Ardelyx, Inc.
Health Care · Biotechnology
Structural: dual commercial franchises on a single molecule (tenapanor) targeting large IBS-C and CKD dialysis markets; Medicare 2025 reimbursement for XPHOZAH removes the key payer overhang that suppressed the stock in 2023-2024.
XPHOZAH dialysis penetration still early (<10% of ~550k US dialysis patients); IBS-C market underpenetrated vs. Linzess/Trulance; operating leverage as SG&A scales sub-linearly; partnership optionality with Kyowa Kirin for Japan XPHOZAH rights.
dialysis formulary adoption slower than modeled (DaVita/Fresenius P&T cycles); generic tenapanor IP risk post-2033; cash burn if ramp lags; competitive pressure from Auryxia and phosphate binders in CKD.
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