Mirum Raises Sales Outlook To $715 Million-$720 Million, Sees Revenue Adding $10 Million-$15 Million A Quarter Through 2027
Executives on the earnings call named adult PFIC as the biggest driver of the raised outlook and said newly launched Atebrios should be adopted faster than Livmarli.
Mirum Pharmaceuticals, a rare-disease drugmaker, expects total revenue to keep rising by $10 million to $15 million a quarter through next year, CEO Chris Peetz said on the company's third-quarter earnings call. The company raised its full-year net product sales guidance to $715 million to $720 million, after reporting $186 million in third-quarter sales.
Adult PFIC leads the raise
Peetz said that for the fourth quarter and into next year, the pace of growth in total revenue, "in this kind of $10 to $15 million a quarter," is something "we fully expect that to continue throughout next year."
Asked by a Wolfe Research analyst whether the guidance increase came mostly from adult PFIC, a rare liver disease, President and Chief Operating Officer Peter Radovich said strength showed up across the portfolio, including Alagille syndrome and the bile acid products. But adult PFIC, he said, is the biggest driver, with "line of sight now after several quarters of this cadence of 10 to 15 million quarter on quarter step up for that to persist through this year and through next year as well."
Radovich said the company believes at least 2,000 adult PFIC patients are addressable in the United States, though the substantial majority remain undiagnosed. He said expanded commercial efforts "should lay a strong foundation for 2027."
Livmarli carries the quarter
Mirum, which has Livmarli, Cholbam and Ctexli on the market and sells Livmarli directly in the U.S., Canada and some European countries, reported $133 million of Livmarli sales in the quarter, including $100 million in the United States. Its bile acid medicines added $52 million, Radovich said.
Chief Financial Officer Eric Bjerkholt said net product sales for the first nine months were about $522 million, which he said already equals full-year 2025 revenue. A year earlier, third-quarter sales were about $133 million. Cash on hand was about $500 million as of September. Total operating expenses for the quarter were about $245 million, and cash used in operations was about $4 million.
In September the company repurchased $20 million of principal on its 2029 convertible notes for about $62 million in cash. Bjerkholt said that, combined with a second-quarter financing, cut the 2029 notes' outstanding balance by more than 80%. Peetz said commercial strength and pipeline progress position Mirum to be cash flow positive next year.
Atebrios launch and the pipeline
Atebrios, the company's fourth medicine, was approved in September for adults and pediatric patients 12 and older with FOP, and launched in the U.S. in October. Asked about the trajectory, Radovich said about 50% of addressable Alagille syndrome patients are on Livmarli roughly five years after approval, and "we would expect Atebrios to be faster adoption" than Livmarli.
Mirum expects the Azure 4 hepatitis delta readout this quarter and the Vantage readout in primary biliary cholangitis in the first quarter of next year. Peetz said five approvals or label expansions lie ahead as the company works toward a portfolio peak revenue potential of more than $4 billion. Full data on the hepatitis delta drug brelovitug are due at the AASLD liver meeting later this week. Mirum plans a planned NDA for volixibat in PSC in the first half of 2027.
Mirum's market value stood at $5.6 billion in the report dated Tuesday, and the Azure 4 readout is due before the year ends.
