Medicure Inc.

Welcome to Medicare's Earnings Conference Call for the quarter and year ended December 31st, 2024. My name is Holly, and I will be your operator for today's call. At this time, all participants are in listen-only mode. Before we proceed, I would like to remind everyone that this presentation contains forward-looking statements relating to future results, events, and expectations, which are made pursuant to the Safe Harbor provisions of the U.S. Securities Litigation Reform Act of 1995. Forward-looking statements involve known and unknown risks and uncertainties, which could cause the company's actual results to differ materially from those in the forward-looking statements. Such risks and uncertainties include, among others, those described in the company's most recent Annual Information Form and Form 20-F. Later we will conduct a question and answer session. Please note that this conference call is being recorded and today's date is April 29th, 2025. I would now like to turn the conference call over to Dr. Albert Friesen, Chief Executive Officer of Medicare Inc. Please go ahead, Dr. Friesen.

Thank you, Holly, and good morning to all on the call. We appreciate your interest and participation in today's call. Joining me today in the 2024 financial statements is Dr. Neil Owens, President and Chief Operating Officer, and Har Sudden, Medicare's Chief Financial Officer. The net revenue for 2024 was $21.9 million, slight increase from the previous year, which was $21.7 million. The company recorded a net loss for 2024 of approximately $1 million or $0.10 per share compared to a net loss of $922,000 or $0.09 per share last year. The net loss is due in large part to non-cash expenses including $2.3 million of amortization of the company's assets and $196,000 of share-based compensation expense on stock options granted to employees and directors during the prior year. There was a bit of a decrease in the Agristat revenue and increase in professional fees as well. There was higher revenue from sales of Zipidimed through Marley Drug and including current year's expenses was R&D of 3.1 million largely for the MC1 PNPO clinical trial. We've added a fifth focus the past year, that being the development of a novel drug related to MC1 with significant market potential. So, a reminder that the five business focuses for Medicare are holding sales and profits from Agristat, growing Zypidemag revenue and profit, growing the Marley Drug online pharmacy business, the development of MC1 for PNPO deficiency, and the new chemical entity related to Medicare's historic drug development with very large market potential. I'd now like to turn the call over to our CFO, Haris Hooden, to review and provide some color on the 2024 financial statements.

Thank you, Dr. Friesen. A couple of quick items to note before I start. All dollar figures are in Canadian dollars unless otherwise noted by each presenter. And as a reminder, you can obtain a copy of our complete set of our financial statements for the year ended December 31st, 2024 on the investors page of our website. Alternatively, a copy of all financial statements and management discussion and analysis can be obtained from cdarplus.ca. I will now provide some key highlights of our financial performance for the year ended December 31st, 2024. Total revenue for the year ended December 31, 2024 was $21.9 million compared to $21.7 million for the year ended December 31, 2023. Net revenues earned from Agristat during the current year totaled $8.1 million, a decrease from the prior year where net revenue from Agristat was $9.7 million. The decrease in agri-site revenue during the current year is a result of pricing pressures from increased competition stemming from the launch of generic Tyro-5 and hydrochloride. Net revenues earned from Cepidemec through the traditional insurance channel during the current year total $3 million, which is an increase from the $2.4 million of net revenue earned during the prior year. The increase in epidemic sales through the traditional insurance channel can be attributed to greater utilization of the product through insurance formularies, specifically Medicare Part D. This increase is offset by increased wholesaler fees in addition to higher coverage gap payments to pharmacy benefit managers. For Marley drug, net revenue during the current year totaled $10.8 million, an increase from the prior year where net revenue totaled $9.6 million. The pharmacy business has undergone a change in its product mix since the prior year, resulting in the increase in revenue during the current year, and the pharmacy continues to focus on fulfillment partnerships, its e-commerce platform, and increased sales of Zupinibank. Offsetting the increase in revenue is a decline in reimbursements from pharmacy benefit managers, which only impact insured prescription revenue. Agristat cost of goods sold for the year ended December 31, 2024, totaled $2.5 million, a decrease from the prior year, where cost of goods sold totaled $3 million. The decrease in cost of goods sold is the result of a decrease in volume of Agristat sold, which is consistent with the lower revenue recorded in the current year. Zepidimac cost of goods sold for the current year totaled $1.4 million, an increase from the prior year, where cost of goods sold for Zepidimac totaled $974,000. Included within the cost of goods sold for Zipidimeg in the current year is $759,000 relating to products sold to customers and $620,000 from amortization of the Zipidimeg intangible asset. The increase in cost of goods sold noted during the current year is due to a higher volume of products sold during 2024, in addition to a recovery, which was recorded in the prior year, of $281,000 relating to Zipidimeg royalties. Marley drug cost of goods sold totaled $4.9 million during the year ended December 31, 2024, an increase from the prior year where cost of goods sold totaled $3.7 million. The increase in cost of goods sold is the result of a higher volume and the nature of products sold through both the mail order and e-commerce platform during the current year. Selling expenses totaled $8 million for the year ended December 31, 2024, a decrease from the prior year where selling expenses were $8.3 million. The decrease in selling expenses during the current year is the result of management's efforts in optimizing its sales and marketing expenses. This included a reorganization of the company's sales team in addition to focusing on marketing channels, which provided the greatest return on investment. General and administrative expenses totaled $4.8 million for the current year in comparison to $4.1 million during the prior year. The increase in general and administrative expenses in the current year is the result of higher professional fees, primarily related to legal fees, offset by lower share-based compensation expense on previously granted stock options to key employees and directors of the company. Research and development expenses for the current year total $3.1 million compared to $2.4 million during the prior year. The increase during the current year is primarily due to the timing of research and development expenditures relating to each development project the company is currently undertaking, which in the current year primarily related to the development of MC1. Other income during the current year totaled $1.9 million. The other income recorded during the current year was the result of a legal settlement between the company and its contract development and manufacturing organization. The company received the settlement payout in the fourth quarter of 2024. During the prior year ended December 31st, 2023, the company did not record any other income. The company recorded finance income of $165,000 during the current year in comparison to finance income of $65,000 during the prior year ended December 31st, 2023. The finance income recorded during the current year consisted primarily of interest income earned on the cash held by the company offset by bank charges and finance expenses on the company's lease obligations. The company recorded a foreign exchange loss of $71,000 during the current year in comparison to a foreign exchange loss of $108,000 during the prior year. The change in foreign exchange relates to changes in the U.S. dollar exchange rate during the respective years, which led to an unfavorable foreign exchange loss during both the current and prior years. Adjusted EBITDA for the current year was negative $437,000 compared to an adjusted EBITDA of $1.9 million during the year ended December 31, 2023. The decrease in adjusted EBITDA during the current year is primarily due to higher mortgage drug costs or goods. lower agri-start revenue, as well as higher research and development expenses. And these amounts are offset by a decrease in selling expenses, higher epidemic sales through both the Marley Drug Pharmacy and traditional insured channel. Subsequent year end, the company acquired 100% of the outstanding shares of Gateway Medical, an independent pharmacy located in Portland, Oregon, in exchange for total consideration of $580,000 USD. In addition, the company also signed an agreement with the intention of acquiring 100% membership interest of West Olympia Pharmacy, an independent pharmacy located in West Olympia, Washington, for total consideration of $975,000 USD. The transaction of West Olympia is subject to the licenses of the pharmacy transferring from the seller to the buyer prior to the transaction closing. The transaction is expected to close in the second quarter of 2025 and both pharmacies were intended to be acquired with the intention of expanding the company's retail pharmacy operating segment and creating synergies with Marley Drug. As at December 31, 2024, the company had cash totaling approximately $7.2 million an increase from the $6.4 million of cash held as of December 31, 2023. The company does not have any debt on its books. I want to remind you that there will be an opportunity at the end of today's call for you to ask questions regarding the financial results of the company as a whole, and with that, I would like to turn the call over to our President and Chief Operating Officer, Dr. Neil Owens, for some additional commentary regarding our operations.

Thank you, Horace, and good morning, everyone. I'd like to start with some updates on our Zipidimeg business. Sales of Zipidimeg sold through Marley Drug grew by 23%, from 2.6 million in 2023 to 3.2 million in 2024. We continue to use a field-based sales team, as well as prescriber and consumer marketing, and have refined our marketing messaging to what we have found resonates best for both. Patients still have challenges in accessing Zipidimeg through their insurance coverage, which is the reason why selling Zipidimeg through Marley Drug is such an effective approach. Similarly, due to wholesaler and coverage gap fees, low PBM reimbursement, and product returns, selling through Marley Drug provides a much higher gross margin. We've also found that adherence rates for patients taking Zipidimeg is more than 40% higher through Marley Drug compared to other retail pharmacies because of our customer service and engagement strategies. This helps for reducing our attrition rate and increasing revenue. Net revenue through insured channels and the standard retail pharmacy model grew by 25% from $2.4 million in 2023 to $3 million in 2024 due to an increase in purchasing from wholesalers and changes in our mix of insured customers. Overall, ZepedaMag represents a priority for growth through efforts of our sales and marketing team. Further on our Marley drug business, net revenue grew by 12.5% from $9.6 million in 2023 to $10.8 million in 2024. This is due to an increase in ZepedaMag sold through the pharmacy business, as well as generic medication sales due to multiple marketing strategies used in 2024. Notably, the sale of Branzavi tablets through Marley Drug, which is an accessible alternative STLT2 inhibitor to Jardiance and Farcega, contributed revenue of $807,000 in 2024. Another recent example is the exclusive sale of Citagliptin, which is a first generic entry for another popular diabetes medication. Medicare is working on leveraging Marley Drug's reputation for customer service, unique branded medication solutions, and national distribution to continue to drive growth. Challenges we've faced include competition and fluctuation in cost of goods, which impact our margins, as well as lowering our customer acquisition cost as much as possible. We also plan to invest further in our e-commerce website to make it a best-in-class experience for customers. Recently, Medicare announced the acquisition of Gateway Medical Pharmacy and signing of a definitive agreement with West Olympia Pharmacy. These additional pharmacy subsidiaries immediately grow our customer and prescriber base for both Zepidemag and other branded products and will be adopted under the Marley Drug brand. Additional benefits of these acquisitions include faster shipping times and redundancy, growing our brand nationally, increasing our revenue, and our cash flow positive. In terms of our agri-staff business, net revenue fell from $9.7 million in 2023 to $8.1 million in 2024 due to generic tire-fibon competition. Medicare remains the only manufacturer of the 3.75-milligram bull's-file format, which is typically administered before the infusion unit. We continue to provide support to our U.S. hospital accounts and plan to remain price competitive in targeted ways. Medicare's R&D focus is primarily on its Phase III study to seek approval of MC1 as the first FDA-approved therapy for patients with PNPO deficiency, which is a rare pediatric disease leading to seizures and is ultimately fatal if untreated. If successful, use of Medicare's legacy product MC1 could lead to a priority review voucher, which can be redeemed or sold, and provides significant value. The FDA granted approval to start enrollment and so enrollment is ongoing with patients receiving treatment with MC1. Medicare also recently received fast track designation for MC1 for its intended indication which will facilitate the review of Medicare's FDA new drug application. Medicare did decide to remove the entire coating of the MC1 tablets to speed up absorption based on feedback from clinicians and therefore that batch was produced and is now being sent to the clinical sites for use. Recently, the phase three study's first patient has completed the study enrollment period and has now moved into a continuation phase post-enrollment. Medicare recently announced that it has signed an asset purchase agreement for the acquisition of the patent and intellectual property related to the discovery of new chemical entities that can be developed for therapeutic use. We believe that the new chemical entities will promise to provide improvements over existing lead compounds in alignment with treatment of diseases being targeted by Medicare and could provide significant long-term value upon completion of all required preclinical and clinical studies and regulatory approval. Medicare has yet to announce the clinical therapeutic target, however, has started preclinical testing and API development of the lead compound. Overall revenue in 2024 of $21.9 million was only slightly higher than 2023 of $21.7 million, despite increases in Zepidemag and Marley drug revenue due to lower aggregate revenue, higher Marley drug cost of goods, as well as higher general and administrative expenses from higher than expected legal expenses and higher research and development expenses, which were $3.1 million in 2024. We are therefore reporting a negative EBITDA of $437,000 and a net loss of $1 million for the year. Medicare remains debt-free, and to reiterate, the company's short-term goals are focused on growing Zepidemag, growing Marley Drug and our pharmacy business, maintaining Agristat sales, and the development of new products. Short-term, seeking the approval of MC1 to receive a priority review voucher, and long-term, the development of our new chemical entities and intellectual property for diseases with large market potential. With that, I'd like to turn the call back to Dr. Friesen for final comments.

Thank you, Neil. Though overall revenue was consistent with last year, there were significant developments through the acquisition of Marley, which we think strongly complements Medicare's business, including sales and marketing of Zepidimeg. The acquisition of the two pharmacies recently supports our focus on growing the business and diversifying our revenue and asset base near-term through acquisitions and long-term through R&D, carefully investing to grow our future profitability. My goal and that of our board, management, and staff is to continue to build this business with a stable, long-term outlook to generate value for our shareholders. And as always, I want to express my sincere appreciation to the outstanding team of employees we've been blessed with. Thank you, our shareholders, for your continued support and interest. Now, Holly, I'll turn it back to you to lead us through the Q&A.

Thank you. At this time, we will be conducting a question and answer session. If you would like to ask a question, please press star 1 on your telephone keypad. A confirmation tone will indicate your line is in the question queue. You may press star 2 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, please, while we poll for questions. Your first question for today is from Zach Treece, a private investor.

Hello, guys. My name is Zach. Thank you guys for the hard work you guys are doing. I just have a few brief questions. My first question is in regard to the general administrative expenses. I saw that legal fees were the primary cause of the increase last year. Do you guys see this coming back down in 2025? I don't know.

Dale, did you want to, or Horace?

Yeah, what I can say is I would expect there is still to be significant legal fees in 2025. We can comment further on that, but I don't see that actually coming down too much further, unfortunately.

Okay. If I may have just two other quick questions. In regard to R&D, it seems that the primary expense right now is for the MC1 development. Do you expect those expenses to continue at a similar level in 2025? Yeah, go ahead.

Yeah, it's a good question. I think that they should come down versus 2024. However, we have started investing in the new intellectual property, so overall our R&D expenses will probably be similar there. It's right around 3 million, I think, that we're forecasting, so it should be consistent with 2024 as well.

Okay, thank you. I appreciate that. Just last question, or yeah, last two questions here. For the phase two trials for MC1, do you guys have any update on the timeline for that?

Yeah, so I can answer that one as well. It is a 12-month study, and so we're expecting to enroll all patients this year. It's a very small study. We're only targeting to enroll 10 patients, but it's an extremely rare disease, so it takes some effort to find all of those patients. But we should expect to enroll all patients this year, and then they will be enrolled for 12 months. We have seen it. As I mentioned, we've had one patient complete in 12 months, but it's going to be staggered as patients enroll. But then we do have a shorter review period once we've completed the study because it's an orphan disease. So it's basically an accelerated review period.

Okay. Thank you. I really appreciate that. And then the last question is regarding your latest acquisitions, which is exciting. I was just wondering if you guys could provide any color on the synergies that you are expecting.

Yeah, I can jump in on that one as well.

There are many. As mentioned, gaining national brand exposure for Zepidimeg and Marley drug is challenging. And what this does is it gives us an immediate exposure to, I would say, tens of thousands of patients through both pharmacies. Not only the patients, but their providers that we can market Zepidimeg and our other branded products to. So basically we can integrate them quite effectively and not only that but we're going to see some cost savings on our cost of goods just through increased purchasing power as we add the pharmacies. But it also provides redundancy just for shipping so that because we fill all 50 states, we send medications to all 50 states, these other pharmacies can provide faster shipping times to the West Coast. only because we're trying to be competitive with other pharmacies that offer home delivery. So we want to be best in class in that sense. And just redundancy overall in terms of fulfillment.

Okay. Thank you. And thank you, Zach, for the questions. Yeah, thanks as well.

Once again, if you would like to ask a question, please press star 1.

We have reached the end of the question and answer session, and I would now like to turn the floor back to Dr. Albert Friesen for closing remarks.

Again, thank you for those on the call. We appreciate it, and we look forward to further updates for the next quarter. Again, thank you. Have a great day.

Thank you, ladies and gentlemen. This concludes today's conference. Thank you for your participation. You may now disconnect.