Spruce Biosciences (SPRB) AI Stock Analysis

• Market Cap: $85.62M
• Dividend Yield: N/A
• Average Volume (3M): 988.68K
• Price to Earnings (P/E): ―
• Beta (1Y): -11.09
• 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: >-0.01
• Price to Book (P/B): <0.01
• Price to Sales (P/S): 0.04
• P/FCF Ratio: >-0.01
• Enterprise Value/Market Cap: 0.00
• Enterprise Value/Revenue: 0.00
• Enterprise Value/Gross Profit: 0.00
• Enterprise Value/Ebitda: 0.00
• 1Y Price Target: $230.50
• Price Target Upside: 212.75% 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: $76.00 ▲(3.12% Upside)

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

Regulatory Progress (Breakthrough Therapy)

FDA Breakthrough Therapy status for TA-ERT materially strengthens Spruce's regulatory pathway, enabling faster review, more intensive FDA interactions and potential priority review. This durable regulatory elevation improves probability of approval and first-in-class positioning for MPS IIIB.

Secured Term Loan Facility

A milestone-based $50M loan facility, secured against company assets and maturing 2029, provides structured growth capital tied to regulatory/commercial progress. This financing reduces immediate liquidity pressure and enables execution of BLA filing and pre-launch activities over the medium term.

Institutional Private Placement

A $50M private placement from healthcare investors supplies critical non-operating capital to fund late-stage development and BLA preparation. Institutional backing signals confidence and materially extends runway to support potential commercialization planning and first-mover advantages in a rare disease.

Negative Factors

Sustained High Cash Burn

Consistently large negative operating and free cash flows mean the company cannot self-fund development. Persistent burn forces reliance on financings or debt, raising dilution/default risk and constraining investment in commercial scale-up should approval occur, a durable operational vulnerability.

Declining Revenue and Large Losses

Sharply falling revenue coupled with substantial net losses reflect the company's clinical-stage status and lack of commercial sales. This structural gap means value creation hinges entirely on successful clinical/regulatory milestones, increasing binary outcome risk over the medium term.

Equity Erosion and Balance-Sheet Shrinkage

Material decline in shareholders' equity from cumulative losses weakens the capital cushion and reduces financial flexibility. A depleted equity base increases the dilutive impact of future financings and limits capacity to absorb setbacks or invest in commercial expansion without additional external funding.

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

Spruce Biosciences is facing significant financial challenges, with declining revenues and persistent losses affecting its financial stability. Despite a low leverage position, the negative cash flow trend is concerning, necessitating strategic adjustments.

Income Statement

Spruce Biosciences shows a limited revenue base with a Total Revenue of $4.91 million in 2024, significantly down from $10.09 million in 2023, indicating a revenue decline. The company has consistently reported negative net income, with a Net Profit Margin of -1080% in 2024, reflecting persistent unprofitability. The EBIT and EBITDA margins are also negative, at -1144% and -1144%, respectively, due to high operating expenses relative to revenue.

Balance Sheet

The company's balance sheet reveals a moderate equity base with Stockholders' Equity at $28.82 million in 2024. The Debt-to-Equity Ratio is 0.08, indicating relatively low leverage. However, the Return on Equity (ROE) is negative due to the negative net income. The Equity Ratio stands at 63.73%, suggesting a strong equity position relative to total assets.

Cash Flow

Spruce Biosciences has shown a substantial decrease in Free Cash Flow from -$33.28 million in 2023 to -$55.96 million in 2024, highlighting a deteriorating cash flow position. The Operating Cash Flow to Net Income Ratio is close to 1, reflecting that operating cash outflows closely match the net losses. The Free Cash Flow to Net Income Ratio further confirms the cash flow challenges.

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: Negative
• Last Price: 73.70
• 50DMA: Negative
• 100DMA: Positive
• 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 Negative. The current price of 73.7 is below the 20-day moving average (MA) of 81.24, below the 50-day MA of 94.31, and above the 200-day MA of 42.71, indicating a neutral trend. The MACD of -3.83 indicates Negative momentum. The RSI at 43.23 is Neutral, neither overbought nor oversold. The STOCH value of 23.62 is Neutral, not indicating any strong overbought or oversold conditions. Overall, these indicators collectively point to a Negative 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	$133.46M	-15.69	10.35%	―	-0.32%	94.05%
Sector *	51 Neutral	$7.86B	-0.30	-43.30%	2.27%	22.53%	-2.21%
CLNN	46 Neutral	$66.09M	-1.53	―	―	-49.17%	23.37%
SPRB	45 Neutral	$85.62M	-0.92	-167.93%	―	-90.18%	-17.93%
IMA	45 Neutral	$81.28M	-0.85	-33.05%	―	-100.00%	45.48%
IMUX	44 Neutral	$79.98M	-0.76	-398.50%	―	―	30.16%
DTIL	41 Neutral	$94.36M	-0.48	-205.16%	―	-99.07%	-10347.56%

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.

Spruce Biosciences Board Member Resigns

On October 15, 2025, Bali Muralidhar, Ph.D. resigned from Spruce Biosciences‘ board of directors and its compensation committee. His departure was not due to any disagreements with the company’s operations or policies.

The most recent analyst rating on (SPRB) stock is a Hold with a $10.00 price target. To see the full list of analyst forecasts on Spruce Biosciences stock, see the SPRB Stock Forecast page.