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NovoCure Ltd.: Q4 FY2025 earnings call

What management said about Q4 FY2025, from the documents filed with the SEC on 26 February 2026: press release. Guidance figures: 4 new. The quarter’s numbers.

Key takeaways

  • Fourth-quarter revenue up 8%: Net revenues were $174.4 million in the fourth quarter, up 8% year-over-year, with the company naming the increase in active patients on therapy as the driver. Source
  • Adjusted EBITDA negative in quarter: Adjusted EBITDA was $(16.4) million for the quarter, against $2.6 million a year earlier. Full-year Adjusted EBITDA was $(34.3) million, against $0.8 million. Source
  • Total active patients reached 4,620: Active patients on TTFields therapy totaled 4,620 at year-end, against 4,126 a year earlier: 4,464 on Optune Gio and 156 on Optune Lua. Source
  • Gross margin fell to 76%: Gross margin was 76% for the quarter, against 79% a year earlier. Source
  • Optune Pax approved for pancreatic cancer: The FDA approved Optune Pax in February 2026 for locally advanced pancreatic cancer, used with gemcitabine and nab-paclitaxel. Source
  • CMS billing privileges revoked, then reinstated: CMS revoked billing privileges in January 2026, retroactive to December 17, 2025, after an administrative issue in a DME supplier re-validation. On February 24, 2026, CMS rescinded the revocation and reinstated the privileges retroactively. Source

“In 2025, a record number of patients received treatment with Novocure’s Tumor Treating Fields therapy, a milestone that reflects our growth and commitment to advancing the treatment of cancer with our technology,”

Frank Leonard, CEO, Novocure

Guidance

AreaPeriodFigureAgainst last quarter
Total net revenues Sourcefull year 2026$675 million - $705 millionNew
Adjusted EBITDA Sourcefull year 2026$(20) million - $0 millionNew
Optune Lua and Optune Pax net revenue Sourcefull year 2026$15 million to $25 millionNew
Gross margin Sourcefull year 2026mid-70’s percentNew

What changed from last quarter

  • New guidance: Full year 2026 financial guidance for revenue, Adjusted EBITDA, Optune Gio growth, Optune Lua and Optune Pax revenue and gross margin was given in this release. Source
  • New: FDA approved Optune Pax for locally advanced pancreatic cancer, used with gemcitabine and nab-paclitaxel, after the preliminary release had listed this decision as expected in Q2 2026. Source
  • Ended: From Q1 2026 the company stops reporting new prescriptions for GBM, MPM and NSCLC, which have been commercially available for more than one year. Active patients will still be reported by product and market. Source
  • New: Prescriptions for pancreatic cancer will be reported for one year after the Optune Pax launch. Source
  • New: Martin Madden took over as Lead Independent Director and Chairperson of the Compensation Committee, succeeding William Vernon, who remains a director. Source
  • Ended: Chief Medical Officer Nicolas Leupin resigned, effective February 25, 2026. Source
  • New: Public health insurers in Czechia announced coverage for Optune Gio for adult patients with newly diagnosed GBM in January 2026. Source

Results and growth drivers

  • Fourth-quarter revenue up 8%: Net revenues were $174.4 million in the fourth quarter, up 8% year-over-year, with the company naming the increase in active patients on therapy as the driver. Source
  • Full-year revenue reached $655.4 million: Full-year net revenues were $655.4 million, up 8% year-over-year. Source
  • Quarterly net loss of $24.5 million: Net loss for the quarter was $24.5 million, or $0.22 per share, against $65.9 million a year earlier, per the statements of operations. Source
  • Adjusted EBITDA negative in quarter: Adjusted EBITDA was $(16.4) million for the quarter, against $2.6 million a year earlier. Full-year Adjusted EBITDA was $(34.3) million, against $0.8 million. Source

Regions and product revenue

  • U.S. led quarterly revenue: U.S. net revenue was $101.6 million in the quarter. Germany $21.3 million, France $20.3 million and Japan $10.2 million; other active markets $16.3 million. The preliminary release showed Germany $21.6 million, France $20.5 million and other markets $15.8 million. Source
  • Greater China partnership revenue: Revenue from the Zai Lab partnership in Greater China totaled $4.6 million in the quarter. Source
  • Optune Lua revenue by indication: Optune Lua recognized $3.5 million in the quarter: $2.4 million from NSCLC and $1.1 million from MPM. Source

“This momentum continues in 2026 with the U.S. FDA approval of Optune Pax for pancreatic cancer, an achievement we are incredibly proud of given the exceptional challenge of developing treatment for this disease.”

Frank Leonard, CEO, Novocure

Patients and prescriptions

  • Total active patients reached 4,620: Active patients on TTFields therapy totaled 4,620 at year-end, against 4,126 a year earlier: 4,464 on Optune Gio and 156 on Optune Lua. Source
  • Optune Gio prescriptions up 6%: Optune Gio received 1,609 GBM prescriptions in the quarter, up 6% from the same period in 2024. The U.S. contributed 950, Germany 178, France 197 and Japan 139. Source
  • Optune Gio active patients by market: Active Optune Gio patients were 2,251 in the U.S., 623 in Germany, 509 in France and 542 in Japan, with 539 in other active markets. Source
  • Optune Lua prescriptions by indication: Optune Lua received 145 prescriptions in the quarter: 118 for NSCLC, of which 87 came from the U.S., and 27 for MPM, of which 10 came from the U.S. Source

Costs, gross margin and expenses

  • Gross margin fell to 76%: Gross margin was 76% for the quarter, against 79% a year earlier. Source
  • Causes of lower gross margin: The company attributed the decline to the continued rollout of the Head Flexible Electrode array for Optune Gio, costs of treating NSCLC patients before reimbursement is set up, and increased tariffs. Source
  • R&D expenses up 19%: Research, development and clinical studies expense was $60.9 million, up 19%, on higher KEYNOTE D58 and LUNAR-2 trial costs and higher regulatory affairs expenses. Source
  • Sales and marketing up 2%: Sales and marketing expense was $68.7 million, up 2%, mainly from higher marketing ahead of the U.S. launch of Optune Pax. Source
  • G&A down 41% on lower share compensation: General and administrative expense was $43.0 million, down 41% from the same period in 2024, primarily from lower share-based compensation. Source

“We are well-positioned to continue to drive our patient-forward mission while prioritizing our goal of achieving profitability.”

Frank Leonard, CEO, Novocure

Cash, debt and share count

  • Cash and investments $447.7 million: Cash, cash equivalents and short-term investments were $447.7 million at year-end, after repaying $561 million of convertible notes at maturity in November 2025. The preliminary release had shown $448.3 million. Source
  • Credit facility balance rose: Senior secured credit facility, net, was $195.0 million at year-end, against $97.3 million a year earlier. The convertible note balance was nil, against $558.2 million. Source
  • Shares outstanding rose: Ordinary shares issued and outstanding were 112,492,667 at December 31, 2025, against 108,516,819 a year earlier. Source

Regulatory, coverage and billing

  • Optune Pax approved for pancreatic cancer: The FDA approved Optune Pax in February 2026 for locally advanced pancreatic cancer, used with gemcitabine and nab-paclitaxel. Source
  • Coverage announced in Czechia and BC: Czech public health insurers covered Optune Gio for newly diagnosed GBM in January 2026. British Columbia Cancer announced coverage for adult newly diagnosed GBM patients in February 2026. Source
  • CMS billing privileges revoked, then reinstated: CMS revoked billing privileges in January 2026, retroactive to December 17, 2025, after an administrative issue in a DME supplier re-validation. On February 24, 2026, CMS rescinded the revocation and reinstated the privileges retroactively. Source
  • No revenue recognition impact expected: The company does not believe the revocation affects its ability to recognize revenue for services provided during the ineligibility period. Source

Pipeline and leadership

  • Brain metastases filing completed: In December 2025 the company submitted the final module of its PMA application to FDA for TTFields in brain metastases from NSCLC. Source
  • Leonard named chief executive: Frank Leonard was appointed CEO in December 2025. He previously served as Novocure’s President. Source
  • Chief medical officer resigned: Chief Medical Officer Nicolas Leupin resigned effective February 25, 2026. Chief Innovation Officer Uri Weinberg will lead the organization that reported to him. Source

Coming up, as management said on 26 February 2026

  • PANOVA-4 topline data: Topline data from the Phase 2 PANOVA-4 trial in metastatic pancreatic cancer is anticipated in Q1 2026. Source
  • TRIDENT topline data: Topline data from the Phase 3 TRIDENT trial in newly diagnosed GBM is anticipated in Q2 2026. Source
  • FDA decision on brain metastases: An FDA decision on the PMA for TTFields in brain metastases from NSCLC is anticipated in Q4 2026. Source
  • KEYNOTE D58 enrollment completion: Completion of enrollment in the Phase 3 KEYNOTE D58 trial in newly diagnosed GBM is anticipated in Q4 2026. Source

Figures management reported

FigureReported
Total active patients on TTFields therapy Source4,620
Active Optune Gio patients Source4,464
Optune Gio GBM prescriptions in quarter Source1,609
Optune Lua prescriptions in quarter Source145
Active Optune Lua patients, NSCLC Source122
Active Optune Lua patients, MPM Source34

Risks management discussed

  • Operational: Gross margin pressure came from the Head Flexible Electrode array rollout, NSCLC treatment costs before reimbursement, and increased tariffs. Source
  • Regulatory: CMS revoked billing privileges in January 2026 over an administrative issue, and the revocation was rescinded on February 24, 2026. Source

Earlier plans management reported on

  • Not stated: The FDA approval of Optune Pax for pancreatic cancer came in February 2026, while the preliminary release had listed the decision for Q2 2026. Source

Other quarters

Summarised with AI from the documents the company filed with the SEC. Every point is checked against the filing before it is shown: management’s own words word for word, figures against the line or table row they come from. A point that fails the check is left out. Source opens the filing at that line.