Liquidity is under pressure as free cash flow swung from a $31.0 million inflow in 2025Q4 to a $21.2 million outflow in 2026Q1, driven largely by volatile working capital changes.
| Metric | TTM | Dec'25 | Dec'24 | Dec'23 | Dec'22 | Dec'21 | Dec'20 | Dec'19 | Dec'18 | Dec'17 | Dec'16 | Dec'15 | Dec'14 | Dec'13 | Dec'12 |
|---|
| Cash from Operations | 60.37M | 67.99M | -40.66M | -23.38M | -73.15M | -252.97M | -110.39M | -257.44M | -97.49M | -56.16M | 57.91M | -52.41M | -27.48M | -11.33M | -7.21M |
| Operating CF Margin % | - | 28.79% | -25.38% | -12.02% | -25.01% | -119.52% | -37.46% | -76.85% | -46.93% | -31.55% | 3772.38% | - | - | - | - |
| Operating CF Growth % | 1582.71% | 267.23% | -73.88% | 68.03% | 71.08% | -129.16% | 57.12% | -164.06% | -73.6% | -196.98% | 210.49% | -90.69% | -142.53% | -57.14% | - |
| Net Income | -20.51M | -5.34M | -69.41M | -51.92M | -92.56M | -282.02M | -383.46M | -279.66M | -143.59M | -76.91M | -135.75M | -60.72M | -37.03M | -13.17M | -8.2M |
| Depreciation & Amortization | 1.28M | 1.27M | 37.5M | 41.85M | 37.7M | 36.13M | 33.59M | 38.65M | 2.42M | 617K | 296K | 96K | 49K | 1.28K | 0 |
| Stock-Based Compensation | 12.76M | 11.28M | 7.78M | 9.32M | 17.85M | 0 | 24.46M | 11.93M | 19.04M | 8.87M | 5.83M | 4.71M | 6.01M | 1.56M | 122K |
| Deferred Taxes | 0 | 0 | 0 | 0 | 0 | 0 | 204.08M | -6.63M | -28.34M | 0 | 0 | 0 | 0 | -2.42M | 0 |
| Other Non-Cash Items | 45.18M | 44.31M | 23.15M | -1.9M | -34.7M | 98.54M | 24.61M | 77.35M | 16.95M | 4.02M | 800K | 558K | 268K | 760.42K | 1.67M |
| Working Capital Changes | 21.66M | 16.47M | -39.68M | -20.73M | -1.44M | -105.61M | -13.67M | -99.07M | 36.02M | 7.25M | 186.73M | 2.94M | 3.22M | 1.93M | -808K |
| Change in Receivables | -1.97M | -14.14M | 4.05M | 994K | 11.7M | -24.03M | 12.01M | -22.2M | 33.38M | -393K | -33.82M | 0 | 87K | -49.71K | -4K |
| Change in Inventory | -20.71M | -23.13M | -28.4M | -2.54M | 19.79M | -24.95M | 6.16M | -29.14M | 26K | 16.79M | 0 | 0 | -773K | 0 | 0 |
| Change in Payables | -2.48M | 3.08M | -1.36M | -5.24M | 1.5M | -11.73M | 3.68M | 1.37M | 13.72M | 4.96M | -274K | 231K | 4.06M | 0 | 0 |
| Cash from Investing | -8.14M | -7.93M | -33K | 0 | -114K | 39.94M | -40M | 211.18M | 36.59M | -177.26M | 12.71M | -13.69M | -65.35M | -11.42M | 1.37M |
| Capital Expenditures | -427K | 0 | -33K | 0 | -114K | -59K | -317K | -6.66M | -1.61M | -1.62M | -2.66M | -414K | -229K | -19.73K | 0 |
| CapEx % of Revenue | 0.18% | 0.12% | 0.02% | - | 0.04% | 0.03% | 0.11% | 1.99% | 0.77% | 0.91% | 173.42% | - | - | - | - |
| Acquisitions | 172K | 0 | 0 | 0 | 0 | 0 | 39.69M | 0 | 6.15M | 1.62M | 2.66M | 414K | 229K | 0 | 0 |
| Investments | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - |
| Other Investing | -7.89M | -7.93M | 0 | 0 | 0 | 0 | -39.69M | 0 | 32.05M | -1.62M | -2.66M | -414K | -229K | -11.41M | 1.37M |
| Cash from Financing | -2.94M | 72.93M | 49.66M | -25.21M | 14.6M | 133.73M | 231.72M | 88.97M | 96.56M | 116.24M | 66.95M | 83.09M | 104.4M | 42.33M | 2.48M |
| Debt Issued (Net) | -5.99M | 4.63M | 7.9M | -32M | -33M | 44.78M | 19.98M | 62.67M | -19K | -5K | -20K | -7K | 234K | 0 | 0 |
| Equity Issued (Net) | 2.09M | 68.36M | 41.38M | 6.79M | 7.53M | 88.95M | 210.52M | 25.74M | 95.93M | 114.93M | 66.84M | 82.97M | 104.17M | 0 | 2.48M |
| Dividends Paid | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| Share Repurchases | 0 | 0 | -1.27M | 0 | 0 | 0 | 0 | -426K | 0 | 0 | 0 | 0 | -162K | 0 | 0 |
| Other Financing | 961K | -63K | 385K | 1K | 40.07M | 0 | 1.23M | 560K | 647K | 1.31M | 124K | 130K | 0 | 42.33M | 0 |
| Net Change in Cash | 49.28M | 132.99M | 8.97M | -48.59M | -58.67M | -79.29M | 81.33M | 42.7M | 35.66M | -117.18M | 137.56M | 17M | 11.56M | 19.57M | -3.37M |
| Free Cash Flow | 60.01M | 67.99M | -40.69M | -23.38M | -73.27M | -253.02M | -110.7M | -264.1M | -99.1M | -57.78M | 55.24M | -52.82M | -27.71M | -11.35M | -7.21M |
| FCF Margin % | 25.82% | 28.79% | -25.4% | -12.02% | -25.05% | -119.55% | -37.57% | -78.83% | -47.7% | -32.46% | 3598.96% | - | - | - | - |
| FCF Growth % | 272.11% | 267.09% | -74.02% | 68.08% | 71.04% | -128.56% | 58.08% | -166.49% | -71.51% | -204.59% | 204.59% | -90.61% | -144.13% | -57.42% | - |
| FCF per Share | 0.22 | 0.26 | -0.19 | -0.12 | -0.40 | -1.52 | -0.80 | -2.23 | -0.85 | -1.33 | 1.46 | -2.00 | -1.80 | -0.76 | -0.71 |
| FCF Conversion (FCF/Net Income) | -2.93x | -12.72x | 0.59x | 0.45x | 0.78x | 0.90x | 0.29x | 0.92x | 0.57x | 0.73x | -0.43x | 0.86x | 0.74x | 0.86x | 0.88x |
| Interest Paid | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 781K | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| Taxes Paid | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
Commercial adoption and reimbursement
According to recent financial statements, Akebia's operating cash flow frequently diverges from net income, as evidenced by the 2026Q1 period where the company reported a $9.1 million net loss alongside a $21.2 million cash outflow, highlighting significant challenges in converting accounting profits into actual liquidity.
The persistent gap between net income and operating cash flow suggests that the company's reported earnings are heavily influenced by non-cash items and working capital fluctuations. Investors should monitor whether this disconnect reflects structural inefficiencies in revenue collection or the timing of milestone-based payments that fail to provide consistent operational support.
As reported in quarterly filings, Akebia's free cash flow trajectory is highly erratic, swinging from a positive $31.0 million in 2025Q4 to a negative $21.2 million in 2026Q1, which underscores the difficulty in maintaining a self-sustaining cash generation profile during the Vafseo commercial launch phase.
The inability to maintain positive free cash flow suggests that the company remains in a capital-intensive growth phase where operational expenses frequently outpace revenue realization. This volatility warrants further investigation into whether the current cash burn is a temporary byproduct of market entry or a sign of deeper structural margin compression.
Based on reported figures, working capital changes have become the primary driver of quarterly cash flow variance, with a $24.5 million outflow in 2026Q1 reversing the $21.9 million inflow seen in 2025Q4, indicating that the company's liquidity is highly sensitive to shifts in accounts receivable and inventory.
These sharp reversals in working capital suggest that the company may be struggling to manage the timing of payments from large dialysis organizations or is experiencing lumpy inventory turnover. Such instability implies that cash availability may be less a function of core product demand and more a reflection of administrative and collection cycles.
Data from recent SEC filings reveals that stock-based compensation remains a consistent non-cash add-back, reaching $3.7 million in 2026Q1, which effectively masks the true economic cost of talent retention and complicates the assessment of the company's underlying cash-generating potential relative to its reported operating losses.
By relying on SBC to mitigate the impact of net losses on the cash flow statement, the company may be understating the true cost of its operations. Analysts should adjust for these figures to determine the actual cash burn rate, as the reliance on equity-based incentives may not be a sustainable substitute for organic cash flow generation.
Quick answers to the most common questions about buying AKBA stock.
Akebia Therapeutics, Inc. (AKBA) generated $68.0M in net cash from operating activities in 2025. This reflects the cash generated directly from core business operations.
Akebia Therapeutics, Inc. (AKBA) generated $68.0M in free cash flow in 2025. Free cash flow is the cash left over after capital expenditures, which can be used to pay dividends, repurchase shares, or pay down debt.
Akebia Therapeutics, Inc. (AKBA) spent $0.0M on capital expenditures in 2025. CapEx represents the cash invested in physical assets like property, plant, and equipment to maintain or grow the business.