Vericel (NASDAQ:VCEL) executives told investors the company closed 2025 with “outstanding” fourth-quarter performance, posting record revenue and profitability while advancing several growth initiatives tied to its MACI cartilage repair franchise and its burn care products.
Record fourth-quarter revenue and profitability
President and CEO Nick Colangelo said Vericel delivered record fourth-quarter total revenue that increased 23% year over year and exceeded the company’s guidance for the period. The strong top-line performance contributed to what management described as significant margin expansion and profit growth, including a gross margin “of nearly 80%” and an adjusted EBITDA margin of 40% in the quarter.
For full-year profitability, Mara said Vericel delivered 74% gross margin (up nearly 200 basis points year over year) and a 26% adjusted EBITDA margin (up over 300 basis points). GAAP net income grew nearly 60% to $16.5 million for 2025.
MACI momentum and commercial execution
Management emphasized strong momentum for MACI in the second half of 2025 and especially in the fourth quarter. Colangelo said MACI posted record fourth-quarter revenue of more than $84 million, up 23% from the prior year, driven by the highest quarterly levels since launch in key activity metrics including MACI implants, implanting surgeons taking biopsies, and biopsies. He added that performance was “particularly strong” in December as commercial and operations teams “executed exceptionally well” to close the year.
Mara reported MACI revenue of $84.1 million in the fourth quarter, representing 23% year-over-year growth and 51% sequential growth versus the third quarter. Full-year MACI revenue rose 21% to $239.5 million.
Colangelo also highlighted MACI’s longer-term trajectory, stating the product has generated compound annual revenue growth of 24% over the past nine years and that, as of the end of 2025, more than 20,000 patients have been treated with MACI. He pointed to MACI’s reimbursement profile as a key support for growth, citing prior authorization approval rates remaining over 95% for commercial patients in 2025.
On pricing versus volume, Mara told analysts that pricing “has been and will remain” part of the company’s growth algorithm, while characterizing the step-up in MACI performance in the second half of 2025 as “volume driven,” with both price and volume contributing.
Strategic priorities: sales force, MACI Arthro, and lifecycle expansion
Looking ahead, Colangelo said the company is focused on three strategic imperatives to support growth in 2026 and beyond:
- Capitalizing on the expanded MACI sales force: Vericel said it completed its MACI sales force expansion in the fourth quarter, with Mara later characterizing the expansion as roughly 30 people and estimating an annual cost impact “in the $10 million range.” Colangelo said the larger footprint should increase reach across the customer base and support both surgeon expansion and deeper penetration among existing MACI surgeons. The company is also implementing “commercial excellence” initiatives, including new tools and resources to enhance commercial analytics and standardize best practices. Management said it expects MACI sales rep productivity to return to 2025 levels “as early as next year.”
- Leveraging MACI Arthro for smaller defects: Colangelo said Vericel has trained approximately 1,000 surgeons on the MACI Arthro technique to date. He said trained surgeons have shown increased biopsy and implant growth after training, with even higher growth and conversion rates among surgeons who have completed a MACI Arthro case. He also said growth in the small condyle defect segment accelerated in MACI Arthro’s first full year on the market in 2025, becoming one of the highest MACI implant growth segments. Colangelo cited early investigator case series suggesting reduced post-surgical pain, improved range of motion, and faster timelines to full weight bearing, with presentations and publications expected. He said Vericel is collecting prospective outcomes data in its MACI clinical registry.
- Lifecycle management and expansion opportunities: The company initiated the phase III MACI Ankle MASCOT clinical study in the fourth quarter. Colangelo said a potential MACI ankle indication represents a substantial opportunity with an estimated addressable market of more than $1 billion. He also said Vericel remains on track to begin commercial manufacturing of MACI at its new facility this year, supporting potential expansion outside the U.S. The company plans a staged approach, targeting a first launch in the U.K. Colangelo said Vericel expects to submit a marketing authorization application to the U.K. MHRA in the middle of the year and “potentially launch” MACI in the U.K. in 2027, adding the company intends to commercialize on its own in the U.K. given concentrated centers of care.
Burn care update and NexoBrid adoption
Vericel also discussed its burn care business, where Mara reported fourth-quarter revenue of $8.8 million, above the company’s guidance range for the quarter. Full-year burn care revenue was $36.8 million, consisting of $32.1 million from Epicel and $4.7 million from NexoBrid.
On commercial execution, Colangelo said the burn care team now cross-sells both products across 17 territories and that the company continues to see dormant Epicel accounts reactivated, while acknowledging burn patient volumes can be sporadic at individual hospitals. On NexoBrid, Colangelo said the product launched with about 90 target accounts and that over 70 accounts have placed orders so far, with the next stage focused on moving accounts “up the curve” toward consistent use.
Management also addressed the possibility of incremental NexoBrid revenue tied to a potential BARDA award. Mara said the company’s 2026 guidance does not assume additional NexoBrid revenue from a BARDA award, though he called incremental BARDA revenue a “reasonable possibility.” In response to analyst questions, Colangelo outlined that the BARDA request includes three components—stockpiling/procurement, additional indications for blast injury, and funding for a room-temperature stable formulation—adding that timing has been affected by government funding dynamics. The company said it believes there is a “pretty strong possibility” an award could occur this year, but it was not prepared to quantify the potential revenue contribution.
2026 outlook and margin expectations
For 2026, Mara guided to total company revenue of approximately $316 million to $326 million. The company’s framework includes:
- MACI revenue of approximately $280 million to $286 million for the full year
- Burn care revenue of approximately $36 million to $40 million (based on a run rate of about $9 million to $10 million per quarter)
Mara said Vericel expects to start 2026 strongly, guiding first-quarter MACI revenue of approximately $54 million to $55 million and burn care revenue of $9 million to $10 million, and stating the company is on track to exceed 20% total revenue growth in the first quarter.
On profitability, Vericel guided for 2026 gross margin of approximately 75% and adjusted EBITDA margin of approximately 27%. Mara said the outlook accounts for additional costs related to the new Burlington manufacturing facility, the expanded MACI sales force, and increased expense from the MACI ankle trial as enrollment begins. Total operating expenses are expected to be about $220 million for the year, with spend expected to be similar each quarter. For the first quarter, the company guided to gross margin of approximately 70% and adjusted EBITDA margin of approximately 10%, reflecting seasonality and the quarterly revenue mix.
Responding to questions about margin dynamics, Mara noted fourth-quarter 2025 gross margin of 79% benefits from seasonal scaling in a quarter that is typically MACI-heavy. On a full-year basis, he said the company moved from 74% in 2025 to guidance of 75% in 2026, while absorbing costs associated with operating multiple facilities. He reiterated the company’s longer-term view that gross margin could reach the high 70s by the end of the decade.
About Vericel (NASDAQ:VCEL)
Vericel Corporation is a biotechnology company specializing in the development, manufacturing and commercialization of cell-based therapies for patients with severe diseases and conditions. The company’s expertise lies in regenerative medicine, where it harnesses the power of autologous cell processing to create products designed to restore function and promote healing in damaged tissues.
Vericel currently markets two FDA-approved therapies. MACI® (autologous cultured chondrocytes on porcine collagen membrane) is indicated for the repair of symptomatic cartilage defects of the knee in adult patients.
