Xeris Biopharma (XERS) 2026年第三季度业绩电话会:上调营收指引
Xeris Biopharma公布2026年第三季度总营收为1.072亿美元,同比增长44%。Recorlev净营收达7150万美元,同比增长93%,为主要增长引擎。调整后EBITDA增长77%至3080万美元,净利润1130万美元。管理层将2026年全年总营收指引上调至3.95亿至4.05亿美元,并将2030年总营收展望上调至逾10亿美元。XP-8121计划于2026年年底前启动III期Cornerstone研究,顶线数据预计于2028年年底公布,有望于2030年获批。
核心要点
- Xeris Biopharma (XERS) 公布2026年第三季度总营收为1.072亿美元,同比增长44%,环比增长16%。
- 在创纪录的转诊量、新患者启动治疗以及商业化团队扩张带来生产力提升的推动下,Recorlev净营收同比增长93%至7150万美元。
- 调整后EBITDA增长77%至3080万美元;净利润达到1130万美元,上年同期为60万美元。
- 管理层将2026年全年总营收指引上调至3.95亿至4.05亿美元,按中值计算同比增长约37%。
- 公司将2030年总营收展望从7.5亿美元上调至逾10亿美元,预计三大商业化品牌均将做出贡献,且Recorlev仍将是主要增长引擎。
- Xeris仍按计划推进于2026年年底前启动XP-8121的关键性III期Cornerstone研究,顶线数据预计将于2028年年底出炉,并有望于2030年获批上市。
核心财务业绩
| 指标 | 2026年第三季度 | 变动 / 对比 | 评述 |
|---|---|---|---|
| 总营收 | 1.072亿美元 | 同比+44%;环比+16% | 创季度营收历史新高 |
| 产品净营收 | 1.063亿美元 | 同比+43% | 增加3220万美元 |
| Recorlev净营收 | 7150万美元 | 同比+93%;环比+26% | 商业化团队扩张带动转诊量和新患者启动用药 |
| Gvoke净营收 | 2170万美元 | 低于上年同期的2520万美元 | 包含医疗补助计划(Medicaid)400万美元的一次性毛额至净额调整 |
| Keveyis净营收 | 1300万美元 | 同比+9% | 连续第四个季度实现同比增长 |
| 毛利率 | 88% | 上年同期为85% | 产品结构优化推动毛利率改善 |
| 研发费用 | 1110万美元 | 同比增加360万美元 | 反映了对XP-8121的研发投入 |
| 销售、一般及行政费用(SG&A) | 6410万美元 | 同比增加1760万美元 | 主要受商业化人员成本增加推动 |
| 调整后EBITDA | 3080万美元 | 同比+77% | 增加1330万美元 |
| 净利润 | 1130万美元 | 上年同期为60万美元 | 盈利能力提升 |
业务与运营表现
Recorlev
Recorlev仍是Xeris最大的增长引擎。净营收同比增长3460万美元至7150万美元。管理层将这一加速增长归因于1月份启动的商业化扩张,增长动力来自于现有及新增处方医生。
公司还指出高皮质醇血症筛查量的增加。美国糖尿病协会(ADA)和欧洲糖尿病研究协会(EASD)更新的指南中,包含了对难治性2型糖尿病进行额外筛查的建议。管理层预计这些市场动向将支持Recorlev在2027年及以后的增长。
Gvoke
Gvoke处方量环比第二季度增长20%,同比增长5%,反映出开学季需求的增强。然而,受医疗补助计划(Medicaid)渠道400万美元一次性毛额至净额调整的影响,季度净营收降至2170万美元。
管理层表示,基础需求已延续至第四季度,预计Gvoke将恢复销量和营收的稳步增长。公司重点提到了一个巨大的处方缺口:约1500万糖尿病患者应当使用即用型胰高血糖素产品,而目前仅有约100万人使用。
Keveyis
Keveyis实现净营收1300万美元,同比增长9%。新增加的商业化资源在本次财报电话会议前几周才完成培训,因此管理层预计其贡献将主要在第四季度和2027年显现。
美国专利商标局于10月13日授予了一项新的Keveyis专利,提供至少延续至2043年的保护期。Xeris计划加大投资,以识别和支持原发性周期性麻痹(PPP)患者。
XP-8121研发管线
Xeris计划在2026年年底前启动关键性III期Cornerstone研究。顶线数据预计将于2028年年底公布,随后有望于2030年获批上市。更广泛的开发计划还包括儿科Capstone研究,以及针对口服治疗控制不佳患者的Touchstone研究。
涵盖XP-8121的第三项美国专利于10月6日获得授权,将专利保护期延长至2043年10月。管理层预计其销售峰值潜力为10亿至30亿美元,同时强调这仍是一项长期商业机遇。
管理层业绩指引
Xeris将2026年全年总营收指引上调至3.95亿至4.05亿美元。按中值计算,同比增长约37%。毛利率指引保持不变,管理层仍预计将较2025年有所提升。
目前预计2026年全年研发费用将较2025年增加约1500万美元,低于此前预期的增加2500万美元。该项修正反映了XP-8121部分费用的发生时间调整,而非开发计划发生变动。
销售、一般及行政费用(SG&A)预计将较2025年增加约6000万美元,而此前预期为增加5000万美元。管理层将这一增长归因于人员成本以及对近期产品组合增长机会的投资。
对于2030年,管理层目前预计总营收将超过10亿美元,高于此前7.5亿美元的展望。公司表示,Recorlev年净营收也有望比此前预测提前三至四年达到10亿美元。
风险与关注要点
- Recorlev的用药准入仍需要事先授权和医疗必要性证明文件。管理层预计这一准入状况短期内不会改变。
- 尽管处方需求增加,但受医疗补助计划(Medicaid)400万美元一次性毛额至净额调整的影响,Gvoke第三季度公布的营收仍受到波及。
- XP-8121研发支出的时间点发生后移,导致2026年预期研发增长缩减。该关键性研究尚未启动,不过管理层预计将在年底前启动。
- 实现上调后的2030年展望取决于Recorlev、Gvoke和Keveyis的持续贡献,其中Recorlev预计仍将是核心增长驱动力。
分析师问答要点
分析师主要聚焦于Recorlev的加速增长以及上调2030年展望背后的假设前提。管理层表示,Recorlev的增长广泛来自于新医生和重复开具处方的医生,并得到了高皮质醇血症筛查量增加的支撑。
在专利保护方面,管理层称XP-8121拥有的三项美国专利(包括物质组成专利保护)构成了坚实基础。新获授权的Keveyis专利也让Xeris更有信心在更长时期内投资原发性周期性麻痹(PPP)市场。
在资本配置方面,管理层优先考虑对现有商业化产品和XP-8121的进一步投入。若有富余资金,Xeris可能会考虑契合其商业化布局、并有望在2030年前增加营收的业务拓展(BD)机会。
管理层还表示,未来对Recorlev的投入将包括循证医学证据生成,特别是在筛查范围从内分泌科医生扩大至治疗难治性心血管代谢疾病、糖尿病和肥胖症的基层医疗机构之际。
财报电话会议完整实录
完整财报电话会议逐字稿
管理层陈述
Operator
Hello, everyone. Thank you for joining us, and welcome to Xeris Biopharma Third Quarter 2026 Earnings Conference Call. [Operator Instructions]
I will now hand the conference over to Cristi Barnett, Vice President of Investor Relations. Please go ahead.
Cristi Barnett
Thank you, Bella. Good morning, everyone, and welcome to Xeris Biopharma's Third Quarter 2026 Financial Results Conference Call. Earlier this morning, we issued a press release detailing our third quarter 2026 financial and operating results. This press release can be found on our website at xerispharma.com. Joining me on today's call are John Shannon, our Chairman and Chief Executive Officer; and Steve Pieper, our Chief Financial Officer. Following our prepared remarks, we will open the call for your questions.
Before we begin, I'd like to remind you that today's discussion will include forward-looking statements regarding Xeris' future expectations, plans, strategies, objectives and financial performance, including our full year 2026 financial guidance and our 2030 outlook. These forward-looking statements are based on management's current assumptions and beliefs and are subject to a number of risks and uncertainties that could cause actual results to differ materially from those expressed or implied. For a discussion of these risks and uncertainties, please refer to the risk factors described in our filings with the SEC, including our most recent annual report on Form 10-K and our subsequent filings with the SEC as well as the forward-looking statements disclaimer in our earnings release. Any forward-looking statements made on this call speak only as of today's date. And except as required by law, the company undertakes no obligation to update or revise these statements.
In addition, during today's call, we will reference certain financial measures that are presented on a non-GAAP basis. A reconciliation of these non-GAAP measures to the most directly comparable GAAP measures is included in our earnings release.
Before I turn it over to John, I'd like to briefly introduce myself. I'm Cristi Barnett, and I recently joined Xeris to lead Investor Relations following Allison Wey's retirement. Some of you may know me from my previous companies. And for those who I haven't yet met, I look forward to connecting and working with you. We will miss Allison here at Xeris, and I'm pleased to carry the Investor Relations baton forward. I look forward to an open dialogue and to keeping you informed about Xeris' progress.
And with that, I'll turn it over to John.
John Shannon
Thank you, Cristi, and welcome to Xeris. We're happy to have you on the team, and good morning, everyone. I'm pleased to report that Xeris had a spectacular third quarter, and we now see our company on a new growth curve, one that is both accelerating our near-term financial outlook and redefining what we believe is possible for this company. Importantly, this new trajectory reflects expected growth from the entire enterprise, Recorlev, Gvoke and Keveyis.
Total revenue grew more than 44% year-over-year, led by Recorlev, where the expanded commercial team moved from build to yield and delivered record referrals and new patient starts. Gvoke delivered a better-than-expected back-to-school prescription lift and prescription demand is back in solid growth mode. And Keveyis continued its steady high-value contribution. And now with the recently issued patent, we intend to intensify our efforts to identify more patients that could benefit from therapy.
Results like these reflect years of disciplined execution and focused innovation, and they reflect who Xeris has become, a leading endocrine and rare disease biopharmaceutical company committed to helping people realize better lives through the development and commercialization of innovative medicines. We convert innovation into durable revenue growth that continues to compound. This is our model, and this quarter is further evidence it is working.
Given the strong momentum across Recorlev, Gvoke and Keveyis, we are raising our full year total revenue guidance to $395 million to $405 million, and we see this new trajectory extending well beyond 2026. We are now on a path to reach more than $1 billion in total revenue in 2030, up from our prior outlook of $750 million, which we first disclosed back in June of 2025.
We also now see Recorlev on a path to $1 billion in annual net revenue 3 to 4 years sooner than we previously projected. These are meaningful increases to our expectations grounded in the progress we are making right now. We are building on a stronger foundation and creating a larger opportunity than we previously envisioned. And beyond 2030, we see significant incremental opportunity with our late-stage pipeline asset, XP-8121.
With that, let's turn to our brands, beginning with Recorlev. Recorlev continues to demonstrate exceptional momentum. And in the third quarter, it shifted into a higher gear. Net revenue increased to more than $71 million, an increase of 93% or $35 million year-over-year. Quarter after quarter, Recorlev has delivered exceptional growth that speaks to the execution by our commercial team and most importantly, the deepening confidence prescribers have in Recorlev as their treatment of choice for endogenous Cushing's syndrome.
We believe Recorlev should be the standard of care, and we intend to drive it there. On our last call, we said the benefits of our January commercial expansion would begin to show up in the third quarter, and they have. Our expanded team is trained, deployed and productive. We had a record number of new referrals, new patient starts in the quarter. The team's productivity is now running ahead of our expectations and is the key driver behind the upward revision of our 2026 and our 2030 outlook.
Also, favorable dynamics should continue to fuel an expansion of the hypercortisolism market. Just last month, the American Diabetes Association and the European Association for the Study of Diabetes issued updated guidance on the role of hypercortisolism in difficult-to-control type 2 diabetes and included recommendations for additional screening. Recorlev's growth continues to benefit from expanded screening that is helping clinicians to identify more patients.
Our Medical Affairs team recently convened our fourth Annual Cortisol Summit Scientific Advisory Board, bringing together leading pituitary and adrenal experts to advance research priorities and clinical management of Cushing's syndrome. And at the Cardiometabolic Health Congress, we presented real-world evidence illustrating the systemic benefits of cortisol normalization in a patient with uncontrolled type 2 diabetes, hypertension and multiple other comorbidities, further underscoring the significant and growing opportunity ahead for Recorlev.
Now turning to Gvoke. Gvoke delivered better-than-expected back-to-school prescription growth in the third quarter, with total prescriptions growing 20% over Q2 and 5% year-over-year. We continue to build the evidence base for ready-to-use glucagon. At the recent Breakthrough T1D Clinical & Research Congress, we presented real-world data on the gap between health care provider awareness of prescribing guidelines for ready-to-use glucagon and actual prescribing practices. That gap is precisely the opportunity in front of us. Of the roughly 15 million people with diabetes who should have a potentially life-saving product like Gvoke, only about 1 million do. Closing that gap remains an important opportunity for us and a meaningful way to improve patient lives.
I'm extremely proud of the team's work here. We began to see Gvoke demand generation build in the second quarter, accelerate in Q3 and carry right into Q4. Our prescription growth reflects improving underlying demand, giving us confidence that Gvoke is on a sustainable growth trajectory. And despite a one-time gross-to-net adjustment in the period, which Steve will walk through shortly, we are confident that Gvoke is now back to contributing steady unit and dollar growth in the future.
And finally, Keveyis. Keveyis delivered more than $13 million in net revenue, demonstrating the brand's continued strength as a meaningful growth contributor to our business going forward. Maintaining patients on therapy remains the ultimate proof point, and our results continue to reflect both the clinical value of Keveyis and the patient-centric support infrastructure we have built for the PPP community. And last month, our steadfast multiyear effort to secure important IP protection for Keveyis was realized. On October 13, the U.S. Patent Office issued a new patent covering Keveyis with protection through at least 2043. With this patent now issued and having demonstrated such remarkable durability, we are investing incrementally in Keveyis and the PPP community to identify and support even more patients.
Turning to our pipeline, specifically our late-stage XP-8121 program. In September, we hosted our XP-8121 program overview, providing a detailed look at our comprehensive clinical development strategy, including Cornerstone, our pivotal Phase III study designed for regulatory approval; Capstone, our pediatric study; and Touchstone, our study in patients with inconsistent control despite oral therapy. We remain on track to initiate Cornerstone by year-end with top line data expected in late 2028 and potential approval and launch in 2030. Since our September update, we have continued to advance all work required to initiate our Cornerstone Phase III study. We are especially encouraged by our start-up study activities and the enthusiasm of sites to participate in Cornerstone.
In parallel, our real-world evidence program continues to advance. This week, at the American Thyroid Association Annual Meeting in Philadelphia, we are presenting real-world evidence on biochemical control among patients treated with oral levothyroxine. These efforts are helping us deepen our understanding of the treatment challenges in hypothyroidism and further inform the opportunity for XP-8121.
We also continue to strengthen the intellectual property supporting XP-8121. On October 6, we were granted our third U.S. patent covering the program, reinforcing XP-8121's patent protection, which extends to October 2043. This patent represents another important milestone in building the long-term foundation for XP-8121. We believe XP-8121 has the potential to address persistent challenges faced by patients and health care providers in managing hypothyroidism. With peak sales potential of $1 billion to $3 billion, XP-8121 represents a significant long-term commercial opportunity and has the potential to become foundational to Xeris' future growth and long-term value creation.
Before I turn the call over to Steve, let me briefly recap the progress we are making against the 3 critical priorities we outlined in March and remain focused on. First, driving rapid revenue growth. Through the first 9 months of the year, total revenue grew 37% year-over-year. Based on that performance, we now expect full year revenue of $395 million to $405 million or growth of 37% at the midpoint. Second, advancing our pipeline. We laid out a comprehensive XP-8121 development program in September and remain on track to initiate our pivotal Phase III Cornerstone study by year-end. We also secured a third U.S. patent. And third, executing with discipline. Adjusted EBITDA grew 77% year-over-year, even as we continue to make strategic investments for growth.
Our record commercial momentum and disciplined execution against our strategic priorities positions us well for the future, and I am incredibly proud of the company we have built and confident in our ability to deliver long-term value for shareholders through the 2030s and beyond.
And with that, I'll turn the call over to Steve.
Steven Pieper
Thanks, John. Good morning, everyone. Before I begin, I would also like to welcome Cristi to the Xeris team. It's great to have you with us. As John highlighted, the third quarter delivered what we said it would. Our investments converting into growth with record revenue and continued adjusted EBITDA expansion.
Total revenue for the third quarter was $107.2 million, up 44% year-over-year and 16% sequentially. Net product revenue was $106.3 million, up 43% or $32.2 million year-over-year. Recorlev generated net revenue of $71.5 million, representing growth of 93% or $34.6 million year-over-year. On a sequential basis, net revenue increased $14.8 million or 26%. As John described, our expanded commercial team has moved from build to yield, and we expect continued contribution from that expansion in Q4 and beyond.
Gvoke generated net revenue of $21.7 million in the third quarter compared to $25.2 million in the third quarter of 2025. Gvoke prescription demand grew 5% year-over-year. This growth was offset by a $4 million one-time gross to net adjustment in our Medicaid channel. We believe Gvoke's return to growth in the third quarter is the beginning of a new growth trajectory.
Keveyis delivered another great quarter, generating net revenue of $13 million, representing growth of 9% compared to the prior year. This performance represents the fourth quarter in a row of year-over-year growth, fueling our confidence that Keveyis can contribute to our growth expectations longer term. Gross margin for the third quarter was 88% compared to 85% in the prior year period, and this improvement was driven by continued favorable product mix.
Turning to operating expenses. R&D expenses totaled $11.1 million in the third quarter, an increase of $3.6 million compared to prior year. This increase reflects continued investment in XP-8121 as we prepare to initiate the Cornerstone study by year-end. SG&A expenses were $64.1 million, an increase of $17.6 million versus the prior year. This increase is primarily due to higher personnel-related expenses for the commercial enterprise. Adjusted EBITDA for the third quarter was $30.8 million, an improvement of $13.3 million or 77% versus the prior year. It is also worth noting that in the third quarter, we delivered net income of $11.3 million compared to $0.6 million in the same period last year.
Moving to our full year 2026 outlook, starting with revenue. With this quarter's record performance, we are raising our full year total revenue guidance to $395 million to $405 million, representing approximately 37% growth at the midpoint. Our gross margin guidance remains unchanged as we expect continued improvement versus prior year.
Moving to expenses. R&D expenses are now expected to increase approximately $15 million compared to 2025, which is lower than our prior expectation of a $25 million increase. This reduction is mainly due to the expected timing of when certain expenses related to the XP-8121 program will be incurred. SG&A is now expected to increase approximately $60 million compared to 2025, up from our prior expectation of $50 million. This reflects increases in personnel-related expenses as well as deliberate investments across areas of our portfolio where we see compelling near-term growth opportunities.
On adjusted EBITDA, through the first 3 quarters of 2026, we have nearly doubled year-over-year, growing from $34 million to $65 million, and we expect continued adjusted EBITDA growth through the remainder of the year. Beyond 2026, as John shared earlier, we are now on a new path to generating more than $1 billion in total revenue in 2030 compared to our previous outlook of $750 million. Our portfolio is delivering, and we are on a new growth trajectory that should extend into 2030 and beyond.
With that, I'll hand the call over to the operator for Q&A. Thank you.
Operator
[Operator Instructions] Your first question comes from the line of Chase Knickerbocker with Craig-Hallum.
Roanna Ruiz with Leerink Partners, please go ahead.
分析师问答
Roanna Clarissa Ruiz
So Recorlev had a strong quarter. And can you talk about the relative magnitude of different drivers behind that, talking about the new and repeat prescribers and the field force, et cetera? And could you help us also understand if this growth in the product could potentially be a good tailwind into 2027, maybe mitigate some of the payer dynamics that we typically see in the early part of the year?
John Shannon
Thanks, Roanna. Yes, it's basically kind of our January expansion really kicking into gear on top of some really outstanding market dynamics where more and more patients are being tested, screened for hypercortisolism, and we're in a perfect position to capture those patients with Recorlev. We are getting business from existing prescribers and new prescribers. It's coming across the board. So it's both depth and breadth of prescribers. And yes, we see this momentum going into '27 and beyond.
Roanna Clarissa Ruiz
Great. And as a quick follow-up, so I noticed you announced some new IP for 8121 and Keveyis in particular. Can you talk about the relative strength of these patents? And is this helping to build your conviction in the long term and part of your longer-term guidance raise?
John Shannon
Well, 8121 is building on -- we now have 3 patents on that product that go as far as composition of matter. So that's extremely strong. Keveyis is one that we've been fighting for, I think, 9 years to get that patent. We think it's a very important patent. We think it's a very strong patent. And it really gives us what we need to really focus on finding more patients and investing in this community in a way that we can do that for a long time. And so we are now in a perfect position to be able to do that. We've had 4 quarters of growth on Keveyis now, and we're adding investments there so that we continue to build on finding more PPP patients and getting them on brand.
Operator
Your next question comes from the line of David Amsellem with Piper Sandler.
David Amsellem
I had a couple of Recorlev questions. I wanted to dive more into how you think you're going to be able to leverage the recent ADA and European updated guidance document? And do you think that could be a source of acceleration in volume and sales as we move through next year? So that's number one. And then can you just give us an update on how access is, how access dynamics are for Recorlev? And as the footprint of the product grows, do you expect any access dynamics to become more challenging or evolve in any way?
John Shannon
Yes. Let me start with the guidance. And guidance just adds to kind of what's been going on in the space where more and more clinicians are screening and diagnosing more patients with hypercortisolemia where drugs and should be working and are not working. So this is just adding to that body of evidence and creating an environment where more and more clinicians are screening and detecting. So we see that as a good thing across the board, and it certainly will help future growth in terms of a market dynamic.
And then in terms of your second quarter -- your second question was...
Steven Pieper
Access.
John Shannon
Access. So David, you know this market pretty well. This is an area where everything is a prior auth, and we still see that. So it's really going down the path of medical necessity and an area where you continue to have to put resources behind and help the clinicians and patients get coverage for these drugs. We don't see that dynamic changing right away or maybe someday down the road. But right now, we don't see any of that happening.
Operator
Your next question comes from the line of Leland Gershell with OpCo.
Unknown Analyst
This is Tracy on for Leland. Congrats on the quarter. Just one from us. You now estimate the total revenue outlook of $1 billion by 2030. Can you comment on any changes in your underlying assumptions to up that number from $750 million?
Steven Pieper
Yes, Tracy, I'll take this one. This is Steve. Thanks for the question. So yes, I think it really starts with just a comment on the overall commercial portfolio. One, we expect all 3 brands to be contributing to growth, primarily led by Recorlev. And that's really on the back of kind of what we're seeing unfold in Q3 and into Q4. But importantly, we expect all 3 brands to be contributing to that growth, and that's really what's driving the uptick in our outlook, which I'd remind folks is really only 3 short years away. So...
Operator
Your next question comes from the line of Brandon Folkes.
Brandon Folkes
Congrats on another very good quarter. Maybe just one for me. With the increased 2030 guidance, with that obviously comes additional cash flow. How do you think about that additional capital deployment, right? We've obviously got a good road map on 8121 now. But beyond that, how should we think about the incremental investments in the base business between now and 2030? Do you account for a much larger team? Or just anything we should think about there in terms of that additional cash generation that comes with that guidance?
John Shannon
Thanks, Brandon. And let's start with our existing products. We see opportunity to invest across the board in those to drive incremental growth. So our prioritization is to invest in our commercial assets, invest in our pipeline 8121. And then if we still have more to invest, then we'll be looking at business development type activities, focused on things that fit into our commercial footprint and our current capabilities, leveraging what we've built to date and especially things that could generate incremental revenue to our revenue growth in the -- between now and 2030, for example. So that's kind of the priorities, and we'll continue to focus on that as we generate even more cash.
Operator
Your last question comes from the line of Chase Knickerbocker with Craig-Hallum.
Chase Knickerbocker
Can you guys hear me all right now?
John Shannon
Yes.
Steven Pieper
Yes.
Chase Knickerbocker
Awesome. Okay. Sorry about that. So I just wanted to double-click on Keveyis actually, best quarter since 2024. Just want to get a sense for the drivers, your increased focus, some additional resources, how much impact is that actually having in the quarter? And then secondly, on that front, I just wanted to get a sense for what you think your market share is by volume in that market right now, just as we think about the impact of some of your litigation.
John Shannon
Chase, the first question is a little easier for us. The new resources that we put in just left training a few weeks ago. So a lot of those are going to really go into the fourth quarter and then into next year, and it will take some time to ramp up. So we are -- we anticipated and we've been watching the steady growth of Keveyis. And so we've got ahead of that and they started making the investments just based on the durability of the brand. And then in terms of market share in that, this is a highly -- really super small ultra-rare disease area. There's really no way to measure market share. We're the only one generating and finding new patients in the marketplace. And so from that perspective, it's hard to tell what other brands or products that these patients are on. So -- but for -- in terms of the patients on Keveyis, there's really no other competition in terms of getting patients started and treated.
Chase Knickerbocker
Got it. Maybe just another follow-up on the ADA guidelines. Is there a way that you kind of think about what percentage of the endo community that's not routinely testing right now? Or how do you guys kind of model the impact as we look into out years?
John Shannon
Chase, that's a really good question. And I think it really extends beyond the endo community, really into the primary care community, the areas where these clinicians are treating a lot of patients in these resistant stubborn conditions, whether it's cardiometabolic or diabetes or obesity. So I think that's where it really helps having the guidance going forward to add to the body of evidence that when these things aren't working, you should look for something else.
Chase Knickerbocker
Since I'm last, I'm going to sneak one more in, John, sorry. Just on kind of whether or not you need to generate any evidence specifically for Recorlev in these treatment-resistant diabetics to fully benefit from the guidelines? Just how you're thinking about that?
John Shannon
Yes. I would -- yes, of course, and we've said we're investing in our commercial footprint, but we're also investing in evidence generation. And you're going to start seeing that come out over the next several years. And like I said, we're now investing in both areas so that we can add to and someday become a leader in this space as this market matures over time.
Operator
We have reached the end of the Q&A session. I will now turn the call back over to John Shannon for closing remarks.
John Shannon
Thanks, everyone, and thanks for your questions. As you heard, this third quarter put us on a new growth curve, and the momentum behind it is broad and compounding. Today, we raised our 2026 full year revenue guidance to $395 million to $405 million and our 2030 total revenue outlook to more than $1 billion. We also now see Recorlev on a path to $1 billion in annual net revenue 3 to 4 years sooner than we previously projected. These are not aspirational numbers. They are the logical extension of the momentum this business is generating right now, and we're just getting started. Thank you for joining us today, and thank you for your continued support and interest in Xeris.
Operator
This concludes today's call. Thank you for attending. You may now disconnect.
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