Heron Therapeutics' 2025 Q3 Earnings and Franchise Growth Drivers: Assessing Sustainable Revenue Momentum and Market Access Tailwinds in Acute Care and Oncology Segments

Heron Therapeutics' third-quarter 2025 earnings report underscores a pivotal inflection point for the company, marked by divergent performance across its acute care and oncology segments. While the acute care franchise delivered robust growth driven by product innovation and strategic commercial initiatives, the oncology segment faced headwinds from declining product demand. This analysis evaluates the sustainability of Heron's revenue momentum, the role of market access tailwinds, and the competitive dynamics shaping its path forward.

Acute Care: A Catalyst for Growth

Heron reported in its Q3 2025 financial results that ZYNRELEF and APONVIE net revenues surged by 49% and 173%, respectively, compared to Q3 2024. These gains were fueled by the December 2024 launch of the ZYNRELEF Vial Access Needle (VAN), which streamlined aseptic preparation and reduced withdrawal time, and the deployment of a dedicated sales team for APONVIE, as described in Heron's full-year 2024 results. Enhanced distributor incentives further amplified adoption, positioning acute care as a core growth engine.

The segment's success is also tied to market access tailwinds. In October 2025, the Centers for Medicare and Medicaid Services (CMS) granted a permanent J-code for ZYNRELEF, simplifying reimbursement and improving billing clarity for providers. This regulatory win addresses a critical barrier in acute care, where reimbursement complexity often stifles adoption. Analysts, in a Reuters preview, project that these tailwinds, combined with expanded label indications for ZYNRELEF, could sustain double-digit growth in 2026.

Oncology: Modest Gains Amid Structural Challenges

The oncology segment, comprising CINVANTI and SUSTOL, reported mixed results. CINVANTI's net revenue grew by 6% year-over-year, driven by stable unit demand and expanded use in chemotherapy-induced nausea and vomiting (CINV) prevention, as noted in Heron's Q3 2025 financial results. However, SUSTOL's decline-down 30.8% in Q3 2025-offset much of this progress, reflecting ongoing competition from generic alternatives and a planned phase-out of the product described in the company's Q3 commercial update.

While Heron maintains a "buy" consensus rating from analysts, the oncology segment's revenue sustainability remains uncertain. Full-year 2024 oncology net revenue grew by 5.8% to $114.2 million, but Q3 2025's 1.7% year-over-year increase suggests a plateauing trend (per Heron's full-year 2024 results). The company's strategic pivot toward acute care-where margins and growth rates are superior-signals a recognition of these structural challenges.

Financial and Strategic Implications

Heron reaffirmed its 2025 net revenue guidance of $153–163 million and adjusted EBITDA guidance of $9–13 million, despite a Q3 net loss of $17.5 million driven by a $11.3 million debt extinguishment charge, discussed on the company's Q3 2025 earnings call. Gross margin contraction to 68.8% due to a SUSTOL polymer inventory write-off further highlights near-term pressures described on the earnings call. However, the acute care segment's momentum and the J-code approval for ZYNRELEF provide a buffer against these headwinds.

The company's capital allocation strategy will be critical. With APONVIE's 173% growth and ZYNRELEF's VAN launch, Heron has demonstrated its ability to innovate and capture market share. Yet, the oncology segment's underperformance raises questions about resource reallocation. Analysts note that maintaining a "buy" rating hinges on Heron's capacity to scale acute care while managing oncology's transition, according to the Reuters preview cited above.

Conclusion: A Tipping Point for Sustainable Growth

Heron Therapeutics' Q3 2025 results reflect a strategic realignment toward high-growth acute care assets, supported by market access wins and product innovation. While the oncology segment's challenges persist, the acute care franchise's trajectory-bolstered by the J-code and commercial execution-positions the company to meet its 2025 guidance and beyond. For investors, the key will be monitoring how effectively Heron balances near-term profitability with long-term value creation in a competitive landscape where reimbursement clarity and product differentiation are paramount.