Mirum Pharmaceuticals NASDAQ: MIRM is a late-stage biotechnology company making significant progress in its fight against rare diseases with no or limited treatment options. Mirum recently reported its Q1 2026 earnings, headlined by 43% year-on-year (YOY) revenue growth.
In 2025, the company reported revenue of $521.3 million, up 54%, with its flagship drug Livmarli responsible for $360 million, a 69% YOY increase. Mirum has two other FDA-approved treatments—Cholbam for disorders of bile-acid synthesis, and Ctexli for cerebrotendinous xanthomatosis, a rare genetic disorder of bile acid metabolism.
The company also raised its full-year revenue guidance to a range of $660 million to $680 million. On average, that would be a 26% YOY increase. However, since the earnings report, MIRM is down about 12% despite bullish analyst sentiment.
What makes Mirum play with guesswork?
Mirum Pharmaceuticals Today
Mirum Pharmaceuticals
- 52 week interval
- $42.89
▼
$114.99
- Target Value
- $137.08
Mirum’s commercial story is unusual for a not-for-profit company: it already has three FDA-approved drugs generating real, incremental revenue. As noted above, Livmarli remains the main engine of growth, with net sales of products for Q1 2026 of $159.9 million representing strong sequential momentum.
Livmarli is currently in a late-stage trial that could expand the drug’s label to include Alagille Syndrome. Topline data for Phase 3 is scheduled for December.
Cholbam and Ctexli provide revenues that single legacy biotechs do not.
The pipeline adds additional revenue opportunities in the future:
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Brelovitug targets delta for chronic hepatitis, and zilurgisertib is already under FDA regulatory review for fibrodysplasia ossificans progressiva—a debilitating and currently incurable arthritis.
Any of these authorizations can significantly expand the company’s market reach. Currently, Volixibat is the best. On May 4, 2026, Mirum reported that the primary endpoint was met in the VISTAS Phase 2b study.
Then there is the benefit of commercial infrastructure. Mirum has spent years building relationships with hepatologists and transplant specialists who treat rare liver disease patients. That distribution channel is expensive to replicate and gives new pipeline drugs a faster path to discovery than a commercial stage launch would suggest. For investors willing to wait, that foundation is a real asset.
Why MIRM Drops?
The simple reason for MIRM’s downfall is that this is still a medium-sized unprofitable company and, although revenues are growing, it is still in its early stages. Short sellers are reacting to one area of data in the earnings report, namely that the company’s operating expenses were higher in the quarter ($949 million) due largely to one-time costs related to its acquisition of Bluejay.
This highlights a key risk for Mirum and many biotech stocks. A company needs to turn positive trial data into long-term, paid-for revenue. Mirum does that; it must now demonstrate that revenue can grow in a way that makes the company profitable.
To that end, management says its research and development (R&D) is funded and expects to be cash-efficient next year with GAAP profit in 2028.
However, the more complicated answer comes from the company’s proposed offering of $600 million in senior convertible notes starting in 2032. The announcement came with an overdraft option for an additional $90 million, offered in a private placement to qualified institutional buyers.
On the face of it, there’s nothing shocking about the announcement, and it certainly won’t be dilutive. And cheap investors would think that some of the money could go to buy more of the money-making drugs.
A Post-Salary Dip Can Be An Affordable Opportunity
Retail investors who bought into MIRM when it went public in 2019 benefited from the company’s strong growth. In fact, over the past five years, MIRM has risen more than 450%, including nearly 115% growth in the past 12 months.
It’s a reminder that investors with patience and conviction can be rewarded when these companies do, as Mirum did. That raises the question of how much upside is still there? Mirum analyst forecasts at MarketBeat have a consensus price of $137.08 as of May 19. That’s more than 40% above the stock’s price as of this writing.
Those estimates make a good reading for Maralizibat’s topline in late 2026. There is another opposite in the way of the company.
Getting caught? Short interest of around 17% means there will be selling pressure at any opportunity, even if it is unfounded in Mirum’s bull case.
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