Akebia Therapeutics 2025 Q3 Earnings Profitability Turns Positive with 102.7% Net Income Swing

Akebia Therapeutics (NASDAQ: AKBA) delivered a strong revenue performance and a dramatic net income turnaround in Q3 2025, surpassing revenue expectations while reporting a modest profit. The company exceeded revenue forecasts by $2.36 million, driven by robust sales of Vafseo and Auryxia. Despite operational challenges in scaling dialysis patient access, Akebia maintained its guidance for year-end patient expansion and profitability under current operating plans.

Revenue

Akebia Therapeutics reported a 57.0% year-over-year increase in total revenue, reaching $58.77 million in Q3 2025. Product revenue, net, accounted for the majority at $56.79 million, with License, collaboration and other revenue contributing $1.98 million to the total. This growth reflects strong demand for Auryxia and Vafseo, particularly in dialysis anemia treatment.

Earnings/Net Income

The company achieved a net income of $540,000 in Q3 2025, marking a 102.7% positive swing from a $20.04 million net loss in the same period last year. This represents a record high for fiscal Q3 net income in 9 years, driven by improved cost management and higher product sales. While the EPS remained stable at $0.00, the net income turnaround underscores Akebia’s progress toward profitability.

Post-Earnings Price Action Review

Following the earnings report, Akebia’s stock price declined sharply, dropping 3.47% during the latest trading day, 21.23% over the past full trading week, and 42.21% month-to-date. The mixed market reaction highlights investor concerns over operational challenges, including adherence issues in dialysis protocols and uncertainty around generic competition for Oryxia.

CEO Commentary

John P. Butler emphasized progress in establishing Vafseo as the standard of care for dialysis anemia, with 725 prescribers and 85% refill prescriptions. Q3 Vafseo net revenue reached $14.3 million, with 5% growth in refill doses. The CEO highlighted the DaVita pilot’s completion and expanded patient access targets, aiming for 275,000 patients by year-end.

Guidance

Akebia expects the DaVita pilot to conclude in November 2025, enabling broader Vafseo access. The company anticipates post-hoc INNO2VATE trial data to drive physician adoption and VOCAL trial enrollment progress. It remains focused on dialysis patient expansion and profitability under current operating plans, having decided against pursuing a non-dialysis label for Vafseo post-FDA Type C meeting.

Additional News

Operational Challenges in Dialysis Expansion

Akebia faces logistical hurdles in scaling Vafseo adoption, including adherence issues at US Renal Care and protocol adjustments. Adherence rates remain below expectations, requiring sales team retraining and inventory management shifts.

Strategic Partnerships

The DaVita pilot, initiated in August 2025, is critical to expanding Vafseo’s reach. The company also collaborates with IRC and smaller providers to increase patient access from 40,000 to nearly 70,000 by Q3 2025.

Analyst Optimism and Market Position

Upbeat analyst ratings and post-hoc data showing improved mortality/hospitalization outcomes for Vafseo versus ESAs have bolstered investor confidence. Akebia’s cash position of $166.4 million supports its path to profitability, with a P/S ratio of 2.37 and a current ratio of 1.98 indicating strong liquidity.