Heron Therapeutics, Inc.

What they do

Heron develops and commercializes therapeutics for acute care and oncology patients. Its acute care portfolio includes ZYNRELEF, a dual-acting extended-release local anesthetic combining bupivacaine and meloxicam for postoperative pain, and APONVIE, an intravenous aprepitant for postoperative nausea and vomiting. Its oncology supportive care portfolio includes CINVANTI and SUSTOL for chemotherapy-induced nausea and vomiting. The company is commercial-stage rather than development-stage, with revenue generated from net product sales.

Revenue drivers

• CINVANTI (oncology supportive care) — Intravenous aprepitant for chemotherapy-induced nausea and vomiting; the largest single product, contributing $21.8 million in Q2 2026 and $42.3 million in the first six months of 2026, though down 9.7% and 15.2% year-over-year respectively.
• ZYNRELEF (acute care) — Extended-release local anesthetic for postoperative pain; contributed $11.1 million in Q2 2026 (up 35.0% year-over-year) and $21.3 million in the first half of 2026, benefiting from CMS reimbursement through the NOPAIN Act and a permanent J-code effective October 1, 2025.
• APONVIE (acute care) — Intravenous aprepitant for postoperative nausea and vomiting; contributed $4.2 million in Q2 2026 (up 73.6% year-over-year) and $7.7 million in the first half of 2026, with CMS pass-through payment status effective April 1, 2023.
• SUSTOL (oncology supportive care) — Extended-release granisetron injection for chemotherapy-induced nausea and vomiting; contributed $0.5 million in Q2 2026, down 77.5% year-over-year, as the company intends to wind down commercialization over the next 12 months.

Recent performance

Total net revenue was $37.7 million in Q2 2026, up 1.3% from $37.2 million in Q2 2025 and up 9% from Q1 2026. The acute care franchise grew 43.9% year-over-year in Q2 2026, with ZYNRELEF at $11.1 million and APONVIE at $4.2 million, while the oncology franchise fell 15.9% to $22.3 million on lower CINVANTI and SUSTOL sales. For the six months ended June 30, 2026, total net revenue was $72.4 million, down 4.9% from $76.1 million, with acute care up 38.2% and oncology down 21.3%. Full-year 2025 revenue was $154.9 million with a net loss of $20.0 million, and operating cash flow was negative $27.6 million.

Strategy

Management said it reset the balance sheet, tightened spending, and is considering strategic alternatives while executing its current plan. The company paused a planned sales force expansion for the second half of 2026 and withdrew its full-year 2026 guidance. Heron intends to wind down SUSTOL commercialization over the next 12 months and may consider reintroducing it as early as late 2027. It also amended its credit facility with Hercules Capital, resetting financial covenants through 2027 and reducing outstanding principal by up to $17.5 million. Management has not set a timetable for the strategic alternatives process and does not intend to comment further unless required.

Risks

• Generic CINVANTI risk — A June 2026 U.S. District Court for the District of Delaware decision regarding certain CINVANTI patents led the company to say it cannot reliably forecast the timing or terms of potential generic entry for its largest product.
• Revenue concentration in products — The company states it is substantially dependent on the commercial success of its products, and CINVANTI alone represented $21.8 million of $37.7 million in Q2 2026 revenue.
• Liquidity and going-concern pressure — As of June 30, 2026, total assets were $252.3 million against total liabilities of $245.4 million, leaving shareholder equity of $6.9 million, with $20.7 million in cash and equivalents (and $42.7 million in cash, equivalents and short-term investments per the earnings release).
• Reimbursement and payor dependence — ZYNRELEF reimbursement through the NOPAIN Act is set to continue through December 31, 2027, and the company identifies failure to maintain favorable pricing or reimbursement policies as a material risk.

Outlook

Heron withdrew its full-year 2026 guidance for net product sales and Adjusted EBITDA, citing the CINVANTI patent decision, the paused sales force expansion, and the strategic alternatives review. Three factors led to that decision: inability to forecast generic entry timing or terms, tightened spending, and the strategic review. Management gave no timetable for the strategic alternatives process and no assurance that it will result in any transaction.