CorMedix Q4 Sales Strong, but Reimbursement Cliff Undermines Near-Term Optimism

What happened

CorMedix is heading into Q4 2025 earnings with DefenCath driving revenues and Melinta adding contributions, as highlighted in a recent Zacks article that emphasizes strong outpatient dialysis use. However, the DeepValue report reveals the company faces a looming TDAPA reimbursement cliff in mid-2026, which has already caused a stock price drop of over 37% in the past year due to lowered 2026 guidance. Management's reset to $300-320 million in 2026 revenue, down from pro-forma 2025 levels, reflects expected pricing compression despite current high-margin sales. The Zacks article portrays near-term upside but underplays critical risks like customer concentration and the binary nature of post-TDAPA volume retention. Investors must look beyond this optimistic narrative to assess whether DefenCath utilization can withstand reimbursement shocks and if Melinta provides stable enough diversification.

Implication

The positive Q4 sales story obscures DefenCath's impending pricing drop when TDAPA expires in July 2026, which could slash net revenue by half in the second half of 2026. CorMedix's 2026 guidance assumes only maintenance of current volumes, with no cushion for customer defections or further reimbursement cuts, making current earnings unsustainable. Melinta adds a ~$130 million revenue base but carries risks from competitive erosion and heavy amortization that compress margins. Key catalysts like ReSPECT data in 2Q26 and post-TDAPA results in 3Q26 will determine if the stock can rebound from its lows, requiring close monitoring. Position sizing must account for these binary outcomes, avoiding overexposure to short-term sales momentum that may not translate into durable cash flow.

Thesis delta

The new article reinforces near-term revenue strength but does not shift the core thesis that DefenCath faces a critical reimbursement cliff in 2H26. Investors should maintain a cautious stance, as the stock's upside depends on successful navigation of TDAPA transition and positive clinical data, not just quarterly sales beats.