Akebia Therapeutics (AKBA) Q4 2025 earnings summary

Executive summary

• Achieved $227.3M in net product revenue in 2025, driven by the commercial launch of Vafseo and continued Auryxia sales.

• Vafseo launch faced challenges in the second half of 2025 but saw renewed demand growth, expanded prescriber access, and a broadened customer base in Q4 and early 2026.

• Over 1,000 prescribers at 24 dialysis organizations have written Vafseo prescriptions; 290,000 patients now have access.

• Introduced a rare kidney disease pipeline, including praliciguat, AKB-097, and AKB-9090, with multiple clinical trials underway or planned.

• Net loss for 2025 decreased to $5.3M from $69.4M in 2024; Q4 net loss was $12.2M, down from $22.8M in Q4 2024.

Financial highlights

• Total revenues reached $236.2M in 2025, up from $160.2M in 2024; Q4 2025 revenues were $57.6M, up from $46.5M in Q4 2024.

• Vafseo net product revenue was $45.8M for 2025, with Q4 impacted by a $4.8M one-time inventory drawdown at USRC.

• Auryxia net product revenue was $181.5M in 2025, up from $152.2M in 2024.

• Cost of goods sold dropped to $12.5M in Q4 2025 from $20.4M in Q4 2024, reflecting elimination of non-cash amortization charges.

• Cash and cash equivalents at year-end 2025 were $184.8M, up from $51.9M at year-end 2024, supporting at least two years of operations.

Outlook and guidance

• Expect Auryxia revenues to decrease in 2026 due to expanded generic competition.

• Anticipate continued Vafseo growth in 2026, supported by improved adherence, broader adoption, and expanded access, but no specific revenue guidance provided.

• Multiple clinical milestones expected in 2026, including VOCAL top-line data, AKB-097 basket study initiation, and AKB-9090 phase I results.