, Inc.

KORU reported second-quarter revenue of $12 million, up 18% year over year. Domestic core revenue was $8 million, up 12%; international core revenue was $3.5 million, up 59%; and pharma services revenue was $600 thousand, down 35%. Gross margin was 65.1% versus 63.5% in the prior-year period, up 160 basis points, and management said the company delivered positive net income for the first time since 2019. For the first half, revenue grew 20%, gross margin improved to 60.3%, operating expenses increased 9%, net losses improved by 60%, and adjusted EBITDA was positive by $900 thousand. Cash at quarter-end was $8.3 million, with minimal cash usage of $500 thousand in the quarter, and the company said it still has an unused $10 million debt facility. Full-year revenue guidance was narrowed to $47.5 million-$48.5 million. Gross margin guidance was raised to 62%-64% from 61%-63%, year-end cash is now expected to be greater than $7.5 million, and management reiterated that full-year adjusted EBITDA is still expected to be positive.

Adam Kalbermatten framed the quarter as evidence that KORU is becoming a broader digitally enabled drug-delivery platform rather than just a mechanical device business. He emphasized three growth pillars: protecting the core U.S. IG business, expanding internationally, and bringing more drugs onto label through pharma partnerships and oncology. He was upbeat about the company’s long-term position, but acknowledged that some international opportunities are taking longer to unlock and that the U.S. oncology timeline will slip after the Phesgo withdrawal.

Tom Adams highlighted record quarterly revenue, gross margin expansion to 65.1%, and positive cash flow from operations, saying improved profitability and tighter spending helped keep Q2 cash usage to $500 thousand. He pointed to stronger manufacturing productivity, higher average selling prices, a more favorable mix, and a new multiyear supplier contract that improves pricing and supports further margin expansion. On guidance, he said international timing issues are the main reason revenue guidance was cut to $47.5 million-$48.5 million, while gross margin guidance rose to 62%-64% and year-end cash is still expected to exceed $7.5 million, with positive adjusted EBITDA still expected for the full year.

Analysts pressed management on why international growth is slowing, what must happen to unlock non-tender markets, and whether some of that revenue could still arrive in 2026. Management said the issue is mostly timing and market setup, not a demand problem, and that some regions may take 12 to 18 months to fully ramp. Questions also focused on the connected monitoring technology acquisition and Phesgo withdrawal; management described the tech as a multiyear build that will add patient communication and data capture capabilities, and said the FDA feedback on Phesgo made other oncology molecules more attractive for the U.S. while international Phesgo remains in play.