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Revenue (Tables)
 12 Months Ended
Dec. 31, 2025
Revenue from Contract with Customer [Abstract]  
Schedule of Revenue
Disaggregation of total revenues by nature is as follows:
Year Ended December 31,
(in thousands)202520242023
Product sales, net$377,808 $319,196 $82,526 
Product supply revenue15,879 11,649 6,121 
Licensing revenue5,088 78 35,809 
Non-cash royalty revenue related to the sale of future royalties8,545 2,692 — 
Total revenues$407,320 $333,615 $124,456 
Total product sales, net was as follows:
Year Ended December 31,
(in thousands)202520242023
Product sales, net
IBSRELA$274,207 $158,286 $80,062 
XPHOZAH103,601 160,910 2,464 
Total product sales, net$377,808 $319,196 $82,526 
Product sales, net as a percentage of total revenues
92.8 %95.7 %66.3 %
The following table summarizes total revenues by collaboration partner:
Year Ended December 31,
(in thousands)202520242023
Licensing revenue
Kyowa Kirin
$— $— $30,000 
Fosun Pharma
5,000 — 5,000 
METiS
— — 750 
Knight
88 78 59 
Total licensing revenue
$5,088 $78 $35,809 
Product supply revenue   
Kyowa Kirin
$15,625 $11,649 $6,092 
Knight
254 — 29 
Total supply revenue
$15,879 $11,649 $6,121 
Non-cash royalty revenue related to the sale of future royalties   
Kyowa Kirin
$8,545 $2,692 $— 
Schedule of Gross To Net Adjustments of Revenue
The activities and ending reserve balances for each significant category of GTN adjustments on product sales, net, which constitute variable consideration, were as follows:
(in thousands)
Discounts and Chargebacks
Rebates, Wholesaler and GPO Fees
Copay Assistance and Returns
Total
Balance as of December 31, 2023$478 $4,234 $3,916 $8,628 
Provisions15,099 65,833 28,925 109,857 
Credits/payments(13,934)(55,592)(21,671)(91,197)
Balance as of December 31, 20241,643 14,475 11,170 27,288 
Provisions(1)
23,356 108,547 31,667 163,570 
Credits/payments(23,306)(88,566)(33,563)(145,435)
Balance as of December 31, 2025$1,693 $34,456 $9,274 $45,423 
(1)Provisions included approximately $4.4 million of net favorable adjustment resulting from changes in prior periods’ estimates.
Schedule of Revenue by Geographic Areas A summary of our revenues by geographic area is as follows:
Year Ended December 31,
(in thousands)202520242023
United States(1)
$377,808 $319,196 $83,276 
International
Asia Pacific(2)
29,170 14,341 41,121 
North America(3)
342 78 59 
Total revenues$407,320 $333,615 $124,456 
(1)Revenues from the United States were comprised of amounts earned from sales of IBSRELA and XPHOZAH.
(2)Revenues from Asia Pacific were comprised of amounts earned in accordance with the Kyowa Kirin Agreement and the Fosun Agreement.
(3)Revenues from North America were comprised of amounts earned from Canada in accordance with the Knight Agreement.
Schedule of Revenue from Customers as a Percentage of Total Product Revenue, Net
Gross product sales from Customers and revenues from collaboration partners, each accounting for more than 10% of total revenues, were as follows:
Year Ended December 31,
202520242023
Customers(1)
BioRidge Pharma, LLC65.9 %75.4 %24.0 %
Cardinal Health21.4 %14.5 %19.8 %
McKesson Corporation17.9 %14.1 %15.7 %
Cencora (formerly AmerisourceBergen Drug Corporation)
17.3 %16.4 %19.1 %
Collaboration partners
Kyowa Kirin5.9 %4.3 %29.0 %
(1)The total of the above percentages exceeds 100% as the numerators used in the calculations represent gross product sales for each Customer, as opposed to product sales, net as presented on our statements of operations and comprehensive loss.