Grifols NASDAQ: GRFS executives said the company began 2026 in line with its internal plans, pointing to continued strength in immunoglobulins, early progress in expanding plasma sourcing outside the U.S., and further steps to improve its debt profile and liquidity.
On the company’s first-quarter 2026 earnings call, CEO Nacho Abia said results were “in line with our expectations and forecast,” and reiterated that Grifols remains on track to achieve its full-year 2026 guidance. Abia highlighted three focus areas for the year: commercial execution in core markets, the ramp-up of Egypt as a plasma sourcing platform after European Medicines Agency approval, and ongoing balance sheet strengthening through refinancing and free cash flow generation.
First-quarter results and 2026 priorities
Abia said first-quarter revenue totaled EUR 1.7 billion, up 3.3% at constant currency. Adjusted EBITDA was EUR 404 million at constant currency (EUR 381 million reported), with a broadly stable year-over-year margin. Free cash flow improved by EUR 30 million versus the prior-year quarter, while leverage stood at 4.3x, which Abia described as consistent with typical first-quarter seasonality.
Management reiterated its 2026 execution priorities, including driving adjusted EBITDA margin to at least 25%, generating adjusted EBITDA growth of 5% to 9% at constant currency, improving free cash flow toward a EUR 500 million to EUR 575 million target, and continuing deleveraging.
Dani Segarra, head of investor relations and sustainability, also noted that Grifols’ board has initiated a process to evaluate a potential U.S. IPO of a portion of shares of a subsidiary tied to the company’s U.S. Biopharma business, but said the company would not be able to address questions on that transaction “at this stage” due to legal and regulatory advice.
Biopharma growth driven by immunoglobulins; albumin pressured in China
Biopharma President Roland Wandeler said the Biopharma business grew 6.8% at constant currency in the first quarter, led by immunoglobulins and partially offset by albumin in China and lower sales in other proteins.
Wandeler said Grifols’ immunoglobulin portfolio delivered 15.3% year-over-year growth at constant currency, supported by Gamunex performance in the U.S. and core European markets and the U.S. launch of Biotest Immuno. He said XEMBIFY continued to see strong double-digit in-market demand growth in the U.S., though ex-factory sales were affected by year-over-year inventory dynamics. Wandeler maintained expectations for “strong double-digit growth” for XEMBIFY for the full year.
In albumin, Wandeler reported a 6.1% constant-currency decline, reflecting the “expected continuation” of market and pricing dynamics in China. He said pricing in hospitals has stabilized, but noted that the first half of 2026 still compares against higher pricing levels in 2025, leading management to expect albumin sales to be lower year-over-year in the first half before stabilizing in the second half.
During Q&A, Wandeler said the company is “cautiously optimistic” on China as first-quarter trends were higher than last year and pricing stabilization appears to be taking hold. He added that Grifols is also looking to expand albumin in markets outside China, including the U.S., where it is benefiting from demand for albumin in bags and is working to expand supply in 2027.
Alpha-1 and specialty proteins outlook; fibrinogen launch plans
Alpha-1 and specialty proteins sales declined 7.4% at constant currency year-over-year in the first quarter, which Wandeler attributed to a prior-year comparison that benefited from inventory buy-ins for Alpha-1 and fibrin sealant. He said the company was encouraged by growth in new patient referrals in Alpha-1, but noted access hurdles and a difficult U.S. reauthorization period early in the year.
Wandeler said Grifols expects top-line results later this year from its Sparkle Outcomes trial, which he indicated could help support access and awareness. In response to a question from Barclays, he confirmed that the company expects “low- to mid-single digit growth” for Alpha-1 and specialty proteins for the full year, while declining to quantify the specific size of inventory-related phasing effects across the category’s components.
On fibrinogen, Wandeler said Grifols has been pleased with early feedback in Germany and Austria, where physicians appreciate features including room temperature storage and speed of reconstitution and infusion. He said the company is preparing for a U.S. launch “later this quarter,” initially focused on congenital fibrinogen deficiency, while separately advancing a trial in acquired fibrinogen deficiency and would share timelines “as we have this more in place.” Wandeler said the congenital fibrinogen deficiency market in the U.S. is about EUR 50 million today, with potential of EUR 800 million.
Wandeler also addressed CIDP dynamics, saying Grifols continues to see growth in CIDP and remains confident in IVIG’s role despite the presence of anti-FcRN therapies in the market.
Egypt plasma platform and U.S. donor center optimization
A central theme of the call was the ramp-up of Egypt as a lower-cost plasma sourcing platform. Abia called the EMA approval a “transformative milestone” that expands sourcing capabilities, supports access to treatment in Egypt, the region, and Europe, and “structurally and meaningfully reduces cost per liter.” He said Grifols is on track to collect 1 million liters of plasma in Egypt in 2026, scaling to 3 million liters by 2029.
Wandeler framed the strategy as a broader redesign of Grifols’ global sourcing model. He said that by 2029 the company expects plasma volume sourced outside the U.S. to increase roughly 2.5-fold, sufficient to supply European and rest-of-world demand and reduce the need to export higher-cost U.S. plasma into lower-priced markets. He described the intended end state as a “two-system model,” with U.S. plasma primarily serving the U.S. market and ex-U.S. plasma supplying ex-U.S. markets.
Wandeler also pointed to productivity actions in the U.S. plasma network, including the closure of 29 underperforming donor centers with partial consolidation into higher-performing locations, which he said supports cost base and network quality while still enabling higher annual plasma collections in the U.S.
When asked to quantify margin savings tied to donor center optimization and plasma sourcing redesign, CFO Rahul Srinivasan said the company has not separated margin improvement by individual driver, though he said footprint optimization and cost-per-liter improvements will contribute to margin improvement.
Cash flow, refinancing, and capital allocation commentary
Srinivasan said first-quarter adjusted EBITDA was EUR 381 million, up 0.8% at constant currency, with a 22.4% margin. He highlighted currency translation pressure from a weaker U.S. dollar and said the company’s bottom-line group profit rose 22% to EUR 73 million. Free cash flow pre-M&A was negative EUR 8 million, which he said reflected normal seasonality and increased inventories to support demand.
On the balance sheet, Srinivasan said Grifols has “materially reshaped” its maturity profile by refinancing all 2027 maturities, with the next maturities now not until Q4 2028. He said the company more than doubled its revolving credit facility from about EUR 940 million to over EUR 2 billion and extended its maturity to six and a half years, while also completing a EUR 500 million partial redemption of 7.5% bonds using surplus cash. Srinivasan added that despite refinancing what he described as the company’s cheapest debt, Grifols is still targeting 2026 cash interest at or below 2025 levels.
He also said two of three rating agencies have upgraded Grifols back into the BB category. Srinivasan noted that following the reinstatement of the dividend policy in 2025, the upcoming annual general meeting will consider approval of the final 2025 cash dividend. He added that the improved capital structure “supports some capital allocation optionality,” including potential share buybacks, though he said any such decision would depend on board judgment around intrinsic value, balance sheet capacity, and timing.
In concluding remarks, Abia said Grifols’ first-quarter performance supports confidence in meeting 2026 objectives, with Biopharma growth led by immunoglobulins, ongoing progress in Egypt, and refinancing actions that “enhance liquidity and reduce our cash financial expenses.”
About Grifols NASDAQ: GRFS
Grifols, Inc NASDAQ: GRFS is a global healthcare company specializing in the development, manufacture and marketing of plasma-derived medicines, diagnostic systems and hospital supplies. With a core focus on immunotherapy and transfusion medicine, the company harnesses human plasma proteins to create therapies that treat a wide range of bleeding disorders, immunodeficiencies and neurological conditions. Grifols also supplies reagents and diagnostic instruments for transfusion centers and clinical laboratories, alongside intravenous solutions and medical devices for hospital use.
The company operates three main business units.
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