Medexus Pharmaceuticals (MDP) Q1 2026 earnings summary

Executive summary

• Fiscal Q1 2026 net revenue was $24.6 million, with $0.5 million net income and $3.4 million adjusted EBITDA, reflecting portfolio lifecycle changes and generic competition for Rupall.

• GRAFAPEX's first full commercial quarter contributed $3 million in product-level net revenue, with strong early adoption and significant formulary inclusions.

• Management expects GRAFAPEX to be accretive to operating cash flows by Q3 2026.

• Positive market response to GRAFAPEX, with broad payer and institutional formulary inclusion and orders from transplant centers.

Financial highlights

• Q1 2026 net revenue: $24.6 million, down 9.9% year-over-year, mainly due to Rupall and Gleolan declines, partially offset by GRAFAPEX launch.

• Adjusted EBITDA: $3.4 million, down from $6.1 million year-over-year, with margin at 14.0%.

• Net income: $0.5 million, compared to $2 million in Q1 2025.

• Gross profit: $13.8 million; gross margin improved to 56.0% from 54.4% year-over-year.

• Operating cash flow: $3.9 million, down from $8.2 million in Q1 2025.

Outlook and guidance

• GRAFAPEX Q2 2026 product-level net revenue expected at $3–$3.5 million, with positive operating cash flow contribution anticipated by Q3 2026.

• Peak sales for GRAFAPEX projected in 3–5 years, with annual net revenue expected to exceed $100 million within five years.

• Rupall revenues expected to continue eroding due to generic competition, with no rebound anticipated.

• GRAFAPEX annual product-level adjusted gross margin projected at ~80%, with initial quarters higher.