Phathom Pharmaceuticals Inc at Goldman Sachs Global Healthcare Conference Transcript

The following is excerpted from the question-and-answer section of the transcript.

Question: Paul Choi - Goldman Sachs Group Inc - Analyst : Okay. Great. So maybe let's start with the commercial piece since you've talked about the launch a little bit here. And both with GERD and HP, you've made a lot of progress in terms of expanding the coverage footprint versus when the product initially got approved in HP a while back. So can you maybe just tell us where you are in terms of coverage overall for both indications? Just what the commercial side and the government side stands at? And maybe, we'll start with that.

Question: Paul Choi - Goldman Sachs Group Inc - Analyst : Okay. So a few more major national payers that check the box on over the next six to nine months.

Question: Paul Choi - Goldman Sachs Group Inc - Analyst : Okay. Great. And then, on the on the government side?

Question: Paul Choi - Goldman Sachs Group Inc - Analyst : Okay. One of the questions I frequently get from investors is just can you explain to me what is BlinkRx? How does the company utilize it? Where are the mechanics there? What is the script going through Blink mean versus a script going through a regular retail channel like at a pharmacy? Can you maybe just walk us at a high level through the mechanics there and how you guys are using Blink?

Question: Paul Choi - Goldman Sachs Group Inc - Analyst : Okay. Great.

Question: Paul Choi - Goldman Sachs Group Inc - Analyst : Yes, it does. I think that's still a bit of confusion, I think, for investors or maybe, at least, for those who are new to the story. And so, the other dimension of that is you're talking about written scripts versus filled scripts, right? And so, can you maybe just understand what's the ratio then at least in terms of what you've reported over the past couple of quarters? And maybe, if you can provide a bit of an update on how that has been trending since you last reported your quarterly results?

Question: Paul Choi - Goldman Sachs Group Inc - Analyst : Okay. Great. And that was just for people's reference, that was just two months later, if I recall, in terms of the give or take.

Question: Paul Choi - Goldman Sachs Group Inc - Analyst : Okay. Great. Molly, maybe if you could just remind us as with all new product launches, often some of the metrics in terms of where we -- what we watch in terms of coverage and reimbursement and things like that. I'm just trying to understand gross to net, and you started talking about industry benchmarks, let's say, for PPIs and things like that. Can you maybe just maybe remind us where historical averages have been for GI drugs such as PPIs, and just where you are and where you think the longer-term trajectory might be for VOQUEZNA? without the prior written consent of Thomson Reuters. 'Thomson Reuters' and the Thomson Reuters logo are registered trademarks of Thomson Reuters and its affiliated companies. JUNE 11, 2024 / 6:40PM, PHAT.OQ - Phathom Pharmaceuticals Inc at Goldman Sachs Global Healthcare Conference

Question: Paul Choi - Goldman Sachs Group Inc - Analyst : Okay. Great. Martin, maybe come back to you and just -- you talked a little bit about BlinkRx being in the toolkit of physicians in terms of their EMRs and things like that. Could you maybe speak a little bit to the patient experience as well as the physician experience in terms of getting prescriptions through, let's say, a road block comps in the middle of a prescription. I mean, how does the patient follow up? Maybe, get it through and push it does require the physicians back office to do a fair amount of leg work. Maybe, just some of the processes there.

Question: Paul Choi - Goldman Sachs Group Inc - Analyst : Okay. Great. To the degree you have information on this, can you maybe comment a little bit on the median patient you're seeing? Are they typically refractory to one or two PPIs? Are you seeing de novo patients who may be newly diagnosed? Is that potentially working? Or are the step edits potentially sort of very strictly being enforced? Any color there would be great.

Question: Paul Choi - Goldman Sachs Group Inc - Analyst : Okay. Great. Like real scope.

Question: Paul Choi - Goldman Sachs Group Inc - Analyst : Okay. Exciting.

Question: Paul Choi - Goldman Sachs Group Inc - Analyst : Okay. Great. Maybe a little bit in terms of your commercial plan. You talked about a tiering strategy in terms of -- you focusing on high-volume prescribers. Maybe, you can comment on where you are in terms of addressing that initial target opportunity of high-volume prescribers? And when does the potential to move into the second or third tranche of prescribers maybe start to open itself up?

Question: Paul Choi - Goldman Sachs Group Inc - Analyst : Okay. I know you're only a couple of quarters into the launch. Could you also maybe comment on what you've seen in terms of repeat prescribing patterns? I know probably for many of these physicians, it's just one -- just a handful of patients. But how many repeat prescribers are you seeing? And are you able to quantify that to date?

Question: Paul Choi - Goldman Sachs Group Inc - Analyst : Okay. Great. In terms of the last commercial piece, I guess, here is, you talked a little bit at the beginning about sort of a few more quarters before the major insurance coverage is complete as well as some of the government stuff. But you've talked about a potential inflection resulting once the coverage is a little more established across both at a national level and the government level. And so, I guess as you think about that as a barrier to broader adoption for VOQUEZNA here, I guess what is -- how would you characterize the pent-up demand, I guess? And what is -- I guess, in your mind, as you guys do your game planning, just thinking about what does that slope of the trajectory look like? Because I think that's what a lot of investors are waiting for. We monitor the TRx data on a weekly or monthly basis, and it's definitely growing, but just understanding when that big moment and spend in the curve could start to occur?

Question: Paul Choi - Goldman Sachs Group Inc - Analyst : Okay. Great. I want to talk a little bit about NERD, the non-erosive opportunity here. And it's interesting additive opportunity for you guys. Can you maybe just remind us how are those patients currently treated? And just -- how do you size up that opportunity, roughly speaking, versus the GERD opportunity or erosive esophagitis opportunity? Just what's the potential there?

Question: Paul Choi - Goldman Sachs Group Inc - Analyst : Okay. Great. You brought up actually a point out which is touches my next question, which is talked about patients cycling through PPIs and often with this class of medicine for GI medicine. (technical difficulty) for the treatment period, but not necessarily, they feel better in terms of their symptoms. But they don't necessarily feel better. After they feel better, they don't necessarily stick with the maintenance experience. So I guess one question is, obviously, patients stuck with their therapy through the maintenance period through their clinical trial. But maybe, how do you guys think about what the real-world experience might be like? I'm sure patients will probably stick through the treatment phase, but just what is the adherence here, and the maintenance phase look like?

Question: Paul Choi - Goldman Sachs Group Inc - Analyst : Maybe, one for both of you and Molly. Molly, you talked about the NERD opportunity being potentially significantly -- a significant expansion in terms of the addressable patient pool. And so, in terms of your commercial footprint and ability to target that on top of your existing indications, how do you guys think about your existing commercial footprint versus what you might potentially need for a NERD launch in a few weeks here?

Question: Paul Choi - Goldman Sachs Group Inc - Analyst : Yeah.

Question: Paul Choi - Goldman Sachs Group Inc - Analyst : That's right. Yeah, it's been the first new product in the category since Dexilant if memory serves.

Question: Paul Choi - Goldman Sachs Group Inc - Analyst : Okay. I want to talk a little bit about life cycle management. I mean, we're talking about your first additional post-approval indication potentially with NERD here, but you're also working on some other things like on-demand use. Can you maybe remind us how that trial is progressing? And just when top line data for that might potentially come, and just what regulatory steps might be involved after that.

Question: Paul Choi - Goldman Sachs Group Inc - Analyst : Okay. And can you maybe just remind us what the Phase 2 data looked like maybe at a high level and how that might figure in your Phase 3 discussions here?

Question: Paul Choi - Goldman Sachs Group Inc - Analyst : Maybe, one more on that before we move on is just you talked about placebo-controlled data. But I suspect maybe a lot of patients currently in terms of real-world practice, maybe take OTC products on demand, not necessarily a PPI, but some OTC product. And so, does an active comparator maybe make sense just in terms of like understanding or improving physician receptivity potentially down the road to an on-demand indication?

Question: Paul Choi - Goldman Sachs Group Inc - Analyst : Okay. Great. Maybe staying on the topic of life cycle management. You've also, in the past, talked about the EoE opportunity, which is pretty attractive, but also targeted by several other companies whether have clinical stage assets and/or approved assets potentially for EoE. So can you maybe just remind us, first, what is the market opportunity there in your mind, or as you model it? And then, second, what are the clinical development plans for vonoprazan in this particular area?

Question: Paul Choi - Goldman Sachs Group Inc - Analyst : Okay. I guess any other, I guess, either life cycle management programs that I haven't called out that you think probably would represent additional opportunities here for vonoprazan beyond on-demand and EoE that you think would be potentially additive to the franchise?

Question: Paul Choi - Goldman Sachs Group Inc - Analyst : Okay. I guess as you think about expanding the franchise beyond vonoprazan, and just maybe thinking about either internally developed assets and/or externally acquired assets. The topic of BD and so forth, doesn't often frequently come up because you're still relatively early in your launch, just a relatively new commercial stage company. But could you maybe speak to your philosophy and just thinking about what are the adjacent opportunities either in the GI space? Or if not in the GI space, what would be potentially synergistic with what Phathom does currently?

Question: Paul Choi - Goldman Sachs Group Inc - Analyst : Okay. I also want to ask about other geographies. Obviously, Takeda sells TAKECAB in Japan. You guys now have the approval here in the US. But additional markets, whether you would want to potentially go it alone in key geographies, let's say, in the key parts of Europe or and/or through a distributor or partnership relationship, how do you guys think about that given the landscape in those key markets?

Question: Paul Choi - Goldman Sachs Group Inc - Analyst : Okay. And then, maybe, from a regulatory standpoint, you guys obviously completed the Phase 3 that supported here your US approval. But just what would be potentially required from either a clinical trial or regulatory perspective for those markets? without the prior written consent of Thomson Reuters. 'Thomson Reuters' and the Thomson Reuters logo are registered trademarks of Thomson Reuters and its affiliated companies. JUNE 11, 2024 / 6:40PM, PHAT.OQ - Phathom Pharmaceuticals Inc at Goldman Sachs Global Healthcare Conference

Question: Paul Choi - Goldman Sachs Group Inc - Analyst : Okay. So what would potential next steps be for MAA or moving forward with the EMA, that's something that you guys have been a little quiet on for a while. I'm just curious how you guys are thinking about potential timing for that? What are next steps for proceeding with the EMA?

Question: Paul Choi - Goldman Sachs Group Inc - Analyst : Okay. So just to make sure I'm clear, your plans in Europe are largely -- it sounds like you want to get the NERD trial completed to support an MAA there with EMA, and that would be the key determinant of our advancing in Europe?

Question: Paul Choi - Goldman Sachs Group Inc - Analyst : Okay. Great. Maybe, as you think about the longer-term opportunity for both vonoprazan in your existing indications and future opportunities, you and I have often talked about a blockbuster opportunity there. And as you look at street numbers over the longer term, numbers are in that ballpark. And I guess, as you think about also the shape of the company and your investment to support the launch right now, how do you think about the transition to either reaching breakeven? What the rough time frame for that might potentially be? And then, attaining sustained profitability?

Question: Paul Choi - Goldman Sachs Group Inc - Analyst : Right. And maybe, can you remind us where TAKECAB is currently tracking, annualizing that. And remember, some of the early years were restricted by prescription volumes, which didn't make the year one or year two of the launch necessarily look particularly compelling. But in terms of more recent performance, where is the asset tracking there in Japan?

Question: Paul Choi - Goldman Sachs Group Inc - Analyst : And that's just on the GERD indication, correct? There's no NERD approval, if I recall correctly.

Question: Paul Choi - Goldman Sachs Group Inc - Analyst : Okay. Great. Well, thanks, Molly and Martin for joining us. We're almost out of time here, so we'll end it on that note. Thank you very much.