OPK Q4 Earnings & Revenues Beat Estimates, Gross Margin Contracts

OPKO Health, Inc. OPK delivered a loss per share of 4 cents in the fourth quarter of 2025, against an earnings per share of a cent in the prior-year quarter. Earnings beat the Zacks Consensus Estimate of a loss of 7 cents per share by 42.9%.

OPK’s Revenues in Detail

OPKO Health registered revenues of $148.5 million in the fourth quarter, down 19.1% year over year. However, the figure topped the Zacks Consensus Estimate by 7.6%.

The overall top line was dampened by lower revenues from services, partly offset by strength in revenues from products, especially Rayaldee.

OPKO Health’s Segmental Revenues

OPKO Health manages its operations through two reportable segments — Diagnostics and Pharmaceuticals.

Within the Diagnostics arm, revenues from services amounted to $71.7 million, down 30.5% year over year. This was primarily due to lower clinical test volume, principally as a result of the sale of certain BioReference assets, partially offset by higher clinical test reimbursement rates. This compares to our projection of $105.3 million from services revenues in the fourth quarter.

Within the Pharmaceuticals arm, revenues from products gained 16.8% year over year to $43.7 million, driven by higher sales volumes in certain international operations. This was partially offset by a decrease in Rayaldee sales. This compares to our projection of $41.5 million from product revenues in the fourth quarter.

Revenues from sales of Rayaldee in the fourth quarter of 2025 totaled $8.8 million, down 3.3% from the prior-year period’s level.

Revenues from the transfer of intellectual property (IP) and other totaled $33.7 million, down 21.8% from the prior-year figure. This decrease was due to lower milestone payments and reduced BARDA funding in the quarter. This compares to our projection of $16.8 million in revenues from the transfer of intellectual property and other in the fourth quarter.

OPKO Health, Inc. Price, Consensus and EPS Surprise

OPKO Health, Inc. price-consensus-eps-surprise-chart | OPKO Health, Inc. Quote

OPK’s Margin Analysis

In the quarter under review, OPKO Health’s gross profit decreased 24.2% year over year to $64.1 million. The gross margin contracted 290 basis points (bps) to 43.2%.

Selling, general and administrative (SG&A) expenses declined 24.6% year over year to $50.5 million. Research and development expenses increased 7.9% year over year to $32.8 million. Adjusted operating expenses of $83.3 million decreased 14.5% year over year.

Operating loss totaled $38.3 million compared with the prior-year quarter’s $33.1 million.

OPKO Health’s Financial Position

OPKO Health exited fourth-quarter 2025 with cash and cash equivalents of $369.1 million compared with $428.9 million at the end of the third quarter.

Cumulative net cash used in operating activities at the end of fourth-quarter 2025 was $178.5 million compared with $183.5 million a year ago.

OPK’s Guidance

OPKO Health has provided its financial outlook for first quarter and full year 2026.

For the first quarter of 2026, OPK expects total revenues between $125 million and $140 million. The Zacks Consensus Estimate is currently pegged at $130.9 million. For 2026, the company expects total revenues between $530 million and $560 million. The Zacks Consensus Estimate is currently pegged at $634.3 million for the same.

Revenues from product sales are expected to be in the range of $38-$45 million for the first quarter and $160-170 million for 2026.

Revenues from services are expected to be in the range of $71-$75 million for the first quarter  and $300-$312 million for 2026.

IP and Other revenues are now expected to be between $15 million and $20 million for the first quarter and $70-$80 million for 2026.

Our Take

OPKO Health’s fourth quarter highlighted continued strategic transformation and financial discipline across its Diagnostics and Therapeutics segments. Following the completion of the BioReference oncology asset sale to Labcorp, the diagnostics business is now streamlined around its core regional clinical lab operations and the nationally expanding 4Kscore franchise.

Fourth-quarter 4Kscore volumes grew year over year, supported by the updated FDA label removing the DRE requirement, while workforce reductions and cost rationalization initiatives significantly improved the expense structure. Management expects BioReference to return to positive operating income and cash flow in 2026, reflecting a leaner and more focused operating model.

Within therapeutics, ModeX advanced multiple clinical-stage programs, including MDX2001 and MDX2004, while preparing additional candidates for first-in-human studies. The Regeneron collaboration, which carries potential milestone value exceeding $1 billion, alongside continued progress under partnerships with Merck and BARDA, reinforces external validation of OPKO’s multispecific antibody platform and provides meaningful nondilutive funding support.

Meanwhile, growing Pfizer profit share from NGENLA, initial royalty contributions from Lilly’s mazdutide launch in China, and an active share repurchase program strengthened the company’s financial position. Collectively, OPKO exits 2025 with improved balance sheet flexibility, advancing clinical catalysts, and a clearer path toward sustainable long-term value creation.

OPK’s Zacks Rank & Stocks to Consider

Opko Health has a Zacks Rank #3 (Hold) at present.

Some better-ranked stocks in the broader medical space are Solventum Corporation SOLV, Boston Scientific Corporation BSX and HealthEquity HQY.

Solventum, sporting a Zacks Rank #1 (Strong Buy) at present, has an estimated long-term growth rate of 4.1%. SOLV’s earnings surpassed estimates in each of the trailing four quarters, with the average surprise being 13.91%. You can see the complete list of today’s Zacks #1 Rank stocks here.

Solventum’s shares have gained 8.2% compared with the industry’s 6.2% growth so far this year.

Boston Scientific, carrying a Zacks Rank #2 (Buy) at present, has an estimated long-term growth rate of 14%. BSX’s earnings surpassed estimates in each of the trailing four quarters, with the average surprise being 8.1%.

Boston Scientific’s shares have gained 13.2% compared with the industry’s 5.6% growth so far this year.

HealthEquity, carrying a Zacks Rank of 2 at present, has an estimated long-term growth rate of 21.7%. HQY’s earnings surpassed estimates in three of the trailing four quarters and missed once, with the average surprise being 11.05%.

HealthEquity’s shares have risen 0.6% compared with the industry’s 6.2% growth so far this year.

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