Spruce Biosciences (SPRB) AI Stock Analysis

• Market Cap: $83.48M
• Dividend Yield: N/A
• Average Volume (3M): 988.68K
• Price to Earnings (P/E): ―
• Beta (1Y): -11.00
• Revenue Growth: -90.18%
• EPS Growth: -17.93%
• Country: US
• Employees: 20
• Sector: Healthcare
• Sector Strength: 45
• Industry: Biotechnology
• EPS (TTM): -14.58
• Shares Outstanding: 1,070,370
• 10 Day Avg. Volume: 2,922,716
• 30 Day Avg. Volume: 988,676
• PEG Ratio: -0.08
• Price to Book (P/B): 0.59
• Price to Sales (P/S): 3.44
• P/FCF Ratio: -0.30
• Enterprise Value/Market Cap: 0.47
• Enterprise Value/Revenue: 55.70
• Enterprise Value/Gross Profit: 55.70
• Enterprise Value/Ebitda: -0.81
• 1Y Price Target: $230.50
• Price Target Upside: 176.08% Upside
• Rating Consensus: Strong Buy
• Number of Analyst Covering: 4
• EPS Forecast (FY): N/A
• Revenue Forecast (FY): N/A

• Rating: 45 Neutral
• Price Target: $81.00 ▼(-2.98% Downside)

The score is primarily held down by weak financial performance (large losses, heavy cash burn, and declining revenue) and bearish-to-neutral technical signals (below key short/intermediate moving averages with negative MACD). Recent financing events modestly improve liquidity/runway, but they do not offset the current loss profile and cash burn.

Positive Factors

Low Leverage

A low debt-to-equity ratio materially reduces financial risk versus many biotech peers, preserving the company’s ability to absorb clinical setbacks and access additional financing on better terms. This structural strength supports longer-term operational flexibility despite current losses.

Secured Term Loan Extends Runway

A milestone-linked $50M facility with an initial funded tranche materially improves medium-term liquidity, supporting the planned BLA filing and pre-launch activities. Structurally, committed capital tied to regulatory/commercial milestones reduces immediate dilution risk and enables continued development and commercialization planning.

Pipeline Targets High Unmet Need

Developing a potential first-in-class disease-modifying therapy for an orphan indication creates a durable competitive opportunity: strong pricing power, concentrated patient populations, and high unmet need that can sustain long-term revenues if clinical and regulatory milestones are met.

Negative Factors

Sustained High Cash Burn

Persistent negative operating and free cash flow of roughly -$47.5M TTM means the company depends on external financing or milestone payments to fund R&D and commercialization. Over months to years this increases dilution risk and constrains strategic options if clinical timelines slip.

Declining Revenue & Large Losses

Sharply falling revenues and sustained multi-year operating losses indicate the business cannot self-fund development or commercial launch. This structural weakness prolongs dependence on capital markets and may force unfavorable financing or partnership terms if product approvals are delayed.

Eroded Equity Base

Severe depletion of shareholders' equity over time reduces the company’s financial cushion, limits non-dilutive financing options, and raises vulnerability to adverse events. A shrunken equity base constrains long-term capital flexibility and heightens the impact of any future setbacks.

Spruce Biosciences Business Overview & Revenue Model

Company Description

Spruce Biosciences, Inc., a biopharmaceutical company, focuses on developing and commercializing novel therapies for rare endocrine disorders. The company engages in developing tildacerfont, a non-steroidal therapy to enhance disease control and reduce steroid burden for adult patients suffering from congenital adrenal hyperplasia (CAH), which is in Phase 2b clinical trial; and to evaluate glucocorticoid reduction and clinical consequences in adult patients with classic CAH that is Phase 2b clinical trial. It is also developing tildacerfont for the treatment of pediatric classic congenital adrenal hyperplasia in children that is in Phase 2 clinical trial; and for females with polycystic ovary syndrome, which is in Phase 2 clinical trial. The company has a license agreement with Eli Lilly and Company to research, develop, and commercialize compounds for various pharmaceutical uses. Spruce Biosciences, Inc. was incorporated in 2014 and is headquartered in Daly City, California.

How the Company Makes Money

Spruce Biosciences primarily makes money through the development and commercialization of its pharmaceutical products. The company's revenue model is centered around advancing its lead product candidate, tildacerfont, through clinical trials and ultimately obtaining regulatory approval and commercializing the drug. Revenue streams may include sales of the approved drug, milestone payments, and royalties from partnerships or licensing agreements with larger pharmaceutical companies. Significant partnerships with research institutions or other biotech firms can also contribute to its revenue through collaborative research and potential co-development agreements.

Spruce Biosciences Financial Statement Overview

Summary

Weak operating fundamentals: sharply declining TTM revenue (~-46%), very large net losses (~-$47.9M), and substantial ongoing cash burn (TTM OCF/FCF ~-$47.5M). The main offset is low leverage (TTM debt-to-equity ~0.14), but the equity base has shrunk materially, reducing financial flexibility.

Income Statement

TTM (Trailing-Twelve-Months) revenue is small and declining sharply (down ~46% vs. the prior period shown), while losses remain very large: net income is about -$47.9M with deeply negative margins. Annual results show revenue peaking in 2023 and falling in 2024, with consistently heavy operating losses across the whole history provided. Strength: gross profit tracks revenue (high reported gross margin), but the cost structure is far ahead of the revenue base, keeping profitability weak and volatile.

Balance Sheet

Leverage is low (TTM debt-to-equity ~0.14; historically ~0.04–0.10), which reduces financial risk versus many peers. However, the equity base and total assets have fallen materially over time (equity down from ~149M in 2020 to ~5.4M in TTM), reflecting accumulated losses and balance-sheet shrinkage. Returns on equity are deeply negative in every period, signaling ongoing value erosion despite modest debt levels.

Cash Flow

Cash burn remains substantial: TTM operating cash flow is about -$47.5M and free cash flow is also about -$47.5M, with free cash flow deteriorating versus 2024 (negative growth). Cash flow broadly tracks net losses (free cash flow to net income ~1.0), implying limited non-cash addbacks and little evidence of a near-term self-funding model. Strength: burn improved in 2023 versus 2022/2021, but it re-accelerated in 2024 and remains heavy in TTM.

Breakdown	TTM	Dec 2024	Dec 2023	Dec 2022	Dec 2021	Dec 2020
Income Statement
Total Revenue	697.00K	4.91M	10.09M	0.00	0.00	0.00
Gross Profit	697.00K	4.91M	10.09M	0.00	0.00	0.00
EBITDA	-47.71M	-52.68M	-47.37M	-45.69M	-41.88M	-29.38M
Net Income	-47.88M	-53.04M	-47.92M	-46.18M	-42.29M	-29.54M
Balance Sheet
Total Assets	15.31M	45.21M	103.95M	85.65M	126.49M	162.88M
Cash, Cash Equivalents and Short-Term Investments	10.67M	38.75M	96.34M	79.08M	88.97M	157.15M
Total Debt	1.04M	2.77M	4.61M	6.32M	6.53M	6.38M
Total Liabilities	9.93M	16.39M	27.44M	17.16M	15.12M	13.46M
Stockholders Equity	5.39M	28.82M	76.51M	68.49M	111.37M	149.43M
Cash Flow
Free Cash Flow	-47.55M	-55.96M	-33.28M	-41.69M	-35.97M	-27.59M
Operating Cash Flow	-47.55M	-55.96M	-33.27M	-41.68M	-35.88M	-27.52M
Investing Cash Flow	0.00	0.00	55.78M	23.69M	-79.17M	-74.00K
Financing Cash Flow	-1.84M	-1.62M	49.14M	-241.00K	643.00K	181.03M

Spruce Biosciences Technical Analysis

• Technical Analysis Sentiment: Positive
• Last Price: 83.49
• 50DMA: Negative
• 100DMA: Negative
• 200DMA: Positive
• MACD: Negative
• RSI: Neutral
• STOCH: Neutral

Evaluating momentum and price trends is crucial in stock analysis to make informed investment decisions. For SPRB, the sentiment is Positive. The current price of 83.49 is above the 20-day moving average (MA) of 79.17, below the 50-day MA of 84.62, and above the 200-day MA of 47.16, indicating a neutral trend. The MACD of -1.07 indicates Negative momentum. The RSI at 52.19 is Neutral, neither overbought nor oversold. The STOCH value of 46.79 is Neutral, not indicating any strong overbought or oversold conditions. Overall, these indicators collectively point to a Positive sentiment for SPRB.

Spruce Biosciences Peers Comparison

Name	Overall Rating	Market Cap	P/E Ratio	ROE	Dividend Yield	Revenue Growth	EPS Growth
FBIO	54 Neutral	$97.77M	-11.54	10.35%	―	-0.32%	94.05%
Sector *	51 Neutral	$7.86B	-0.30	-43.30%	2.27%	22.53%	-2.21%
DTIL	46 Neutral	$95.81M	-0.46	-205.16%	―	-99.07%	-10347.56%
SPRB	45 Neutral	$83.48M	-0.98	-167.93%	―	-90.18%	-17.93%
CLNN	45 Neutral	$47.58M	-1.26	―	―	-49.17%	23.37%
IMA	45 Neutral	$83.04M	-0.87	-33.05%	―	-100.00%	45.48%
IMUX	44 Neutral	$78.65M	-0.76	-398.50%	―	―	30.16%

Spruce Biosciences Corporate Events

Spruce Biosciences Secures $50 Million Term Loan Facility

On January 7, 2026, Spruce Biosciences entered into a loan facility of up to $50 million with Avenue Venture Opportunities Fund II, L.P., featuring an initial $15 million tranche to be funded around January 9, 2026 and additional milestone-based tranches tied to regulatory and commercial progress for TA-ERT, as well as warrants and a potential conversion feature for the lender. The growth capital, secured against substantially all of the company’s assets and structured with a maturity date of July 1, 2029, is expected to extend Spruce’s cash runway into 2027, support its planned biologics license application filing and pre-launch commercial activities for TA-ERT, and potentially position the therapy as the first disease-modifying treatment for MPS IIIB in a market that currently lacks FDA-approved options, while the company reported preliminary cash and cash equivalents of approximately $48.9 million as of December 31, 2025.

The most recent analyst rating on (SPRB) stock is a Hold with a $82.00 price target. To see the full list of analyst forecasts on Spruce Biosciences stock, see the SPRB Stock Forecast page.

Spruce Biosciences Appoints Keli Walbert as Director

On December 11, 2025, Spruce Biosciences, Inc. appointed Keli Walbert as a Class I Director, with her term expiring at the 2027 Annual Meeting of Stockholders. She was also appointed to the Compensation Committee and will receive stock options and a cash retainer as part of her compensation. This appointment is expected to enhance the company’s governance structure, with no related person transactions disclosed between Ms. Walbert and the company.

The most recent analyst rating on (SPRB) stock is a Buy with a $160.00 price target. To see the full list of analyst forecasts on Spruce Biosciences stock, see the SPRB Stock Forecast page.

Spruce Biosciences Announces Board Resignation and Stock Repricing

Spruce Biosciences announced that on December 11, 2025, Tiba Aynechi, Ph.D. resigned from its board of directors and as Chair of the Compensation Committee, with her departure not stemming from any disagreements with the company. On the same day, the board approved a stock option repricing to reduce the exercise price of certain stock options to $104.13 per share, aiming to retain and motivate employees and directors without causing stock dilution or significant cash expenditures.

The most recent analyst rating on (SPRB) stock is a Buy with a $160.00 price target. To see the full list of analyst forecasts on Spruce Biosciences stock, see the SPRB Stock Forecast page.