Ardelyx Eyes $500M+ Revenue as IBSRELA Growth Puts Profitability Within Reach

Key Points

• Ardelyx said its two commercial products, IBSRELA and XPHOZAH, are on track to generate more than $500 million in revenue this year, with IBSRELA the main growth driver at $410 million to $430 million.
• Management said IBSRELA is growing rapidly thanks to a bigger sales force, better prescription fulfillment through its specialty pharmacy network, and targeted physician outreach. The company also reiterated a long-term goal of $1 billion in IBSRELA revenue by 2029.
• Ardelyx said profitability could be within reach this year if revenue lands in its guided range, though it is not issuing formal profit guidance yet because it wants confidence that profitability will be sustainable.

Ardelyx NASDAQ: ARDX executives said at the Jefferies Global Healthcare Conference that the company is focused on expanding demand for its commercial products, IBSRELA and XPHOZAH, while continuing to invest in its pipeline and positioning the business for sustainable profitability.

Chief Financial Officer Sue Hohenleitner said Ardelyx expects its two commercial products to generate more than $500 million in top-line revenue this year. IBSRELA, the company’s treatment for irritable bowel syndrome with constipation, or IBS-C, represents the largest portion of that outlook, with guidance of $410 million to $430 million. XPHOZAH, used for patients on dialysis with hyperphosphatemia, is expected to contribute $110 million to $120 million.

Hohenleitner outlined four strategic priorities: increasing IBSRELA demand, sustaining XPHOZAH momentum, advancing the company’s pipeline and maintaining strong financial performance, including top-line growth and a healthy cash position.

IBSRELA Remains Ardelyx’s Main Growth Driver

Chief Commercial Officer Eric Foster said IBSRELA is positioned as an option for IBS-C patients who need something different after treatment with GC-C agonists such as LINZESS or Trulance. He said Ardelyx research indicates that about 77% of patients continue to have symptoms or are not satisfied on a GC-C agonist.

Foster said IBSRELA benefits from a unique mechanism of action as an NHE3 inhibitor, along with clinical efficacy and safety data. Ardelyx is targeting about 14,000 health care providers, including high-prescribing gastroenterologists, primary care physicians and advanced practice providers, who represent roughly half of the total prescription market the company is focused on.

Foster said IBSRELA grew 73% year over year in 2025 and 58% year over year in the first quarter compared with the prior-year period. He attributed the growth to several factors, including a larger sales force, more targeted physician engagement, improved prescription fulfillment through the IBSRELA Pharmacy Network and patient activation efforts.

The company doubled the size of its IBSRELA sales force in late 2024 and is adding about 20 representatives, bringing the total to 144. Foster said the new representatives are expected to be in the field by July 1. Ardelyx is also adding field reimbursement managers to help physicians navigate payer requirements.

Specialty Pharmacy Network Seen as Key Lever

Foster said Ardelyx is steering more IBSRELA prescriptions through a limited specialty pharmacy network because retail pharmacies are often less suited to manage prior authorizations and other steps needed for branded products. He said prescriptions sent through the network have higher fulfillment rates and, on average, about one additional refill per year. He said average refills are around five or six annually.

“The worst thing that can happen is a physician write a prescription for a product and the patient not get it,” Foster said, describing the network as one of the company’s main growth levers.

On patient awareness, Foster said Ardelyx plans to continue investing in digital and social channels. Hohenleitner said the company is not planning a broad traditional direct-to-consumer television campaign, though Foster said targeted streaming media could be considered later this year. Hohenleitner said operating expenses are expected to rise about 25% year over year, to as much as $520 million, driven in part by high-return commercial programs and research and development spending.

Company Reiterates Longer-Term IBSRELA Ambition

Hohenleitner said Ardelyx’s goal of reaching $1 billion in IBSRELA revenue in 2029 implies about a 38% compound annual growth rate from the current guidance range, which she described as achievable based on recent growth trends. Foster said the IBS-C market remains sizable and is growing at double-digit rates, while the competitive landscape appears open over the next several years.

Ardelyx is also studying IBSRELA in chronic idiopathic constipation, or CIC. Hohenleitner said the company has dosed the first patients in a Phase 3 trial, with all pre-specified sites up and running. The trial is expected to enroll about 700 patients in a placebo-controlled, double-blind study with three active arms plus placebo. She said full enrollment is expected by the end of this year, with the trial taking about 26 weeks.

Foster said the CIC market is two to three times larger than IBS-C, though much of it is treated over the counter. He said a CIC indication could increase the overall value of IBSRELA and potentially strengthen physician confidence in the molecule. Hohenleitner also said Ardelyx recently received an Orange Book-listed formulation patent for tenapanor that extends to November 2042, complementing existing composition-of-matter and method-of-use patents.

XPHOZAH Growth Continues Despite Reimbursement Disruption

Hohenleitner said XPHOZAH guidance of $110 million to $120 million would represent growth of about 6% to 16% from the prior year. She said paid writers grew about 19% in the first quarter, while total prescriptions grew about 32%.

Foster said the hyperphosphatemia market has been disrupted during the TDAPA period, which ends at the close of 2026, but Ardelyx believes XPHOZAH will be well positioned in 2027. He said the product is indicated for use in addition to a phosphate binder and noted that many dialysis patients continue to have elevated phosphorus levels despite binder therapy.

Hohenleitner said Ardelyx continues to stand by its longer-term expectation for XPHOZAH to reach $750 million before loss of exclusivity. She said that outlook does not assume restoration of Medicare Part D coverage. The company is operating under a “business as usual” reimbursement assumption while awaiting further developments, she said.

Profitability Described as “Right Around the Corner”

On profitability, Hohenleitner said Ardelyx is not yet issuing formal profitability guidance because management wants confidence that profitability would be sustainable once achieved. She said that, depending on where revenue falls within the guided ranges, profitability could be possible this year, but the company is not ready to guide to a specific quarter.

“When we say we’re profitable, we’re profitable from here out,” Hohenleitner said. She added that the company has already laid out a capital allocation strategy focused on investing in IBSRELA, advancing its current pipeline, considering opportunistic deals and strengthening the balance sheet.

Hohenleitner also discussed Ardelyx’s preclinical compound 10531, describing it as highly soluble and potent. She said the company is evaluating it across several areas and has not yet determined whether it will become a next-generation tenapanor product or pursue another adjacent opportunity.

About Ardelyx NASDAQ: ARDX

Ardelyx, Inc NASDAQ: ARDX is a clinical‐stage biopharmaceutical company focused on discovering, developing and commercializing targeted small molecule drugs for cardio‐renal and gastrointestinal diseases. The company's lead marketed product, tenapanor (sold under the brand name XPHOZAH in the United States), is approved for the treatment of hyperphosphatemia in patients with chronic kidney disease on dialysis. Ardelyx's proprietary approach targets epithelial transporters in the gastrointestinal tract, offering localized activity with limited systemic exposure.

Beyond tenapanor, Ardelyx's development pipeline includes treatments designed to address other complications in kidney disease and related metabolic disorders.

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