Ardelyx Inc

Ardelyx shares fell about 13% in Friday morning trading after the company lowered its full-year 2026 revenue outlook for irritable bowel syndrome drug Ibsrela. The company now expects 2026 Ibsrela sales of $350 million to $370 million, down from a prior range of $410 million to $430 million, and reported second-quarter Ibsrela sales below expectations. Second-quarter GAAP earnings per share came in at a loss of $0.07, missing estimates by $0.01, while revenue of $120.8 million missed by $0.84 million. Costs and operating expenses rose roughly 19% year-over-year to about $133.3 million. Ardelyx ended the quarter with cash, cash equivalents, and short-term investments of approximately $281.8 million, up from about $264.7 million at the end of 2025.

Access barriers and physician misperceptions are curbing uptake of Ardelyx's Xphozah in the dialysis hyperphosphatemia market, according to a new cross-study analysis from Spherix Global Insights. Nephrologists report they would nearly triple their use of Xphozah if reimbursement and coverage barriers were removed, yet current use stands at approximately one in ten dialysis patients. Physicians estimate that roughly one-third of treated hyperphosphatemia patients receive combination therapy, but Spherix patient chart data show the actual figure is closer to one in seven. The analysis also found that the proportion of patients who initiated and later discontinued Xphozah doubled over the past year to 8%, with gastrointestinal tolerability cited as the leading reason. These dynamics are set to intensify as the Transitional Drug Add-on Payment Adjustment expires at the end of 2026, moving phosphate-lowering therapies toward a bundled reimbursement model that no longer meaningfully differentiates products.

Ardelyx shares fell about 6% on Friday after the company lost an appeal against the Health and Human Services Department regarding a Medicare decision that eliminated Part D coverage for its kidney disease therapy, Xphozah. The U.S. Court of Appeals for the District of Columbia Circuit reaffirmed a lower court ruling that had dismissed Ardelyx's lawsuit challenging Medicare's proposal to include oral-only phosphate-lowering therapies such as Xphozah in the End-Stage Renal Disease Prospective Payment System, a bundled payment system for dialysis services. Jefferies analyst Dennis Ding noted the setback removes an opportunity for Xphozah to be reimbursed as a standalone option for Medicare patients with chronic kidney disease, though he reiterated a Buy rating and $15 target on Ardelyx.