Phathom Pharmaceuticals, Inc. Q2 FY2025 earnings call

• Launch Progress: Over 580,000 VOQUEZNA prescriptions filled by July 25, with 49% growth in 14 weeks; Q2 filled ~173,000, a 36% increase from Q1. Commercial access was over 80% of lives covered.
• Sales Force Focus: Shifted focus to gastroenterologists (GIs); removed over 20,000 unproductive primary care physician (PCP) targets. GIs accounted for ~70% of VOQUEZNA prescriptions written to date, and on average wrote more than twice the prescriptions per month compared to PCPs.
• Exclusivity: FDA updated Orange Book for VOQUEZNA exclusivity through May 2032, with potential extension to 2033. Pediatric exclusivity and multiple ANDA review rounds could further extend exclusivity.
• Development Plans: Moved forward with a Phase II trial in eosinophilic esophagitis (EoE) starting Q4 2025, which may extend exclusivity by 6 months via pediatric evaluation.
• Cost Savings: Achieved a $12 million reduction in Q2 non-GAAP operating expenses compared to Q1, with Q3 expenses expected below $60 million and Q4 below $55 million, including costs for the EoE trial.

In the second quarter of 2025, Phathom reported $39.5 million in revenue, representing a 39% growth over the first quarter. The primary segment is VOQUEZNA. Over 580,000 VOQUEZNA prescriptions had been filled by July 25, with a 49% growth in 14 weeks since the last report. In Q2, approximately 173,000 prescriptions were filled, showing a 36% growth over Q1. Commercial access remained north of 80% of lives covered, and about 68% of Q2 VOQUEZNA prescriptions were filled through the retail channel, while the remainder used the BlinkRx cash pay option.

• Revenue Guidance: Full year 2025 revenue guidance set at $165 million to $175 million.
• Expense Projections: Q3 non-GAAP operating expenses expected below $60 million; Q4 non-GAAP operating expenses expected below $55 million, including costs for the EoE trial starting in Q4.

• Supply Disruption: Potential disruption in VOQUEZNA triple pack due to clarithromycin supply issues, though no commercial disruption yet.
• Generic Competition: Risk of generic vonoprazan competitors entering the market, but exclusivity extends to 2033.
• Clinical Trial Risks: Uncertainties with Phase II EoE trial outcomes and pediatric exclusivity evaluation timelines.

Q: Can you give more color on how the sales force will target to drive depth and frequency of writing prescriptions?

A: Realigned sales territories, added all gastroenterologists to the target list, removed unproductive PCPs. Spending more time in physicians' offices to build relationships and education drives utilization, as more time with GIs leads to higher prescription frequency.

Q: Is the anticipated acceleration of revenue from GI focus baked into current guidance?

A: Long term it's a driver to the upside, but hard to predict timing. The new targeting strategy may take 1-3 quarters to show consistent revenue growth.

Q: When does transition from GI to primary care writing occur?

A: GI alone has significant revenue potential; PCP market is additive, not essential for a blockbuster status. GI is a constant growth driver, with PCP being meaningfully additive.

Q: Impact of Medicare/Medicaid tap on gross to nets?

A: Medicare scripts often use BlinkRx cash pay, but focus is on driving script volume. Average BlinkRx cash pay is $50.

Q: Physician feedback on EoE and pediatric study timing?

A: PPI is current first-line in EoE; vonoprazan could disrupt this. Pediatric study timing depends on Phase II EoE trial outcomes and FDA conversations for exclusivity extension.