Oct 29, 2026 earnings call — Access First push for VOQUEZNA
Phathom reiterated full-year revenue guidance of $310 million-$325 million.
Revenue $0.1B (est $0.1B) · EPS $-0.16 (est $-0.11) · Next-quarter revenue outlook $0.3B–$0.3B
Key quotes
"We have implemented our Access First initiatives, including multiple levers to help improve VOQUEZNA's access experience for physicians and patients."
"For Q3, we reported net revenues of $84.7 million, cash operating expenses of $60.5 million, positive operating profit of $5.8 million, both of those operating metrics excluding stock-based compensation, and cash generated from operations of about $2.1 million."
"On October 21, 2026, BDR Pharmaceuticals filed suit against the FDA, principally challenging the FDA's alleged refusal to receive their ANDA referencing Phathom's NDA for VOQUEZNA."
Analyst Q&A 11
making it easier for doctors to get prescriptions covered
Q (Kristen Kluska · Cantor Fitzgerald): She asked how initiatives besides BlinkRx are improving prescriptions and access, and asked about next legal steps on the GAIN Act litigation.
A: Management said access has three parts: payer coverage, prior authorization logistics, and affordability. They said they educate physicians and staff on documenting prior PPI use and on local plan requirements to improve PA success, and BlinkRx plus a $0 copay helps perceptions of affordability. On litigation they said FDA opened the docket and they will not predict next steps in the legal process.
"A lot of what we've been doing is around educating around the process and educating around confidence that your patients can in fact get it." — Steve Basta (CEO)
who gets $0 copay and impact on discounts
Q (Martin Auster · Raymond James): He asked who is eligible for the $0 copay through BlinkRx, what share of scripts it might help, and whether it will change gross-to-net long term.
A: Management said the enhanced copay program is for commercially insured patients whose plans cover VOQUEZNA; they cannot buy down government-insured patients. They said they will cover incremental cost to reduce a patient's copay to zero and expect a small GTN impact, with Sanjeev calling it insignificant overall and net positive as more scripts contribute positively.
"If a patient has a $100 copay on their insurance plan, we will go ahead and buy that all the way down to zero." — Steve Basta (CEO)
competitor impact and margin drivers
Q (Mike DiFiore · Evercore): He asked if a second PCAB would change payer negotiations or access, and whether inventory reserve or fulfillment costs explain gross margin decline.
A: Management said they have not seen payer negotiations change meaningfully because of a potential second PCAB and that some plans review processes but nothing fundamental has shifted. On margins they said the gross margin effect was primarily from a one-time manufacturing charge last quarter and they do not see recurring distribution cost pressure.
"We've not seen any of that change in any meaningful way based upon the potential introduction of a second PCAB." — Steve Basta (CEO)
range drivers and pricing with new competitor
Q (Paul Choi · Goldman Sachs): He asked what could get results to the upper half of guidance and whether pricing would follow PPI analogs if another PCAB enters.
A: Management reiterated confidence in momentum, noting covered prescriptions grew 19% sequentially and Access First is showing early results; they reaffirm guidance but would announce specifics when available. On pricing impact from a new entrant, they said they are not in a position to project pricing impacts until they see the entrant's pricing and strategy.
"I am not sure we are in a position to project what is going to happen in terms of pricing impacts in the market, given that we have not seen what the second entrant PCAB pricing might be or exactly what their strategies may be." — Steve Basta (CEO)
why doctors don’t send more scripts to BlinkRx
Q (Annabel Samimy · Stifel): She asked whether resistance to BlinkRx is from physicians or patients, what steady-state percent might go through BlinkRx, and whether BlinkRx affects GTN; she also asked about new studies and IP.
A: Management said it is not active resistance but inertia: physicians habitually send prescriptions to the local pharmacy in the EHR and need short education to change that habit; $0 copay helps the conversation. They said BlinkRx improves refill rates and is positive for the company and patient, and that most new studies are for market expansion except the EoE study, which could support pediatric exclusivity extension.
"What the inertia looks like is physicians just have a habit of prescribing to the patient's local pharmacy because that pharmacy is in the patient's records in the EHR." — Steve Basta (CEO)
what success looks like in EoE phase II
Q (Joseph Stringer · Needham & Company): He asked what a successful Phase II EoE signal would look like, and what next steps and timelines toward pediatric extension would be if results are favorable.
A: Management explained the trial has a 12-week blinded randomized phase with VOQUEZNA or placebo (data due this quarter) and a subsequent 12-week open-label phase (full 24-week data by end of Q1). They said the primary endpoint is histologic: reduction of eosinophil counts, and if results support it they will discuss a phase III plan with FDA in 2027 and whether to include pediatric patients for a written request tied to pediatric exclusivity.
"The primary endpoint in the study is a reduction of eosinophil counts." — Steve Basta (CEO)
how 2027 growth and BD plans
Q (Yatin Suneja · Guggenheim): He asked how much 2027 revenue build will be commercial-driven and how management will think about M&A or bringing new assets now that operating cash flow is positive.
A: Management said they are not giving 2027 financial guidance but do not expect a fundamental change in commercial infrastructure; the sales force and marketing are in place and commercial spend will be largely in line with this year. They said they intend to build a significant GI business and expect to bring in one or more additional GI products in coming years, timing based on finding the right assets and terms.
"Our expectation is over the coming years, we bring in additional GI products." — Steve Basta (CEO)
effect of a second PCAB and PCP push
Q (Dennis Ding · Jefferies): He asked whether a second PCAB would slow growth or mirror other categories, and whether they will re-emphasize primary care in 2027.
A: Management said a second entrant will likely expand category awareness and that the market leader typically benefits because physicians adopting the class often choose the established product; they expect a tailwind from broader awareness. They said their priority remains gastroenterology (70%+ sales calls) through 2027 and they do not plan a near-term shift to PCPs.
"I think the scenario you're describing is exactly what we would expect to have happen, which is the second product entrant actually shifts much more awareness." — Steve Basta (CEO)
what ‘covered prescriptions’ means for patient cost
Q (Matthew Caufield · H.C. Wainwright & Company): He asked whether the 65% covered prescriptions are fully paid by plans or partially paid, and whether the split between full and partial coverage is improving.
A: Management said out-of-pocket cost varies by patient category: commercial patients with coverage can use copay programs (retail $25 or BlinkRx $0) but government-insured patients cannot get the same copay support and their costs vary by Medicare Part D or Medicaid rules. They said the additional $0 copay will be offset by incremental scripts and has an insignificant impact on gross-to-net because much of the buydown is already included.
"When we think about coverage, there really are different categories of patients who will experience different out-of-pocket cost." — Steve Basta (CEO)
metrics on BlinkRx usage and benefits
Q (Chase Knickerbocker · Craig-Hallum): He asked if they would disclose the percent of scripts through BlinkRx and metrics (PA approval, fill, refill rates) versus retail.
A: Management declined to disclose a detailed set of metrics publicly but said they track many internal measures (TRx dispense, NRx, new-to-brand, PA submissions, approvals, refill rates) and are seeing a shift with more new-to-brand scripts landing at BlinkRx after Access First initiatives. They said BlinkRx improves PA submission and approval rates, fill and refill rates, and that benefits accrue gradually as new scripts turn into multiple refills over months.
"We're going to pass on providing a litany of metrics that we then would end up evaluating every quarter to look at how each one works." — Steve Basta (CEO)
how many prescribers already have access working
Q (Daniel Clark · Leerink Partners): He asked what percent of prescribers already have the access process dialed in and what percent could benefit, and when access tailwinds might show in revenue timing.
A: Management said prescribers sit on a continuum of confidence; even top prescribers can increase use from a small share of their acid suppression scripts to a larger share by learning the access supports and affordability. They said moving prescribers along that continuum—showing true patient out-of-pocket cost and support—will deepen prescribing, and once confidence grows they will broaden use to more patient groups over time.
"It's hard to put a specific percentage on prescribers that have this dialed in, for example, as a sort of characterization versus needing to improve." — Steve Basta (CEO)