Evoke Pharma Inc (EVOK)·Q4 2024 Earnings Summary

Executive Summary

• Q4 revenue was approximately $3.3M, up 24.6% sequentially; full-year 2024 revenue reached $10.25M (+97.8% YoY), modestly above the revised FY24 guide, with Q4 net loss of ~$1.2M or $0.49 per share .
• Management issued FY2025 net revenue guidance of approximately $16M (+~60% YoY), citing momentum in prescriber growth, improved fulfillment with ASPN, and reimbursement initiatives as drivers .
• Commercial KPIs strengthened: cumulative prescribers reached 2,553 (+46% during 2024), fill rates rose 72% YoY, and patient enrollments increased 22% YoY; management highlighted expanding pharmacy partnerships and new field reimbursement managers to improve prior authorization throughput .
• Strategic and regulatory tailwinds include new patents (Orange Book-listed in Q1’25), the Vanda CRL (tradipitant) keeping GIMOTI the only FDA-approved diabetic gastroparesis therapy in over a decade, and the FDA’s indicated discontinuation of domperidone expanded access supply in early 2025, all reinforcing GIMOTI’s positioning .

What Went Well and What Went Wrong

• What Went Well

  • Sequential acceleration: “Q4 2024 revenue increased 24.6% to $3.3 million over Q3 2024,” capping FY revenue at $10.25M (+97.8% YoY) and exceeding prior guidance .
  • Commercial execution: Transition to ASPN Pharmacies improved fulfillment; prescriber base grew 46% to 2,553; fill rates +72% YoY; patient enrollments +22% YoY. CEO: “2024 was a transformative year… Our revenue nearly doubled year-over-year, reaching $10.2 million…” .
  • Strategic moat: Two new U.S. patents (Orange Book-listed in Q1’25) and Vanda’s CRL underscore GIMOTI’s uniqueness; FDA’s domperidone discontinuation heightens need for non-oral alternatives .

• What Went Wrong

  • Losses persist amid higher OpEx: Q4 net loss ~$1.2M ($0.49/share) despite revenue growth; Q4 SG&A rose to ~$4.4M and total OpEx to ~$4.5M as commercialization costs stepped up .
  • Prior-authorization friction: Only ~50% of PAs are completed; company is adding 4 field reimbursement managers to improve conversion and reduce leakage, implying current access frictions remain a headwind .
  • Guidance dependencies and macro risks: 2025 guidance depends on reimbursement/fill assumptions and external factors (macroeconomy, supply chain, inflation), suggesting execution/macro sensitivity remains elevated .

Financial Results

Notes: Management does not disclose Q4 COGS separately; gross margin and EBITDA not provided in Q4 materials. S&P Global consensus estimates were unavailable at the time of analysis; we will update when accessible.

Segment breakdown: Not applicable (single commercial product, GIMOTI) .

KPIs

Guidance Changes

Earnings Call Themes & Trends

Management Commentary

• CEO (press release): “2024 was a transformative year… Our revenue nearly doubled year-over-year, reaching $10.2 million, and we exceeded our previous guidance… The transition to ASPN Pharmacies played a crucial role… improving prescription fulfillment rates and patient access.”
• CCO (call): “We launched a fully integrated omnichannel program powered by artificial intelligence… our reach to targeted physicians [rose] to 60%… 2,000 additional calls… 16% email open rate vs. industry average 2%.”
• CFO (call): “We are projecting net revenue guidance of approximately $16 million [for 2025], which represents a 60% increase over 2024… highly confident in our ability to execute.”
• CEO (call): “GIMOTI remains the only approved product to treat this disease… we now have 6 [Orange Book] listed patents related to GIMOTI into 2030.”

Q&A Highlights

• Competitive landscape: On domperidone and Vanda CRL, management sees volume uncertainty but expects patients to turn to GIMOTI as options narrow; positioning as leader reinforced .
• Reimbursement and Medicaid: Adding pharmacies improved Medicaid/Medicare conversion; Medicaid share rose from ~2% to 5–7% by late 2024, supporting broader access .
• Access friction: Prior authorization completion ~50%; company deployed 4 FRMs to lift conversion, improve gross-to-net, and support prescribers .

Estimates Context

• S&P Global consensus estimates for Q4 2024 (EPS and revenue) were unavailable at the time of this analysis. We will update comparisons vs. Wall Street consensus upon availability from S&P Global.

Key Takeaways for Investors

• Revenue inflected: Q4 sequential growth (+24.6%) and full-year doubling indicate improving adoption; 2025 guide (+~60% YoY) suggests continued momentum if access and reimbursement initiatives deliver .
• Access engine is the lever: ASPN partnership, expanded pharmacy network, and new FRMs directly target PA bottlenecks—key to unlocking conversion, refill durability, and gross-to-net .
• Differentiation building: Real-world data (ACG/DDW) and GLP-1 supportive-care data show meaningful HRU reductions vs. oral metoclopramide, strengthening clinical/economic value case with payers and prescribers .
• Competitive moat: New patents, Vanda CRL, and domperidone discontinuation reinforce GIMOTI’s unique positioning as the only FDA-approved DGP therapy—an important stock catalyst as the narrative shifts to share capture .
• Watch OpEx discipline: SG&A and total OpEx stepped up in Q4 to support growth; scaling revenue against these higher costs will be pivotal for loss reduction in 2025 .
• Liquidity runway: ~$13.6M cash at year-end and runway into Q1’26 reduce near-term financing risk, allowing focus on execution .
• Near-term trading setup: Updates on payer conversion/PA completion, prescriber adds, and quarterly revenue cadence vs. ~$16M FY25 guide will likely drive shares; regulatory/IP and domperidone developments are supportive catalysts .

Supporting Sources:

• Q4/FY24 press release and financials
• 8-K with Item 2.02 and Exhibit 99.1
• Q4 2024 earnings call transcript
• Q3 2024 press release/financials
• Q2 2024 press release/financials
• FDA domperidone and positioning updates
• Patent allowances (Dec 2024)
• GLP-1 supportive care data (ACG 2024)