OptiNose (OPTN) Piper Sandler 36th Annual Healthcare Conference summary

Market opportunity and label expansion

• XHANCE received a new indication for chronic sinusitis without nasal polyps, opening access to a much larger market than nasal polyps alone, with an estimated 30 million sufferers in the U.S.

• About 10 million chronic sinusitis patients see a doctor annually, with two-thirds visiting primary care and one-third specialists.

• The company estimates $300 million in sales potential for XHANCE with the expanded label.

• The sales strategy remains focused on specialists, especially ENT and allergy, with some primary care targeting.

• Sales targeting was adjusted in anticipation of the new indication to focus on doctors with the greatest potential in chronic sinusitis.

Commercial execution and prescription growth

• Prescription growth is driven by a mix of new prescribers, returning physicians, and increased prescribing by existing doctors.

• A new distribution hub was implemented to improve prescription fulfillment, customer service, and manage higher volumes.

• The sales force consists of 75 territories, with 74 currently filled, and no plans for significant expansion in 2025.

• The majority of sales calls target ENT and allergy specialists, with a smaller focus on primary care.

• The company is open to a primary care co-promotion partner to access the broader primary care market.

Payer access and utilization management

• XHANCE has 70–80% commercial coverage, with similar Medicaid coverage but less in Medicare; most coverage requires prior authorization or step edits.

• Utilization management typically requires adult status, on-label indication, and prior failure of a nasal steroid.

• The company balances reducing access hurdles with maintaining profitability, considering copay support and overall cost.

• Most plans have updated criteria to include both chronic sinusitis and nasal polyps after the label expansion.