Heron Therapeutics announced that its postoperative nausea and vomiting (PONV) drug APONVIE has been incorporated into the Fifth Consensus Guidelines for the Management of Postoperative Nausea and Vomiting, published in Anesthesia and Analgesia. The guidelines, which are developed by a multidisciplinary panel of anesthesiologists, surgeons, and pharmacists, recommend APONVIE as a neurokinin‑1 receptor antagonist for adult patients. The recommendation highlights the drug’s rapid 30‑second intravenous push and long‑acting profile, positioning it as a preferred option over oral formulations and underscoring its potential to improve patient outcomes and streamline peri‑operative care.
The inclusion is a significant endorsement that can accelerate physician adoption, expand formulary access, and enhance payer coverage. APONVIE’s rapid onset and sustained effect make it attractive for high‑risk surgical patients, a group that experiences PONV in up to 80% of cases. By gaining guideline recognition, the drug is positioned to capture a larger share of the $1.5 billion annual PONV market, which could translate into higher sales and stronger competitive differentiation for Heron’s acute‑care portfolio.
On the same day, Heron reported its Q3 2025 earnings. Total revenue fell to $38.2 million, missing analyst expectations of $39.49 million. Net loss widened to $17.5 million, or $0.10 per share, compared with a $0.0153 per share loss forecast. The revenue miss was driven by a 4% decline in the company’s core acute‑care segment, offset by a 173% year‑over‑year jump in APONVIE sales to $3 million from $1.1 million in Q3 2024. The earnings miss was largely attributable to higher inventory reserves and write‑offs that compressed gross margin from 71.2% to 68.8%.
Investors reacted to the earnings miss, with the market focusing on the revenue shortfall and the wider‑than‑expected loss per share. Management emphasized that the Q3 results reflected short‑term execution challenges rather than a long‑term trend. CEO Craig Collard highlighted the importance of preventing PONV for a safe and satisfying recovery, underscoring the strategic value of APONVIE’s guideline endorsement. Heron reaffirmed its full‑year 2025 guidance—net revenue of $153 million to $163 million and adjusted EBITDA of $9.0 million to $13.0 million—while signaling confidence in continued growth of its acute‑care products.
The guideline inclusion, coupled with the Q3 earnings data, paints a nuanced picture: while short‑term financial performance fell short of expectations, the strategic milestone for APONVIE positions Heron for long‑term upside in a high‑growth therapeutic area. The company’s focus on cost discipline, inventory management, and market expansion will be critical to translating the guideline endorsement into sustained revenue growth.
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