Akebia stock slumps ~20% amid 'cautious' outlook for Auryxia FY23 sales

Akebia Therapeutics (NASDAQ:AKBA) stock fell ~22% on Thursday despite Q4 results beating estimates.

Net loss narrowed to -$7.55M, compared to -$70.68M in Q4 2021. Total revenue declined -7.4% Y/Y to $55.18. However, both numbers surpassed analysts expectations.

Full year 2022 total revenue grew +37% Y/Y to $292.60M.

Q4 net product revenue of Auryxia increased +18% Y/Y to ~$49.68M, while for full year it grew +24.5% Y/Y to ~$177.07M.

The company said the growth was mainly due to pricing and improved payer mix, and a 2022 year-end inventory build by a customer that exceeded 2021.

However, total units sold decreased Y/Y, according to Akebia.

The company expects net product revenue between $175M and $180M in 2023 for Auryxia — used to treat Hyperphosphatemia and Iron Deficiency Anemia in certain patients with chronic kidney disease (CKD).

Akebia noted that the Auryxia revenue outlook assumes, , among other things, an increase in realized net price per pill, partially offset by reduction in total units sold and inventories returning to normal levels.

"We have set 2023 net product revenue guidance at $175-180 million as we remain cautious about a phosphate binder market recovery; the market continues to contract modestly due to COVID-19 and dialysis staffing issues. We will continue to be mindful of non-essential spend and work to reduce costs overall," said Akebia CFO David Spellman.

The company added that it is also working to extend its revenues from Auryxia beyond the expected loss of exclusivity in March 2025.

In addition, Akebia said that is seeking a partner to commercialize vadadustat in Europe.

In February, a panel of the European Medicines Agency (EMA) had recommended the approval of Vafseo (vadadustat) in the EU to treat symptomatic anemia associated with CKD in adults on chronic maintenance dialysis.

Vadadustat has not had a similar luck in the U.S. as in March 2022 the FDA had declined to approve the therapy.

Q4 License, collaboration and other revenue declined -68.5% Y/Y to $5.5M.

Akebia said it expects cash resources will be sufficient to fund its current operating plan for at least the next 12 months. Cash and cash equivalents as of Dec. 31, 2022 were $90.5M.

Research and development expenses for full year 2022 declined to $129.11M, compared to $147.85M in 2021. The company said the reduction was mainly due to decreased headcount related costs because of the April 2022 reduction in force, decreased consulting costs, and reduced outsourced contract services.