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Opko Health Inc (OPK)
NASDAQ:OPK
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Opko Health
(NASDAQ:OPK)
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Rating:46Neutral
Price Target:
$1.00
▼(-16.67% Downside)
Action:ReiteratedDate:02/27/26
The score is held down primarily by weak financial performance (shrinking revenue, recurring losses, and negative free cash flow) and bearish technical signals (below key moving averages with negative MACD). These are partially offset by a more constructive earnings-call outlook—strong cash, active repurchases, and pipeline/partnership progress—though 2026 guidance still points to elevated costs and near-term pressure.
Positive Factors
Strong liquidity & capital returns
A $369M cash balance and an active buyback program provide a meaningful financial cushion and flexibility. This liquidity supports continued R&D and trial funding without immediate dilution, enables opportunistic balance-sheet actions, and signals management confidence—durable advantages for executing multi-year programs.
High-value partnerships & ModeX pipeline
Strategic collaborations with Regeneron and Merck and multiple ModeX clinical-stage assets materially de-risk OPKO's pipeline. Partner funding, milestone structures, and external validation accelerate development timelines, broaden commercialization paths and create long-term optionality beyond in-house resources.
Nondilutive government funding (BARDA)
Substantial BARDA support reduces OPKO's direct cash requirements for specific programs, lowering dilution and financing pressure. Nondilutive funding that covers trial expenses improves project economics and increases the likelihood these programs can advance to value-inflection points without eroding the company’s cash runway.
Negative Factors
Multi-year revenue decline
Sustained revenue contraction reduces operating scale and weakens the core business base that funds R&D and fixed costs. Continued top-line shrinkage increases reliance on milestone and partner receipts, which are lumpy, making consistent investment and margin recovery more difficult over the next several quarters.
Negative operating & free cash flow
Persistent negative operating and free cash flow indicate the business consumes cash to sustain operations and growth initiatives. Over 2–6 months this increases reliance on the balance sheet, asset sales, or financing, and sustained cash burn risks eroding the current liquidity cushion if operating performance does not improve.
Operating losses & investment-heavy 2026 guidance
Management plans higher R&D and overall spend that outpaces forecast revenue in 2026, implying continued operating losses. While investment can drive future returns, the near-term structural mismatch raises the probability of further cash consumption, potential financing needs, and pressure on shareholder equity if milestones or partner receipts lag.
Opko Health (OPK) vs. SPDR S&P 500 ETF (SPY)
Market Cap
$882.86M
Dividend YieldN/A
Average Volume (3M)2.68M
Price to Earnings (P/E)―
Beta (1Y)0.53
Revenue Growth-9.75%
EPS Growth-31.28%
CountryUS
Employees2,997
SectorHealthcare
Sector Strength45
IndustryMedical - Diagnostics & Research
Share Statistics
EPS (TTM)-0.04
Shares Outstanding767,701,300
10 Day Avg. Volume1,573,325
30 Day Avg. Volume2,676,298
Financial Highlights & Ratios
PEG Ratio-0.02
Price to Book (P/B)0.76
Price to Sales (P/S)1.59
P/FCF Ratio-5.05
Enterprise Value/Market Cap1.11
Enterprise Value/Revenue1.61
Enterprise Value/Gross Profit3.88
Enterprise Value/Ebitda-14.71
Forecast
1Y Price Target
$3.00Price Target Upside150.00% Upside
Rating ConsensusStrong Buy
Number of Analyst Covering3
EPS Forecast (FY)-0.26
Revenue Forecast (FY)$580.97M
Opko Health Business Overview & Revenue Model
Company DescriptionOPKO Health, Inc., a healthcare company, engages in the diagnostics and pharmaceuticals businesses in the United States, Ireland, Chile, Spain, Israel, Mexico, and internationally. The company's Diagnostics segment operates BioReference Laboratories that offers laboratory testing services for the detection, diagnosis, evaluation, monitoring, and treatment of diseases, including esoteric testing, molecular diagnostics, anatomical pathology, genetics, women's health, and correctional healthcare to physician offices, clinics, hospitals, employers and governmental units; and a novel diagnostic instrument system to provide blood test results in the point-of-care setting, as well as 4Kscore prostate cancer testing services. Its Pharmaceutical segment offers Rayaldee to treat secondary hyperparathyroidism in adults with stage 3 or 4 chronic kidney disease, and vitamin D insufficiency; OPK88004, an orally administered selective androgen receptor modulator; OPK88003, a once-weekly administered peptide for the treatment of type 2 diabetes and associated obesity that is in Phase IIb trials; and hGH-CTP, a once-weekly human growth hormone injection that completed Phase III clinical trial in partnership with Pfizer, Inc. This segment develops and commercializes longer-acting proprietary versions of already approved therapeutic proteins. The company also offers specialty APIs; develops, manufactures, markets, and sells pharmaceutical, nutraceutical, veterinary, and ophthalmic products; commercializes food supplements and over the counter products; manufactures and sells products primarily in the generics market; and imports, markets, distributes, and sells pharmaceutical products in a range of indications, including cardiovascular products, vaccines, antibiotics, gastro-intestinal products, hormones, and others. In addition, it operates pharmaceutical platforms in Ireland, Chile, Spain, and Mexico. The company was founded in 1991 and is headquartered in Miami, Florida.
How the Company Makes MoneyOpko Health generates revenue through multiple streams, primarily from the sale of pharmaceuticals and diagnostic tests. The company markets its proprietary drugs and therapies, including treatments for endocrinology and urology. Additionally, Opko's 4Kscore Test contributes significantly to its revenue, being a leading diagnostic tool for prostate cancer detection. The company also engages in partnerships and collaborations with other healthcare organizations, which can result in shared revenue from co-developed products or licensing agreements. Furthermore, Opko has a focus on research and development, which may lead to new product offerings and additional revenue streams in the future.
Opko Health Earnings Call Summary
Earnings Call Date:Feb 26, 2026
(Q4-2025)
| Next Earnings Date:May 12, 2026
Earnings Call Sentiment Neutral
The call communicated substantial strategic and operational progress — meaningful ModeX pipeline advancement, high-value partnerships (Regeneron, Merck), nondilutive government funding (BARDA), a stronger cash position, and active share repurchases. Offsetting these positives are near-term financial pressures: YoY revenue decline driven by divestitures and milestone timing, Q4 net loss vs prior-year income, higher R&D spend and anticipated elevated costs in 2026, plus seasonal/weather impacts on Q1 volumes. Overall, the company is positioned for longer-term value creation but faces short-term headwinds as it invests through a transition year.Q4-2025 Updates
Positive Updates
Strong liquidity and active capital return
Ended Q4 2025 with $369 million in cash and cash equivalents; deployed >$109 million in convertible note and common stock repurchases during 2025 and almost $230 million since 2024; repurchased 9.8 million shares in Q4 and 34.6 million shares for ~ $47 million in 2025; ~$113 million remaining under buyback authorization.
ModeX pipeline acceleration and high-value partnerships
ModeX now has multiple clinical-stage programs (3 in clinic, 2 entering soon). Key assets: MDX2001 (tetraspecific) dosed >25 patients and reached ~10x starting dose with acceptable safety; MDX2004 (trispecific immune rejuvenator) entered Phase I in Australia and Israel; MDX2003 received IND approval in Australia with first-in-human trials imminent; EBV vaccine partnered with Merck (Phase I >200 subjects). Entered collaboration with Regeneron with potential milestone payments >$1 billion and full funding/reimbursement for selected programs.
Meaningful nondilutive funding and government support
Received $28.5 million in BARDA funding in 2025 (total $54 million since inception); FDA cleared IND for MDX2301 (COVID multispecific antibody) to enter clinic H1 2026; BARDA will assume clinical trial costs for supported programs.
Diagnostics transformation and 4Kscore momentum
Completed sale of BioReference oncology assets (transformed BioReference into a regionally focused clinical lab with national 4Kscore franchise). Remaining BioReference operations generated ~ $300 million in 2025 revenue. Workforce reduced ~29% to ~1,400 FTEs to streamline cost base. 4Kscore: Q4 revenue $7 million (more than +16% YoY vs $6M in 2024) and test volume +6% YoY; new label (no DRE required) should support primary care adoption and margin expansion.
Pharmaceutical commercial positives
Pharmaceutical product sales increased to $43.7 million from $37.4 million in Q4 2024 (+~17%), driven by foreign exchange tailwinds and higher international volumes. Pfizer gross profit share was $12.5 million in Q4 (+30% YoY), the highest recorded to date. First royalty payment from mazdutide (Lilly/Innovent in China) contributed $4.3 million in Q4.
Clear 2026 financial & operational roadmap
Management provided FY2026 guidance: revenue $530–$560 million (services $300–$312M; product $160–$170M; partnerships $70–$80M), R&D investment $125–$135 million offset by $22–$26M in BARDA/Regeneron reimbursements, and plan to continue accelerating share repurchases.
Negative Updates
Quarterly revenue decline and return to loss
Consolidated Q4 2025 revenue was $148.5 million vs $183.6 million in Q4 2024, a decline of ~19.1% YoY (partly due to asset sale timing). Company reported a net loss of $31.3 million ($0.04 per share) vs net income of $14 million ($0.01) in Q4 2024.
Operating losses and increased R&D spend
Consolidated operating loss widened to $38.3 million in Q4 2025 vs $33.1 million in Q4 2024. Pharmaceutical operating loss increased to $10.7 million from $2.1 million (Q4) driven by higher R&D; Q4 R&D was $32.4 million vs $29.8 million (+~8.7% YoY). FY 2026 total costs guidance $725–$750 million, which outpaces revenue guidance and reflects continued heavy investment.
Diagnostics revenue reduction from divestiture
Q4 Diagnostics revenue (post-transaction) was $71.1 million vs $103.1 million in Q4 2024 (≈-31% YoY), primarily reflecting the Labcorp oncology asset sale and the shifting of unprofitable esoteric tests to partners; Diagnostics still recorded an operating loss of $18.3 million (improved vs $21.7M prior).
Product volume pressures and variable funding
Rayaldee contribution declined slightly to $8.8 million from $9.1 million (Q4), with an approximate 17% decline in volumes; BARDA funding in Q4 fell to $6.9 million vs $11.0 million in prior-year quarter (-~37%), increasing short-term variability in program funding timing.
Near-term headwinds and seasonality
Management expects Q1 2026 volumes to be negatively impacted by Northeast weather ($3–$5 million effect); also disclosed sizable depreciation & amortization (expected ≈$100 million for 2026) that will weigh on reported results.
Timing variability of milestone revenue
IP and other revenue was $33.7 million in Q4 2025 vs $43.1 million in Q4 2024; Q4 2024 benefited from a larger Merck milestone (~$12.5M) while Q4 2025 included a smaller Regeneron milestone (~$7.2M) — highlighting milestone timing variability impacting quarter-to-quarter comparisons.
Company Guidance
OPKO guided Q1 2026 revenue of $125–$140M (services $71–$75M, pharmaceutical product $38–$45M, IP/other $15–$20M including Pfizer gross-profit share of $5–$6M) and called out weather-related volume headwinds of ~$3–$5M; Q1 total costs & expenses are expected to be $170–$180M (R&D $30–$32M, collaboration funding offset $7–$9M, depreciation & amortization ~ $24M). For full-year 2026 the company expects total revenue of $530–$560M (services $300–$312M, pharma product $160–$170M, partnering/collaboration revenue $70–$80M including Pfizer gross-profit share $34–$37M), total costs & expenses of $725–$750M, R&D of $125–$135M (partially offset by $22–$26M of BARDA/Regeneron funding), and depreciation & amortization of ~ $100M. OPKO closed the quarter with $369M of cash (repurchased 9.8M shares in Q4 and 34.6M shares for ~$47M in 2025) and has ~$113M remaining under its buyback authorization.Opko Health Financial Statement Overview
Summary
Overall fundamentals are weak: multi-year revenue contraction, recurring net losses, and negative operating/free cash flow in 2022–2025 (with further FCF deterioration in 2025). The balance sheet provides some cushion with manageable leverage and meaningful equity, but sustained cash burn and worsening returns increase risk if operating performance doesn’t improve.Income Statement
Revenue has been shrinking for several years, including a ~5% decline in 2025 versus 2024 and materially larger declines versus earlier years. Profitability is weak: the company posted net losses in every year except 2020, with 2025 showing a large loss and a deeply negative net margin despite a strong gross margin recovery. Operating results remain pressured, with negative EBITDA in most recent periods (2025 and 2023–2022), indicating the business has not yet stabilized at the operating level.28
Negative
Balance Sheet
Leverage looks manageable with debt-to-equity generally in the ~0.15–0.37 range and equity remaining sizable across the period. However, persistent losses are weighing on shareholder returns (negative return on equity in most years, worsening again in 2025), which raises the risk of continued equity erosion if profitability does not improve.62
Positive
Cash Flow
Cash generation is a key concern: operating cash flow and free cash flow were negative in 2022–2025, with 2025 free cash flow declining further versus 2024. While free cash flow has been less negative than net income in recent years (suggesting meaningful non-cash charges), the business is still consuming cash, which can increase reliance on financing or asset sales if the trend persists.24
Negative
| Breakdown | Dec 2025 | Dec 2024 | Dec 2023 | Dec 2022 | Dec 2021 |
|---|---|---|---|---|---|
Income Statement | |||||
| Total Revenue | 606.89M | 713.14M | 863.50M | 1.00B | 1.77B |
| Gross Profit | 370.26M | 311.03M | 318.13M | 288.22M | 581.52M |
| EBITDA | -48.55M | 135.28M | -65.52M | -270.81M | 83.57M |
| Net Income | -225.73M | -53.22M | -188.86M | -328.40M | -30.14M |
Balance Sheet | |||||
| Total Assets | 1.93B | 2.20B | 2.01B | 2.17B | 2.40B |
| Cash, Cash Equivalents and Short-Term Investments | 369.07M | 431.94M | 95.88M | 153.19M | 134.71M |
| Total Debt | 412.24M | 504.44M | 326.56M | 305.55M | 254.75M |
| Total Liabilities | 517.31M | 834.76M | 622.48M | 605.61M | 714.59M |
| Stockholders Equity | 1.27B | 1.37B | 1.39B | 1.56B | 1.69B |
Cash Flow | |||||
| Free Cash Flow | -190.82M | -208.50M | -44.47M | -119.77M | 6.18M |
| Operating Cash Flow | -178.54M | -183.49M | -28.20M | -95.19M | 38.34M |
| Investing Cash Flow | 230.30M | 352.21M | -18.20M | 91.04M | 35.95M |
| Financing Cash Flow | -118.06M | 184.17M | -11.30M | 22.97M | -10.35M |
Opko Health Technical Analysis
Neutral
1.20
Price Trends
1.27
Negative
1.34
Negative
1.35
Negative
Market Momentum
-0.03
Positive
42.95
Neutral
46.52
Neutral
Evaluating momentum and price trends is crucial in stock analysis to make informed investment decisions. For OPK, the sentiment is Neutral. The current price of 1.2 is below the 20-day moving average (MA) of 1.22, below the 50-day MA of 1.27, and below the 200-day MA of 1.35, indicating a bearish trend. The MACD of -0.03 indicates Positive momentum. The RSI at 42.95 is Neutral, neither overbought nor oversold. The STOCH value of 46.52 is Neutral, not indicating any strong overbought or oversold conditions. Overall, these indicators collectively point to a Neutral sentiment for OPK.
Opko Health Risk Analysis
Opko Health disclosed 56 risk factors in its most recent earnings report. Opko Health reported the most risks in the "Legal & Regulatory" category.
Finance & Corporate - Financial and accounting risks. Risks related to the execution of corporate activity and strategy
Latest Risks Added 0 New Risks
Opko Health Peers Comparison
UnderperformOutperform
Sector (51)
Name | Overall Rating | Market Cap | P/E Ratio | ROE | Dividend Yield | Revenue Growth | EPS Growth |
|---|---|---|---|---|---|---|---|
61 Neutral | $873.91M | -68.50 | -2.69% | ― | 10.15% | -295.52% | |
56 Neutral | $990.08M | -46.82 | 24.11% | ― | 14.46% | ― | |
53 Neutral | $713.77M | -16.81 | -3.80% | ― | 13.60% | 74.64% | |
52 Neutral | $1.25B | -11.64 | -12.42% | ― | 10.10% | -44.29% | |
51 Neutral | $7.86B | -0.30 | -43.30% | 2.27% | 22.53% | -2.21% | |
48 Neutral | $412.94M | -1.21 | -68.45% | ― | 0.21% | -233.51% | |
46 Neutral | $882.86M | -4.79 | -13.32% | ― | -9.75% | -31.28% |
* Healthcare Sector Average
OPK
Opko Health
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-31.03%
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Glossary
BuyA stock rated as a "Buy" is expected to perform better than the overall market or a specific benchmark over the near-to-medium term. This rating suggests the stock is likely to deliver higher returns compared to other stocks in the same sector or market index. Note: This is not investment advice; please consult a financial advisor before making investment decisions.
HoldA stock rated as a "Hold" is expected to perform in line with the overall market or a specific benchmark. This rating indicates that the stock is neither particularly compelling nor unfavorable for investment. Note: This is not investment advice; please consult a financial advisor before making investment decisions.
SellA stock rated as a "Sell" is expected to perform worse than the overall market or a specific benchmark over the near-to-medium term. This rating suggests the stock may deliver lower returns compared to other stocks in the same sector or market index. Note: This is not investment advice; please consult a financial advisor before making investment decisions.
Disclaimer
This AI Analyst Stock Report is automatically generated by our AI systems using advanced algorithms and publicly available financial, technical, and market data. While the information provided aims to be accurate and insightful, it is intended for informational purposes only and should not be considered financial advice. Any content created by an AI (Artificial Intelligence) system may contain inaccuracies and/or contain errors. Investing in stocks carries inherent risks, and past performance is not indicative of future results. This report does not account for your personal financial circumstances, objectives, or risk tolerance. Always conduct your own research or consult with a qualified financial advisor before making investment decisions. The analysis and recommendations provided are based on historical and current data and may not fully reflect future market conditions or unexpected developments. Neither the creators of this report nor its affiliated entities guarantee the accuracy, completeness, or reliability of the information presented. Use this report at your own discretion and risk.