Q1 2026 Heron Therapeutics Inc Earnings Call

May 11, 2026

Speaker #1: All participants are on a listen-only mode. After the speaker's presentation, there will be a question-and-answer session. To ask a question during the session, you will need to press *11 on your telephone.

Operator: After the speaker's presentation, there will be a question-and-answer session. To ask a question during the session, you will need to press star one one on your telephone. You will hear an automated message advising that your hand is raised. To withdraw your question, please press star one one again. Please be advised that today's conference is being recorded. I would now like to hand the conference over to your first speaker today, Melissa Jarel, Vice President of Legal. You may begin.

Operator: All participants are on a listen only mode. After the speaker's presentation, there will be a question-and-answer session. To ask a question during the session, you will need to press star one one on your telephone. You will hear an automated message advising that your hand is raised. To withdraw your question, please press star one one again. Please be advised that today's conference is being recorded. I would now like to hand the conference over to your first speaker today, Melissa Jarel, Vice President of Legal. You may begin.

Speaker #1: You will then hear an automated message advising that your hand is raised. To withdraw your question, please press *11 again. Please be advised that today's conference is being recorded.

Speaker #1: I would now like to hand the conference over to your first speaker today, Melissa Jarel. Vice President of Legal. You may begin.

Speaker #2: Thank you, Operator, and hello everyone. Thank you for joining us on the HERON Therapeutics conference call today to discuss the company's financial results for the first quarter 2026.

Melissa Jarel: Thank you, operator. Hello, everyone. Thank you for joining us on the Heron Therapeutics conference call today to discuss the company's financial results for Q1 2026. With me today from Heron are Craig Collard, Chief Executive Officer, Ira Duarte, Executive Vice President, Chief Financial Officer, William Forbes, Executive Vice President, Chief Development Officer, Mark Hensley, Chief Operating Officer, and Kevin Warner, Senior Vice President, Medical Affairs, Strategy, and Engagement. For those of you participating via conference call, slides are made available via webcast and can also be accessed via the investor relations page of our website following the conclusion of today's call. Before we begin, let me quickly remind you that during the course of this conference call, the company will make forward-looking statements. We caution you that any statement that is not a statement of historical fact is a forward-looking statement.

Speaker #2: With me today from HERON are Craig Collard, Chief Executive Officer, Ira Duarte, Executive Vice President, Chief Financial Officer, Bill Forbes, Executive Vice President, Chief Development Officer, Mark Hensley, Chief Operating Officer, and Kevin Warner, Senior Vice President, Medical Affairs, Strategy and Engagement.

Operator: Welcome to the Heron Therapeutics Q1 2026 conference call. I would now like to hand the conference over to your first speaker today, Melissa Jarel, Vice President of Legal. You may begin.

Speaker #1: Good day, and thank you for standing by. Welcome to the HERON Therapeutics Q1 2026 conference call. At this time, all participants are in a listen-only mode.

Speaker #1: After the speaker's presentation, there will be a question-and-answer session. To ask a question during the session, you will need to press *11 on your telephone.

Speaker #2: For those of you participating via conference call, slides are made available via webcast and can also be accessed via the Investor Relations page of our website following the conclusion of today's call.

Speaker #2: Before we begin, let me quickly remind you that during the course of this conference call, the company will make forward-looking statements. We caution you that any statement that is not a statement of historical fact is a forward-looking statement.

Speaker #1: I would now like to hand the conference over to your first speaker today, Melissa Jarel. Vice President of Legal. You may begin.

Speaker #2: This includes remarks about the company's projections, expectations, plans, beliefs, and future performance, all of which constitute forward-looking statements for the purposes of the Safe Harbor Provision under the Private Securities Litigation Reform Act of 1995.

Melissa Jarel: This includes remarks about the company's projections, expectations, plans, beliefs, and future performance, all of which constitute forward-looking statements for the purposes of the safe harbor provision under the Private Securities Litigation Reform Act of 1995. These statements are based on judgment and analysis as of the date of this conference call and are subject to numerous important risks and uncertainties that could cause actual results to differ materially from those described in the forward-looking statements. The risks and uncertainties associated with the forward-looking statements made in this conference call and webcast are described in the safe harbor statement in today's press release and in Heron's public periodic filings with the SEC. Except as required by law, Heron assumes no obligation to update these forward-looking statements to reflect future events or actual outcomes and does not intend to do so.

Melissa Jarel: Thank you, operator, and hello, everyone. Thank you for joining us on the Heron Therapeutics conference call today to discuss the company's financial results for Q1 2026. With me today from Heron are Craig Collard, Chief Executive Officer, Ira Duarte, Executive Vice President, Chief Financial Officer, Bill Forbes, Executive Vice President, Chief Development Officer, Mark Hensley, Chief Operating Officer, and Kevin Warner, Senior Vice President, Medical Affairs, Strategy, and Engagement. For those of you participating via conference call, slides are made available via webcast and can also be accessed via the investor relations page of our website following the conclusion of today's call. Before we begin, let me quickly remind you that during the course of this conference call, the company will make forward-looking statements. We caution you that any statement that is not a statement of historical fact is a forward-looking statement.

Speaker #2: With me today from Heron are Craig Collard, Chief Executive Officer; Ira Duarte, Executive Vice President and Chief Financial Officer; Bill Forbes, Executive Vice President and Chief Development Officer; Mark Hensley, Chief Operating Officer; and Kevin Warner, Senior Vice President, Medical Affairs, Strategy, and Engagement.

Speaker #2: These statements are based on judgment and analysis as of the date of this conference call and are subject to numerous important risks and uncertainties that could cause actual results to differ materially from those described in the forward-looking statements.

Speaker #2: The risk and uncertainties associated with the forward-looking statements made in this conference call and webcast are described in the Safe Harbor Statement in today's press release and in HERON's public periodic filings with the SEC.

Speaker #2: Except as required by law, HERON assumes no obligation to update these forward-looking statements to reflect future events or actual outcomes and does not intend to do so.

Speaker #2: And with that, I would now like to turn the call over to Craig Collard, Chief Executive Officer of HERON.

Melissa Jarel: With that, I would now like to turn the call over to Craig Collard, Chief Executive Officer of Heron.

Speaker #3: Thanks, Melissa. Hello everyone, and welcome to HERON Therapeutics' first quarter 2026 earnings call. Today, we're thrilled to share our financial results and provide commercial updates on our business.

Craig Collard: Thanks, Melissa. Hello, everyone, and welcome to Heron Therapeutics' Q1 2026 earnings call. Today, we're thrilled to share our financial results and provide commercial updates on our business. I'd like to begin by highlighting several key accomplishments. Coming off a strong Q4 2025, we entered the new year with tremendous momentum. As expected, Q1 of any year historically brings seasonal headwinds driven by co-pay resets and insurance adjustments, and this year was no exception. However, 2026 presented additional challenge for us. 2 weeks of severe weather early in the quarter that significantly compounded the typical seasonal softness, making January our most difficult month since I joined the company. The impact of the weather was felt most acutely in elective surgeries, which are highly sensitive to extreme conditions and saw a sharp decline during that period.

Speaker #3: I'd like to begin by highlighting several key accomplishments. Coming off a strong fourth quarter 2025, we entered the new year with tremendous momentum. As expected, the first quarter of any year historically brings seasonal headwinds driven by copay resets and insurance adjustments, and this year was no exception.

Speaker #2: The risk and uncertainties associated with the forward-looking statements made in this conference call and webcast are described in the Safe Harbor Statement in today's press release, and in HERON's public periodic filings with the SEC.

Speaker #3: However, 2026 presented additional challenges for us. Two weeks of severe weather early in the quarter that significantly compounded the typical seasonal softness, making January our most difficult month since I joined the company.

Speaker #2: Except as required by law, HERON assumes no obligation to update these forward-looking statements to reflect future events or actual outcomes and does not intend to do so.

Speaker #3: The impact of the weather was felt most acutely in elective surgeries, which are highly sensitive to extreme conditions and saw a sharp decline during that period.

Speaker #2: And with that, I would now like to turn the call over to Craig Collard, Chief Executive Officer of HERON.

Melissa Jarel: With that, I would now like to turn the call over to Craig Collard, Chief Executive Officer of Heron.

Speaker #3: Thanks, Melissa. Hello everyone, and welcome to Heron Therapeutics' first quarter 2026 earnings call. Today, we're thrilled to share our financial results and provide commercial updates on our business.

Craig Collard: Thanks, Melissa. Hello, everyone, welcome to Heron Therapeutics' Q1 2026 earnings call. Today, we're thrilled to share our financial results and provide commercial updates on our business. I'd like to begin by highlighting several key accomplishments. Coming off a strong Q4 2025, we entered the new year with tremendous momentum. As expected, the Q1 of any year historically brings seasonal headwinds driven by co-pay resets and insurance adjustments, and this year was no exception. However, 2026 presented additional challenge for us. 2 weeks of severe weather early in the quarter that significantly compounded the typical seasonal softness, making January our most difficult month since I joined the company. The impact of the weather was felt most acutely in elective surgeries, which are highly sensitive to extreme conditions and saw a sharp decline during that period.

Speaker #3: Importantly, this was not an isolated experience. Multiple publicly traded pharmaceutical and surgical companies have reported the same weather-driven disruption across January and February. The breadth of this industry-wide impact validates that the headwinds we faced were external and temporary in nature, not reflective of any underlying weakness in our business or markets.

Craig Collard: Importantly, this was not an isolated experience. Multiple publicly traded pharmaceutical and surgical companies have reported the same weather-driven disruption across January and February. The breadth of this industry-wide impact validates that the headwinds we faced were external and temporary in nature, not reflective of any underlying weakness in our business or markets. Despite this, the team responded well. February brought a clear upward trend, March closed strongly with over $15 million in net sales, demonstrating the underlying strength and resilience of the business. While the weather undoubtedly weighed on our Q1 results, it has not shaken our confidence in the year ahead. We fully expect the remaining deferred elective procedures to be rescheduled throughout the remainder of 2026, creating a meaningful tailwind as we progress through the year.

Speaker #3: Despite this, the team responded well. February brought a clear upward trend, and March closed strongly with over 15 million dollars in net sales, demonstrating the underlying strength and resilience of the business.

Speaker #3: While the weather undoubtedly weighed on our Q1 results, it has not shaken our confidence in the year ahead. We fully expect the remaining deferred elective procedures to be rescheduled throughout the remainder of 2026, creating a meaningful tailwind as we progress through the year.

Speaker #3: The impact of the weather was felt most acutely in elective surgeries, which are highly sensitive to extreme conditions and saw a sharp decline during that period.

Speaker #3: This aligns with our historical pattern where Q3 and Q4 consistently represent our highest volume quarters and we anticipate 2026 will be no different. Turning to our acute care portfolio, we delivered revenue growth of 32% compared to the same period last year, with Zenerlev growing 27% and Apondi growing over 50%, respectively.

Craig Collard: This aligns with our historical pattern where Q3 and Q4 consistently represent our highest volume quarters, and we anticipate 2026 will be no different. Turning to our acute care portfolio, we delivered revenue growth of 32% compared to the same period last year, with ZYNRELEF growing 27% and APONVIE growing over 50% respectively. Two structural drivers are worth highlighting. Our IGNITE program, an incentive program with our orthopedic distribution partners, has been very successful. We're continuing it into 2026 as a key growth driver for ZYNRELEF. With APONVIE, we are beginning to realize the commercial benefits of its inclusion in the Fifth Consensus Guidelines for the Management of Postoperative Nausea and Vomiting, a meaningful clinical endorsement that we believe will serve as a sustained tailwind for adoption.

Craig Collard: Importantly, this was not an isolated experience. Multiple publicly traded pharmaceutical and surgical companies have reported the same weather-driven disruption across January and February. The breadth of this industry-wide impact validates that the headwinds we faced were external and temporary in nature, not reflective of any underlying weakness in our business or markets. Despite this, the team responded well. February brought a clear upward trend, and March closed strongly with over $15 million in net sales, demonstrating the underlying strength and resilience of the business. While the weather undoubtedly weighed on our Q1 results, it has not shaken our confidence in the year ahead. We fully expect the remaining deferred elective procedures to be rescheduled throughout the remainder of 2026, creating a meaningful tailwind as we progress through the year.

Speaker #3: Two structural drivers are worth highlighting: our Ignite program, the incentive program with our orthopedic distribution partners, has been very successful, and we're continuing it into 2026 as a key growth driver for Zenerlev.

Speaker #3: With Apondi, we are beginning to realize that commercial benefits of its inclusion in the fifth consensus guidelines for the management of postoperative nausea and vomiting.

Speaker #3: A meaningful clinical endorsement that we believe will serve as a sustained tailwind for adoption. We will provide additional detail later in the presentation on the strategic and commercial implications of that inclusion.

Craig Collard: We will provide additional detail later in the presentation on the strategic and commercial implications of that inclusion. Turning to our sales force expansion, implementation is on track for Q3 with the recruitment already underway. We view this as a significant catalyst for growth across our portfolio. We will walk through the strategy in more detail in the presentation. Moving on to oncology, we continue to deliver solid performance with CINVANTI despite increased competitive pressure. For the quarter, CINVANTI maintained exit market share of 25% in the NK1 category. Although net sales reflected normal quarter-to-quarter timing, CINVANTI itself has remained resilient, demonstrating strong customer loyalty and continued demand even in this very competitive landscape. We have a number of new accounts coming on board in Q2 that we anticipate could add upwards of $10 million in net revenue on an annualized basis.

Craig Collard: This aligns with our historical pattern where Q3 and Q4 consistently represent our highest volume quarters. We anticipate 2026 will be no different. Turning to our acute care portfolio, we delivered revenue growth of 32% compared to the same period last year, with ZYNRELEF growing 27% and APONVIE growing over 50% respectively. Two structural drivers are worth highlighting. Our IGNITE program, the incentive program with our orthopedic distribution partners, has been very successful. We're continuing it into 2026 as a key growth driver for ZYNRELEF. With APONVIE, we are beginning to realize the commercial benefits of its inclusion in the fifth consensus guidelines for the management of postoperative nausea and vomiting, a meaningful clinical endorsement that we believe will serve as a sustained tailwind for adoption.

Speaker #3: Turning to our Salesforce expansion, implementation is on track for the third quarter with the recruitment already underway. We view this as a significant catalyst for growth across our portfolio and we will walk through the strategy in more detail in the presentation.

Speaker #3: Moving on to oncology, we continue to deliver solid performance with Sinvonti despite increased competitive pressure. For the quarter, Sinvonti maintained exit market share of 25% in the NK1 category and although net sales reflected normal quarter-to-quarter timing, Sinvonti itself has remained resilient, demonstrating strong customer loyalty and continued demand even in this very competitive landscape.

Speaker #3: With Apondi, we are beginning to realize that commercial benefits of its inclusion in the fifth consensus guidelines for the management of postoperative nausea and vomiting.

Speaker #3: We have a number of new accounts coming on board in Q2 that we anticipate could add upwards of $10 million in net revenue on an annualized basis.

Speaker #3: We will cover this in greater detail as part of the commercial performance update. Before I turn things over to Mark to cover our commercial performance, I want to take a moment again to recognize the entire HERON team for their performance this quarter.

Craig Collard: We will cover this in greater detail as part of the commercial performance update. Before I turn things over to Mark to cover our commercial performance, I want to take a moment again to recognize the entire Heron team for their performance this quarter. We fight every day in a very competitive environment, and this quarter offered other challenges that we had no control over, yet our team continues to persevere and move forward. I will now turn the call over to Mark to cover our commercial performance. Go ahead, Mark.

Speaker #3: Turning to our Salesforce expansion, implementation is on track for the third quarter, with recruitment already underway. We view this as a significant catalyst for growth across our portfolio, and we will walk through the strategy in more detail in the presentation.

Speaker #3: We fight every day in a very competitive environment, and this quarter offered other challenges that we had no control over, yet our team continues to persevere and move forward.

Speaker #3: Moving on to oncology, we continue to deliver solid performance with Sinvonti despite increased competitive pressure. For the quarter, Sinvonti maintained exit market share of 25% in the NK1 category, and although net sales reflected normal quarter-to-quarter timing, Sinvonti itself has remained resilient, demonstrating strong customer loyalty and continued demand even in this very competitive landscape.

Speaker #3: I will now turn the call over to Mark to cover our commercial performance. Go ahead, Mark.

Speaker #4: Thanks, Craig. Moving to product performance, starting with our overall net sales picture for the quarter. This chart shows quarterly net revenue for each product across the last four quarters.

Mark Hensley: Thanks, Craig. Moving to product performance, starting with our overall net sales picture for the quarter. This chart shows quarterly net revenue for each product across the last four quarters. Total net sales of $34.7 million in Q1. On the acute care side, $13.6 million combined. ZYNRELEF at $10.2 million, APONVIE at $3.4 million. On the oncology side, $21.1 million combined. CINVANTI at $20.5 million, SUSTOL at $0.6 million, reflecting the planned wind down we've previously discussed. You can see the sequential dynamics on each product. A few of these reflect ordering and channel patterns rather than changes in underlying demand. The cleaner read on adoption across all four products is the demand unit and ordering account data, which I'll cover in detail as we go.

Speaker #4: Total net sales of $34.7 million in Q1. On the acute care side, $13.6 million combined, Zenerlev at 10.2 million, Apondi at 3.4 million, on the oncology side, $21.1 million combined, Sinvonti at 20.5 million, Sustell at 0.6 million, reflecting the planned wind-down we've previously discussed.

Speaker #3: We have a number of new accounts coming on board in Q2 that we anticipate could add upwards of $10 million in net revenue on an annualized basis.

Speaker #4: You can see the sequential dynamics on each product. A few of these reflect ordering and channel patterns rather than changes in underlying demand. The cleaner read on adoption across all four products is the demand unit and ordering account data, which I'll cover in detail as we go.

Speaker #3: We fight every day in a very competitive environment, and this quarter offered other challenges that we had no control over, yet our team continues to persevere and move forward.

Speaker #3: I will now turn the call over to Mark to cover our commercial performance. Go ahead, Mark.

Speaker #4: But before we get into individual product performance, there's an important strategic point on the next slide. This slide shows our net selling price per unit across the four products over the last four quarters.

Mark Hensley: Before we get into individual product performance, there is an important strategic point on the next slide. This slide shows our net selling price per unit across the four products over the last four quarters. The Y-axis values aren't displayed. What matters is the directional trend within each product. Starting with ZYNRELEF, net selling price has been steadily increasing across the period. Our pricing posture is holding. The J-code and NOPAIN Act environment are supporting that trajectory. For APONVIE, net price has been stable. That's what we'd expect for a product still in its growth phase, where our focus is volume penetration rather than per unit price extraction. On CINVANTI, you'll notice the Q4 bar is slightly lower than the surrounding quarters, with Q1 returning to a level consistent with our strategy. That Q4 dynamic was temporary. Q1 reflected normal channel ordering patterns following the Q4 activity.

Mark Hensley: Thanks, Craig Collard. Moving to product performance, starting with our overall net sales picture for the quarter. This chart shows quarterly net revenue for each product across the last four quarters. Total net sales of $34.7 million in Q1. On the acute care side, $13.6 million combined. ZYNRELEF at $10.2 million, APONVIE at $3.4 million. On the oncology side, $21.1 million combined. CINVANTI at $20.5 million, SUSTOL at $0.6 million, reflecting the planned wind down we've previously discussed. You can see the sequential dynamics on each product. A few of these reflect ordering and channel patterns rather than changes in underlying demand. The cleaner read on adoption across all four products is the demand unit and ordering account data, which I'll cover in detail as we go.

Speaker #4: The Y-axis values aren't displayed, what matters is the directional trend within each product. Starting with Zenerlev, net selling price has been steadily increasing across the period.

Speaker #4: Total net sales of $34.7 million in Q1. On the acute care side, $13.6 million combined. Zynrelef at $10.2 million, Apadaz at $3.4 million. On the oncology side, $21.1 million combined.

Speaker #4: Our pricing posture is holding, and the J-code and no-pain environment are supporting that trajectory. For Apondi, net price has been stable. That's what we'd expect for a product still in its growth phase, where our focus is volume penetration rather than per-unit price extraction.

Speaker #4: Sinvonti at $20.5 million, Sustell at $0.6 million, reflecting discussed. You can see the sequential dynamics on each product. A few of these reflect ordering and channel patterns rather than changes in underlying demand.

Speaker #4: On Sinvonti, you'll notice the Q4 bar is slightly lower than the surrounding quarters. With Q1 returning to a level consistent with our strategy. That Q4 dynamic was temporary, and Q1 reflected normal channel ordering patterns following the Q4 activity.

Speaker #4: The cleaner read on adoption across all four products is the demand unit and ordering account data, which I'll cover in detail as we go.

Mark Hensley: Before we get into individual product performance, there's an important strategic point on the next slide. This slide shows our net selling price per unit across the four products over the last four quarters. The Y-axis values aren't displayed. What matters is the directional trend within each product. Starting with ZYNRELEF, net selling price has been steadily increasing across the period. Our pricing posture is holding, and the J-code and NOPAIN Act environment are supporting that trajectory. For APONVIE, net price has been stable. That's what we'd expect for a product still in its growth phase, where our focus is volume penetration rather than per unit price extraction. On CINVANTI, you'll notice the Q4 bar is slightly lower than the surrounding quarters, with Q1 returning to a level consistent with our strategy. That Q4 dynamic was temporary, and Q1 reflected normal channel ordering patterns following the Q4 activity.

Speaker #4: The more important point, our underlying pricing strategy on Sinvonti is intact and disciplined. And Sustell, declining in line with planned wind-down. The headline message of this slide is straightforward: across our active commercial products, we are maintaining pricing discipline not chasing volume through price concessions.

Mark Hensley: The more important point, our underlying pricing strategy on CINVANTI is intact and disciplined. SUSTOL, declining in line with planned wind down. The headline message of this slide is straightforward. Across our active commercial products, we are maintaining pricing discipline, not chasing volume through price concessions. That's a deliberate strategic choice. It protects the long-term economics of the franchise and supports the durable recurring demand we're building. Now on to ZYNRELEF. You can see the two charts on the slide. Average daily units on the left, ordering accounts on the right. Both have continued to trend up through Q1. The number I'd anchor on is demand unit growth of 22% year-over-year. The broader local anesthetic market was down sequentially in Q1. In that environment, ZYNRELEF outgrew the market on a year-over-year basis and held share sequentially. The underlying franchise is performing.

Speaker #4: That's a deliberate strategic choice. It protects the long-term economics of the franchise and supports the durable recurring demand we're building. Now on to Zenerlev.

Speaker #4: Our pricing posture is holding, and the J code and no-pain environment are supporting that trajectory. For Apondi, net price has been stable. That's what we'd expect for a product still in its growth phase, where our focus is volume penetration rather than per-unit price extraction.

Speaker #4: You can see the two charts on the slide. Average daily units on the left, ordering accounts on the right. Both have continued to trend up through Q1.

Speaker #4: The number I'd anchor on is demand unit growth of 22% year over year. The broader local anesthetic market was down sequentially in Q1, and that environment, Zenerlev outgrew the market on a year-over-year basis and held share sequentially.

Speaker #4: The more important point, our underlying pricing strategy on Sinvonti is intact and disciplined. And Sustell, declining in line with planned wind down. The headline message of this slide is straightforward: across our active commercial products, we are maintaining pricing discipline not chasing volume through price concessions.

Mark Hensley: The more important point, our underlying pricing strategy on CINVANTI is intact and disciplined. SUSTOL, declining in line with planned wind down. The headline message of this slide is straightforward. Across our active commercial products, we are maintaining pricing discipline, not chasing volume through price concessions. That's a deliberate strategic choice. It protects the long-term economics of the franchise and supports the durable recurring demand we're building. Now on to ZYNRELEF. You can see the two charts on the slide. Average daily units on the left, ordering accounts on the right. Both have continued to trend up through Q1. The number I'd anchor on is demand unit growth of 22% year over year. The broader local anesthetic market was down sequentially in Q1. In that environment, ZYNRELEF outgrew the market on a year over year basis and held share sequentially. The underlying franchise is performing.

Speaker #4: The underlying franchise's performance. On reimbursement, the permanent J-code, J0668, has been live since October. Combined with the no-pain act framework that took effect at the start of 2025, the reimbursement environment for Zenerlev is the cleanest it's been since launch.

Mark Hensley: On reimbursement, the permanent J-code, J0668, has been live since October. Combined with the NOPAIN Act framework that took effect at the start of 2025, the reimbursement environment for ZYNRELEF is the cleanest it's been since launch. That framework streamlines reimbursement across approximately 110 million covered lives on the commercial side. Two quarters in, reimbursement conversations are smoother, and the friction at the billing office level continues to come down. Looking at the Q2 through Q4 drivers on the right side of the slide, IGNITE has been extended throughout 2026 and expanded with IGNITE 2.0, which I'll cover on the next two slides. We're also seeing expansion of users within accounts, meaning more surgeons within each adopting institution moving on to ZYNRELEF as part of their protocol.

Speaker #4: That framework streamlines reimbursement across approximately 110 million covered lives on the commercial side. Two quarters in, reimbursement conversations are smoother, and the friction at the billing office level continues to come down.

Speaker #4: That's a deliberate strategic choice. It protects the long-term economics of the franchise and supports the durable recurring demand we're building. Now on to Zenerlev.

Speaker #4: You can see the two charts on the slide. Average daily units on the left, ordering accounts on the right. Both have continued to trend up through Q1.

Speaker #4: Looking at the Q2 through Q4 drivers on the right side of the slide, Ignite has been extended throughout 2026 and expanded with Ignite 2.0, which I'll cover on the next two slides.

Speaker #4: The number I'd anchor on is demand unit growth of 22% year over year. The broader local anesthetic market was down sequentially in Q1. And that environment, Zenerlev outgrew the market on a year-over-year basis and held share sequentially.

Speaker #4: We're also seeing expansion of users within accounts, meaning more surgeons within each adopting institution moving on to Zenerlev as part of their protocol. And we'll be expanding our Zenerlev sales team in Q3 2026, target at geographies where all three foundational drivers are fully in place.

Mark Hensley: We'll be expanding our ZYNRELEF sales team in Q3 2026, targeted geographies where all three foundational drivers are fully in place. Formulary access, the IGNITE program, and payer coverage. That expansion sits alongside the aprepitant team expansion I'll cover on the APONVIE slide, reflecting our confidence in the trajectory of both franchises. On the longer-term side, our prefilled syringe presentation is in late stage development, though we'll cover that in more detail later in the presentation. Moving on to slide 10. Here's the data behind IGNITE 1.0. The chart shows ZYNRELEF unit volume across our IGNITE targeted accounts. Pre-IGNITE versus post-IGNITE. We went from approximately 9,000 units in the last pre-IGNITE quarter of last year to over 19,000 units by Q4 of last year. That's 111% growth within these targeted accounts in just two quarters of the program.

Speaker #4: The underlying franchise's performance. On reimbursement, the permanent J code, J0668, has been live since October. Combined with the NO PAIN Act framework that took effect at the start of 2025, the reimbursement environment for Zynrelef is the cleanest it's been since launch.

Mark Hensley: On reimbursement, the permanent J-code, J0668, has been live since October. Combined with the NOPAIN Act framework that took effect at the start of 2025, the reimbursement environment for ZYNRELEF is the cleanest it's been since launch. That framework streamlines reimbursement across approximately 110 million covered lives on the commercial side. 2 quarters in, reimbursement conversations are smoother, and the friction at the billing office level continues to come down. Looking at the Q2 through Q4 drivers on the right side of the slide, IGNITE has been extended throughout 2026 and expanded with IGNITE 2.0, which I'll cover on the next 2 slides. We're also seeing expansion of users within accounts, meaning more surgeons within each adopting institution moving onto ZYNRELEF as part of their protocol.

Speaker #4: Formulary access, the Ignite program, and payer coverage. That expansion sits alongside the appropriate team expansion I'll cover on the Apondi slide. Reflecting our confidence in the trajectory of both franchises.

Speaker #4: On the longer-term side, our pre-filled syringe presentation is in late-stage development. Bill will cover that in more detail later in the presentation. Moving on to slide 10.

Speaker #4: Here's the data behind Ignite 1.0. The chart shows Zenerlev unit volume across our Ignite targeted accounts. Pre-Ignite versus post-Ignite. We went from approximately 9,000 units in the last pre-Ignite quarter of last year to over 19,000 units by Q4 of last year.

Speaker #4: Looking at the Q2 through Q4 drivers on the right side of the slide, Ignite has been extended throughout 2026 and expanded with Ignite 2.0, which I'll cover on the next two slides.

Speaker #4: That's 111% growth within these targeted accounts in just two quarters of the program. This is the data that gave us the conviction to extend Ignite through 2026 and expand it further.

Mark Hensley: This is the data that gave us the conviction to extend IGNITE through 2026 and expand it further. On slide 11, you can see what IGNITE 2.0 looks like. IGNITE 1.0 in H2 2025 covered 2,261 accounts. IGNITE 2.0, which is now live for full year 2026, covers 3,109 accounts. That's a 38% increase, adding 848 additional accounts to the program. More accounts in the program means more concentrated distributor focus on the institutions we've identified as most likely to adopt and deepen ZYNRELEF use. The structural drivers that produce 111% unit growth in IGNITE 1.0 are now applied to a meaningfully larger base of accounts in 2026.

Mark Hensley: We'll be expanding our ZYNRELEF sales team in Q3 2026, targeted at geographies where all three foundational drivers are fully in place: formulary access, the IGNITE program, and payer coverage. That expansion sits alongside the aprepitant team expansion I'll cover on the APONVIE slides, reflecting our confidence in the trajectory of both franchises. On the longer-term side, our prefilled syringe presentation is in late-stage development, though we'll cover that in more detail later in the presentation. Moving on to slide 10. Here's the data behind IGNITE 1.0. The chart shows ZYNRELEF unit volume across our IGNITE targeted accounts. Pre-IGNITE versus post-IGNITE. We went from approximately 9,000 units in the last pre-IGNITE quarter of last year to over 19,000 units by Q4 of last year. That's 111% growth within these targeted accounts in just 2 quarters of the program.

Speaker #4: Target at geographies where all three foundational drivers are fully in place. Formulary access, the Ignite program, and payer coverage. That expansion sits alongside the appropriate team expansion I'll cover on the Apondi slide.

Speaker #4: On a slide 11, you can see what Ignite 2.0 looks like. Ignite 1.0 in the second half of 2025 covered 2,261 accounts. Ignite 2.0, which is now live for full year '26, covers 3,109 accounts.

Speaker #4: Reflecting our confidence in the trajectory of both franchises. On the longer-term side, our pre-filled syringe presentation is in late-stage development. Though we'll cover that in more detail later in the presentation.

Speaker #4: That's a 38% increase. Adding 848 additional accounts to the program. More accounts in the program means more concentrated distributor focus on the institutions we've identified as most likely to adopt and deepen Zenerlev use.

Speaker #4: Moving on to slide 10. Here's the data behind Ignite 1.0. The chart shows Zenerlev unit volume across our Ignite targeted accounts. Pre-Ignite versus post-Ignite.

Speaker #4: The structural drivers that produce 111% unit growth in Ignite 1.0 are now applied to a meaningfully larger base of accounts in 2026. I will now turn it over to Bill to cover the pre-filled syringe.

Speaker #4: We went from approximately 9,000 units in the last pre-Ignite quarter of last year to over 19,000 units by Q4 of last year. That's 111% growth within these targeted accounts in just two quarters of the program.

Mark Hensley: I will now turn it over to Bill to cover the prefilled syringe.

Speaker #1: Thank you, Mark. This slide highlights the strong momentum in our acute care franchise and the continued advancement of the Zenerlev pre-filled syringe program. We have seen consistent and accelerating adoption across our device preparation platforms as we transition from the vented vial spike, or VVS, to the significantly improved vial access needle, or VAN.

William Forbes: Thank you, Mark. This slide highlights the strong momentum in our acute care franchise and the continued advancement of the ZYNRELEF prefilled syringe program. We have seen consistent and accelerating adoption across our device preparation platforms as we transition from the vented vial spike or VVS to the significantly improved Vial Access Needle or VAN. This evolution has been well-received and reflects clear progress in ease of use and workflow efficiency. At the same time, market demand continues to shift toward ready-to-use systems, which are emerging as an important growth driver as hospitals prioritize efficiency, safety, and streamlined operating room workflows. Independent third-party forecasts reinforce the durability of this trend, with prefilled syringe adoption expected to scale meaningfully over time. From a program standpoint, the ZYNRELEF PFS is fully funded and on track.

Bill Forbes: Thank you, Mark. This slide highlights the strong momentum in our acute care franchise and the continued advancement of the ZYNRELEF prefilled syringe program. We have seen consistent and accelerating adoption across our device preparation platforms as we transition from the vented vial spike or VVS to the significantly improved Vial Access Needle or VAN. This evolution has been well-received and reflects clear progress in ease of use and workflow efficiency. At the same time, market demand continues to shift toward ready-to-use systems, which are emerging as an important growth driver as hospitals prioritize efficiency, safety, and streamlined operating room workflows. Independent third-party forecasts reinforce the durability of this trend, with prefilled syringe adoption expected to scale meaningfully over time. From a program standpoint, the ZYNRELEF PFS is fully funded and on track.

Speaker #4: This is the data that gave us the conviction to extend Ignite through 2026 and expand it further. On slide 11, you can see what Ignite 2.0 looks like.

Speaker #4: Ignite 1.0 in the second half of 2025 covered 2,261 accounts. Ignite 2.0, which is now live for full year '26, covers 3,109 accounts. That's a 38% increase.

Speaker #1: This evolution has been well received and reflects clear progress in ease of use and workflow efficiency. At the same time, market demand continues to shift toward ready-to-use systems, which are emerging as an important growth driver as hospitals prioritize efficiency, safety, and streamlined operating room workflows.

Speaker #4: Adding 848 additional accounts to the program. More accounts in the program means more concentrated distributor focus on the institutions we've identified as most likely to adopt and deepen Zenerlev use.

Speaker #1: Independent third-party forecasts reinforce the durability of this trend, with pre-filled syringe adoption expected to scale meaningfully over time. From a program standpoint, the Zenerlev PFS is fully funded and on track.

William Forbes: Thank you, Mark. This slide highlights the strong momentum in our acute care franchise and the continued advancement of the ZYNRELEF prefilled syringe program. We have seen consistent and accelerating adoption across our device preparation platforms as we transition from the vented vial spike, or VVS, to the significantly improved Vial Access Needle, or VAN. This evolution has been well received and reflects clear progress in ease of use and workflow efficiency. At the same time, market demand continues to shift toward ready-to-use systems, which are emerging as an important growth driver as hospitals prioritize efficiency, safety, and streamlined operating room workflows. Independent third-party forecasts reinforce the durability of this trend, with prefilled syringe adoption expected to scale meaningfully over time. From a program standpoint, the ZYNRELEF PFS is fully funded and on track.

Speaker #1: It was designed to align with contemporary health system expectations, including both ASHP and joint commission guidance. While improving operating room workflow, reducing preparation steps, and lowering the risk of medication errors and contamination.

William Forbes: It was designed to align with contemporary health system expectations, including both ASHP and The Joint Commission guidance, while improving operating room workflow, reducing preparation steps, and lowering the risk of medication errors and contamination. The development program is well advanced. Registration batches have been manufactured and placed on stability, and we remain on track to generate 12-month stability data in Q1 2027. Mark, I'll turn it back to you.

Bill Forbes: It was designed to align with contemporary health system expectations, including both ASHP and The Joint Commission guidance, while improving operating room workflow, reducing preparation steps, and lowering the risk of medication errors and contamination. The development program is well advanced. Registration batches have been manufactured and placed on stability, and we remain on track to generate 12-month stability data in Q1 2027. Mark, I'll turn it back to you.

Speaker #1: The development program is well advanced. Registration batches have been manufactured and placed on stability, and we remain on track to generate 12-month stability data in the first quarter of 2027.

Speaker #1: Mark, I'll turn it back to you.

Speaker #2: Thanks, Bill. Now to Apondi. There are two charts on this slide. Average daily units on the left, ordering accounts on the right. Both showed continued steady upward trajectory through Q1.

Mark Hensley: Thanks, Bill. Now to APONVIE. There are two charts on this slide, average daily units on the left, ordering accounts on the right. Both showed continued steady upward trajectory through Q1. On the Q1 metrics, APONVIE demand units grew 68% year over year. Average daily units grew 70% over Q1 of last year. We exited Q1 with 371 ordering accounts in March. That's an all-time high for the product and up 67% versus March of last year. APONVIE is now P&T approved in 1,903 accounts, representing 5.8 million medium to high-risk procedures annually. The last number defines the size of the addressable opportunity that APONVIE has now been formally cleared into. On the growth drivers ahead, APONVIE's permanent product-specific J-code became active 1 April.

Speaker #2: On the Q1 metrics, Apondi demand units grew 68% year over year. Average daily units grew 70% over Q1 of last year. We exited Q1 with 371 ordering accounts in March.

Speaker #1: It was designed to align with contemporary health system expectations, including both ASHP and Joint Commission guidance, while improving operating room workflow, reducing preparation steps, and lowering the risk of medication errors and contamination.

Speaker #2: That's an all-time high for the product and up 67% versus March of last year. And Apondi is now a P&T-approved and 1,903 accounts. Representing 5.8 million medium to high-risk procedures annually.

Speaker #2: The last number defines the size of the addressable opportunity that Apondi has now been formally cleared into. On the growth drivers ahead, Apondi's permanent product-specific J-code became an active April 1, having a permanent dedicated billing code in place removes a layer of reimbursement complexity for the product.

Speaker #1: Mark, I'll turn it back to you.

Mark Hensley: Having a permanent dedicated billing code in place removes a layer of reimbursement complexity for the product. We'll be expanding our dedicated aprepitant sales force in Q3 2026. That team currently covers both APONVIE and CINVANTI, and the expansion adds capacity to support both products. Lastly, APONVIE has been prominently included in the Fifth Consensus Guidelines for the Management of Postoperative Nausea and Vomiting. That's a meaningful clinical catalyst. I'll hand it over to Kevin to walk through the guidelines and what they mean for the product.

Mark Hensley: Thanks, Bill. Now to APONVIE. There are two charts on this slide. Average daily units on the left, ordering accounts on the right. Both showed continued steady upward trajectory through Q1. On the Q1 metrics, APONVIE demand units grew 68% year-over-year. Average daily units grew 70% over Q1 of last year. We exited Q1 with 371 ordering accounts in March. That's an all-time high for the product and up 67% versus March of last year. APONVIE is now P&T approved in 1,903 accounts, representing 5.8 million medium to high-risk procedures annually. The last number defines the size of the addressable opportunity that APONVIE has now been formally cleared into. On the growth drivers ahead, APONVIE's permanent product-specific J-code became active 1 April.

Speaker #2: We'll be expanding our dedicated appropriate Salesforce in Q3 2026. That team currently covers both Apondi and Sinvonti and the expansion adds capacity to support both products.

Speaker #2: On the Q1 metrics, Apondi demand units grew 68% year over year. Average daily units grew 70% over Q1 of last year. We exited Q1 with 371 ordering accounts in March.

Speaker #2: And lastly, Apondi has been prominently included in the fifth consensus guidelines for the management of post-operative nausea and vomiting. That's a meaningful clinical catalyst.

Speaker #2: I'll hand it over to Kevin to walk through the guidelines and what they mean for the product.

Speaker #3: Thanks, Mark. We wanted to provide a brief overview to help the street understand the broader clinical and economic significance of the recently published fifth consensus guidelines for the management of post-operative nausea and vomiting.

Kevin Warner: Thanks, Mark. We wanted to provide a brief overview to help the Street understand the broader clinical and economic significance of the recently published Fifth Consensus Guidelines for the Management of Postoperative Nausea and Vomiting. These guidelines represent an important shift in perioperative care, moving from reactive management of PONV toward a far more proactive, patient-centered prevention strategy. From a medical affairs perspective, guideline updates are highly important because they often serve as the foundation for durable institutional change. Historically, adoption occurs over time through provider education, EMR order sets, anesthesia workflows, perioperative pathways, and treatment algorithms. Once integrated into institutional protocols, these practices tend to become highly durable standards of care. Importantly, the updated guidelines substantially elevated the role of NK1 antagonists within multimodal prophylaxis strategies.

Speaker #2: The last number defines the size of the addressable opportunity that Apondi has now been formally cleared into. On the growth drivers ahead, Apondi's permanent product-specific J code became an active April 1, having a permanent dedicated billing code in place removes a layer of reimbursement complexity for the product.

Speaker #3: These guidelines represent an important shift in perioperative care, moving from reactive management of PONV toward a far more proactive patient-centered prevention strategy. From a medical affairs perspective, guideline updates are highly important because they often serve as the foundation for durable institutional change.

Mark Hensley: Having a permanent dedicated billing code in place removes a layer of reimbursement complexity for the product. We'll be expanding our dedicated aprepitant sales force in Q3 2026. That team currently covers both APONVIE and CINVANTI. The expansion adds capacity to support both products. Lastly, APONVIE has been prominently included in the 5th consensus guidelines for the management of postoperative nausea and vomiting. That's a meaningful clinical catalyst. I'll hand it over to Kevin to walk through the guidelines and what they mean for the product.

Speaker #2: We'll be expanding our dedicated appropriate sales force in Q3 2026. That team currently covers both Apondi and Sinvonti, and the expansion adds capacity to support both products.

Speaker #3: Historically, adoption occurs over time, through provider education, EMR order sets, anesthesia workflows, perioperative pathways, and treatment algorithms. Once integrated into institutional protocols, these practices tend to become highly durable standards of care.

Speaker #2: And lastly, Apondi has been prominently included in the fifth consensus guidelines for the management of post-operative nausea and vomiting. That's a meaningful clinical catalyst.

Speaker #3: Importantly, the updated guidelines substantially elevated the role of NK1 antagonists within multimodal prophylaxis strategies. A prepotent-based therapy, including Apondi, received an A1 evidence rating for prevention of PONV in adults, reflecting the highest level of evidence supporting efficacy and safety.

Speaker #2: I'll hand it over to Kevin to walk through the guidelines and what they mean for the product.

Kevin Warner: Thanks, Mark. We wanted to provide a brief overview to help the street understand the broader clinical and economic significance of the recently published fifth consensus guidelines for the management of postoperative nausea and vomiting. These guidelines represent an important shift in perioperative care, moving from reactive management of PONV toward a far more proactive, patient-centered prevention strategy. From a medical affairs perspective, guideline updates are highly important because they often serve as the foundation for durable institutional change. Historically, adoption occurs over time through provider education, EMR order sets, anesthesia workflows, perioperative pathways, and treatment algorithms. Once integrated into institutional protocols, these practices tend to become highly durable standards of care. Importantly, the updated guidelines substantially elevated the role of NK1 antagonists within multimodal prophylaxis strategies.

Kevin Warner: Aprepitant-based therapies, including APONVIE, receive an A1 evidence rating for prevention of PONV in adults, reflecting the highest level of evidence supporting efficacy and safety. APONVIE is specifically named within the guidelines as the first and only FDA-approved IV push NK1 antagonist for the prevention of PONV in adults. We believe this distinction is clinically meaningful because it combines efficacy, workflow efficiency, and ease of perioperative implementation in a way that supports both providers and patients. Another key evolution within the guidelines is the broader recommendation for multimodal prophylaxis. While patient and procedure-specific risk stratification remains central, the updated guidance recognizes that the benefit of prophylaxis often outweighs the risk of undertreatment. As a result, many institutions are expected to adopt a more liberal prophylaxis strategy across broader patient populations.

Speaker #3: These guidelines represent an important shift in perioperative care, moving from reactive management of PO and B toward a far more proactive, patient-centered prevention strategy.

Speaker #3: Apondi is specifically named within the guidelines as the first and only FDA-approved IV push NK1 antagonist for the prevention of PONV in adults. We believe this distinction is clinically meaningful because it combines efficacy workflow efficiency and ease of perioperative implementation in a way that supports both providers and patients.

Speaker #3: From a medical affairs perspective, guideline updates are highly important because they often serve as the foundation for durable institutional change. Historically, adoption occurs over time, through provider education, EMR order sets, anesthesia workflows, perioperative pathways, and treatment algorithms.

Speaker #3: Another key evolution within the guidelines is the broader recommendation for multimodal prophylaxis. While patient and procedure-specific risk stratification remains central, the updated guidance recognizes that the benefit of prophylaxis often outweighs the risk of undertreatment.

Speaker #3: Once integrated into institutional protocols, these practices tend to become highly durable standards of care. Importantly, the updated guidelines substantially elevated the role of NK1 antagonists within multimodal prophylaxis strategies.

Speaker #3: As a result, many institutions are expected to adopt a more liberal prophylaxis strategy across broader patient populations. The guidelines specifically recommend that patients with greater than two risk factors representing roughly half of the surgical population receive three to four prophylactic interventions.

Speaker #3: Aprepitant-based therapies, including Apondi, received an A1 evidence rating for prevention of PO and B in adults, reflecting the highest level of evidence supporting efficacy and safety.

Kevin Warner: aprepitant-based therapies, including APONVIE, receive an A1 evidence rating for prevention of PONV in adults, reflecting the highest level of evidence supporting efficacy and safety. APONVIE is specifically named within the guidelines as the first and only FDA-approved IV push NK1 antagonist for the prevention of PONV in adults. We believe this distinction is clinically meaningful because it combines efficacy, workflow efficiency, and ease of perioperative implementation in a way that supports both providers and patients. Another key evolution within the guidelines is the broader recommendation for multimodal prophylaxis. While patient and procedure-specific risk stratification remains central, the updated guidance recognizes that the benefit of prophylaxis often outweighs the risk of undertreatment. As a result, many institutions are expected to adopt a more liberal prophylaxis strategy across broader patient populations.

Kevin Warner: The guidelines specifically recommend that patients with greater than 2 risk factors, representing roughly half of the surgical population, receive 3 to 4 prophylactic interventions. These medium and high-risk patients often require highly effective antiemetic strategies without adding recovery-limiting adverse effects. We believe APONVIE is uniquely positioned in this setting. Its efficacy profile, combined with a differentiated safety profile that does not overlap with many commonly used antiemetics, supports use in patients where prevention matters most. Importantly, APONVIE provides antiemetic protection without contributing to sedation or negatively impacting postoperative recovery pathways, which is increasingly important in enhanced recovery protocols and ambulatory surgery. 1 of the most significant additions to the fifth edition guidelines was the expanded focus on post-discharge nausea and vomiting, or PDNV. The guidelines emphasize that PONV is not simply an acute PACU complication. For many patients, symptoms occur after discharge when clinical support resources are less available.

Speaker #3: Apondi is specifically named within the guidelines as the first and only FDA-approved IV push NK1 antagonist for the prevention of PO and B in adults.

Speaker #3: These medium and high-risk patients often require highly effective antiemetic strategies, without adding recovery-limiting adverse effects. We believe Apondi is uniquely positioned in this setting.

Speaker #3: We believe this distinction is clinically meaningful because it combines efficacy, workflow efficiency, and ease of perioperative implementation in a way that supports both providers and patients.

Speaker #3: Its efficacy profile, combined with the differentiated safety profile that does not overlap with many commonly used antiemetics, supports use in patients where prevention matters most.

Speaker #3: Another key evolution within the guidelines is the broader recommendation for multimodal prophylaxis. While patient- and procedure-specific risk stratification remains central, the updated guidance recognizes that the benefit of prophylaxis often outweighs the risk of under-treatment.

Speaker #3: Importantly, Apondi provides antiemetic protection without contributing to sedation or negatively impacting post-operative recovery pathways, which has increasingly important in enhanced recovery protocols and ambulatory surgery.

Speaker #3: As a result, many institutions are expected to adopt a more liberal prophylaxis strategy across broader patient populations. The guidelines specifically recommend that patients with greater than two risk factors, representing roughly half of the surgical population, receive three to four prophylactic interventions.

Speaker #3: One of the most significant additions to the fifth edition guidelines was the expanded focus on post-discharge nausea and vomiting, or PDNV. The guidelines emphasize that PONV is not simply an acute PACU complication.

Kevin Warner: The guidelines specifically recommend that patients with greater than 2 risk factors, representing roughly half of the surgical population, receive 3 to 4 prophylactic interventions. These medium and high-risk patients often require highly effective antiemetic strategies without adding recovery-limiting adverse effects. We believe APONVIE is uniquely positioned in this setting. Its efficacy profile, combined with the differentiated safety profile that does not overlap with many commonly used antiemetics, supports use in patients where prevention matters most. Importantly, APONVIE provides antiemetic protection without contributing to sedation or negatively impacting postoperative recovery pathways, which is increasingly important in enhanced recovery protocols and ambulatory surgery. One of the most significant additions to the fifth edition guidelines was the expanded focus on post-discharge nausea and vomiting, or PDNV. The guidelines emphasize that PONV is not simply an acute PACU complication. For many patients, symptoms occur after discharge when clinical support resources are less available.

Speaker #3: For many patients, symptoms occur after discharge, when clinical support resources are less available. The guidelines cite data, showing approximately 37% of patients may experience PDNV, with implications for dehydration, wound complications, unplanned healthcare utilization, and potential readmissions.

Kevin Warner: The guidelines cite data showing approximately 37% of patients may experience PDNV, with implications for dehydration, wound complications, unplanned healthcare utilization, and potential readmissions. As outpatient surgery volumes continue to expand and same-day discharge becomes increasingly common, these downstream complications become even more relevant in value-based care models. Importantly, the guidelines now recommend that patients at risk for PDNV receive prophylactic long-acting antiemetics prior to discharge. We believe APONVIE aligns well with this recommendation, given its 48-hour duration of action and ability to provide extended receptor coverage during the vulnerable post-discharge period. The guidelines also reinforce several important differentiators associated with APONVIE and NK1 antagonist therapy more broadly. APONVIE is administered as a simple 30-second IV push with rapid onset and greater than or equal to 97% receptor occupancy within 5 minutes, integrating efficiently into standard anesthesia workflows.

Speaker #3: As outpatient surgery volumes continue to expand and same-day discharge becomes increasingly common, these downstream complications become even more relevant and value-based care models. Importantly, the guidelines now recommend that patients at risk for PDNV receive prophylactic long-acting antiemetics prior to discharge.

Speaker #3: Importantly, Apondi provides antiemetic protection without contributing to sedation or negatively impacting post-operative recovery pathways, which has become increasingly important in enhanced recovery protocols and ambulatory surgery.

Speaker #3: We believe Apondi aligns well with this recommendation, given its 48-hour duration of action and ability to provide extended receptor coverage during the vulnerable post-discharge period.

Speaker #3: The guidelines also reinforce several important differentiators associated with Apondi and NK1 antagonist therapy more broadly. Apondi is administered as a simple 30-second IV push, with rapid onset and greater than or equal to 97% receptor occupancy within five minutes.

Speaker #3: For many patients, symptoms occur after discharge, when clinical support resources are less available. The guidelines cite data showing approximately 37% of patients may experience PDNV, with implications for dehydration, wound complications, unplanned healthcare utilization, and potential readmissions.

Speaker #3: Integrating efficiently into standard anesthesia workflows. This becomes particularly relevant for providers who may not have had adequate preoperative time or oral administration or who are caring for patients with limitations to oral therapies, including those with gastroparesis, GLP-1 utilization, diabetes-related GI dysfunction, or altered gastric emptying.

Kevin Warner: This becomes particularly relevant for providers who may not have had adequate preoperative time for oral administration, or who are caring for patients with limitations to oral therapies, including those with gastroparesis, GLP-1 utilization, diabetes-related GI dysfunction, or altered gastric emptying. The strength of evidence supporting aprepitant-based therapy was also highlighted throughout the guidelines. Multiple randomized trials demonstrated aprepitant to be comparable or superior to ondansetron for prevention of PONV. Meta-analysis showed significant reductions in PONV risk when used alone or within multimodal regimens. In a large Cochrane systematic review evaluating nearly 100,000 patients, ranked aprepitant as the single most effective antiemetic. Importantly, the updated guidelines frame PONV prevention not simply as a patient comfort initiative, but as a meaningful clinical quality and operational issue. Poorly controlled PONV contributes to extended PACU stays, rescue medication use, delayed discharge, dehydration, wound stress, aspiration concerns, and readmissions.

Speaker #3: As outpatient surgery volumes continue to expand and same-day discharge becomes increasingly common, these downstream complications become even more relevant in value-based care models. Importantly, the guidelines now recommend that patients at risk for PDNV receive prophylactic long-acting antiemetics prior to discharge.

Speaker #3: The strength of evidence supporting a prepotent-based therapy was also highlighted throughout the guidelines. Multiple randomized trials demonstrated a prepotent to be comparable or superior to ondansetron for prevention of PONV.

Speaker #3: Meta-analysis showed significant reductions in PONV risk when used alone or within multimodal regimens. In a large Cochrane systemic review patients, ranked a prepotent as the single most effective antiemetic.

Speaker #3: Importantly, the updated guidelines frame PONV prevention not simply as a patient comfort initiative, but as a meaningful clinical quality and operational issue. Poorly controlled PONV contributes to extended PACU states, rescue medication use, delayed discharge, dehydration, wound stress, aspiration concerns, and readmissions.

Speaker #3: Integrating efficiently into standard anesthesia workflows. This becomes particularly relevant for providers who may not have had adequate preoperative time or oral administration or who are caring for patients with limitations to oral therapies including those with gastroparesis, GLP-1 utilization, diabetes-related GI dysfunction, or altered gastric emptying.

Kevin Warner: This becomes particularly relevant for providers who may not have had adequate preoperative time for oral administration, or who are caring for patients with limitations to oral therapies, including those with gastroparesis, GLP-1 utilization, diabetes-related GI dysfunction, or altered gastric emptying. The strength of evidence supporting aprepitant-based therapy was also highlighted throughout the guidelines. Multiple randomized trials demonstrated aprepitant to be comparable or superior to ondansetron for prevention of PONV. Meta-analysis showed significant reductions in PONV risk when used alone or within multimodal regimens. In a large Cochrane systematic review evaluating nearly 100,000 patients ranked aprepitant as the single most effective antiemetic. Importantly, the updated guidelines frame PONV prevention not simply as a patient comfort initiative, but as a meaningful clinical quality and operational issue. Poorly controlled PONV contributes to extended PACU states, rescue medication use, delayed discharge, dehydration, wound stress, aspiration concerns, and readmissions.

Speaker #3: In many high-risk procedures, including abdominal bariatric, ENT, ophthalmology, and other belt-up surgeries, preventing vomiting is viewed as critically important to protecting surgical outcomes and patient safety.

Kevin Warner: In many high-risk procedures, including abdominal, bariatric, ENT, ophthalmology, and other belt up surgeries, preventing vomiting is viewed as critically important to protecting surgical outcomes and patient safety. Appropriate prophylaxis also support perioperative operational efficiency by reducing nursing burden, minimizing recovery delays, improving throughput, and enhancing both patient and staff satisfaction. The guidelines additionally highlighted the pharmacoeconomic value of effective prophylaxis strategies. One metric discussed was number needed to treat or NNT. For aprepitant combined with dexamethasone, the reported NNT was 3.8, meaning approximately 4 patients treated prevents one additional case of PONV. Compared with many commonly used antiemetics, this represents a highly favorable value proposition. From a health system perspective, this becomes clinically and economically meaningful very quickly. A single episode of PONV has been estimated to cost approximately $1,000 when considering rescue therapy, nursing utilization, prolonged PACU time, and delayed discharge.

Speaker #3: The strength of evidence supporting an aprepitant-based therapy was also highlighted throughout the guidelines. Multiple randomized trials demonstrated aprepitant to be comparable or superior to ondansetron for prevention of PONV.

Speaker #3: Appropriate prophylaxis also supports perioperative operational efficiency. By reducing nursing burden, minimizing recovery delays, improving throughput, and enhancing both patient and staff satisfaction, the guidelines additionally highlighted the pharmacoeconomic value of effective prophylaxis strategies.

Speaker #3: Meta-analysis showed significant reductions in PONV risk when used alone or within multimodal regimens. In a large Cochrane systemic review evaluating nearly 100,000 patients, ranked a prepitant as the single most effective antiemetic.

Speaker #3: One metric discussed was number needed to treat, or NNT. For a prepotent, combined with dexamethasone, the reported NNT was 3.8, meaning approximately four patients treated prevents one additional case of PONV.

Speaker #3: Importantly, the updated guidelines frame PONV prevention not simply as a patient comfort initiative, but as a meaningful clinical, quality, and operational issue. Poorly controlled PONV contributes to extended PACU stays, rescue medication use, delayed discharge, dehydration, wound stress, aspiration concerns, and readmissions.

Speaker #3: Compared with many commonly used antiemetics, this represents a highly favorable value proposition. From a health system perspective, this becomes clinically and economically meaningful very quickly.

Speaker #3: A single episode of PONV has been estimated to cost approximately $1,000 when considering rescue therapy, nursing utilization, prolonged PACU time, and delayed discharge. When viewed in that context, preventing complications with an intervention costing approximately $60 per dose becomes highly rational and understandable for providers and institutions alike.

Speaker #3: In many high-risk procedures, including abdominal bariatric, ENT, ophthalmologic, and other belt-up surgeries, preventing vomiting is viewed as critically important to protecting surgical outcomes and patient safety.

Kevin Warner: In many high-risk procedures, including abdominal, bariatric, ENT, ophthalmologic, and other belt up surgeries, preventing vomiting is viewed as critically important to protecting surgical outcomes and patient safety. Appropriate prophylaxis also supports perioperative operational efficiency by reducing nursing burden, minimizing recovery delays, improving throughput, and enhancing both patient and staff satisfaction. The guidelines additionally highlighted the pharmacoeconomic value of effective prophylaxis strategies. One metric discussed was number needed to treat, or NNT. For aprepitant combined with dexamethasone, the reported NNT was 3.8, meaning approximately 4 patients treated prevents one additional case of PONV. Compared with many commonly used antiemetics, this represents a highly favorable value proposition. From a health system perspective, this becomes clinically and economically meaningful very quickly. A single episode of PONV has been estimated to cost approximately $1,000 when considering rescue therapy, nursing utilization, prolonged PACU time, and delayed discharge.

Kevin Warner: When viewed in that context, preventing complications with an intervention costing approximately $60 per dose becomes highly rational and understandable for providers and institutions alike, particularly as value-based care models increasingly focus on patient satisfaction, throughput, readmission, recovery quality, and total episode of care costs. Ultimately, we believe the Fifth Consensus Guidelines reinforce several important macro trends shaping the perioperative landscape, including greater use of multimodal prophylaxis, increasing recognition of post-discharge nausea and vomiting, continued migration toward outpatient surgery, demand for workflow efficiency, and the growing need for safe, effective, non-sedating, long-acting therapies that support enhanced recovery pathways, which we believe APONVIE is uniquely positioned to address. I will now turn the call back to Mark to discuss our oncology supportive care franchise.

Speaker #3: Appropriate prophylaxis also supports perioperative operational efficiency. By reducing nursing burden, minimizing recovery delays, improving throughput, and enhancing both patient and staff satisfaction. The guidelines additionally highlighted the pharmacoeconomic value of effective prophylaxis strategies.

Speaker #3: Particularly as value-based care models, increasingly focused on patient satisfaction throughput, readmissions, recovery quality, and total episode of care cost. Ultimately, we believe the fifth consensus guidelines reinforce several important macro trends shaping the perioperative landscape, including greater use of multimodal prophylaxis, increasing recognition of post-discharge nausea and vomiting, continued migration toward outpatient surgery, demand for workflow efficiency, and the growing need for safe, effective, non-sedating, long-acting therapies that support enhanced recovery pathways.

Speaker #3: One metric discussed was number needed to treat, or NNT. For aprepitant combined with dexamethasone, the reported NNT was 3.8, meaning approximately four patients treated prevents one additional case of PONV.

Speaker #3: Which we believe Apondi is uniquely positioned to address. I will now turn the call back to Mark to discuss our oncology supportive care

Kevin Warner: When viewed in that context, preventing complications with an intervention costing approximately $60 per dose becomes highly rational and understandable for providers and institutions alike, particularly as value-based care models increasingly focus on patient satisfaction, throughput, readmission, recovery quality, and total episode of care costs. Ultimately, we believe the fifth consensus guidelines reinforce several important macro trends shaping the perioperative landscape, including greater use of multimodal prophylaxis, increasing recognition of post-discharge nausea and vomiting, continued migration toward outpatient surgery, demand for workflow efficiency, and the growing need for safe, effective, non-sedating, long-acting therapies that support enhanced recovery pathways, which we believe APONVIE is uniquely positioned to address. I will now turn the call back to Mark to discuss our oncology supportive care franchise.

Speaker #4: Thanks, Kevin. Turning to oncology supportive care. There are two charts on this slide. Average daily units on the left, ordering accounts on the right.

Mark Hensley: Thanks, Kevin. Turning to oncology supportive care. There are two charts on this slide, average daily units on the left, ordering accounts on the right. CINVANTI's average daily units have remained resilient, sustaining a consistent trend in utilization throughout 2024 and into 2026. That's a meaningful durability marker for a product in its mature commercial phase in a category that has faced steady competitive pressure. On ordering accounts, you can see the two layers on the right chart. The blue line shows existing accounts running at approximately 1,100 every month, which speaks to the stickiness of the customer base. The purple line shows new and returning accounts averaging about 59 per month in Q1 of 2026. In March specifically, 1,188 accounts ordered CINVANTI. That number was in line with the 12-month average of approximately 1,200 accounts.

Speaker #3: Particularly, as value-based care models, increasingly focus on patient satisfaction, throughput, readmissions, recovery quality, and total episode of care cost. Ultimately, we believe the fifth consensus guidelines reinforce several important macro trends shaping the perioperative landscape, including greater use of multimodal prophylaxis, increasing recognition of post-discharge nausea and vomiting, continued migration toward outpatient surgery, demand for workflow efficiency, and the growing need for safe, effective non-sedating, long-acting therapies that support enhanced recovery pathways.

Speaker #4: Sinvonti's average daily units have remained resilient. Sustaining a consistent trend in utilization throughout 2024 and into 2026. That's a meaningful durability marker for a product in its mature commercial phase.

Speaker #4: In a category that has faced steady competitive pressure. On ordering accounts, you can see the two layers on the right chart. The blue line shows existing accounts running at approximately $1,100 every month, which speaks to the stickiness of the customer base.

Speaker #4: The purple line shows new and returning accounts, averaging about $59 per month in Q1 of '26. In March, specifically, $1,188 accounts ordered Sinvonti. That number was in line with the 12-month average of approximately $1,200 accounts.

Speaker #3: Which we believe Apondi is uniquely positioned to address. I will now turn the call back to Mark to discuss our oncology supportive care franchise.

Speaker #4: On market share, Sinvonti ended Q1 with 25% exit share in March of 2026. That was also in line with the 12-month average. The stability is the takeaway.

Mark Hensley: On market share, CINVANTI ended Q1 with 25% exit share in March 2026. That was also in line with the 12-month average. The stability is the takeaway. We are holding our position in a competitive category. Looking at growth drivers for the rest of 2026, Craig referenced a number of new accounts coming online this year. Those new formulary wins are due to our REIGNITE program. It's focused on CINVANTI access in major teaching hospitals, where we have already secured formulary wins, and the near-term pipeline represents approximately $10 million in new opportunity. As I mentioned earlier, our dedicated aprepitant sales force expansion in Q3 2026 will support CINVANTI as well as APONVIE. CINVANTI will be promoted in the second position by that team. Now to the broader category dynamics.

Speaker #1: Thanks, Kevin. Turning to oncology supportive care. There are two charts on this slide. Average daily units on the left, ordering accounts on the right.

Speaker #4: We are holding our position in a competitive category. Looking at growth drivers for the rest of 2026, Craig referenced a number of new accounts coming online this year.

Speaker #1: Sinvonte's average daily units have remained resilient. Sustaining a consistent trend in utilization throughout 2024 and into 2026. That's a meaningful durability marker for a product in its mature commercial phase.

Speaker #4: Those new formulary wins are due to our Reignite program. It's focused on Sinvonti access in major teaching hospitals, where we have already secured formulary wins in the near-term pipeline represents approximately $10 million in new opportunity.

Speaker #1: In a category that has faced steady competitive pressure. On ordering accounts, you can see the two layers on the right chart. The blue line shows existing accounts running at approximately $1,100 every month.

Speaker #4: And as I mentioned earlier, our dedicated to prepotent sales force expansion in the third quarter of 2026 will support Sinvonti as well as Apondi.

Speaker #1: Which speaks to the stickiness of the customer base. The purple line shows new and returning accounts, averaging about 59 per month in Q1 of '26.

Speaker #4: Sinvonti will be promoted in the second position by that team. Now to the broader category dynamics. On the next slide, the chart shows the broader NK1 category.

Speaker #1: In March, specifically, 1,188 accounts ordered Sinvonte. That number was in line with the 12-month average of approximately 1,200 accounts. On market share, Sinvonte ended Q1 with 25% exit share in March of 2026.

Mark Hensley: On the next slide, the chart shows the broader NK1 category for chemotherapy-induced nausea and vomiting over the last 12 months. The stacked bars show total category units broken out by competitor product. The percentages at the top of each bar show month-over-month volatility in the overall category, ranging from down 19% in some months to up 21% in others. The line running across the chart is CINVANTI's market share within that category. Despite all the category-level volatility, CINVANTI's share has been remarkably stable. The 12-month average is 25%. March 2026 closed at 25%. That share stability in a category where the underlying volume is highly variable month-to-month is the durability marker for this franchise.

Speaker #4: For chemotherapy-induced nausea and vomiting over the last 12 months. The stack bars show total category units broken out by competitor product. The percentages at the top of each bar show month-over-month volatility in the overall category, ranging from down 19% in some months to up 21% in others.

Speaker #1: That was also in line with the 12-month average. The stability is the takeaway. We are holding our position in a competitive category. Looking at growth drivers for the rest of 2026, Craig referenced a number of new accounts coming online this year.

Speaker #4: The line running across the chart is Sinvonti's market share within that category. Despite all the category-level volatility, Sinvonti's share has been remarkably stable. The 12-month average is 25%.

Speaker #1: Those new formulary wins are due to our Reignite program. Its focus on Sinvonte access and major teaching hospitals, where we have already secured formulary wins in the near-term pipeline represents approximately $10 million in new opportunity.

Speaker #4: March 2026 closed at 25%. That share stability in the category where the underlying volume is highly variable month to month is the durability marker for this franchise.

Speaker #1: And as I mentioned earlier, our dedicated to Prepitant sales force expansion in the third quarter of 2026 will support Sinvonte, as well as Apondi.

Speaker #4: To wrap up the commercial section, Xinra left demand grew 22% year over year, with Ignite 2.0 expanding our targeted account base by 38% for 2026.

Mark Hensley: To wrap up the commercial section, ZYNRELEF demand grew 22% year-over-year, with IGNITE 2.0 expanding our targeted account base by 38% for 2026. APONVIE demand grew 68%. Ordering accounts hit an all-time high, and the Fifth Consensus Guidelines have positioned the product as the evidence-graded standard for PONV prophylaxis. CINVANTI held a stable 25% market share in a volatile category, with REIGNITE building approximately $10 million of near-term pipeline. Across all of it, our pricing discipline is intact, our structural drivers are in place, and our commercial leverage continues to expand with both our ZYNRELEF team and our dedicated aprepitant team set to expand in Q3. The drivers we put in motion in 2025 are working as designed, and we have line of sight to deliver on the full-year framework we laid out in February.

Speaker #1: Sinvonte will be promoted in the second position by that team. Now to the broader category dynamics. On the next slide, the chart shows the broader NK1 category for chemotherapy-induced nausea and vomiting over the last 12 months.

Speaker #4: Apondi demand grew 68%. Ordering accounts hit an all-time high, and the fifth consensus guidelines have positioned the product as the evidence-graded standard for PONV prophylaxis.

Mark Hensley: On the next slide, the chart shows the broader NK1 category for chemotherapy-induced nausea and vomiting over the last 12 months. The stacked bars show total category units broken out by competitor product. The percentages at the top of each bar show month-over-month volatility in the overall category, ranging from down 19% in some months to up 21% in others. The line running across the chart is CINVANTI's market share within that category. Despite all the category-level volatility, CINVANTI's share has been remarkably stable. The 12-month average is 25%. March 2026 closed at 25%. That share stability in a category where the underlying volume is highly variable month to month is the durability marker for this franchise.

Speaker #1: The stack bar showed total category units broken out by competitor product. The percentages at the top of each bar show month-over-month volatility in the overall category, ranging from down 19% in some months to up 21% in others.

Speaker #4: Sinvonti held a stable 25% market share in a volatile category, with Reignite building approximately $10 million of near-term pipeline. Across all of it, our pricing discipline is intact, our structural drivers are in place, and our commercial leverage continues to expand.

Speaker #1: The line running across the chart is Sinvonte's market share within that category. Despite all the category-level volatility, Sinvonte's share has been remarkably stable. The 12-month average is 25%.

Speaker #4: With both our Xinra left team and our dedicated to prepotent team set to expand in Q3. The drivers we put in motion in '25 are working as designed, and we have line of sight to deliver on the full-year framework we laid out in February.

Speaker #1: March 2026 closed at 25%. That share stability in the category where the underlying volume is highly variable month to month is the durability marker for this franchise.

Speaker #4: With that, I'll now turn it over to Ira.

Mark Hensley: With that, I'll now turn it over to Ira.

Speaker #5: Thank you, Mark.

Speaker #1: To wrap up the commercial section, Xinra left demand grew 22% year over year, with Ignite 2.0 expanding our targeted account base by 38% for 2026.

Mark Hensley: To wrap up the commercial section, ZYNRELEF demand grew 22% year over year, with IGNITE 2.0 expanding our targeted account base by 38% for 2026. APONVIE demand grew 68%. Ordering accounts hit an all-time high, and the 5th consensus guidelines have positioned the product as the evidence-graded standard for PONV prophylaxis. CINVANTI held a stable 25% market share in a volatile category, with REIGNITE building approximately $10 million of near-term pipeline. Across all of it, our pricing discipline is intact, our structural drivers are in place, and our commercial leverage continues to expand with both our ZYNRELEF team and our dedicated aprepitant team set to expand in Q3. The drivers we put in motion in 2025 are working as designed, and we have line of sight to deliver on the full-year framework we laid out in February.

Ira Duarte: Thank you, Mark. As Craig noted, our financial results this quarter came in modestly below plan.

Speaker #6: As Craig noted, our financial results this quarter came in modestly below plan. That said, while winter storms outside of our control, how we manage our business in response to them is not.

Ira Duarte: That said, while winter storms are outside of our control, how we manage our business in response to them is not. Disciplined cost management remains a hallmark of this team that our shareholders have come to rely on. Net revenues for the Q were $34.7 million, with growth margin coming in at 69%, below our typical low to mid-70% range. As we have discussed in prior calls, we have a secondary supplier for CINVANTI and carried a contractual obligation to produce a certain inventory quantities over the past year. That secondary product is manufactured in smaller batch sizes at roughly 3 times the cost per batch of our primary supplier. This inventory will work its way through our system over the next 2 quarters, after which we will return exclusively to our primary supplier.

Speaker #1: Apondi demand grew 68%. Ordering accounts hit an all-time high, and the fifth consensus guidelines have positioned the product as the evidence-graded standard for PONV prophylaxis.

Speaker #6: And discipline, cost management remains a hallmark of this team that our shareholders have come to rely on. Net revenues for the quarter were $34.7 million, with gross margin coming in at 69%, below our typical low to mid-70s percent range.

Speaker #1: Sinvonte held a stable 25% market share in a volatile category, with Reignite building approximately $10 million of near-term pipeline. Across all of it, our pricing discipline is intact, our structural drivers are in place, and our commercial leverage continues to expand.

Speaker #6: As we have discussed in prior calls, we have a secondary supplier for Sinvonti, and carried a contractual obligation to produce a certain inventory quantities over the past year.

Speaker #1: With both our Xinra left team and our dedicated to prepitant team set to expand in Q3. The drivers we put in motion in '25 are working as designed, and we have line of sight to deliver on the full-year framework we laid out in February.

Speaker #6: That secondary product is manufactured in smaller batch sizes at roughly three times the cost per batch of our primary supplier. This inventory will work its way through our system over the next two quarters after which we will return exclusively to our primary supplier.

Speaker #1: With that, I'll now turn it over to Ira.

Mark Hensley: With that, I'll now turn it over to Ira.

Speaker #2: Thank you, Mark.

Ira Duarte: Thank you, Mark. As Craig noted, our financial results this quarter came in modestly below plan. That said, while winter storms are outside of our control, how we manage our business in response to them is not. Disciplined cost management remains a hallmark of this team that our shareholders have come to rely on. Net revenues for the quarter were $34.7 million, with gross margin coming in at 69%, below our typical low to mid-70% range. As we have discussed in prior calls, we have a secondary supplier for CINVANTI and carried a contractual obligation to produce a certain inventory quantities over the past year. That secondary product is manufactured in smaller batch sizes at roughly 3 times the cost per batch of our primary supplier.

Speaker #3: As Craig noted, our financial results this quarter came in modestly below plan. That said, while winter storms outside of our control, how we manage our business in response to them is not.

Speaker #6: Once those contractual obligations are fulfilled, we expect gross margins to normalize back to the mid-70% range. Adjusted EBITDA was -727,000 for the quarter, reflecting the combined impact of the storm-related revenue softness and the temporary gross margin pressure from our secondary Sinvonti supplier.

Ira Duarte: Once those contractual obligations are fulfilled, we expect growth margins to normalize back to the mid-70% range. Adjusted EBITDA was -$727,000 for the quarter, reflecting the combined impact of the storm-related revenue softness and the temporary growth margin pressure from our secondary CINVANTI supplier. Both factors are temporary, and we expect adjusted EBITDA to return to positive territory as we move through 2026. Looking ahead, the recovery is already underway. As noted earlier on the call, March net revenues returned to over $15 million, a strong signal for Q2 and one that reinforces our confidence in achieving our full-year targets. To reaffirm our 2026 guidance, we are maintaining net product sales of $173 to 183 million and adjusted EBITDA of $10 to 20 million, reflecting continued profitability alongside meaningful commercial expansion.

Speaker #3: And discipline, cost management remains a hallmark of this team that our shareholders have come to rely on. Net revenues for the quarter were $34.7 million, with gross margin coming in at 69%, below our typical low to mid-70s percent range.

Speaker #6: Both factors are temporaries, and we expect adjusted EBITDA to return to positive territory as we move through 2026. Looking ahead, the recoveries already underway.

Speaker #3: As we have discussed in prior calls, we have a secondary supplier for Sinvonte, and carried a contractual obligation to produce a certain inventory quantities over the past year.

Speaker #6: As noted earlier on the call, March net revenues returned to over $15 million, a strong signal for the second quarter, and one that reinforces our confidence in achieving our full-year targets.

Speaker #3: That secondary product is manufactured in smaller batch sizes at roughly three times the cost per batch of our primary supplier. This inventory will work its way through our system over the next two quarters, after which we will return exclusively to our primary supplier.

Speaker #6: To reaffirm our 2026 guidance, we are maintaining net product sales of $173 to $183 million and adjusted EBITDA of $10 to $20 million. Reflecting continued profitability alongside meaningful commercial expansion.

Ira Duarte: This inventory will work its way through our system over the next two quarters, after which we will return exclusively to our primary supplier. Once those contractual obligations are fulfilled, we expect growth margins to normalize back to the mid-70% range. Adjusted EBITDA was -$727,000 for the quarter, reflecting the combined impact of the storm-related revenue softness and the temporary growth margin pressure from our secondary CINVANTI supplier. Both factors are temporary, and we expect adjusted EBITDA to return to positive territory as we move through 2026. Looking ahead, the recovery is already underway. As noted earlier on the call, March net revenues returned to over $15 million, a strong signal for the second quarter and one that reinforces our confidence in achieving our full-year targets.

Speaker #3: Once those contractual obligations are fulfilled, we expect gross margins to normalize back to the mid-70% range. Adjusted EBITDA was negative $727,000 for the quarter, reflecting the combined impact of the storm-related revenue softness and the temporary gross margin pressure from our secondary Sinvonte supplier.

Speaker #6: With that, we are happy to open the call for questions.

Ira Duarte: With that, we are happy to open the call for questions.

Speaker #7: Certainly. As a reminder to ask a question, please press star 11 on your telephone and wait for your name to be announced. To withdraw your question, please press star 11 again; please stand by while we compile our Q&A roster.

Operator: Certainly. As a reminder, to ask a question, please press star one one on your telephone and wait for your name to be announced. To withdraw your question, please press star one one again. Please stand by while we compile our Q&A roster. Our first question will be coming from the line of Brandon Folkes of H.C. Wainwright. Brandon, your line is open.

Speaker #3: Both factors are temporaries, and we expect adjusted EBITDA to return to positive territory as we move through 2026. Looking ahead, the recoveries already underway.

Speaker #7: Our first question will be coming from the line of Brandon Folks of HC Wainwright. Brandon, your line is open.

Speaker #3: As noted earlier on the call, March net revenues returned to over $15 million, a strong signal for the second quarter and one that reinforces our confidence in achieving our full-year targets.

Speaker #8: Hi. Thanks for taking my questions today. Maybe just a few from me. Firstly, on your guidance, can you just talk about some of the pushes and pulls on Xinra Leaf that you assume to meet the overall company-level revenue guidance?

Brandon Folkes: Hi, thanks for taking my questions today. Maybe just a few from me. Firstly, on your guidance, can you just talk about some of the pushes and pulls on ZYNRELEF that you assume to meet the overall company level revenue guidance? You know, do you assume ZYNRELEF taking market share? You know, maybe secondly, apologies if I missed this. Can you just give me some details on the Baxter settlement, just sort of what that allows, what that sort of keeps exclusivity on? That's it from me. Maybe one more. You know, you talk about friction. Can you just talk about how you meaningfully change the adoption curve, you know, across ZYNRELEF and APONVIE? On ZYNRELEF, you know, it sounds like there's friction in the sort of the office to decide to use ZYNRELEF.

Speaker #3: To reaffirm our 2026 guidance, we are maintaining net product sales of $173 to $183 million and adjusted EBITDA of $10 to $20 million, reflecting continued profitability alongside meaningful commercial expansion.

Ira Duarte: To reaffirm our 2026 guidance, we are maintaining net product sales of $173 to $183 million and adjusted EBITDA of $10 to $20 million, reflecting continued profitability alongside meaningful commercial expansion. With that, we are happy to open the call for questions.

Speaker #8: Do you assume Xinra Leaf taking market share? And then maybe secondly, apologies if I missed this, can you just give me some details on the batch to settlement to sort of what that allows, what that sort of keeps exclusivity?

Speaker #3: With that, we are happy to open the call for questions.

Speaker #2: Certainly. As a reminder, to ask a question, please press star one-one on your telephone and wait for your name to be announced. To withdraw your question, please press star one-one again. Please stand by while we compile our Q&A line for Brandon Folks of HC Wainwright.

Speaker #8: Yeah. That's it from me. Oh, maybe one more. Just you talked about friction. So can you just talk about how you meaningfully change the adoption curve across Xinra Leaf and Apondi?

Speaker #2: Brandon, your line is open.

Speaker #8: And on Xinra Leaf, it sounds like there's friction in the sort of the office to decide to use Xinra Leaf. How do you change that ahead of the pre-fold syringe and eliminate the friction you're seeing today so that the pre-fold syringe can sort of maximize the value that it can bring?

Speaker #4: Hi. Thanks for taking my questions today. Maybe just a few from me. Firstly, on your guidance, can you just talk about some of the pushes and pulls on Xinra Leaf that you assume to meet the overall company-level revenue guidance?

Brandon Folkes: Hi. Thanks for taking my questions today. Maybe just a few from me. Firstly, on your guidance, can you just talk about some of the pushes and pulls on ZYNRELEF that you assume to meet the overall company level revenue guidance? You know, do you assume ZYNRELEF taking market share? Then, you know, maybe secondly, apologies if I missed this, can you just give me some details on the Baxter settlement, just sort of what that allows, what that sort of keeps exclusivity on? Yeah, that's it from me. Maybe one more just, you know, you talk about friction. So can you just talk about how you meaningfully change the adoption curve, you know, across ZYNRELEF and APONVIE? On ZYNRELEF, you know, it sounds like there's friction in the sort of the office to decide to use ZYNRELEF.

Brandon Folkes: How do you change that ahead of the prefilled syringe and eliminate the friction you're seeing today so that the prefilled syringe can sort of maximize the value that it can bring? Thank you.

Speaker #4: Do you assume Xinra Leaf is taking market share? And then maybe secondly, probably just if I missed this, can you just give me some details on the back-to-settlement—sort of what that allows, what that sort of keeps in terms of exclusivity?

Speaker #8: Thank you.

Speaker #9: Hey, Brandon. Thank you for the questions. I'll start with the batch to settlement, and then I'll turn it to Mark. Look, based on the terms of the settlement, we really can't go into the details of that other than to say that the dates and everything that have been published.

Craig Collard: Hey, Brandon. Thank you for the questions. I'll start with the Baxter settlement, and then I'll turn it to Mark. Look, based on the terms of the settlement, we really can't go into the details of that other than to say that, you know, the dates and everything that had been published. Outside of that, we're just forbidden from saying anything on that. I'll turn it over to Mark to talk about his other left questions that you asked.

Speaker #9: But outside of that, we're just forbidden from saying anything on that. So I'll turn it over to Mark to talk about the Xinra left questions that you asked.

Speaker #4: Yeah, that's it from me. Oh, maybe one more. Just—you talked about friction. So, can you just talk about how you meaningfully change the adoption curve across Xinra Leaf and Apondi?

Speaker #10: Yeah. It's a great question. I think kind of one and three are kind of part and parcel to the same. But in terms of our confidence, there are several factors that we're looking at.

Mark Hensley: Yeah, it's a great question. I think kind of one and three are kind of part and parcel to the same. In terms of our confidence, there are several factors that we're looking at. First, we talked about the weather and the elective procedures being pushed out of January. Obviously we believe those will be rescheduled throughout the year, and so certainly that'll be a nice tailwind for us. As it relates to both ZYNRELEF and APONVIE really, we're really focused on the expansion of the sales force in the kind of mid-year. We certainly think that will help our share of voice and really kind of build upon the foundation that we've already built.

Speaker #4: And on Xinra Leaf, it sounds like there's friction in the sort of the office to decide to use Xinra Leaf. How do you change that ahead of the pre-filled syringe and eliminate the friction you're seeing today, so that the pre-filled syringe can sort of maximize the value that it can bring?

Speaker #10: First, we talked about the weather and the elective procedures being pushed out of January. Obviously, we believe those will be rescheduled throughout the year, and so certainly that'll be a nice tailwind for us.

Speaker #10: As it relates to both Xinra left and Apondi, really, we're really focused on the expansion of the sales force in the kind of mid-year.

Speaker #4: Thank you.

Speaker #10: We certainly think that will help our share of voice and really kind of build upon the foundation that we've already built. And then Ignite 2.0, you see the slides and kind of what that delivered in the third and fourth quarter of last year.

Speaker #5: Hey, Brandon. Thank you for the questions. I'll start with the back-to-settlement, and then I'll turn it to Mark. Look, based on the terms of the settlement, we really can't go into the details of that other than to say that the dates and everything that have been published.

Mark Hensley: IGNITE 2.0, you know, you see the slides and kind of what that delivered in the 4, you know, Q3 and Q4 of last year. The expansion of that by 38%, in 2026, we believe will be a really nice tailwind for us as we go forward. On the friction piece, you know, for us, we don't really see accounts that don't want to use ZYNRELEF. Really, the hardest part for us is getting to a meaningful enough a number of them to have that kind of quarter-over-quarter growth that we would want to see with the product, right? A lot of that is the reason why we're expanding the team in the kind of, you know, mid-year.

Speaker #10: And so the expansion of that by 38% in 2026, we believe, will be a really nice tailwind for us as we go forward. And then on the friction piece, I think for us, we don't really see accounts that don't want to use Xinra left.

Speaker #5: But outside of that, we're just forbidden from saying anything on that. So I'll turn it over to Mark to talk about the Xinra left questions that you asked.

Speaker #6: Yeah. It's a great question. I think kind of one and three are kind of part and parcel of the same. But in terms of our confidence, there are several factors that we're looking at.

Mark Hensley: Yeah, it's a great question. I think kind of one and three are kind of part and parcel to the same. You know, in terms of our confidence, there are several factors that we're looking at. First, you know, we talked about the weather and the elective procedures being pushed out of January. You know, obviously we believe those will be rescheduled throughout the year, certainly that'll be a nice tailwind for us. You know, as it relates to both ZYNRELEF and APONVIE really, you know, we're really focused on the expansion of the sales force in the kind of mid-year. We certainly think that will help our share of voice, you know, really kind of build upon the foundation that we've already built.

Speaker #10: Really, the hardest part for us is getting to a meaningful enough number of them to have that kind of quarter-over-quarter growth that we would want to see with the product, right?

Speaker #6: First, we talked about the weather and the elective procedures being pushed out of January. Obviously, we believe those will be rescheduled throughout the year.

Speaker #10: And so a lot of that is the reason why we're expanding the team in the kind of mid-year and certainly that share of voice will continue to grow.

Speaker #6: And so certainly, that'll be a nice tailwind for us. As it relates to both Xinra Left and Apondi, really, we're really focused on the expansion of the sales force in the kind of mid-year.

Mark Hensley: Certainly that share of voice will continue to grow. Because we are continuing to see market share grow within our targeted accounts, certainly within the accounts where we are aligned, not only at Heron but within our IGNITE program. You know, we just want to continue to expand upon that across the country.

Speaker #10: And so because we're continuing to see market share grow within our targeted accounts, certainly within the accounts where we're aligned, not only at Heron, but within our Ignite program, and so we just want to continue to expand upon that across the country.

Speaker #6: We certainly think that will help our share of voice and really kind of build upon the foundation that we've already built. And then Ignite 2.0—you see the slides and kind of what that delivered in the third and fourth quarter of last year.

Mark Hensley: IGNITE 2.0, you know, you see the slides and kind of what that delivered in Q3 and Q4 of last year. The expansion of that by 38%, you know, in 2026 we believe will be a really nice tailwind for us as we go forward. You know, on the friction piece, you know, I think for us, we don't really see accounts that don't want to use ZYNRELEF. Really, the hardest part for us is getting to a meaningful enough number of them to have that kind of quarter-over-quarter growth that we would want to see with the product, right? A lot of that is the reason why we're expanding the team in the kind of, you know, mid-year.

Speaker #8: Great. Thank you very much.

Brandon Folkes: Great. Thank you very much.

Speaker #6: And so the expansion of that by 38% in 2026, we believe, will be a really nice tailwind for us as we go forward. And then on the friction piece, I think for us, we don't really see accounts that don't want to use Xinra left.

Speaker #7: And our next question. We'll be coming from the line of Serge Ballenger of Needham & Company, your line is open.

Operator: Our next question will be coming from the line of Serge Belanger of Needham & Company. Your line is open.

Speaker #11: Hi. Good morning. This is John on for Serge today. Thanks for taking our questions. First, if I could just follow up on Xinra Leaf again with regard to the 1Q winter storm headwinds.

[Analyst] (Needham & Company): Hi, good morning. This is John on for Serge today. Thanks for taking our questions. First, if I could just follow up on ZYNRELEF again with regard to the Q1 winter storm headwinds. Just curious if you could quantify the impact with regard to surgical volumes for the quarter there. Second, on the implementation of NOPAIN. Obviously, it's been online for over a year now. Curious, what impacts you're seeing on commercial coverage and how this has changed over time and what you might be expecting for 2026. Then if I could just squeeze one more in on the CrossLink partnership. It seems like you're, you know, adding on to the initial IGNITE program, targeting more accounts here in 2026.

Speaker #6: Really, the hardest part for us is getting to a meaningful enough number of them to have that kind of quarter-over-quarter growth that we would want to see with a product, right?

Speaker #11: Just curious if you could quantify the impact with regard to surgical volumes for the quarter there. And then second, on the implementation of no pain, obviously, it's been online for over a year now.

Speaker #6: And so a lot of that is the reason why we're expanding the team in the kind of mid-year. And certainly, that share of voice will continue to grow.

Ira Duarte: Certainly that share of voice will continue to grow. Because we're continuing to see market share grow within our targeted accounts, certainly within the accounts where we're aligned, not only at Heron but within our IGNITE program. We just wanna continue to expand upon that across the country.

Speaker #6: And so because we're continuing to see market share grow within our targeted accounts, certainly within the accounts where we're aligned, not only at Heron, but within our Ignite program, and so we just want to continue to expand upon that across the country.

Speaker #11: Curious what impacts you're seeing on commercial coverage and how this has changed over time and what you might be expecting for '26. And then if I could just squeeze one more in on the cross-link partnership.

Speaker #4: Great. Thank you very much.

Brandon Folkes: Great. Thank you very much.

Speaker #11: It seems like you're adding on to the initial Ignite program, targeting more accounts here in '26. Curious if this is just throwing more muscle at the program to increase the accounts you're getting into and what else we might expect from this.

Speaker #2: And our next question, we'll be coming from the line of Serge Ballenger of Needham and Company. Your line is open.

Operator: Our next question will be coming from the line of Serge Belanger of Needham & Company. Your line is open.

[Analyst] (Needham & Company): Curious if this is just, you know, throwing more muscle at the program to increase the accounts you are getting into and what else we might expect from this. Thank you.

Speaker #7: Hi, good morning. This is John. I'm in for Serge today. Thanks for taking our questions. First, if I could just follow up on Xinra Leaf again with regard to the Q1 winter storm headwinds.

[Analyst] (Needham & Company): Hi, good morning. This is John on for Serge today. Thanks for taking our questions. First, if I could just follow up on ZYNRELEF again with regard to the Q1 winter storm headwinds. Just curious if you could quantify the impact with regard to surgical volumes for the quarter there. Second, on the implementation of NOPAIN Act. Obviously, it's been online for over a year now. Curious, what impacts you're seeing on commercial coverage, how this has changed over time, and what you might be expecting for 2026. If I could just squeeze one more in on the CrossLink Life Sciences partnership. It seems like you're, you know, adding on to the initial IGNITE program, targeting more accounts here in 2026.

Speaker #11: Thank you.

Speaker #9: Great. Thank you for the questions. On surgical volume, our data shows it's kind of high single-digit. Decline from the fourth quarter. So pretty meaningful impact, larger than we've seen in prior years.

Mark Hensley: Great. Thank you for the questions. You know, on surgical volume, you know, our data shows it's kind of high single-digit decline from Q4. Pretty meaningful impact, you know, larger than we've seen in prior years. You know, we think that's part weather-related, part, you know, a record Q4 from a surgical volume perspective and maybe, you know, some of our surgical partners just taking a deep breath in the quarter. Certainly, we expect that to significantly improve. Obviously, some of those surgeries that were lost, we would imagine that those would be rescheduled.

Speaker #7: Just curious if you could quantify the impact with regard to surgical volumes for the quarter there. And then second, on the implementation of no pain, obviously, it's been online for over a year now.

Speaker #9: We think that's part weather-related, part our record Q4 from a surgical volume perspective, and maybe some of our surgical partners just taking a deep breath in the quarter.

Speaker #7: Curious what impacts you're seeing on commercial coverage and how this has changed over time, and what you might be expecting for '26. And then if I could just squeeze one more in on the cross-link partnership.

Speaker #9: But certainly, we expect that to significantly improve and obviously some of those surgeries that were lost, we would imagine that those would be rescheduled.

Speaker #7: It seems like you're adding on to the initial Ignite program, targeting more accounts here in '26. Curious if this is just throwing more muscle at the program to increase the accounts you're getting into and what else we might expect from this.

Mark Hensley: You know, to your second question on commercial coverage, we obviously, NOPAIN Act, you know, is a great factor for ZYNRELEF, and certainly removes, you know, the word I've been using is friction, at least on the Medicare side, on the government payer side. Since its implementation, we've seen more and more commercial payers begin to add ZYNRELEF, you know, outside of the surgical bundles, reimbursing outside of that bundle. You know, we reported the number on the call at 110 million lives is the estimate that we have on the commercial side. You know, largely across the United States, very well covered for ZYNRELEF.

Speaker #9: To your second question on commercial coverage, we obviously no pain is a great factor for Xinra left. And certainly, it removes the word I've been using as friction, at least on the Medicare side, on the government-payer side.

[Analyst] (Needham & Company): Curious if this is just, you know, throwing more muscle at the program to increase the accounts you're getting into and what else we might expect from this. Thank you.

Speaker #7: Thank you.

Speaker #9: And since it's implementation, we've seen more and more commercial payers begin to add Xinra left outside of the surgical bundles to reimbursing outside of that bundle.

Speaker #5: Great, thank you for the questions. On surgical volume, our data shows it's a kind of high single-digit decline from the fourth quarter, so pretty meaningful impact.

Mark Hensley: Great. Thank you for the questions. You know, on surgical volume, you know, our data shows it's kind of high single-digit decline from Q4. Pretty meaningful impact, you know, larger than we've seen in prior years. You know, we think that's part weather related, part, you know, a record Q4 from a surgical volume perspective and maybe, you know, some of our surgical partners just taking a deep breath in the quarter. Certainly we expect that to significantly improve and obviously some of those surgeries that were lost, we would imagine that those would be rescheduled. You know, to your second question on commercial coverage.

Speaker #9: We reported the number on the call at 110 million lives as the estimate that we have on the commercial side. And so kind of largely across the United States, very well covered for Xinra left.

Speaker #5: Larger than we've seen in prior years. We think that's part weather-related, part our record Q4 from a surgical volume perspective, and maybe some of our surgical partners just taking a deep breath in the quarter.

Speaker #9: There are pockets where we see Xinra left still bundled, but certainly, we have the ability to go in and have those conversations at the payer level.

Mark Hensley: There are pockets, you know, where we see ZYNRELEF still bundled, but certainly, we have the ability to go in and have those conversations at the payer level. For the most part, you know, they're willing to listen and make some changes for our patients. You know, as it relates to CrossLink, you know, we allow them to select the accounts, you know. By doing so, the natural selection, you know, gave us an expansion in that program, you know, again, at 38%. You know, the alignment between Heron and CrossLink now is almost 90%, you know, in terms of our focus. That's the highest it's ever been, significantly higher than the back half of 2025.

Speaker #5: But certainly, we expect that to significantly improve and obviously, some of those surgeries that were lost, we would imagine that those would be rescheduled.

Speaker #9: And for the most part, they're willing to listen and make some changes for our patients. And then as it relates to cross-link we allow them to select the accounts and so by doing so, the natural selection gave us an expansion in that program.

Speaker #5: To your second question on commercial coverage, we obviously know pain is a great factor for Xinra left. And certainly, it removes the word I've been using is friction, at least on the Medicare side, on the government-payer side.

Mark Hensley: We, you know, obviously no pain, you know, is a great factor for ZYNRELEF, and certainly removes, you know, the word I've been using is friction, at least on the Medicare side, on the government payer side. Since its implementation, we've seen more and more commercial payers begin to add ZYNRELEF, you know, outside of the surgical bundles, reimbursing outside of that bundle. You know, we reported the number on the call at 110 million lives is the estimate that we have on the commercial side. You know, and so, you know, kind of largely across the United States, very well covered for ZYNRELEF.

Speaker #9: Again, at 38%. And so the alignment between Heron and cross-link now is almost 90% in terms of our focus. That's the highest it's ever been significantly higher than the back half of 2025.

Speaker #5: And since its implementation, we've seen more and more commercial payers begin to add Xinra left outside of the surgical bundles to reimbursing outside of that bundle.

Speaker #5: We reported the number on the call at 110 million lives as the estimate that we have on the commercial side. And so kind of largely across the United States, very well covered for Xinra left.

Speaker #9: And so what that really means is that we have a Heron employee in the account. We have a cross-link employee in that account. We have really good payer coverage in those accounts.

Mark Hensley: What that really means is that we have a Heron employee in the account. We have a CrossLink employee in that account. We have really good, you know, payer coverage in those accounts. That's why they were selected. Those three, you know, pieces of the puzzle have shown us that that's where we really, you know, have good success and are able to move ZYNRELEF forward. That gives us a lot of confidence for 2026.

Speaker #9: That's why they were selected. And so those three pieces of the puzzle have shown us that that's where we really have good success and are able to move Xinra left forward.

Speaker #5: There are pockets where we see Xinra left still bundled, but certainly we have the ability to go in and have those conversations at the payer level.

Mark Hensley: There are pockets, you know, where we see ZYNRELEF still bundled, but certainly we have the ability to go in and have those conversations at the payer level. For the most part, you know, they're, they're willing to listen and make some changes for our patients. You know, as it relates to CrossLink Life Sciences, you know, we allow them to select the accounts, you know, by doing so, the natural selection, you know, gave us an expansion in that program, you know, again at 38%. You know, the alignment between Heron and CrossLink Life Sciences now is almost 90%, you know, in terms of our focus. That's the highest it's ever been, significantly higher than the back half of 2025.

Speaker #5: And for the most part, they're willing to listen and make some changes for our patients. And then as it relates to cross-link we allow them to select the accounts and so by doing so, the natural selection gave us an expansion in that program.

Speaker #9: And so that gives us a lot of confidence for 2026.

Speaker #11: Great. Thanks so much for the color.

[Analyst] (Needham & Company): Great. Thanks so much for the color.

Mark Hensley: Yep.

Speaker #7: And as a reminder, to ask a question, please press star 11 on your telephone and wait for your name to be announced. To withdraw your question, please press star 11 again.

Operator: As a reminder, to ask a question, please press star one one on your telephone and wait for your name to be announced. To withdraw your question, please press star one one again. I would now like to turn the conference back to Craig Collard for closing remarks.

Speaker #5: Again, at 38%. And so the alignment between Heron and cross-link now is almost 90% in terms of our focus. That's the highest it's ever been, significantly higher than the back half of 2025.

Speaker #7: I would now like to turn the conference back to Craig Collard for closing remarks.

Speaker #9: Thank you, Operator. We just want to thank everyone for joining the call today, and we look forward to speaking to you all next quarter.

Craig Collard: Thank you, Operator. We just wanna thank everyone for joining the call today, and we look forward to speaking to you all next quarter.

Speaker #5: And so what that really means is that we have a Heron employee in the account. We have a cross-link employee in that account. We have really good payer coverage in those accounts.

Mark Hensley: What that really means is that we have a Heron employee in the account. We have a Crosslink employee in that account. We have really good, you know, payer coverage in those accounts. That's why they were selected. Those three, you know, pieces of the puzzle have shown us that that's where we really, you know, have good success and are able to move ZYNRELEF forward. That gives us a lot of confidence for 2026.

Operator: This concludes today's program. Thank you for participating. You may now disconnect.

Speaker #5: That's why they were selected. And so those three pieces of the puzzle have shown us that that's where we really have good success and are able to move Xinra left forward.

Speaker #5: And so, that gives us a lot of confidence for 2026.

Speaker #7: Great. Thanks so much for the color.

[Analyst] (Needham & Company): Great. Thanks so much for the color.

Mark Hensley: Yep.

Speaker #2: And as a reminder, to ask a question, please press star 11 on your telephone and wait for your name to be announced. To withdraw your question, please press star 11 again.

Speaker #2: I would now like to turn the conference back to Craig Collard for closing remarks.

Speaker #5: Thank you, operator. We just want to thank everyone for joining the call today. And we look forward to speaking to you all next quarter.

Mark Hensley: Thank you, operator. We just wanna thank everyone for joining the call today, and we look forward to speaking to you all next quarter.

Operator: Good day. Thank you for standing by. Welcome to the Heron Therapeutics Q1 2026 Conference Call. At this time, all participants are in a listen-only mode. After the speaker's presentation, there will be a question and answer session. To ask a question during the session, you will need to press star 11 on your telephone. You will then hear an automated message advising that your hand is raised. To withdraw your question, please press star 11 again. Please be advised that today's conference is being recorded. I would now like to hand the conference over to your first speaker today, Melissa Jarel, Vice President of Legal. You may begin.

Speaker #2: disconnect. Good day and thank you for standing by. Welcome to the HERON Therapeutics Q1 2026 conference call. At this time, all participants are in a listen-only mode.

Mark Hensley: Certainly that share of voice will continue to grow. Because we're continuing to see market share grow within our targeted accounts, certainly within the accounts where we're aligned, not only at Heron but within our IGNITE program. We just wanna continue to expand upon that across the country.

Mark Hensley: On the next slide, the chart shows the broader NK1 category for chemotherapy-induced nausea and vomiting over the last 12 months. The stacked bars show total category units broken out by competitor product. The percentages at the top of each bar show month-over-month volatility in the overall category, ranging from down 19% in some months to up 21% in others. The line running across the chart is CINVANTI's market share within that category. Despite all the category-level volatility, CINVANTI's share has been remarkably stable. The 12-month average is 25%. March 2026 closed at 25%. That share stability in a category where the underlying volume is highly variable month to month is the durability marker for this franchise.

Mark Hensley: With that, I'll now turn it over to Ira.

Brandon Folkes: Great. Thank you very much.

Operator: Our next question will be coming from the line of Serge Belanger of Needham & Company. Your line is open.

John Gionco: Hi, good morning. This is John on for Serge today. Thanks for taking our questions. First, if I could just follow up on ZYNRELEF again with regard to the Q1 winter storm headwinds. Just curious if you could quantify the impact with regard to surgical volumes for the quarter there. Second, on the implementation of NOPAIN Act. Obviously, it's been online for over a year now. Curious, what impacts you're seeing on commercial coverage, how this has changed over time, and what you might be expecting for 2026. If I could just squeeze one more in on the CrossLink Life Sciences partnership. It seems like you're, you know, adding on to the initial IGNITE program, targeting more accounts here in 2026.

John Gionco: Curious if this is just, you know, throwing more muscle at the program to increase the accounts you're getting into and what else we might expect from this. Thank you.

Mark Hensley: Great. Thank you for the questions. You know, on surgical volume, you know, our data shows it's kind of high single-digit decline from Q4. Pretty meaningful impact, you know, larger than we've seen in prior years. You know, we think that's part weather related, part, you know, a record Q4 from a surgical volume perspective and maybe, you know, some of our surgical partners just taking a deep breath in the quarter. Certainly we expect that to significantly improve and obviously some of those surgeries that were lost, we would imagine that those would be rescheduled. You know, to your second question on commercial coverage.

John Gionco: Great. Thanks so much for the color.

Mark Hensley: Yep.

Craig Collard: Thank you, operator. We just wanna thank everyone for joining the call today, and we look forward to speaking to you all next quarter.

Kevin Warner: When viewed in that context, preventing complications with an intervention costing approximately $60 per dose becomes highly rational and understandable for providers and institutions alike, particularly as value-based care models increasingly focus on patient satisfaction, throughput, readmission, recovery quality, and total episode of care costs. Ultimately, we believe the fifth consensus guidelines reinforce several important macro trends shaping the perioperative landscape, including greater use of multimodal prophylaxis, increasing recognition of post-discharge nausea and vomiting, continued migration toward outpatient surgery, demand for workflow efficiency, and the growing need for safe, effective, non-sedating, long-acting therapies that support enhanced recovery pathways, which we believe APONVIE is uniquely positioned to address. I will now turn the call back to Mark to discuss our oncology supportive care franchise.

Operator: Good day. Thank you for standing by. Welcome to the Heron Therapeutics Q1 2026 conference call. At this time, all participants are are in a listen-only mode. After the speaker's presentation, there will a be a question and answer session. To ask a question a question during the session, you will need to press star one one on your telephone. You will then hear an automated message advising that your hand is raised. To withdraw your question, press star one one again. Please be advised that today's conference is being recorded. I would now like to hand the conference over to your first speaker today, Melissa Jarel, Vice President of Legal. You may begin.

Melissa Jarel: With that, I would now like to turn the call over to Craig Collard, Chief Executive Officer of Heron.

Craig Collard: Importantly, this was not an isolated experience. Multiple publicly traded pharmaceutical and surgical companies have reported the same weather-driven disruption across January and February. The breadth of this industry-wide impact validates that the headwinds we faced were external and temporary in nature, not reflective of any underlying weakness in our business or markets. Despite this, the team responded well. February brought a clear upward trend, and March closed strongly with over $15 million in net sales, demonstrating the underlying strength and resilience of the business. While the weather undoubtedly weighed on our Q1 results, it has not shaken our confidence in the year ahead. We fully expect the remaining deferred elective procedures to be rescheduled throughout the remainder of 2026, creating a meaningful tailwind as we progress through the year.

Mark Hensley: The more important point, our underlying pricing strategy on CINVANTI is intact and disciplined. SUSTOL, declining in line with planned wind down. The headline message of this slide is straightforward. Across our active commercial products, we are maintaining pricing discipline, not chasing volume through price concessions. That's a deliberate strategic choice. It protects the long-term economics of the franchise and supports the durable recurring demand we're building. Now on to ZYNRELEF. You can see the two charts on the slide. Average daily units on the left, ordering accounts on the right. Both have continued to trend up through Q1. The number I'd anchor on is demand unit growth of 22% year over year. The broader local anesthetic market was down sequentially in Q1. In that environment, ZYNRELEF outgrew the market on a year over year basis and held share sequentially. The underlying franchise is performing.

Mark Hensley: On reimbursement, the permanent J-code, J0668, has been live since October. Combined with the NOPAIN Act framework that took effect at the start of 2025, the reimbursement environment for ZYNRELEF is the cleanest it's been since launch. That framework streamlines reimbursement across approximately 110 million covered lives on the commercial side. 2 quarters in, reimbursement conversations are smoother, and the friction at the billing office level continues to come down. Looking at the Q2 through Q4 drivers on the right side of the slide, IGNITE has been extended throughout 2026 and expanded with IGNITE 2.0, which I'll cover on the next 2 slides. We're also seeing expansion of users within accounts, meaning more surgeons within each adopting institution moving onto ZYNRELEF as part of their protocol.

Bill Forbes: Thank you, Mark. This slide highlights the strong momentum in our acute care franchise and the continued advancement of the ZYNRELEF prefilled syringe program. We have seen consistent and accelerating adoption across our device preparation platforms as we transition from the vented vial spike, or VVS, to the significantly improved Vial Access Needle, or VAN. This evolution has been well received and reflects clear progress in ease of use and workflow efficiency. At the same time, market demand continues to shift toward ready-to-use systems, which are emerging as an important growth driver as hospitals prioritize efficiency, safety, and streamlined operating room workflows. Independent third-party forecasts reinforce the durability of this trend, with prefilled syringe adoption expected to scale meaningfully over time. From a program standpoint, the ZYNRELEF PFS is fully funded and on track.

Mark Hensley: Having a permanent dedicated billing code in place removes a layer of reimbursement complexity for the product. We'll be expanding our dedicated aprepitant sales force in Q3 2026. That team currently covers both APONVIE and CINVANTI. The expansion adds capacity to support both products. Lastly, APONVIE has been prominently included in the 5th consensus guidelines for the management of postoperative nausea and vomiting. That's a meaningful clinical catalyst. I'll hand it over to Kevin to walk through the guidelines and what they mean for the product.

Kevin Warner: The guidelines specifically recommend that patients with greater than 2 risk factors, representing roughly half of the surgical population, receive 3 to 4 prophylactic interventions. These medium and high-risk patients often require highly effective antiemetic strategies without adding recovery-limiting adverse effects. We believe APONVIE is uniquely positioned in this setting. Its efficacy profile, combined with the differentiated safety profile that does not overlap with many commonly used antiemetics, supports use in patients where prevention matters most. Importantly, APONVIE provides antiemetic protection without contributing to sedation or negatively impacting postoperative recovery pathways, which is increasingly important in enhanced recovery protocols and ambulatory surgery. One of the most significant additions to the fifth edition guidelines was the expanded focus on post-discharge nausea and vomiting, or PDNV. The guidelines emphasize that PONV is not simply an acute PACU complication. For many patients, symptoms occur after discharge when clinical support resources are less available.

Kevin Warner: This becomes particularly relevant for providers who may not have had adequate preoperative time for oral administration, or who are caring for patients with limitations to oral therapies, including those with gastroparesis, GLP-1 utilization, diabetes-related GI dysfunction, or altered gastric emptying. The strength of evidence supporting aprepitant-based therapy was also highlighted throughout the guidelines. Multiple randomized trials demonstrated aprepitant to be comparable or superior to ondansetron for prevention of PONV. Meta-analysis showed significant reductions in PONV risk when used alone or within multimodal regimens. In a large Cochrane systematic review evaluating nearly 100,000 patients ranked aprepitant as the single most effective antiemetic. Importantly, the updated guidelines frame PONV prevention not simply as a patient comfort initiative, but as a meaningful clinical quality and operational issue. Poorly controlled PONV contributes to extended PACU states, rescue medication use, delayed discharge, dehydration, wound stress, aspiration concerns, and readmissions.

Speaker #2: After the speaker's presentation, there will be a question-and-answer session. To ask a question during the session, you will need to press star 11 on your telephone.

Speaker #2: You will then hear an automated message advising that your hand is raised. To withdraw your question, please press star one one again. Please be advised that today's conference is being recorded.

Speaker #2: I would now like to hand the conference over to your first speaker today, Melissa Jarel, Vice President of Legal. You may begin.

Speaker #1: Thank you, operator. And hello, everyone. Thank you for joining us on the Heron Therapeutics conference call today to discuss the company's financial results for the first quarter 2026.

Melissa Jarel: Thank you, operator, and hello, everyone. Thank you for joining us on the Heron Therapeutics conference call today to discuss the company's financial results for Q1 2026. With me today from Heron are Craig Collard, Chief Executive Officer; Ira Duarte, Executive Vice President, Chief Financial Officer; Bill Forbes, Executive Vice President, Chief Development Officer; Mark Hensley, Chief Operating Officer; and Kevin Warner, Senior Vice President, Medical Affairs, Strategy, and Engagement. For those of you participating via conference call, slides are made available via webcast and can also be accessed via the investor relations page of our website following the conclusion of today's call. Before we begin, let me quickly remind you that during the course of this conference call, the company will make forward-looking statements. We caution you that any statement that is not a statement of historical fact is a forward-looking statement.

Speaker #1: With me today from HERON are Craig Collard, chief executive officer; Ira Duarte, executive vice president, chief financial officer; Bill Forbes, executive vice president, chief development officer; Mark Hensley, chief operating officer; and Kevin Warner, senior vice president, medical affairs, strategy, and engagement.

Speaker #1: For those of you participating via conference call, slides are available via webcast and can also be accessed via the Investor Relations page of our website following the conclusion of today's call.

Speaker #1: Before we begin, let me quickly remind you that during the course of this conference call, the company will make forward-looking statements. We caution you that any statement that is not a statement of historical fact is a forward-looking statement.

Melissa Jarel: This includes remarks about the company's projections, expectations, plans, beliefs, and future performance, all of which constitute forward-looking statements for the purposes of the Safe Harbor provision under the Private Securities Litigation Reform Act of 1995. These statements are based on judgment and analysis as of the date of this conference call and are subject to numerous important risks and uncertainties that could cause actual results to differ materially from those described in the forward-looking statements. The risks and uncertainties associated with the forward-looking statements made in this conference call and webcast are described in the Safe Harbor statement in today's press release and in Heron's public periodic filings with the SEC. Except as required by law, Heron assumes no obligation to update these forward-looking statements to reflect future events or actual outcomes and does not intend to do so.

Speaker #1: This includes remarks about the company's projections, expectations, plans, beliefs, and future performance, all of which constitute forward-looking statements for the purposes of the Safe Harbor provision under the Private Securities Litigation Reform Act of 1995.

Speaker #1: These statements are based on judgment and analysis as of the date of this conference call and are subject to numerous important risks and uncertainties that could cause actual results to differ materially from those described in the forward-looking statements.

Speaker #1: The risk and uncertainties associated with the forward-looking statements made in this conference call and webcast are described in the Safe Harbor statement in today's press release and in Heron's public periodic filings with the SEC.

Speaker #1: Except as required by law, HERON assumes no obligation to update these forward-looking statements to reflect future events or actual outcomes and does not intend to do so.

Speaker #1: And with that, I would now like to turn the call over to Craig Collard, Chief Executive Officer of Heron.

Melissa Jarel: With that, I would now like to turn the call over to Craig Collard, Chief Executive Officer of Heron.

Speaker #2: Thanks, Melissa. Hello, everyone, and welcome to HERON Therapeutics' first quarter 2026 earnings call. Today, we're thrilled to share our financial results and provide commercial updates on our business.

Craig Collard: Thanks, Melissa. Hello, everyone, welcome to Heron Therapeutics' Q1 2026 Earnings Call. Today, we're thrilled to share our financial results and provide commercial updates on our business. I'd like to begin by highlighting several key accomplishments. Coming off a strong Q4 2025, we entered the new year with tremendous momentum. As expected, Q1 of any year historically brings seasonal headwinds driven by co-pay resets and insurance adjustments, this year was no exception. However, 2026 presented additional challenge for us. 2 weeks of severe weather early in the quarter that significantly compounded the typical seasonal softness, making January our most difficult month since I joined the company. The impact of the weather was felt most acutely in elective surgeries, which are highly sensitive to extreme conditions and saw a sharp decline during that period.

Speaker #2: I'd like to begin by highlighting several key accomplishments. Coming off a strong fourth quarter 2025, we entered the new year with tremendous momentum. As expected, the first quarter of any year historically brings seasonal headwinds driven by copay resets and insurance adjustments, and this year was no exception.

Speaker #2: However, 2026 presented additional challenges for us. Two weeks of severe weather early in the quarter that significantly compounded the typical seasonal softness, making January our most difficult month since I joined the company.

Speaker #2: The impact of the weather was felt most acutely in elective surgeries, which are highly sensitive to extreme conditions and saw a sharp decline during that period.

Craig Collard: Importantly, this was not an isolated experience. Multiple publicly traded pharmaceutical and surgical companies have reported the same weather-driven disruption across January and February. The breadth of this industry-wide impact validates that the headwinds we faced were external and temporary in nature, not reflective of any underlying weakness in our business or markets. Despite this, the team responded well. February brought a clear upward trend, and March closed strongly with over $15 million in net sales, demonstrating the underlying strength and resilience of the business. While the weather undoubtedly weighed on our Q1 results, it has not shaken our confidence in the year ahead. We fully expect the remaining deferred elective procedures to be rescheduled throughout the remainder of 2026, creating a meaningful tailwind as we progress through the year.

Speaker #2: Importantly, this was not an isolated experience. Multiple publicly traded pharmaceutical and surgical companies have reported the same weather-driven disruption across January and February. The breadth of this industry-wide impact validates that the headwinds we faced were external and temporary in nature, not reflective of any underlying weakness in our business or markets.

Speaker #2: Despite this, the team responded well. February brought a clear upward trend, and March closed strongly with over $15 million in net sales, demonstrating the underlying strength and resilience of the business.

Speaker #2: While the weather undoubtedly weighed on our Q1 results, it has not shaken our confidence in the year ahead. We fully expect the remaining deferred elective procedures to be rescheduled throughout the remainder of 2026, creating a meaningful tailwind as we progress through the year.

Speaker #2: This aligns with our historical pattern where Q3 and Q4 consistently represent our highest volume quarters and we anticipate 2026 will be no different. Turning to our acute care portfolio, we delivered revenue growth of 32% compared to the same period last year, with Zenerleft growing 27% and Apondi growing over 50%, respectively.

Craig Collard: This aligns with our historical pattern where Q3 and Q4 consistently represent our highest volume quarters, and we anticipate 2026 will be no different. Turning to our acute care portfolio, we delivered revenue growth of 32% compared to the same period last year, with ZYNRELEF growing 27% and APONVIE growing over 50% respectively. Two structural drivers are worth highlighting. Our IGNITE program, the incentive program with our orthopedic distribution partners, has been very successful, and we're continuing it into 2026 as a key growth driver for ZYNRELEF. With APONVIE, we are beginning to realize the commercial benefits of its inclusion in the 5th consensus guidelines for the management of postoperative nausea and vomiting, a meaningful clinical endorsement that we believe will serve as a sustained tailwind for adoption.

Speaker #2: Two structural drivers are worth highlighting: our Ignite program, the incentive program with our orthopedic distribution partners, has been very successful, and we're continuing it into 2026 as a key growth driver for Zenerleft.

Speaker #2: With Apondi, we are beginning to realize the commercial benefits of its inclusion in the Fifth Consensus Guidelines for the management of postoperative nausea and vomiting.

Speaker #2: A meaningful clinical endorsement that we believe will serve as a sustained tailwind for adoption. We will provide additional detail later in the presentation on the strategic and commercial implications of that inclusion.

Craig Collard: We will provide additional detail later in the presentation on the strategic and commercial implications of that inclusion. Turning to our Salesforce expansion, implementation is on track for Q3 with the recruitment already underway. We view this as a significant catalyst for growth across our portfolio. We will walk through the strategy in more detail in the presentation. Moving on to oncology, we continue to deliver solid performance with CINVANTI despite increased competitive pressure. For the quarter, CINVANTI maintained exit market share of 25% in the NK1 category. Although net sales reflected normal quarter-to-quarter timing, CINVANTI itself has remained resilient, demonstrating strong customer loyalty and continued demand even in this very competitive landscape. We have a number of new accounts coming on board in Q2 that we anticipate could add upwards of $10 million in net revenue on an annualized basis.

Speaker #2: Turning to our Salesforce expansion, implementation is on track for the third quarter, with recruitment already underway. We view this as a significant catalyst for growth across our portfolio, and we will walk through the strategy in more detail in the presentation.

Speaker #2: Moving on to oncology, we continue to deliver solid performance with Sinvonti despite increased competitive pressure. For the quarter, Sinvonti maintained exit market share of 25% in the NK1 category, and although net sales reflected normal quarter-to-quarter timing, Sinvonti itself has remained resilient, demonstrating strong customer loyalty and continued demand even in this very competitive landscape.

Speaker #2: We have a number of new accounts coming on board in Q2 that we anticipate could add upwards of $10 million in net revenue on an annualized basis.

Speaker #2: We will cover this in greater detail as part of the commercial performance update. Before I turn things over to Mark to cover our commercial performance, I want to take a moment again to recognize the entire Heron team for their performance this quarter.

Craig Collard: We will cover this in greater detail as part of the commercial performance update. Before I turn things over to Mark to cover our commercial performance, I want to take a moment again to recognize the entire Heron team for their performance this quarter. We fight every day in a very competitive environment. This quarter offered other challenges that we had no control over, yet our team continues to persevere and move forward. I will now turn the call over to Mark to cover our commercial performance. Go ahead, Mark.

Speaker #2: We fight every day in a very competitive environment, and this quarter offered other challenges that we had no control over, yet our team continues to persevere and move forward.

Speaker #2: I will now turn the call over to Mark to cover our commercial performance. Go ahead, Mark.

Speaker #3: Thanks, Craig. Moving to product performance, starting with our overall net sales picture, the chart shows quarterly net revenue for each product across the last four quarters.

Mark Hensley: Thanks, Craig. Moving to product performance, starting with our overall net sales picture for the quarter. This chart shows quarterly net revenue for each product across the last four quarters. Total net sales of $34.7 million in Q1. On the acute care side, $13.6 million combined. ZYNRELEF at $10.2 million. APONVIE at $3.4 million. On the oncology side, $21.1 million combined. CINVANTI at $20.5 million. SUSTOL at $0.6 million, reflecting the planned wind down we've previously discussed. You can see the sequential dynamics on each product. A few of these reflect ordering and channel patterns rather than changes in underlying demand.

Speaker #3: Total net sales of $34.7 million in Q1. On the acute care side, $13.6 million combined—Zynrelef at $10.2 million, Aponvi at $3.4 million. On the oncology side, $21.1 million combined—Cinvanti at $20.5 million, Sustol at $0.6 million, reflecting the planned wind-down we've previously discussed.

Speaker #3: You can see the sequential dynamics on each product. A few of these reflect ordering and channel patterns rather than changes in underlying demand. The cleaner read on adoption across all four products is the demand unit and ordering account data, which I'll cover in detail as we go.

Mark Hensley: The cleaner read on adoption across all 4 products is the demand unit and ordering account data, which I'll cover in detail as we go. Before we get into individual product performance, there's an important strategic point on the next slide. This slide shows our net selling price per unit across the 4 products over the last 4 quarters. The Y-axis values aren't displayed. What matters is the directional trend within each product. Starting with ZYNRELEF, net selling price has been steadily increasing across the period. Our pricing posture is holding, and the J-code and NOPAIN environment are supporting that trajectory. For APONVIE, net price has been stable. That's what we'd expect for a product still in its growth phase, where our focus is volume penetration rather than per unit price extraction.

Speaker #3: But before we get into individual product performance, there's an important strategic point on the next slide. This slide shows our net selling price per unit across the four products over the last four quarters.

Speaker #3: The Y-axis values aren't displayed; what matters is the directional trend within each product. Starting with Zynrelef, net selling price has been steadily increasing across the period.

Speaker #3: Our pricing posture is holding, and the J code and no-pain environment are supporting that trajectory. For Apondi, net price has been stable. That's what we'd expect for a product still in its growth phase, where our focus is volume penetration rather than per-unit price extraction.

Speaker #3: On Sinvonti, you'll notice the Q4 bar is slightly lower than the surrounding quarters, with Q1 returning to a level consistent with our strategy. That Q4 dynamic was temporary, and Q1 reflected normal channel ordering patterns following the Q4 activity.

Mark Hensley: On CINVANTI, you'll notice the Q4 bar is slightly lower than the surrounding quarters, with Q1 returning to a level consistent with our strategy. That Q4 dynamic was temporary, Q1 reflected normal channel ordering patterns following the Q4 activity. The more important point, our underlying pricing strategy on CINVANTI is intact and disciplined. SUSTOL, declining in line with planned wind down. The headline message of this slide is straightforward. Across our active commercial products, we are maintaining pricing discipline, not chasing volume through price concessions. That's a deliberate strategic choice. It protects the long-term economics of the franchise and supports the durable recurring demand we're building. Now on to ZYNRELEF. You can see the two charts on the slide. Average daily units on the left, ordering accounts on the right. Both have continued to trend up through Q1.

Speaker #3: The more important point, our underlying pricing strategy on Sinvonti is intact and disciplined. And Sustol, declining in line with planned wind down. The headline message of this slide is straightforward: across our active commercial products, we are maintaining pricing discipline not chasing volume through price concessions.

Speaker #3: That's a deliberate strategic choice. It protects the long-term economics of the franchise and supports the durable recurring demand we're building. Now on to Zenerleft.

Speaker #3: You can see the two charts on the slide. Average daily units on the left, ordering accounts on the right. Both have continued to trend up through Q1.

Speaker #3: The number I’d anchor on is demand unit growth of 22% year over year. The broader local anesthetic market was down sequentially in Q1, and in that environment, Zynrelef outgrew the market on a year-over-year basis and held share sequentially.

Mark Hensley: The number I'd anchor on is demand unit growth of 22% year-over-year. The broader local anesthetic market was down sequentially in Q1. In that environment, ZYNRELEF outgrew the market on a year-over-year basis and held share sequentially. The underlying franchise is performing. On reimbursement, the permanent J-code, J0668, has been live since October. Combined with the NOPAIN Act framework that took effect at the start of 2025, the reimbursement environment for ZYNRELEF is the cleanest it's been since launch. That framework streamlines reimbursement across approximately 110 million covered lives on the commercial side. Two quarters in, reimbursement conversations are smoother, and the friction at the billing office level continues to come down.

Speaker #3: The underlying franchise's performance. On reimbursement, the permanent J code, J0668, has been live since October. Combined with the no-pain act framework that took effect at the start of 2025, the reimbursement environment for Zenerleft is the cleanest it's been since launch.

Speaker #3: That framework streamlines reimbursement across approximately 110 million covered lives on the commercial side. Two quarters in, reimbursement conversations are smoother, and the friction at the billing office level continues to come down.

Speaker #3: Looking at the Q2 through Q4 drivers on the right side of the slide, Ignite has been extended throughout 2026 and expanded with Ignite 2.0, which I'll cover on the next two slides.

Mark Hensley: Looking at the Q2 through Q4 drivers on the right side of the slide, IGNITE has been extended throughout 2026 and expanded with IGNITE 2.0, which I'll cover on the next two slides. We're also seeing expansion of users within accounts, meaning more surgeons within each adopting institution moving on to ZYNRELEF as part of their protocol. We'll be expanding our ZYNRELEF sales team in Q3 2026, targeted geographies where all three foundational drivers are fully in place. Formulary access, the IGNITE program, and payer coverage. That expansion sits alongside the aprepitant team expansion I'll cover on the APONVIE slide, reflecting our confidence in the trajectory of both franchises. On the longer-term side, our prefilled syringe presentation is in late stage development, though we'll cover that in more detail later in the presentation. Moving on to slide 10.

Speaker #3: We're also seeing expansion of users within accounts, meaning more surgeons within each adopting institution moving on to Zenerleft as part of their protocol. And we'll be expanding our Zenerleft sales team in Q3 2026, targeted at geographies where all three foundational drivers are fully in place.

Speaker #3: Formulary access, the Ignite program, and payer coverage. That expansion sits alongside the apprependent team expansion I'll cover on the Apondi slide, reflecting our confidence in the trajectory of both franchises.

Speaker #3: On the longer-term side, our pre-filled syringe presentation is in late-stage development. Though we'll cover that in more detail later in the presentation. Moving on to slide 10.

Speaker #3: Here's the data behind Ignite 1.0. The chart shows Zenerleft unit volume across our Ignite targeted accounts. Pre-Ignite versus post-Ignite. We went from approximately 9,000 units in the last pre-Ignite quarter of last year to over 19,000 units by Q4 of last year.

Mark Hensley: Here's the data behind IGNITE 1.0. The chart shows ZYNRELEF unit volume across our IGNITE targeted accounts. Pre-IGNITE versus post-IGNITE. We went from approximately 9,000 units in the last pre-IGNITE quarter of last year to over 19,000 units by Q4 of last year. That's 111% growth within these targeted accounts in just two quarters of the program. This is the data that gave us the conviction to extend IGNITE through 2026 and expand it further. On slide 11, you can see what IGNITE 2.0 looks like. IGNITE 1.0 in H2 2025 covered 2,261 accounts. IGNITE 2.0, which is now live for full year 2026, covers 3,109 accounts.

Speaker #3: That's 111% growth within these targeted accounts in just two quarters of the program. This is the data that gave us the conviction to extend Ignite through 2026 and expand it further.

Speaker #3: On a slide 11, you can see what Ignite 2.0 looks like. Ignite 1.0 in the second half of 2025 covered 2,261 accounts. Ignite 2.0, which is now live for full year '26, covers 3,109 accounts.

Speaker #3: That's a 38% increase. Adding 848 additional accounts to the program. More accounts in the program means more concentrated distributor focus on the institutions we've identified as most likely to adopt and deepen Zenerleft use.

Mark Hensley: That's a 38% increase, adding 848 additional accounts to the program. More accounts in the program means more concentrated distributor focus on the institutions we've identified as most likely to adopt and deepen ZYNRELEF use. The structural drivers that produce 111% unit growth in IGNITE 1.0 are now applied to a meaningfully larger base of accounts in 2026. I will now turn it over to Bill to cover the prefilled syringe.

Speaker #3: The structural drivers that produce 111% unit growth in Ignite 1.0 are now applied to a meaningfully larger base of accounts in 2026. I will now turn it over to Bill to cover the pre-filled syringe.

Speaker #2: Thank you, Mark. This slide highlights the strong momentum in our acute care franchise and the continued advancement of the Zenerleft pre-filled syringe program. We have seen consistent and accelerating adoption across our device preparation platforms as we transition from the vented vial spike or VVS to the significantly improved vial access needle or VAN.

William Forbes: Thank you, Mark. This slide highlights the strong momentum in our acute care franchise and the continued advancement of the ZYNRELEF prefilled syringe program. We have seen consistent and accelerating adoption across our device preparation platforms as we transition from the vented vial spike, or VVS, to the significantly improved Vial Access Needle, or VAN. This evolution has been well-received and reflects clear progress in ease of use and workflow efficiency. At the same time, market demand continues to shift toward ready-to-use systems, which are emerging as an important growth driver as hospitals prioritize efficiency, safety, and streamlined operating room workflows. Independent third-party forecasts reinforce the durability of this trend, with prefilled syringe adoption expected to scale meaningfully over time. From a program standpoint, the ZYNRELEF PFS is fully funded and on track.

Speaker #2: This evolution has been well received and reflects clear progress, ease of use, and workflow efficiency. At the same time, market demand continues to shift toward ready-to-use systems, which are emerging as an important growth driver as hospitals prioritize efficiency, safety, and streamlined operating room workflows.

Speaker #2: Independent third-party forecasts reinforce the durability of this trend, with pre-filled syringe adoption expected to scale meaningfully over time. From a program standpoint, the Zenerleft PFS is fully funded and on track.

Speaker #2: It was designed to align with contemporary health system expectations, including both ASHP and joint commission guidance. While improving operating room workflow, reducing preparation steps, and lowering the risk of medication errors and contamination.

William Forbes: It was designed to align with contemporary health system expectations, including both ASHP and Joint Commission guidance, while improving operating room workflow, reducing preparation steps, and lowering the risk of medication errors and contamination. The development program is well advanced. Registration batches have been manufactured and placed on stability, and we remain on track to generate 12-month stability data in Q1 2027. Mark, I'll turn it back to you.

Speaker #2: The development program is well advanced. Registration batches have been manufactured and placed on stability, and we remain on track to generate 12-month stability data in the first quarter of 2027.

Speaker #2: Mark, I'll turn it back to you.

Speaker #1: Thanks, Bill. Now to Apondi. There are two charts on this slide. Average daily units on the left, ordering accounts on the right. Both showed continued steady upward trajectory through Q1.

Mark Hensley: Thanks, Bill. Now to APONVIE. There are two charts on this slide. Average daily units on the left, ordering accounts on the right. Both showed continued steady upward trajectory through Q1. On the Q1 metrics, APONVIE demand units grew 68% year over year. Average daily units grew 70% over Q1 of last year. We exited Q1 with 371 ordering accounts in March. That's an all-time high for the product and up 67% versus March of last year. APONVIE is now P&T approved in 1,903 accounts, representing 5.8 million medium to high-risk procedures annually. The last number defines the size of the addressable opportunity that APONVIE has now been formally cleared into. On the growth drivers ahead, APONVIE's permanent product-specific J-code became active 1 April.

Speaker #1: On the Q1 metrics, Apondi demand units grew 68% year over year. Average daily units grew 70% over Q1 of last year. We exited Q1 with 371 ordering accounts in March.

Speaker #1: That's an all-time high for the product and up 67% versus March of last year. And Apondi is now P&T-approved and in 1,903 accounts, representing 5.8 million medium- to high-risk procedures annually.

Speaker #1: The last number defines the size of the addressable opportunity that Apondi has now been formally cleared into. On the growth drivers ahead, Apondi's permanent product-specific J code became active April 1. Having a permanent, dedicated billing code in place removes a layer of reimbursement complexity for the product.

Mark Hensley: Having a permanent dedicated billing code in place removes a layer of reimbursement complexity for the product. We'll be expanding our dedicated aprepitant sales force in Q3 2026. That team currently covers both APONVIE and CINVANTI, and the expansion adds capacity to support both products. Lastly, APONVIE has been prominently included in the fifth consensus guidelines for the management of postoperative nausea and vomiting. That's a meaningful clinical catalyst. I'll hand it over to Kevin to walk through the guidelines and what they mean for the product.

Speaker #1: We'll be expanding our dedicated apprependent sales force in Q3 2026. That team currently covers both Apondi and Sinvonti, and the expansion adds capacity to support both products.

Speaker #1: And lastly, Apondi has been prominently included in the fifth consensus guidelines for the management of post-operative nausea and vomiting. That's a meaningful clinical catalyst.

Speaker #1: I'll hand it over to Kevin to walk through the guidelines and what they mean for the product.

Speaker #3: Thanks, Mark. We wanted to provide a brief overview to help the Street understand the broader clinical and economic significance of the recently published fifth consensus guidelines for the management of post-operative nausea and vomiting.

Kevin Warner: Thanks, Mark. We wanted to provide a brief overview to help the Street understand the broader clinical and economic significance of the recently published 5th consensus guidelines for the management of postoperative nausea and vomiting. These guidelines represent an important shift in perioperative care, moving from reactive management of PONV toward a far more proactive patient-centered prevention strategy. From a medical affairs perspective, guideline updates are highly important because they often serve as the foundation for durable institutional change. Historically, adoption occurs over time through provider education, EMR order sets, anesthesia workflows, perioperative pathways, and treatment algorithms. Once integrated into institutional protocols, these practices tend to become highly durable standards of care. Importantly, the updated guidelines substantially elevated the role of NK1 antagonists within multimodal prophylaxis strategies.

Speaker #3: These guidelines represent an important shift in perioperative care, moving from reactive management of PONB toward a far more proactive, patient-centered prevention strategy. From a medical affairs perspective, guideline updates are highly important because they often serve as the foundation for durable institutional change.

Speaker #3: Importantly, the updated guidelines substantially elevated the role of NK1 antagonists within multimodal prophylaxis strategies. Aprepitant-based therapies, including Aponvi, received an A1 evidence rating for prevention of PONV in adults, reflecting the highest level of evidence supporting efficacy and safety.

Speaker #3: Apondi is specifically named within the guidelines as the first and only FDA-approved IV push NK1 antagonist for the prevention of PONB in adults. We believe this distinction is clinically meaningful because it combines efficacy, workflow efficiency, and ease of perioperative implementation in a way that supports both providers and patients.

Speaker #3: As a result, many institutions are expected to adopt a more liberal prophylaxis strategy across broader patient populations. The guidelines specifically recommend that patients with greater than two risk factors—representing roughly half of the surgical population—receive three to four prophylactic interventions.

Kevin Warner: The guidelines specifically recommend that patients with greater than 2 risk factors, representing roughly half of the surgical population, receive 3 to 4 prophylactic interventions. These medium and high-risk patients often require highly effective antiemetic strategies without adding recovery-limiting adverse effects. We believe APONVIE is uniquely positioned in this setting. Its efficacy profile, combined with a differentiated safety profile that does not overlap with many commonly used antiemetics, supports use in patients where prevention matters most. Importantly, APONVIE provides antiemetic protection without contributing to sedation or negatively impacting postoperative recovery pathways, which is increasingly important in enhanced recovery protocols and ambulatory surgery. One of the most significant additions to the fifth edition guidelines was the expanded focus on post-discharge nausea and vomiting, or PDNV. The guidelines emphasize that PONV is not simply an acute PACU complication. For many patients, symptoms occur after discharge when clinical support resources are less available.

Speaker #3: These medium- and high-risk patients often require highly effective antiemetic strategies, without adding recovery-limiting adverse effects. We believe Apondi is uniquely positioned in this setting.

Speaker #3: For many patients, symptoms occur after discharge, when clinical support resources are less available. The guidelines cite data showing that approximately 37% of patients may experience PDNV, with implications for dehydration, wound complications, unplanned healthcare utilization, and potential readmissions.

Speaker #3: As outpatient surgery volumes continue to expand and same-day discharge becomes increasingly common, these downstream complications become even more relevant in value-based care models. Importantly, the guidelines now recommend that patients at risk for PDNV receive prophylactic long-acting antiemetics prior to discharge.

Speaker #3: Integrating efficiently into standard anesthesia workflows. This becomes particularly relevant for providers who may not have had adequate preoperative time or oral administration, or who are caring for patients with limitations to oral therapies, including those with gastroparesis, GLP-1 utilization, diabetes-related GI dysfunction, or altered gastric emptying.

Kevin Warner: This becomes particularly relevant for providers who may not have had adequate preoperative time for oral administration, or who are caring for patients with limitations to oral therapies, including those with gastroparesis, GLP-1 utilization, diabetes-related GI dysfunction, or altered gastric emptying. The strength of evidence supporting aprepitant-based therapy was also highlighted throughout the guidelines. Multiple randomized trials demonstrated aprepitant to be comparable or superior to ondansetron for prevention of PONV. Meta-analysis showed significant reductions in PONV risk when used alone or within multimodal regimens. In a large Cochrane systemic review evaluating nearly 100,000 patients ranked aprepitant as the single most effective antiemetic. Importantly, the updated guidelines frame PONV prevention not simply as a patient comfort initiative, but as a meaningful clinical quality and operational issue.

Speaker #3: The strength of evidence supporting aprepitant-based therapy was also highlighted throughout the guidelines. Multiple randomized trials demonstrated aprepitant to be comparable or superior to ondansetron for prevention of PONV.

Speaker #3: Meta-analysis showed significant reductions in PONV risk when used alone or within multimodal regimens. In a large Cochrane systemic review evaluating nearly 100,000 patients, ranked apprependent as the single most effective antiemetic.

Speaker #3: Importantly, the updated guidelines frame PONV prevention not simply as a patient comfort initiative, but as a meaningful clinical quality and operational issue. Poorly controlled PONV contributes to extended PACU stays, rescue medication use, delayed discharge, dehydration, wound stress, aspiration concerns, and readmissions.

Kevin Warner: Poorly controlled PONV contributes to extended PACU stays, rescue medication use, delayed discharge, dehydration, wound stress, aspiration concerns, and readmission. In many high-risk procedures, including abdominal, bariatric, ENT, ophthalmology, and other belt up surgeries, preventing vomiting is viewed as critically important to protecting surgical outcomes and patient safety. Appropriate prophylaxis also support perioperative operational efficiency by reducing nursing burden, minimizing recovery delays, improving throughput, and enhancing both patient and staff satisfaction. The guidelines additionally highlighted the pharmacoeconomic value of effective prophylaxis strategies. One metric discussed was number needed to treat or NNT. For aprepitant combined with dexamethasone, the reported NNT was 3.8, meaning approximately 4 patients treated prevents 1 additional case of PONV. Compared with many commonly used antiemetics, this represents a highly favorable value proposition. From a health system perspective, this becomes clinically and economically meaningful very quickly.

Speaker #3: In many high-risk procedures, including abdominal, bariatric, ENT, ophthalmologic, and other belt-up surgeries, preventing vomiting is viewed as critically important to protecting surgical outcomes and patient safety.

Speaker #3: One metric discussed was number needed to treat, or NNT. For aprepitant, combined with dexamethasone, the reported NNT was 3.8, meaning approximately four patients treated prevents one additional case of PONV.

Kevin Warner: A single episode of PONV has been estimated to cost approximately $1,000 when considering rescue therapy, nursing utilization, prolonged PACU time, and delayed discharge. When viewed in that context, preventing complications with an intervention costing approximately $60 per dose becomes highly rational and understandable for providers and institutions alike, particularly as value-based care models increasingly focus on patient satisfaction, throughput, readmissions, recovery quality, and total episode of care costs. Ultimately, we believe the 5th consensus guidelines reinforce several important macro trends shaping the perioperative landscape, including greater use of multimodal prophylaxis, increasing recognition of post-discharge nausea vomiting, continued migration toward outpatient surgery, demand for workflow efficiency, and the growing need for safe, effective, non-sedating, long-acting therapies that support enhanced recovery pathways, which we believe APONVIE is uniquely positioned to address. I will now turn the call back to Mark to discuss our oncology supportive care franchise.

Speaker #3: Particularly as value-based care models increasingly focus on patient satisfaction, throughput, readmissions, recovery quality, and total episode of care cost. Ultimately, we believe the fifth consensus guidelines reinforce several important macro trends shaping the perioperative landscape, including greater use of multimodal prophylaxis, increasing recognition of post-discharge nausea and vomiting, continued migration toward outpatient surgery, demand for workflow efficiency, and the growing need for safe, effective, non-sedating, long-acting therapies that support enhanced recovery pathways.

Speaker #3: Which we believe Apondi is uniquely positioned to address. I will now turn the call back to Mark to discuss our oncology supportive care franchise.

Speaker #1: Thanks, Kevin. Turning to oncology supportive care. There are two charts on this slide. Average daily units on the left, ordering accounts on the right.

Mark Hensley: Thanks, Kevin. Turning to oncology supportive care. There are two charts on this slide. Average daily units on the left, ordering accounts on the right. CINVANTI's average daily units have remained resilient, sustaining a consistent trend in utilization throughout 2024 and into 2026. That's a meaningful durability marker for a product in its mature commercial phase in a category that has faced steady competitive pressure. On ordering accounts, you can see the two layers on the right chart. The blue line shows existing accounts running at approximately 1,100 every month, which speaks to the stickiness of the customer base. The purple line shows new and returning accounts averaging about 59 per month in Q1 of 2026. In March specifically, 1,188 accounts ordered CINVANTI. That number was in line with the 12-month average of approximately 1,200 accounts.

Speaker #1: Sinvonti's average daily units have remained resilient. Sustaining a consistent trend in utilization throughout 2024 and into 2026. That's a meaningful durability marker for a product in its mature commercial phase.

Speaker #1: In a category that has faced steady competitive pressure, on ordering accounts, you can see the two layers on the right chart. The blue line shows existing accounts running at approximately $1,100 every month, which speaks to the stickiness of the customer base.

Speaker #1: The purple line shows new and returning accounts, averaging about 59 per month in Q1 of '26. In March specifically, 1,188 accounts ordered Sinvonti. That number was in line with the 12-month average of approximately 1,200 accounts.

Speaker #1: On market share, Sinvonti ended Q1 with 25% exit share in March of 2026. That was also in line with the 12-month average. The stability is the takeaway.

Mark Hensley: On market share, CINVANTI ended Q1 with 25% exit share in March of 2026. That was also in line with the 12-month average. The stability is the takeaway. We are holding our position in a competitive category. Looking at growth drivers for the rest of 2026, Craig referenced a number of new accounts coming online this year. Those new formulary wins are due to our REIGNITE program. It's focused on CINVANTI access in major teaching hospitals where we have already secured formulary wins, and the near-term pipeline represents approximately $10 million in new opportunity. As I mentioned earlier, our dedicated aprepitant sales force expansion in Q3 of 2026 will support CINVANTI as well as APONVIE. CINVANTI will be promoted in the second position by that team. Now to the broader category dynamics.

Speaker #1: We are holding our position in a competitive category. Looking at growth drivers for the rest of 2026, Craig referenced a number of new accounts coming online this year.

Speaker #1: Those new formulary wins are due to our Reignite program. It's focused on Sinvonti access in major teaching hospitals, where we have already secured formulary wins. The near-term pipeline represents approximately $10 million in new opportunity.

Speaker #1: And as I mentioned earlier, our dedicated, apprenpendent sales force expansion in the third quarter of 2026 will support Sinvonti as well as Apondi. Sinvonti will be promoted in the second position by that team.

Speaker #1: Now, to the broader category dynamics. On the next slide, the chart shows the broader NK1 category for chemotherapy-induced nausea and vomiting over the last 12 months.

Mark Hensley: On the next slide, the chart shows the broader NK1 category for chemotherapy-induced nausea and vomiting over the last 12 months. The stacked bars show total category units broken out by competitor product. The percentages at the top of each bar show month-over-month volatility in the overall category, ranging from down 19% in some months to up 21% in others. The line running across the chart is CINVANTI's market share within that category. Despite all the category-level volatility, CINVANTI's share has been remarkably stable. The 12-month average is 25%. March 2026 closed at 25%. That share stability in a category where the underlying volume is highly variable month to month is the durability marker for this franchise.

Speaker #1: The stacked bars show total category units broken out by competitor product. The percentages at the top of each bar show month-over-month volatility in the overall category, ranging from down 19% in some months to up 21% in others.

Speaker #1: The line running across the chart is Sinvonti's market share within that category. Despite all the category-level volatility, Sinvonti's share has been remarkably stable. The 12-month average is 25%.

Speaker #1: March 2026 closed at 25%. That share stability in the category, where the underlying volume is highly variable month to month, is the durability marker for this franchise.

Speaker #1: To wrap up the commercial section, Xinra left demand grew 22% year over year, with Ignite 2.0 expanding our targeted account base by 38% for 2026.

Mark Hensley: To wrap up the commercial section, ZYNRELEF demand grew 22% year over year, with IGNITE 2.0 expanding our targeted account base by 38% for 2026. APONVIE demand grew 68%. Ordering accounts hit an all-time high. The fifth consensus guidelines have positioned the product as the evidence-graded standard for PONV prophylaxis. CINVANTI held a stable 25% market share in a volatile category, with REIGNITE building approximately $10 million of near-term pipeline. Across all of it, our pricing discipline is intact, our structural drivers are in place, and our commercial leverage continues to expand with both our ZYNRELEF team and our dedicated aprepitant team set to expand in Q3. The drivers we put in motion in 2025 are working as designed. We have line of sight to deliver on the full year framework we laid out in February.

Speaker #1: Apondi demand grew 68%. Ordering accounts hit an all-time high, and the fifth consensus guidelines have positioned the product as the evidence-graded standard for PONV prophylaxis.

Speaker #1: Sinvonti held a stable 25% market share in a volatile category, with Reignite building approximately $10 million of near-term pipeline. Across all of it, our pricing discipline is intact, our structural drivers are in place, and our commercial leverage continues to expand.

Speaker #1: With both our Xinra left team and our dedicated Apprependent team set to expand in Q3, the drivers we put in motion in '25 are working as designed, and we have line of sight to deliver on the full-year framework we laid out in February.

Speaker #1: With that, I'll now turn it over to Ira.

Mark Hensley: With that, I'll now turn it over to Ira.

Speaker #2: Thank you, Mark.

Speaker #3: As we have discussed in prior calls, we have a secondary supplier for Sinvonti, and carried a contractual obligation to produce a certain inventory quantities over the past year.

Ira Duarte: This inventory will work its way through our system over the next 2 quarters, after which we will return exclusively to our primary supplier.

Speaker #3: Once those contractual obligations are fulfilled, we expect gross margins to normalize back to the mid-70% range. Adjusted EBITDA was -727,000 for the quarter, reflecting the combined impact of the storm-related revenue softness and the temporary gross margin pressure from our secondary Sinvonti supplier.

Ira Duarte: Once those contractual obligations are fulfilled, we expect gross margins to normalize back to the mid 70% range. Adjusted EBITDA was -$727,000 for the quarter, reflecting the combined impact of the storm-related revenue softness and the temporary gross margin pressure from our secondary CINVANTI supplier. Both factors are temporary, and we expect adjusted EBITDA to return to positive territory as we move through 2026. Looking ahead, the recovery is already underway. As noted earlier on the call, March net revenues returned to over $15 million, a strong signal for Q2 and one that reinforces our confidence in achieving our full-year targets.

Speaker #3: Both factors are temporaries, and we expect adjusted EBITDA to return to positive territory as we move through 2026. Looking ahead, the recoveries already underway.

Speaker #3: As noted earlier on the call, March net revenues returned to over $15 million—a strong signal for the second quarter, and one that reinforces our confidence in achieving our full-year targets.

Speaker #3: To reaffirm our 2026 guidance, we are maintaining net product sales of $173 to $183 million and adjusted EBITDA of $10 to $20 million. Reflecting continued profitability alongside meaningful commercial expansion.

Ira Duarte: To reaffirm our 2026 guidance, we are maintaining net product sales of $173 to 183 million and adjusted EBITDA of $10 to 20 million, reflecting continued profitability alongside meaningful commercial expansion. With that, we are happy to open the call for questions.

Speaker #3: With that, we are happy to open the call for questions.

Speaker #2: Certainly. As a reminder, to ask a question, please press star one one on your telephone and wait for your name to be announced. To withdraw your question, please press star one one again. Please stand by while we compile our Q&A roster.

Speaker #2: Our first question will be coming from the line of Brandon Folks of HC Wainwright. Brandon, your line is open.

Brandon Folkes: Hi, thanks for taking my questions today. Maybe just a few from me. Firstly, on your guidance, can you just talk about some of the pushes and pulls on ZYNRELEF that you assume to meet the overall company level revenue guidance? You know, do you assume ZYNRELEF taking market share? You know, maybe secondly, apologies if I missed this, can you just give me some details on the Baxter settlement, just sort of what that allows, what that sort of keeps exclusivity on it? That's it from me. Maybe one more just. You know, you talk about friction. Can you just talk about how you meaningfully change the adoption curve, you know, across ZYNRELEF and APONVIE? On ZYNRELEF, you know, it sounds like there's friction in the sort of the office to decide to use ZYNRELEF.

Speaker #4: Do you assume Xinra Leaf taking market share? And then maybe secondly, probably just if I missed this, can you just give me some details on the back-to-settlement to sort of what that allows, what that sort of keeps exclusivity?

Speaker #4: Yeah. That's it from me. Oh, maybe one more. Just you talked about friction. So can you just talk about how you meaningfully change the adoption curve across Xinra Leaf and Apondi?

Speaker #4: And on Xinra Leaf, it sounds like there's friction in the sort of the office to decide to use Xinra Leaf. How do you change that ahead of the pre-fold syringe and eliminate the friction you're seeing today so that the pre-fold syringe can sort of maximize the value that it can bring?

Speaker #4: Thank you.

Craig Collard: Hey, Brandon, thank you for the questions. I'll start with the Baxter settlement, then I'll turn it to Mark. Look, based on the terms of the settlement, we really can't go into the details of that other than to say that, you know, the dates and everything that had been published. Outside of that, we're just forbidden from saying anything on that. I'll turn it over to Mark to talk about his other last questions that you asked.

Speaker #5: But outside of that, we're just forbidden from saying anything on that. So I'll turn it over to Mark to talk about the Xinra left questions that you asked.

Speaker #6: Yeah. It's a great question. I think kind of one and three are kind of part and parcel to the same. But in terms of our confidence, there are several factors that we're looking at.

Mark Hensley: Yeah, it's a great question. I think kind of one and three are kind of part and parcel of the same. You know, in terms of our confidence, there are several factors that we're looking at. First, you know, we talked about the weather and the elective procedures being pushed out of January. You know, obviously, we believe those will be rescheduled throughout the year, certainly that'll be a nice tailwind for us. You know, as it relates to both ZYNRELEF and APONVIE, really, you know, we're really focused on the expansion of the sales force in the kind of mid-year. We certainly think that will help our share of voice, you know, and really kind of build upon the foundation that we've already built.

Speaker #6: First, we talked about the weather and the elective procedures being pushed out of January. Obviously, we believe those will be rescheduled throughout the year.

Speaker #6: And so, certainly, that'll be a nice tailwind for us. As it relates to both Xinra Left and Apondi, we're really focused on the expansion of the sales force in the kind of mid-year.

Mark Hensley: IGNITE 2.0, you know, you see the slides and kind of what that delivered in Q3 and Q4 of last year. The expansion of that by 38%, you know, in 2026 we believe will be a really nice tailwind for us as we go forward. On the friction piece, you know, I think for us, we don't really see accounts that don't want to use ZYNRELEF. Really, the hardest part for us is getting to a meaningful enough a number of them to have that kind of quarter-over-quarter growth that we would wanna see with the product, right? A lot of that is the reason why we're expanding the team in the kind of, you know, mid-year.

Speaker #6: Really, the hardest part for us is getting to a meaningful enough number of them to have that kind of quarter-over-quarter growth that we would want to see with a product, right?

Speaker #6: And so, a lot of that is the reason why we're expanding the team in the kind of mid-year. And certainly, that share of voice will continue to grow.

Mark Hensley: Certainly that share of voice will continue to grow. Because we're continuing to see market share grow within our targeted accounts, certainly within the accounts where we're aligned, not only at Heron but within our IGNITE program. We just want to continue to expand upon that across the country.

Speaker #4: Great. Thank you very much.

Brandon Folkes: Great. Thank you very much.

Speaker #2: And our next question. We'll be coming from the line of Serge Ballinger of Needham & Company, your line is open.

Operator: Our next question will be coming from the line of Serge Belanger of Needham & Company. Your line is open.

Speaker #7: Hi. Good morning. This is John on for Serge today. Thanks for taking our questions. First, if I could just follow up on Xinra Leaf again with regard to the Q1 winter storm headwinds.

[Analyst] (Needham & Company): Hi, good morning. This is John on for Serge Belanger today. Thanks for taking our questions. First, if I could just follow up on ZYNRELEF again with regard to the Q1 winter storm headwinds. Just curious if you could quantify the impact with regard to surgical volumes for the quarter there. Second, on the implementation of NOPAIN Act, obviously, it's been online for over a year now. Curious, what impacts you're seeing on commercial coverage and how this has changed over time and what you might be expecting for 2026. If I could just squeeze one more in on the CrossLink Life Sciences partnership. It seems like you're, you know, adding on to the initial IGNITE program, targeting more accounts here in 2026.

Speaker #7: Just curious if you could quantify the impact with regard to surgical volumes for the quarter there. And then second, on the implementation of No Pain, obviously, it's been online for over a year now.

Speaker #7: Curious what impacts you're seeing on commercial coverage, and how this has changed over time, and what you might be expecting for '26. And then, if I could just squeeze one more in on the Cross-Link partnership.

Speaker #7: Thank you.

Speaker #5: Great. Thank you for the questions. On surgical volume, our data shows it's kind of high single-digit decline from the fourth quarter, so pretty meaningful impact.

Mark Hensley: Great. Thank you for the questions. On surgical volume, our data shows it's kind of high single-digit decline from Q4. Pretty meaningful impact, larger than we've seen in prior years. We think that's part weather-related, part a record Q4 from a surgical volume perspective and maybe some of our surgical partners just taking a deep breath in the quarter.

Speaker #5: But certainly, we expect that to significantly improve, and obviously, some of those surgeries that were lost—we would imagine that those would be rescheduled.

Mark Hensley: Certainly, we expect that to significantly improve, and obviously some of those surgeries that were lost, we would imagine that those would be rescheduled. You know, to your second question on commercial coverage, we, you know, we obviously know pain, you know, is a great factor for ZYNRELEF, and certainly removes, you know, the word I've been using is friction, at least on the Medicare side, on the government payer side. Since its implementation, we've seen more and more commercial payers begin to add ZYNRELEF, you know, outside of the surgical bundles, reimbursing outside of that bundle. You know, we reported the number on the call at 110 million lives is the estimate that we have on the commercial side.

Speaker #5: And since its implementation, we've seen more and more commercial payers begin to add Xinra, left outside of the surgical bundles, to reimbursing outside of that bundle.

Speaker #5: We reported the number on the call at 110 million lives as the estimate that we have on the commercial side. And so, kind of largely across the United States, very well covered for Xinra Left.

Mark Hensley: So, you know, kind of largely across the United States, very well covered for ZYNRELEF. There are pockets, you know, where we see ZYNRELEF still bundled, but certainly we have the ability to go in and have those conversations at the payer level. For the most part, you know, they're willing to listen and make some changes for our patients. Then, you know, as it relates to CrossLink, you know, we allow them to select the accounts, you know, and so by doing so, the natural selection, you know, gave us an expansion in that program, you know, again at 38%.

Speaker #5: There are pockets where we see Xinra left still bundled, but certainly, we have the ability to go in and have those conversations at the payer level.

Speaker #5: And for the most part, they're willing to listen and make some changes for our patients. And then, as it relates to Cross-Link, we allow them to select the accounts, and so by doing so, the natural selection gave us an expansion in that program.

Speaker #5: Again, at 38%. And so, the alignment between Heron and CrossLink now is almost 90% in terms of our focus. That's the highest it's ever been—significantly higher than the back half of 2025.

Mark Hensley: You know, it's the alignment between Heron and CrossLink now is almost 90%, you know, in terms of our focus. That's the highest it's ever been, significantly higher than the back half of 2025. What that really means is that we have a Heron employee in the account. We have a CrossLink employee in that account. We have really good, you know, payer coverage in those accounts. That's why they were selected. Those three, you know, pieces of the puzzle have shown us that that's where we really, you know, have good success and are able to move ZYNRELEF forward. That gives us a lot of confidence for 2026.

Speaker #5: And so, what that really means is that we have a Heron employee in the account, we have a CrossLink employee in that account, and we have really good payer coverage in those accounts.

Speaker #5: That's why they were selected. And so those three pieces of the puzzle have shown us that that's where we really have good success and are able to move Xinra Left forward.

Speaker #5: And so, that gives us a lot of confidence for 2026.

Speaker #7: Great. Thanks so much for the color.

[Analyst] (Needham & Company): Great. Thanks so much for the color.

Mark Hensley: Yep.

Speaker #2: And as a reminder, to ask a question, please press star 11 on your telephone and wait for your name to be announced. To withdraw your question, please press star 11 again.

Speaker #2: I would now like to turn the conference back to Craig Collard for closing remarks.

Speaker #5: Thank you, operator. We just want to thank everyone for joining the call today, and we look forward to speaking to you all next quarter.

Mark Hensley: Thank you, operator. We just wanna thank everyone for joining the call today, and we look forward to speaking to you all next quarter.

Operator: This concludes today's program. Thank you for participating. You may now disconnect.