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 growth and efficiency.

• VOQUEZNA, a first-in-class potassium-competitive acid blocker, addresses unmet needs in gastroesophageal reflux, targeting the 40% of PPI-treated 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 path to $1–2 billion in annual revenue.

• Top 300 GI prescribers have already converted about 20% of their scripts to VOQUEZNA, supporting the feasibility of broader GI adoption.

• Growth strategy includes expanding from GI to primary care as patients cycle back, aiming for further revenue expansion.

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 strong top-line growth.

• Operating profitability expected in H2 2026, with positive free cash flow targeted for 2027.

• Enhanced capital structure ensures liquidity to meet business and debt obligations through at least 2027.

• Consistent delivery on financial guidance, with revenue and expense management supporting growth trajectory.

Product lifecycle, exclusivity, and future opportunities

• Regulatory exclusivity for VOQUEZNA extends to May 2032, with potential generic entry in 2033–2034; pediatric extension could add 6 months.

• Considering lifecycle management options, including potential over-the-counter (OTC) transition post-exclusivity, with a multi-hundred million dollar OTC market opportunity.

• On-demand use is being assessed for market potential, following positive phase II data; decision on phase III trial pending market assessment.

• High patient persistence observed, with average patients filling 6–7 prescriptions in the first year and some returning to VOQUEZNA after discontinuation.

• Education and access programs, such as BlinkRx, are key to overcoming HCP adoption barriers and ensuring patient access.