Zevra Therapeutics: Q2 2026 Earnings

For reference: Q1 2026 (reported May 6, 2026) delivered net revenue of $36.2M, comprising $24.6M of MIPLYFFA net revenue, $10.2M in net reimbursements, and $1.1M in AZSTARYS royalties. Q1 also included a $43.3M gain from the SDX portfolio sale to Commave Therapeutics, helping produce net income of $37.9M and fund the full repayment of a $63.1M term loan, leaving the company debt free. Q2's sequential MIPLYFFA growth of 23%, on top of Q1's already strong performance, confirms the commercial ramp continued to accelerate rather than plateau.

• MIPLYFFA, Zevra's approved therapy for Niemann-Pick disease type C, continues to drive the large majority of company revenue, now accounting for 76% of the total
• US net sales accelerated to $30.2M, up 40% YoY and 23% sequentially, the second consecutive quarter of strong sequential growth
• MIPLYFFA was included in newly updated Clinical Practice Guidelines for the treatment and management of NPC, published in the Journal of Inherited Metabolic Disease, reinforcing its position as standard of care
• The European expanded access program continues to contribute meaningful reimbursement revenue ahead of a full EU commercial launch

• The DiSCOVER trial evaluating celiprolol for Vascular Ehlers-Danlos Syndrome had enrolled 62 patients as of Q1 2026, with 2 confirmed events under its event driven design
• The company has planned a follow-up meeting with the FDA in the second half of 2026 to explore pathways to accelerate clinical development for this program
• Zevra remains debt free following the full repayment of its $63.1M term loan earlier in 2026, funded by proceeds from the SDX portfolio divestiture
• Combined cash, equivalents, and investments of $260.2M provide substantial runway to fund both continued MIPLYFFA commercialization and pipeline development

• Heading into the print, analysts expected earnings of $0.08 per share and revenue of approximately $33.9M, both of which the company cleared comfortably
• Zevra's average full year EPS estimate stood at approximately $1.00 for both the current and next fiscal year prior to this report
• The company's prior quarter, Q1 2026, produced a 280% EPS surprise and a 21.57% revenue surprise, with shares moving 23.16% on the news, underscoring how sensitive this small cap name has been to earnings surprises
• Next scheduled report: Q3 2026, expected early November 2026

Zevra's Q2 2026 print extends what is becoming a consistent pattern for this small cap rare disease name: MIPLYFFA sales accelerating quarter over quarter, expenses coming down even as revenue scales, and both the top and bottom line clearing Street expectations by a wide margin. The 23% sequential growth in MIPLYFFA US sales, following an already strong Q1, is the single most important data point here, it shows the commercial launch trajectory for this Niemann-Pick disease type C therapy has real, compounding momentum rather than decelerating off an initial launch pop. A debt free balance sheet with $260M in cash and investments gives management ample room to fund the DiSCOVER trial and pursue further pipeline development without needing to raise capital under pressure. The obvious structural risk, that 76% of revenue still flows through a single product, remains unchanged by this quarter's results and is the key variable long term investors need to track. But for a story built around successfully commercializing a rare disease therapy, this was about as clean a quarter as the company could have delivered, and it follows an already strong Q1 that itself produced a 23% single day stock move. Next earnings expected early November 2026.