Bull case
Akebia Therapeutics is well positioned on the strength of Vafseo’s January 2025 launch in DD-CKD, where nearly 100% contract coverage, premium TDAPA economics, and access to a >540k-patient US market support early adoption, especially among ~80k home dialysis patients and ~150k patients on high ESAs. The investment case is further strengthened by VOICE, which showed non-inferiority and superiority on the primary composite endpoint and a statistically significant reduction in hospitalizations versus ESAs, validating the only oral, non-ESA HIF stabilizer option in the US and improving the odds of broader dialysis-provider uptake. Beyond Vafseo, the pipeline adds long-duration upside through AKB-097 in >160k IgAN patients, ~100k LN patients, and ~4k C3G patients, while praliciguat’s Phase 2 FSGS program offers a differentiated, combination-friendly mechanism with meaningful unmet need.