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.