Q1 2026 HLS Therapeutics Inc Earnings Call
Operator 3: Good morning, welcome to the Q1 Fiscal 2026 Financial Results Conference Call for the HLS Therapeutics. At this point, I would like to turn the call over to David Mason, investor relations, for the introductory remarks.
Operator: Good morning, welcome to the Q1 Fiscal 2026 Financial Results Conference Call for the HLS Therapeutics. At this point, I would like to turn the call over to David Mason, investor relations, for the introductory remarks.
Speaker #2: Good morning, everyone, and thank you for joining us today. With me on the call is Craig Millian, Chief Executive Officer; John Hanna, Chief Financial Officer; and Brian Walsh, Chief Commercial Officer.
Dave Mason: Good morning, everyone, and thank you for joining us today. With me on the call is Craig Millian, Chief Executive Officer; John Hanna, Chief Financial Officer; and Brian Walsh, Chief Commercial Officer. Earlier this morning, we issued a news release announcing our financial results for the 3 months ended 31 March 2026. This news release, along with our MD&A and financial statements, is available on our website and on SEDAR+. Please note that slides accompanying today's call can be viewed via the webcast, a link to which is available in our earnings press release and on our website on the Events page. Certain matters discussed in today's conference call or answers that may be given to questions could constitute forward-looking statements. Actual results could differ materially from those anticipated. Risk factors that could affect results are detailed in the company's annual information form, which has been filed on SEDAR+.
Dave Mason: Good morning, everyone, and thank you for joining us today. With me on the call is Craig Millian, Chief Executive Officer; John Hanna, Chief Financial Officer; and Brian Walsh, Chief Commercial Officer. Earlier this morning, we issued a news release announcing our financial results for the three months ended 31 March 2026. This news release, along with our MD&A and financial statements, is available on our website and on SEDAR+. Please note that slides accompanying today's call can be viewed via the webcast, a link to which is available in our earnings press release and on our website on the Events page. Certain matters discussed in today's conference call or answers that may be given to questions could constitute forward-looking statements. Actual results could differ materially from those anticipated. Risk factors that could affect results are detailed in the company's annual information form, which has been filed on SEDAR+.
Speaker #2: Earlier this morning, we issued a news release announcing our financial results for the three months ended March 31, 2026. This news release, along with our MD&A and financial statements, is available on our website and on SEDAR+.
Speaker #2: Please note that slides accompanying today's call can be viewed via the webcast, a link to which is available in our earnings press release and on our website on the Events page.
Speaker #2: Certain matters discussed in today's conference call, or answers that may be given to questions, could constitute forward-looking statements. Actual results could differ materially from those anticipated.
Speaker #2: Risk factors that could affect results are detailed in the company's annual information form, which has been filed on Cedar Plus. During the call, we will refer to adjusted EBITDA.
Dave Mason: During the call, we will refer to adjusted EBITDA. Adjusted EBITDA does not have any standardized meaning prescribed by IFRS. Adjusted EBITDA is defined in our press release and annual filings that are available on SEDAR+ and on our website. Please note that all financial information provided is in US dollars unless otherwise specified. I would now like to turn the meeting over to Mr. Millian. Please go ahead.
Dave Mason: During the call, we will refer to adjusted EBITDA. Adjusted EBITDA does not have any standardized meaning prescribed by IFRS. Adjusted EBITDA is defined in our press release and annual filings that are available on SEDAR+ and on our website. Please note that all financial information provided is in US dollars unless otherwise specified. I would now like to turn the meeting over to Mr. Millian. Please go ahead.
Speaker #2: Adjusted EBITDA does not have any standardized meaning prescribed by IFRS. Adjusted EBITDA is defined in our press release and annual filings that are available on Cedar Plus and on our website.
Speaker #2: Please note that all financial information provided is in US dollars, unless otherwise specified. And I would now like to turn the meeting over to Mr. Millian.
Speaker #2: Please go ahead. Thanks, Dave. Good morning, everyone, and thank you for joining us today. On our call today, I'll take you through our Q1 performance along with a corporate update.
Craig Millian: Thanks, Dave. Good morning, everyone, and thank you for joining us today. On our call today, I will take you through our Q1 performance along with a corporate update. Brian will follow with a deeper look at performance for each of our products with a focus on the NILEMDO launch. John will cover the financials in detail, and then I'll be back with a few closing thoughts before we open it up for questions. Starting with the big picture, we believe today's HLS is in a very favorable position. Vascepa is still growing in its seventh year on the market. Clozaril is showing resilience, and NILEMDO is off to a great start, better than expected in many respects. Over the past couple years, we've put HLS on a solid operational and financial footing, making necessary improvements to increase efficiency and profitability while de-levering our balance sheet.
Craig Millian: Thanks, Dave. Good morning, everyone, and thank you for joining us today. On our call today, I will take you through our Q1 performance along with a corporate update. Brian will follow with a deeper look at performance for each of our products with a focus on the NILEMDO launch. John will cover the financials in detail, and then I'll be back with a few closing thoughts before we open it up for questions. Starting with the big picture, we believe today's HLS is in a very favorable position. Vascepa is still growing in its seventh year on the market. Clozaril is showing resilience, and NILEMDO is off to a great start, better than expected in many respects. Over the past couple years, we've put HLS on a solid operational and financial footing, making necessary improvements to increase efficiency and profitability while de-levering our balance sheet.
Speaker #2: Brian will then follow with a deeper look at performance for each of our products with a focus on the Nalendo launch. John will cover the financials in detail.
Speaker #2: And then I'll be back with a few closing thoughts before we open it up for questions. Starting with the big picture, we believe today's HLS is in a very favorable position.
Speaker #2: With CIPA still growing in its seventh year on the market, PLAZA is showing resilience, and Nalendo is off to a great start—better than expected in many respects.
Speaker #2: Over the past couple of years, we've put HLS on a solid operational and financial footing, making necessary improvements to increase efficiency and profitability while delevering our balance sheet.
Speaker #2: In addition, we brought in two important new assets last year: Nalendo and Nexloset. We believe these will be important catalysts for growth. With a stronger financial foundation and an expanded cardiovascular portfolio, we're now focused on accelerating growth in the years to come.
Craig Millian: In addition, we brought in two important new assets last year, NILEMDO and NEXLETOL, that we believe will be important catalysts for growth. With a stronger financial foundation and expanded cardiovascular portfolio, we're now focused on accelerating growth in the years to come. With that, let me start by walking you through the first quarter highlights. Starting with the top line, revenue in Q1 was CAD 12.9 million, up 2% year over year. That growth was led by a 15% increase in Vascepa net sales, the highest year over year quarterly growth we've seen since Q2 of last year. This is encouraging in that the leadership and staffing changes along with the commercial strategy that we put in place last year are having the desired impact. Adjusted EBITDA for the quarter was CAD 3.5 million, down about CAD 300,000 from the prior year.
Craig Millian: In addition, we brought in two important new assets last year, NILEMDO and NEXLETOL, that we believe will be important catalysts for growth. With a stronger financial foundation and expanded cardiovascular portfolio, we're now focused on accelerating growth in the years to come. With that, let me start by walking you through the first quarter highlights. Starting with the top line, revenue in Q1 was CAD 12.9 million, up 2% year over year. That growth was led by a 15% increase in Vascepa net sales, the highest year over year quarterly growth we've seen since Q2 of last year. This is encouraging in that the leadership and staffing changes along with the commercial strategy that we put in place last year are having the desired impact. Adjusted EBITDA for the quarter was CAD 3.5 million, down about CAD 300,000 from the prior year.
Speaker #2: With that, let me start by walking you through the first quarter highlights. Starting with the top line, revenue in Q1 was $12.9 million, up 2% year over year.
Speaker #2: That growth was led by a 15% increase in the CIPA net sales, the highest year-over-year quarterly growth we've seen since Q2 of last year.
Speaker #2: This is encouraging in that the leadership and staffing changes along with the commercial strategy that we put in place last year are having the desired impact.
Speaker #2: Adjusted EBITDA for the quarter was $3.5 million, down about $300,000 from the prior year. And that is as expected. As previously discussed, we're making a small increase in commercial investment to help ensure a successful Nalendo launch.
Craig Millian: That is as expected. As previously discussed, we're making a small increase in commercial investment to help ensure a successful NILEMDO launch. We expect that launch-related expenses will be mostly front-loaded in H1 of the year, with margins improving in H2 as spend normalizes and NILEMDO revenue ramps up. Cash from operations was up 80% year over year. On the balance sheet, net debt at the end of Q1 was CAD 31.9 million, down 52% in just 2 years. This delevering has strengthened our financial position and will increase our options for deploying capital. Now a few comments on our business performance. Turning to Clozaril, Q1 results were in line with expectations. As discussed on the last call, Clozaril encountered some contracting dynamics in Ontario in the latter part of 2025.
Craig Millian: That is as expected. As previously discussed, we're making a small increase in commercial investment to help ensure a successful NILEMDO launch. We expect that launch-related expenses will be mostly front-loaded in H1 of the year, with margins improving in H2 as spend normalizes and NILEMDO revenue ramps up. Cash from operations was up 80% year over year. On the balance sheet, net debt at the end of Q1 was CAD 31.9 million, down 52% in just 2 years. This delevering has strengthened our financial position and will increase our options for deploying capital. Now a few comments on our business performance. Turning to Clozaril, Q1 results were in line with expectations. As discussed on the last call, Clozaril encountered some contracting dynamics in Ontario in the latter part of 2025.
Speaker #2: We expect that launch-related expenses will be mostly front-loaded in the first half of the second half as spend normalizes and Nalendo revenue ramps up.
Speaker #2: Cash from operations was up 80% year over year. And on the balance sheet, net debt at the end of Q1 was $31.9 million, down 52% in just two years.
Speaker #2: This de-levering has strengthened our financial position and will increase our options for deploying capital. Now a few comments on our business performance. Turning to PLAZA, Q1 results were in line with expectations.
Speaker #2: As discussed on the last call, plaza encountered some contracting dynamics in Ontario in the latter part of 2025. And as expected, this is impacting year-over-year comparisons in the first half of 2026.
Craig Millian: As expected, this is impacting year-over-year comparisons in the H1 of 2026. While we are seeing those residual impacts, we're also seeing positive signs that our business is stabilizing. Most encouraging is that we saw a sequential return to Clozaril monthly patient growth in Ontario specifically and across Canada more broadly in both March and April. Month-to-month growth in our patient base is a positive leading indicator suggesting business results should follow. Regarding Vascepa, we're encouraged by the strong prescription and net sales growth seen in the Q1. For full year 2026, we're projecting double-digit growth in both prescriptions and revenue. With sustained demand growth, an increasingly stable payer mix, and a cost structure that's now spread across multiple products, Vascepa should contribute growth along with margin expansion for years to come.
Craig Millian: As expected, this is impacting year-over-year comparisons in the H1 of 2026. While we are seeing those residual impacts, we're also seeing positive signs that our business is stabilizing. Most encouraging is that we saw a sequential return to Clozaril monthly patient growth in Ontario specifically and across Canada more broadly in both March and April. Month-to-month growth in our patient base is a positive leading indicator suggesting business results should follow. Regarding Vascepa, we're encouraged by the strong prescription and net sales growth seen in the Q1. For full year 2026, we're projecting double-digit growth in both prescriptions and revenue. With sustained demand growth, an increasingly stable payer mix, and a cost structure that's now spread across multiple products, Vascepa should contribute growth along with margin expansion for years to come.
Speaker #2: And while we are seeing those residual impacts, we're also seeing positive signs that our business is stabilizing. Most encouraging is that we saw a sequential return to Plaza monthly patient growth in Ontario specifically, and across Canada more broadly, in both March and April.
Speaker #2: Month-to-month growth in our patient base is a positive leading indicator, suggesting business results should follow. Regarding the CIPA, we're encouraged by the strong prescription and net sales growth seen in the first quarter.
Speaker #2: For full year 2026, we're projecting double-digit growth in both prescriptions and revenue. With sustained demand growth and an increasingly stable payer mix, and a cost structure that's now spread across multiple products, the CIPA should contribute growth along with margin expansion for years to come.
Speaker #2: Now let's turn to Nalendo, which had its full commercial launch in April. With just over one full month on the market, we've shipped nearly a quarter million Canadian dollars' worth of Nalendo.
Craig Millian: Now let's turn to NILEMDO, which had its full commercial launch in April. With just over one full month on the market, we've shipped nearly a quarter million CAD worth of NILEMDO. Multiple wholesalers are placing reorders based on strong initial demand, and the weekly run rate for ex-factory sales is growing. On the private payer side, Canada Life and Sun Life, two of the largest plans in Canada, are already listing NILEMDO with full coverage and without restrictions. These two plans cover about 40% of all privately insured patients in Canada. Although early, we're pleased with how this launch is progressing. Regarding NEXLIZET, the fixed-dose combo pill combining bempedoic acid and ezetimibe, we expect to respond to Health Canada on their outstanding queries this quarter, keeping us on track to launch in H1 2027.
Craig Millian: Now let's turn to NILEMDO, which had its full commercial launch in April. With just over one full month on the market, we've shipped nearly a quarter million CAD worth of NILEMDO. Multiple wholesalers are placing reorders based on strong initial demand, and the weekly run rate for ex-factory sales is growing. On the private payer side, Canada Life and Sun Life, two of the largest plans in Canada, are already listing NILEMDO with full coverage and without restrictions. These two plans cover about 40% of all privately insured patients in Canada. Although early, we're pleased with how this launch is progressing. Regarding NEXLIZET, the fixed-dose combo pill combining bempedoic acid and ezetimibe, we expect to respond to Health Canada on their outstanding queries this quarter, keeping us on track to launch in H1 2027.
Speaker #2: Multiple wholesalers are placing reorders based on strong initial demand, and the weekly run rate for X Factory sales is growing. On the private payer side, Canada Life and Sun Life, two of the largest plans in Canada, are already listing Nalendo with full coverage and without restrictions.
Speaker #2: These two plans cover about 40% of all privately insured patients in Canada. Although early, progressing. Regarding Nexloset, the fixed-dose combo pill combining bempedog acid and ezetimibe, we expect to respond to health Canada on their outstanding queries this quarter.
Speaker #2: Keeping us on track to launch in the first half of 2027. The sequencing of the Nalendo launch in Q2, followed by Nexloset in the first half of 2027, gives HLS two distinct growth catalysts within 12 months.
Craig Millian: The sequencing of the NILEMDO launch in Q2, followed by NEXLIZET in H1 2027, gives HLS two distinct growth catalysts within 12 months. From a big-picture perspective, HLS is becoming a leading Canadian cardiovascular company. We have a growing portfolio of oral first-in-class medicines, each with compelling outcomes data, long patent runways in Canada, and a distinct role in addressing cardiovascular risk. Although we'll be tripling the number of products in our CV portfolio, the incremental investment required is modest. We believe these dynamics add up to a unique and perhaps underappreciated opportunity as the economics of our cardiovascular franchise model are compelling. First, there are the expanding margins. We're leveraging existing infrastructure with no need to expand our customer-facing footprint.
Craig Millian: The sequencing of the NILEMDO launch in Q2, followed by NEXLIZET in H1 2027, gives HLS two distinct growth catalysts within 12 months. From a big-picture perspective, HLS is becoming a leading Canadian cardiovascular company. We have a growing portfolio of oral first-in-class medicines, each with compelling outcomes data, long patent runways in Canada, and a distinct role in addressing cardiovascular risk. Although we'll be tripling the number of products in our CV portfolio, the incremental investment required is modest. We believe these dynamics add up to a unique and perhaps underappreciated opportunity as the economics of our cardiovascular franchise model are compelling. First, there are the expanding margins. We're leveraging existing infrastructure with no need to expand our customer-facing footprint.
Speaker #2: From a big-picture perspective, HLS is becoming a leading Canadian cardiovascular company. We have a growing portfolio of oral, first-in-class medicines, each with compelling outcomes data, long patent runways in Canada, and a distinct role in addressing cardiovascular risk.
Speaker #2: And although we'll be tripling the number of products in our CV portfolio, the incremental investment required is modest. We believe these dynamics add up to a unique and perhaps underappreciated opportunity, as the economics of our cardiovascular franchise model are compelling.
Speaker #2: First, there are the expanding margins. We're leveraging existing infrastructure with no need to expand our customer-facing footprint. With a stable cost structure as we introduce these new medicines, and as sales volumes increase, the cardiovascular portfolio will become significantly more profitable in years to come.
Craig Millian: With a stable cost structure, as we introduce these new medicines and as sales volumes increase, the cardiovascular portfolio will become significantly more profitable in years to come. Second, the revenue opportunity here is significant. Based on what we believe are conservative assumptions, the NILEMDO and NEXLIZET franchise has the potential to more than double the size of the company. For those of you on the webcast, we're showing a slide with an illustrative example of how we're thinking about revenue potential for the NILEMDO and NEXLIZET franchise. Based on conservative estimates for peak market penetration of the target population, along with preliminary assumptions around patient compliance and gross to net, we get to a revenue range of CAD 50 to 100 million. Again, at that level, we would essentially double the size of the company. We believe there could be additional upside to our assumptions.
Craig Millian: With a stable cost structure, as we introduce these new medicines and as sales volumes increase, the cardiovascular portfolio will become significantly more profitable in years to come. Second, the revenue opportunity here is significant. Based on what we believe are conservative assumptions, the NILEMDO and NEXLIZET franchise has the potential to more than double the size of the company. For those of you on the webcast, we're showing a slide with an illustrative example of how we're thinking about revenue potential for the NILEMDO and NEXLIZET franchise. Based on conservative estimates for peak market penetration of the target population, along with preliminary assumptions around patient compliance and gross to net, we get to a revenue range of CAD 50 to 100 million. Again, at that level, we would essentially double the size of the company. We believe there could be additional upside to our assumptions.
Speaker #2: And second, the revenue opportunity here is significant. Based on what we believe our conservative assumptions, the Nalendo and Nexloset franchise has the potential to more than double the size of the company.
Speaker #2: For those of you on the webcast, we're showing a slide with an illustrative example of how we're thinking about revenue potential for the Nalendo Nexloset franchise.
Speaker #2: Based on conservative estimates for peak market penetration of the target population, along with preliminary assumptions around patient compliance and gross-to-net, we get to a revenue range of $50 to $100 million Canadian dollars.
Speaker #2: Again, at that level, we would essentially double the size of the company. And we believe there could be additional upside to our assumptions. That said, I want to caveat that we will have a more fully formed view on peak sales potential once we finalize public payer negotiations by early next year.
Craig Millian: That said, I want to caveat that we will have a more fully formed view on peak sales potential once we finalize public payer negotiations by early next year. The bottom line is that NILEMDO and NEXLIZET are entering a sizable market targeting a well-defined patient population with unmet need. We are in a great position to capture this opportunity. Let's move on to guidance, where we are reaffirming our 2026 outlook. Revenue of $56 to 60 million, reflecting mid-single-digit growth and adjusted EBITDA of $18.5 to 21 million, which is relatively flat as we absorb the NILEMDO launch costs. As I mentioned, the launch investment is concentrated in the H1. We expect to see margin expansion as sales momentum picks up in the H2 of 2026 and into 2027.
Craig Millian: That said, I want to caveat that we will have a more fully formed view on peak sales potential once we finalize public payer negotiations by early next year. The bottom line is that NILEMDO and NEXLIZET are entering a sizable market targeting a well-defined patient population with unmet need. We are in a great position to capture this opportunity. Let's move on to guidance, where we are reaffirming our 2026 outlook. Revenue of $56 to 60 million, reflecting mid-single-digit growth and adjusted EBITDA of $18.5 to 21 million, which is relatively flat as we absorb the NILEMDO launch costs. As I mentioned, the launch investment is concentrated in the H1. We expect to see margin expansion as sales momentum picks up in the H2 of 2026 and into 2027.
Speaker #2: The bottom line is that Nalendo and Nexloset are entering a sizable market targeting a well-defined patient population with unmet need. And we are in a great position to capture this opportunity.
Speaker #2: Let's move on to guidance, where we are reaffirming our 2026 outlook. Revenue of 56 to 60 million dollars reflecting mid-single-digit growth and adjusted EBITDA of 18 and a half to 21 million dollars which is relatively flat as we absorb the Nalendo launch costs.
Speaker #2: As I mentioned, the launch investment is concentrated in the first margin expansion as sales momentum picks up in the second half of 2026 and into 2027.
Speaker #2: This is reflected in the quarterly gating for adjusted EBITDA, where we expect a higher split in the second half of the year. So, while 2026 is a year of incremental investment, the real growth story for HLS becomes the trajectory heading into 2027.
Craig Millian: This is reflected in the quarterly gating for adjusted EBITDA, where we expect a higher split in the H2 of the year. While 2026 is a year of incremental investment, the real growth story for HLS becomes the trajectory heading into 2027. I'll come back to that in my closing remarks. For now, let me hand it over to Brian.
Craig Millian: This is reflected in the quarterly gating for adjusted EBITDA, where we expect a higher split in the H2 of the year. While 2026 is a year of incremental investment, the real growth story for HLS becomes the trajectory heading into 2027. I'll come back to that in my closing remarks. For now, let me hand it over to Brian.
Speaker #2: And I'll come back to that in my closing remarks. But for now, let me hand it over to Brian. Thanks, Craig. Good morning, everyone.
Brian Walsh: Thanks, Craig. Good morning, everyone. I'll take you through our products, starting with Clozaril and Vascepa, then focusing on the NILEMDO launch. Starting with Clozaril Canada, Q1 results were as anticipated. Due to the 2025 Ontario GPO renegotiations that we've detailed previously, year-over-year comparisons will be unfavorable in the H1 of the year and are expected to normalize in the H2. Importantly, patient volume in Ontario returned to sequential growth in March and again in April. Evidence that changes have been worked through, and we are expecting continued sequential patient growth in Ontario throughout the year. We also continue to see high patient retention in Quebec, while other provinces are showing solid growth. British Columbia, in particular, delivered 11% patient growth versus Q1 last year. The Clozaril fundamentals are intact.
Brian Walsh: Thanks, Craig. Good morning, everyone. I'll take you through our products, starting with Clozaril and Vascepa, then focusing on the NILEMDO launch. Starting with Clozaril Canada, Q1 results were as anticipated. Due to the 2025 Ontario GPO renegotiations that we've detailed previously, year-over-year comparisons will be unfavorable in the H1 of the year and are expected to normalize in the H2. Importantly, patient volume in Ontario returned to sequential growth in March and again in April. Evidence that changes have been worked through, and we are expecting continued sequential patient growth in Ontario throughout the year. We also continue to see high patient retention in Quebec, while other provinces are showing solid growth. British Columbia, in particular, delivered 11% patient growth versus Q1 last year. The Clozaril fundamentals are intact.
Speaker #2: I'll take you through our products, starting with plaza and the CIPA, then focusing on the Nalendo launch. Starting with plaza Canada, Q1 results were as anticipated.
Speaker #2: Due to the 2025 Ontario GPO renegotiations that we've detailed previously, year-over-year comparisons will be unfavorable in the first half of the year and are expected to normalize in the second half.
Speaker #2: Importantly, patient volume in Ontario returned to sequential growth in March and again in April, evidence the changes have been worked through, and we are expecting continued sequential patient growth in Ontario throughout the year.
Speaker #2: We also continue to see high patient retention in Quebec, while other provinces are showing solid growth. British Columbia, in particular, delivered 11% patient growth versus Q1 last year.
Speaker #2: The Plaza fundamentals are intact. The largest strategic accounts were retained, and patient volumes are growing again in Ontario and across Canada overall. The brand maintains approximately a 50% market share and remains a strong, stable cash contributor.
Brian Walsh: The largest strategic accounts were retained, and patient volumes are growing again in Ontario and across Canada overall. The brand maintains approximately a 50% market share and remains a strong, stable cash contributor. As for Clozaril in the US, revenues were down 2% in line with expectations. We expect to take a modest and customary price increase later this year, and we'll continue to look for ways to maintain patient volumes and expand the specialty pharmacy program to bolster this business. On Vascepa, Q1 unit growth remained strong at 18% versus prior year and net sales growth strengthened, a validation of the go-to-market changes we made in 2025. New-to-brand prescription improvements that began in Q4 2025 continued into Q1. Prescriber breadth and depth are both tracking positively, demonstrating that we are not just deepening prescribing with existing writers, but also expanding the prescriber base.
Brian Walsh: The largest strategic accounts were retained, and patient volumes are growing again in Ontario and across Canada overall. The brand maintains approximately a 50% market share and remains a strong, stable cash contributor. As for Clozaril in the US, revenues were down 2% in line with expectations. We expect to take a modest and customary price increase later this year, and we'll continue to look for ways to maintain patient volumes and expand the specialty pharmacy program to bolster this business. On Vascepa, Q1 unit growth remained strong at 18% versus prior year and net sales growth strengthened, a validation of the go-to-market changes we made in 2025. New-to-brand prescription improvements that began in Q4 2025 continued into Q1. Prescriber breadth and depth are both tracking positively, demonstrating that we are not just deepening prescribing with existing writers, but also expanding the prescriber base.
Speaker #2: As for plaza in the US, revenues were down 2%, in line with expectations. We expect to take a modest and customary price increase later this year and will continue to look for ways to maintain patient volumes and expand, especially the pharmacy program, to bolster this business.
Speaker #2: On the CIPA, Q1 unit growth remained strong at 18% versus prior year and net sales growth strengthened, a validation of the go-to-market changes we made in 2025.
Speaker #2: New to brand prescription improvements that began in Q4 2025 continued into Q1. Prescriber Breath and Depth are both tracking positively demonstrating that we are not just deepening prescribing with existing writers, but also expanding the prescriber base.
Speaker #2: And payer mix continues to stabilize, which should help improve the profitability of the brand. The CIPA has patent protection through the late 2030s, and we see a long runway for continued profitable growth.
Brian Walsh: Payor mix continues to stabilize, which should help improve the profitability of the brand. Vascepa has patent protection through late 2030s, and we see a long runway for continued profitable growth. Now let's turn to NILEMDO. The opportunity is well-defined. In Canada, roughly 5 to 6 million Canadians live with cardiovascular disease or elevated cardiovascular risk. 3 million are on statins. We are targeting a clearly identified subset, those not reaching their LDL goal despite treatment and those that cannot tolerate statins or cannot titrate to an effective dose. bempedoic acid works outside the muscle tissue, avoiding the side effects many patients experience on statins. We estimate that population conservatively at half a million Canadians, a large reachable group with a clear clinical need. From a pricing perspective, NILEMDO is priced at CAD 4.25 per day.
Brian Walsh: Payor mix continues to stabilize, which should help improve the profitability of the brand. Vascepa has patent protection through late 2030s, and we see a long runway for continued profitable growth. Now let's turn to NILEMDO. The opportunity is well-defined. In Canada, roughly 5 to 6 million Canadians live with cardiovascular disease or elevated cardiovascular risk. 3 million are on statins. We are targeting a clearly identified subset, those not reaching their LDL goal despite treatment and those that cannot tolerate statins or cannot titrate to an effective dose. bempedoic acid works outside the muscle tissue, avoiding the side effects many patients experience on statins. We estimate that population conservatively at half a million Canadians, a large reachable group with a clear clinical need. From a pricing perspective, NILEMDO is priced at CAD 4.25 per day.
Speaker #2: Now let's turn to Nalendo. The opportunity is well-defined. In Canada, roughly five to six million Canadians live with cardiovascular disease or elevated cardiovascular risk.
Speaker #2: Three million are on statins. We are targeting a clearly identified subset: those not reaching their LDL goal despite treatment, and those that cannot tolerate statins or cannot titrate to an effective dose.
Speaker #2: Bempedoic acid works outside the muscle tissue avoiding the side effects many patients experience on statins. We estimate that population conservatively at half a million Canadians, a large, reachable group with a clear clinical need.
Speaker #2: From a pricing perspective, Nalendo is priced at $425 Canadian per day. That places it squarely in the gap between generic statins and more costly PCSK9 injectables.
Brian Walsh: That places it squarely in the gap between generic statins and more costly PCSK9 injectables, which are approximately CAD 15 to CAD 20 per day. It's worth noting that PCSK9 inhibitors have less than 1% market share of LDL low-lowering therapy in Canada. This is largely due to the access restrictions that are in place. NILEMDO fills that gap with an oral, well-tolerated option at a price point that payers and physicians can genuinely get behind. The formal commercial launch from NILEMDO occurred in April, and early indicators are that we are off to a very strong start. Our reps are reporting something that you rarely see at launch. Large numbers of clinicians who already have lists of their patients identified and who are ready to prescribe NILEMDO. These are statin-intolerant patients who have been waiting for an oral option.
Brian Walsh: That places it squarely in the gap between generic statins and more costly PCSK9 injectables, which are approximately CAD 15 to CAD 20 per day. It's worth noting that PCSK9 inhibitors have less than 1% market share of LDL low-lowering therapy in Canada. This is largely due to the access restrictions that are in place. NILEMDO fills that gap with an oral, well-tolerated option at a price point that payers and physicians can genuinely get behind. The formal commercial launch from NILEMDO occurred in April, and early indicators are that we are off to a very strong start. Our reps are reporting something that you rarely see at launch. Large numbers of clinicians who already have lists of their patients identified and who are ready to prescribe NILEMDO. These are statin-intolerant patients who have been waiting for an oral option.
Speaker #2: Which are approximately $15 to $20 Canadian per day. And it's worth noting that PCSK9 inhibitors have less than 1% market share of LDL-lowering therapy in Canada.
Speaker #2: This is largely due to the access restrictions that are in place. Nalendo fills that gap with an oral, well-tolerated option at a price point that payers and physicians can genuinely get behind.
Speaker #2: The formal commercial launch for Nalendo occurred in April, and early indicators are that we are off to a very strong start. Our reps are reporting something that you rarely see at launch.
Speaker #2: Large numbers of clinicians already have lists of their patients identified and are ready to prescribe Nalendo. These are statin-intolerant patients who have been waiting for an oral option.
Speaker #2: Clinicians are familiar with the drug and have been following its real-world progress in the US and Europe. They are excited by the clear outcomes trial data and have been waiting to have this option available for their Canadian patients.
Brian Walsh: Clinicians are familiar with the drug and have been following its real-world progress in the US and Europe. They are excited by the clear outcomes trial data and have been waiting to have this option available for their Canadian patients. Our awareness, trial, and usage, or ATU study, a blinded market research study that was completed in January, provides us with empirical evidence on the baseline of awareness and readiness of physicians to prescribe in Canada. The study was comprised of 70 target cardiologists and endocrinologists, and it showed over 90% total awareness before we had promoted the product at all. These physicians follow the same global guidelines and literature as their US and European peers, and NILEMDO has been part of that landscape for years. Over 80% indicated willingness to prescribe. Our national advisory board echoed the same message, clear unmet need and strong physician anticipation.
Brian Walsh: Clinicians are familiar with the drug and have been following its real-world progress in the US and Europe. They are excited by the clear outcomes trial data and have been waiting to have this option available for their Canadian patients. Our awareness, trial, and usage, or ATU study, a blinded market research study that was completed in January, provides us with empirical evidence on the baseline of awareness and readiness of physicians to prescribe in Canada. The study was comprised of 70 target cardiologists and endocrinologists, and it showed over 90% total awareness before we had promoted the product at all. These physicians follow the same global guidelines and literature as their US and European peers, and NILEMDO has been part of that landscape for years. Over 80% indicated willingness to prescribe. Our national advisory board echoed the same message, clear unmet need and strong physician anticipation.
Speaker #2: Our awareness, trial, and usage—or ATU—study, a blinded market research study that was completed in January, provides us with empirical evidence on the baseline of awareness and readiness of physicians to prescribe in Canada.
Speaker #2: The study was comprised of 70 target cardiologists and endocrinologists, and it showed over 90% total awareness before we had promoted the product at all.
Speaker #2: These physicians follow the same global guidelines and literature as their US and European peers, and Nalendo has been part of that landscape for years.
Speaker #2: Over 80% indicated willingness to prescribe. Our national advisory board echoed the same message, clear unmet need and strong physician anticipation. We expect this X-factory demand to accelerate in the coming weeks as awareness grows around the private payer access we achieved in April.
Brian Walsh: We expect this ex-factory demand to accelerate in the coming weeks as awareness grows around the private payer access we achieved in April. Canada Life and Sun Life, two of the largest private payers in Canada, have now listed NILEMDO as a full benefit with no prior authorization. Canada Life was in effect for the commercial launch, and Sun Life went effective on 29 April. Together, they represent approximately 40% of privately insured lives. These early listings are evidence that the value proposition for the brand is resonating. Active discussions with the remaining major private insurers are progressing well, and we expect the vast majority of private insured patients will have coverage by the time we report Q2 earnings. On public reimbursement, our dossier has been submitted to both CADTH and INESSS, with their evaluations expected this summer.
Brian Walsh: We expect this ex-factory demand to accelerate in the coming weeks as awareness grows around the private payer access we achieved in April. Canada Life and Sun Life, two of the largest private payers in Canada, have now listed NILEMDO as a full benefit with no prior authorization. Canada Life was in effect for the commercial launch, and Sun Life went effective on 29 April. Together, they represent approximately 40% of privately insured lives. These early listings are evidence that the value proposition for the brand is resonating. Active discussions with the remaining major private insurers are progressing well, and we expect the vast majority of private insured patients will have coverage by the time we report Q2 earnings. On public reimbursement, our dossier has been submitted to both CADTH and INESSS, with their evaluations expected this summer.
Speaker #2: Canada Life and Sun Life, two of the largest private payers in Canada, have now listed Nalendo as a full benefit with no prior authorization. Canada Life was in effect for the commercial launch, and Sun Life went effective on April 29th.
Speaker #2: Together, they represent approximately 40% of privately insured lives. These early listings are evidence that the value proposition for the brand is resonating. Active discussions with the remaining major private insurers are progressing well, and we expect the vast majority of privately insured patients will have coverage by the time we've reported Q2 earnings.
Speaker #2: On public reimbursement, our dossier has been submitted to both CDA and NS, with their evaluations expected this summer. That will feed into PCPA negotiations, targeting initial provincial listings in the first half of 2027.
Brian Walsh: That will feed into pCPA negotiations, targeting initial provincial listings in H1 2027. On NEXLETOL, we are expecting approval and launch in H1 2027. We think of NILEMDO and NEXLETOL as separate but connected catalysts. NILEMDO establishes the foundation, physician familiarity with the mechanism, the outcomes data, and the patient population. Within a year, we follow with NEXLETOL, a fixed-dose combination delivering greater LDL lowering with less pill burden, a natural step for a physician already writing NILEMDO. From a reimbursement standpoint, we expect to be able to converge the NILEMDO and NEXLETOL timelines, meaning the public listing process for NEXLETOL does not need to start from zero. This is a meaningful structural advantage of the staged approach. One further note, European LDL guidelines have moved from 1.8 to 1.4 millimole per liter for very high-risk patients.
Brian Walsh: That will feed into pCPA negotiations, targeting initial provincial listings in H1 2027. On NEXLETOL, we are expecting approval and launch in H1 2027. We think of NILEMDO and NEXLETOL as separate but connected catalysts. NILEMDO establishes the foundation, physician familiarity with the mechanism, the outcomes data, and the patient population. Within a year, we follow with NEXLETOL, a fixed-dose combination delivering greater LDL lowering with less pill burden, a natural step for a physician already writing NILEMDO. From a reimbursement standpoint, we expect to be able to converge the NILEMDO and NEXLETOL timelines, meaning the public listing process for NEXLETOL does not need to start from zero. This is a meaningful structural advantage of the staged approach. One further note, European LDL guidelines have moved from 1.8 to 1.4 millimole per liter for very high-risk patients.
Speaker #2: On Nexoset, we are expecting approval and launch in the first half of 2027. We think of Nalendo and Nexoset as separate but connected catalysts.
Speaker #2: Nalendo establishes the foundation: physician familiarity with the mechanism, the outcomes data, and the patient population. Within a year, we follow with Nexoset, a fixed-dose combination delivering greater LDL-lowering with less pill burden.
Speaker #2: A natural step for a physician already writing Nalendo. From a reimbursement standpoint, we expect to be able to converge the Nalendo and Nexoset timelines.
Speaker #2: Meaning the public listing process for Nexoset does not need to start from zero. This is a meaningful structural advantage of the staged approach. One further note, European LDL guidelines have moved from 1.8 to 1.4 millimole per liter for very high-risk patients.
Speaker #2: We expect Canadian guidelines will follow. A review is expected within the next 12 to 24 months. This would expand the addressable population meaningfully. And this would occur after the Nexoset launch.
Brian Walsh: We expect Canadian guidelines will follow. A review is expected within the next 12 to 24 months. This would expand the addressable population meaningfully, and this would occur after the NEXLETOL launch. This upside is not in our current estimates. Finally, as it relates to economics, NEXLETOL adds a third product on the same commercial infrastructure with modest incremental investment required. With NILEMDO gaining momentum in 2026 and both products in market in 2027, we have a lot to look forward to in the cardiovascular franchise. With that, I'll turn it over to John for a detailed look at our financials. John?
Brian Walsh: We expect Canadian guidelines will follow. A review is expected within the next 12 to 24 months. This would expand the addressable population meaningfully, and this would occur after the NEXLETOL launch. This upside is not in our current estimates. Finally, as it relates to economics, NEXLETOL adds a third product on the same commercial infrastructure with modest incremental investment required. With NILEMDO gaining momentum in 2026 and both products in market in 2027, we have a lot to look forward to in the cardiovascular franchise. With that, I'll turn it over to John for a detailed look at our financials. John?
Speaker #2: This upside is not in our current estimates. Finally, as it relates to economics, Nexoset adds a third product on the same commercial infrastructure with modest incremental investment required.
Speaker #2: With Nalendo gaining momentum in 2026, and both products in market in 2027, we have a lot to look forward to in the cardiovascular franchise.
Speaker #2: With that, I'll turn it over to John for a detailed look at our financials. John?
Speaker #1: Thank you, Brian, and good morning, everyone. In my section, I'll review Q1 results, the balance sheet, and our capital allocation priorities. My comments are all in US dollars as per our reported numbers.
John Hanna: Thank you, Brian, and good morning, everyone. In my section, I'll review Q1 results, the balance sheet, and our capital allocation priorities. My comments are all in US dollars as per our reported numbers, unless otherwise stated. Starting with revenue, total revenue for Q1 was $12.9 million, up 2% from $12.6 million in Q1 last year. The increase is due to growth in Vascepa net sales, which were $4.8 million, up 15% from Q1 last year, as well as appreciation of the Canadian dollar to the US dollar. Clozaril net sales, Canada and US regions combined, were $7.8 million compared to $8.2 million in Q1 last year. Clozaril net sales in the US were down slightly in Q1, while in Canada, Clozaril net sales in Q1 were impacted by the factors discussed by Craig and Brian.
John Hanna: Thank you, Brian, and good morning, everyone. In my section, I'll review Q1 results, the balance sheet, and our capital allocation priorities. My comments are all in US dollars as per our reported numbers, unless otherwise stated. Starting with revenue, total revenue for Q1 was $12.9 million, up 2% from $12.6 million in Q1 last year. The increase is due to growth in Vascepa net sales, which were $4.8 million, up 15% from Q1 last year, as well as appreciation of the Canadian dollar to the US dollar. Clozaril net sales, Canada and US regions combined, were $7.8 million compared to $8.2 million in Q1 last year. Clozaril net sales in the US were down slightly in Q1, while in Canada, Clozaril net sales in Q1 were impacted by the factors discussed by Craig and Brian.
Speaker #1: Unless otherwise stated, starting with revenue, total revenue for Q1 was $12.9 million, up 2% from $12.6 million in Q1 last year. The increase is due to growth in Vascepa net sales, which were $4.8 million, up 15% from Q1 last year, as well as appreciation of the Canadian dollar to the US dollar.
Speaker #1: Clauseral net sales, Canada and US regions combined, were $7.8 million compared to $8.2 million in Q1 last year. Clauseral net sales in the US were down slightly in Q1, while in Canada, Clauseral net sales in Q1 were impacted by the factors discussed by Craig and Brian.
Speaker #1: Finally, royalty revenue was $246,000 in Q1, compared to $197,000 in Q1 last year. On the expense side, Q1 operating expenses, comprising sales and marketing, G&A, and medical, regulatory, and patient support, were $6.7 million, compared to $6.4 million in Q1 last year.
John Hanna: Finally, royalty revenue was $246,000 in Q1 compared to $197,000 in Q1 last year. On the expense side, Q1 operating expenses comprising sales and marketing, G&A, and medical, regulatory, and patient support were $6.7 million compared to $6.4 million in Q1 last year. The increase reflects our investment in the NILEMDO launch, which accounted for approximately $0.5 million of incremental OpEx. Cost of sales in Q1 was $2.7 million compared to $2.4 million in Q1 last year, with the increase largely due to demand growth in Vascepa. Q1 adjusted EBITDA was $3.5 million compared to $3.8 million in Q1 last year. Adjusted EBITDA was impacted by the NILEMDO launch investment, as just described.
John Hanna: Finally, royalty revenue was $246,000 in Q1 compared to $197,000 in Q1 last year. On the expense side, Q1 operating expenses comprising sales and marketing, G&A, and medical, regulatory, and patient support were $6.7 million compared to $6.4 million in Q1 last year. The increase reflects our investment in the NILEMDO launch, which accounted for approximately $0.5 million of incremental OpEx. Cost of sales in Q1 was $2.7 million compared to $2.4 million in Q1 last year, with the increase largely due to demand growth in Vascepa. Q1 adjusted EBITDA was $3.5 million compared to $3.8 million in Q1 last year. Adjusted EBITDA was impacted by the NILEMDO launch investment, as just described.
Speaker #1: The increase reflects our investment in the Nalendo launch, which accounted for approximately $0.5 million of incremental OPEX. Cost of sales in Q1 was $2.7 million, compared to $2.4 million in Q1 last year.
Speaker #1: With the increase largely due to demand growth in Vascepa. Q1 adjusted EBITDA was $3.5 million, compared to $3.8 million in Q1 last year. Adjusted EBITDA was impacted by the Nalendo launch investment, as just described.
Speaker #1: As we have discussed, launch costs will be largely confined to the first half of 2026, with margins improving as we move through the second half of the year.
John Hanna: As we have discussed, launch costs will be largely confined to H1 2026, with margins improving as we move through H2 of the year. There is generally seasonal quarterly variation in adjusted EBITDA, as those of you on the webcast can see on this slide. We expect a similar pattern in 2026, though more pronounced in H1 given the NILEMDO launch investment, with revenue beginning to ramp in Q2 and accelerating through H2 of the year. For Q1, the direct brand contribution from Clozaril to adjusted EBITDA was CAD 5.6 million. In addition, even with additional launch expense, the direct brand contribution from the entire CV portfolio was breakeven in Q1. Cash from operations in Q1 was CAD 6.4 million, up 80% compared to Q1 last year.
John Hanna: As we have discussed, launch costs will be largely confined to H1 2026, with margins improving as we move through H2 of the year. There is generally seasonal quarterly variation in adjusted EBITDA, as those of you on the webcast can see on this slide. We expect a similar pattern in 2026, though more pronounced in H1 given the NILEMDO launch investment, with revenue beginning to ramp in Q2 and accelerating through H2 of the year. For Q1, the direct brand contribution from Clozaril to adjusted EBITDA was CAD 5.6 million. In addition, even with additional launch expense, the direct brand contribution from the entire CV portfolio was breakeven in Q1. Cash from operations in Q1 was CAD 6.4 million, up 80% compared to Q1 last year.
Speaker #1: There is generally seasonal quarterly variation in adjusted EBITDA, as those of you on the webcast can see on this slide. We expect a similar pattern in 2026.
Speaker #1: Though more pronounced in the first half given Nalendo launch investment, with revenue beginning to ramp in Q2 and accelerating through the second half of the year.
Speaker #1: For Q1, the direct brand contribution from Clauseral to adjusted EBITDA was $5.6 million. In addition, even with additional launch expense, the direct brand contribution from the entire CV portfolio was break-even in Q1.
Speaker #1: Cash from operations in Q1 was $6.4 million, up 80% compared to Q1 last year. The increase reflects the operational improvements made over the past two years, along with significantly lower interest expense—$0.7 million in the quarter compared to $1.7 million in Q1 last year—as a result of the new credit agreement and lower debt balance overall.
John Hanna: The increase reflects the operational improvements made over the past 2 years, along with significantly lower interest expense, $0.7 million in the quarter compared to $1.7 million in Q1 last year, as a result of the new credit agreement and lower debt balance overall. Our focus on operational improvements has increased our profitability and generated the strong cash flows that are enabling our balanced capital allocation approach today. Our balanced approach for capital allocation allows us to accomplish multiple objectives. First, deploying capital to expand our portfolio. With our balance sheet now in much better shape, we have greater flexibility to pursue additional opportunities. We are primarily focused on commercial stage assets in our core or adjacent therapeutic areas that can leverage our existing infrastructure. Second is to continue to delever the balance sheet by paying down debt.
John Hanna: The increase reflects the operational improvements made over the past 2 years, along with significantly lower interest expense, $0.7 million in the quarter compared to $1.7 million in Q1 last year, as a result of the new credit agreement and lower debt balance overall. Our focus on operational improvements has increased our profitability and generated the strong cash flows that are enabling our balanced capital allocation approach today. Our balanced approach for capital allocation allows us to accomplish multiple objectives. First, deploying capital to expand our portfolio. With our balance sheet now in much better shape, we have greater flexibility to pursue additional opportunities. We are primarily focused on commercial stage assets in our core or adjacent therapeutic areas that can leverage our existing infrastructure. Second is to continue to delever the balance sheet by paying down debt.
Speaker #1: Our focus on operational improvements has increased our profitability and generated the strong cash flows that are enabling our balanced capital allocation approach today. Our balanced approach for capital allocation allows us to accomplish multiple objectives.
Speaker #1: First, deploying capital to expand our portfolio. With our balance sheet now in much better shape, we have greater flexibility to pursue additional opportunities. We are primarily focused on commercial stage assets in our core or adjacent therapeutic areas, that can leverage our existing infrastructure.
Speaker #1: Second, is to continue to deliver the balance sheet by paying down debt. In Q1, we made principal repayments totaling $5.1 million. At March 31st, 2026, the principal balance on our term loan stood at $42.2 million, down 12% from the end of 2025.
John Hanna: In Q1, we made principal repayments totaling CAD 5.1 million. At 31 March 2026, the principal balance on our term loan stood at CAD 44.2 million, down 12% from the end of 2025. As a result of our continued delevering, net debt stood at CAD 31.9 million at the end of Q1, down 17% from the end of 2025. Thirdly is the return of capital to shareholders via share buybacks. During 2025, we purchased more than 500,000 shares. Although we do not currently have an active NCIB in place, we will explore opportunities to launch one in 2026 as we believe the shares represent compelling value at current prices. Finally, looking at the balance sheet, cash was CAD 12.3 million at quarter end, up from CAD 11.7 million at the end of 2025.
John Hanna: In Q1, we made principal repayments totaling CAD 5.1 million. At 31 March 2026, the principal balance on our term loan stood at CAD 44.2 million, down 12% from the end of 2025. As a result of our continued delevering, net debt stood at CAD 31.9 million at the end of Q1, down 17% from the end of 2025. Thirdly is the return of capital to shareholders via share buybacks. During 2025, we purchased more than 500,000 shares. Although we do not currently have an active NCIB in place, we will explore opportunities to launch one in 2026 as we believe the shares represent compelling value at current prices. Finally, looking at the balance sheet, cash was CAD 12.3 million at quarter end, up from CAD 11.7 million at the end of 2025.
Speaker #1: As a result of our continued delivering, net debt stood at $31.9 million at the end of Q1, down 17% from the end of 2025.
Speaker #1: And thirdly, is the return of capital to shareholders via share buybacks. During 2025, we purchased more than $500,000 shares. Although we do not currently have an active NCIB in place, we will explore opportunities to launch one in 2026, as we believe the shares represent compelling value at current prices.
Speaker #1: Finally, looking at the balance sheet, cash was $12.3 million at quarter end. Up from $11.7 million at the end of 2025. In summary, as we look ahead, we will continue with our balance view to capital allocation.
John Hanna: In summary, as we look ahead, we will continue with our balanced view to capital allocation, debt repayment, investing in growth, and returning capital to shareholders. With our strengthened balance sheet and improved cash flow profile, we are increasingly well-positioned to be more active on the business development front. With that, I'll pass it back to Craig for his closing comments.
John Hanna: In summary, as we look ahead, we will continue with our balanced view to capital allocation, debt repayment, investing in growth, and returning capital to shareholders. With our strengthened balance sheet and improved cash flow profile, we are increasingly well-positioned to be more active on the business development front. With that, I'll pass it back to Craig for his closing comments.
Speaker #1: Debt repayment, investing in growth, and returning capital to shareholders. With our strengthened balance sheet and improved cash flow profile, we are increasingly well positioned to be more active on the business development front.
Speaker #1: And with that, I'll pass it back to Craig for his closing comments.
Speaker #2: Thanks, John. Before we open it up to Q&A, three quick thoughts on why we think this is a compelling time to pay attention to HLS.
Brian Walsh: Thanks, John. Before we open it up to Q&A, three quick thoughts on why we think this is a compelling time to pay attention to HLS. First, with significant growth in adjusted EBITDA and cash from operations, along with a substantial reduction in net debt, we are a fundamentally stronger company than we were even just 12 months ago. Second, with NILEMDO, we've launched an important medicine with exciting potential, and the launch is going well. Physician awareness was over 90% before we made a single sales call. Ex-factory sales run rate is tracking well, and we've already achieved full coverage at both Canada Life and Sun Life. These early signals are positive. Third, the acceleration is ahead of us, not behind us. Private payer coverage will continue to ramp throughout this year.
Craig Millian: Thanks, John. Before we open it up to Q&A, three quick thoughts on why we think this is a compelling time to pay attention to HLS. First, with significant growth in adjusted EBITDA and cash from operations, along with a substantial reduction in net debt, we are a fundamentally stronger company than we were even just 12 months ago. Second, with NILEMDO, we've launched an important medicine with exciting potential, and the launch is going well. Physician awareness was over 90% before we made a single sales call. Ex-factory sales run rate is tracking well, and we've already achieved full coverage at both Canada Life and Sun Life. These early signals are positive. Third, the acceleration is ahead of us, not behind us. Private payer coverage will continue to ramp throughout this year.
Speaker #2: First, with significant growth in adjusted EBITDA and cash from operations, along with a substantial reduction in net debt, we are fundamentally stronger company than we were even just 12 months ago.
Speaker #2: Second, with Nalendo, we've launched an important medicine with exciting potential, and the launch is going well. Physician awareness was over 90% before we made a single sales call.
Speaker #2: X Factory sales run rate is tracking well, and we've already achieved full coverage at both Canada Life and Sun Life. These early signals are positive.
Speaker #2: And third, the acceleration is ahead of us, not behind us. Private payer coverage will continue to ramp throughout this year. We expect to achieve public payer reimbursement in early 2027, and we expect to launch next Lizette, a combination pill in the first half of 2027.
Brian Walsh: We expect to achieve public payer reimbursement in early 2027, and we expect to launch NEXLIZET, the combination pill, in H1 2027. We're confident that the NILEMDO-NEXLIZET franchise has the potential to more than double our business, with patent protection running to the late 2030s. With our balance sheet in the best shape it's been in years, we have the firepower to do more business development. The portfolio is in place, the team is executing, and the catalysts are in front of us, and we look forward to keeping you updated. That concludes my prepared remarks, and at this point, I'll ask our operator to please provide instructions for asking questions. Operator?
Craig Millian: We expect to achieve public payer reimbursement in early 2027, and we expect to launch NEXLIZET, the combination pill, in H1 2027. We're confident that the NILEMDO-NEXLIZET franchise has the potential to more than double our business, with patent protection running to the late 2030s. With our balance sheet in the best shape it's been in years, we have the firepower to do more business development. The portfolio is in place, the team is executing, and the catalysts are in front of us, and we look forward to keeping you updated. That concludes my prepared remarks, and at this point, I'll ask our operator to please provide instructions for asking questions. Operator?
Speaker #2: We're confident that the Nalendo Next Lizette franchise has the potential to more than double our business, with patent protection running to the late 2030s.
Speaker #2: And with our balance sheet in the best shape it's been in years, we have the firepower to do more business development. So the portfolio is in place, the team is executing, and the catalysts are in front of us.
Speaker #2: And we look forward to keeping you updated. That concludes my prepared remarks, and at this point, I'll ask our operator to please provide instructions for asking questions.
Speaker #2: Operator?
Speaker #3: Thank you. At this time, if you'd like to ask a question, please press star one on your telephone keypad. To withdraw your question, press star two.
Operator 2: Thank you. Your first question comes from Michael Freeman from Raymond James. Please go ahead.
Operator: Thank you. At this time, if you'd like to ask a question, please press star one on your telephone keypad. To withdraw your question, press star two. Again, if you'd like to ask a question, press star one. One moment, please, for your first question. Your first question comes from Michael Freeman from Raymond James. Please go ahead.
Speaker #3: Again, if you'd like to ask a question, press star one. One moment, please, for your first question. Your first question comes from Michael Freeman from Raymond James.
Speaker #3: Please go ahead.
Speaker #2: Hey, good morning, Craig, Brian, John. Congratulations on these results and all the exciting things happening. I wonder if you could just give us a bit more color on the Nalendo launch.
Michael Freeman: Hey, good morning, Craig, Brian, John. Congratulations on these results and all the exciting things happening. I wonder if you could just give us a bit more color on the NILEMDO launch, how you're staging this launch, physicians you're targeting, sales force you're deploying, and as much information as you can share on its reception and signals of growth and the health of this launch.
Michael Freeman: Hey, good morning, Craig, Brian, John. Congratulations on these results and all the exciting things happening. I wonder if you could just give us a bit more color on the NILEMDO launch, how you're staging this launch, physicians you're targeting, sales force you're deploying, and as much information as you can share on its reception and signals of growth and the health of this launch.
Speaker #2: How you're staging this launch, physicians you're targeting, Salesforce you're deploying, and as much information as you can share on its reception and signals of growth and the health of this launch.
Speaker #4: Sure. Hey, Michael. Thanks for the question. So, we've maintained a commercial cardiovascular infrastructure in Canada for a number of years now, with a medical science liaison team that's been established across Canada, and a sales force of over 20 individuals.
Brian Walsh: Sure.
Brian Walsh: Sure.
Craig Millian: Yeah, Brian.
Craig Millian: Yeah, Brian.
Brian Walsh: Hey, Michael. Thanks for the question. So we've maintained a commercial cardiovascular infrastructure in Canada for a number of years now with the medical science liaison team that's been established across Canada and a sales force over 20 individuals, very experienced in cardiovascular specialties. So that's our team to take this portfolio to the next level. We fully trained the team in the beginning of April on NILEMDO. The medical team has been out for about a year since we first had licensed the deal, engaging with key opinion leaders. We activated the sales team with this launch in April. We've been seeing, you know, as indicated in some of my remarks, very positive reception from physicians through advisory boards, from payers through initial discussions.
Brian Walsh: Hey, Michael. Thanks for the question. So we've maintained a commercial cardiovascular infrastructure in Canada for a number of years now with the medical science liaison team that's been established across Canada and a sales force over 20 individuals, very experienced in cardiovascular specialties. So that's our team to take this portfolio to the next level. We fully trained the team in the beginning of April on NILEMDO. The medical team has been out for about a year since we first had licensed the deal, engaging with key opinion leaders. We activated the sales team with this launch in April. We've been seeing, you know, as indicated in some of my remarks, very positive reception from physicians through advisory boards, from payers through initial discussions.
Speaker #4: We're experienced in cardiovascular specialty. So that's our team to take this portfolio to the next level. We fully trained the team in the beginning of April on Nalendo, the medical team has been out for about a year since we first licensed the deal.
Speaker #4: Engaging with key opinion leaders. And we activated the sales team with this launch in April. We've been seeing as indicated in some of my remarks, very positive reception from physicians through advisory boards, from payers through initial discussions, the value propositions resonating very well.
Brian Walsh: The value proposition's resonating very well, where there's the unmet need for a low, an affordable oral option and the speed to these early listings, and we believe more to come in the coming weeks, show that that's resonating well. They're making this product available quickly and with no restrictions for patients. Importantly, physicians, we expect to be able to write the product, patients go to the pharmacy and get the prescription.
Brian Walsh: The value proposition's resonating very well, where there's the unmet need for a low, an affordable oral option and the speed to these early listings, and we believe more to come in the coming weeks, show that that's resonating well. They're making this product available quickly and with no restrictions for patients. Importantly, physicians, we expect to be able to write the product, patients go to the pharmacy and get the prescription.
Speaker #4: Where there's the unmet need for an affordable oral option, and the speed to these early listings and we believe more to come in the coming weeks.
Speaker #4: So, that's resonating well. They're making this product available quickly and with no restrictions for patients. So, importantly, physicians, we expect to be able to write the product, patients go to the pharmacy, and fill and get the prescription.
Brian Walsh: All things are, you know, going well, I would say even ahead of our ambitions on the private payer side, and we'll work through the, you know, the plan with respect to public reimbursement as I detail more in negotiations later part of this year.
Speaker #4: So, all things are going well. I would say even ahead of our ambitions on the private payer side, and we'll work through the plan with respect to public reimbursement as I detailed more in negotiations, later part of this year.
Brian Walsh: All things are, you know, going well, I would say even ahead of our ambitions on the private payer side, and we'll work through the, you know, the plan with respect to public reimbursement as I detail more in negotiations later part of this year.
Craig Millian: Yeah.
Craig Millian: Yeah.
Speaker #4: Anything to add, Craig?
Brian Walsh: Anything to add, Craig?
Brian Walsh: Anything to add, Craig?
Speaker #2: Yeah, no, I'd like to just add a few thoughts, Michael. A couple of things. So, one is, so the launch—we had a set of, we have many KPIs, and at this point, all of them are ahead of plan.
Craig Millian: Yeah, yeah. No, I'd like to just add a few thoughts, Michael. You know, a couple of things. One is, the launch, you know, we had a set of, we had many KPIs, at this point, all of them are ahead of plan. We don't have prescribing data yet. That'll come soon, we'll certainly be able to report that on future calls. If we look at the leading indicators, looking at our sales ramp every week.
Craig Millian: Yeah, yeah. No, I'd like to just add a few thoughts, Michael. You know, a couple of things. One is, the launch, you know, we had a set of, we had many KPIs, at this point, all of them are ahead of plan. We don't have prescribing data yet. That'll come soon, we'll certainly be able to report that on future calls. If we look at the leading indicators, looking at our sales ramp every week.
Speaker #2: So we don't have prescribing data yet. That'll come soon, and we'll certainly be able to report that on future calls. But if we look at the leading indicators, looking at our sales ramp every week—although we've only been on the market one full month in April, and then parts of May.
Craig Millian: We've only been on the market, you know, one full month in April and then, you know, parts of May, every week we're seeing significant increase in shipments, including reorders from wholesalers, which is a good indication that there is pull-through at the pharmacy level and physicians are prescribing. We're hearing very positive anecdotes from our reps in the field. We also are ahead of plan, I would say, in terms of our private payer coverage. What's interesting is we're seeing this demand despite the fact that we're just now, you know, getting these plans on board. That should be another catalyst.
Craig Millian: We've only been on the market, you know, one full month in April and then, you know, parts of May, every week we're seeing significant increase in shipments, including reorders from wholesalers, which is a good indication that there is pull-through at the pharmacy level and physicians are prescribing. We're hearing very positive anecdotes from our reps in the field. We also are ahead of plan, I would say, in terms of our private payer coverage. What's interesting is we're seeing this demand despite the fact that we're just now, you know, getting these plans on board. That should be another catalyst.
Speaker #2: Every week, we're seeing significant increase in shipments, including reorders from wholesalers, which is a good indication that there is pull-through at the pharmacy level and physicians are prescribing.
Speaker #2: We're hearing very positive anecdotes from our reps in the field. We also are ahead of plan, I would say, in terms of our private payer coverage.
Speaker #2: So it's interesting, as we're seeing this demand despite the fact that we're just now getting these plans on board. So that should be another catalyst.
Speaker #2: And as Brian mentioned, we've got the two large ones already covering Nalendo—excuse me, covering Vascepa—and a number of other large private payers who we are in active discussions with, and we expect those will be on board as well in the next couple of months, certainly ahead of when we report Q2 earnings.
Craig Millian: As Brian mentioned, we've got the two large ones already covering Vascepa now, excuse me, covering NILEMDO, and a number of other large private payers we're in active discussions with, and we expect, those will be on board as well in the next, you know, couple of months, certainly ahead of when we report Q2 earnings. Those are all very positive. The last thing I'll say is, what's also very encouraging is the, kind of the synergy we're seeing with Vascepa. I think the fact that we're seeing significant growth in Q1 for Vascepa is not an accident.
Craig Millian: As Brian mentioned, we've got the two large ones already covering Vascepa now, excuse me, covering NILEMDO, and a number of other large private payers we're in active discussions with, and we expect, those will be on board as well in the next, you know, couple of months, certainly ahead of when we report Q2 earnings. Those are all very positive. The last thing I'll say is, what's also very encouraging is the, kind of the synergy we're seeing with Vascepa. I think the fact that we're seeing significant growth in Q1 for Vascepa is not an accident.
Speaker #2: So those are all very positive. The last thing I'll say is what's also very encouraging is that kind of the synergy we're seeing with Vascepa and I think the fact that we're seeing significant growth in Q1 for Vascepa is not an accident.
Speaker #2: I think our thesis was that the rising tide would lift all boats, and that bringing in—frankly, upgrading some of our talent, at least in commercial leadership and in the field, and bringing in the highly motivated, experienced people to launch Nalendo—there would be some very positive halo effects on Vascepa, and we're seeing that as well.
Craig Millian: I think our thesis was that, you know, the rising tide will lift all boats, and that bringing in, really frankly upgrading, you know, some of our talent, you know, at least in commercial leadership and in the field, and bringing in, you know, kind of a highly motivated, experienced people to launch NILEMDO. There would be some very positive halo effects on Vascepa, and we're seeing that as well. you know, all signs are really frankly ahead of where we thought we would be at this point, which is very exciting. I don't wanna get ahead of my skis because it is early, so I don't wanna be hyperbolic here, but I think we're just very pleased with how this is all playing out.
Craig Millian: I think our thesis was that, you know, the rising tide will lift all boats, and that bringing in, really frankly upgrading, you know, some of our talent, you know, at least in commercial leadership and in the field, and bringing in, you know, kind of a highly motivated, experienced people to launch NILEMDO. There would be some very positive halo effects on Vascepa, and we're seeing that as well. you know, all signs are really frankly ahead of where we thought we would be at this point, which is very exciting. I don't wanna get ahead of my skis because it is early, so I don't wanna be hyperbolic here, but I think we're just very pleased with how this is all playing out.
Speaker #2: So, all signs are really, frankly, ahead of where we thought we would be at this point, which is very exciting. I don't want to get ahead of my skis because it is early, so I don't want to be hyperbolic here, but I think we're just very pleased with how this is all playing out.
Speaker #1: Thank you, Craig. And thanks for the reminder on the Vascepa synergy. That's an important waypoint. I wonder, for my second question, I wonder if you could comment on these two events and read-throughs to HLS.
Michael Freeman: Thank you, Craig, and thanks for the reminder on the Vascepa synergy. That's an important way point. I wonder, for my second question, I wonder if you could comment on these two events and read throughs to HLS. One, you did mention the European recommendations on LDL levels. I wonder if you could speak a little bit more about potential impact should Canada pursue a similar policy? Then, any read-throughs on, you know, NILEMDO-NEXLIZET's developer being acquired recently? How should we think about that in the frame of HLS investment?
Michael Freeman: Thank you, Craig, and thanks for the reminder on the Vascepa synergy. That's an important way point. I wonder, for my second question, I wonder if you could comment on these two events and read throughs to HLS. One, you did mention the European recommendations on LDL levels. I wonder if you could speak a little bit more about potential impact should Canada pursue a similar policy? Then, any read-throughs on, you know, NILEMDO-NEXLIZET's developer being acquired recently? How should we think about that in the frame of HLS investment?
Speaker #1: One, you did mention the European recommendations on LDL levels, and I wonder if you could speak a little bit more about the potential impact. Should Canada pursue a similar policy?
Speaker #1: And then, any read-throughs on Nalendo next, Lausette's developer being acquired recently? How should we think about that in the frame of HLS investment?
Speaker #4: Sure. So I'll start with the second question and maybe let Brian speak to the first one. So as far as the acquisition recently announced related to Asperion, we envision no impact whatsoever in our conversations with our partner.
Craig Millian: Sure. I'll start with the second question and maybe let Brian speak to the first one. As far as the acquisition recently announced related to Esperion, no impact. There's no impact whatsoever in our conversations with our partner. You know, same level of commitment, business as usual on a go-forward basis. I, you know, again, I don't wanna speak for them, but I think they very much view operations to continue as they have. We very much view this as a non-event as it relates to impact on our business in Canada.
Craig Millian: Sure. I'll start with the second question and maybe let Brian speak to the first one. As far as the acquisition recently announced related to Esperion, no impact. There's no impact whatsoever in our conversations with our partner. You know, same level of commitment, business as usual on a go-forward basis. I, you know, again, I don't wanna speak for them, but I think they very much view operations to continue as they have. We very much view this as a non-event as it relates to impact on our business in Canada.
Speaker #4: Same level of commitment, business as usual, on a go-forward basis. And again, I don't want to speak for them, but I think they very much view operations to continue as they have.
Speaker #4: So we very much view this as a non-event as it relates to impact on our business in Canada. And then, as far as the recent guideline changes—which continues, kind of thematically, the idea that lower is better as it relates to LDL cholesterol—and the fact that the vast majority of patients, despite the availability of statins for decades, are not getting to goal, either due to, frankly, efficacy or due to the inability to get to enough dosage without experiencing side effects, so that they can't get to their LDL goals.
Craig Millian: As far as the recent guideline changes, which continues kind of thematically the idea that lower is better as it relates to LDL cholesterol and the fact that the vast majority of patients, despite the availability of statins for decades, many are not getting to goal, either due to frankly efficacy or due to the inability to get to enough dosage without experiencing side effects that they can't get to their LDL goals. This change in guideline, we envision will actually expand the patient pool as far as patients who previously might have been at goal. I think of things in terms of milligrams per deciliter.
Craig Millian: As far as the recent guideline changes, which continues kind of thematically the idea that lower is better as it relates to LDL cholesterol and the fact that the vast majority of patients, despite the availability of statins for decades, many are not getting to goal, either due to frankly efficacy or due to the inability to get to enough dosage without experiencing side effects that they can't get to their LDL goals. This change in guideline, we envision will actually expand the patient pool as far as patients who previously might have been at goal. I think of things in terms of milligrams per deciliter.
Speaker #4: So, this change in guideline we envision will actually expand the patient pool as far as patients who previously might have been at goal. I think of things in terms of milligrams per deciliter.
Craig Millian: You know, getting used to be 100, that was lowered to 70, now it's 50 for high-risk patients, which is gonna require even more aggressive treatment. I think that fits very well certainly with our combo pill, which achieves up to 38% LDL lowering.
Craig Millian: You know, getting used to be 100, that was lowered to 70, now it's 50 for high-risk patients, which is gonna require even more aggressive treatment. I think that fits very well certainly with our combo pill, which achieves up to 38% LDL lowering.
Speaker #4: So, 'getting to' used to be 100, that was lowered to 70, now it's 50 for high-risk patients. Which is going to require even more aggressive treatment, and I think that fits very well, certainly with our combo pill, which achieves up to 38% LDL lowering, and...
Speaker #4: Yeah, I would just add, I think we've spoken to a number of emulators, many involved with the guidelines in Canada, and although we expect it will take maybe one to two years for the Canadian guidelines to reflect, they and really the community are looking to the US and European guidelines and incorporating that into their behaviors today.
Brian Walsh: Yeah, I would just add, I think we've spoken to a number of opinion leaders, many involved with the guidelines in Canada. Although we expect it will take maybe one to two years for the Canadian guidelines to reflect, they and really the community are looking to the US and European guidelines and incorporating that into their behaviors today. As we indicate these listings that we're getting don't come with restrictions. As physicians adapt their behavior, they'll be able to use NILEMDO, you know, where they see appropriate to meet the goals that they have for their patients. We think even though the guidelines will lag in Canada, the behavior will change well ahead of that.
Brian Walsh: Yeah, I would just add, I think we've spoken to a number of opinion leaders, many involved with the guidelines in Canada. Although we expect it will take maybe one to two years for the Canadian guidelines to reflect, they and really the community are looking to the US and European guidelines and incorporating that into their behaviors today. As we indicate these listings that we're getting don't come with restrictions. As physicians adapt their behavior, they'll be able to use NILEMDO, you know, where they see appropriate to meet the goals that they have for their patients. We think even though the guidelines will lag in Canada, the behavior will change well ahead of that.
Speaker #4: As we indicate, these listings that we're getting are not coming with restrictions. So, as physicians adapt their behavior, they'll be able to use Nalendo where they see appropriate to meet the goals that they have for their patients.
Speaker #4: So we think, even though the guidelines will lag in Canada, the behavior will change well ahead of that. And we're continuing—we'll be doing work to quantify that, but it's not a factor that's based in the numbers that Craig shared, in terms of the starting addressable population.
Brian Walsh: You know, we're continuing You know, we're doing work to quantify that, it's not a factor that's, you know, based in the numbers that Craig shared in terms of the starting addressable population.
Brian Walsh: You know, we're continuing You know, we're doing work to quantify that, it's not a factor that's, you know, based in the numbers that Craig shared in terms of the starting addressable population.
Speaker #1: Okay. And just so I have it right, could you repeat what the prior level was and what it's been reduced to now?
Michael Freeman: Okay. Just so I have it right, could you repeat what the prior level was and what it's been reduced to now?
Michael Freeman: Okay. Just so I have it right, could you repeat what the prior level was and what it's been reduced to now?
Speaker #4: Yeah, it was currently in Canada it's 1.8 millimoles per liter. And the European guidelines are indicating to 1.4 millimoles per liter for high-risk patients.
Brian Walsh: Yeah. It was currently in Canada, it's 1.8 millimoles per liter, and the European guidelines are indicating to 1.4 millimoles per liter for high-risk patients.
Brian Walsh: Yeah. It was currently in Canada, it's 1.8 millimoles per liter, and the European guidelines are indicating to 1.4 millimoles per liter for high-risk patients.
Speaker #1: Excellent. Okay. Thank you very much. I'll pass it on.
Michael Freeman: Excellent. Okay. Thank you very much. I'll pass it on.
Michael Freeman: Excellent. Okay. Thank you very much. I'll pass it on.
Speaker #5: As a reminder, if you would like to ask a question, please press star one on your telephone keypad. And there are no further questions. To Craig Millian, CEO, for closing remarks.
Operator 2: As a reminder, if you would like to ask a question, please press star one on your telephone keypad. There are no further questions at this time. I will turn the call back over to Craig Millian, CEO, for closing remarks.
Operator: As a reminder, if you would like to ask a question, please press star one on your telephone keypad. There are no further questions at this time. I will turn the call back over to Craig Millian, CEO, for closing remarks.
Speaker #4: Great, thank you. So, thanks to everyone for participating, especially. I know the weekend is coming up in Canada, so I appreciate that and wish everyone a happy holiday weekend.
Craig Millian: Great. Thank you. Thanks to everyone for participating, especially I know there's a long holiday weekend coming up in Canada, so appreciate that and wish everyone a happy holiday weekend. We look forward to continuing to report on our progress in the coming quarters, and speaking again to you all very soon. Take care.
Craig Millian: Great. Thank you. Thanks to everyone for participating, especially I know there's a long holiday weekend coming up in Canada, so appreciate that and wish everyone a happy holiday weekend. We look forward to continuing to report on our progress in the coming quarters, and speaking again to you all very soon. Take care.
Speaker #4: And we look forward to continuing to report on our progress in the coming quarters, and speaking again to you all very soon. Take care.
Operator 2: Ladies and gentlemen, this concludes today's conference call. You may now disconnect. Thank you.
Operator: Ladies and gentlemen, this concludes today's conference call. You may now disconnect. Thank you.
