We have out-licensed to external partners for the development and commercialization of tenapanor outside of the U.S. We recognize revenue from our collaboration partnerships as licensing revenue, product supply revenue or non-cash royalty revenue related to the sale of future royalties. See Note 7. Collaboration and Licensing Agreements and “Collaboration and Licensing Revenue” caption of Note 2. Summary of Significant Accounting Policies of our 2025 Form 10-K for more information on the nature, purpose, significant rights and obligations of the parties, as well as our accounting policies for such revenue streams.


	Three Months Ended June 30,				Six Months Ended June 30,
(in thousands)	2026		2025		2026		2025
Licensing revenue

Fosun Pharma	$	95	$	—	$	115	$	5,000
Knight	1		20		32		40

Total licensing revenue	$	96	$	20	$	147	$	5,040
Product supply revenue
Fosun Pharma	$	1,976	$	—	$	2,328	$	—
Kyowa Kirin	—		6,185		2		6,185
Knight	—		—		—		254
Total supply revenue	$	1,976	$	6,185	$	2,330	$	6,439
Non-cash royalty revenue related to the sale of future royalties
Kyowa Kirin	$	676	$	1,380	$	1,371	$	2,406


	2026						2025
(in thousands) Current	Kyowa Kirin		Fosun Pharma		Total		Kyowa Kirin		Fosun Pharma		Total
Deferred revenue balance as of January 1,	$	—	$	1,206	$	1,206	$	10,686	$	—	$	10,686
Prepaid product supply	—		7,529		7,529		227		—		227
Product supply delivered	—		(1,997)		(1,997)		(4,633)		—		(4,633)
Reclassify amounts to be recognized in the next 12 months	—		—		—		—		—		—
Deferred revenue balance as of June 30,	$	—	$	6,738	$	6,738	$	6,280	$	—	$	6,280


	2026						2025
(in thousands) Non-current	Kyowa Kirin		Fosun Pharma		Total		Kyowa Kirin		Fosun Pharma		Total
Deferred revenue balance as of January 1,	$	13,699	$	—	$	13,699	$	7,232	$	—	$	7,232
Prepaid product supply	—		—		—		5,063		—		5,063
Product supply delivered	—		—		—		—		—		—
Reclassify amounts to be recognized in the next 12 months	—		—		—		—		—		—
Deferred revenue balance as of June 30,	$	13,699	$	—	$	13,699	$	12,295	$	—	$	12,295

Significant developments and updates related to our collaboration partnerships in the six months ended June 30, 2026 and 2025 are discussed below.

In March 2026, Fosun Pharma reported the first commercial sales of tenapanor, marketed under the Chinese trade name Wan Ti Le, for patients with CKD on hemodialysis with hyperphosphatemia in China. Pursuant to the terms of the license and manufacturing services agreements with Fosun Pharma, we are eligible to receive reimbursement of cost plus a reasonable overhead for the supply of product and tiered royalties on net sales ranging from the mid-teens to 20%.

In February 2025, we announced the NDA approval by China’s Center for Drug Evaluation of the NMPA for tenapanor in the control of serum phosphorus in adult patients with CKD on hemodialysis. This approval triggered a $5.0 million milestone to us, which was recorded as licensing revenue in our condensed statements of operations and comprehensive loss in the 2025 first quarter.

Effective as of March 13, 2026, we entered into a termination agreement with Knight, pursuant to which we and Knight agreed to mutually terminate our exclusive license agreement for the development, commercialization and distribution of tenapanor in Canada for hyperphosphatemia and IBS-C. The decision was not related to any concerns regarding the safety, efficacy or quality of the product. Sales of IBSRELA in Canada were discontinued effective March 31, 2026. The termination did not have a material effect on our operations or financial results, and we do not expect it to adversely impact our operations or financial results in the future.

In connection with the AstraZeneca Termination Agreement, we recognized royalty expense as cost of sales in our condensed statements of operations and comprehensive loss of $3.8 million and $12.7 million in the three and six months ended June 30, 2025, respectively. As of the end of the 2025 second quarter, we had fully recognized the maximum $75.0 million royalty obligation, which had been fully remitted as of the end of the 2025 third quarter.