Q2 2025 Ardelyx Inc Earnings Call

Good day, everyone and welcome to the Ardell. First quarter 2025 earnings call. At this time, all participants are in a listen-only mode. Now, I'd like to turn the conference over to Kate and lowi vice president of corporate Communications and investor relations Caitlyn. You may begin

thank you, good afternoon and Welcome to our second quarter, 2025 Financial results call

That will be filed today and can be found on our website at ardelyx.com.

Well, we may elect to update these forward-looking statements in the future. We specifically disclaim any obligation to do so. So, even if our views change,

Our president and CEO Mike Rob will begin today's call with opening remarks in an overview of the company's progress during the second quarter of 2025. Next chief commercial officer, Eric Foster will provide an update on the performance of Israel and expose up Justin wrens. Chief Financial and operations officer will conclude today's prepared remarks with a review of the company's financial performance. During the second quarter end of June 30th 2025, before we open the call to questions with that. Let me pass a call over to Mike

Good afternoon. It's a pleasure to be with you today, to share our second quarter 2025 results. According to our strategy, the momentum behind our products and exceptional execution by our team.

We're proud to report a standout quarter for both Israel and expoza reinforcing the power of our commercial model and the real world impact are differentiated therapies are having for patients with ibsc and CKD on dialysis.

These results, validate our strategy, and highlight, our ability to deliver on our priorities.

In the second quarter, we generated 97.7 million in total revenue representing 33% year-over-year growth, a strong signal of accelerating demand across our portfolio.

Its Relic continues to perform with net sales revenue of $65 million during the second quarter, an 84% year-over-year increase and a 46% quarter-over-quarter increase.

Its relative demand growth is broad-based with record highs across all our key indicators.

Ours relative team has done an exceptional job expanding reach. Deepening prescriber engagement conviction and prescription pulled through.

Given this outstanding momentum, we are raising our full-year 2025 net sales revenue guidance for Israela to $250 million to $260 million, a meaningful step forward as we scale the opportunity ahead for this important medicine.

Expose had a very encouraging quarter as well.

With a change Market landscape exposed, a recorded net sales, revenue of 25 million of 7% compared to the first quarter this year. And when adjusted for the 1-time reserve that was released in q1, net sales grew 27%.

This performance speaks volumes about the strength and agility of the Expos team as they help guide healthcare providers through this changed landscape.

Our Q2 results further strengthen our conviction in the significant opportunity we have ahead as we drive continued growth for exposure.

Notably, our strong commercial execution and continued disciplined investments in our business have resulted in a meaningful quarter-over-quarter improvement in net loss as well.

Additionally, we strengthen our balance sheet and further enhance our financial flexibility by drawing additional 50 million dollars of debt.

As we progressed, we've also thoughtfully scaled, the organization and we've been deliberate in our leadership team to match the opportunity ahead.

Over the past 18 months, we've added transformative talent that will help guide us into our next phase of growth.

We recently promoted promoted, Mike Keller, heard a cheap business officer and appointed, Laura Williams, as Chief patient officer.

We also welcome 3, Dynamic and experienced leaders to our executive team at Connor. As chief medical officer, John Bishop as Chief technical operations officer and Jamie Brady as Chief Human Resources officer

This group brings deep expertise, vision and executional Excellence. Exactly what we need as we execute on our ambition, to create a significant Enterprise and build a company of lasting impact.

As you also saw in the press release. We issued early today. Justin Wren, our chief financial and operations, officer will be leaving the company.

Justin has been instrumental in our deluxe's journey leading with strength Goodwill and purpose through periods of both challenged and transformation.

He has built a world-class organization and positioned us to thrive going forward.

We are incredibly grateful to Justin and that he will remain with us to ensure a seamless leadership transition.

Justin, thank you for your partnership, your leadership, and your unwavering commitment to our mission.

Our Delta is stronger, more focused and energized by the opportunities ahead. We are united by a deep commitment to patients backed by best-in-class science and guided by a team that knows how to execute.

Our therapies are making a real difference. Our strategy is working, and we are well positioned to deliver even greater impact moving forward.

Eric.

Thank you, Mike. It's great to be with you today and I'm excited to share insights into the performance. We delivered during the second quarter and how we plan to maintain that momentum for the remainder of the Year. Let me start with israella Isla recorded an impressive. 65 million in net sales, revenue for Q2 demonstrating 84%, year-over-year, growth, and 46%. Quarter over quarter growth. We saw a clear acceleration in demand, delivering our strongest quarter since launch supported by growth, across all key demand indicators, compared to the first quarter of this year.

This performance was driven by focused commercial execution, which generated growth in both breadth and depth of prescribing and an improvement in prescription pull-through. Let me dive into it a bit more, starting with commercial execution.

During the quarter, the team drove significant increases in new and total prescriptions through increased field activities to targeted, hcps.

We also deployed highly effective marketing activities, including peer-to-peer hcp, education, programs, and digital HC hcp and consumer engagement by focusing on, increasing the breadth of writers. We generated growth in new writers, new prescriptions and new patient starts. In addition, existing writers expanded their view of patients. They consider candidates for Abella and in turn increase their depth of prescribing.

We were also pleased to see that refills made up a greater proportion of prescriptions in Q2, which means new prescriptions are spinning off more refills. Both new and refill prescriptions reached all-time highs

We also saw early evidence that the investment in the field. Access manager team is having a positive impact on our prescription. Pull through the team focused on educating offices to ensure that providers can navigate the access landscape if needed.

We are seeing early indicators that approval rates and resubmission rates are improving. It is still early for the field. Access manager team but we are pleased with the progress and results to date.

It has been 3, full quarters since we completed our sales force expansion and the field team is hitting their stride in the second half, they will continue their focus on Target, hcps, and reinforce abella's, unique and differentiated position as the next choice therapy after trial with a secretagogue. We know that only a quarter of patients on a secretagogue are satisfied and there remains significant opportunity in the market.

We will continue to sales and marketing activities that drove increased demand during the first half of 202.

With the aim of continuing to expand both depth and breadth of the prescribing base.

Additionally, our expanded field access team. Will maintain their focus on improving prescription. Pull through to help ensure that all appropriate patients prescribed isella get on treatment.

Working with our Deluxe assist, our team is focused on supporting hcps to understand the channels that are best equipped to handle prescriptions.

The field access manager team. Also works closely with hcps to provide prior authorization support to improve patient pull through.

Coming off a strong Q2 performance. I have full confidence in our team, if Stella is an important medicine that delivers meaningful benefits to patients. And our commercial strategy is working. As we look to the second half of the year, we remain focused on executing at a high level and expect our strong momentum to continue. We are raising our guidance for this year. We are confident in our ability to deliver Peak sales of more than 1 billion dollars.

now, on to expoza,

We are very pleased with the performance that Exposed delivered in the second quarter, achieving $25 million in net product sales revenue, a 27% increase over the first quarter of this year. When the one-time Q1 reserve release is excluded, it is driven by meaningful demand growth. Expose is an important medicine to help patients achieve target phosphorus levels, and our strategy of providing broad-based patient access to Expose, regardless of payer, is increasing support for prescription pull-through. This is working in the new market environment for phosphate management. We are seeing growth across all key demand indicators.

Including improved access for patients on both patient assistance and paid prescriptions, as well as growth in our non-Medicare payer segments.

The total number of writers and new, and refill. Prescriptions demand accelerated during the quarter. And we are confident, we have the right strategy in place to continue to drive growth in the second half of 2025.

Taking a closer look at some of the factors behind the Q2 results. This market, like IPS, is responsive to the promotional messaging from our field-based area, business directors, and our marketing efforts. Since the beginning of the year, the field and marketing teams have been focused on ensuring HCPs understand the access path for exposure, and we are seeing positive signs that this messaging is resonating.

From the prior quarter, as well as the total number of writers.

These are positive indicators that give us confidence that our strategy and messaging are generating Clarity and confidence in prescribing.

Core to our strategy is driving prescriptions to our Deluxe Assist in order to support patients and providers as they navigate the access landscape in this new environment.

During the second quarter, we saw growth in the percentage of prescriptions, growing through our Deluxe Assist and the number of Target HCPs who have had a patient successfully access exposure through our Deluxe Assist. Both are strong indicators that we are gaining momentum in this new environment.

We have grown the total number of paid prescriptions month over month since March, and we are focused on continuing that steady and consistent growth for the remainder of the year by generating greater depth and breadth in prescribing among exposed writers.

To support patient access. We will continue to engage and partner with leadership teams at dialysis providers on ways, to educate and support access to expoza.

Finally, on patient pull-through, we will continue to support HCPs and patients in their prior authorization and pull-through needs. Our Deluxe Assist plays an integral role, regardless of payer, and we remain committed to patient access for the long term.

As you can see, the expose a team is focused in the right areas and we are delivering strong results. We know there continues to be a significant unmet need among patients with elevated phosphorus, despite treatment with binders and we seek to deliver on that opportunity as such. We remain confident in our ability to achieve Peak cells of 750 million.

It was a strong quarter for both Israel and expoza. The team is focused and executing at the highest level generating increased demand and improvements in patient. Pull through, we are optimistic about the remainder of 2025 and we look forward to continued growth throughout the year. I will now turn it over to Justin Justin Justin.

Thanks Eric before jumping into the financials from the quarter. I wanted to take a moment to share my thoughts on leaving our Deluxe later this year.

I have had the privilege of seeing the evolution of our Deluxe over the past 5 years.

as many of you who have followed us for a long time, know there have been some challenges but there have been many more successes

during my time at our Deluxe, I've had the opportunity to help launch 2 drugs, build, a supply chain and support systems designed to ensure the product was always available for patients navigate challenging financial markets. And what I most proud of build a team capable and equipped to support the future operations for this company.

After establishing the infrastructure required to be a successful commercial company, Ardelyx is in a strong position, and it seems like the right time for me to make a transition.

I look forward to staying on to help with the smooth transition of the finance leadership for the company. Our Deluxe is a great company with an exciting future, and I look forward to continuing to follow the company's future successes after my departure.

Now on to the strong financial performance we delivered during the second quarter, ended June 30, 2025, as Mike and Eric both shared. We generated significant patient demand during the second quarter.

We have continued to thoughtfully invest in our business. To support that growth and finish Q2 with Improvement in net loss on a quarter of a quarter basis.

This performance reinforces our confidence in our ability to continue to generate significant revenue and carefully structure and manage our cost base.

We shared our full financials in the press release and 8K issued earlier. Today, I will not go into all the individual items but instead focus on the key drivers during the quarter starting with Revenue.

For the period end of June 30th 2025. We reported total revenue of 97.7 million, an increase of 33% compared to the 7 3. 2 4,

The growth was driven by significant increases in Revenue, by azella and product Supply sales to our collaboration partners.

During the second quarter of 2025, we recorded asella, net product sales, revenue of 65 million, an increase of 84% over the same period last year.

Israel has demonstrated consistent growth since launch, and our strong performance in the second quarter was a reflection of the continued patient demand. We also saw an improvement in our growth in net deductions during Q2 compared to the first quarter, due to decreased costs associated with our commercial co-pay program.

We finished the second quarter with a gross, net deduction of approximately 32.2%.

We expect to continue our strong performance for the remainder of 2025. As such, we are raising our guidance and currently expect to finish the year with between $250 million and $260 million in net product sales revenue.

As well as modest improvements in our growth and net deduction.

Exposure. We also had a very encouraging performance, recording $25 million in sales during the second quarter of 2025, which we delivered despite the loss of our largest payer, Medicare, compared to $37.1 million recorded during the second quarter of last year.

The 25 million for exposure re-reported for Q2 reflects a 7% increase in net sales, revenue from q1 of 2025 driven by patient demand.

As a reminder, our first quarter exposes a sec, net sales, revenue included a 3.8 million returns reserved release. Excluding the reserve release. We delivered. A 27% increase in net sales revenue compared to q1 of 2025.

Our gross in net deduction was 29% for explosive in line. With our first quarter growth to net of approximately 31% when 1 excluding the q1 returns Reserve release.

Looking ahead. The signals we are seeing are very encouraging.

The exposure strategy is working; we've established its place in the new market environment, and the business is positioned for further growth in the second half of the year, driven by patient demand.

In addition to product sales, we also recorded more than $6 million in product supply revenue related to sales to our international commercialization partners.

Now, turning to expenses.

R&D expenses were $15.7 million for the second quarter of 2025, compared to $12.8 million for the same quarter of the prior year. SG&A expenses were in line with our expectations at $84 million, compared to $64.7 million that we reported in the second quarter of last year.

The increase in sta was related to our continued investment in commercial activities for arella and expoza, including the Israelis sales force expansion, as well as growth of the overall corporate infrastructure to support our strategy.

We expect our SG&A run rate to increase to approximately $90 million on a quarterly basis for the remainder of the year, with incremental increases each quarter.

In the second quarter of 2025, we also had $11.7 million in non-cash stock compensation expense and $2.2 million in non-cash interest expense.

I would also note that we satisfied our $75 million total royalty obligation to Astroica during the second quarter. This obligation is now complete. We have already seen an improvement to our gross margin since May.

We had a net wasp approximately 19.1 million or 8 cents per share in the second quarter compared to a net loss of 16.5 million or 7 cents per share in the same period of last year. It should be noted that this is significant Improvement compared to the first quarter of 2025 when we reported a net loss of 41 million or 17 cents per share.

With respect to cash. We ended the second quarter with 238.5 million of cash, cash equivalents and short-term Investments.

This includes 48.7 million of incremental debt from our partners at SLR capital.

At a favorable interest rate of 8.7%, we believe this was a prudent opportunity to further strengthen our balance sheet and bring our current outstanding debt to $200 million, with an abundant interest rate of approximately 9.67%, only through June 30th of 2028.

We also have the option for an additional $100 million in 250 million tanches through next year.

We believe that the performance in the second quarter, demonstrates our commitment to Growing the Top Line, while focusing on the bottom line.

We remain committed to achieving the peak net sales revenue opportunities that we see for both of our commercial products, totaling more than $1.75 billion. We are thoughtfully investing in our business and maximizing shareholder value.

And with that, I'll hand it back to Mike.

Thanks Eric and and thank you, Justin. I hope that what you have taken away from our call today is that the performance is an indication of what you can expect from us a focus on execution continued momentum and delivering on our priorities.

I'd like to express my gratitude to everyone on Team Mardel for your hard work and commitment to bringing our important message to patients.

Thank you all to our shareholders for your continued trust and support.

I will now open the call to questions, Elvis.

Thank you. If you'd like to ask a question. Please press star 1 on your phone now and you'll be placed into the queue in the order received, please be prepared to ask your question when prompted again, everyone press star 1 for a question.

Our first question comes from Louise Chen from Scotia Bank. Please go ahead.

Number 1. I wanted to ask you if there was any update on a potential EU partner and then secondly I wanted to ask you how you're thinking about getting the cash flow positive. Is it a near-term or a medium-term goal for you? Thank you.

Hi Louise. How are you? Um, listen a second part of your questions first is. Obviously, we always look to cash flow break even and free cash flow in order to reinvest in the business. That's clearly an important thing. I think you can do the math with the guidance that we've given and see that. It's not that far off and on the horizon. And um, in terms of EU, you know, we're going to continue to evaluate opportunities. You know, you look at both of these businesses as it relates to Europe, um and let's not even think about the Halo negative halo of mfn over making those decisions. You know, there's nothing really substantive to talk about in terms of those opportunities at this stage.

Thank you.

Our next question comes from Dennis, Dang from Jefferies & Company.

Hi. Uh, thanks for taking our questions. I have two. If I may, one is on Iptoz, so talk about the new guidance and what’s factored into that. It seems a little bit conservative given the demanding scripts that we're seeing, and also the fact that it's an $8 million or about $10 million raise from the Q2 base. So, I’m wondering if there’s anything that we are not thinking about, but you are seeing on the ground.

And then my second question is on expose, it. Can you remind us what the gross, the net was in Q2, I think he may have said 29%, which is surprising given. That's better than q1 but you are booking Only commercial and Medicaid Revenue in Q2 which have worse. Gross investment Medicare. So how how are you thinking about gross enough for the second half of the year for sure? I'll have just an address of that. Sure. Thank you, James for the questions. Um, I'll have Justin address the second in a minute with the first, you know, I you should know as well enough by now that, um, when we give numbers, we are thoughtful and deliberate about what we say, nothing to read into this. Except that that 10 million dollar increase in our guidance is a meaningful step in the right direction of of what this opportunity is. And you know I think should put little doubt in people's minds about our long-term projections, the opportunity for this business. Um, so I would focus on that and you know with opportunity to give you more perspective on how we believe this year will play out. Um,

We certainly will provide that.

You want to provide some perspective on with you to chat? Thanks, Dennis. So, you're correct in Q1 when excluding time returns reserved release. We did our gross. Net would have been approximately 31%, and for Q2, it was approximately 29%.

Um it does pertain to product mix, right? Patient mix and the who the pair is so those are pretty close to each other. There's really mild differences. We did have an improvement in commercial co-pay. That was the primary driver again, co-pay for both of our products, typically improves over the course of the Year. Many of our patients are on what I'll call calendar year, healthcare plans. So if if their commercial patients, they may have a higher deductible in the beginning part of the year and it improves for them as a patient over time. So the primary difference between q1 and Q2 is on the amount of commercial co-pay that we need to, again, help the patient and patient assistance, I would look for it to be in that 30% range in general for the rest of this year. Again, 29 to 31 is a reasonable range and we're still learning, you know, in the the new environment there might be minor changes here and there but I expect it to be in that General range.

Thank you.

Next, we have Ryan Dashner from Raymond James.

Hi, thanks for the question, and congrats on the quarter. Um, I'm curious how much of this this quarter is of this sales growth, do you attribute to expanded sales team? Um, now that it's firing on all cylinders and you've got 3, full quarters in, do you expect continued meaningful script, pull through acceleration into 2026 due to this expanded field team, um, or, or that start to taper off around that time. Thanks.

Increased activity, we certainly expected to continue for the remainder of the year.

Thank you very much. Um, it is a quick follow-up, just wanted to see how you're thinking about, um, 1 quarter, sort of seasonality going forward. How we should think about um, that, um, over the next few years. Thanks sure. I asked Eric to provide some more perspective on it but, you know, I I think as we spoke about in the first quarter it's the first time we saw it in a way that we did and as this business grows and the magnitude of of that impact, is there? I think it's something that's proven to have in there. Um,

Eric. Yeah, like I said, we're very confident in our results at this point. Um, we want to make sure we're mindful of the summer months, um, and we don't get ahead of ourselves. So, uh, really confident about our performance at this point in the year and certainly look forward to being able to to move into, uh, um, back half of this year. Um, we know that, you know, primarily we do see that seasonality in q1. I think for us as we move into the back half of this year, it's more just being making sure that we're recognizing what's going on during the summer months where you have more vacations, you know, Physicians are taking vacations, patients are taking vacations, you've got returned to school. That happens in in August and then really things start to pick back up towards the end of the quarter, as they move into uh as they move into fourth quarter. So for us, um, we're very confident that things at this point in time will be mindful of those. Um, you know those events as we go through this quarter and um feel really confident about how we're going to be able to finish things up.

Thank you very much.

Thanks Ryan.

Our next question, comes from Julian, Harrison of btig.

Hi, congrats on the quarter and thanks for taking the questions on expose, the apologies, if I missed it. Um, wondering if there was any contribution, from transitional, scripts in 2q, or are we completely past that now. And, and then on April a did, do you have any sense for how uptake in the first line setting is trending? Did, are you seeing any traction there? Did you promote use at all in that setting? Or is that something typically just happening on its own right now?

Sure, let me address the first part of your question. When I expose a transition script, you know, there was an inconsequential amount there and how long that lasts, you know, that's something we're not really taking a whole lot of stance on. So, you know, generally it's about 50/50 in the overall mix between Medicaid and commercial. It's a way to think about it.

in terms of, uh,

first line therapy. Yeah, good. Good question. Thank you for that Julian. Yes, you know, first line therapy. Certainly, we are aware of some of that. I think, as you look at our positioning and kind of post-use, um, with a secret to God. And having significant opportunity, there we feel very confident in our positioning there. Um, I think as Physicians continue to get confident in isella and the impact that it can have for patients, certainly, they may go to that uh, earlier than what they're used to going to uh that they're what they're used to going to. Um and it is important to note our indication is for first line.

So um it's more than appropriate for Physicians to go to that first line. Um and for us it's about making sure that we have patient access so if they're able to get it first line and they have confidence in the product um for the patient and it's the right choice, they should be able to get it. Um, if it's post use with the secret of Gog, again, we've got Focus there on patient pull through and very confident in the improvements that we're seeing there and expect that to continue for the remainder of the year.

Excellent, thank you and congrats again.

Thanks Julian.

Up. Next, we have Joseph tell me from PD Cohen.

Hi there. Good afternoon. Uh, thank you for taking my questions. Congrats on the progress and best wishes to to Justin as next steps. Um maybe on the pull down of the 50 million, can you go into a little bit more detail of to what triggered that outside of the favorable, um, interest rate Dynamics? And maybe when you think about that remaining 100, what would be sort of the, the triggers to pull the rest down. Um, obviously you instituted the, the new CMO, um, should we be thinking about this as sort of opportunistic, BD or, um, you know, kind of building out the pipeline at all, or kind of, what would you be using this cache for? Thank you. That is a quick comment and then I'll ask Justin to mention, you know. Um SLR solar has been a phenomenal partner of ours and you know with the opportunity to get this. It's it's it's something that just made sense to strengthen the balance sheet, as I said in my opening comments um Justin I need to go get your ads. Yeah, thanks Mike and thanks Joe. Um again I hope

Optionality, going forward.

And maybe just some more, if I, if I met, um, do you think that both of the sales teams are now right sized to meet your um, you know, kind of peak guidance that you've set out for both exposure and azorella? Or when's the right time to kind of reassess if you're, if you're at the right size? Thank you. Yeah. Just 1, quick comment from you. And I'll ask Eric to to step in is we are always assessing how best to optimize our footprint and what we're doing. So that should never stop. Um, you know, I think we were pretty confident in terms of where we are in right size. But, um, Eric anything that yeah, thanks, Joe. Yeah, pretty confident, in terms of where we are with the bra, you know, just a reminder, we're coming off our 3, highest quarters of demand. So we feel like the, the the team is really hitting their stride uh, in addition to the expansion of the field, access manager. So um focusing on improvements in the middle of the funnel um, to be able to improve access. So I think right now, um, you know, as we look at the sizing of our teams, we feel very confident where it is to Mike's point we are always assessing, um, to look for opportunities, to be able to drive incremental demand. Um, but

We also have, um, our marketing activities that are out there. Um, as I mentioned earlier, highly impactful marketing activities that supplement, uh, the Field Force activity, right? Um, that’s out there on the exposed side. You know, as we’ve said since the beginning of the year, it’s about patient access, and physicians know the difference between Medicare, um, or non-Medicare segments. And so, we’re focused on the same number of nephrologists that we were focused on last year. And as you can see by some of the numbers and the improvements in the demand indicators from

1 to Q2 certainly feels like their efforts are appropriate and having an impact on those positions that we're targeting. And so right now, we feel really good about the sizing that we have for that.

Great, thank you so much.

Thanks Joe.

Our next question comes from yall from Citigroup.

Hi, this is Julian Kim on for you go. Congrats on the quarter and thanks for taking my question. Maybe just 2 quick ones from us. We were wondering if there's any color at all. You can provide on the breakdown of new patients versus refills, and prescriptions for Sorella,

Yeah, we've not historically, given a whole lot of um, detail around that I think, as you heard in Eric's comments, we have seen a good amount of increase in in refill, which is exactly what I want to see. You know, these patients be sticky, um, and with the benefit that these, uh, medicines are providing. So, we like to see that Trend. I mean, the specifics. We have not historically given those details, anything out. No, nothing more to add there, just about making sure that the patient's going to the right channel to be able to get the product. And with that, you know, we saw more refills this quarter than we have seen, um, in the past certainly versus new prescriptions. And that again, is just another indicator that gives us confidence, in terms of what we're able to achieve with the trail.

Gotcha very encouraging and if I may just 1 more question, is there any update or what is the latest update in terms of the ongoing uh CMS legal proceedings?

Yeah. I mean um as you can imagine, we've gotten out of the business of trying to protect uh, the administration government. Um, but you know, we have our case will be uh, arguments will be September 25th. Um, there's no statutory requirement for when we get a response back. And the as soon as we know anything of substance, we certainly will provide that for all of you.

Great, congrats on the quarter again and thanks so much.

Thank you.

Our next question, comes from Laura Chico, from boy voice securities.

Hey, good afternoon, I I've got to start out with a shout out to Justin best of luck. Justin, uh, sorry to see you leaving, um, but you know, congrats on the quarter and I guess 1 on exposure. Now, there's been a couple quarters in the new reimbursement environment. Just wondering Mike if you can kind of recalibrate for us and just tell you, tell us what gives you confidence in the new Peak estimate for exposure that you're seeing now in this reimbursement environment and when might you be in a position to restore guidance for exposure, thanks very much.

You know, it's substantively less than 100,000 patients, that gets you to that 750 million dollars. Um, so I've got great confidence and this trajectory and the performance that we're seeing here in our commitment to the patients, um, I have great faith in the, in the Expos of team and Eric the pull through work that the fans are doing across the board. The the marketing efforts the entire exposed team is focused on what's doing right for these patients. Um, and you know, as a result, I we at large um, have great confidence in in that number that we provided

So what is the average duration on treatment? Now, for a patient there, thanks very much, guys.

Sure. I mean, I I think the average duration for um, ibsc scripts um, is about 5 and, you know, we're trending the same if not a little bit better. Um, so, you know, I I feel very good about the uh, refill rates that we're seeing here, just given, you know, this tends to be a disease of the experience of the patients have is somewhat um uh waxing remitting. Um and you know that has been historically the case and we'll see if that is the case with us or if it's a tacky full access you see with the GCC Agonist that's the sort of thing that we pay close attention to.

Very helpful. Thanks guys.

Thanks Laura.

Next, we have for car agall from Cantor Fitzgerald.

Hi. Uh, thank you for taking my questions and congrats on the quarter. So, first on Israel, um, you committed to typical summer seasonality, but it seems like the three key scripts are also looking good. So, maybe just comment on how you see it for the rest of the year and just the market overall. If you look at some of the prior trends, the second half, in aggregate, tends to be much stronger than the first half. So, should this year be any different? And just had a quick follow-up.

Yeah, thank you for the question. Um, you know, as I said at the start with the first question I got was, um, what do we think about this 250 to 260 compared to the performance and exactly what you just described with an opportunity to prove provide you more perspective, as we go through the rest of the year? We certainly will do that. You know, this is a meaningful step for us to give a $10 million increase in our guidance. Um, we haven't done that before in this way, so um, we are going to take Mindful and thoughtful steps as we see the performance show itself. And you know, the data that you look at historically that you just described. Sure, I can't argue against that. Um, and we will provide more perspective as we can going forward.

Thank you and I realize on exposure realize you're not providing the guidance but consensus is setting at 90 million 99 million for the full year. So maybe a certificate comment on your comfort on where the street at estimates are for exposure for the full year. And, uh, would you expect sequential quarterly growth for exposure for rest of the year? Thank you. Yeah, you're you're nice question, but you're going to you Corner me in to giving guidance. Um, but, uh, I won't bite on all of it. But I will bite on is, you know, we just, uh, scored a 25 million quarter that we've said is based upon true real Demand on the non-medicare population. Um, and you know, do the math, if it was flat, um, and not much gets us to, uh, exactly the kind of modest growth that you would need. Um, so I feel very good about the trajectory that we're on. Um and I feel confident that we will not do this in future, be able to provide you some guidance, you know with growth since March I am going to be thoughtful

about doing that because I don't want to get out of myself, um, or any of us ahead of our skis. And we're what we're trying to do. So um, you know, that's why we're sticking to our guns and and uh, not providing guidance yet, but we will.

Thank you.

Next, we have Aiden Hugh from Ladenburg Thalmann.

Hi, good afternoon, and congratulations on the strong quarter actual record score for Thrilla, I think. So, let me ask you a general question first. So, you're now...

Was on track to January 400 million a year and you only traded at billion dollar valuation. So you know 1 can imagine that you might be approached by a larger players and if you do what do you see the potential? Uh acquires interest more in ghee? Space on the renal space and this is obviously a very hypothetical question. But

Do you think your value is more on ghee or on the renal side?

For exposure. And I think we're showing everyone, um, or that the dra and the GI markets hard to understand. I can't understand that because it's pretty straightforward with what we're doing in our performance. Um, so, you know, our objective here is to build a great company, um, and a sustainable Enterprise and, you know, I'm less interested in how other people think of us. In terms of bigger, companies, out there versus ultimately, the patients that we're here to serve.

Thank you appreciate. Appreciate you answering. Thank you.

Our next question comes from Allison bratzeli.

Hi. This is Ashley on for Allison. Um congrats on the great quarter guys. Um I just had 2 questions um 1 for expoza. I know this is already asked in terms of guidance, but if there's anything that you can point us to, in terms of what you're hoping to see, in terms of any specific metrics or indicators, that would give you the confidence to provide guidance, maybe in the second half of the year. Um, that would be really helpful and then second on your

Uh, licensing revenue and product Supply revenue and non-cash royalty revenue from your partners. Um, we're seeing some really good growth on that front. So just wondering what that could look like in the second half of the year. Um or if you have any expectations, thanks sure. Um Justin, I'll just a second question in a minute. Um for your first 1, it's frankly more of the same

Name.

Right? If you look at what we've done, Q1 without peculiarities, we saw there and uncertainties of people had. I think what we've shown everyone in Q2 is to trust us; our strategy is right. Um, and we're serving these patients who, you know, really need better phosphorus control. So I think that's unequivocal. Um, I'm thoughtful; we are conservative and mindful of the way we give guidance. And I think it's seeing more of the same, honestly. Um, as we navigate this quarter and into next, um, to gain the confidence to provide you some guidance.

Just in the yes thank you. So um we do generate product Supply revenue from our 3 International collaborative collaborative Partners. Um we did have a good second quarter as you noted just over 6 million dollars. Uh so our partners order from us you know, quasi regularly but not quarterly. So we do expect some additional revenue from our partners in the for fourth quarter of this year and be relatively comparable to the quarter. We just had. Um, so I would model Limited in Q3 and then 2026. We haven't gotten to yet because they haven't placed their orders yet. Um, and then on the, our partners is going to do well, Kyra, Karen is doing well, uh, in Japan with their sales for hyper fosfat. Um, we did monetize that royalty stream with our partners in healthcare royalty partners and so I do expect that to grow throughout this every quarter. Hopefully um, as Kyro Kieran does well in pain.

Training their space. They've had a very good launch, um, but that money is primarily passed through, uh, in full to healthcare royalty Partners. So, um, any modest increase you see in non-cash, royalty revenue is offset, uh,

by a corresponding debit, if you will into our p&l

Got it. Thanks so much, guys.

Next, we have Varina Reese from Lying Partners.

Hi. All this is amazing on Verana. Um just 1 from us. Um, sorry if it's been asked already, but can you provide more granular detail on the current prescription? Mix between Medicare Pap and uh Revenue generating, non-medicare patients for expoza and uh how do you expect this to evolve throughout the remainder of 25?

Great question. Um, so we don't talk about the number of scripts that are non-revenue. Um,

As we've not done that historically, but for Medicaid and commercial for exposure, you know, roughly 50/50 is turning out the way we expected it to.

Fantastic. Thanks.

Thank you.

That concludes our question and answer session. Michael. Turn things back over to you for any additional or closing comments. Excellent. Thank you all for joining us this afternoon. We are as ever focused on our vision of the healthier tomorrow for patients and to maximizing shareholder value.

With that, we can close the call. Thank you, Elvis.

that concludes our meeting today, you may now disconnect