Medicure Inc. ($MPH)

Good day, and welcome to Medicure's earnings conference call for the year ended December 2025. My name is Ali, and I will be your operator for today's call. [Operator Instructions] Before we proceed, I would like to remind everyone that this presentation contains forward-looking statements relating to future results, events and expectations which are pursuant to the safe harbor provisions of the United States Securities Litigation Reform Act of 1995. Forward-looking statements involve known and unknown risks and uncertainties, which could cause the company's actual results to differ materially from those in the forward-looking statements. Such risks and uncertainties include, among others, those described in the company's most recent annual information form and Form 20-F. [Operator Instructions] And please note, this conference call is being recorded, and today's date is April 27, 2026. I would now like to turn the conference call over to Dr. Albert Friesen, Chief Executive Officer of Medicure Inc. Please go ahead, Dr. Friesen.

Thank you, Ali, and good morning to all on the call. We appreciate your interest and participation in today's call. Joining me today on the 2025 year-end statement call is Haaris Uddin, Medicure's Chief Financial Officer. Net revenue was $28.9 million for the year ending December 31, 2025, compared to $21.9 million in the previous year. Net revenue was $8.5 million during the quarter compared to $5.9 million for the previous year's quarter. The company recorded a net loss for the year ending December 31 of $7.1 million or $0.68 per share compared to a net loss of $1 million for the year end in 2024. The net loss is due in large part to a CMS rebate liability issued to the company in the amount of $2.1 million and the $3.2 million invested in research and development primarily related to MC-1 for the treatment of PNPO deficiency and noncash expenses, including $2.6 million of amortization. So a total of $7.9 million of expenses related to noncash items, unusual fee from CMS and an important R&D investment which could lead to significant potential nondilutive cash influx in the future. Medicure's investment of $3.2 million in R&D during the year underscores our commitment to advancing innovative therapies such as the Phase III trial of Medicure's MC-1 for the treatment of PNPO deficiency and delivering long-term value to patients and shareholders. And a reminder to shareholders of 5 focuses of our business are: sales and profits from AGGRASTAT, growing ZYPITAMAG, revenue and profit, growing Marley Drug online pharmacy business, developing MC-1 for PNPO deficiency and advancing a new chemical entity related to Medicure legacy drug with a large market potential. I'd now like to turn the call over to our CFO, Haaris Uddin, to review and provide some color on 2025.

Thank you, Dr. Friesen. A couple of quick items to note before I start. All dollar figures are in Canadian dollars, unless otherwise noted by each presenter. And as a reminder, you will be able to obtain a complete copy of our financial statements for the year ended December 31, 2025, along with previous financial statements on the Investors page of our website. In addition, a copy of all financial statements, management's discussion and analysis and Form 20-F can be obtained from sedarplus.ca. I will now provide some key highlights of our financial performance for the year ended December 31, 2025. Total net revenue for the year ended December 31, 2025, was $28.9 million compared to $21.9 million during the prior year. Net revenues earned from AGGRASTAT during the current year totaled $5.7 million, a decrease from the prior year, where net revenue from AGGRASTAT was $8.1 million. The decrease in AGGRASTAT revenue during the current year is a result of a lower volume of units sold as a result of increased competition from generic tirofiban hydrochloride. Medicure remains the only manufacturer of the 3.75 milligram bolus vial format, which is typically administered before the infusion unit. We continue to provide support to our local -- to our U.S. hospital accounts and plan to remain price competitive in targeted wave. Net revenue earned from ZYPITAMAG through the traditional insurance channel during the year ended December 31, 2025, totaled $2.8 million which is a slight decrease from the $3 million of net revenue earned during the year ended December 31, 2024. The decrease in net revenue noted during the current year is attributable to lower utilization of the products sold through insurance formularies specifically Medicare Part D. The primary focus of the company continues to be growing ZYPITAMAG revenue through the [indiscernible] channel and through Marley Drug throughout 2026. It is important to note that sales of ZYPITAMAG through Marley Drug are excluded from this number. With regards to Marley Drug, net revenue during the current year totaled $12.8 million, an increase from the $10.8 million earned from Marley Drug during the year ended December 31, 2024. Net revenue attributable to the ZYPITAMAG through Marley Drug was $3.7 million during the current year, an increase from the year ended December 31, 2024, whereas ZYPITAMAG sale through Marley Drug were $3.2 million. The increase in revenue from Marley Drug is attributable to increased ZYPITAMAG sales, in addition to an increase in BRENZAVVY sales along with other exclusive products that are offered through Marley Drug. We continue to see access challenges for patients seeking ZYPITAMAG through traditional insurance channel, which has reinforced the effectiveness of our direct distribution strategy through Marley Drug. Their approach allows us to mitigate pressures associated with wholesaler fees, coverage gap costs, lower PBM reimbursement rates and product returns. As a result, Marley Drug provides a more efficient and controlled channel to deliver the ZYPITAMAG to patients. Additionally, the platform enables us to expand access to other products such as BRENZAVVY, further strengthening our competitive positioning within the retail and mail order pharmacy landscape. We have also found that the adherence rate for patients taking ZYPITAMAG is more than 40% higher through Marley Drug in comparison to other retail pharmacies. And this is primarily driven by the pharmacies customer service, which includes Marley Drug dedicated call center for which patients can call and ask questions about their medication, which not only helped reduce our customer attrition rate but also supports patient care. During the year ended December 31, 2025, the company made 2 acquisitions. On March 11, 2025, the company acquired Gateway Medical Pharmacy, an independent pharmacy located in Portland, Oregon, which also has the ability to complete non-sterile compounding revenue for Gateway Medical Pharmacy during the year-end December 31, 2025, totaled $2.8 million. And in addition, on June 16, 2025, the company acquired West Olympia Pharmacy, an independent pharmacy located in Olympia, Washington. West Olympia Pharmacy has a strong customer base and offers its patients additional services, which include administering vaccinations and weight management support. Revenue earned from West Olympia Pharmacy during the current year was $4.7 million. The company has now started to offer ZYPITAMAG through both pharmacies and the company intends on introducing additional product offerings at both Gateway Medical Pharmacy and West Olympia Pharmacy in subsequent quarters, which have increased revenue at Marley Drug. Moving to cost of goods sold. AGGRASTAT cost of goods for the year ended December 31, 2025, totaled $3.1 million, an increase from the prior year, where cost of goods sold during the year ended December 31, 2024, totaled $2.5 million. The increase in cost of goods sold is a result of an inventory write-down completed in the current year in the amount of $458,000. The inventory written down related to a GPO specific branded inventory, which unfortunately could not be used within the regular AGGRASTAT channel, where the inventory pull-through remains strong. In addition, to ensure the company remains competitive with generic alternatives, the company has decreased its selling price of AGGRASTAT during the current year, which has had a negative impact on the gross margin of the product. With that being said, the overall outlook on AGGRASTAT is still positive as we have already seen a reduction in the number of overall generic alternatives available on the market. ZYPITAMAG cost of goods sold for the year ended totaled $1.2 million, a decrease from the prior year, where cost of goods totaled $1.4 million. Included within cost of goods for ZYPITAMAG in the current year is $608,000 relating to products sold to customers and $632,000 of amortization of the ZYPITAMAG intangible assets. The decrease in cost of goods of goods sold in ZYPITAMAG is directly correlated with the decrease in revenue through the insurer channel. Marley Drug cost of goods totaled $6.8 million during the year ended December 31, 2025, an increase from the prior year with cost of goods totaled $4.9 million for the quarter. The increase in cost of goods sold in the current year as a result of higher volume and the nature of products sold through the pharmacy. Gateway Pharmacy costs of goods sold during the year ended December 31, 2025, was $1.9 million and West Olympia's cost of good flow during the current year was $4 million. As both pharmacies were acquired during the current year, there was no cost of goods sold recorded for either Gateway Pharmacy or West Olympia Pharmacy during the year ended December 31, 2024. Our 3 pharmacies: Marley Drug, Gateway Medical Pharmacy and West Olympia Pharmacy are what make up our pharmacy business segment. The company plans on leveraging the additional purchasing power acquired through the acquisitions of Gateway Medical Pharmacy and West Olympia Pharmacy to obtain better pricing from its wholesalers on pharmaceutical products which, in return, should improve the gross margin of the business segment. We saw a small improvement in our cost of goods during the latter half of Q4 and hope to continue this trend throughout 2026. Selling expenses totaled $10.4 million for the year ended December 31, 2025, an increase from the prior year where selling expenses totaled $8 million. The increase in selling expenses during the current year is primarily driven by a $2.1 million rebate liability issued to the company by the centers of Medicaid and Medicare Services, also known as CMS. CMS' assessment as part of the 2022 Inflation Reduction Act indicated that the company had increased its price of ZYPITAMAG above a benchmark inflation rate. We do not believe this assessment is accurate as the company has never increased the prices of ZYPITAMAG since its initial launch, but rather their assessment is being made on an incorrect calculation. However, on the voice of our legal counsel and to avoid further penalties on the assessed rebates, which would not be recoverable, the company paid the assessed rebate subsequent to year-end as a sign of good faith to CMS. The company has filed a formal appeal to CMS with regards to this and hope to recover the rebate paid in subsequent periods. The remaining increase noted in selling expenses are the result of the acquisitions of Gateway Medical Pharmacy and West Olympia Pharmacy during the current year. General and administrative expenses totaled $5 million for the year ended December 31, 2025, a slight increase from the prior year where general and administrative expenses totaled $4.8 million. The slight increase in general and administrative expenses in the current year is a result of the acquisitions of Gateway Medical Pharmacy and West Olympia Pharmacy offset by lower professional fees and lower share-based compensation expense during the current year. Research and development expenses for the year ended December 31, 2025, totaled $3.2 million compared to $3.1 million during the prior year. The slight increase in research and development expenses during the current year is primarily due to timing of expenditures. The company recorded finance income net of $122,000 during the current year in comparison to finance income net of $165,000 during the prior year. The finance income recorded during the current period primarily relates to interest income earned, offset by bank charges, interest on the company's lease obligations and holdback payable and noncrash -- noncash accretion expense on the company's acquisition payable liability. The company recorded a foreign exchange loss net of $123,000 during the year ended December 31, 2025, in comparison to a foreign exchange loss of $71,000 during the year ended December 31, 2024. The change in foreign exchange loss relates to changes in the U.S. dollar exchange rate during each respective year. Adjusted EBITDA for the year ended December 31, 2025, was negative $1.5 million compared to an adjusted EBITDA of negative $437,000 during the year ended December 31, 2024. The decrease in adjusted EBITDA during the current year is due to an increase in operating loss, which primarily related to lower net revenue of AGGRASTAT, higher cost of goods sold through the company's pharmacy business segment, offset by higher ZYPITAMAG revenue through Marley Drug. And lastly, higher revenue through the company's pharmacy business segment as well. As at December 31, 2025, the company had cash totaling approximately $3.8 million, a decrease from December 31, 2024, where the company had $7.2 million of cash held. The decrease in cash balance for the company in the current year is primarily attributable to the acquisitions of both Gateway Pharmacy and West Olympia Pharmacy during the current year. The company does not have any debt on its books. I want to remind you that there will be an opportunity at the end of today's call for you to ask questions regarding the financial results of the company as a whole. And with that, I would like to turn the call back over to our CEO, Dr. Albert Friesen, for some additional comments and closing remarks.

Thank you, Haaris. Overall, the company's revenue increased from the prior year. The acquisitions of Gateway and West Olympia pharmacies created additional synergies for the company and also provided some additional channels for the company to market and sell ZYPITAMAG. Medicure's R&D focus, as mentioned, is a Phase III study to seek approval for MC-1 as the first FDA-approved therapy for patients with PNPO deficiency, a rare pediatric disease leading to seizures and is ultimately fatal if untreated. A successful use of Medicure's legacy product MC-1 could lead to a priority review voucher, which we can redeem or sell and provide significant value. Enrollment is currently ongoing with patients receiving treatment with MC-1, Medicure has received fast track designation, so expedited review. And the Phase III has had 2 of the patients already completed 12 months in the study over 12 months, and we're targeting the end of -- the minimal enrollment by the end of June of this year. Medicure signed an asset purchase agreement for the acquisition of a patent and intellectual property related to a new chemical entity developing additional therapeutic use. We believe the new chemical entity holds promise to provide significant improvements over existing lead compounds and is aligned with the treatment of diseases being treated by Medicure, and this could provide significant long-term value upon completion of all required preclinical and clinical studies. Medicure is now has yet to announce the clinical target. However, the target is large and the preclinical and API development is underway. We are still focused on growing the business and diversifying our revenue and asset base near term through acquisitions and long term through R&D, carefully investing to grow our future profitability. My goal and that of our Board, management staff is to continue to build this business with a stable long-term outlook to generate value for shareholders. And as always, I want to express my sincere appreciation to the outstanding team we have been blessed with. Thank you, our shareholders, for your continued support and interest. And now I'll turn it over to the moderator to entertain Q&A.

[Operator Instructions] As we have no questions on the line at this time. I would like to turn the call back over to Dr. Friesen for any closing remarks you may have.

Again, thank you for your time and interest, and we look forward to your participation at the next quarterly report. Thank you, and goodbye.

Thank you. Ladies and gentlemen, this concludes today's conference. Thank you for participating, and you may now disconnect.