Akebia Therapeutics, Inc. (AKBA) Q2 2026 Earnings: Revenue $49M (-21.4%)
AKBA — Q2 2026 Financial Report Analysis
Q2 · Fiscal year 2026 · Published by Pham Hop
Akebia revenue fell 21% to $49.1M as Auryxia sales nearly halved after Teva’s generic launch; Vafseo grew 60% to $21.3M but the company swung to a $6.3M operating loss.
Revenue
$49M
-21.4% YoY
Net income
-$8.9M
Diluted EPS
$-0.03
Operating margin
-12.9%
This period vs a year ago
Same period last year
This period
Revenue▼-21.4%
≈$63M
$49M
Year-ago figures (≈) are worked out from the growth rate the company reported. Each row has its own scale.
Overview
Akebia's second quarter of 2026 shows the handoff between its two kidney-disease drugs happening faster on the way down than on the way up. Total revenue fell 21% to $49.1 million as sales of Auryxia, its older phosphate-control drug, almost halved after a second generic (Teva's) entered the market in March 2026. Vafseo, its newer oral anemia pill for dialysis patients, grew 60% year on year to $21.3 million, but that was not enough to fill the gap. With research spending up 28% and a $1.9 million restructuring charge, the company swung from a $14.1 million operating profit a year ago to a $6.3 million operating loss, and posted a net loss of $8.9 million (−$0.03 per share).
At a glance
Vafseo $21.3 million, +60% YoY and +35% vs Q1 2026 — the growth product is now 46% of product sales, up from 22% a year ago.
Auryxia $25.5 million, −46% YoY and −30% vs Q1 2026 — the Teva generic launched on March 11, 2026, and this is the first full quarter of its impact.
Cash $155.5 million, down $29.3 million in six months — enough, management says, for at least two years, but only if it refinances a term loan whose principal payments start January 1, 2027.
Key figures
Metric
Q2 2026
Q2 2025
YoY Change
Total revenue
$49.1M
$62.5M
−21.4%
Net product revenue
$46.8M
$60.5M
−22.7%
— Vafseo
$21.3M
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$13.3M
+60.4%
— Auryxia (incl. authorized generic)
$25.5M
$47.2M
−46.0%
License, collaboration & other revenue
$2.4M
$2.0M
+17.5%
Gross margin
78.8%
84.1%
−5.3 pts
Research & development
$14.1M
$11.0M
+27.7%
Selling, general & administrative
$28.2M
$26.6M
+6.1%
Operating income (loss)
−$6.3M
$14.1M
n/m
Operating margin
−12.9%
22.6%
−35.4 pts
Net income (loss)
−$8.9M
$0.2M
n/m
Diluted EPS
−$0.03
$0.00
n/m
Cash & cash equivalents (period-end)
$155.5M
$184.8M (Dec 31, 2025)
−$29.3M
Source: Form 10-Q for the quarter ended June 30, 2026. Gross margin is revenue minus cost of product and other revenue, as a share of revenue. n/m = not meaningful (sign change).
What drove the quarter
Auryxia is in steep generic decline. Auryxia (ferric citrate) lost patent exclusivity in March 2025. For the first year, the only generic was an "authorized generic" — Akebia's own drug sold under a generic label by its partner Mylan, so Akebia still booked that revenue. That changed on March 11, 2026, when Teva won FDA approval for an independent generic. The 10-Q says that since Teva's entry "we have experienced, and we expect to continue to experience, a significant reduction in the volume of Auryxia sales." The numbers bear that out: Auryxia went from $36.2 million in Q1 2026 (implied from the six-month total of $61.7 million) to $25.5 million in Q2.
Vafseo is growing, but at a price that won't last. Vafseo (vadadustat) launched in January 2025 as the only oral HIF-based anemia treatment in the U.S. (HIF drugs nudge the body to make more of its own red blood cells, instead of injecting a synthetic hormone). Sales rose from $15.8 million in Q1 2026 to $21.3 million in Q2. A large part of that pricing power comes from TDAPA — a temporary Medicare add-on payment that reimburses dialysis centers separately for new drugs for two years. For Vafseo that window runs through December 31, 2026. After it ends, Akebia says it expects to price Vafseo "within the range of the price for ESAs" (erythropoiesis-stimulating agents — the long-established injectable anemia drugs such as Epogen), which are "priced significantly lower than Vafseo's current price." Management states plainly that it expects higher Vafseo unit volume in 2027 but "Vafseo revenues to decrease significantly in 2027 as compared to 2026."
Spending is going up, not down. R&D rose to $14.1 million from $11.0 million, driven by clinical trials for the two mid-stage rare-kidney-disease assets: external spending on praliciguat and ebribafusp went from $22 thousand to $2.5 million. SG&A rose 6% on "increased commercialization activities." In June, Akebia restructured its commercial field force, cutting about 13% of its total workforce at a cost of $1.9 million this quarter.
Below the operating line, things improved. Other expense fell to $3.1 million from $6.9 million, mainly because non-cash interest on the settlement-royalty liability owed to CSL Vifor dropped to $1.7 million from $5.4 million. A year ago, a $7.0 million loss on revaluing a lender's warrants also hit net income; this quarter that line was a $0.6 million gain.
Takeaway: Akebia is spending more on a growing pipeline just as both commercial products face a revenue cliff — Auryxia from generics now, Vafseo from the end of special Medicare pricing on December 31, 2026. Vafseo's 60% growth is real, but management has already told investors 2027 Vafseo revenue will fall, so this quarter's mix is likely closer to a high-water mark than a base.
What the headline numbers hide
Cash flow is worse than the net loss. Operating cash flow was −$17.7 million for the first six months, roughly equal to the $18.0 million net loss, but the two are made of different pieces: non-cash items added back about $21 million, while $20.8 million drained out through working capital (for example, accounts payable fell from $21.2 million to $9.4 million). A year earlier, operations generated $8.8 million of cash.
Receivables are rising while sales fall. Accounts receivable tied to product sales rose to $48.1 million at June 30 from $44.4 million at year-end, even though product revenue is shrinking. That means customers are taking longer to pay or timing of shipments shifted — worth watching next quarter.
Gross margin is flattered by old inventory — and also hurt by write-downs. Vafseo's cost of sales was only $1.0 million in Q2 because the drug was manufactured before approval and expensed as R&D at the time. At full cost, Akebia says it would have been $3.5 million. That $2.5 million benefit fades as the remaining $18.2 million of reduced-cost Vafseo inventory runs out. Pulling the other way, inventory write-downs (excess, obsolete or scrapped product) were $1.7 million in Q2 and $4.9 million in the half, versus almost nothing a year ago — likely tied to Auryxia demand dropping faster than planned.
One-offs in both years. This quarter: $1.9 million restructuring charge. Excluding it, the operating loss would still have been about $4.4 million. Last year: the $7.0 million warrant loss, which is why Q2 2025 net income was only $0.2 million despite $14.1 million of operating profit. Operating income is the cleaner comparison, and it fell by $20.4 million.
No share-count tailwind. The diluted share count (269.6 million) is roughly flat versus a year ago; Akebia sold 3.1 million new shares through its at-the-market program this quarter for $3.2 million net, and in June raised its authorized common stock from 350 million to 500 million shares — headroom for future equity issuance.
Debt and runway
Akebia has $52.4 million of principal outstanding on a BlackRock senior secured term loan, at a floating 11.0% interest rate as of June 30. Interest-only payments end December 31, 2026; $50.6 million of principal is scheduled for 2027 and the loan matures January 29, 2028. Management says cash plus expected product, royalty, supply and license revenue covers "at least two years" — but that estimate is "contingent upon us refinancing" the loan. Without a refinancing, the company only commits to "at least 12 months" from the August 2026 filing date. It also still owes payments to CSL Vifor (about $11 million paid in the first half).
Pipeline milestones
Vafseo VOICE trial (June 2026): a planned interim analysis of this U.S. Renal Care outcomes trial met its predefined stopping criteria, showing both non-inferiority and superiority on the primary composite endpoint, and the trial was stopped early on that basis. This could support Vafseo's case with dialysis providers as it shifts to post-TDAPA pricing.
Ebribafusp (complement inhibitor, acquired from Q32 Bio in November 2025): a Phase 2 "basket" study across IgA nephropathy, C3 glomerulopathy and lupus nephritis was announced in August 2026.
Praliciguat: in a Phase 2 trial for focal segmental glomerulosclerosis (FSGS), a rare kidney disease; first patient dosed December 2025.
AKB-9090: first subject dosed in April 2026 in a Phase 1 study, targeting kidney injury after cardiac surgery.
Outlook
The 10-Q gives no numeric revenue guidance. What management does commit to on paper: continued "significant" Auryxia erosion, Vafseo revenue falling significantly in 2027 on lower pricing, and R&D spending continuing to rise. Our read: the second half of 2026 is likely the best Vafseo can do under current reimbursement, while Auryxia keeps shrinking. That makes the two things to watch (1) whether the VOICE data and the proposed Kidney Care Access Protection Act improve post-TDAPA Vafseo economics, and (2) whether Akebia refinances its term loan before principal payments begin in January 2027 — the condition its two-year runway depends on. Without a refinancing or another revenue source, more share issuance looks likely given the newly expanded authorized share count.