Kamada in 2025: Growth Returned, but 2026 Will Test Cash Quality More Than Pace

Getting To Know The Company

At first glance, Kamada can still look like another Israeli biotech name built around pipeline, regulation, and future optionality. That is now too narrow a read. Economically, Kamada in 2025 is already a commercial specialty-plasma company: a portfolio of rare-disease plasma products, a local distribution arm that is improving through biosimilars, and a U.S. plasma-collection ramp that is meant to strengthen both supply and growth.

What is working now is real. Revenue rose to $180.5 million, gross profit rose to $76.4 million, operating income rose to $26.2 million, and net income jumped to $20.2 million. The proprietary-products engine is still the core of the story, but the distribution arm, with gross profit up to $4.1 million from $2.2 million a year earlier, is already more relevant than the revenue headline alone suggests.

But Kamada's active bottleneck is no longer basic selling ability. It is not classic bank pressure either. The company ended 2025 with $75.5 million of cash, an unused NIS 35 million on-call credit line, and the old financial covenants were removed in February 2025. The real bottleneck is the quality of conversion from growth into accessible cash. Heavier working capital, CAPEX, dividends, and the remaining Saol-related payments leave the main 2026 question focused not on sales pace, but on how much cash actually remains after the real uses.

That is also what a superficial reader can miss if they stop at the headline. CYTOGAM fell by $5.4 million, the GLASSIA royalty rate stepped down from 12% to 6% starting in August 2025, and reported R&D was flattered by a $3.0 million non-refundable payment that offset expenses after an Inhaled AAT out-licensing process was cancelled. At the same time, operating cash flow fell to $25.5 million from $47.6 million, largely because of working capital.

The fast economic map for Kamada looks like this:

There is an important capital-markets frame here as well. In early April the equity was trading around a NIS 1.5 billion market cap, while short interest remained very low, 0.08% of float versus a sector average of 0.38%, with an SIR of 0.29 versus 1.278 for the sector. In other words, the market is not reading Kamada as a pressure story today. It is reading it as a proof story.

Events And Triggers

The main change around 2025 is that Kamada no longer has one dominant trigger. It has a chain of them. The 2026 read now sits on four linked issues: the plasma ramp, the distribution expansion, the changing weight of KEDRAB and VARIZIG, and the fact that the large Inhaled AAT option is no longer there.

Management is already asking more of 2026 than the 2025 numbers deliver on their own

Kamada guided for 2026 revenue of $200 million to $205 million and adjusted EBITDA of $50 million to $53 million. At the midpoint, that implies 13% revenue growth and 23% adjusted EBITDA growth. That is a more demanding target than it first appears. It comes after CYTOGAM weakened, after the GLASSIA royalty rate stepped down, and while the company is still investing in plasma collection and manufacturing capacity.

That means management is not building 2026 on a simple continuation of 2025. It is building on replacement engines doing the work: KEDRAB, VARIZIG, ex-U.S. sales, biosimilars, and potentially normal source plasma sales. This is already a proof year, not a passive continuation year.

The plasma ramp can improve the economics, but it still has to prove itself

The company now has three plasma collection centers in the U.S.: Beaumont, Houston, and San Antonio. The Houston site received FDA approval in 2025. The San Antonio site completed its FDA audit in February 2026, and the company expects approval in the first half of 2026. Once fully ramped, Houston and San Antonio are each expected to contribute about $8 million to $10 million of annual revenue from normal source plasma sales.

That is material because it operates at two levels. First, it can reduce dependence on third-party plasma suppliers. Second, it can turn plasma collection itself into a revenue line. But this is still not clean cash in hand. The company itself lists the friction points: donor availability, regulation, pricing, future supply agreements, and overall market conditions in the collection industry. Value is being built here, but it has not yet been locked in.

The Saol acquisition is still creating value, and still consuming cash

The acquisition of CYTOGAM, HEPAGAM B, VARIZIG, and WINRHO SDF changed Kamada several years ago, and it is still shaping the company now. On the positive side, it gave Kamada a deeper U.S. commercial portfolio, and the company kept growing through VARIZIG and KEDRAB. On the other side, as of year-end 2025 there were still $60.4 million of contingent consideration and assumed liabilities outstanding, and management expects about $9.9 million of payments over the next 12 months.

That matters because Kamada is no longer in the "was the acquisition strategically right" phase. It is in the phase of where the cash generated by the acquisition is still getting absorbed. On an operating-profit basis, the acquisition is working. On a full shareholder-accessible basis, there is still a material cost sitting above it.

Inhaled AAT came off the table, and the company became even more commercial

In December 2025 Kamada discontinued Phase 3 InnovAATe after a futility analysis concluded the trial was unlikely to meet its primary endpoint. This was not a safety event. At the same time, the company incurred $2.6 million of closeout costs, but it had also received a $3.0 million non-refundable payment tied to an exclusivity letter for a potential out-licensing transaction, which was then recorded as an offset to R&D after the process was voided.

From a thesis perspective, this is a real turning point. Kamada exited the year more commercial and less pipeline-driven. That lowers future burn, but it also reduces optionality. Anyone buying the 2026 story is now buying mainly a commercial and industrial engine, not a large late-stage development option.

Efficiency, Profitability, And Competition

The real interest in Kamada is not only that the numbers improved. It is who carried the improvement, and who is already pushing back against it.

The proprietary engine is still strong, but it is less clean than it looks

Proprietary-products revenue rose 10.4% to $156.2 million. Within that, KEDRAB climbed to $53.6 million, VARIZIG rose to $11.1 million, KAMRAB rose to $17.2 million, and ex-U.S. GLASSIA sales reached $19.4 million. That matters because it shows the company is not relying on one single product to grow.

But the picture is not one-directional. CYTOGAM fell to $17.1 million from $22.5 million in 2024, mainly because antivirals such as letermovir and maribavir gained better market access. At the same time, GLASSIA royalties from Takeda fell to $15.8 million from $16.9 million, mainly because the royalty rate stepped down from 12% to 6% starting in August 2025.

So 2025 was not a year in which everything moved higher. It was a year in which KEDRAB, VARIZIG, and ex-U.S. activity covered for CYTOGAM weakness and for the beginning of a structural royalty headwind in GLASSIA. That changes the 2026 read materially: the company already has to replace an engine, not just extend it.

Concentration is still material. The company itself states that KEDRAB, GLASSIA, CYTOGAM, and GLASSIA royalties together represented about 59% of total revenue in 2025. In addition, at least one customer remained above the 10% threshold at $53.6 million of revenue. That does not make the story fragile, but it does mean 2026 will still depend on a relatively small number of levers.

Distribution is still small in size, but much less small in quality

Distribution still contributed only $24.3 million out of $180.5 million of total revenue. It would be easy to dismiss it. That would be wrong. Gross profit in this segment rose to $4.1 million from $2.2 million, and gross margin jumped to 17% from 11%. The two biosimilars already launched generated $2.4 million of sales in 2025, and management expects two more launches in 2026, with a broader target of $15 million to $20 million of sales from the existing biosimilar portfolio within four to five years.

So distribution does not yet change the size of the company. It is already changing the quality of the mix. If that continues, it can make Kamada less dependent on each individual product in the proprietary portfolio.

Operating profit improved, but below the surface there are distortions

R&D expense fell to $13.0 million from $15.2 million. On the surface that looks like relief. In practice it needs to be read carefully: the number includes the $3.0 million offset tied to the cancelled Inhaled AAT out-licensing process. Without that offset, 2025 R&D would not have looked as light. So the report shows a decline, but the economics of that decline are not fully clean.

Cost of sales also carries an important signal. In 2025 the company recognized $13.5 million of inventory impairment and net-realizable-value charges, versus $8.6 million in 2024 and $4.4 million in 2023. That does not mean there is an inventory crisis. It does mean the improvement in profitability happened alongside an area where accounting judgment became heavier, and this is exactly one of the two issues the auditor highlighted as a critical audit matter, together with goodwill testing.

General and administrative expense also rose 19.1% to $18.7 million, mainly because of higher IT spending. So 2025 should not be read as a year of one clean commercial engine. It was a year in which commercial momentum improved, while another layer of cost, judgment, and complexity was also building underneath.

From a competition standpoint, Kamada still benefits from a rare portfolio and plasma-manufacturing know-how, but it competes against much larger players. The company itself lists CSL, Takeda, Grifols, Octapharma, Biotest, ADMA, and others. In AAT specifically, the threat is no longer purely theoretical: in October 2025 Sanofi reported positive Phase 2 results for efdoralprin alfa, a recombinant candidate that could, if it reaches market, put future pressure on the AAT market and on the economics surrounding GLASSIA.

Cash Flow, Debt, And Capital Structure

This is where the core thesis sits. When the investment question is about funding flexibility and how much accessible value really reaches shareholders, the right frame is all-in cash flexibility. In other words, not how much the business produced before discretionary uses, but how much cash was left after the real uses of the period.

Operating cash flow stayed positive, but the full picture is much tighter

Operating cash flow came in at $25.5 million, versus $47.6 million in 2024. That is still respectable relative to $20.2 million of net income, so this is not a story of earnings existing only on paper. But the drop is sharp, and it was driven almost entirely by working capital: a $5.4 million increase in receivables, a $6.1 million increase in inventory, and a $6.9 million decline in payables.

If one stops there, one can say the core business still produces cash. That would be incomplete. After $9.8 million of CAPEX, $11.5 million of dividends, $1.0 million of lease principal repayments, and $5.9 million of long-term liability payments tied to the Saol acquisition, the all-in picture shows roughly negative $2.7 million. That is why cash fell to $75.5 million despite a profitable year.

This is exactly where two cash readings need to be separated. On a normalized basis, one can argue the commercial core is still healthy because operating cash flow remained positive. On the full-cash basis, which is more relevant here, flexibility is still not clean because the cash generated continues to be absorbed by working capital, deal payments, investment, and shareholder returns.

Inventory is no longer a background line

Inventory rose to $84.9 million from $78.8 million. Within that, raw materials rose to $34.3 million from $30.5 million, and finished goods rose to $35.4 million from $29.4 million. In other words, part of the cash is tied up not only in raw-material build, but also in goods already completed.

There is a balancing point, however. After year-end the company collected $10.4 million against the December 2025 receivables balance, including $457 thousand from balances that had been past due for more than 121 days. That does not resolve the working-capital question, but it does suggest that the concern here is more about the amount of cash tied up than about outright receivables quality.

The balance sheet is not under stress, but value is still not fully accessible

It is important not to confuse two different things here. On a balance-sheet basis, Kamada is not under acute pressure. Cash stood at $75.5 million. The new on-call bank facility was unused. The old bank loan had already been repaid in 2023. The old covenant package was removed with the February 2025 facility change. Even lease debt, at $11.6 million, is not the main issue.

But at the common-shareholder level, part of the value is still not readily accessible. The reason is that roughly $60.4 million of contingent consideration and assumed liabilities still sit above the cash balance, and another $9.9 million is expected to be paid over the next 12 months. Add to that the $14.4 million dividend declared in March 2026, and the issue becomes clear: the constraint is not the ability to pay. It is how much freedom is left after paying.

So this is not a solvency story. It is a story of operating value versus accessible value. Kamada is building more operating value, but not all of that value is yet moving easily up to ordinary shareholders.

Outlook And Forward View

Before going into more detail, it helps to align on four points the market should not miss:

• The reported decline in R&D is not a clean number because it includes a one-time $3.0 million offset.
• 2026 begins after the GLASSIA royalty rate has already stepped down, so other engines need to replace it.
• Operating cash flow stayed positive, but 2025 all-in cash flexibility was slightly negative.
• Distribution and plasma collection look like quality-improving engines, but they still need to become recurring proof points.

2026 looks like a proof year, not a clean breakout year

The right label for next year is a proof year. Not because the business is fragile, but because too many moving parts need to work at the same time: KEDRAB needs to keep carrying momentum, VARIZIG needs to stay strong, CYTOGAM needs at least to stop sliding, distribution needs to keep scaling, San Antonio needs to turn from construction and approval into contribution, and all of that needs to happen with more disciplined working capital.

The KEDRAB agreement also gives the company a kind of floor. Under the fifth amendment with Kedrion, Kamada expects at least about $90 million of aggregate revenue in 2026 and 2027 from the remaining minimum quantities committed for that phase of the agreement. That does not remove dependency, but it does provide a visible base layer on the revenue side.

What has to happen for the thesis to improve

First, San Antonio needs to move from being an in-progress site to becoming an approved and contributing site. Without that, the plasma ramp will remain more of a CAPEX and expectation story than an economic one.

Second, the replacement engines have to prove they are truly replacement engines. If GLASSIA royalties remain lower and CYTOGAM does not recover, then KEDRAB, VARIZIG, ex-U.S. sales, and biosimilars need not only to cover the revenue gap, but also to leave a better margin and cash profile behind them.

Third, working capital needs to calm down. It does not require a dramatic reversal. It is enough for inventory and receivables to stop growing faster than sales for the market read to improve materially.

Fourth, management will have to show that the adjusted EBITDA growth it is guiding to actually starts flowing through into reported operating profit and cash after the real uses. Otherwise, the market will leave that guidance in the category of impressive non-IFRS framing rather than decisive proof.

What the market may miss in the near term

The market may look at the 2026 guidance and read it as a natural continuation of 2025. That is too generous a read, because 2025 also benefited from one-off offsets and from the fact that operating cash flow still provided some cushion.

The real metric over the next 2 to 4 quarters will be less "are sales growing" and more "who is paying for that growth". If revenue continues to rise but inventory, receivables, and CAPEX keep doing the same, the market will grow more skeptical. If instead Kamada shows San Antonio approval, distribution traction, and calmer working capital, the read can improve relatively quickly because there is no heavy short base already waiting on the other side.

Risks

Product and customer concentration are still material

About 59% of 2025 revenue came from KEDRAB, GLASSIA, CYTOGAM, and GLASSIA royalties. At least one customer remained above 10% of revenue. In addition, 55% of total revenue still came from the U.S., and 28% of total revenue came through third-party distributors in markets outside the U.S. This does not mean the company is relying on only one hand. It does mean diversification is still only partial.

CYTOGAM and GLASSIA are pulling in two uncomfortable directions

CYTOGAM was already pressured in 2025 by stronger antiviral market access. At the same time, GLASSIA now carries a lower royalty rate, and over time it could also face new technological competition in AAT. If those two pressure points persist together, Kamada will need stronger replacement engines than it has today.

Plasma can become a growth engine, but it is also an execution risk

Plasma collection depends on donors, regulation, pricing, labor availability, and competition. The future transfer of HEPAGAM B, VARIZIG, and WINRHO SDF from Emergent to the Beit Kama facility is also expected to take four to five years and requires process changes, contractual amendments, and regulatory approvals. Strategically, the direction makes sense. Operationally, it creates a non-trivial transition period.

Currency and the Israeli operating backdrop are still in the story

The company had excess NIS liabilities over NIS assets of $19.6 million. A 10% move in the shekel against the dollar would change the exposure by roughly $2.0 million. In addition, the main manufacturing plant in Beit Kama remains a real operating concentration point, and the company itself states that political, economic, and military instability in Israel and the region can affect the business.

Bottom Line

Kamada ends 2025 as a company that is commercially stronger than it looked several years ago. Growth returned, the distribution engine improved, and the balance sheet does not signal distress. What supports the thesis today is a broader commercial portfolio, some visible demand floor in KEDRAB, and a plasma ramp that can strengthen both supply and revenue. The central blocker is that cash is still not accumulating as easily as profit is being recorded.

The current thesis in one line is: Kamada has already shown it can grow, but 2026 will test whether that growth truly turns into funding flexibility rather than only into a better earnings line.

What changed versus the earlier read of the story is that Kamada has become more commercial and less pipeline-driven, and the debate has shifted from growth itself to the quality of that growth.

The strongest counter-thesis is that the caution is overstated because the company still holds a large cash balance, has no visible bank pressure, has a visible KEDRAB revenue floor, and 2026 guidance already points to double-digit growth even after the GLASSIA royalty-rate reduction.

What could change the market interpretation in the short to medium term is actual approval and contribution from San Antonio, proof that biosimilars are genuinely lifting distribution profitability, and a visible stop to the working-capital inflation.

Why does this matter? Because in a commercial plasma company, the difference between growing profit and cash that actually remains after deal payments, investment, and dividends is the difference between value being created and value being accessible to shareholders.

Over the next 2 to 4 quarters, San Antonio needs to move from approval to contribution, working capital needs to calm down, KEDRAB and VARIZIG need to keep growing, and distribution needs to show that biosimilars add quality, not only volume. What would weaken the thesis? Continued CYTOGAM erosion, an inability to sell plasma on good terms, or another year in which cash erodes despite strong profitability.

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