CorMedix expects a higher add-on payment in 2027 before it falls from the first quarter to the second
Key Facts
DaVita’s chief financial officer expects the DefenCath add-on payment to decline clearly between the first and second quarters of 2027, after CorMedix estimated that the add-on could rise at the start of the year. The CFO said on DaVita’s third-quarter earnings call that the add-on would remain low or could continue to decline in the second half of 2027. The path depends on recalculating the amount each quarter based on updated volume and average sales price. The reimbursement level is therefore tied to changes in use and prices during the year, rather than a fixed amount throughout 2027. CorMedix had said the CMS methodology would reduce the add-on payment to dialysis providers after the product moves to the post-TDAPA system.
The transition of DefenCath reimbursement from TDAPA to the post-TDAPA add-on began on July 1, 2026, according to CorMedix’s quarterly report. CMS set the add-on at $2.37 for the third and fourth quarters of 2026, according to the company’s annual report. CorMedix estimated that the 2027 add-on could reach three to five times the level in the second half of 2026 if CMS used the same methodology. The company said this estimate could allow for higher sales prices in 2027 compared with the second half of 2026. But CMS approved quarterly updates to the add-on through change requests during the year, based on the latest available pricing and use data.
CorMedix’s results show that DefenCath accounts for a large share of the company’s revenue, alongside the Melinta portfolio it acquired. Consolidated revenue totaled $101.9 million in the second quarter of 2026, including $66.1 million in DefenCath sales and $35.8 million related to the Melinta portfolio. The company said DefenCath sales in the quarter benefited from continued use by major customers at outpatient dialysis centers. CorMedix kept its fiscal 2026 consolidated revenue forecast at $325 to $345 million. It also raised its adjusted earnings before interest, taxes, depreciation and amortization forecast to $125–140 million.
On its call, DaVita said expected treatment volume growth in 2027 was higher than 2026 growth, but also pointed to expected pressure from commercial insurance mix and lower drug costs. The company said adjusted operating income in the third quarter was $561 million, and adjusted earnings per share were $3.82. The DefenCath reimbursement impact adds another factor to the dialysis operator’s margin outlook. The CFO said, "We’ll know more in February" about the balance between revenue pressures and cost support for dialysis margins. The quarterly review of the add-on’s path allows reimbursement estimates to change during 2027 as newer data become available.
CorMedix shares closed at $7.64 on October 29, 2026, compared with a close of $8.20 in the previous session, according to EL7 data. Stocktwits coverage published on October 30 said the stock hit a new 52-week low. Data for that day also showed an intraday low of $6.04, with the price at $6.255 when the source was updated. The coverage ended by comparing the share move with DaVita’s warning about the DefenCath add-on path; the available closing data for October 29 alone do not establish that the remarks caused the price decline. Separately, CorMedix expects FDA action in the first half of 2027 on its application to expand the REZZAYO indication, subject to acceptance of the application for review.
DefenCath also faces a separate regulatory deadline in hospitals: CorMedix said the NTAP add-on expires on November 14, 2026, three years after FDA approval. That deadline concerns the product’s reimbursement in hospitals, while the change discussed by DaVita concerns the add-on tied to dialysis treatment. These timelines place more than one reimbursement mechanism before the product in the coming months. Under the post-TDAPA system, CMS will update the add-on quarterly in 2027, using the latest pricing and use data and older ASP data when newer data are unavailable. DaVita expects to have a clearer picture of the balance between revenue and costs in February, while CorMedix is targeting FDA action on the REZZAYO application in the first half of 2027 if it is accepted for review.