Phathom Pharmaceuticals, Inc. Q1 FY2026 earnings call

• Steve Basta noted they more than doubled revenue from Q1 2025 to Q1 2026. Expanded sales team with nearly 50 new reps, now has over 290 reps starting Q2. Rolling out enhanced HCP marketing programs. Believes on track to 1 billion in annual revenue from gastroenterology prescriptions with potential for second billion from primary care. Top 300 gastroenterology writers have strong NBRX market share. Q1 TRX showed seasonality but underlying trends positive. - Sanjeev Narula discussed Q1 revenues of 58.3M, year-on-year growth of 104% and sequential growth of 1% over Q4 2025. Gross to net discount came in at lower end of 55-59% range. Gross margin ~80%. Q1 cash operating expenses ~$56.2 million. Anticipated top-line data from EOE trial by late Q4 2026 or early Q1 2027. Maintaining 2026 revenue guidance of 320-345 million, gross to net discount 55-59%, gross margin ~80%, cash operating expenses excluding stock-based compensation 235-255 million. Revenues weighted towards back half of year. Anticipating operating profitability excluding stock-based compensation by Q3 2026 and positive cash flow in 2027.

Net revenues for Q1 were 58.3 million, up from 28.5 million in Q1 2025. Cash operating expenses excluding stock-based compensation were 56.2 million for Q1. Through April 17th, about 1.35 million Vaquesna prescriptions have been filled. Covered prescriptions increased about 5% during the most recent four-week period compared to the prior four-week period. Of the approximately 268,000 prescriptions filled in Q1, about 168,000 were covered prescriptions (63% of total) and about 100,000 were cash pay. Year-over-year, covered prescriptions grew about 91% and total prescriptions filled grew about 115%. Covered NBRX grew approximately 11% over Q4 2025. Top 300 gastroenterology writers had about 20% TRX share compared to PPIs and ~45% BRX market share among new-to-brand writing. Top 3,000 gastroenterology writers had cumulative NBRX market share north of 30% compared to PPIs.

• Maintaining 2026 net revenue guidance between 320 to 345 million. - Gross to net discount guidance remains within 55 to 59% range. - Gross margin guidance remains approximately 80%. - Cash operating expenses excluding stock-based compensation anticipated to be between 235 to 255 million. - Revenues expected to be more heavily weighted towards the back half of the year. - Anticipating operating profitability excluding stock-based compensation by Q3 2026 and positive cash flow in 2027.

Q: On competition, Steve discussed that as a second PCAB entrant comes to market, awareness will build and their market share won with Vaquesna is solid. Yatin also asked about gross to net dynamic, and Steve said channel mix affects it but guidance remains in range.

Q: Umar asked about commercial focus feedback and M&A priorities. Steve said there's growing momentum in adoption, and they're starting to evaluate complementary GI assets.

Q: Kristen asked about physician understanding of additive benefits and patient feedback. Steve said physicians are seeing positive feedback from patients and it drives growth.

Q: Paul asked about breakdown of incremental prescription growth by NERD vs GERD and category management. Steve said it's hard to break down by specific diagnosis but gastroenterologists start with severe patients.

Q: Joseph asked about patients cycling from primary care back. Steve said it's early days but seeing primary care physicians writing scripts for Vaquesna from patients who came back.

Q: Annabelle asked about cash pay vs covered patients and EOE trial. Steve said Q1 had a cash pay bump due to health plan resets and EOE trial enrollment is fast due to interest in first-line therapy.

Q: Dennis asked about shape of gross to net and impact of new competitor. Steve said hard to predict quarter-to-quarter gross to net and confident in momentum with gastroenterology community.

Q: Matthew asked about revenue growth between halves and OPEX trends. Steve said revenue is second half weighted and Q2 OPEX will have a slight bump due to sales force fully in place and EOE trial timing.

Q: Martin asked about context of new-to-brand prescription share and ceiling for higher prescribers. Steve said new-to-brand trends are improving and will continue to improve, with NBRX driving TRX growth.

Q: Chase asked about competitor superiority claims and first mover advantage. Steve said data shows Vaquesna's effectiveness and positive physician experience will not be disrupted by competitor claims