Ironwood Pharmaceuticals — Q3 2026 Earnings Summary

Financial Performance:

• Total revenue for Q3 2026 was $133.0 million, an increase from $122.1 million in Q3 2025.
• GAAP net income for Q3 2026 was $59.8 million ($0.36 per share basic and diluted), compared to $40.1 million ($0.25 basic, $0.23 diluted) in Q3 2025.
• Non-GAAP net income for Q3 2026 was $60.0 million ($0.36 per share basic and diluted), compared to $41.9 million ($0.26 basic, $0.24 diluted) in Q3 2025.
• Adjusted EBITDA for Q3 2026 was $97.9 million, up from $81.8 million in Q3 2025.
• Total costs and expenses were $39.9 million in Q3 2026, down from $46.6 million in Q3 2025, driven by a decrease in SG&A expenses ($11.6 million vs. $21.9 million) and the absence of restructuring expenses ($0 vs. $2.2 million).
• R&D expenses were $28.3 million in Q3 2026, compared to $22.5 million in Q3 2025.
• Interest expense was $6.2 million in Q3 2026, compared to $8.4 million in Q3 2025.
• Cash and cash equivalents ended Q3 2026 at $86.4 million, down from $215.5 million at the end of 2025.
• Cash from operations was $130.8 million in Q3 2026, compared to $47.6 million in Q3 2025.
• Accounts receivable were $132.7 million as of September 30, 2026.
• Ironwood repaid $60.0 million on its revolving credit facility during Q3 2026, reducing the outstanding balance to $325.0 million with $225.0 million of remaining borrowing capacity.
• Nine-month 2026 total revenue was $352.6 million, compared to $248.4 million in the same period of 2025.
• Nine-month 2026 GAAP net income was $151.9 million, compared to $26.3 million in the same period of 2025.
• Nine-month 2026 Adjusted EBITDA was $257.6 million, compared to $127.2 million in the same period of 2025.

Guidance and Future Outlook:

• Full-year 2026 U.S. LINZESS net sales guidance was raised to $1.20–$1.25 billion, representing a greater than 35% year-over-year increase.
• Full-year 2026 total revenue guidance was raised to $485–$510 million.
• Full-year 2026 adjusted EBITDA guidance was raised to greater than $350 million.
• Guidance increases are driven by improved net price and mid-single-digit prescription demand growth for LINZESS.
• Management expects LINZESS to return to blockbuster status for 2026, with year-to-date U.S. net sales ($880 million) already exceeding full-year 2025 U.S. net sales.
• Ironwood plans to file for regulatory approval for apraglutide in 2029, subject to STARS-2 trial results, and aims to identify opportunities to accelerate the development program.

Business Segments and Product Lines:

• U.S. LINZESS prescription demand increased 4.9% year-over-year in Q3 2026 to 63.4 million capsules.
• U.S. LINZESS net sales were $324.9 million in Q3 2026, a 3.2% increase from $314.9 million in Q3 2025.
• Collaboration revenue from LINZESS U.S. sales was $129.9 million in Q3 2026, an 8.6% increase from $119.6 million in Q3 2025.
• Net profit for the LINZESS U.S. brand collaboration was $255.9 million in Q3 2026, a 9.8% increase from $233.1 million in Q3 2025.
• LINZESS commercial margin was 79.8% in Q3 2026, up from 75.9% in Q3 2025.
• Apraglutide is an investigational once-weekly synthetic GLP-2 analog for short bowel syndrome with intestinal failure (SBS-IF).
• The STARS-2 confirmatory Phase 3 trial for apraglutide is ongoing, with planned activation of over 100 sites in 22 countries on track.
• All planned clinical trial applications for apraglutide have been submitted to international health authorities and are under review or approved.

Market and Competitive Landscape:

• LINZESS is the #1 prescribed brand in the U.S. for IBS-C and CIC based on IQVIA data.
• Q3 2026 LINZESS U.S. net sales growth was driven by 4.9% demand growth and a low single-digit net price decline due to unfavorable gross-to-net rebate reserves.
• Ironwood and AbbVie share equally in U.S. brand collaboration profits.
• AbbVie markets linaclotide (LINZESS) as CONSTELLA in Europe and partners with Astellas in Japan.
• Ironwood has partnered with Grand Life Sciences for development and commercialization in China and with AbbVie for all other territories worldwide.

Risks and Challenges:

• LINZESS is contraindicated in patients less than 2 years of age due to the risk of serious dehydration.
• LINZESS is contraindicated in patients with known or suspected mechanical gastrointestinal obstruction.
• Diarrhea is the most common adverse reaction in adult and pediatric patients treated with LINZESS.
• Forward-looking statements regarding apraglutide approval, clinical trial progress, and financial guidance are subject to risks including clinical trial delays, safety issues, regulatory decisions, and competition.
• Risks include uncertainty regarding pricing and reimbursement policies, patent protection, and the ability to manage expenses or cash use.

Management Commentary and Tone:

• CEO Tom McCourt stated the company delivered a third consecutive strong quarter, executing on three strategic priorities: maximize LINZESS, advance apraglutide, and deliver sustained profits and cash flows.
• McCourt expressed confidence in increasing full-year 2026 financial guidance for the second consecutive quarter.
• McCourt noted the focus on activating apraglutide trial sites as quickly as possible to accelerate the trial and bring the drug to patients.
• Ironwood announced that Chief Commercial Officer Tammi Gaskins will become CEO and join the Board of Directors effective January 1, 2027, while Tom McCourt will retire from his role but remain on the Board.

Other Key Points:

• The company hosted a conference call on November 5, 2026, to discuss results and business activities.
• Ironwood recorded $27.8 million of income tax expense in Q3 2026, the majority of which was non-cash, utilizing net operating losses and tax credits.
• The company's balance sheet shows a reduction in total liabilities from $658.7 million at year-end 2025 to $387.8 million as of September 30, 2026.
• Stockholders' deficit improved from $(261.8) million at year-end 2025 to $(97.2) million as of September 30, 2026.
• Ironwood does not provide guidance on GAAP net income or a reconciliation of expected adjusted EBITDA to expected GAAP net income due to the uncertainty of non-GAAP adjustments.