Analyst Ratings February 19, 2026

Truist Sticks With Buy on Praxis; Highlights Upside If Ulixa Prices Higher Than Base Case

Analyst model ties meaningful upside to ulixa pricing; Q4 earnings missed estimates but cash and regulatory milestones support pipeline progress

By Avery Klein PRAX
Truist Sticks With Buy on Praxis; Highlights Upside If Ulixa Prices Higher Than Base Case
PRAX

Truist Securities reaffirmed a Buy rating on Praxis Precision Medicines (PRAX) and held a $500 price target, citing potential material upside from higher-than-expected pricing for ulixa in essential tremor. The firm’s base wholesale acquisition cost model is roughly $27,000 per year, but key opinion leaders signaled comfort with materially higher net pricing, a scenario that would lift Truist’s projections. Praxis reported a fourth-quarter EPS of -3.5, missing the -3.09 consensus, while retaining a strong cash position and advancing two new drug applications alongside a breakthrough therapy designation.

Key Points

  • Truist reaffirmed a Buy rating on Praxis with a $500 price target, implying about 67% upside from the current $299.85 share price.
  • Truist models a base-case WAC for ulixa at approximately $27,000 per year (net pricing of $20,000 after ~25% rebate), but key opinion leaders indicated comfort with net pricing up to ~$35,000, which would imply a WAC near $50,000 and roughly 75% upside to the base case.
  • Praxis posted Q4 EPS of -3.5, missing the -3.09 analyst estimate, yet retains a strong cash position and is advancing two new drug applications while holding a breakthrough therapy designation.

Overview

Truist Securities has reiterated its Buy rating on Praxis Precision Medicines Inc. (NASDAQ: PRAX) and maintained a $500.00 price target, a level the firm says implies about a 67% upside from the stock’s quoted price of $299.85. The equity has already shown substantial momentum, delivering a 305.69% total return over the past year, according to the data cited by the firm.


Pricing assumptions for ulixa

In discussions with payor key opinion leaders, Truist assessed potential pricing outcomes for ulixa, the company’s candidate for essential tremor. The brokerage’s current base-case model assumes a launch wholesale acquisition cost (WAC) of roughly $27,000 per year, which is derived from an assumed net price of $20,000 after applying an approximate 25% rebate.

Truist notes that the pricing framework underlying its analysis is anchored to the cost structure of branded beta-blockers. Feedback from key opinion leaders indicated tolerance for net pricing as high as approximately $35,000. If that tolerance were realized, the equivalent WAC would be about $50,000 per year - a level Truist describes as representing roughly 75% upside to its base-case price assumption and as providing significant upside to its financial projections for Praxis.


Recent financial and clinical developments

Praxis reported fourth-quarter results showing an EPS of -3.5, which missed analysts’ expectations of -3.09. Despite the earnings shortfall, the company is reported to maintain a strong cash position. Praxis is advancing two new drug applications and has received a breakthrough therapy designation for a program in its pipeline, developments the company and investors view as material to future value creation.


Market context and implications

Truist’s reiterated Buy reflects a scenario in which pricing outcomes for ulixa exceed the firm’s current base-case assumptions, materially enhancing revenue projections and company valuation. At the same time, the recent earnings miss highlights near-term financial pressures. Investors appear to be weighing the runway provided by cash reserves and the potential of regulatory milestones against current operating results.


Bottom line

Truist’s stance places primary emphasis on pricing flexibility for ulixa as a lever for upside, while the company’s Q4 results and ongoing regulatory activity remain central to near-term expectations. The combination of a large one-year return to date, a significant price target gap, and mixed quarterly results frames a debate between near-term financial performance and longer-term pipeline-driven potential.

Risks

  • Pricing uncertainty - actual net prices and rebate levels for ulixa could differ from Truist’s base-case model, affecting revenue projections and valuation.
  • Earnings and near-term financial performance - the fourth-quarter EPS of -3.5 missed expectations, indicating potential operating pressures in the near term.
  • Regulatory and approval uncertainty - while Praxis is progressing two new drug applications and has a breakthrough therapy designation, the outcomes and timing of regulatory reviews remain uncertain.

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