Xeris Biopharma Q1 Earnings Call Highlights

Key Points

• Xeris Biopharma posted strong Q1 2026 results, with total revenue up 38% year over year to $83.1 million and net product revenue up 43%. The company also raised the low end of its full-year revenue guidance to $380 million-$390 million.
• RECORLEV was the main growth driver, with revenue nearly doubling to about $50 million on record referrals and new patient starts. Management said the product should benefit further from the recent commercial expansion, especially in the second half of 2026.
• GVOKE was flat in the quarter at $20.8 million as Medicare-related coverage and cost changes pressured prescription volume, though Xeris expects modest full-year growth. Meanwhile, KEVEYIS continued to grow and the company remains on track to start a Phase 3 trial for XP-8121 later this year.

Xeris Biopharma NASDAQ: XERS reported a sharp increase in first-quarter 2026 revenue and raised the low end of its full-year revenue outlook, citing strong demand for RECORLEV and continued execution across its commercial portfolio.

On the company’s earnings call, Chief Executive Officer John Shannon said Xeris was “off to an amazing start in 2026,” pointing to 43% growth in first-quarter net product revenue to more than $82 million. Chief Financial Officer Steve Pieper said total revenue for the quarter was $83.1 million, up 38% year over year, while net product revenue rose 43% to $82.5 million.

The company now expects full-year revenue of $380 million to $390 million, compared with its prior range of $375 million to $390 million. Shannon said the updated outlook reflects “the positive demand trends we are seeing overall, especially for RECORLEV.”

RECORLEV Drives First-Quarter Growth

RECORLEV was the primary growth driver in the quarter. Shannon said revenue for the product nearly doubled to $50 million, representing 95% growth and a $24 million increase from the prior-year period. Pieper reported RECORLEV net revenue of $49.8 million, up $24.2 million year over year.

Management attributed the growth to record referrals and record new patient starts. Shannon said the company saw a significant increase in new patients after typical first-quarter payer resets, particularly in March, which contributed to management’s optimism for the rest of the year.

Xeris also completed a commercial expansion for RECORLEV during the quarter. Shannon said the expansion significantly increased the company’s sales force and patient support teams, allowing for more interactions with health care providers and patients. He said Xeris expects the impact from that expansion to begin contributing incrementally in the second half of 2026 and to provide longer-term benefits.

During the question-and-answer session, Shannon said the company does not expect the expanded commercial team to “fully hit stride” for six to nine months. Pieper added that the expected contribution from the expanded commercial footprint had already been included in the company’s original guidance.

Shannon also said about 60% of RECORLEV patients are new to therapy, while the remainder are generally switches from other products. He said the company’s expanded field organization increased its target audience from roughly 7,000 to 8,000 health care providers to about 12,000, with around 80 sales representatives in the field.

GVOKE Faces Medicare-Related Pressure

GVOKE generated first-quarter net revenue of $20.8 million, essentially flat from the prior year. Shannon said the product’s performance was slightly below internal expectations due to Medicare policy and plan changes that affected coverage, deductibles and out-of-pocket costs. Those factors reduced the number of patients filling prescriptions, he said.

Pieper said soft prescription demand was partially offset by favorable net pricing. He said the weakness was primarily driven by lower total prescription volume in the Medicare channel.

In response to an analyst question, Shannon said there were “a couple small changes” in payer dynamics but “nothing really big,” with Medicare resets being the primary issue. He said the company saw demand begin to improve in March and expects GVOKE to recover from the first-quarter challenges.

Management said it still expects modest growth from GVOKE in 2026. Shannon emphasized that Xeris continues to see a large opportunity for the product, saying the vast majority of the 15 million patients who should have ready-to-use glucagon rescue therapy still do not have one.

KEVEYIS Posts Another Quarter of Growth

KEVEYIS generated first-quarter net revenue of $11.9 million, up 4% year over year. Shannon described the performance as “exceptional” and noted it marked the second consecutive quarter of year-over-year growth for the product.

Pieper said the growth reflected modest improvements in both net pricing and the number of patients on therapy compared with the first quarter of 2025. Shannon said the results highlight both the clinical value of KEVEYIS and the company’s patient support infrastructure for individuals living with primary periodic paralysis.

Profitability Improves as Expenses Rise

Xeris reported first-quarter gross margin of 87%, up 2 percentage points from the prior year, which Pieper attributed primarily to favorable product mix dynamics.

Research and development expenses were $8.8 million, up 13% from the prior-year quarter. Pieper said the increase was tied to higher personnel costs and investments in XP-8121 as the company prepares to initiate a Phase 3 trial later this year.

Selling, general and administrative expenses were $53.1 million, up 21% year over year, driven mainly by the commercial expansion for RECORLEV. Pieper said the investments reflect a disciplined approach to scaling the organization in line with its growth trajectory.

Adjusted EBITDA was $15.1 million, an improvement of $10.7 million from the prior year. Xeris also reported net income of $2.2 million, improving by more than $11 million compared with the year-earlier period.

For 2026, Xeris continues to expect R&D expenses to increase by about $25 million year over year, driven by the planned Phase 3 initiation of XP-8121. SG&A expenses are still expected to rise by about $45 million, mainly reflecting the full-year cost of the RECORLEV commercial expansion. Pieper said the company remains committed to positive adjusted EBITDA in 2026, growing on an absolute dollar basis versus 2025.

XP-8121 Remains on Track for Phase 3

Shannon said XP-8121 is progressing well and remains on track to begin Phase 3 later this year. The program is being developed for hypothyroid patients who struggle to maintain stable hormone levels due to gastrointestinal absorption issues.

Shannon said XP-8121 uses the company’s XeriSol formulation technology, the same technology used in GVOKE, and would leverage Xeris’ drug-device combination expertise, relationships in endocrinology and commercial infrastructure. He said Xeris plans to host a program review in the fall to share more detail on the Phase 3 trial design.

Asked about capital allocation, Pieper said the company’s performance is contributing to a healthier balance sheet and greater optionality. He said Xeris is primarily focused on reinvesting in the business for growth, while Shannon said future pipeline opportunities and external transactions could be considered if they fit the company’s R&D and commercial capabilities.

About Xeris Biopharma NASDAQ: XERS

Xeris Biopharma is a clinical-stage biopharmaceutical company focused on developing and commercializing novel therapies for endocrine and orphan diseases. The company's proprietary formulation platform is designed to enable liquid stability of drugs that traditionally require reconstitution before injection. By eliminating the need for on-site mixing and simplifying administration, Xeris aims to improve patient safety, adherence, and convenience in high-need therapeutic areas.

The company's flagship product, Gvoke, is a ready-to-use liquid glucagon autoinjector and prefilled syringe that has been approved by the U.S.

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