OPKO Elects Shares Over Cash to Settle $121 Million in Convertible Notes

OPKO Health is a Miami-based multinational biopharmaceutical and diagnostics company with an approximate $1.2 billion market cap. Its two main segments are a diagnostics business run through BioReference Laboratories and a pharmaceutical and royalty business that includes the growth hormone Ngenla (partnered with Pfizer), the vitamin D therapy Rayaldee, and a portfolio of early-stage antibody programs developed through its ModeX subsidiary.

The company has been reshaping its balance sheet through asset sales. In September 2025, it sold BioReference's oncology assets to Labcorp for $225 million. That transaction, while reducing revenue, also eliminated a significant cost base: service revenue dropped from $204 million in the first half of 2025 to $146.7 million in the first half of 2026, but the operating loss narrowed materially once the lower-margin oncology business was gone. Q2 2026 was the strongest recent quarter operationally, with total revenue of $163.5 million and an operating loss of just $7 million, though a $46 million IP revenue line — partly driven by a one-time equity stake received from Nicoya — padded the quarter.

Full-year 2026 guidance projects total revenues of $560 million to $585 million against total costs and expenses of $710 million to $740 million, implying an operating loss of $125 million to $180 million. Cash, cash equivalents, and restricted cash stood at $300.8 million as of June 30, 2026, down from $369.1 million at year-end 2025 — a decline that reflects both ongoing operational cash consumption and approximately $105 million in share repurchases completed through June 30 under a program authorized in July 2025.