Trevi Therapeutics (TRVI) has entered a new phase in its development story by kicking off Phase 3 and Phase 2B chronic cough trials while operating with a sizeable cash position that supports ongoing work and potential FDA review.

The latest trial updates and earnings release have come alongside a share price of $18.50, with a 90 day share price return of 27.59% and a year to date share price return of 55.59%. Over the longer term, total shareholder return has been very large at around 7x over five years. This points to strong momentum in how investors have been reassessing Trevi Therapeutics as its chronic cough programs progress and competitive pressure falls.

If you are interested in other potential high growth stories in healthcare and biotech, a natural next step is to scan companies through the 42 healthcare AI stocks.

Bulls view Trevi Therapeutics as a rare, focused opportunity in chronic cough, supported by sufficient cash to fund its trials. Bears highlight ongoing losses and the potential risk of dilution. Which side does the current valuation support?

Most Popular Narrative: 29.3% Undervalued

Trevi Therapeutics currently trades at $18.50, compared with a most widely followed fair value narrative of $26.18 per share. That gap reflects a story built almost entirely around Haduvio and its chronic cough programs.

Approximately US$188 million in cash, cash equivalents and marketable securities at year end 2025 with an indicated runway into 2028 funds top line data across key IPF, non IPF ILD and refractory chronic cough studies. This limits near term financing pressure and can support more controlled decision making around future capital structure, share count and potential earnings per share.

Want to see how this cash runway, projected revenue build and assumed margins all come together at a double digit discount rate? The narrative leans on a single drug, several label expansion paths and a profit multiple that stands well above typical sector benchmarks. Curious which specific trial outcomes and pricing assumptions need to line up for Trevi Therapeutics to reach that $26.18 mark.

Result: Fair Value of $26.18 (UNDERVALUED)

However, you still need to factor in that Trevi Therapeutics currently depends on a single drug, and it may require further capital raising if trial costs extend.

Another View On Trevi Therapeutics Valuation

That 29.3% undervalued story rests on long term revenue, margin and pricing assumptions. On today’s figures though, Trevi Therapeutics trades on a P/B of 15.3x versus 7.1x for peers and 2.6x for the broader US Pharmaceuticals industry, even though it is still loss making. Does that premium leave enough room for error?

Next Steps

Curious where all this leaves Trevi Therapeutics today? Take a closer look at the underlying data, including the company’s 4 important warning signs, so you can form your own view.

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This article by Simply Wall St is general in nature. We provide commentary based on historical data and analyst forecasts only using an unbiased methodology and our articles are not intended to be financial advice. It does not constitute a recommendation to buy or sell any stock, and does not take account of your objectives, or your financial situation. We aim to bring you long-term focused analysis driven by fundamental data. Note that our analysis may not factor in the latest price-sensitive company announcements or qualitative material. Simply Wall St has no position in any stocks mentioned.