Adjusted EBITDA Profitability and Improvement
Company reported positive adjusted EBITDA for Q4 2025 of $1,000,000 (a $900,000 improvement vs Q3 2025) and positive adjusted EBITDA for the full year 2025 of $300,000. Management projects adjusted EBITDA of $1,000,000 to $2,000,000 for 2026.
Gross Margin Expansion
Q4 2025 gross margin was 21%, up from 14% in Q3 2025 and 15% in Q4 2024, noted as one of the strongest quarterly gross margins in company history. Full-year 2025 gross margin was 17%, in line with 2025 guidance.
Positive Operating Cash Flow and Cash Position
Generated positive operating cash flow in Q4 2025 of $2,300,000. Year-end cash, cash equivalents and available-for-sale investments were $25,000,000; cash increased $1,300,000 from the end of Q3 and management states an increase of $3,400,000 since Q4 2024.
Customer Diversification and New Long-Term Contracts
Now serves approximately 300 customers, including all five leading U.S. dialysis providers and customers in 30+ countries. Key commercial wins/agreements in 2025 include continued supply to Fresenius, a DaVita extension through 2026 with increased pricing, a multi-year multimillion-dollar agreement with Innovative Renal Care (IRC) now supplying 70% of their clinics, long-term supply to DCI covering >80% of their clinics, and a three-year agreement with Concerto covering 100% of their skilled nursing dialysis facilities. Added 30 new customers in the Western U.S. after a competitor wound down operations.
New Product Launch — Single-Use Bicarbonate Cartridge
Introduced an FDA 510(k)-cleared single-use bicarbonate cartridge in two sizes (720g and 900g); management expects approximately $1,000,000 in net sales from cartridges in 2026.
Operational Restructuring and Leadership Addition
Executed targeted operational actions across manufacturing, supply chain, logistics and overhead to align capacity with demand, which contributed materially to margin expansion. Appointed Rashad Brown as VP of Manufacturing and Supply Chain to drive further manufacturing efficiencies in 2026 and beyond.
Long-Term Growth Targets and Strategic Roadmap
Company provided a multi-year plan: by 2029 management believes Rockwell Medical can exceed $100,000,000 in annual net sales, trend gross margins toward ~30%, and reach annual profitability in the $5,000,000 to $10,000,000 range, with plans to broaden the product portfolio and pursue higher-margin renal care products.