Rhythm Pharmaceuticals, Inc.

Q2 2026 global net product sales of IMCIVREE were $71.3 million, up 19% sequentially from Q1 2026; U.S. revenue was $51 million, or 72% of product revenue. International revenue was $20.3 million versus $23.2 million in Q1, affected by a $3.8 million retrospective French contribution charge, of which $2.3 million related to 2025 revenue. Cost of goods sold was 12.5% of product revenue. R&D expense was $43.4 million versus $42.3 million a year ago, SG&A was $67.4 million versus $45.9 million a year ago, and GAAP EPS was a net loss of $0.73 per share, including $0.02 per share from accrued dividends on convertible preferred stock. Cash used in operations was about $9 million, and cash, cash equivalents and short-term investments were about $331 million at quarter-end. Full-year 2026 non-GAAP operating expense guidance is now $363 million to $397 million, including non-GAAP R&D of $175 million to $195 million and non-GAAP SG&A of $188 million to $202 million. Management said the lower midpoint of R&D guidance reflects shifted timing of certain RM-718 and bivamelagon CMC work into early 2027, without changing development timelines.

David Meeker framed the quarter around what he called a strong start to the U.S. launch of IMCIVREE in acquired hypothalamic obesity, saying the first 14 weeks reinforced management’s conviction that HO is a meaningful long-term opportunity. He also highlighted positive PWS data from ENDO and described RM-718 as a de-risked next-generation candidate with comparable efficacy and better tolerability characteristics versus earlier MC4R agonists. His tone was upbeat but measured, repeatedly noting it is still early in the HO launch and that the company is focused on building a durable franchise across multiple rare neuroendocrine diseases.

Hunter Smith said Rhythm exited Q2 in a solid financial position, with about $331 million in cash, cash equivalents and short-term investments and cash used in operations of about $9 million. He broke out the quarter’s revenue drivers, including strong U.S. demand tied to the HO launch, continued BBS growth, a modest benefit from specialty pharmacy shipment timing, and a $3.8 million French retrospective charge that weighed on international revenue. He also noted COGS at 12.5% of product revenue, SG&A rising to $67.4 million because of commercial expansion, and R&D at $43.4 million, while lowering the midpoint of full-year non-GAAP R&D guidance by $20 million due to timing shifts in RM-718 and bivamelagon CMC activities.

Analysts focused on whether the HO launch has any early discontinuation signal, whether the current pace of start forms is a launch bolus or sustainable, and how much GLP-1 use or payer step edits could affect uptake. Management said it is too early to quantify discontinuation rates, but suggested HO could have a lower discontinuation profile than BBS based on early experience and clinical data, and said there is no GLP-1 step edit in the HO policies currently in place. They also said the early start-form pace likely includes some pent-up demand, but emphasized broad prescriber mix, ongoing diagnosis efforts, and additional patients still being worked up. On commercial structure, Jennifer Chien confirmed the 42 territory managers were already split into dedicated HO and BBS teams.