GRAFAPEX Achieves Cash-Flow Accretion and Strong Early Traction
Product-level performance for GRAFAPEX was accretive to quarterly operating cash flows in fiscal Q4 2026. For the 12 months ended March 31, 2026, GRAFAPEX generated $11.6M of product-level net revenue, exceeding the $11.2M invested in the launch over the same period. Management expects GRAFAPEX to generate $30M–$32M in fiscal 2027 and to exceed $100M in annual product-level net revenue within five years of launch.
Adoption Metrics — Hospital and Payer Coverage
As of the press release date, 74 of 180 U.S. transplant centers (41.1%) have ordered GRAFAPEX for procedures and 54 of those institutions (73.0% of ordering centers) have reordered. Commercial coverage includes over 200 million total covered lives, and 42 health plans have established coverage pathways (noting some quarter-to-quarter consolidation in payer counts).
Q4 Margin and Profitability Improvements
Fiscal Q4 2026 adjusted EBITDA was $4.3M, up from $2.3M a year earlier (an increase of approximately +87%). Fiscal Q4 operating income was $1.2M vs an operating loss of $1.2M in the prior-year quarter (improvement of $2.4M). Gross margin improved to 53.8% in Q4 2026 from 50.2% prior (+3.6 percentage points), driven by a higher contribution from GRAFAPEX and the absence of U.S. Gleolan sales.
Improved Annual Gross Margin and Adjusted EBITDA Generation
Fiscal 2026 gross margin improved to 54.8% from 52.2% year-over-year (+2.6 percentage points). The company reported adjusted EBITDA of $16.5M for fiscal 2026 (evidence of underlying cash-generative operations despite transitional pressures from portfolio changes).
Operating Cash Flow and Post-Launch Cash Generation
Operating cash flow was $3.8M in Q4 and $18.9M for fiscal 2026. Since launch, the company has generated an average of $4.2M of cash from operating activities per quarter over the five quarters following GRAFAPEX launch.
Strategic Business Development Win — UM171 (ZEMCELPRO) Canadian Rights
Medexus signed agreements for exclusive Canadian commercialization rights to UM171 Cell Therapy (ZEMCELPRO), a proprietary advanced clinical-stage investigational drug with conditional marketing authorization in Europe. Potential commercialization timing in Canada was stated as earliest 2028 via an expedited pathway or approximately 2031 via full clinical development, and the asset is a strategic fit with existing transplant products.
Balance Sheet Actions and Financing Improvements
The company paid a $15M regulatory milestone related to GRAFAPEX, reduced quarterly principal repayments under a new credit agreement with National Bank of Canada, and reported net debt to adjusted EBITDA of 0.95 (trailing four quarters). Management has executed share repurchases totaling over $1.2M under the NCIB.