Ironwood Pharmaceuticals reported fourth‑quarter 2025 results that fell short of expectations, with revenue of $47.7 million and a GAAP net loss of $2.3 million, translating to an earnings per share loss of $0.01. The quarter’s performance was a sharp decline from the $90.55 million in revenue and $2.31 million in net income reported in Q4 2024, underscoring a significant year‑over‑year contraction.
The revenue miss and net loss were driven primarily by unfavorable phasing of gross‑to‑net rebate reserves and increased pricing pressure from the Medicare Part D redesign. LINZESS, the company’s flagship product, saw its commercial margin shrink from 64% in Q4 2024 to 54% in Q4 2025, reflecting the impact of rebate adjustments and net‑price erosion on the product’s profitability.
CEO Thomas McCourt emphasized that the company remains focused on maximizing LINZESS, advancing apraglutide, and delivering sustained profits and cash flows. "As we enter 2026, we remain focused on our core priorities of maximizing LINZESS, advancing apraglutide and delivering sustained profits and cash flows. We believe our full‑year 2026 financial guidance demonstrates the significant progress we've made across these priorities and our ability to drive increasing shareholder value," McCourt said.
Ironwood reiterated its 2026 guidance, projecting U.S. LINZESS net sales between $1.125 billion and $1.175 billion, total revenue of $450 million to $475 million, and adjusted EBITDA exceeding $300 million. The guidance reflects management’s confidence that improved net pricing and modest prescription demand growth will offset the Q4 headwinds and support a robust growth trajectory.
The company also confirmed that the design of a confirmatory Phase III trial for apraglutide has been finalized, with site initiations slated for the second quarter of 2026. The trial represents a key milestone in Ironwood’s pipeline and is expected to strengthen the company’s long‑term revenue prospects.
Investors reacted to the Q4 miss, but the strong 2026 guidance provided a counterbalance, indicating that management’s outlook for the next year remains optimistic despite the short‑term setbacks.
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