Earnings call transcript: Rockwell Medical Q3 2025 sees revenue drop, stock falls

Rockwell Medical Inc. (NASDAQ:RMTI) reported its Q3 2025 earnings, revealing a revenue of $15.9 million, slightly below the forecast of $16.18 million. The earnings per share (EPS) matched expectations at -$0.05. Following the announcement, Rockwell Medical’s stock dropped 11.43% in premarket trading, reflecting investor concerns over the company’s financial performance and market outlook.

Key Takeaways

• Rockwell Medical’s revenue fell 44% compared to Q3 2024.
• The company maintained its EPS forecast, meeting expectations.
• Stock price dropped significantly in premarket trading, down 11.43%.
• Gross margin decreased to 14% from 22% year-over-year.
• The company is focusing on expanding its home dialysis product line.

Company Performance

Rockwell Medical’s Q3 performance was marked by a significant decline in revenue and gross profit compared to the previous year. The company’s net sales of $15.9 million represented a 44% decrease from the same quarter in 2024. Despite this, the adjusted EBITDA showed improvement, rising to $50,000 from a negative $200,000 in Q2 2025. The company is navigating a challenging market environment, characterized by decreased demand and increased competition.

Financial Highlights

• Revenue: $15.9 million, down 44% year-over-year.
• Earnings per share: -$0.05, unchanged from forecast.
• Gross profit: $2.3 million, down 64% year-over-year.
• Gross margin: 14%, down from 22% in Q3 2024.
• Cash and equivalents: $23.7 million, up from $18.4 million in Q2 2025.

Earnings vs. Forecast

Rockwell Medical’s EPS met the forecast at -$0.05, while revenue fell short by approximately $1.73 million or 10.7%. The revenue miss highlights ongoing challenges in the hemodialysis market and the company’s efforts to adapt to changing market conditions.

Market Reaction

The company’s stock reacted negatively to the earnings report, with a premarket decline of 11.43%. The stock’s last trading price was $0.93, down from the previous close of $1.05. This movement places the stock closer to its 52-week low of $0.7801, indicating investor concerns about the company’s future growth prospects.

Outlook & Guidance

Rockwell Medical is focusing on expanding its home dialysis product offerings and optimizing its cost structure. The company is also exploring business development and acquisition opportunities, particularly on the West Coast. Guidance for 2026 is expected to be provided with the Q4 earnings release.

Executive Commentary

CEO Dr. Marc Strobeck emphasized the company’s efforts to strengthen its contract portfolio, with over 80% of customers under long-term agreements. CFO Jesse Neri highlighted the potential growth in the bicarbonate cartridge product line and the progress made in restructuring operations.

Risks and Challenges

• Market Saturation: Increased competition in the hemodialysis market could pressure margins.
• Supply Chain Issues: Potential disruptions could impact product availability and costs.
• Economic Pressures: Macroeconomic factors may affect healthcare spending and demand.
• Dependency on Key Customers: Reliance on major customers poses risks if agreements are not renewed.
• Regulatory Changes: Changes in healthcare regulations could impact operations and profitability.

Q&A

During the earnings call, analysts focused on the company’s restructuring efforts and market expansion plans. Key discussions included the potential for new business development and the importance of reducing labor and material costs to improve profitability.

Full transcript - Rockwell Medical Inc (RMTI) Q3 2025:

Conference Call Operator: Good morning and welcome to Rockwell Medical’s Third Quarter 2025 Results Conference Call and Webcast. Please note this event is being recorded. At this time, I would like to turn the conference call over to Heather Hunter, Chief Operating Officer at Rockwell Medical. Heather, please go ahead.

Heather Hunter, Chief Operating Officer, Rockwell Medical: Good morning and thank you for joining us for this update on Rockwell Medical. Joining me on today’s conference call are Dr. Marc Strobeck, Rockwell Medical’s President and Chief Executive Officer, and Jesse Neri, Rockwell Medical’s Chief Financial Officer. Before we begin, I would like to remind you that this conference call will contain forward-looking statements about Rockwell Medical within the meaning of the federal securities laws, including but not limited to the types of statements identified as forward-looking in our annual report on Form 10-K and our subsequent periodic reports filed with the SEC. These statements are subject to risks and uncertainties that could cause actual results to differ. Please note that these forward-looking statements reflect our opinions and expectations only as of today. Except as required by law, we specifically disclaim any obligation to update or revise these forward-looking statements in light of new information or future events.

Factors that could cause actual results or outcomes to differ materially from those expressed in or implied by such forward-looking statements are discussed in greater detail in our periodic reports filed with the SEC. Rockwell Medical’s quarterly report on Form 10-Q for the three months ended September 30, 2025, was filed prior to this call and provides a full analysis of the company’s business strategy as well as the company’s third quarter 2025 results. The reconciliation of non-GAAP measures we discussed on today’s call can also be found in today’s press release. Our Form 10-Q and other reports filed with the SEC, along with today’s press release, our updated investor presentation, and a replay of today’s conference call and webcast can be found on Rockwell Medical’s website under the Investor section. Now, I would like to turn the conference call over to Rockwell Medical’s President and CEO, Dr. Marc Strobeck.

Dr. Marc Strobeck, President and Chief Executive Officer, Rockwell Medical: Thank you, Heather. Good morning and thank you for joining us today for Rockwell Medical’s third quarter 2025 earnings conference call and webcast. As we approach the end of the year, I want to provide you with an update on what has truly been a year of resilience, transformation, and growth for Rockwell. We are effectively managing the transition of our largest customer away from us while securing our base business through multi-year contracts, right-sizing our organization to enhance operational efficiency, and adding new customers, all while continuing to meet strong customer demand with high-quality products supported by exceptional customer service. I am proud to say that we have made substantial progress. We continue to fundamentally strengthen our contract portfolio with over 80% of our customers operating under long-term agreements. This provides stability and revenue visibility that positions us well for the future.

We continue to optimize our organizational structure to align with our current scale while maintaining our operational excellence and customer service standards. This right-sizing effort has been executed thoughtfully, ensuring we retain the capabilities and capacity needed to serve our customers and capitalize on growth opportunities as they emerge. Most importantly, we have demonstrated our ability to successfully manage through this transition period while maintaining our market position and building momentum for future growth. The strategic decisions we made earlier in the year are now translating into tangible results, and we remain confident in our ability to achieve our full-year guidance targets. Looking at our third quarter financial performance, I am pleased to report several key achievements that demonstrate our continued progress through this year of transition. Most notably, we are pleased to report that we were profitable on an adjusted EBITDA basis for the third quarter.

This continues to track in line with our full-year guidance range. The trajectory we are seeing gives us confidence in our ability to achieve sustainable profitability as we move forward with our strengthened contract portfolio and further optimize cost structure. While our net sales of $15.9 million reflected the expected impact from our largest customer’s transition, our adjusted gross margin performance remained consistent and well within the guidance range of 16%-18%. This growing stability in our margin profile, even during a period of customer transition, speaks to the quality of our customer base and the value proposition we deliver in the hemodialysis concentrates market. We continue to make meaningful progress with both new and existing customers. Our pipeline has the potential to be transformational for Rockwell Medical.

These discussions span various customer segments and geographic markets, and while we maintain our characteristically conservative approach to guidance, the breadth and quality of these opportunities reinforce our optimism about the company’s growth trajectory in 2026 and beyond. During the third quarter, we signed several new long-term product purchasing agreements with university medical centers, kidney centers, and hospital systems. One agreement worth highlighting is with a single dialysis center located in Southern Florida. This is a three-year commitment with the option to renew for two additional one-year periods that has the potential to generate approximately $1 million in annualized net sales for the company. During the third quarter, we also expanded our product purchase agreement with the largest provider of dialysis in skilled nursing facilities in the United States.

The agreement will be in effect for three years with the option to renew for one additional year and includes supply and purchasing minimums for our liquid and dry acid and bicarbonate concentrates, including our bicarbonate cartridge, which, as a reminder, officially launched earlier this year. Discussions with our formerly largest customer are still ongoing. We continue to supply them through the third quarter and expect to supply them through the end of the year. As a reminder, this customer originally planned to complete their transition to a new supplier in the middle of this year. However, due to a Class 1 recall by this new supplier and other unforeseen circumstances, the customer continues to rely on Rockwell Medical for a portion of its hemodialysis concentrate supply.

We believe that this speaks to both the quality of our products and the operational challenges inherent in switching suppliers for mission-critical dialysis treatments. It’s worth noting that this large customer represented 12% of our net sales in the third quarter of 2025, demonstrating that while this relationship remains meaningful to our business, our successful diversification efforts have significantly reduced our dependence on any single customer. We believe that this reduced concentration risk, combined with our strengthened contract portfolio across our broadened customer base, positions us well regardless of how our discussions with the largest customer ultimately end up. We will continue to approach these discussions with the same professionalism and customer-centric focus that have characterized our long-standing relationship with this large customer, while maintaining our disciplined approach to guidance and ensuring that any future commitments align with our strategic objectives and operational capabilities.

Now, I’ll turn the call over to Jesse to review our third quarter 2025 financial results in further detail.

Jesse Neri, Chief Financial Officer, Rockwell Medical: Thanks, Marc. Good morning, everyone. Our focus in 2025 has been to adjust our cost structure to align with the changes to our customer base. While improving efficiency is an ongoing exercise, we have made progress over the last two quarters in restructuring the size of our operations and expect those efforts to be substantially completed by the end of this year. We measure our progress in this area by focusing on three key metrics: gross margin, adjusted EBITDA, and cash. We believe adjusted EBITDA is a good proxy for profitability because we remove non-cash items, non-operating items, restructuring costs, and other items that are not part of the concentrates business. Since there have been so many changes over the past year, we believe the most meaningful comparison is against the previous quarter instead of the prior year.

I will now review our financial results for the three and nine months ended September 30, 2025, in greater detail. Net sales for the third quarter were $15.9 million, which were in line with net sales for the second quarter and represent a 44% decrease over net sales of $28.3 million for the same period in 2024. The decrease in net sales was driven by the transition of our largest customer to another supplier. Net sales for the nine months ended September 30, 2025, were $50.9 million, which represents a 34% decrease over net sales of $76.8 million for the same period in 2024. Gross profit for the third quarter was $2.3 million, which was in line with the gross profit for the second quarter and represents a 64% decrease over $6.2 million for the same period in 2024.

Gross profit for the nine months ended September 30 was $7.8 million, which represents a 44% decrease over $13.9 million for the same period in 2024. Gross margin for the third quarter 2025 was 14%, down from 16% in Q2 2025 and 22% for Q2 2024. Excluding restructuring costs, gross margin was 18% in Q3 2025, an improvement over the first and second quarters of 2025. Gross margin for the nine months ended September 30, 2025, was 15%, which represents a decrease from 18% for the same period in 2024. Gross margin in 2025 was 17%, excluding restructuring expenses. Net loss for the third quarter of 2025 was $1.8 million, which was consistent with the first and second quarters of 2025, but was down compared to net income of $1.7 million for the same period in 2024.

Net loss for the nine months ended September 30, 2025, was $4.8 million compared to a net income of $300,000 for the same period in 2024. Adjusted EBITDA for Q3 2025 was $50,000, which represents an improvement over adjusted EBITDA of negative $200,000 in Q2 2025 and a negative $400,000 in Q1 2025. Adjusted EBITDA for the nine months ended September 30, 2025, was a negative $600,000 compared with a positive adjusted EBITDA of $3.7 million for the same period in 2024. While this represents a significant year-over-year decline, the trajectory shows meaningful improvement when compared to the first-half performance, indicating that our strategic initiatives and new customer relationships are beginning to generate positive momentum for our financial results. Cash, cash equivalents, and investments available for sale at September 30, 2025, was $23.7 million, an increase from $18.4 million at the end of Q2.

The increase in cash was primarily driven by the issuance of common stock in connection with our ATM facility, partially offset by cash paid in connection with CETA, Avocua Asset Acquisition. The increased cash position offers us the opportunity to continue to pursue business development opportunities and further invest in infrastructure enhancements and monetization. Now, I will turn the call back over to Marc. Thank you, Jesse. Operator, please open the phone lines for any questions.

Conference Call Operator: Thank you. If you would like to ask a question, please press star followed by the number one on your telephone keypad. Our first question comes from Ram Selvaraju from HC Wainwright. Please go ahead. Your line is open.

Ram Selvaraju, Analyst, HC Wainwright: Thanks very much for taking my questions. Firstly, I was wondering if you could give us some additional color on when you expect the situation with your former largest customer to be fully resolved, if you anticipate a final decision to be taken before the end of this year, or if you anticipate continuing to provide services to this customer into 2026. Thank you.

Jesse Neri, Chief Financial Officer, Rockwell Medical: Yeah. Thanks, Ram. We expect that to resolve this quarter. We are currently in a contract discussion with them, and we expect to be able to discuss that shortly.

Ram Selvaraju, Analyst, HC Wainwright: Okay. With respect to 2026, can you give us a sense of when you believe you might be in a position to provide forward revenue guidance for the full year 2026? I wondered if you could elaborate on what types of business development activities you might look to undertake given your current balance sheet strength. Thank you.

Jesse Neri, Chief Financial Officer, Rockwell Medical: Yeah. Yeah. Typically, we provide 2026 guidance early in the year, so we expect to continue to do that. Our anticipation is that as we release our fourth quarter earnings, we’ll be able to provide visibility into the company’s performance in 2026. As far as business development activities, we continue to be very active in that. Now that we have a strong cash balance that we are now employing as growth capital, we are currently in discussions with multiple companies around acquisitions of their business and customer base. Assuming those continue to progress, we’ll be able to announce shortly what the impact of those will be.

Ram Selvaraju, Analyst, HC Wainwright: Okay. Lastly, could you just talk a little bit about what you see as the key prospects near and medium term for the bicarbonate disposables business?

Jesse Neri, Chief Financial Officer, Rockwell Medical: Yeah. With the introduction of our bicarbonate cartridge earlier in the year and now with our first large customer now beginning to access that particular product, we think that there’s an opportunity to grow significantly beyond that. That’s a much higher margin product opportunity for us. It’s been a significant effort to put that in place in relatively short order, have that ready to go, having it, again, with the quality standards that we expect for all of our products leaving our organization. It’s taken us some time to put all of that in place, but we are now in a position, I think, to maximize that. We expect more and more of our existing customer base to begin to start purchasing that product from us.

Ram Selvaraju, Analyst, HC Wainwright: Thank you.

Conference Call Operator: Our next question comes from Nick Sherwood from Maxim Group. Please go ahead. Your line is open.

Nick Sherwood, Analyst, Maxim Group: Hi. Good morning, everyone. My first question is, how are you balancing some of this organizational restructuring while also ensuring you’re making proper investments into the business? I mean, you just mentioned potential acquisitions, but is there anything more internal that you’re focusing on? Are you making new hires, or is kind of a lot of that investment based on some of these potential acquisitions you just mentioned?

Jesse Neri, Chief Financial Officer, Rockwell Medical: Yeah. As you can imagine, it’s been sort of a tricky algorithm for us to work through, which is decreasing certain, obviously, products and the single largest customer moving away from us while simultaneously adding new customers and making sure that we continue to supply product to our existing customer base at the quality standards and with the service that we’ve provided previously. What that has essentially amounted to is a titration of resources within our organization, shifting of priorities, shifting of some of those resources to focus more on growth opportunities in those areas, and winding down some of the activities and sort of operations in areas that are no longer going to be supported by our organization. It’s been a balance, and the team has done an incredibly good job of managing that difficult sort of titration exercise.

As Jesse pointed out in his section, we’re beginning to start to see the fruits of that, and we expect to see more of that here in the fourth quarter coming up and through 2026.

Ram Selvaraju, Analyst, HC Wainwright: Understood. Appreciate the detail. My second question is, where do you see the most kind of room to run with improving your gross margin? Is it material costs? Is it labor costs? Are there sort of efficiencies that you can develop in your distribution system where you can kind of get more product on fewer shipments, or is it packaging? Can you kind of just thinking about 2026, what are some of those early targets you’re looking at that can make the biggest impact in improving margins?

Jesse Neri, Chief Financial Officer, Rockwell Medical: I think in the immediate term, labor costs is certainly an area where we can become more efficient. I think that’s number one. Over the long term, we definitely see upside in reducing our materials costs and distribution as well.

Ram Selvaraju, Analyst, HC Wainwright: Okay. Labor and then some of the materials after that. My third and final question is, on the adjusted EBITDA reconciliation, there was a facility closure. Can you kind of just give me a little bit of background to what was happening there and, yeah, just any detail you can provide?

Jesse Neri, Chief Financial Officer, Rockwell Medical: Yeah. So one of our facilities, we’ve now trimmed, again, in part because the lease for that facility was coming up. We were able to consolidate our manufacturing activities into our existing facilities. We were able to essentially wind that down and begin to start to offload that expense. That’s what you’re going to begin to see here in the third quarter and then more specifically in the fourth quarter.

Ram Selvaraju, Analyst, HC Wainwright: Okay. So we should see maybe a little bit of a similar impact on the operating expenses in the fourth quarter as well as compared to the third quarter?

Jesse Neri, Chief Financial Officer, Rockwell Medical: That’s correct.

Ram Selvaraju, Analyst, HC Wainwright: Okay. Thanks for answering all my questions. I will turn it to you.

Jesse Neri, Chief Financial Officer, Rockwell Medical: Absolutely.

Conference Call Operator: Our last question comes from Anthony Vendetti from Maxim Group. Please go ahead. Your line is open.

Dr. Marc Strobeck, President and Chief Executive Officer, Rockwell Medical: Sure. Thanks. Mark, I just wanted you to give us an update on two things. One is the West Coast expansion and then just an update on the home dialysis business.

Jesse Neri, Chief Financial Officer, Rockwell Medical: Yeah. Yeah. The West Coast continues to be an area of opportunity for us. We are expanding our customer base now into the West Coast. We expect to have or we hope to have an announcement here shortly related to sort of further customers that we are acquiring in that area. That is going to be an area of focus for us in 2026, which will be how to maximize the opportunity there for Rockwell Medical, whether that comes through continued customer acquisition or that comes through setting up a small facility in the West. I think we are now beginning to build a critical mass of customers out there that likely warrants that. As we have said previously, we have taken the approach of not building something hoping folks would come, but waiting till we have a significant customer base out there to warrant the presence of a facility.

I think based on our assessment now and certainly through the fourth quarter, we’re likely in a position of where we will contemplate that. We believe that’s a significant area of growth for us. Your second question, what?

Nick Sherwood, Analyst, Maxim Group: At home.

Jesse Neri, Chief Financial Officer, Rockwell Medical: At home, we continue to be a very large supplier to that market. As you know, we supply one of the largest at-home hemodialysis providers in the United States. Our new product configuration, which I think is more amenable for at-home use, has begun to start to take off. Again, that is a higher margin product opportunity for us. We believe we’ll continue to see that growth through the end of the year and into 2026 as more of the at-home users begin to convert to that product configuration. We think that will have a place within the overall hemodialysis market. Those organizations that are working in there and using our product, I think, are establishing that. We continue to be excited about the prospects there, but are well-positioned to support that market as it continues to develop.

Dr. Marc Strobeck, President and Chief Executive Officer, Rockwell Medical: Okay. Maybe just a final question. Just to get an understanding of the magnitude, what percent right now of your business is at home?

Jesse Neri, Chief Financial Officer, Rockwell Medical: Right now, it’s a small percentage, probably single-digit percentage at this point. It’s our anticipation that that will continue to grow. We think the overall at-home market is probably going to be about 10-15% here in the near term in the overall hemodialysis market.

Dr. Marc Strobeck, President and Chief Executive Officer, Rockwell Medical: Okay. Great. Thank you so much. Appreciate it.

Jesse Neri, Chief Financial Officer, Rockwell Medical: Thanks, Anthony.

Conference Call Operator: There are no further questions. I will now turn the call back over to Dr. Strobeck.

Jesse Neri, Chief Financial Officer, Rockwell Medical: Thank you for joining us today for an update on Rockwell Medical, and we look forward to providing you with more updates in the next quarter.

Conference Call Operator: This concludes today’s call. You may now disconnect.

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