Rockwell Medical (RMTI) Q4 2025 earnings summary

Executive summary

• Achieved profitability on an adjusted EBITDA basis for the second consecutive year in 2025, despite significant changes in customer base, purchasing volumes, and distribution footprint.

• Delivered one of the highest quarterly gross margins in company history in Q4 2025 and generated positive cash flow from operations.

• Diversified customer mix, now serving about 300 customers in the U.S. and over 30 countries internationally, including all top five U.S. dialysis providers.

• Expanded and extended key customer agreements, notably with DaVita, IRC, DCI, Concerto Renal Services, and signed a multi-year agreement with Innovative Renal Care.

• Responded to a major supply chain disruption by rapidly scaling production and adding 30 new West Coast customers, now representing over 10% of the clinic footprint.

Financial highlights

• Net sales for Q4 2025 were $18.3 million, up 15% sequentially but down 26% year-over-year; full year 2025 net sales were $69.3 million, down 32% from 2024.

• Gross margin for Q4 2025 was 21%, up from 14% in Q3 and 15% in Q4 2024; full year 2025 gross margin was 17%.

• Gross profit for Q4 2025 was $3.9 million, up 70% sequentially; full year gross profit was $11.7 million.

• Net loss for Q4 2025 was $600,000, a significant improvement from $1.8 million in Q3 and $800,000 in Q4 2024; full year net loss was $5.3 million, including $4 million in non-cash and $1.2 million in restructuring costs.

• Adjusted EBITDA for Q4 2025 was $1 million; full year Adjusted EBITDA was $300,000, down from $5 million in 2024.

• Cash and equivalents at year-end 2025 totaled $25 million, up from $21.6 million at year-end 2024, with $2.3 million positive cash flow from operations in Q4.

Outlook and guidance

• 2026 guidance projects Adjusted EBITDA between $1 million and $2 million and positive operating cash flow.

• Net sales and gross margin guidance for 2026 to be provided after ongoing customer negotiations conclude.

• Long-term goals include annual net sales above $100 million by 2029, gross margins approaching 30%, and annual profitability of $5–$10 million.

• 2025 results met annual guidance for net sales, gross margin, and Adjusted EBITDA.

• Focus for 2026 is on revenue growth, profitability expansion, and portfolio diversification.