Will Strong Livmarli Uptake Continue to Aid MIRM's Revenues in 2026?

Mirum Pharmaceuticals’ MIRM revenue base is largely supported by its lead product, Livmarli (maralixibat), which has been witnessing steady sales uptake since its launch. The drug remains a key top-line driver for the company.

Livmarli is an orally administered ileal bile acid transporter (“IBAT”) inhibitor approved for the treatment of cholestatic pruritus in patients with Alagille syndrome (“ALGS”) worldwide. The drug is also approved for treating certain patients with progressive familial intrahepatic cholestasis (“PFIC”) in the United States and Europe.

The FDA has also approved a new tablet formulation of Livmarli for treating cholestatic pruritus in ALGS and PFIC patients, a move expected to improve convenience for older patients.

In the first nine months of 2025, Livmarli’s net product sales were $253.6 million, up 70% year over year. The continued demand for Livmarli is driving the top line, and the momentum is likely to continue heading into the new year.

Looking ahead, sales are expected to grow steadily as Mirum expands its commercial footprint and strengthens its marketing infrastructure, driving continued momentum for Livmarli. Management expects Livmarli product revenues to increase in future quarters, owing to the strong global adoption of the product.

Besides Livmarli, Mirum is also making good progress with its other marketed products — Cholbam capsules and Ctexli tablets, which are approved for certain rare diseases. These products were added to Mirum’s commercial portfolio following the acquisition of Travere Therapeutics’ TVTX bile acid products in 2023.

The acquisition of Travere Therapeutics’ bile acid products has diversified Mirum’s revenue stream. Sales from the bile acid products, comprising Cholbam and Ctexli tablets, also contributed meaningfully to MIRM’s top line during the first nine months of 2025.

Mirum now expects total revenues to be in the range of $500-$510 million in 2025, compared with the earlier expectation of $490-$510 million, reflecting growing momentum with Livmarli and incremental sales from the bile acid products.

Apart from these products, MIRM’s lead pipeline candidate, volixibat, is currently being evaluated in two phase IIb studies for treating patients with primary biliary cholangitis (the VANTAGE study) and primary sclerosing cholangitis (the VISTAS study).

MIRM’s Competition in the Target Market

Though Mirum is riding on the robust sales performance of Livmarli, the company’s heavy reliance on the drug for revenues remains a concern. Any regulatory setback for the drug in the days ahead could hurt the stock.

Competition is also rising from Albireo AB (now part of Ipsen), which markets Bylvay — an IBAT inhibitor directly competing with Livmarli in the PFIC and ALGS indications. Since both therapies work by inhibiting IBAT to lower serum bile acid levels, this is likely to induce acute competition that could impact Mirum’s market share and revenue trajectory. Bylvay is considered the most direct competitor for Livmarli in the PFIC and ALGS markets.

GSK plc GSK is developing its IBAT inhibitor, linerixibat, for treating adult patients with cholestatic pruritus associated with primary biliary cholangitis. A regulatory filing seeking approval for linerixibat is currently under review in the United States, with a decision from the FDA due on March 24, 2026.

A potential nod to linerixibat is likely to pose stiff competition for Mirum’s volixibat, given the huge resources available to a large drugmaker like GSK.

MIRM’s Price Performance, Valuation and Estimates

In the past six months, shares of Mirum have rallied 35.9% compared with the industry’s rise of 21.6%. The stock has also outperformed the sector and the S&P 500 during the same time frame, as seen in the chart below.

From a valuation standpoint, Mirum is trading at a premium to the industry. Going by the price/book ratio, the company’s shares currently trade at 11.87, higher than 3.55 for the industry. The stock is also trading above its five-year mean of 6.87.

The Zacks Consensus Estimate for its 2025 loss per share has narrowed from 67 cents to 41 cents over the past 60 days. During the same time frame, estimates for 2026 have declined from earnings of 4 cents per share to a loss of 29 cents.

MIRM's Zacks Rank

Mirum currently carries a Zacks Rank #3 (Hold). You can see the complete list of today’s Zacks #1 Rank (Strong Buy) stocks here.

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This article originally published on Zacks Investment Research (zacks.com).

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