Executive Summary

Q2 2025 was operationally constructive but headline results modest: revenue of $37.2M (+3% YoY, -4% QoQ) and GAAP diluted EPS of $(0.02), with product gross margin of 73.5% vs 70.8% a year ago, aided by lower reserves; management cited a ~$(0.4)M wholesaler drawdown tied to the 400mg VAN transition as a transitory headwind .
Acute Care momentum continued: ZYNRELEF unit demand +6.3% q/q and APONVIE +19% q/q; Oncology was steady with CINVANTI resilient; cash and short-term investments were $40.6M at quarter-end .
2025 net revenue guidance was maintained at $153–$163M, while Adjusted EBITDA guidance was raised to $9–$13M, reflecting YTD Adjusted EBITDA of $8.0M; management highlighted levers for 2H acceleration (dedicated sales teams, CrossLink incentives, J-code effective Oct 1) .
Balance sheet de-risked: comprehensive capital restructuring extended maturities to 2030, reduced total debt from $175M to $145M, added new 2031 converts, and raised $27.7M gross in equity; CFO indicated credit cost “a little bit north of 10%” and ~$11–12M net cash added at closing—potential stock catalysts alongside revenue reacceleration and J-code ramp .

What Went Well and What Went Wrong

What Went Well
- ZYNRELEF and APONVIE demand trends were strong: +6.3% and +19% q/q, respectively; APONVIE now has a dedicated sales team (launched July 1) to drive further adoption .
- Margin execution: product gross margin reached 73.5% (vs 70.8% in Q2’24), benefiting from mix and lower reserves/write-offs, despite VAN transition dynamics .
- Capital structure reset: new Hercules facility (up to $150M), exchange/retirement of 2026 converts, issuance of 2031 converts ($35M), and $27.7M equity placement—pushing maturities to ≥2030 and reducing total debt to ~$145M .
What Went Wrong
- Headline miss vs S&P consensus: revenue $37.2M vs $38.1M* and EPS $(0.02) vs $(0.01)*; wholesaler inventory normalization (~$(0.4)M) masked underlying demand growth .
- Oncology softness YoY: Q2 Oncology -9% YoY due to SUSTOL (-43%); CINVANTI down modestly (-3%) .
- Shares outstanding likely to trend higher post-transactions; CFO guided to pro forma common shares of ~183M, with incremental potential from converts—an overhang until growth inflects .

Financial Results

Revenue, EPS vs prior year and prior quarters

Metric	Q2 2024	Q4 2024	Q1 2025	Q2 2025
Revenue ($M)	$36.024	$40.781	$38.903	$37.200
GAAP Diluted EPS ($)	$(0.06)	$0.02	$0.01	$(0.02)

Margins (disclosed)

Metric	Q2 2024	Q2 2025
Product Gross Margin (%)	70.8%	73.5%

Actual vs S&P Global Consensus (Q2 2025)

Metric	Actual	Consensus	# of Est.
Revenue ($M)	$37.200	$38.075*	4*
GAAP Diluted EPS ($)	$(0.02)	$(0.01)*	3*

Values with * retrieved from S&P Global.

Segment revenue (Three Months Ended June 30)

Segment ($000s)	Q2 2024	Q2 2025	YoY
Acute Care	$6,851	$10,653	+55.5%
• APONVIE	$1,020	$2,464	+141.6%
• ZYNRELEF	$5,831	$8,189	+40.4%
Oncology	$29,173	$26,547	(9.0%)
• CINVANTI	$24,927	$24,143	(3.1%)
• SUSTOL	$4,246	$2,404	(43.4%)
Total Net Revenue	$36,024	$37,200	+3.3%

Selected KPIs and operating items

KPI	Q2 2025
ZYNRELEF unit demand growth (q/q)	+6.3%
APONVIE unit demand growth (q/q)	+19%
ZYNRELEF wholesaler adjustment (revenue impact)	≈$(0.4)M
ZYNRELEF ordering accounts (through June)	>700 accounts
APONVIE average daily units (June)	Near 1,000
Cash, cash equivalents, ST investments	$40.6M (6/30/25)
Adjusted EBITDA ($M)	$1.771 Q2; $7.987 YTD
J-code status for ZYNRELEF	Permanent J-code effective Oct 1, 2025

Guidance Changes

Metric	Period	Previous Guidance	Current Guidance	Change
Net Revenue	FY 2025	$153–$163M (Q1’25)	$153–$163M (Q2’25)	Maintained
Adjusted EBITDA	FY 2025	$4–$12M (Q1’25)	$9–$13M (Q2’25)	Raised

Earnings Call Themes & Trends

Topic	Previous Mentions (Q4 2024, Q1 2025)	Current Period (Q2 2025)	Trend
Reimbursement (NOPAIN, J-code)	CMS Final Rule grants separate payment from Apr 1, 2025; VAN approved; strong setup for ZYNRELEF .	Permanent J-code effective Oct 1; management expects streamlined reimbursement and more commercial adoption over time .	Improving tailwinds
ZYNRELEF commercial execution	VAN launched; CrossLink partnership highlighted; large TAM across expanded label .	Unit demand +6.3% q/q; focused pull-through; CrossLink per-unit incentives; new clinical educator team; >700 ordering accounts .	Building momentum
APONVIE adoption	Early growth; hospital access building .	Unit demand +19% q/q; dedicated 6-rep team launched July 1; some 340B mix impact on revenue .	Accelerating with focused go-to-market
Oncology franchise stability	CINVANTI steady; SUSTOL variable .	CINVANTI modestly down YoY; SUSTOL down YoY; franchise remains consistent overall .	Stable to slightly softer
Capital structure	N/A.	New Hercules facility; convert exchange; new 2031 converts; $27.7M equity; rate “a little bit north of 10%” and ~$11–12M net cash at close .	De-risked, extended maturity profile
Legal/Patent	Mylan settlement: generic entry for CINVANTI/APONVIE in 2032 .	N/A in Q2 update; continuing strategy .	Clarity maintained

Management Commentary

“We enter the third quarter with strong momentum and a clear focus on accelerating the expansion of our core products.” — Craig Collard, CEO .
“Product gross profit…was $27.3M or 73.5%,…up from 70.8% last year…due to higher cost per unit sold from supplier mix, offset by lower inventory reserves and write-offs.” — Craig Collard .
“ZYNRELEF demand units grew 6.3% over Q1…Q2 revenue was impacted by a transient inventory drawdown at our wholesalers…we estimate it reduced net sales by approximately $0.4M.” — Mark Hensley, COO .
“The J code will streamline reimbursement…we don’t necessarily see an impact immediately, but…as commercial payers come on board…[it] really does help us longer term.” — Craig Collard .
“Overall [Hercules] rate is a little bit north of 10%, and the funds to the balance sheet is probably about $11–12M after all expenses.” — Ira Duarte, CFO .

Q&A Highlights

ZYNRELEF VAN transition: Inventory normalization completed by July 1; estimated $(0.4)M Q2 revenue impact; demand grew despite wholesaler drawdown .
Reimbursement outlook: Permanent J-code for ZYNRELEF expected to ease billing/reimbursement and support broader commercial payer alignment over time; NO PAIN separate payment already in effect .
Salesforce reorganization: Split into dedicated ZYNRELEF and APONVIE teams; enhanced CrossLink per-unit incentives focused on formulary-approved targets to drive pull-through .
APONVIE revenue vs demand: 19% demand growth vs 9% revenue due to wholesaler normalization and 340B mix at large academic centers; expected to normalize in 2H .
Capital plan: New credit facility, convert actions, and equity raise; pro forma common shares ~183M; cost of debt “north of 10%”; ~$11–12M net cash added at close .

Estimates Context

Q2 2025 results modestly missed S&P consensus: revenue $37.2M vs $38.1M* and EPS $(0.02) vs $(0.01)*, reflecting the temporary wholesaler adjustment despite healthy unit growth .
Near-term consensus embeds sequential growth: Q3 2025 revenue ~$39.03M*, EPS ~$(0.01); Q4 2025 revenue ~$39.83M; sets a bar consistent with management’s normalization commentary and J-code/field-force catalysts into 2H [GetEstimates Q3/Q4 2025]*.
FY 2025: Management maintained $153–$163M revenue and raised Adjusted EBITDA to $9–$13M; estimate models may need to adjust mix/margins to reflect higher 2H pull-through and lower inventory frictions .