Akebia's 2024 Q4 Earnings Call: Unpacking the Contradictions on Vafseo Dosing and Regulatory Strategies

These are the key contradictions discussed in Akebia Therapeutics' latest 2024Q4 earnings call, specifically including: Vafseo Dosing Frequency and Regulatory Interactions:



Vafseo Launch and Revenue:
- Akebia expected $10 million to $11 million in net product revenue for Vafseo in the first quarter of 2025, exceeding current analyst estimates.
- The strong start is attributed to effective contracting with dialysis providers, building prescriber demand, and a successful transition to specialty pharmacy distribution.

Demand and Reimbursement Trends:
- Vafseo prescriptions for Medicare Advantage patients accounted for 15% of all prescriptions in February, indicating progress in coverage expansion.
- Increased prescription demand led to a backlog of about 3 weeks at the start of the year, which was subsequently reduced by leveraging a robust distribution network.

Research and Development Pipeline:
- Akebia plans to initiate the VALOR study in the second half of 2025, focusing on treating anemia in nondialysis patients.
- The study is embedded within Akebia's current operating plan, with cost efficiencies expected due to the existing commercial product and efficient enrollment targeting nephrologists.

Financial Update and Cash Position:
- Akebia's total revenues for 2024 were $160.2 million, with Auryxia net product revenues contributing $152.2 million.
- The company's cash and cash equivalents as of December 31, 2024, were $51.9 million, supported by ATM facility sales and a BlackRock credit agreement for future operational planning.