Akebia Therapeutics, Inc. quarterly report, Q1 FY2026

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Akebia Therapeutics, Inc. (AKBA) - Q1 2026 Filing Summary

Business Context and Reporting Period

This Quarterly Report on Form 10-Q covers the period ended March 31, 2026. Akebia is a commercial-stage biopharmaceutical company focused on kidney disease therapeutics. Its portfolio includes two FDA-approved products: Auryxia (ferric citrate) and Vafseo (vadadustat). A critical business event during this period was the entry of a generic version of Auryxia into the U.S. market by Teva Pharmaceuticals on March 11, 2026, following the loss of exclusivity in March 2025.

Key Financial Metrics

Metric Q1 2026 Q1 2025
Total Revenues $53.5 million $57.3 million
Net Loss $(9.1) million $6.1 million (Income)
Net Loss Per Share (Diluted) $(0.03) $0.03
Cash and Cash Equivalents $162.6 million $184.8 million (Dec 31, 2025)
Operating Cash Flow $(21.2) million $(13.6) million
Total Debt (Current + Long-term) $48.9 million (Term Loans) N/A
Accumulated Deficit $(1.69) billion $(1.68) billion

Material Changes vs. Prior Period

  • Revenue Decline: Total revenues decreased 7% year-over-year. Product revenue dropped to $52.0 million from $55.8 million, driven primarily by a 17% decline in Auryxia revenue ($36.2M vs $43.8M) due to generic competition. This was partially offset by a 31% increase in Vafseo revenue ($15.8M vs $12.0M).
  • Profitability Shift: The company reported a net loss of $9.1 million compared to net income of $6.1 million in Q1 2025. Operating income turned negative at $(4.7) million from $13.5 million.
  • Expense Increases:
    • Cost of Goods Sold (COGS): Increased 61% to $12.3 million, largely due to a $3.2 million inventory write-down for excess and obsolete inventory.
    • R&D Expenses: Increased 52% to $14.8 million, driven by clinical trial activities for praliciguat and AKB-9090.
    • SG&A Expenses: Increased 18% to $30.4 million due to higher headcount costs.
  • Debt Structure: The company maintains a $55.0 million senior secured term loan facility with BlackRock. As of March 31, 2026, the interest rate was 11.00%.

Guidance, Outlook, and Risks

  • Liquidity: Management believes cash resources ($162.6 million) and expected revenues are sufficient to fund operations for at least two years. However, this outlook is contingent on achieving anticipated Vafseo revenue projections.
  • Commercial Outlook:
    • Auryxia: Revenue is expected to be adversely impacted by the entry of Teva's generic and potential future generic entrants. The company is selling an authorized generic version through Mylan Therapeutics.
    • Vafseo: The company is focused on commercialization in the U.S. and maintaining contracts with dialysis organizations. Reimbursement is currently supported by the Transitional Drug Add-on Payment Adjustment (TDAPA), which expires in 2027.
  • Pipeline Updates:
    • praliciguat: First patient dosed in a Phase 2 trial for FSGS in December 2025.
    • AKB-097: Acquired from Q32 Bio in November 2025; Phase 2 basket study expected to initiate in H2 2026.
    • AKB-9090: First patient dosed in a Phase 1 trial for cardiac surgery-related acute kidney injury in April 2026.
  • Key Risks:
    • Generic Competition: Significant erosion of Auryxia revenue due to loss of exclusivity.
    • Reimbursement: Uncertainty regarding post-TDAPA reimbursement rates for Vafseo and Auryxia under the ESRD Prospective Payment System.
    • Supply Chain: Reliance on third-party manufacturers, including WuXi STA in China, exposes the company to geopolitical and trade policy risks (e.g., tariffs, BIOSECURE Act).
    • Debt Covenants: The BlackRock Credit Agreement requires maintaining either $15.0 million in cash or $150.0 million in trailing twelve-month revenue.

Investor Verification Checklist

  • Verify the specific impact of Teva's generic entry on Auryxia sales volume and pricing in subsequent quarters.
  • Monitor Vafseo adoption rates among large dialysis organizations (DaVita, Fresenius, USRC) to assess revenue growth potential.
  • Review the status of the TDAPA reimbursement program and any legislative updates (e.g., Kidney Care Access Protection Act) affecting post-2027 pricing.
  • Assess the company's ability to meet BlackRock debt covenants given the current revenue trajectory.
  • Track progress of the Phase 2 trials for praliciguat and AKB-097 as potential future revenue drivers.
  • Evaluate the impact of U.S.-China trade tensions and the BIOSECURE Act on the supply chain for Vafseo drug substance manufactured by WuXi STA.