On August 13, ARS Pharmaceuticals (NASDAQ:SPRY) held its second-quarter 2026 earnings call, the first for new President and CEO Donn Casale. He used it to lay out three priorities: sharper commercial targeting for neffy, tighter financial discipline, and a pipeline push into chronic spontaneous urticaria. The quarter itself showed a company still early in proving its epinephrine nasal spray can win over prescribers who default to needle-based injectors out of habit.
Bull Case: A Prescriber Habit Starts Shifting
The headline number is market share. Neffy’s total US share reached 5% in the second quarter, double the 2.5% mark from a year earlier. Inside the field sales team’s targeted call universe, share jumped further, to 8% from 4%. That targeted approach is showing up in the prescriber data too, with more than 16,000 unique neffy prescribers in the quarter, over three times the year-ago total. Casale pointed to a stark gap between covered and uncovered territory: where the sales team is active, neffy holds 8% share versus roughly 1% where it isn’t.
To lead that push, ARS brought on Meg Smith as Chief Commercial Officer, a 25-year veteran Casale worked with at Dynavax. The field organization is now fully built out and pointed at the highest-value prescribers, who represent 44% of the total market opportunity. Beyond neffy, ARS is extending its intranasal epinephrine platform into CSU, a market with no FDA-approved on-demand treatment for acute flares today, a gap the company believes its existing commercial infrastructure is positioned to fill.
Bear Case: Spending Cuts Signal Deeper Strain
The flip side of that story is cost. Second quarter total revenue was $33.7 million, with $26.2 million of that coming from US net product sales, against total operating expenses of $95.1 million, including $12.8 million in cost of goods sold. SG&A alone ran approximately $77.6 million for the quarter, a level Casale acknowledged reflected an earlier strategy built around broad consumer advertising that didn’t convert well in what he described as a prevention-based market rather than a treatment market.
The company is now guiding to combined SG&A and R&D expenses of $114 million to $126 million for the back half of 2026, with cash-based spending in that category expected to fall to $100 million to $110 million, a cut of more than 40% in cash SG&A from the first half of the year. That reduced spending pace is expected to hold through 2027. On the pipeline side, the CSU phase II-B interim readout, previously expected by the end of 2026, has slipped to the first quarter of 2027, a delay the company attributed to the trial’s design requiring patients to log three separate flare episodes before data can be collected.
Wall Street Stays Skeptical
Hedge fund positioning in ARS Pharmaceuticals held flat at 31 funds holding a stake, unchanged from the prior quarter, showing neither building conviction nor an exodus. Short interest tells a sharper story, with 31.17% of the float sold short, a level that points to heavy organized skepticism about the stock. That combination suggests the market is waiting for evidence rather than pricing in the turnaround Casale described on the call.
A Story Still Being Written
ARS Pharmaceuticals ended the quarter with $143.8 million in cash and short-term investments, and management is targeting cash flow breakeven by the end of 2027. That timeline depends on the more disciplined spending plan holding and on market share gains continuing at a steady, quarter-over-quarter pace rather than the overnight spike Casale said isn’t coming. For the neffy franchise to justify the current cost cuts, prescriber conviction has to keep building in the targeted call universe. For the CSU program to matter, the delayed phase II-B data will need to clear the bar once it arrives in early 2027. Both threads are still open.
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