ADMA returned to growth in the second quarter of 2026, with revenue up 2% to $124.4 million and ASCENIV up 24% to $102.9 million as June delivered the strongest sequential utilization since the first half of 2024 and BIVIGAM demand stabilized. Gross margin expanded to 69% and adjusted EBITDA rose 22% to $61.8 million, and the company reiterated its full-year 2026 guidance while continuing aggressive buybacks of about 7.1 million shares in the quarter. Adjusted net income growth was limited to 8% as the effective tax rate climbed roughly 10 points to 24.7% against prior-year discrete tax benefits, and competitive pricing pressure in standard IG persisted.
Welcome, everyone. Thank you for joining us this afternoon to discuss ADMA Biologics' financial results for the second quarter of 2026 and recent corporate updates. I am joined today by Adam Grossman, our President and Chief Executive Officer, Terry Kohler, our Chief Financial Officer and Treasurer. During today's call, Adam will provide some introductory comments and provide an update on corporate progress. Terry will provide an overview of the company's second quarter 2026 financial results. Adam will provide some brief summary remarks before opening up the call for questions. Earlier today, we issued a press release detailing the second quarter 2026 financial results and summarized certain achievements and recent corporate updates. The release is available on our website at www.admabiologics.com.
Before we begin our formal comments, I will remind you that we will be making forward-looking statements during today's call that represent the company's intentions, expectations, or beliefs concerning future events, which constitute forward-looking statements for the purposes of the safe harbor provisions under the Private Securities Litigation Reform Act of 1995. All forward-looking statements are subject to factors, risks, and uncertainties, such as those detailed in today's press release announcing this call, and in our filings with the SEC, which may cause actual results to differ materially from the results expressed or implied by such statements. Any forward-looking statements represent our views only as of the date of this call and should not be relied upon as representing our views as of any subsequent date. We specifically disclaim any obligations to update any such statements except as required by the federal securities laws.
We refer you to the Disclosure Notice section in our earnings release we issued today and the Risk Factors section of our quarter report on Form 10-Q for the quarter ended June 30th, 2026, for a discussion of important factors that could cause actual results to differ materially from those forward-looking statements. Please note that the discussion on today's call includes certain non-GAAP financial measures, including adjusted EBITDA and adjusted net income. A reconciliation of these non-GAAP financial measures to the most directly comparable GAAP metric is available in our earnings release, which is available on our website at www.admabiologics.com. I would like to now turn the call over to Adam Grossman. Adam?
Good afternoon, everyone, and thank you for joining us. Our second quarter results reflect strong execution across the business and demonstrate the power of ASCENIV's long-term growth trajectory. During the quarter, we delivered continued financial progress, strong cash generation, and improving commercial momentum, while ASCENIV utilization strengthened throughout the period. ASCENIV demand accelerated during the second quarter, and June delivered the strongest sequential utilization growth we have experienced since the first half of 2024. This momentum was driven by increasing physician adoption, broader provider engagement, new patient starts, and higher patient utilization. As we have discussed previously, distributor-reported end-user utilization remains our leading indicator of continued revenue growth. Based on the end market utilization data we continuously review, we believe current ASCENIV inventory levels remain appropriate and are consistent with underlying demand.
Importantly, ASCENIV utilization strengthened progressively throughout the quarter across our commercial network, reinforcing our view that ASCENIV remains early in its penetration of the later-line refractory primary immunodeficiency market. While we continue to see competitive pressures in the U.S. immunoglobulin market, BIVIGAM demand stabilized during the quarter, resulting in sequential improvements in both utilization and revenue. Increased supply and competitive pricing pressures remain within the U.S. standard immunoglobulin market. We continue to maintain our disciplined approach that prioritizes durable, profitable growth over unsustainable discounting and other incentives. Importantly, despite this evolving standard IG backdrop, ASCENIV continued to outperform and utilization expanded. Increasing physician adoption, new patient starts, and record utilization further demonstrate the relative insulation provided by ASCENIV's differentiated product profile and its positioning among later line, refractory, and medically complex primary immunodeficiency patients.
One of the most important developments during the quarter was the continued expansion of ASCENIV's real-world evidence base. We've submitted an abstract for presentation at the 2026 American College of Allergy, Asthma and Immunology annual scientific meeting, highlighting results from a Real-world health outcomes and health resource utilization analysis of 127 medically complex primary immunodeficiency patients, the majority of whom had previously received other immunoglobulin replacement therapies prior to switching to ASCENIV. The analysis compared patient outcomes and healthcare resource utilization during the 12 months before ASCENIV initiation with the 12 months following administration. Following initiation of ASCENIV treatment, patients experienced statistically significant reductions in infection-related hospitalizations, outpatient healthcare utilization, oral antibiotic use, and corticosteroid use. The proportion of patients experiencing infection-related emergency room visits also declined.
We believe these results are especially meaningful because they were observed in a medically complex population with significant baseline disease burden and healthcare resource utilization. The study's cohort included patients with chronic pulmonary and respiratory comorbidities, prolonged use of antibiotics or corticosteroids, and prior infection-related hospitalizations or emergency room utilization. We believe these findings further support ASCENIV's differentiated clinical profile and growing body of real-world evidence. These findings also reinforce our view of ASCENIV's positioning as a later line therapy for PI patients whose disease remains inadequately controlled and provides additional support for continued physician adoption, patient access, and payer engagement. We believe these findings complement ASCENIV's existing broad commercial payer coverage and could further strengthen commercial payer access.
More broadly, we feel payer willingness to engage in these discussions reflects growing recognition of ASCENIV's differentiated value proposition and the significant clinical and financial burden associated with recurrent infections, hospitalizations, and other healthcare utilization among medically complex patients. Operationally, we believe we are well-positioned to support the continued revenue growth. Our yield-enhanced manufacturing process remains embedded in commercial production and continues to support product availability, manufacturing efficiency, and margin performance. Our diversified plasma sourcing strategy provides reliable access to high-titer plasma, and we believe our current supply infrastructure is sufficient to support anticipated demand. We are confident our financial position also remains a significant strategic advantage. Strong profitability and cash generation provide us with substantial flexibility to invest in commercial expansion, manufacturing initiatives, and our capital-efficient pipeline while continuing to execute on our capital allocation priorities.
During the quarter, we repurchased approximately 7.1 million shares of common stock under our previously authorized share repurchase program. These repurchases were funded through internally generated cash flow. We continue to believe that returning capital to stockholders at attractive value represents an effective use of capital while preserving meaningful financial flexibility. We remain on track to complete our previously stated $200 million or more 2026 share repurchase target. Looking ahead, we continue to see multiple expected durable drivers of ASCENIV growth. These include increasing patient utilization, expanding physician adoption, new patient starts, broader prescriber engagement, growing payer access, and an expanding body of clinical and real-world evidence. Accordingly, we are reiterating our full year 2026 financial guidance and remain confident in our ability to meet or exceed those expectations. Beyond ASCENIV, we continue to advance SG-001 through a capital-efficient development pathway.
We are progressing with plasma collection optimization, potency assay development, and additional preclinical activities supporting planned cGMP conformance lot production during the second half of 2026. It is well documented in the published literature that a significant unmet medical need exists despite current S. pneumonia prevention recommendations. Immunocompromised patients remain at a disproportionately high risk for severe pneumococcal disease. Underlying impairments in functional immunity limit vaccine-mediated protection, leaving a persistent need for alternative targeted preventive strategies in the patients at greatest risk. We believe SG-001 has the potential to mitigate the disease burden and are encouraged by the preclinical studies conducted to date. These activities are intended to support the anticipated submission of our pre-IND meeting package to the FDA by year-end.
Encouraging preclinical findings generated to date continue to support our belief that SG-001 could address a meaningful unmet medical need and represent a substantial long-term growth opportunity for ADMA. If approved, we believe SG-001 represents a $300 million-$500 million annual revenue opportunity. Leveraging ADMA's existing manufacturing capabilities and commercial infrastructure could support an efficient development program and potentially expeditious commercial launch. We believe ADMA enters the second half of 2026 from a position of increasing strength. ASCENIV demand is accelerating. Differentiated value proposition is becoming increasingly well supported. BIVIGAM demand is stabilizing in the face of increased competitive pressures. We believe our manufacturing and plasma sourcing platforms are positioned to support sustained growth and ensure the continuity of care for patients. Our business is performing across all facets. We are making progress with our stated corporate goals and objectives. We continue to generate significant cash.
Before I turn the call over to Terry, I would like to recognize and thank the entire ADMA team for their continued dedication, efforts, and execution. Our commitment to patients, operational discipline, and focus on excellence remain central to our performance and position the company for sustained long-term success. Terry?
Thank you, Adam. I'll begin with our second quarter financial results before discussing our balance sheet, cash generation, capital allocation priorities, and outlook for the remainder of 2026. Total revenue for the second quarter was $124.4 million, compared to $122 million in the prior year period, representing 2% year-over-year growth. ASCENIV revenue was $102.9 million, increasing 24% year-over-year, while BIVIGAM revenue was $19.4 million, reflecting sequential improvement from the first quarter as market conditions stabilized. Gross profit for the quarter was $86.3 million, resulting in gross margin of 69%, compared to 55% in the prior year period. Margin expansion primarily reflected continued ASCENIV mix expansion together with the ongoing benefits of our yield enhanced manufacturing process. Adjusted EBITDA was $61.8 million, increasing 22% year-over-year. Adjusted net income totaled $39 million, increasing 8% year-over-year. GAAP net income for the second quarter was $37.8 million, increasing 11% year-over-year.
It is important to note that ADMA's effective tax rate for the quarter was 24.7%, an increase of approximately 10 percentage points compared to the prior year period. The increase was primarily driven by discrete tax benefits recognized in the prior year quarter. The company continues to anticipate its normalized effective tax rate to be approximately 24% going forward. Taken collectively, the second quarter financial results demonstrate the continued earnings leverage of our business model as ASCENIV becomes an increasingly larger component of our product mix, and our manufacturing platform continues to deliver operating efficiencies. Turning to the balance sheet. We ended the quarter with approximately $136 million in cash and cash equivalents. Net leverage remains less than a half a turn, and we maintain approximately $100 million of additional borrowing capacity under our existing revolving credit facility.
We believe our balance sheet continues to provide significant strategic flexibility to invest in commercial expansion, manufacturing initiatives, and pipeline development while continuing to execute a disciplined capital allocation strategy. As the company continues to remain actively repurchasing its own shares, we repurchased approximately 7.1 million shares during the quarter under our authorized share repurchase program using internally generated cash flow, bringing the year-to-date total repurchases to approximately 13.8 million shares and representing approximately 5.3% of ADMA's common stock outstanding as of June 30th, 2026. We believe repurchasing shares at attractive valuations represents an effective allocation of capital while maintaining substantial financial flexibility to support long-term growth initiatives. Cash from operations totaled approximately $30 million during the quarter, reflecting continued earnings growth and disciplined working capital management.
Accounts receivable totaled $138.2 million at quarter end and days sales outstanding, or DSOs, of approximately 101 days, improving from approximately 107 days at the end of the first quarter. As we discussed previously, DSOs have stabilized over the first half of 2026, and we will continue to target DSOs between 90 to 105 days in the second half of the year. Importantly, the quality of our receivables remains excellent. All of our receivables from Q1 2026 have been collected, and we continue to expect collection in full of all of our outstanding receivables. Inventory at the quarter end was $239.3 million. Inventory levels remain consistent with our commercial planning assumptions and are intended to support continued growth in ASCENIV and ensure the continuity of care of all patients. Turning to our outlook. We are reiterating our full year 2026 financial guidance.
We continue to expect total revenue of $530 million-$560 million, adjusted EBITDA of $265 million-$300 million, and adjusted net income of $170 million-$200 million. Our outlook continues to assume sustained competitive dynamics and pricing pressure within the standard immune globulin market through the balance of the year. At the same time, it reflects our expectation that ASCENIV will remain the company's principal driver of revenue growth, profitability, and cash generation. Our guidance also incorporates planned investments supporting commercial expansion manufacturing initiatives, and continued advancement of SG-001, while preserving the financial flexibility to continue returning capital to stockholders. Importantly, our outlook continues to reflect what we believe are prudent planning assumptions, despite the improving commercial indicators discussed today.
Based on our second quarter performance, continued strong cash generation, and the commercial indicators Adam discussed earlier, we remain confident in our ability to meet or exceed our full-year expectations. Overall, we believe ADMA remains exceptionally well-positioned. We believe our differentiated commercial portfolio, expanding profitability, strong cash generation, disciplined capital allocation strategy, and flexible balance sheet provide a solid foundation to continue investing in the business while creating meaningful long-term value for stockholders. With that, I'll turn the call back to Adam.
Thank you, Terry. As we conclude, we believe the second quarter further validated the strength and durability of ADMA's business. In the face of ongoing competitive immunoglobulin market pressures, ASCENIV demand strengthened throughout the quarter, with June delivering the strongest sequential month-over-month end-user growth we have experienced since the first half of 2024. At the same time, BIVIGAM demand is stabilizing, resulting in sequential improvement in both utilization and revenue. Together, these trends for our IG product portfolio reinforce our confidence that ASCENIV remains well-positioned to drive continued growth through the balance of 2026 and beyond, and BIVIGAM will maintain its present positioning. Equally important, we believe ASCENIV's differentiated value proposition continues to strengthen.
This view is supported by the expanded base of real-world evidence that has been published, as well as through a new abstract submitted to the 2026 American College of Allergy, Asthma and Immunology annual scientific meeting, which documents significant improvements in health outcomes and reductions in healthcare resource utilization among medically complex primary immunodeficiency patients. We believe these findings further support increasing physician adoption, payer engagement, and long-term commercial expansion for ASCENIV. Operationally and financially, we believe ADMA remains exceptionally well-positioned to execute on our long-term strategy. Our yield-enhanced manufacturing platform, diversified plasma sourcing strategy, strong balance sheet, and significant cash generation are expected to provide the flexibility to invest in commercial growth, advance our pipeline, and continue returning capital to stockholders through disciplined share repurchases.
Beyond ASCENIV, we continue to execute against our development strategy and remain on track to submit our pre-IND meeting package for SG-001 to the FDA by year-end and produce conformance batches in the second half of 2026. We continue to believe SG-001 represents a compelling long-term opportunity that leverages ADMA's existing manufacturing platform, commercial infrastructure, and decades of expertise in the specialty plasma-derived biologics in an area of medicine where significant unmet medical needs persist. Commercial momentum continues to build. Our differentiated evidence base continues to expand, our financial profile continues to strengthen. Collectively, these strengths reinforce our confidence in ADMA's long-term growth trajectory and are expected to position the company to execute against its core mission to continue creating meaningful benefits for patients and healthcare providers, which translates into value creation for our stockholders in the years ahead.
Before opening the call for questions, I would once again like to thank our employees for their extraordinary efforts working for the patients counting on us. At ADMA, we are operating on the forefront of science, rapidly implementing innovative technologies and tackling challenges to address unmet medical needs. Without your efforts, dedication, and unwavering commitment to operational excellence, we would not be achieving all that we have and what is yet to come. We also extend our gratitude to our stockholders for their continued support of our company and its important mission. Thank you for your continued support and interest in ADMA. Operator, we can now open the call for questions.