BioCryst Pharmaceuticals - Q4 2025

Transcript

Operator (participant)

Welcome to the BioCryst 4th quarter 2025 conference call. All participants will be in listen-only mode. Should you need assistance, please signal a conference specialist by pressing the star key followed by zero. After today's presentation, there will be an opportunity to ask questions. To ask a question, you may press star, then one on your telephone keypad. To withdraw your question, please press star then two. Please note this event is being recorded. I would now like to turn the conference over to Nick Wilder with BioCryst. Please go ahead.

Nick Wilder (Manager, Investor Relations)

Good morning, and welcome to BioCryst's full year 2025 corporate update and financial results conference call. Participating with me today are President and CEO, Charlie Gayer, Chief Financial Officer, Anthony Doyle, and Chief Development Officer, Dr. Bill Sheridan. A press release and slide presentation about today's news are available on our investor relations website. Today's call may contain forward-looking statements, including statements regarding future results, unaudited and forward-looking financial information, as well as the company's future performance and or achievements. These statements are subject to known and unknown risks and uncertainties, which may cause our actual results, performance, or achievements to be materially different from any future results or performance expressed or implied in this presentation. For additional information, including a detailed discussion of these risks, please refer to slide 2 of the presentation. In addition, today's conference call includes non-GAAP financial measures.

For a reconciliation of these non-GAAP financial measures against the most directly comparable GAAP financial measure, please refer to the earnings press release available on our investor relations website. I'd now like to turn the call over to Charlie.

Charlie Gayer (President and CEO)

Thanks. Thanks, Nick. This is my first earnings call as CEO of BioCryst, and I'm happy to report. Happy about where the company is today and even more excited about our future. We closed 2025 with strong momentum, delivering full-year ORLADEYO revenue of $601.8 million. That was up 38% for the year and 43% when you exclude our Europe business that we sold in October. We are also starting 2026 on a high note as we expanded our HAE portfolio and with our acquisition of Astria Therapeutics last month. As I step into my new role, I want to be clear about BioCryst strategy. We are and will remain a profitable, rare disease company, committed to meeting the unmet needs of patients through commercialization, innovation, and excellence that is backed by well understood biology and disciplined clinical development.

Where we will continue to evolve is how focused and explicit we are about capital allocation and accountability. We want to ensure that every dollar we deploy has a clear line of sight to driving long-term value creation. Coming back to our HAE portfolio, we see tremendous opportunity to build value by meeting the needs of a growing number of HAE patients. We view HAE not as a winner-take-all efficacy race, but as a structurally segmented market driven by biology, patient preference, and real-world experience. Rather than a market that resets with every new entrant, we see a market that segments based on the needs of individual patients. We now have a portfolio of differentiated products in ORLADEYO capsules for ages 12 and up, ORLADEYO Pellets for younger kids, and a late-stage asset in navenibart.

Each of these therapies will allow us to achieve growth and durable revenue within specific segments of the market. ORLADEYO has grown strongly, in part because of its differentiation as the oral option. More importantly, there is a super responder population that can get injectable-like attack control. We saw in our pivotal trial that just over 50% of patients starting on ORLADEYO stayed on for two years and had a 91% reduction from baseline. In the real world, 60% of patients stay on therapy through 12 months, and nearly 50% of all patients who have tried ORLADEYO in the U.S. over the past five years are still on therapy. Most ORLADEYO super responders are unlikely to switch, even if another oral option reaches the market, because their needs are already met.

Now we have a new member of the ORLADEYO family. We are excited to launch ORLADEYO Pellets for kids ages 2 to under 12 at the AAAAI conference this weekend. The unmet need is significant because HAE and related attacks are underdiagnosed in younger kids, and prophy usage is only half that of adults. Availability of a safe, effective, and targeted oral prophy has the potential to change how kids with HAE grow up, and ORLADEYO is likely to be the only oral option for several years to come. We think about navenibart through that same lens of structural differentiation in HAE. navenibart is not intended to replace ORLADEYO. It is intended to allow BioCryst to address patients' needs across the full spectrum of efficacy, dosing, and convenience preferences in HAE prophylaxis.

There are approximately 5,000 US patients who have great attack control by injecting anywhere from twice a week to every four weeks. Most of them are reluctant to take a chance on oral because they are well controlled already, and the injections themselves are not a barrier to treatment. Oral is not their need. Our research shows that many are very attracted to the idea of a simple, high-efficacy injectable dosed just 2 or 4 times per year... That is a leap patients dosing an injectable 12, 26, or even one over one hundred times per year are likely to make because it aligns with what they know and provides something better. Our objective is to keep the HAE prophylaxis treatment decisions within the BioCryst portfolio.

That is another way we think about long-term durability, not as defending a single product, but as owning the prophy decision framework in HAE. We will offer three compelling options, all from a team that the HAE community knows and trusts. Before turning to Bill, I want to briefly touch on BCX-17725, our early-stage program in Netherton syndrome. This is a classic rare disease story, a devastating genetic condition that is underdiagnosed because there are no good treatment options. We are encouraged by the results in healthy volunteers and the investigator enthusiasm for this program. We're on a path to generate clinical data in patients by the end of the year, and we'll use that evidence, plus feedback from patients and investigators to guide next steps.

Looking ahead to 2026 and beyond, we see durable revenue growth anchored by a skilled, motivated, and resilient commercialization team, meeting the needs of adults and kids who want oral HAE prophylaxis. A second molecule advancing well in late-stage development that has the potential to lead the injectable prophylaxis segment, and additional rare disease optionality in our pipeline, positioning BioCryst for sustained value creation. With that, I'll turn it over to Bill to provide more color on our pipeline.

Bill Sheridan (Chief Development Officer)

Thank you, Charlie. I'll cover our HAE programs to start with, and then provide a brief update on our Netherton syndrome program. First, the navenibart pivotal phase 3 trial continues to recruit very well, with strong enthusiasm for the study from investigators and potential trial patients. We expect to complete enrollment of the required 145 patients around the middle of 2026. The primary efficacy analysis of the Alpha Orbit pivotal trial will be the comparison between each navenibart dosing regimen and placebo, of the time-normalized rate of investigator-confirmed HAE attacks through 6 months.

The phase 2 efficacy and safety profile that we are reporting at AAAAI this weekend from the Alpha Solar trial is excellent, with no safety signals in 29 patients through up to 24 months of dosing, and reductions from baseline in mean attack rates of 92% for every three months dosing and 90% for every six months dosing. Overall, the mean attack rate decreased from 2.23 per month at baseline to 0.16 per month during navenibart treatment. For both dose regimens, the median attack rate reduction was 97%. These are outstanding results. These strong results illustrate the durability, consistency, and quality of treatment responses with navenibart and provide high confidence that the pivotal trial will be successful.

We expect the pivotal trial results to confirm that navenibart every 3 months or every 6 months, will set a new standard in the field and provide a very attractive choice for HAE patients seeking injectable prophylactic therapies. Second, we are thrilled that our application for ORLADEYO oral pellets for children aged 2 to less than 12 was approved by FDA in December 2025. We are now continuing with marketing authorization applications in other major regions, with the goal of transforming treatment choice for patients, for parents, and children with HAE around the world. Third, our clinical development program for our KLK5 inhibitor, Fc-fusion protein BCX17725 in Netherton syndrome, has now moved into patient-focused research. The healthy volunteer Parts 1 and 2 of our phase 1 trial with single and multiple ascending doses have been completed.

BCX17725 was administered by subcutaneous and intravenous routes in these healthy volunteer cohorts. Our investigational drug was safe and well tolerated. There were no discontinuations, no dose-related adverse findings, and no safety signals. The top dose administered was 12 milligrams per kilogram every two weeks for three doses. As noted in our last call, we were pleased to see evidence of the drug distributing to the epidermis. Drug exposure was approximately linear and proportional to dose, and the estimated half-life was about 12-19 days, supporting continued study of every two-week administration schedules. Today, I'll provide a refresher on study design and update on progress in the Netherton syndrome cohorts. The study design is outlined on slide 18.

The patient cohorts in the study are open label and designed to evaluate potential effects of the drug on clinical signs and symptoms of Netherton syndrome, as well as safety and drug exposure. There are two patient cohorts: a short-term administration cohort in Part 3, with 4 weeks of dosing, and a longer-term cohort in Part 4, with 12 weeks of dosing. Some sites are activated for Part 3 after short-term non-clinical safety studies were completed, and subsequently were activated for Part 4 on the once we had longer-term non-clinical safety studies done. We are prioritizing recruitment into Part 4, as this will give us a longer dosing experience and anticipate that no more than three patients will be entered into Part 3. Our clinical investigators are excited about the potential for this drug in Netherton syndrome and have identified patients who could be eligible.

We expect to recruit up to 12 patients in Part 4 and generate results by the end of this year. For efficacy, the primary efficacy endpoint is changed from baseline in the Ichthyosis Area and Severity Index, otherwise known as the IASI score, and key secondary endpoints include the Investigator Global Assessment score and the Worst Itch Numerical Rating Scale score, and we will also evaluate quality of life metrics. We intend to select doses and endpoints for a pivotal trial based on what we see in this phase one trial. I'll now turn the call to Babar for the financial review.

Babar Ghias (CFO and Head of Corporate Development)

Thanks, Bill. Last year was a defining year for our company. We delivered strong top-line growth, record profitability, and reinforced our strong balance sheet position. Those results weren't just numbers. They were proof that our strategy is working and our operating model is built for scale. Before I turn to financials, I want to highlight that we are providing more clarity in our financials to enable a better understanding of the strength of our core business. Please refer to today's press release for our GAAP financial metrics. In my remarks, I will be referring to non-GAAP figures, which are adjusted for the sale of the European ORLADEYO business, stock-based comp, workforce reduction costs, and transaction-related costs. We believe that non-GAAP figures provide a clearer view of the business on a forward-looking basis. Our non-GAAP 2025 total revenue increased 45% year-on-year.

Since other revenues include contribution from RAPIVAB, which is non-core to our business, I would draw your attention to the non-GAAP ORLADEYO revenues, which increased by approximately $169 million or 43% year-on-year. This was a result of phenomenal day-to-day execution by our commercial team over the course of 2025. By leveraging our superior real-world evidence generation capabilities, we successfully drove higher patient volume and made significant progress on paid shipments. We have already started to see the impact of the European divestiture on our operating performance in Q4. Our non-GAAP operating profit jumped to $214 million, an increase of 198% year-on-year, highest ever in BioCryst's history. R&D costs came down slightly in 2025 as we progress key programs while winding down some others and realigning the team structure.

We anticipate that 2026 R&D costs will increase over 2025 as we complete the ongoing phase 3 trial and BLA-enabling CMC activities for navenibart. These activities, once complete, will naturally bring down development costs beyond 2026. We will remain razor-focused on maintaining R&D spending discipline and allocating capital to high ROI opportunities. In the same spirit, we will quickly terminate programs that do not have a compelling path forward. Our sales and marketing expenses for the year were $144 million on a non-GAAP basis, which were primarily up due to some reallocation methodology, pre-launch costs for pediatrics, and higher specialty distribution fees and incentive comps, naturally owing due to the strong top-line growth. As you can calculate, that for every dollar invested in our sales and marketing engine, we generated an approximately four times return on ORLADEYO net sales.

While we do anticipate some small incremental in annual expense tied to top-line growth, the ROI on ORLADEYO will continue to expand as we drive the business toward its blockbuster potential. Looking further ahead to potential approval of navenibart, the sales and marketing expense supporting our HAE franchise as a whole will be very stable, predictable, and carry an even greater ROI upside. We have built one of the best rare disease commercial organizations in the industry, a highly scalable infrastructure that will enable us to deliver multiple successful launches in years to come in HAE and beyond, whether it's another candidate from our pipeline or something that we acquire in license. Driven by our strong operational results, we finished the year with a formidable liquidity position of $337.5 million in cash and investments on hand.

Concurrent with the closing of the Astria acquisition, we entered into a highly attractive $400 million financing facilities with Blackstone Life Sciences, a financial partner that is aligned with our vision of growth. With the sustained momentum, coupled with the added benefit that now for the next two years, we will be able to utilize our prior period tax NOLs, we will be in a very strong cash flow generating position. This will afford us optionality to evaluate a wide array of capital allocation strategies that reinforce durable value creation, be it M&A, debt paydown, or buybacks. Moving on to guidance. We are maintaining expectations for full-year 2026 ORLADEYO revenues to be between $625 million and $645 million, which at the midpoint represents approximately 13% growth over 2025 revenues adjusted for Europe.

We expect full-year 2026 non-GAAP OpEx to be between $450 million and $470 million, which now includes expenses on Astria, as previously guided. As Charlie emphasized, we remain very confident that ORLADEYO is in a solid footing to achieving blockbuster potential. We continue to see patient growth driven by the trends that we explained earlier, coupled with the recent pediatric approval, which will be an important component of the growth. After turning over this profitability card in 2025, we are very committed to staying profitable and continuing to drive cash flow generation going forward. To summarize, as we reflect on 2025, it is clear that the strength we delivered this past year is more than a financial milestone. It's a springboard for what comes next.

We are entering 2026 with momentum, a sharpened competitive edge, and a discipline that ensures every investment we make is working towards value creation.

Our goal is to keep advancing our pipeline through both organic innovation and selective disciplined BD that can expand our capabilities and accelerate our impact in the rare disease space. We are very excited to keep building the next growth phase of BioCryst, a company that not only performs quarter to quarter, but compounds value over the long term as we execute on that vision. Operator, we are now ready for your questions.

Operator (participant)

We will now begin the question-and-answer session. To ask a question, you may press star, then one on your telephone keypad. If you are using a speakerphone, please pick up your handset before pressing keys. If at any time your question has been addressed, and you would like to withdraw your question, please press star, then two. At this time, we will pause momentarily to assemble our roster. Our first question comes from Laura Chico with Wedbush Securities. Please go ahead.

Laura Chico (Managing Director, Equity Research)

Good morning, guys. Thanks for taking the question. I guess I wanted to start off on navenibart. Could you talk a little bit more about the timing for the regulatory submission by year-end 2027? Does that assume phase 3 data is still arriving by early 2027? I guess I just wanted to understand the steps that have to occur between top-line data and submission. Related to that, you mentioned the AAAAI late breaker. How should we think about this, I guess, in relation to Alpha Star? It seems quite consistent in terms of the attack rate reductions. I'm wondering if there's incremental learnings here around maybe attack-free period. Thanks very much.

Charlie Gayer (President and CEO)

Thanks, Laura. it, yeah, we're clearly super excited about navenibart. Yes, everything is on track for filing such that we would be on track for filing by the end of next year, and so on track for approval by late 2028. The... Bill, do you want to answer the question just about the regulatory process?

Bill Sheridan (Chief Development Officer)

Sure.

Charlie Gayer (President and CEO)

Next steps.

Bill Sheridan (Chief Development Officer)

Like for other prophylactic therapies in HAE, 12 months, it's a chronic condition. You need 12 months of safety. That'll be delivered in mid-2027, and that's really what's driving the timing of the BLA submission. What was the final question?

Charlie Gayer (President and CEO)

The final question, just the data. Yeah, we're really excited about the data. The 92% reduction, mean reduction for the 3-month dose, the 90% for the 6-month dose, just so shows incredible consistency. I think what's also really important is the mean attack rate of 0.16 across the population from their baseline. You know, that's less than two attacks per year for patients. What that means is, plus, the severity of the attacks went down as well. For most of the year, patients are functionally attack free, that's what patients are looking for.

Laura Chico (Managing Director, Equity Research)

Thanks very much. I'll hop back in the queue.

Operator (participant)

Our next question comes from Brian Abrahams with RBC Capital Markets. Please go ahead.

Brian Abrahams (Managing Director)

Hey, good morning, guys. thanks for taking my questions. Congrats on the continued strong progress. You talked a little bit about the ORLADEYO super responders, you know, staying on, with, you know, good persistence for long periods of time. I guess, do you have any sense of how to predict who would be a super responder? Just maybe along those lines, I'm curious how you envision positioning navenibart in that context in terms of, you know, do you push patients to switch to ORLADEYO, and then if they don't respond, you know, they could, you know, navenibart could be an option for them, or would you be primarily positioning navenibart for those, you know, 5,000 patients doing well on injectables who could use something that's less frequently dosed?

Just maybe remind us of some of the aspects of the profile for navenibart in terms of numbers of injections, anti-drug antibodies, refrigeration requirements, just anything else that needs to be done, with regards to formulation, ahead of commercialization. Thanks.

Charlie Gayer (President and CEO)

Great. Thanks. Thanks, Brian. I'll start, and then I'll have Bill answer some of those questions as well. As far as the predictability of the super responders in ORLADEYO, there really is no way to predict other than patients trying. First of all, patients got to want to be on an oral, and we know that the majority of patients actually would prefer an oral. As we've looked at all of our clinical data, you know, all the different factors, age, sex, prior prophy history, weight, everything else, there is nothing that can predict who is going to respond. As we know, HAE is a, you know, attacks are often driven by stress, other life factors. I think, you know, our strategy is to try to get patients who are interested in oral to try.

Most of them do great. We want them to do a 3-to-6-month trial to really figure out if it's the right drug for them. As we see, you know, by a year, about 60% of them realize that it is the right drug for them. As far as the navenibart positioning versus ORLADEYO, we see the primary opportunity for navenibart to be those 5,000 patients on injectables. Like I said in my remarks, those patients are on injectables because they're doing well, but they're, you know, some of them are injecting 100+ times a year. To be able to do just 2 to 4 injections, we think is going to be really compelling, and that's what we see in our patient research. ORLADEYO then is going to be for patients who want to start prophy on oral.

It's going to be the known, trusted option with many years of data and experience. ORLADEYO is for anyone who wants oral. navenibart is for people who want an even better injectable positioning. For those patients who try ORLADEYO, and it's not the drug for them, that also is an opportunity for navenibart, all within the same BioCryst portfolio. For navenibart, the number of injections is really going to be very simple. It's going to be launched with an auto-injector and the 3-month dose after a 600 mg loading dose, which will be 2 injections, 2-milliliter injections. The 3-month dose is then one injection. The 6-month dose is 2 injections. Very simple. Bill, there was also a question just around ADAs and.

Bill Sheridan (Chief Development Officer)

Yeah.

Charlie Gayer (President and CEO)

Other things that...

Bill Sheridan (Chief Development Officer)

Before I get into that, with regard to predictability, I'll just reinforce what Charlie said. You have to try ORLADEYO to find out whether you're gonna be a super responder. It benefits people in every category with HAE. In addition to age, sex, race, weight, prior Prophy exposure, you can also add to that whether you have a high attack rate or a low attack rate, whether it's less or more predictable, whether you have type one or type two HAE or C1 inhibitor, normal HAE, all of those categories benefit, and we've shown that very definitively from both our clinical trials and our real-world evidence studies. You also asked about the maturity of the formulation development program for navenibart. It's all done. It's very mature.

CMC is in a great spot.

Charlie Gayer (President and CEO)

Just a question about ADAs.

Bill Sheridan (Chief Development Officer)

With regard to ADAs, there's no evidence of ADAs impacting efficacy in the phase 2 experience. You know, of course, with every biologic, it's part of the development program. You develop assays and look for ADAs. You always find them, and what matters is, do people continue to benefit from the drug? So far, that is exactly the case. There's no evidence of ADA impacting either safety or efficacy.

Charlie Gayer (President and CEO)

Just to remind folks, the data being presented this weekend, these are patients on navenibart who out to as far as 24 months.

Bill Sheridan (Chief Development Officer)

Yeah.

Charlie Gayer (President and CEO)

With a mean of about 12 months.

Bill Sheridan (Chief Development Officer)

One last thing about the injections, they don't hurt.

Charlie Gayer (President and CEO)

Yes.

Brian Abrahams (Managing Director)

It's really helpful. Bill, Charlie, thank you guys so much.

Bill Sheridan (Chief Development Officer)

Thanks, Brian.

Operator (participant)

The next question comes from Steven Seedhouse with Cantor Fitzgerald. Please go ahead.

Mikaela Vanik (Research Associate)

Yes. Hi, this is Mikaela Vanik on for Steve. For Netherton, we just wanted to clarify, are you guys going to be releasing part 3 and 4 data at the same time? Also, could you talk about disease severity, the variability at baseline? Do you anticipate that, how difficult would it be to enroll variable patients, I mean, more uniform patients? You know, what background treatments are allowed and how patients proceed based on their disease phenotype? Thank you.

Charlie Gayer (President and CEO)

Okay. I'll start with just the part 3 and 4. Bill can talk about the disease severity and the patient types. Our plan is to release all the data together. We're only gonna have maybe 2 or 3 patients in part 3, and as Bill said, we're now prepared across our sites to go into part 4, and that 3-month dosing is what we think is really gonna be meaningful. We don't plan to do one patient at a time. We want to release a complete data set. Bill, just talk about the patients.

Bill Sheridan (Chief Development Officer)

Sure. With regard to the spectrum of severity, there is one for sure in Netherton syndrome. What we're finding from our research onto the prevalence of the disease, for example, is, like Charlie said, it's underdiagnosed, and that's probably partly because mostly because there are no approved treatments, but also because differences in severity from one patient to the next. The patients we've met with this illness have obvious, really obvious disease, and they have adapted coping strategies, and, you know, their lives have been dramatically impacted. That part of it I'm not worried about in terms of recruiting subjects.

You know, the investigators that we have that are lining up their subjects are more worried about getting spots for their subjects in the trial rather than not having enough patients to put in the trial. The, with regard to the eligibility, yes, we need to have evidence of illness so that we can identify whether there's benefit from the drug. We're doing that. We're selecting patients that have obvious illness. You know, I think, I think it'll, I think it'll be fine. I'm not worried about that.

Mikaela Vanik (Research Associate)

Okay. Thank you.

Operator (participant)

The next question comes from Maury Raycroft with Jefferies. Please go ahead.

Speaker 9

Hi, this is Amy on for Maury, and congratulations on the quarter. Just a follow-up on a previous question. Can you provide more specifics to how you would provide updates and disclosure around the navenibart program? Can you talk about your strategy to potentially get FDA on accelerating the timelines? Thank you.

Charlie Gayer (President and CEO)

Sure. For navenibart, as Bill mentioned, the enrollment is going well, we would probably update once we have the pivotal study fully enrolled. Then, what was the second part?

Bill Sheridan (Chief Development Officer)

The second part is about doing our best to pull that forward...

Charlie Gayer (President and CEO)

Yeah.

Bill Sheridan (Chief Development Officer)

as this program matures.

Charlie Gayer (President and CEO)

That's obviously something we'll be focused on. For example, elements of the BLA that we can start writing, we'll start to write. We won't have a crystal clear understanding of the timing of the BLA until two things happen, one is the last patient, first visit, so that we can predict when the last visit is for 12 months later, obviously. The next is getting clarity with the division at a pre-BLA meeting on the total content of the BLA, obviously, that comes later. I think we'll be able to provide more clarity in due course.

Speaker 9

Thank you.

Operator (participant)

The next question comes from Jon Wolleben, Citizens JMP. Please go ahead.

Speaker 8

Hi, this is Catherine on for Jon. I just have a quick question about if you guys are seeing any impacts from kind of the recent new entrants, including the oral acute therapies. Are any patients, like, sort of switching to ORLADEYO, or are you seeing kind of differences in the reasons for patients switching? I know there's not really been much of an impact on revenues, but if you expect any impact or if you're starting to see it at all, any color on that? Thank you.

Charlie Gayer (President and CEO)

Sure, Catherine. You know, as we said, particularly a lot last year, leading up to new entrants coming in, we did not expect there to be an impact on ORLADEYO from new prophy entrants because there's a real difference between patients who want oral prophy and then patients who are more comfortable with injectables. We expected the injectables to be competing more with existing injectables, and that's what we're seeing. It's not changing ORLADEYO prescribing patterns or patient patterns in general. As far as oral, on-demand oral acute therapy, that's something we're certainly seeing. Not seeing it affect ORLADEYO negatively in any way.

We think over time, there is a potential for a tailwind of just patients who want to be in an all-oral combination, so one pill once a day to prevent attacks, and then for the occasional breakthrough attacks, treat with another oral. That's a great opportunity for many patients, but it's too early to say whether that tailwind is going to occur.

Speaker 8

Thank you so much.

Operator (participant)

The next question comes from Serge Bélanger with Needham & Company. Please go ahead.

Speaker 10

Hi, good morning. This is John on for Serge today. Thanks for taking our questions. First, just on ORLADEYO. You know, you guys took a 9% price increase in January. Beyond that, you know, curious which levers you'll be looking at most closely in 2026, whether it be, you know, maintaining trends of new patient adds or making slight improvements on paid prescription rates, either in Medicare or commercial channels. And then on the pellet formulation for pediatrics, curious how we should think about the pacing of patient identification and conversion throughout 2026. And does your current guidance, you know, assume any material contribution from this segment this year?

Charlie Gayer (President and CEO)

Great. Thanks. Thanks, John. Yeah, we did take up a 9% price increase in early January, which is higher than we've done in the past. We'll net about half of that, so about 4.5%. That is something more because ORLADEYO was a lot lower priced than most of the other products in the market, and so this was just a little bit of a catch up, but not something that we need that kind of pricing going forward to get to our long-term peak of $1 billion. For this year, the KPI that is most important to us is net patient growth.

As we've said, in our slides today, what we need is 150 patients, net patient growth average per year for this year and three more years to hit $1 billion in 2029. We are very much within sight of getting to that $1 billion. That, that's the number 1 thing. Of course, we're always working to improve the paid rate incrementally. We made a big jump in that last year, and now it's just about making incremental improvements, and we're using our real-world evidence. For example, in patients with normal C1 inhibitor, we're starting to see more plans adopt favorable coverage policies for this based on the real-world evidence that we're providing. That's a constant process.

For the pellets, one of the things I mentioned in my remarks is HAE is underdiagnosed in kids. We've found about 500 patients in claims data for kids under age 12, but statistically, based on the epidemiology, there should be 1,200. One of the reasons is, you know, parents are sometimes reluctant to get their kids tested because they're frankly hoping their kids don't have HAE. But the availability of an oral therapy, we think, and we've seen this in the early days of the HAE market, having a therapy encourages diagnosis. There's a market growth opportunity, and then kids are only treated with prophy at about a 40% rate, which is half that of adults.

There's kind of a potential to up to double the number of kids diagnosed and up to double the treatment rate, and we think that an oral prophy is the thing to do that. As far as guidance, yeah, the pellets, the pedes launch is in our guidance for this year, but it's a really small part. We are very bullish long term on what this indication is gonna mean for kids and for revenue. What we don't know is how quickly that transformation is gonna happen. We've been conservative in our thinking for this year, and then we'll see how it goes. It, you know, if it goes faster than we expect, it could be a tailwind.

Operator (participant)

Great, thanks for the color. Again, if you have a question, please press star, then one. Our next question comes from Stacy Ku with TD Cowen. Please go ahead.

Speaker 11

Hi, team. This is Vish on for Stacy. Congratulations on a great year, and really appreciate your comments on the competitive dynamics. Thanks for taking our questions. We have a couple. First, for ORLADEYO expectations for Q1, can you give us an idea of how the reauthorization process is progressing this year? We know you had made some improvements in the process last year, which resulted in faster than expected reauthorizations. Just walk us through what you're seeing and what we and investors should expect for Q1. Then, second, and final for us, are you know, given the EU business sale, are you willing to split your 2026 guidance for us into ex- for US and ex-US contributions? How should we be thinking about that?

Charlie Gayer (President and CEO)

Great, thanks, Vish. I'll take the first question, then pass it over to Babar for the second question. Q1, every Q1 is the big reauthorization season. It's a ton of work. Our team prepares for it. They're right in the midst of that process, and our team's gotten really good at it. What you should expect for Q1, because this year we don't have any huge tailwind like we did last year with the Medicare patients and the Affordable Care Act, making, the IRA, making it more affordable for patients. The Medicare patients are in great shape, we won't have that tailwind. This year, you should expect revenue probably to be slightly down versus Q4 as we go through the reauth.

We have to give away more free product, we have to pay a higher percentage of co-pays for the commercial patients. That drops revenue even as our patient base continues to grow. Down a bit in Q1, and then it pops up again in Q2. Babar, you wanna just talk about the U.S. versus global?

Babar Ghias (CFO and Head of Corporate Development)

Sure, yeah. With respect to your question on the costs and contributions from Europe, if you look at our press release in the financial tables, we actually attempted to break out all that European business. I think as we have previously stated, that European business, while growing, was also loss-making. You can actually see that our base business margins were incredibly strong compared to the U.S. business margins are incredibly strong compared to Europe. When you look at that profitability metric that I quoted, $214 million, that strips out all of Europe. From the exhibits, you can glean that the base business costs are $380 million, roughly, for U.S. in 2025.

To give you a perspective, what looks like in 2026, and this goes back to the same cost discipline, we shed off Europe, but we added a very, very highly de-risked late-stage program in navenibart. Our total costs are in the $450-$470, of which the base business is actually not growing by much. The cost additions are primarily coming from adding Astria. That's the discipline that I talked about, that we will continue to make sure that our base business costs remain low and, we continue to drive growth. Hope that answers your question.

Speaker 11

Yeah. Sorry, thanks for the clarity, Babar. My question was relating to the 2026 guidance, the $625 million-$645 million that we're expecting for this year. How should we think about the US and ex-US split there?

Babar Ghias (CFO and Head of Corporate Development)

Yeah, a majority of that is going to be from the U.S. We have

Speaker 11

Okay.

Babar Ghias (CFO and Head of Corporate Development)

- some markets, as you can see, you know, after Europe, the split usually. Now it's a little bit over 90%, so majority of that, while we're not breaking out, majority of that is, you know, from, coming from the U.S. business.

Speaker 11

Got it. Thank you very much.

Operator (participant)

This concludes our question and answer session. I would like to turn the conference back over to Charlie Gayer for any closing remarks.

Charlie Gayer (President and CEO)

Thanks, thanks very much. 2026, as we've been describing, is a really big year for BioCryst. We've got continued ORLADEYO patient growth. We're super excited about the launch of ORLADEYO for kids. A lot of important clinical trial execution for navenibart in BCX17725, that's going well. I'd really like to thank all the hardworking owners at BioCryst for what they did to make 2025 a great year, and what they're doing this year to deliver another year of great results. Thanks, everyone. Have a great day.

Operator (participant)

The conference is now concluded. Thank you for attending today's presentation. You may now disconnect.