Nuvation Bio (NUVB) TD Cowen 46th Annual Health Care Conference summary

Market and product launch dynamics

• Patient starts have been robust, with Q4 new patient starts increasing to 216 from 204 in Q3, outpacing previous launches by a factor of six.

• Early launch focused on sicker, late-line patients, but first-line patient share is rising monthly, expected to drive long-term growth.

• Discontinuation rates were misunderstood; 75% of discontinuations occurred in third-line or later, consistent with clinical trial data and not indicative of overall high discontinuation.

• Duration of response is 50 months in first-line, 12 months in second-line, and much shorter in later lines, supporting strong revenue stacking as first-line share grows.

• Revenue ramp is expected to be non-linear, with higher growth in the second half of the year and consensus revenue target of $147 million for the year.

Competitive landscape and access

• Product is becoming the standard of care among ROS1 TKIs, with superior efficacy and tolerability compared to competitors.

• Community adoption is increasing, shifting from initial academic center dominance; community centers represent about 70% of the patient base.

• Nationwide trends in genetic testing, such as state mandates, are expected to further expand the eligible patient pool.

• Access remains a priority, with contracting and payer dynamics (340B, Medicaid) influencing gross-to-net, which was about 25% in Q4 and expected to rise slightly.

International expansion and partnerships

• Eisai partnership will bring a €25 million milestone payment upon European approval, expected early next year, reinforcing the balance sheet.

• European pricing will be lower than the U.S., but the opportunity is significant due to a larger population.

• Head-to-head study against Crizotinib is required for China but not for Europe; European approval is anticipated without it.

• High double-digit royalties are expected from the Eisai partnership.