Why It Matters

Ardelyx Inc. filed its third-quarter 2026 in-house lobbying disclosure on October 9, covering access, pricing, and reimbursement issues, including Medicare End-Stage Renal Disease (ESRD) pharmaceutical access and reimbursement, as well as the ESRD benefit. The filing lands as the Centers for Medicare and Medicaid Services (CMS) has a proposed rule for calendar year 2027 open that addresses how phosphate binders are paid under the End-Stage Renal Disease (ESRD) prospective payment system. ​

By the Numbers

Ardelyx's third-quarter 2026 filing reports a filing amount of $520,000. That is up $20,000 from the second-quarter 2026 amended in-house figure of $500,000, and down $130,000 from the in-house third-quarter 2025 report of $650,000.

Three lobbyists are named on the filing: Paul Pereira, senior vice president, patient advocacy and government affairs; Theresa Jolivette, senior director, federal government affairs; and Zach Kribs, director, government affairs, central. Matt Lash, who appeared on the second-quarter 2026 amended filing, is not listed.

Broader Context

CMS's proposed calendar year 2027 ESRD rule proposes changes to the payment approach for phosphate binders and remains open as of the filing's October 9 signed date.

S. 2730, the Kidney Care Access Protection Act, has a House companion, H.R. 6214.

The American Society of Nephrology (ASN) has repeatedly raised concerns with CMS about including oral-only phosphate binders in the ESRD PPS. The Medicare Payment Advisory Commission (MedPAC) said in an August 2024 comment letter that CMS should maintain its existing transitional drug add-on payment adjustment (TDAPA) policy when incorporating oral-only phosphate binders.

In March 2025, Sen. Bill Cassidy (R-LA) reintroduced the Restore Protections for Dialysis Patients Act, and Ardelyx was listed among the bill's endorsers.

The Bottom Line

Ardelyx's reported in-house spend was $520,000 in the third quarter of 2026, down from $650,000 in the third quarter of 2025, though this comparison rests on only a few filings.

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