Q1 2027 Medexus Pharmaceuticals Inc Earnings Call

August 11, 2026

Speaker #1: Greetings. Welcome to the Medexus Pharmaceuticals first quarter 2027 conference call. At this time, all participants are in a listen-only mode. A question-and-answer session will follow the formal presentation.

Operator: Greetings. Welcome to the Medexus Pharmaceuticals Q1 2027 conference call. At this time, all participants are in a listen-only mode. A question and answer session will follow the formal presentation. If anyone should require operator assistance during the conference, please press star zero on your telephone keypad. Please note this conference is being recorded. I will now turn the conference over to your host, Victoria Rutherford, Investor Relations. You may begin.

Speaker #1: If anyone should require operator assistance during the conference, please press star zero on your telephone keypad. Please note, this conference is being recorded. I will now turn the conference over to your host, Victoria Rutherford, Investor Relations.

Speaker #1: You may begin.

Victoria Rutherford: Thank you, and good morning, everyone. Welcome to the Medexus Pharmaceuticals first fiscal quarter 2027 earnings call. On the call this morning are Ken d'Entremont, Chief Executive Officer, and Brendon Buschman, Chief Financial Officer. If you have any questions after the conference call or would like further information about the company, please contact Adelaide Capital at 480-625-5772. I would like to remind everyone that this discussion will include forward-looking information as defined in Canadian securities laws that is based on certain assumptions that Medexus believes to be reasonable in the circumstances, but is subject to risks and uncertainties. Actual results may differ materially from historical results or results anticipated by the forward-looking information.

Speaker #2: Thank you, and good morning, everyone. Welcome to the Medexus Pharmaceuticals First Fiscal Quarter 2027 Earnings Call. On the call this morning are Ken Dontramont, Chief Executive Officer, and Brendan Bushman, Chief Financial Officer.

Speaker #2: If you have any questions after the conference call or would like further information about the company, please contact Adelaide Capital at 480-625-5772. I would like to remind everyone that this discussion will include forward-looking information, as defined in Canadian Securities Laws, that is based on certain assumptions that Medexus believes to be reasonable in the circumstances but is subject to risks and uncertainties.

Speaker #2: Actual results may differ materially from historical results or results anticipated by the forward-looking information. In addition, this discussion will also include non-GAAP measures such as adjusted EBITDA, adjusted EBITDA margin, adjusted gross margin, and net debt, which do not have any standardized meaning under IFRS and therefore may not be comparable to similar measures presented by other companies.

Victoria Rutherford: In addition, this discussion will also include non-GAAP measures such as adjusted EBITDA, adjusted EBITDA margin, adjusted gross margin, and net debt, which do not have any standardized meaning under IFRS and therefore may not be comparable to similar measures presented by other companies. For more information about forward-looking information and non-GAAP measures, including reconciliations, please refer to the company's MD&A, which, along with the financial statements, is available on the company website at www.medexus.com and on SEDAR+ at www.sedarplus.ca. As a reminder, Medexus reports on a March 31 fiscal year basis. Medexus reports financial results in USD and all references are in USD unless otherwise specified. I would now like to turn the call over to Victoria Rutherford.

Speaker #2: For more information about forward-looking information and non-GAAP measures, including reconciliations, please refer to the company's MD&A, which, along with the financial statements, is available on the company website at www.medexus.com and on SEDAR+ at www.sedarplus.ca.

Speaker #2: As a reminder, Medexus reports on a March 31st fiscal year basis. Medexus reports financial results in US dollars and all references are in US dollars unless otherwise specified.

Speaker #2: I would now like to turn the call over to Ken Dontramont.

Speaker #3: Thank you, Victoria. And thank you, everyone, for joining us on this call today. We’re pleased with our first quarter results, which reinforce our confidence in the growth trajectory of Graphopex and the strength of our business.

Ken d'Entremont: Thank you, Victoria, and thank you everyone for joining us on this call today. We are pleased with our first quarter results, which reinforce our confidence in the growth trajectory of GRAFAPEX and the strength of our business. GRAFAPEX delivered its strongest quarter to date with product level performance of GRAFAPEX, net of working capital changes, accretive to quarterly operating cash flows in fiscal Q1 2027. The product continues to perform in line with our expectations that product level net revenue from GRAFAPEX will be $30 to $32 million for fiscal year 2027, making it an increasingly important driver of Medexus' operating and financial performance. For the three months ending 30 June, we recognized product level net revenue from GRAFAPEX of $4.9 million, compared to approximately $3.2 million of product level personnel and infrastructure investments over the same period. Commercial adoption also continues to progress well.

Speaker #3: Graphopex delivered its strongest quarter to date, with product-level performance of Graphopex—net of working capital changes—accrued up to quarterly operating cash flows in fiscal Q1 '27.

Speaker #3: The product continues to perform in line with our expectations that product-level net revenue from Graphopex will be $30 million to $32 million for fiscal year 2027, making it an increasingly important driver of Medexus's operating and financial performance.

Speaker #3: For the three months ending June 30th, we recognize product-level net revenue from Graphopex of $4.9 million, compared to approximately $3.2 million of product-level personnel and infrastructure investments over the same period.

Speaker #3: Commercial adoption also continues to progress well. Wholesaler data as of June 30, 2026, shows that 75 individual healthcare institutions have already ordered Graphopex for procedures in their institutions, and 54 of those institutions have placed repeat orders.

Ken d'Entremont: Wholesaler data as of 30 June 2026 shows that 75 individual healthcare institutions have already ordered GRAFAPEX for procedures in their institutions, and 54 of those institutions have placed repeat orders. Ordering by healthcare institutions and payer coverage and access trends have been highly encouraging, and the early indicators of patient-level demand continue to reinforce the value proposition GRAFAPEX brings to patients, providers, and payers. Based on the continued commercial traction we are seeing, we continue to expect GRAFAPEX to achieve annual product level net revenue of approximately $100 to $175 million within five years after commercial launch. Beyond the continued success of GRAFAPEX, we remain excited about the broader opportunities we see in the Allo HSCT space and are continuing to invest strategically to strengthen our leadership in this space. in June, we signed agreements for the exclusive Canadian rights to commercialize UM171 cell therapy.

Speaker #3: Ordering by healthcare institutions and payer coverage and access trends have been highly encouraging, and the early indicators of patient-level demand continue to reinforce the value proposition Graphopex brings to patients, providers, and payers.

Speaker #3: Based on the continued commercial traction we are seeing, we continue to expect Graphopex to achieve annual product-level net revenue of approximately 100 to 175 million within five years after commercial launch.

Speaker #3: Beyond the continued success of Graphopex, we remain excited about the broader opportunities we see in the alloHSCT space and our continuing to invest strategically to strengthen our leadership in this space.

Speaker #3: In June, we signed agreements for the exclusive Canadian rights to commercialize UM171 cell therapy. As we discuss on our last call, this is a proprietary advanced clinical stage investigational drug product that recently received conditional marketing authorization in Europe from the European Commission as themselves pro.

Ken d'Entremont: As we discussed on our last call, this is a proprietary, advanced clinical stage investigational drug product that recently received conditional marketing authorization in Europe from the European Commission as Zemcelpro. If approved in Canada, UM171 cell therapy would be an excellent strategic fit with treosulfan, which we commercialize in Canada as Trecondyv. Turning to our overall financial performance, net revenue for fiscal Q1 2027 increased to $28.6 million from $24.6 million in the prior year, while adjusted EBITDA increased to $4.7 million from $3.4 million. We also generated net income of $0.5 million, consistent with prior year period, and operating income improved to $2.1 million from $0.9 million. We otherwise remain focused on delivering strong overall performance across our portfolio of products in both the US and Canada.

Speaker #3: If approved in Canada, UM171 cell therapy would be an excellent strategic fit with Trio Sulfan, which we commercialize in Canada as Trikondif. Turning to our overall financial performance, net revenue for fiscal Q1 '27 increased to $28.6 million from $24.6 million in the prior year.

Speaker #3: While adjusted EBITDA increased to 4.7 million from 3.4 million. We also generated net income of 0.5 million consistent with prior year period and operating income improved to 2.1 million from 0.9 million.

Speaker #3: We otherwise remain focused on delivering strong overall performance across our portfolio products in both the US and Canada. Supported by our resilient portfolio of established products, the continued growth of Graphopex and exciting new product opportunity in UM171 cell therapy in Canada and strong fiscal foundation, we remain focused on discipline execution, generating cash, investing in business opportunities that create long-term value.

Ken d'Entremont: Supported by our resilient portfolio of established products, the continued growth of GRAFAPEX, an exciting new product opportunity in UM171 cell therapy in Canada, and strong fiscal foundation, we remain focused on disciplined execution, generating cash, investing in business opportunities that create long-term value. I will now turn the call over to Brendon, who will discuss our financial results in more detail.

Speaker #3: I will now turn the call over to Brendan, who will discuss our financial results in more detail.

Speaker #4: Thank you, Ken. Our strong results for fiscal Q1 '27 demonstrate both the growth trajectory of Graphopex and the durability of our portfolio of established products.

Brendon Buschman: Thank you, Ken. Our strong results for fiscal Q1 2027 demonstrate both the growth trajectory of GRAFAPEX and the durability of our portfolio of established products. As Ken mentioned, we generated $4.9 million of product level net revenue from GRAFAPEX in fiscal Q1 2027 and product level performance of GRAFAPEX, net of working capital changes, continues to be accretive to quarterly operating cash flows. Underlying patient demand was $4.8 million for fiscal Q1 2027, representing growth of 23%, compared to $3.9 million for fiscal Q4 2026 and 118% compared to $2.2 million for fiscal Q1 2026. Turning to the full quarterly results, total net revenue for fiscal Q1 2027 was $28.6 million. This represents an increase of $4 million compared to $24.6 million for the same period last year.

Speaker #4: As Ken mentioned, we generated $4.9 million of product-level net revenue from Graphopex in fiscal Q1 '27, and product-level performance of Graphopex, net of working capital changes, continues to be accrued up to quarterly operating cash flows.

Speaker #4: Underlying patient demand was 4.8 million dollars for fiscal Q1 '27, representing growth of 23% compared to 3.9 million for fiscal Q4 '26 and 118% compared to 2.2 million for fiscal Q1 '26.

Speaker #4: Turning to the full quarterly results, total net revenue for fiscal Q1 '27 was $28.6 million. This represents an increase of $4 million compared to $24.6 million for the same period last year.

Speaker #4: The 4 million dollar year-over-year net revenue increase was primarily due to an increase in product-level net revenue from Graphopex and Exinity. Gross profit was 15.9 million dollars for fiscal Q1 '27 compared to 13.8 million for the same period last year.

Brendon Buschman: The $4 million year-over-year net revenue increase was primarily due to an increase in product level net revenue from GRAFAPEX and IXINITY. Gross profit was $15.9 million for fiscal Q1 2027, compared to $13.8 million for the same period last year. Gross margin was 55.6% for fiscal Q1 2027, compared to a gross margin of 56.0% for the same period last year. Adjusted gross margin was 63.8%, compared to 65.5% for the same period last year. The gross margin and adjusted gross margin decreases are due to the prior year one-time positive impact of royalty revenue on gross margin and adjusted gross margin in fiscal Q1 2026, without which gross margin and adjusted gross margin would have increased in fiscal Q1 2027 compared to fiscal Q1 2026, due to changes in the relative contribution of product level net revenue, in particular, an increasing level of net sales of GRAFAPEX.

Speaker #4: Gross margin was 55.6% for fiscal Q1 '27, compared to a gross margin of 56.0% for the same period last year. Adjusted gross margin was 63.8%, compared to 65.5% for the same period last year.

Speaker #4: The gross margin and adjusted gross margin decreases are due to the prior year's one-time positive impact of royalty revenue on gross margin and adjusted gross margin in fiscal Q1 '26.

Speaker #4: Without which, gross margin and adjusted gross margin would have increased in fiscal Q1 '27 compared to fiscal Q1 '26, due to changes in the relative contribution of product-level net revenue.

Speaker #4: In particular, an increasing level of net sales of Graphopex. Selling general and administrative expenses were 13 million dollars for fiscal Q1 '27 compared to 12.2 million for the same period last year.

Brendon Buschman: Selling, general, and administrative expenses were $13 million for fiscal Q1 2027, compared to $12.2 million for the same period last year. Adjusted EBITDA was $4.7 million for fiscal Q1 2027, an increase of $1.3 million compared to $3.4 million for the same period last year. The $1.3 million year-over-year adjusted EBITDA increase was primarily due to the $4.9 million of product level net revenue from GRAFAPEX for fiscal Q1 2027, exceeding the $3.2 million of GRAFAPEX personnel and infrastructure investments in the same period. Along with the year-over-year increase in product level net revenue from IXINITY, partially offset by the one-time positive impact of royalty revenue in the comparative quarter. Net income was $0.5 million for fiscal Q1 2027, which is consistent with fiscal Q1 2026.

Speaker #4: Adjusted EBITDA was 4.7 million dollars for fiscal Q1 '27, an increase of 1.3 million dollars compared to 3.4 million for the same period last year.

Speaker #4: The $1.3 million year-over-year adjusted EBITDA increase was primarily due to the $4.9 million of product-level net revenue from Graphopex for fiscal Q1 '27, exceeding the $3.2 million of Graphopex personnel and infrastructure investments in the same period.

Speaker #4: Along with the year-over-year increase in product-level net revenue from Exinity, this was partially offset by the one-time positive impact of royalty revenue in the comparative quarter.

Speaker #4: Net income was $0.5 million for fiscal Q1 '27, which is consistent with fiscal Q1 '26. Cash used by operating activities was $0.7 million for Q1 '27, a decrease of $4.6 million compared to $3.9 million in cash provided by operating activities for the same period last year.

Brendon Buschman: Cash used by operating activities was $0.7 million for Q1 2027, a decrease of $4.6 million compared to $3.9 million in cash provided by operating activities for the same period last year, primarily due to the settlement of year-end payables and the associated timing of working capital items. As of 30 June 2026, our net debt was $20.9 million, an increase of $5.2 million compared to $15.7 million as at 31 March 2026. Net debt to adjusted EBITDA was 1.18x as of 30 June 2026. We are entering the remainder of fiscal year 2027 from a position of financial strength. We expect to generate meaningful operating cash flow in fiscal year 2027 as GRAFAPEX continues to scale and our portfolio of established products continues to demonstrate its resilience. As always, there can be variability in quarter-to-quarter results, and the operating environment also remains variable.

Speaker #4: Primarily due to the settlement of year-end payables and the associated timing of working capital items. As of June 30, 2026, our net debt was $20.9 million, an increase of $5.2 million compared to $15.7 million as at March 31, 2026.

Speaker #4: Net debt to adjusted EBITDA was 1.18 times as of June 30, 2026. We are entering the remainder of fiscal year 2027 from a position of financial strength.

Speaker #4: We expect to generate meaningful operating cash flow in fiscal year 2027 as Graphopex continues to scale and our portfolio of established products continues to demonstrate its resilience.

Speaker #4: As always, there can be variability in quarter-to-quarter results, and the operating environment also remains variable. But we are encouraged by the strength of our business and remain well-positioned to continue building the company and expanding its portfolios in the coming quarters and beyond.

Brendon Buschman: We are encouraged by the strength of our business and remain well-positioned to continue building the company and expanding its portfolios in the coming quarters and beyond. Operator, I will now open the call to analyst questions.

Speaker #4: Operator will now open the call to analyst questions.

Speaker #2: Certainly. At this time, we will be conducting a question-and-answer session. If you would like to ask a question, please press star one on your telephone keypad.

Operator: Certainly. At this time, we will be conducting a question and answer session. If you would like to ask a question, please press star one on your telephone keypad. A confirmation tone will indicate your line is in the question queue. You may press star two if you would like to remove your question from the queue. For participants using speaker equipment, it may be necessary to pick up your handset before pressing the star keys. One moment while we poll for questions. Your first question for today is from Andre Uddin with Research Capital.

Speaker #2: A confirmation tone will indicate your line is in the question queue. You may press star two if you would like to remove your question from the queue.

Speaker #2: For participants using speaker equipment, it may be necessary to pick up your handset before pressing the star keys. One moment while we poll for questions.

Speaker #2: Your first question for today is from Andre Udin with Research Capital.

Speaker #1: Great. Thanks, operator. Hi, Ken and Brendan. You reported a nice Graphopex sales this quarter. Can you tell us approximately what percentage of that revenue is now coming from repeat ordering versus first-time orders?

Andre Uddin: Thanks, operator. Hi, Ken and Brendon. You reported nice GRAFAPEX sales this quarter. Can you tell us approximately what percentage of that revenue is now coming from repeat ordering versus first-time orders, and how has that mix changed over, let's say, the last two quarters? Thanks.

Speaker #1: And how has that mix changed over, let's say, the last two quarters? Thanks.

Speaker #3: Thanks, Andrei. I don't know the exact percentage. Brendan, unless you have it, but I can't tell you directionally most of the revenue is coming from repeat orders of hospitals that are starting to adopt it more broadly.

Ken d'Entremont: Thanks, Andre. I don't know the exact percentage, Brendon, unless you have it, but I can tell you directionally, most of the revenue is coming from repeat orders of hospitals that are starting to adopt it more broadly. I think the leading indicator is that first order, but that then tends to develop into much broader use once they have the first experience, and that really is a driver behind our revenue.

Speaker #3: I think the leading indicator is that first order, but that then tends to develop into much broader use once they have the first experience, and that really is a driver behind our revenue.

Speaker #1: Okay, that's fine. And then, just looking at your peak Graphopex sales estimate of $100 to $175 million, based on your model and what you're seeing, what has changed, would you say, most positively since you initially established that range?

Andre Uddin: Okay, that's fine. Just looking at your peak GRAFAPEX sales estimate of USD 100 to 175 million. Based on your model, in terms of what you're seeing, what has changed would you say the most positively since you initially established that range? Is it the number of centers, the procedures per center, the market share pricing, or is it something else? Thanks.

Speaker #1: Is it the number of centers, the procedures per center, the market share, pricing, or is it something else? Thanks.

Speaker #3: Yeah, all good questions. There's a lot in there. Pricing has been excellent. We've received our price universally, and as you can tell from our numbers, we're not discounting anything—almost.

Brendon Buschman: Yeah, all good questions. There's a lot in there. Pricing's been excellent. We've received our price universally, and as you can tell from our numbers, we're not discounting anything almost. So we're really pleased with price, and we've got very broad adoption acceptance commercially as well as within the institution. So price is strong. I think our best indicator of future revenue is the degree to which hospitals are adopting this as standard of care. Obviously, that is a goal of ours, and we've described that the USD 100 to 175 million represents 29% to 42% market share. And we're seeing many hospitals that have already achieved that. So I think that's our most encouraging metric that reinforces the support and our belief that we'll achieve the guidance.

Ken d'Entremont: Yeah, all good questions. There's a lot in there. Pricing's been excellent. We've received our price universally, and as you can tell from our numbers, we're not discounting anything almost. So we're really pleased with price, and we've got very broad adoption acceptance commercially as well as within the institution. So price is strong. I think our best indicator of future revenue is the degree to which hospitals are adopting this as standard of care. Obviously, that is a goal of ours, and we've described that the USD 100 to 175 million represents 29% to 42% market share. And we're seeing many hospitals that have already achieved that. So I think that's our most encouraging metric that reinforces the support and our belief that we'll achieve the guidance.

Speaker #3: So we're really pleased with price, and we've got very broad adoption and acceptance commercially, as well as within the institution. So price is strong. I think our best indicator of future revenue is the degree to which hospitals are adopting this as standard of care.

Speaker #3: Obviously, that is a goal of ours and we've described that the 100 to 175 million represents 29 to 42 percent market share and we're seeing hospitals many hospitals that have already achieved that.

Speaker #3: So I think that's our most encouraging metric, and it reinforces the support and our belief that we'll achieve the guidance.

Speaker #1: Okay, that's great. And just one more question: can you provide more detail, ideally, on where you envision your business development going over the next year?

Andre Uddin: Okay, that's great. Just one more question. Can you provide more detail on where you envision your business development going over the next year?

Speaker #3: Yeah, clearly we're focused on HSCTs, or stem cell transplantation, and adjacent areas, so building on the platform that Graphopex provides for us. UM71 is a clear indication of that.

Ken d'Entremont: Yeah. Clearly, we are focused in Allo HSCT and stem cell transplantation and adjacent areas. So building on the platform that GRAFAPEX provides for us. UM171 is a clear indication of that. That's a cell source that would be used following a conditioning agent like GRAFAPEX, so strategically, right in line with where we want to be. So I would expect that we would continue to do business development in that same area.

Speaker #3: That's a cell source that would be used following a conditioning agent like Graphopex. And so, strategically, rated in line with where we want to be.

Speaker #3: So, I would expect that we would continue to do business development in that same area.

Speaker #1: Okay. That's great. Thanks. Thanks, Ken.

Andre Uddin: Okay. That's great. Thanks. Thanks, Ken.

Speaker #2: Your next question is from Scott Henry with AGP.

Operator: Your next question is from Scott Henry with AGP.

Speaker #5: Thank you. And good morning. Starting on the big picture, with Graphopex, obviously, very strong quarter. In first quarter of 4.9 million close to 5.

Scott Henry: Thank you, and good morning. Starting on the big picture with GRAFAPEX. Obviously, a very strong quarter in Q1 of USD 4.9 million, close to USD 5 million. Your USD 30 million to USD 32 million for the year is still a pretty big number relative to USD 5 million. Can you talk a little bit about how we should think about the trajectory to get to where we are in Q1 to where you expect to be in the full year? Thank you.

Speaker #5: But $30 to $32 million for the year is still a pretty big number relative to $5 million. So can you talk a little bit about how we should think about the trajectory from where we are in Q1 to where you expect to be for the full year?

Speaker #5: Thank you.

Speaker #3: Yeah. Thanks, Scott. Great question. I'm sure that's on a lot of people's minds. So the reason we have confidence in the 30 to 32 is because of the leading indicators, which are obviously formulary listings, commercial support from the payers, and then finally first use from the hospitals.

Brendon Buschman: Yeah. Thanks, Scott. A great question. I am sure that is on a lot of people's minds. The reason we have confidence in the USD 30 million to USD 32 million is because of the leading indicators, which are obviously formulary listings, commercial support from the payers, and then finally, first use from the hospitals. We are seeing all those leading indicators very much support what we have given as the guidance. As we go through the year, this quarter that we are working on now will probably be the most challenging quarter, because it is the summer months. You will remember last year we had a significant dip in July. This year, we have not seen that to nearly the same degree.

Ken d'Entremont: Yeah. Thanks, Scott. A great question. I am sure that is on a lot of people's minds. The reason we have confidence in the USD 30 million to USD 32 million is because of the leading indicators, which are obviously formulary listings, commercial support from the payers, and then finally, first use from the hospitals. We are seeing all those leading indicators very much support what we have given as the guidance. As we go through the year, this quarter that we are working on now will probably be the most challenging quarter, because it is the summer months. You will remember last year we had a significant dip in July. This year, we have not seen that to nearly the same degree.

Speaker #3: And so we're seeing all those leading indicators very much support what we've given as the guidance. So as we go through the year, this quarter that we're working on now will probably be the most challenging quarter, because it's the summer months, and you'll remember last year we had a significant dip in July.

Speaker #3: And this year, we haven't seen that to nearly the same degree. So even though I think we described June as being our strongest month ever, with significant uptake—and I think the Bloomberg data supported that—the uptake we're seeing in the summer months has been really strong.

Ken d'Entremont: Even though I think we described June as being our strongest month ever, a significant uptake, and I think the Bloomberg data supported that. The uptake we are seeing in the summer months has been really strong. The uptake in July, which historically last year was a very soft month for us, this year it was our second best month ever. That gives us a lot of confidence that now moving into August, September, which tend to be strong months, we are going to see continued acceleration of our revenue growth. That leads into further quarters where we expect to continue to see growth. We are on a really good trajectory, and the leading indicators support what we have guided to.

Speaker #3: And the uptake in July which historically last year was a very soft month for us, this year it was our second best month ever.

Speaker #3: And so, that gives us a lot of confidence that, now moving into August and September—which tend to be strong months—we're going to see continued acceleration of our revenue growth. That leads into further quarters, where we expect to continue to see growth.

Speaker #3: So we're on a really good trajectory in the leading indicators support what we've guided to.

Speaker #5: Okay, great. It's certainly an impressive target for the product. Shifting gears, just for clarity—it looks like there was about $1.3 million in GTA royalty revenue. I assume that shows up in the US revenue line.

Scott Henry: Okay, great. It is certainly an impressive target for the product. Shifting gears, I guess for clarity, it looks like there was about USD 1.3 million in Gleolan royalty revenue. I assume that shows up in the US revenue line. Is that correct?

Speaker #5: Is that correct?

Speaker #1: Yeah. I can speak to that. So that's in the comparative quarter. So that's revenue we received in Q1 of '26. So the quarter ending June 30th, 2025.

Brendon Buschman: Yeah, I can speak to that. So that is in the comparative quarter. So that is revenue we received in Q1 of 2026. So the quarter ending 30 June 2025. And that related to Gleolan in the US, which was a product we gave back to the licensor in March of 2025. But as a term of giving that product back, we received royalty revenue through till 30 June. So that is what that $1.3 million relates to. It is in the comparative quarter. It is a one-time royalty revenue. And it is just creating a little bit of noise when you compare the quarter-over-quarter.

Speaker #1: And that's related to Gleoland in the US, which was a product we gave back to the licensor in March 2025. But as a term of giving that product back, we received royalty revenue through till June 30.

Speaker #1: So that's what that $1.3 million relates to. It's in the comparative quarter. It's a one-time royalty revenue, and it's just creating a little bit of noise when you kind of compare the quarter-over-quarter.

Speaker #5: But isn't it so it is not also in Q1 '27 fiscal?

Scott Henry: But is it so it is not also in Q1 2027 fiscal?

Speaker #1: No, it's not.

Brendon Buschman: No, it is not.

Speaker #5: Okay. Then digging into that just briefly, but first sequentially the Canadian sales improved up a million basically from fourth quarter fiscal '26. Which I assume was RuPaul.

Scott Henry: Okay. Then digging into that just briefly, but first sequentially, the Canadian sales improved up CAD 1 million basically from Q4 fiscal 2026, which I assume was Rupall.

Speaker #5: Should we expect that strength to continue, or is this just a strong first quarter?

Brendon Buschman: Right.

Brendon Buschman: Should we expect that strength to continue or was this just a strong Q1?

Speaker #1: So if you're comparing sort of quarter over previous quarter, that strength in RuPaul is mostly just the seasonality of the allergy season, which was a little bit stronger this year as a result of some of the forest fires.

Brendon Buschman: So if you are comparing quarter over previous quarter, that strength in Rupall is mostly just the seasonality of the allergy season, which was a little bit stronger this year as a result of some of the forest fires. But if you are just looking at it compared to the comparative quarter being Q1 of last year, it is going to be a little bit more consistent. If you remember, the product was genericized in, I believe it was January of 2025. We saw a pretty quick erosion and then it stabilized. I would just look at last year's quarterly phasing for the Canadian portfolio and expect it to be reasonably similar for fiscal 2027 here.

Speaker #1: But if you're just looking at it kind of compared to the comparative quarter being Q1 of last year, it's going to be a little bit more consistent.

Speaker #1: So if you remember the product was genericized in I believe it was January of 2025. And so we saw a pretty quick erosion and then it's kind of stabilized.

Speaker #1: So I would just sort of look at last year's quarterly phasing for the Canadian portfolio and expect it to be reasonably similar for fiscal '27 here.

Speaker #5: Okay, great. And then just a final question: On UM171, what should we think about as the next steps in terms of gauging how the timeline on that is progressing?

Scott Henry: Okay, great. Just a final question on UM171. What should we think about as the next steps in terms of gauging how the timeline on that is progressing? I know there is a couple options. Just want to get an idea of what to focus on there. Thank you.

Speaker #5: I know there are a couple of options. I just want to get an idea of what to focus on there. Thank you.

Speaker #3: Yeah. The next step is to get in front of Health Canada and discuss the regulatory path forward, being a Canadian development where there’s a large unmet medical need.

Ken d'Entremont: Yeah. The next step is to get in front of Health Canada and discuss the regulatory path forward. Being a Canadian development where there is a large unmet medical need, we are optimistic that we will be able to find an expedited path. But there is no guarantee on that until we negotiate that with the agency.

Speaker #3: We're optimistic that we'll be able to find an expedited path, but there's no guarantee on that until we negotiate with the agency.

Speaker #5: And in a situation like that, do you have to request a meeting? Have you requested a meeting? Is there a timeline when we think that may happen?

Scott Henry: And in a situation like that, do you have to request a meeting? Have you requested a meeting? Is there a timeline when we think that may happen? Just any color along the specific next steps around that

Speaker #5: Just any color along the specific next steps around that? Process getting in front of Health Canada?

Ken d'Entremont: Yes

Scott Henry: process of getting in front of Health Canada.

Speaker #3: Yes. So we have to request the meeting. I believe that has been done. I'm not sure that it's been set yet, but we would expect it to happen in the fall.

Ken d'Entremont: Yes. We have to request the meeting. I believe that has been done. I am not sure that it has been set yet, but we would expect it to happen in the fall.

Speaker #5: Okay. That's great. Thank you. And thank you for taking the questions.

Scott Henry: Okay. That is great. Thank you. And thank you for taking the questions.

Speaker #2: Your next question for today is from Michael Freeman with Raymond James.

Operator: Your next question for today is from Michael Freeman with Raymond James.

Speaker #6: Hey. Good morning. Time Brendan. And congratulations on these strong results. I'm going to start on graphopex. I recall you discussing that adult utilization is the key driver of this drug and then the reimbursement was very supportive of that.

Michael W. Freeman: Hey, good morning, Tim, Brendan, and congratulations on these strong results. I am going to start on GRAFAPEX. I recall you discussing that adult utilization is the key driver of this drug, and the reimbursement was very supportive of that. I wonder if you could describe penetration into the adult population and what you are seeing among docs for that adult population.

Speaker #6: I wonder if you could describe penetration into the adult population, and what you're seeing among docs for that adult population.

Speaker #3: Yeah, thanks, Michael. It's a good question. So, yeah, the growth that we're experiencing is largely coming from the adult population. I mean, we had really strong uptake in pediatrics initially, right out of the gate last year.

Ken d'Entremont: Yeah. Thanks, Michael. It is a good question. So, yeah, the growth that we are experiencing is largely coming from the adult population. We had real strong uptake in pediatrics initially right out of the gate last year. This growth is happening from adult institutions and with adult patients. As you probably know, or remind you that 85% of the market is adult patients. So clearly getting strong uptake in that segment is really important to us, and that is where we are seeing the growth coming from.

Speaker #3: And now this growth is happening from adult institutions, and with adult patients. And, as you probably know—or to remind you—85% of the market is adult patients.

Speaker #3: So, clearly, getting strong uptake in that segment is really important to us, and that's where we're seeing the growth coming from.

Speaker #6: That's great. I appreciate that color. Now, still on Graphopex, I wonder if you could just discuss what you're seeing as inventory levels among wholesalers, and if we're—and we saw a pretty close alignment between underlying demand and product-level revenue this quarter.

David Brown: That is great. I appreciate that color. Still on GRAFAPEX, I wonder if you could just discuss what you are seeing as inventory levels among wholesalers. We saw a pretty close alignment between underlying demand and product level revenue this quarter. I wonder if you could discuss that relationship and how you are seeing inventory levels now.

Michael W. Freeman: That is great. I appreciate that color. Still on GRAFAPEX, I wonder if you could just discuss what you are seeing as inventory levels among wholesalers. We saw a pretty close alignment between underlying demand and product level revenue this quarter. I wonder if you could discuss that relationship and how you are seeing inventory levels now.

Speaker #6: I was wondering if you could discuss that relationship and how you're seeing inventory levels now.

Speaker #3: I'll let Brendan take that one.

Ken d'Entremont: I'll let Brendon take that one.

Speaker #1: Perfect. Yeah, I can speak to that. Yeah. I know it's in our MDNA and our inventory levels at the end of June were about one time one month worth of inventory, a little bit less depending on which month you use.

Brendon Buschman: Perfect. I can speak to that. I know what's in our MD&A and our inventory levels at the end of June were about one month's worth of inventory, a little bit less, depending on which month you use. What we really saw is a strong, if you go back to the initial launch, wholesalers looking to hold two-plus months of inventory on hand. Then over the course of the year, that kind of reduced to about one time. So that was the case at 31 March, was the case at 30 June, which is why you sort of see that consistency between the demand sales and the ex-factory sales. We hope that consistency continues, but we don't have any control over wholesaler ordering patterns.

Speaker #1: But what we've really seen is a strong—if you go back to the initial launch, wholesalers were looking to hold two-plus months of inventory on hand.

Speaker #1: And then over the course of the year, that kind of reduced to about one times. So that was the case at March 31st. It was the case at June 30th, which is why you sort of see that consistency between the demand sales and the ex-factory sales.

Speaker #1: We hope that consistency continues, but we don't have any control over wholesaler ordering patterns.

Speaker #6: Okay. All right. Thank you, Brendan. Maybe one last one on some other aspects of your portfolio. I wonder if you could comment on the status of Rupall sales post-genericization.

David Brown: Okay. All right. Thank you, Brendon. Maybe one last one on some other aspects of your portfolio. I wonder if you could comment on the status of Rupall sales post-genericization. You mentioned some stability there, but wondered if you could go a bit deeper and then also touch on how IXINITY is trending.

Michael W. Freeman: Okay. All right. Thank you, Brendon. Maybe one last one on some other aspects of your portfolio. I wonder if you could comment on the status of Rupall sales post-genericization. You mentioned some stability there, but wondered if you could go a bit deeper and then also touch on how IXINITY is trending.

Speaker #6: You mentioned some stability there, but I wonder if you could go a bit deeper. And then also touch on how Xfinity is trending.

Speaker #3: I'll let Brendan take those two.

Ken d'Entremont: I'll have Brendon take those, too.

Speaker #1: Perfect. Yeah. So, RuPaul, I'm trying to remember—a couple of quarters ago, we had sort of spoken about how it had lost about 60% to about two-thirds of its unit volume.

Brendon Buschman: Perfect. So Rupall, I am trying to remember, a couple of quarters ago, we had spoken about how it had lost about 60% to about two-thirds of its unit volume. That has stayed stable. We have seen over the last couple of quarters that sort of market share. It is still slowly declining, but the rate of decline has slowed meaningfully. On IXINITY, we are seeing continued durable product, as we have talked about over the last couple of years at this point. What we did see this quarter, one of the reasons for the year-over-year improvement in revenue and EBITDA is IXINITY did have a strong quarter. Part of that, we believe, is timing, but timing of patient orders, not wholesaler orders. We did see, I think we called out in the MD&A, a 12% increase in demand quarter over comparative quarter.

Speaker #1: That has stayed stable. So we have seen over the last couple of quarters that sort of market share. It is still slowly declining, but the rate of decline has slowed meaningfully.

Speaker #1: On Xfinity, we are seeing continued, durable product performance, as we've talked about over the last couple of years at this point. What we did see this quarter—one of the reasons for the year-over-year improvement in revenue and EBITDA—is that Xfinity did have a strong quarter.

Speaker #1: And part of that, we believe, is timing. But timing of patient orders, not wholesaler orders. So it's we did see, I think we called out in the MDNA a 12% increase in demand.

Speaker #1: Quarter over comparative quarter, but it's still a little bit of wait and see how much that is durable and how much of that is just due to, say, people filling prescriptions before going on vacation, for example.

Brendon Buschman: But it is still a little bit of wait and see how much of that is durable and how much of that is just due to, say, people filling prescriptions before going on vacation, for example.

Speaker #6: Got it. Got it. Okay. That's all rational. Thank you very much. I'll pass it on.

Michael W. Freeman: Got it. Okay. That is all rational. Thank you very much. I will pass it on.

Speaker #2: Your next question is from David Martin with Bloomberg.

Operator: Your next question is from David Martin with Bloom Burton.

Speaker #5: Good morning. Can I have Brendan? This is Gurish on for David. Correct, on the quarter. Just starting with Graphopex, are you seeing any sort of off-label use for other indications such as Casgevy?

[Company Representative] (Bloom Burton): Good morning, Ken and Brendon Buschman. This is Gireesh on for David Martin. Correct on the quarter. Just starting with GRAFAPEX, are you seeing any sort of off-label use for other indications, such as CASGEVY?

[Analyst] (Bloom Burton): Good morning, Ken and Brendon Buschman. This is Gireesh on for David Martin. Correct on the quarter. Just starting with GRAFAPEX, are you seeing any sort of off-label use for other indications, such as CASGEVY?

Speaker #3: Yeah. Good question. So I think when we describe the pediatric uptake, we did call out that in the pediatric area, there tends to be a high degree of off-label use.

Ken d'Entremont: Yeah, a good question. I think when we describe the pediatric uptake, we did call out that in the pediatric area, there tends to be a high degree of off-label use. What we are seeing with the adult population, which is driving most of the volume now, is largely on-label. The initial uses tend to be very much on-label. AML, MDS, which are the two largest forms of leukemia that undergo allo transplant, at 10 grams, which is the label dose, that tends to be where they start. Then as they get comfort, it may move off-label, but it is our belief that most of the use we have gotten so far has been very much on-label.

Speaker #3: What we're seeing with the adult population which is driving most of the volume now is largely on label. So the initial uses tend to be very much on label.

Speaker #3: So, AML and MDS, which are the two largest forms of leukemia that undergo allotransplant: at 10 grams, which is the labeled dose, that tends to be where they start.

Speaker #3: And then as they get comfort, it may move off-label. But it's our belief that most of the use we've gotten so far has been very much on label.

Speaker #5: Okay, thanks. And could you quantify the expected impact of tariffs on your margins? And do you expect any further impact, or will any sort of cost be passed down?

[Company Representative] (Bloom Burton): Okay, thanks. Could you quantify the expected impact of tariffs on your margins, and do you expect any further impact or will any sort of cost be passed down?

[Analyst] (Bloom Burton): Okay, thanks. Could you quantify the expected impact of tariffs on your margins, and do you expect any further impact or will any sort of cost be passed down?

Speaker #1: Yeah, I can speak to that. So, our messaging on tariffs has been pretty consistent over the last few quarters. Our expectation remains on Rasuvo.

Brendon Buschman: Yeah, I can speak to that. Our messaging on tariffs has been pretty consistent over the last few quarters. Our expectation remains on Rasuvo, which is brought in from Germany, that the 15% EU-US negotiated tariff will apply. With GRAFAPEX, that could still apply, but there is a potential for an orphan drug carve-out. So we are waiting to sort of see how that pans out. But we still believe our base case or worst case, I guess, in that case, is the same 15% applying to GRAFAPEX. So the impact on our overall margins is not material. We do not anticipate any tariff specific price changes.

Speaker #1: Which is brought in from Germany, and the 15% EU/US negotiated tariff will apply. With Graphopex, that could still apply, but there is a potential for an orphan drug carve-out.

Speaker #1: So we are still we're waiting to sort of see how that pans out. But we still sort of believe our base case or worst case, I guess, in that case is the 15% the same 15% applying to graphopex.

Speaker #1: So the impact on our overall margins is not material. We don't anticipate any tariff-specific price changes.

Speaker #5: Okay, thanks. And just following up on Rasuvo, you did mention there was an ANDA filed this quarter. Is the 30-month stay in effect?

[Company Representative] (Bloom Burton): Okay, thanks. Just following up on Rasuvo, you did mention there was an ANDA filer this quarter. Is the 30-month stay in effect, and does this litigation change how you are thinking about the durability of Rasuvo demand, given that tailwind that happened when the competitor had exited?

[Analyst] (Bloom Burton): Okay, thanks. Just following up on Rasuvo, you did mention there was an ANDA filer this quarter. Is the 30-month stay in effect, and does this litigation change how you are thinking about the durability of Rasuvo demand, given that tailwind that happened when the competitor had exited?

Speaker #5: And does this litigation change how you're thinking about the durability of Rasuvo demand, given that tailwind that happened when the competitor had exited?

Ken d'Entremont: Yeah. So we do expect a 30-month stay to apply here. It has been filed. So, we think that the drug will just continue to perform along the demand trend that has been established. So we got the one-time kind of bump. It has been stable since then, and we would expect that to continue.

Speaker #3: Yeah. So we do expect a 30-month stay to apply here. It's been filed, so we think that the drug will just continue to perform along the demand trend that has been established.

Speaker #3: So we got the one-time kind of bump. It's been stable since then. And we would expect that to continue.

Speaker #5: Okay, thank you. That's it from us.

[Company Representative] (Bloom Burton): Okay. Thank you. That is it from us.

[Analyst] (Bloom Burton): Okay. Thank you. That is it from us.

Speaker #2: Your next question for today is from Chris Pugh with Canaccord.

Operator: Your next question for today is from Chris Pugh with Canaccord.

Speaker #6: Good morning. Yeah, thanks for taking my question. Another question on Graphopex regarding the NTAP. It looks like the fiscal year for Medicare ends at the end of September.

Chris Pugh: Good morning. Thanks for taking my question. Another question on GRAFAPEX regarding the NTAP. It looks like fiscal year for Medicare ends at the end of September. I am wondering if you are having any discussions with Medicare ahead of this first year of the program, and can we assume that it is going to continue?

Speaker #6: I'm wondering if you're having any discussions with Medicare ahead of this first year of the program, and can we assume that it's going to continue?

Speaker #3: Yeah. Thanks, Chris, for the question. So yes, the NTAP has been confirmed to continue for another year, which you’re right. It would be the second term for the NTAP for Graphoxetine, which would be initiated in October.

Ken d'Entremont: Yeah. Thanks, Chris, for the question. Yes, the NTAP has been confirmed to continue for another year, which you are right. The second term for the NTAP for GRAFAPEX would be initiated in October.

Speaker #6: Okay, that's great. And perhaps a question on the balance sheet: so the trading leverage ratio is about 1.2 times. Do you have, perhaps, a target leverage ratio before you're going to be diverting more capital towards that paydown versus other types of capital deployment?

Chris Pugh: Okay. That is great. Perhaps a question on the balance sheet. The trading leverage ratio is about 1.2 times. Do you have perhaps a target leverage ratio before you are going to be diverting more capital towards debt paydown versus other types of capital deployment?

Brendon Buschman: It is a good question. It is something we are obviously constantly looking at as we balance our leverage versus paying for some of the BD opportunities that we are looking at. I will say historically, we had gotten up into the 3 times range, and I think given the durability of our established portfolio and our level of conviction on GRAFAPEX, we would be comfortable getting back to that range.

Speaker #1: It's a good question. It's something we're obviously constantly looking at as we balance our leverage versus paying for some of the BD opportunities that we're looking at.

Speaker #1: I will say historically, we had kind of gotten up into the three times range. And I think given the durability of our sort of established portfolio and our level of conviction on graphopex, we would be kind of comfortable getting back to that range.

Speaker #6: Okay. Great. That's for me.

Chris Pugh: Okay, great. That's for me.

Speaker #2: Once again, if you would like to ask a question, please press star one. We have reached the end of the question-and-answer session. And I will now turn the call over to Ken for closing remarks.

Operator: Once again, if you would like to ask a question, please press star one. We have reached the end of the question and answer session, and I will now turn the call over to Ken for closing remarks.

Speaker #3: Thank you, everyone, for joining us on the call today. We are encouraged by the strong start to fiscal ’27 and the progress we continue to make across the business.

Ken d'Entremont: Thank you, everyone, for joining us on the call today. We are encouraged by the strong start to fiscal 2027 and the progress we continue to make across the business. The commercial success of GRAFAPEX, combined with our expanding presence in the Allo HSCT space, reinforces our confidence at Medexus's long-term growth strategy. We appreciate your continued interest and support, and thank you for joining us.

Speaker #3: The commercial success of graphopex combined with our expanding presence in the allo HSCT space reinforces our confidence that Medexus is long-term growth strategy. We appreciate your continued interest and support.

Speaker #3: And thank you for joining us.

Operator: This concludes today's conference, and you may disconnect your lines at this time. Thank you for your participation.

Q1 2027 Medexus Pharmaceuticals Inc Earnings Call

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