Akebia Vafseo Sales Reverse After Sequential Gain

The Tip Desk · November 5, 2026 · 4 min read

Vafseo net product revenue was $14.8 million in the third quarter, down from $21.3 million in the second quarter, as patients reached about 11,500.

Akebia Therapeutics (AKBA), a biopharmaceutical company focused on kidney disease, reported Vafseo (vadadustat) net product revenues of $14.8 million in the third quarter ended September 30, 2026, reversing a 34% sequential increase in the second quarter.

The company said the sequential decline was driven by an inventory reduction at its largest customer and by market dynamics as Vafseo’s Transitional Drug Add-on Payment Adjustment (TDAPA) expiration approaches. Year over year, Vafseo sales were $14.8 million versus $14.3 million in the third quarter of 2025.

Patients on Vafseo increased to approximately 11,500 at the end of the third quarter, an 8.1% rise from the end of the second quarter, after a 41% increase from the end of the first quarter to more than 10,500 patients. Prescribers rose to approximately 1,300, up more than 7% from the second quarter. Chief Executive Officer John P. Butler said the company’s commercial priority remains making Vafseo standard of care for anemia in patients on dialysis and increasing the number of patients on therapy.

Total revenues were $36.9 million in the third quarter of 2026, compared with $58.8 million a year earlier. The company said the decrease was due to lower Auryxia (ferric citrate) revenues. Auryxia net product revenues were $20.0 million, versus $42.5 million in the third quarter of 2025. Akebia continued to expect Auryxia revenues to decrease in 2026 versus 2025 because of generic competition and pricing pressure. License, collaboration and other revenues were $2.1 million.

Net loss was $14.4 million, or $0.05 a share, compared with net income of $0.5 million, or $0.00 a share, in the third quarter of 2025. The company said the swing to a loss resulted from lower revenues, partially offset by lower operating expenses that included a $1.3 million restructuring charge. Income from operations was a loss of $11.5 million.

Selling, general and administrative expenses were $23.5 million, which the company said was driven by lower marketing costs and decreased headcount-related costs. Research and development expenses were $16.2 million, which the company said was driven by increased clinical trial activities related to praliciguat and ebribafusp alfa. Cost of goods sold was $6.4 million. Vafseo-related cost of goods sold in both periods was derived from pre-launch inventory that does not include the full cost of manufacturing, the company said.

In November, Akebia announced topline results of VOCAL, an open-label trial of three-times-weekly dosing of vadadustat versus standard-of-care ESA in patients with anemia due to chronic kidney disease receiving in-center hemodialysis. VOCAL met the primary endpoint of non-inferiority to ESA based on change in hemoglobin. In October at ASN Kidney Week, Dr. Geoffrey A. Block of U.S. Renal Care presented VOICE data showing a statistically significant improved safety outcome on a hierarchical composite of all-cause mortality and hospitalization, driven by a reduction in hospitalization rate. Butler said the company believes the data have the potential to drive Vafseo to become standard of care.

Butler said the company is working to strengthen its market position as it enters 2027, when it believes Vafseo access will expand beyond TDAPA-only patients to nearly all clinically eligible patients.

In September, Akebia dosed the first patient in a Phase 2 open-label basket trial of ebribafusp alfa, which the company believes has the potential to be a next-generation complement inhibitor. The trial is designed to enroll up to 30 patients with C3 glomerulopathy, lupus nephritis or IgA nephropathy. Akebia expects to report initial data in 2027.

Cash and cash equivalents were approximately $159.3 million as of September 30, 2026, compared with $155.5 million as of June 30, 2026. The company said it believes existing cash resources, cash expected from product, royalty, supply and license revenues, and a plan to refinance its senior secured term loan facility will enable it to fund its current operating plan for at least two years.