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Zevra Therapeutics, Inc.: Q4 FY2025 earnings call

What management said about Q4 FY2025, from the documents filed with the SEC on 9 March 2026: press release. The quarter’s numbers.

Key takeaways

  • Q4 revenue rose 31% sequentially: Q4 2025 net revenue was $34.1 million, up 31% on the prior quarter's $26.1 million reported in the Q3 release, and up from $12.0 million in Q4 2024. Source
  • MIPLYFFA drove most revenue: MIPLYFFA net revenue was $26.4 million in Q4 2025, up from $22.4 million in Q3 2025 and $10.1 million in Q4 2024. Full-year MIPLYFFA net revenue was $87.4 million. Source
  • Prescription enrollment forms rose: The company received 24 MIPLYFFA prescription enrollment forms in Q4 2025, 52 in 2025 and 161 since launch. The Q3 release reported eight in Q3 2025. Source
  • DiSCOVER enrollment reached 52: Eight patients enrolled in the event-driven Phase 3 DiSCOVER trial in Q4 2025, bringing the year-end total to 52, with one confirmed event. Source
  • EMA review of arimoclomol continues: The marketing authorisation application for NPC is under EMA review. The Q3 release said it had been validated. Arimoclomol holds EMA Orphan Medicinal Product designation. Source
  • Cash position of $238.9 million: Cash, cash equivalents and securities were $238.9 million at December 31, 2025, up from $230.4 million at September 30, 2025. Management said this supports execution independent of capital markets. Source

“MIPLYFFA is making a meaningful difference for patients with Niemann-Pick disease type C, and its strong, accelerating performance reinforces our confidence in its long-term potential,”

Neil F. McFarlane, Zevra's President and Chief Executive Officer

What changed from last quarter

  • New: The global corporate headquarters was officially relocated to Boston. The prior release was datelined Celebration, Florida. Source
  • New: In Q4 2025 the company executed a distribution agreement to broaden access to arimoclomol in select territories beyond Europe. Source
  • New: The company recently engaged FDA in a Type C meeting on regulatory options to accelerate the Vascular Ehlers-Danlos Syndrome development program. Source

Results and growth drivers

  • Q4 revenue rose 31% sequentially: Q4 2025 net revenue was $34.1 million, up 31% on the prior quarter's $26.1 million reported in the Q3 release, and up from $12.0 million in Q4 2024. Source
  • Full-year revenue reached $106.5 million: Full-year 2025 net revenue was $106.5 million, against $23.6 million in 2024. MIPLYFFA was the largest component at $87.4 million. Source
  • Full-year net income was $83.2 million: Full-year 2025 net income was $83.2 million, or $1.40 basic and $1.35 diluted per share, compared with a net loss of $(105.5) million in 2024. Source
  • Q4 net income of $12.2 million: Q4 2025 net income was $12.2 million, or $0.20 basic and $0.19 diluted per share, compared with a Q4 2024 net loss of $(35.7) million. Source

Product sales and channels

  • MIPLYFFA drove most revenue: MIPLYFFA net revenue was $26.4 million in Q4 2025, up from $22.4 million in Q3 2025 and $10.1 million in Q4 2024. Full-year MIPLYFFA net revenue was $87.4 million. Source
  • OLPRUVA revenue remained small: OLPRUVA net revenue was $0.4 million in Q4 2025 and $0.8 million for the year. The Q3 release said OLPRUVA sales and marketing efforts were scaled back. Source
  • EAP reimbursements added to revenue: Net reimbursements from the EAP were $5.6 million in Q4 2025 and $13.0 million for 2025, against $9.1 million in 2024 and $2.4 million in Q3 2025. Source
  • AZSTARYS royalties continued: Royalties and other reimbursements under the AZSTARYS license were $1.8 million in Q4 2025 and $5.0 million for 2025, against $4.3 million in 2024. Source

“Looking ahead, we are focused on executing against multiple near-term growth opportunities in 2026, and believe we are well-positioned to execute on our strategic priorities to create meaningful value for the rare disease community and our shareholders.”

Neil F. McFarlane, Zevra's President and Chief Executive Officer

Patient uptake and access

  • Prescription enrollment forms rose: The company received 24 MIPLYFFA prescription enrollment forms in Q4 2025, 52 in 2025 and 161 since launch. The Q3 release reported eight in Q3 2025. Source
  • Market access reached 68% of lives: Market access for MIPLYFFA reached 68% of covered lives at year-end, which the company said supports broad access to the product. Source
  • Expanded access enrollment reached 113: The company reported 113 patients enrolled in the global expanded access program at December 31, 2025. Source

Operating costs and expenses

  • Q4 operating expenses were $23.0 million: Q4 2025 operating expenses were $23.0 million, including $4.3 million of non-cash stock compensation. Cost of product revenue was $1.5 million, excluding intangible amortization, against $1.4 million a year earlier. Source
  • SG&A rose on commercial spending: Q4 2025 SG&A was $20.4 million. The company attributed the increase mainly to higher third-party costs for commercial products, plus personnel-related costs. Source
  • R&D expense fell from 2024: R&D expense was $12.7 million for 2025, down from $42.1 million in 2024, due to lower personnel-related and third-party costs. Source
  • Impairment and PRV gain in statements: The full-year statements show a $58.7 million impairment of intangible assets and a $148.3 million gain on sale of PRV. The release narrative does not discuss either item. Source

Pipeline and regulatory progress

  • DiSCOVER enrollment reached 52: Eight patients enrolled in the event-driven Phase 3 DiSCOVER trial in Q4 2025, bringing the year-end total to 52, with one confirmed event. Source
  • EMA review of arimoclomol continues: The marketing authorisation application for NPC is under EMA review. The Q3 release said it had been validated. Arimoclomol holds EMA Orphan Medicinal Product designation. Source
  • Celiprolol holds FDA designations: Celiprolol, the investigational candidate for Vascular Ehlers-Danlos Syndrome, has Orphan Drug and Breakthrough Therapy designations from FDA. Source

Clinical data and publications

  • Four-year expanded access data presented: Four-year real-world data from the U.S. expanded access program showed the product was well tolerated and stabilized disease progression overall. Adult subgroup results were consistent. Source
  • Early benefit seen in post hoc analysis: A post hoc efficacy analysis of the randomized, placebo-controlled study showed slowed progression versus placebo from three months, with benefit increasing through 12 months. Source
  • NPC1 genotype abstract accepted: Abstract P214, on NPC1 genotypes from the U.S. expanded access program, was accepted for poster presentation at the Annual Clinical Genetics Meeting. Source

Capital, cash and share count

  • Cash position of $238.9 million: Cash, cash equivalents and securities were $238.9 million at December 31, 2025, up from $230.4 million at September 30, 2025. Management said this supports execution independent of capital markets. Source
  • Share count and dilution: At December 31, 2025, 56,854,781 common shares were outstanding and 67,939,395 were fully diluted, including 7,060,457 award shares and 4,024,157 warrant shares. Source
  • Long-term debt and warrant liability: Long-term debt was $61.9 million and warrant liability was $9.6 million at December 31, 2025. Current income tax payable was $13.7 million. Source

Figures management reported

FigureReported
MIPLYFFA net revenue, full year 2025 Source$87.4 million
MIPLYFFA net revenue, Q4 2025 Source$26.4 million
OLPRUVA net revenue, full year 2025 Source$0.8 million
OLPRUVA net revenue, Q4 2025 Source$0.4 million
EAP net reimbursements, full year 2025 Source$13.0 million
AZSTARYS royalties and other reimbursements, full year 2025 Source$5.0 million
R&D expense, full year 2025 Source$12.7 million
R&D expense, Q4 2025 Source$2.6 million
MIPLYFFA prescription enrollment forms, Q4 2025 Source24
MIPLYFFA market access, covered lives Source68%
Expanded access program patients enrolled Source113
DiSCOVER trial enrollment, year-end 2025 Source52 enrolled; one confirmed event
Arimoclomol EMA marketing authorisation status Sourceunder review; 120-day list of questions received

Risks management discussed

  • Operational: The release describes DiSCOVER as event-driven, with one confirmed event among 52 enrolled patients at year-end. No readout timing is given. Source
  • Regulatory: The company has engaged FDA in a Type C meeting on regulatory options. The release does not report the meeting outcome. Source

Earlier plans management reported on

  • On track: Management said the EMA review is progressing as expected, with the 120-day list of questions received at year-end. Source
  • Not stated: The company said it is prepared to respond to the EMA's 120-day questions within the regulatory 90-day clock stop period. 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.