Phathom Pharmaceuticals (PHAT) TD Cowen 46th Annual Health Care Conference summary

Strategic focus and market opportunity

• Shifted commercial focus to gastroenterology (GI) specialists, aligning sales and incentives to target patients inadequately treated by PPIs, resulting in improved organizational efficiency and growth.

• VOQUEZNA, a first-in-class potassium-competitive acid blocker, addresses unmet needs in gastroesophageal reflux with rapid, potent, and durable pH elevation, targeting the 40% of PPI patients still experiencing symptoms.

• Achieved over 1.1 million prescriptions and $175 million in revenue in the last year, with guidance for $320–$345 million in 2026 and a clear path to $1 billion in annual revenue by converting 20–30% of GI PPI prescriptions.

• Top 300 GI prescribers have already converted about 20% of their scripts to VOQUEZNA, with plans to expand this rate across the broader GI community through education, sampling, and patient feedback.

• Future growth includes expanding into primary care as GI-treated patients return to their PCPs, potentially doubling the revenue opportunity.

Financial performance and outlook

• Revenue grew from $55 million to $175 million year-over-year, with significant reduction in cash usage from $85 million to $5 million per quarter.

• Operating expenses are projected at $235–$255 million for 2026, a 14% reduction from 2025, while maintaining 80% revenue growth.

• Expecting operating profitability in H2 2026 and positive free cash flow from 2027 onward.

• Enhanced capital structure ensures sufficient liquidity to meet business and debt obligations through at least 2028.

• Consistent delivery on quarterly guidance and financial targets, supporting confidence in execution.

Regulatory exclusivity and lifecycle management

• Regulatory exclusivity for VOQUEZNA extends to May 2032 under the GAIN Act, with potential generic entry not expected before 2033–2034.

• Potential for an additional 6-month exclusivity extension via pediatric studies, pending EoE trial outcomes.

• Lifecycle management includes assessing over-the-counter (OTC) opportunities post-Rx exclusivity, with a multi-hundred million dollar OTC market identified.