Cuộc họp công bố kết quả kinh doanh Quý 2/2026 của CorMedix (CRMD): Doanh thu đạt 101,9 triệu USD, nâng dự báo EBITDA

Điểm chính

• CorMedix báo cáo doanh thu hợp nhất quý 2/2026 đạt 101,9 triệu USD, tăng từ mức 39,7 triệu USD trong quý 2/2025. DefenCath đóng góp 66,1 triệu USD, trong khi danh mục sản phẩm Melinta thâu tóm đóng góp 35,8 triệu USD.
• EBITDA điều chỉnh tăng lên 58,7 triệu USD từ mức 22,4 triệu USD cùng kỳ năm trước. Lợi nhuận ròng đạt 26,0 triệu USD, tương đương 0,33 USD trên mỗi cổ phiếu phổ thông và 0,29 USD trên mỗi cổ phiếu pha loãng.
• Công ty tái khẳng định dự báo doanh thu cả năm 2026 ở mức 325 triệu USD đến 345 triệu USD và nâng dự báo EBITDA điều chỉnh lên 125 triệu - 140 triệu USD.
• CorMedix đã ký hợp đồng cung cấp DefenCath nhiều năm với một tổ chức lọc máu lớn khác, mở rộng phạm vi bao phủ đến cả 5 nhà cung cấp dịch vụ lọc máu lớn nhất Mỹ. Chương trình thử nghiệm dự kiến liên quan đến khoảng vài trăm phòng khám dự kiến sẽ bắt đầu vào quý 3/2026.
• Nghiên cứu Giai đoạn 3 ReSPECT đối với Rezzayo trong dự phòng bệnh nhiễm nấm xâm lấn đã đạt tiêu chí đánh giá chính của FDA. CorMedix và Mundipharma đang hỗ trợ việc nộp hồ sơ xin đăng ký thuốc bổ sung (sNDA) dự kiến vào quý 3/2026.
• Tiền và các khoản tương đương tiền đạt tổng cộng 256,7 triệu USD vào cuối quý, trong khi dòng tiền từ hoạt động kinh doanh đạt 128,6 triệu USD trong 6 tháng đầu năm 2026.

Kết quả tài chính cốt lõi

Tình hình kinh doanh và vận hành

DefenCath và chuyển đổi sau giai đoạn TDAPA

CorMedix cho biết khối lượng đơn hàng DefenCath trong tháng 7 phù hợp với các giả định sau giai đoạn TDAPA làm cơ sở cho dự báo năm 2026. Khối lượng đơn hàng ở các nhà cung cấp dịch vụ lọc máu lớn hơn đã ổn định, trong khi các nhà cung cấp nhỏ hơn có dấu hiệu sụt giảm nhẹ, cả hai đều nằm trong dự kiến của ban quản lý.

Hợp đồng nhiều năm mới ký giúp CorMedix hiện có các thỏa thuận cung cấp thương mại với cả 5 nhà cung cấp dịch vụ lọc máu lớn nhất Mỹ. Khách hàng mới nhất này đã đặt một đơn hàng ban đầu và có kế hoạch triển khai chương trình thử nghiệm vào quý 3/2026. Ban quản lý ước tính chương trình thử nghiệm có thể liên quan đến vài trăm phòng khám, với tiềm năng mở rộng mức độ sử dụng trong năm 2027.

CorMedix cũng đã sửa đổi hợp đồng với các khách hàng lớn để áp dụng mức giá cho quý 3 và quý 4/2026. Một số điều khoản sửa đổi bao gồm cam kết về giá và sản lượng cho năm 2027, cải thiện khả năng dự báo trong giai đoạn chuyển đổi cơ chế hoàn trả.

Việc ký kết hợp đồng với Medicare Advantage vẫn là trọng tâm tăng trưởng dài hạn. Ban quản lý cho biết các cuộc thảo luận đang tiến triển nhưng lưu ý rằng chu kỳ đàm phán hợp đồng có thể kéo dài. Dự báo năm 2026 của công ty chưa bao gồm bất kỳ đóng góp nào từ Medicare Advantage.

Các bằng chứng thực tế bổ sung về DefenCath dự kiến sẽ được công bố tại Tuần lễ Thận ASN và IDWeek trong quý 4. Các bài trình bày theo kế hoạch bao gồm kết quả cuối cùng từ nghiên cứu U.S. Renal Care và các nghiên cứu bên ngoài đánh giá DefenCath kết hợp với nắp kháng khuẩn chlorhexidine cũng như lợi ích lâm sàng và kinh tế tiềm năng liên quan đến việc giảm sử dụng tPA.

Chương trình dự phòng của Rezzayo

Nghiên cứu Giai đoạn 3 ReSPECT đã đạt tiêu chí đánh giá chính của FDA về tỷ lệ sống sót không nhiễm nấm vào ngày thứ 90, chứng minh tính không kém hơn so với phác đồ chống nấm chuẩn trong biên độ đã xác định trước. Ban quản lý cũng viện dẫn hồ sơ an toàn tích cực ở các tiêu chí đánh giá phụ, bao gồm các biến cố bất lợi xuất hiện trong quá trình điều trị dẫn đến thay đổi liều, rút khỏi thử nghiệm hoặc ngừng nghiên cứu.

Sau cuộc họp tiền NDA với FDA, CorMedix đang hợp tác với Mundipharma để hỗ trợ nộp hồ sơ xin đăng ký thuốc bổ sung (sNDA) cho Rezzayo trong dự phòng bệnh nhiễm nấm xâm lấn trong quý 3/2026. Dữ liệu bổ sung từ Giai đoạn 3 dự kiến sẽ được trình bày tại một hoặc nhiều hội nghị y khoa trong quý 4/2026.

Mundipharma hiện nắm giữ đơn đăng ký thuốc mới (NDA) tại Mỹ. Theo thỏa thuận giữa hai công ty, quyền sở hữu sẽ được chuyển giao cho CorMedix sau khi đơn đăng ký thuốc bổ sung (sNDA) cho chỉ định dự phòng được phê duyệt.

Nghiên cứu DefenCath TPN

CorMedix đã nộp một bản sửa đổi đề cương để thu hẹp một số tiêu chuẩn loại trừ và kích hoạt thêm các trung tâm nghiên cứu cho thử nghiệm Giai đoạn 3 về nuôi dưỡng hoàn toàn qua đường tĩnh mạch (TPN). Ban quản lý tiếp tục kỳ vọng nghiên cứu sẽ hoàn thành vào năm 2028.

Kế hoạch định hướng của ban quản lý

Ban quản lý cho biết doanh thu DefenCath đang hướng tới khoảng giữa đến nửa trên của mức dự báo cả năm. Công ty có kế hoạch xem xét lại dự báo khi có thêm cơ sở rõ ràng hơn về xu hướng đặt hàng sau giai đoạn TDAPA.

Các khoản đầu tư dự kiến liên quan đến khả năng Rezzayo được phê duyệt bao gồm việc bổ sung khoảng 15 đến 20 vị trí thương mại và y tế. Các chi phí này đã được phản ánh trong dự báo chi phí hoạt động bằng tiền mặt.

Rủi ro và các điểm cần theo dõi chính

• Khả năng dự báo xu hướng đặt hàng sau TDAPA vẫn còn hạn chế, đặc biệt là ở các nhà cung cấp dịch vụ lọc máu nhỏ hơn.
• Thời điểm và quy mô mở rộng của tổ chức lọc máu lớn mới ký hợp đồng sẽ phụ thuộc vào kết quả của chương trình thử nghiệm ban đầu.
• Chu kỳ ký kết hợp đồng với Medicare Advantage rất kéo dài và ban quản lý chưa tính đóng góp liên quan trong dự báo năm 2026.
• Quy định hoàn trả chi phí ESRD cuối cùng có thể khác với cơ chế theo quý đề xuất được thảo luận trong cuộc họp.
• Nhãn hiệu chỉ định dự phòng cuối cùng của Rezzayo vẫn đang chờ FDA xem xét và ban quản lý chưa có cơ sở đánh giá phạm vi chính thức của nhãn hiệu này.
• Thời gian nộp hồ sơ và phê duyệt pháp lý của Rezzayo phụ thuộc vào việc nộp hồ sơ đúng hạn và sự chấp thuận của FDA.

Điểm nhấn phần Hỏi & Đáp của các chuyên gia phân tích

• Chương trình thử nghiệm với nhà cung cấp dịch vụ lọc máu mới: Ban quản lý ước tính chương trình thử nghiệm DefenCath ban đầu có thể áp dụng cho vài trăm phòng khám, nhưng cho biết còn quá sớm để định lượng tác động tiềm năng trong năm 2027.
• Sản lượng trong quý hiện tại: Sản lượng tháng 7 ổn định ở các nhà cung cấp lớn hơn, trong khi các khách hàng nhỏ hơn ghi nhận sự sụt giảm nhất định. Ban quản lý xác định việc mở rộng phạm vi áp dụng và ký kết hợp đồng với Medicare Advantage là các động lực tăng trưởng sản lượng chính.
• Phản hồi thị trường về Rezzayo: CorMedix vẫn chưa tiến hành nghiên cứu thị trường diện rộng vì toàn bộ tập dữ liệu Giai đoạn 3 chưa được công bố. Dữ liệu bổ sung dự kiến sẽ có trong quý 4 năm 2026.
• Tỷ lệ chi phí hoạt động: Ban quản lý cho biết công ty chưa thực hiện các biện pháp cắt giảm chi phí chủ động nào. Chi phí quản lý doanh nghiệp quý 2 đã giảm nhờ khoản ghi nhận hoàn trả bảo hiểm 4,2 triệu USD, bao gồm 2,7 triệu USD chủ yếu liên quan đến chi phí pháp lý phát sinh trong quý 1 năm 2026.
• Hạ tầng thương mại: Ban quản lý xác nhận không thực hiện hành động nào nhằm thu hẹp hạ tầng bán hàng và tiếp thị của DefenCath trước giai đoạn hoàn trả sau TDAPA.

Toàn văn cuộc họp báo cáo kết quả kinh doanh

Toàn văn cuộc gọi công bố kết quả kinh doanh

Phần trình bày của ban lãnh đạo

Operator

Today's conference call is being recorded. [Operator Instructions] At this time, I would like to turn the conference call over to Dan Ferry from LifeSci Advisors. Please go ahead.

Phần hỏi đáp

Daniel Ferry

Good morning, and welcome to the CorMedix Second Quarter 2026 Earnings and Corporate Update Conference Call. Leading the call today is Joseph Todisco, Chairman and Chief Executive Officer of CorMedix. We're joined by Elizabeth Masson-Hurlburt, EVP and Chief Operating and Commercial Officer, and Susan Blum, EVP and Chief Financial Officer. In addition, Beth Zelnick Kaufman, EVP and Chief Legal and Compliance Officer and Corporate Secretary, and Dr. Matt David, EVP and Chief Business Officer, are on the line and will be available during the Q&A session.

Before we begin, I would like to remind everyone that during the call, management may make what are known as forward-looking statements within the meaning set forth in the Private Securities Litigation Reform Act of 1995. These statements are statements other than statements of historical fact regarding management's expectations, beliefs, goals, and plans, about the company's prospects and future financial position.

Actual results may differ materially from the estimates and projections on which these statements are based due to a variety of important factors, including the risks and uncertainties described in greater detail in CorMedix filings with the SEC, which are available free of charge at the SEC's website or upon request from CorMedix. CorMedix may not actually achieve the goals or plans described in these forward-looking statements. An investor should not place undue reliance on these statements. CorMedix does not intend to update these forward-looking statements, except as required by law.

During this call, the company will discuss certain non-GAAP [indiscernible] on Form 8-K, filed with the SEC. This information is also available on the Investor Relations section of CorMedix's website. At this time, it is now my pleasure to turn the call over to Joseph Todisco, Chairman and Chief Executive Officer of CorMedix. Joe, please go ahead.

Joseph Todisco

Thank you, Dan. Navigate the evolving post-TDAPA landscape, meaningfully advancing our high-value pipeline, highlighted by the positive Phase 3 ReSPECT data for Rezzayo, and now working collaboratively with Mundipharma towards their submission of the sNDA for Rezzayo in the prophylaxis of invasive fungal disease. And lastly, deploying our capital in a disciplined manner to drive long-term value for shareholders while building an increasingly diversified and resilient business.

We announced this morning second quarter consolidated revenue of $101.9 million and adjusted EBITDA of $58.7 million. Susan will provide more granular details of second quarter financial results. Today we also announced that we've signed a multi-year commercial supply agreement for DefenCath with an additional large dialysis organization, or LDO. With this agreement, CorMedix now has commercial supply agreements in place with all 5 of the top dialysis providers in the U.S.

The newly signed LDO has placed an initial order and will initially begin a pilot of DefenCath in the third quarter of this year with a potential opportunity to expand utilization in 2027. We view the signing of this agreement as an important milestone and validation of DefenCath's clinical value proposition with the largest providers in the U.S. dialysis market.

Turning to guidance, we are reaffirming our full-year 2026 revenue guidance with a range of $325 million to $345 million, and raising our full-year adjusted EBITDA guidance to a new range of $125 million to $140 million. We will revisit guidance as the year progresses and as we gain additional visibility into post-TDAPA ordering patterns. While we're only a few weeks into the third quarter, DefenCath order volumes in July have tracked consistent with the post-TDAPA forecast underlying our financial guidance.

In addition to the new LDO agreement, we have signed contract amendments with our major customers covering third and fourth quarter 2026 pricing and in some instances pricing and volume commitments for 2027. These amendments give us improved visibility into pricing and utilization through year-end and are designed to keep patients on therapy through the reimbursement transition. We continue to focus significant internal resources on the DefenCath growth strategy through Medicare Advantage contracting, and I'm pleased with the progress of those discussions. Contracting cycles with these plans can be lengthy, and we have not assumed a contribution for Medicare Advantage in our 2026 guidance. Continually, Medicare Advantage represents a meaningful long-term growth avenue for DefenCath.

DefenCath's clinical value and its potential for meaningful downstream cost savings continue to be supported by a growing body of real-world evidence that our partners are publishing, and we anticipate additional data presentations this fall at the American Society of Nephrology's Kidney Week and at IDWeek.

Turning to our pipeline, we now have top-line results from the ReSPECT study, a Phase 3 clinical study evaluating Rezzayo for the prophylaxis of invasive fungal disease in adult immunosuppressed patients, or IFD. Assuming timely submission and FDA acceptance of the filing, we would anticipate agency action in the first half of the year, including the anticipated addition of 15 to 20 positions across both commercial and medical. These investments are sized to allow us to move quickly at approval while preserving flexibility if regulatory timelines shift and are already reflected in our narrowed full-year cash OPEX guidance of $145 million to $155 million. As a reminder, our cash OPEX guidance excludes non-cash charges such as stock-based compensation.

I would now like to turn the call over to our Chief Operating and Commercial Officer, Elizabeth Masson-Hurlburt, to provide an update on clinical activities. Liz, please go ahead.

Elizabeth Masson-Hurlburt

Thank you, Joe, and good morning, everyone. As Joe mentioned, we were pleased to announce preliminary top-line results of the ReSPECT study at the end of April, and following a constructive pre-NDA meeting with the FDA, are working diligently with our partner, Mundipharma, in support of their submission of the sNDA for Rezzayo in prophylaxis in the third quarter.

As a reminder, the ReSPECT study met its primary endpoint for FDA of fungal-free survival at day 90, showing non-inferiority versus the standard antifungal regimen, or SAR, meeting the pre-specified non-inferiority margin. In addition, results showed a favorable profile across multiple secondary endpoints, most notably in treatment-emergent adverse events leading to dose reduction, interruption or withdrawal of study drugs, and study discontinuation.

As we stated previously, the objective with the ReSPECT study was to show comparable efficacy to standard of care while also demonstrating a favorable overall safety profile with regard to drug-drug interactions and toxicity. We believe the study has achieved this objective and that the results position Rezzayo, if approved, as a differentiated option for prophylaxis of IFD with a meaningful potential commercial opportunity. It's important to remember that this was a global study conducted by our partner, Mundipharma, who owns global IP rights and will pursue regulatory approvals outside of the United States.

Mundipharma is currently the holder of the U.S. NDA and under the terms of our agreement, transfers ownership of the NDA to CorMedix following approval of an sNDA for the prophylaxis indication, at which point CorMedix would own and control the U.S. assets. Under our agreement, the parties must work together on the publication of data and submissions to FDA. In terms of data publication, we currently expect additional data from the Phase 3 ReSPECT study to be published later this year at 1 or more medical conferences during the fourth quarter.

Turning to DefenCath, we also expect additional real-world evidence to be published in the fourth quarter, with multiple abstracts having been submitted to both ASN and IDWeek. Assuming acceptance, these publications will present the final results from the U.S. Renal Care real-world evidence study, which, at interim analysis, showed a meaningful impact on infection-related hospitalizations and catheter-related bloodstream infections, as well as 2 other external studies. The first will highlight the demonstrated efficacy of DefenCath when used in combination with chlorhexidine antimicrobial caps. The second is expected to highlight the clinical and economic benefits of DefenCath in the outpatient hemodialysis setting related to a meaningful reduction in tPA use by facilities.

All combined, we expect that these data will add to the growing body of evidence supporting the clinical and pharmacoeconomic value of DefenCath. Shifting gears to our Phase 3 TPN study, we recently submitted a protocol amendment to FDA that narrows certain exclusion criteria, which we believe can support increased enrollment in the coming months. And we have additionally activated additional sites. We will continue to update investors on our progress as we move through the year, and we continue to expect study completion in 2028. I would now like to turn the call over to Susan to discuss the company's second quarter financial results and financial position. Susan? Thank you.

Susan Blum

Thank you, Liz, and good morning, everyone. We are pleased to announce our second quarter results which reflect strong execution across the business, continued demand for DefenCath, and the contribution from the acquired Melinta portfolio. As a reminder, because the Melinta acquisition closed in August 2025, the second quarter of 2026 is a full quarter of Melinta operations, while the second quarter of 2025 did not. Accordingly, year-over-year comparisons are heavily influenced by the broader product portfolio and cost structure of the combined company. We also filed our Form 10-Q this morning, and I encourage investors to review it for additional details and important disclosures.

Turning to the numbers, second quarter 2026 consolidated revenue was $101.9 million, compared with $39.7 million in the second quarter of 2025. Second quarter revenue included $66.1 million in sales of DefenCath and $35.8 million in revenue associated with the acquired Melinta portfolio. DefenCath sales increased year-over-year largely due to the onboarding of a large dialysis customer in mid-2025. Operating expenses were $34.2 million in the quarter, compared with $18.3 million in the second quarter of 2025, an increase of approximately 87%.

The increase of $15.9 million over the prior year period was driven primarily by the contribution of operating expenses from the Melinta acquisition for the full quarter and reflects the larger combined company. Research and development expenses were $6.7 million in the second quarter of 2026, compared with $2.4 million for the same period in 2025. The increase was due primarily to higher personnel and clinical trial services in support of ongoing clinical programs, including pediatric studies for several [indiscernible] and continued investments in the development of DefenCath for the TPN indications.

Sales and marketing expense increased approximately 95% to $12.4 million in the second quarter of 2026 from $6.4 million in the second quarter of 2025. The increase was due primarily to higher personnel costs associated with a larger product portfolio and related marketing programs. General and administrative expenses increased approximately 59% to $15.1 million in the second quarter of 2026 from $9.5 million in the second quarter of 2025. The increase was driven by higher costs associated with operating as a combined company following [indiscernible], including branded prescription drug fees and higher personnel, information technology, legal, and facilities costs. G&A expenses in the quarter also reflects a reduction to expense of $4.2 million, which represents the amount of expected insurance reimbursement of legal fees incurred by the company to support its ongoing securities litigation.

Of the $4.2 million credit reported in the second quarter, $2.7 million is the amount of credit that the company has incurred related to legal fees that were incurred in prior periods. On the bottom line, CorMedix recorded net income of $26.0 million, or $0.33 and $0.29 per basic and diluted share, respectively, in the second quarter of 2026, compared with net income of $19.8 million, or $0.29 and $0.28 per basic and diluted share, respectively, in the second quarter of 2025. In addition to net revenue and operating expenses, EPS was impacted by income tax expense of $12.7 million, as well as non-operating income and expenses net of approximately $4.2 million associated with the mark-to-market of marketable equity securities and contingent consideration, which reflects the approximate fair value of future milestone and royalties payable to former Melinta shareholders.

On a non-GAAP basis, adjusted EBITDA was $58.7 million for the second quarter of 2026, compared with adjusted EBITDA of $22.4 million in the second quarter of 2025. This adjusted EBITDA metric excludes non-cash items such as depreciation, amortization, and non-GAAP. We ended the second quarter with $256.7 million in cash and cash equivalents for this quarter.

For the first 6 months of 2026, net cash provided by operating activities was $128.6 million, compared with $49.7 million for the first 6 months of 2025. As Joe mentioned, we are confident in our fiscal year 2026 financial guidance, which includes full-year 2026 consolidated revenue of $325 million to $345 million, full-year DefenCath revenue guidance of $175 million to $195 million, and revised full-year adjusted EBITDA guidance of $125 million to $140 million. We continue to believe we are well positioned with a strong balance sheet, meaningful cash generation, and the financial flexibility to support our operating priorities, pipeline development, and shareholder value.

Joseph Todisco

We have a lot of opportunity ahead of us. CorMedix has built meaningful momentum through the first half of 2026 across all 3 pillars of our investment thesis. First, DefenCath continues to perform in line with our internal expectations at the TDAPA expiration, demonstrating durable underlying utilization, which we believe positions the franchise to remain a meaningful value generator following the reimbursement transition. Second, we're advancing a pipeline of high-value late-stage opportunities, including Rezzayo for prophylaxis and DefenCath in TPN, which could meaningfully expand our long-term revenue opportunity.

And third, we have delivered significant profitability in cash generation over the last year. $277.8 million of adjusted EBITDA over the trailing 12 months, and $267 million of combined cash and investments at quarter end allows us to reinvest in growth and pursue business development opportunities. We remain confident in our outlook for this year and our past sustained growth and profitability beyond it. This concludes our prepared remarks, and I'll ask the operator to open up now for questions.

We will now begin the question and answer session.

Operator

[Operator Instructions] Our first question comes from Roanna Ruiz with Leerink. Please go ahead.

Roanna Ruiz

Hi, guys. This is Anna on for Roanna. Thanks so much for taking our question and congrats on the progress. I just wanted to check in on how the new multi-year agreement with the LDO is expected to impact your 2027 expectations and if you could give any color on how long it takes for a new site to reach this steady state production in line with other operators.

Joseph Todisco

Okay, thanks, Anna. So we just recently signed that agreement and they're rolling out a pilot. We're waiting to see kind of actually what they're looking for and we're hopeful for additional utilization. So once we get better visibility, we'll be in a position probably to talk more about 2027. There's a lot of variables that go into 2027 guidance. I don't expect we'll be in a position to comment on it until either late this year or early next year. So there's just a lot of pushes and pulls. We don't have any cause now to either adjust the top or bottom of that guidance, but as we move through the year and we get better visibility, we can provide updates.

Roanna Ruiz

Sure, thanks. And is any of that LDO pilot included in the 2026 guidance?

Joseph Todisco

No, no, right now it's, well obviously it's tracking the revenue, so it's within the revenue that we're seeing from the pilot is within our existing guidance. And for DefenCath, we are right now tracking to the kind of mid-top part of the DefenCath guidance. So let's see where we go through the year. And as I said, we'll update as we go.

Operator

Great. Thanks so much. Our next question comes from Leonid Timoshev with RBC Capital Markets. Please go ahead.

Leonid Timoshev

Hey, guys. Thanks for taking my question. I want to ask on maybe if you can comment on what you're seeing in terms of volume growth in the existing channels thus far in this quarter, just given that we're in the post-TDAPA period now. And then related to that, just as a follow-up, how are you thinking about how you're going to be able to do that?

Joseph Todisco

So, look, in terms of volume growth, I think what we're seeing in July is really kind of stabilized volumes with the larger players, which is what we expected, and some attrition with the really small players, which is also what we expected, with some adoption and or Medicare Advantage contracting. I think we're cautiously optimistic we're making good progress. That, you know, perhaps we have something in place that takes effect early next year and starts to really impact the DefenCath volumes. Those are really the 2 levers that I see, you know, from the DefenCath standpoint. Now, the final ESRD rule, obviously they put out the proposed rule. It was a little bit different than what we were expecting in terms of the quarterly mechanism. I expect there's going to be a lot of comment on that. Not sure if that's actually what will make it into the final rule, but we'll expect the final rule.

Operator

Our next question comes from Jason Butler with Citizens JMP. Please go ahead.

Jason Butler

Hi, thanks for taking the questions. First one, can you give any more color on the size or scope of the pilot study being conducted by the new LDO? And then for Rezzayo and profi, can you talk about, you know, since you had the Phase 3 results, the feedback you're getting from potential prescribers, just what the results are? Perception to that data has been as you think about a potential label expansion. Thank you.

Joseph Todisco

Yes, look, right now the size and scope of the pilot, we've shifted initial order. We think it's a couple hundred clinics. We'll see where we can go from there. I don't want to get out over my skis on the pilot yet, Jason. So right now we're really happy to have finally gotten that LDO kind of over the hump and to the point of commercialization. So we're taking that 1 day by day. On the Rezzayo profi, the full data set is not yet out, so we really haven't been able to conduct a robust market research. As we said in the script, we are working with our partner, Mundipharma. We would expect it to be published later in the fourth quarter at 1 or more medical conferences. And once we have that data...

Operator

Great, thank you. Our next question comes from Serge Belanger with Needham & Company. Please go ahead. Thank you.

Serge Belanger

Hi, good morning. Thanks for taking the question. I guess first on the new LDO, first, congratulations. It's just a pilot program. I guess my question is why did the LDO decide to enter an agreement now? Now when the product has been available for 2 years and I know the company had some meaningful efforts to sign them up. Secondly, on Rezzayo, following your FDA meeting, just curious what your expectations are for potential labeling of the product. I believe a Phase 3 trial was conducted in allogeneic HSCT patients. Curious if you'll be able to address the broad patient population that could benefit from Rezzayo. Thanks.

Joseph Todisco

Thanks, Serge. Look, on the new LDO, I really can't speak to the motivations of the company. Obviously, we have built a wealth of real-world evidence around the clinical efficacy and the pharmacoeconomic benefits of DefenCath, and as I said, we're happy that now they are choosing to begin implementation of DefenCath. On Rezzayo, look, it's going to be a label review issue. So until we work through this process, just coming out of the pre-NDA meeting, we don't have yet visibility of what the final label will be.

Operator

Our next question comes from Brandon Folkes with H.C. Wainwright. Please go ahead.

Brandon Folkes

Hi, thanks for taking my question and congrats on the progress. Maybe just 1 from me. Can you just talk about the SG&A in the quarter and the updated guidance? Did you take any actions in the quarter, you know, whether it's especially on the sales and marketing infrastructure, right, just on DefenCath or the existing Melinta portfolio, just any color there on the expense discipline on the SG&A line. Thank you.

Joseph Todisco

Thanks, Brandon. I'll let Susan comment. We didn't take any deliberate actions. We're obviously trending a little bit light on the expense side. Some of the staffing, some of that we're bringing on or is coming in later in the year. But, yes.

Susan Blum

Also, we did, and we disclosed this in our Form 10-Q, we had a reduction of G&A for $4.2 million in the quarter. It's reflecting artificially low because of that. $2.7 million of that was incurred primarily in Q1 of 2026. So we added the deductible under our insurance policies for the litigation costs. So we were able to claim the reimbursement of those, and that's what we reported in the second quarter. So it essentially eliminated those litigation legal fees that we had incurred in Q1 and in Q2 during the second quarter. So if you think about the run rate for expenses it would be maybe it would be $2.7 million higher because of what we reversed from prior periods.

Brandon Folkes

That makes sense. It does. And then just to confirm, so, you know, there's been no action from the Department of Health on the DefenCath sales and marketing infrastructure ahead of sort of the lower re-embedding period? No, there have been no actions taken in the company. Perfect. Thank you very much and congrats on the progress. Thank you.

Operator

This concludes our question and answer session. Thank you for attending today's presentation. You may now disconnect.