Medicure Inc.

Good day and welcome to Medicare's earnings conference call for the year ended December 2025. My name is Ali 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 pursuant to the safe harbor provisions of the United States 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. And please note, this conference call is being recorded. And today's date is April 27th, 2026. 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, Ali. And good morning to all on the call. We appreciate your interest and participation in today's call. Joining me Today, on the 2025 year-end statement, call is Horace, Medicare's Chief Financial Officer. Net revenue was $28.9 million for the year ending December 31st, 2025, compared to $21.9 million in the previous year. Net revenue was $8.5 million during the quarter, compared to $5.9 for the previous year's quarter. The company recorded a net loss for the year ending December 31st of $7.1 million, or $0.68 per share, compared to a net loss of $1 million for the year ending 2024. The net loss is due in large part to a CMS rebate liability issued to the company in the amount of $2.1 million, and the $3.2 million invested in research and development primarily related to MC1 for the treatment of PNPO deficiency and non-cash expenses including $2.6 million of amortization. So a total of $7.9 million of expenses related to non-cash items, unusual fee from CMS and important R&D investment which could lead to significant potential non-dilutive cash influx in the future. Medicare's investment in 3.2 million in R&D during the year underscores our commitment to advancing innovative therapies, such as the phase three trial of Medicare's MC1 for the treatment of PNPO deficiency, and delivering long-term value to patients and shareholders. And the reminder to shareholders, the five focuses of our business are sales and profits from Agristat, growing Cypidemag revenue and profit, growing Marley Drug online pharmacy business, developing MC1 for P and PO deficiency, and advancing a new chemical entity related to Medicare's legacy drug with a large market potential. I'd now like to turn the call over to our CFO, Haris Uddin, to review and provide some color on 2025.

Haris Uddin Thank you, Dr. Frazen. 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 will be able to obtain a complete copy of our financial statements for the year ended December 31st, 2025, along with previous financial statements on the Investors page of our website. In addition, a copy of all financial statements, management's discussion and analysis, and Form 20F can be obtained from cdarplus.ca. I will now provide some key highlights of our financial performance for the year ended December 31st, 2025. Total net revenue for the year ended December 31st, 2025 was $28.9 million compared to $21.9 million during the prior year. Net revenues earned from Agristat during the current year totaled $5.7 million, a decrease from the prior year where net revenue from Agristat was $8.1 million. The decrease in AgriStar revenue during the current year is a result of a lower volume of units sold as a result of increased competition from generic Tyro-5 and hydrochloride. Medicare remains the only manufacturer of the 3.75 mg bolus vial 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. Net revenue earned from Zipidimeg through the traditional insurance channel during the year ended December 31, 2025 totaled $2.8 million, which is a slight decrease from the $3 million of net revenue earned during the year ended December 31, 2024. The decrease in net revenue noted during the current year is attributable to lower utilization of the products sold through insurance formularies, specifically Medicare Part D. The primary focus of the company continues to be growing Zipidimeg revenue through the insurer channel and through Marley Drug throughout 2026. It is important to note that sales of Zipidimeg through Marley Drug are excluded from this number. With regards to Marley Drug, net revenue during the current year totaled $12.8 million, an increase from the $10.8 million earned from Marley Drug during the year ended December 31st, 2024. Net revenue attributable to Zepidimac through Marley Drug was $3.7 million during the current year, an increase from the year end of December 31, 2024, whereas Zepidimac sales through Marley Drug were $3.2 million. The increase in revenue through Marley Drug is attributable to increased Zepidimac sales in addition to an increase in Branzabi sales along with other exclusive products that are offered through Marley Drug. We continue to see access challenges for patients seeking Cepidimeg through traditional insurance channels, which has reinforced the effectiveness of our direct distribution strategy through Marley Drug. The approach allows us to mitigate pressures associated with wholesaler fees, coverage gap costs, lower PBM reimbursement rates, and product returns. As a result, Marley Drug provides a more efficient and controlled channel to deliver Cepidimeg to patients. Additionally, the platform enables us to expand access to other products such as Branzavi, further strengthening our competitive positioning within the retail and mail order pharmacy landscape. We have also found that the adherence rate for patients taking Zepidimeg is more than 40% higher through Marley Drug in comparison to other retail pharmacies, and this is primarily driven by the pharmacy's customer service, which includes Marley Drug's dedicated call center for which patients can call and ask questions about their medications, which not only helps reduce our customer attrition rate, but also supports patient care. During the year ended December 31, 2025, the company made two acquisitions. On March 11, 2025, the company acquired Gateway Medical Pharmacy, an independent pharmacy located in Portland, Oregon, which also has the ability to complete non-sterile compounding. Revenue for Gateway Medical Pharmacy during the year ended December 31, 2025, totaled $2.8 million. And in addition, on June 16, 2025, the company acquired West Olympia Pharmacy, an independent pharmacy located in Olympia, Washington. West Olympia Pharmacy has a strong customer base and offers its patients additional services, which include administering vaccinations and weight management support. Revenue earned from West Olympia Pharmacy during the current year was $4.7 million. The company has now started to offer Zepidimeg through both pharmacies, and the company intends on introducing additional product offerings at both Gateway Medical Pharmacy and West Olympia Pharmacy in subsequent quarters, which have increased revenue at Marley Drug. Moving to cost of goods sold. Agri-Shark cost of goods sold for the year ended December 31st, 2025 totaled $3.1 million. An increase from the prior year where cost of goods sold during the year ended December 31st, 2024 totaled $2.5 million. The increase in cost of goods sold is a result of an inventory write-down completed in the current year in the amount of $458,000. The inventory written down related to a GPO-specific branded inventory, which unfortunately could not be used within the regular Agristat channel, where the inventory pulled through remained strong. In addition, to ensure the company remains competitive with generic alternatives, the company has decreased its selling price of Agristat during the current year, which has had a negative impact on the gross margin of the product. With that being said, the overall outlook on Agristat is still positive as we have already seen a reduction in the number of overall generic alternatives available on the market. The epitome cost of goods sold for the year ended totaled $1.2 million, a decrease from the prior year where cost of goods sold totaled $1.4 million. Included within cost of goods sold for Zepidemec in the current year is $608,000 relating to products sold to customers and $632,000 of amortization of the Zepidemec intangible assets. The decrease in cost of goods sold through Zepidemec is directly correlated with a decrease in revenue through the insurer channel. From our lead draw, cost of goods sold totaled $6.8 million during the year ended December 31, 2025. An increase from the prior year with cost of goods sold totaled $4.9 million for that quarter. The increase in cost of goods sold during the current year is a result of higher volume and the nature of products sold through the pharmacy. Gateway Pharmacy's cost of goods sold during the year ended December 31, 2025 was $1.9 million and West Olympia's cost of goods sold during the current year was $4 million. As both pharmacies were acquired during the current year, there was no cost of goods sold recorded for either Gateway Pharmacy or West Olympia Pharmacy during the year ended December 31, 2024. Our three pharmacies, Marley Drug, Gateway Medical Pharmacy and West Olympia Pharmacy are what make up our pharmacy business segment. The company plans on leveraging the additional purchasing power acquired through the acquisitions of Gateway Medical Pharmacy and West Olympia Pharmacy to obtain better pricing from its wholesalers on pharma's local products, which in return should improve the gross margin of the business segment. We saw a small improvement in our cost of goods sold during the latter half of Q4 and hope to continue this trend throughout 2026. Selling expenses totaled $10.4 million for the year ended December 31, 2025. An increase from the prior year where selling expenses totaled $8 million. The increase in selling expenses during the current year is primarily driven by a $2.1 million rebate liability issued to the company by the Centers of Medicaid and Medicare Services, also known as CMS. CMS' assessment as part of the 2022 Inflation Reduction Act indicated that the company had increased its prices of Zipinimeg above a benchmark inflation rate. We do not believe this assessment is accurate, as the company has never increased the prices of Zipinimeg since its initial launch, but rather their assessment is being made on an incorrect calculation. However, on the voice of our legal counsel, and to avoid further penalties on the assessed rebate which would not be recoverable, the company paid the assessed rebate subsequent to year-end as a sign of good faith to CMS. The company has filed a formal appeal to CMS with regards to this and hopes to recover the rebate paid in subsequent periods. The remaining increase noted in selling expenses are the result of the acquisitions of Gateway Medical Pharmacy and West Olympia Pharmacy during the current year. General and administrative expenses totaled $5 million for the year ended December 31st, 2025, a slight increase from the prior year where general and administrative expenses totaled $4.8 million. The slight increase in general and administrative expenses in the current year is a result of the acquisitions of Gateway Medical Pharmacy and West Olympia Pharmacy offset by lower professional fees and lower share-based compensation expense during the current year. Research and development expenses for the year end of December 31st, 2025 totaled $3.2 million compared to $3.1 million during the prior year. The slight increase in research and development expenses during the current year is primarily due to timing of expenditures. The company recorded finance income net of $122,000 during the current year in comparison to finance income net of $165,000 during the prior year. The finance income recorded during the current period primarily relates to interest income earned offset by bank charges, interest on the company's lease obligations and holdback payable, and non-cash accretion expense on the company's acquisition payable liability. The company recorded a foreign exchange loss net of $123,000 during the year ended December 31, 2025 in comparison to a foreign exchange loss of $71,000 during the year ended December 31, 2024. The change in foreign exchange loss relates to changes in the U.S. dollar exchange rate during each respective year. Adjusted EBITDA for the year ended December 31st, 2025 was negative 1.5 million compared to an adjusted EBITDA of negative 437,000 during the year ended December 31st, 2024. The decrease in adjusted EBITDA during the current year is due to an increase in operating loss, which primarily related to lower net revenue of Agristat, higher cost of goods sold through the company's pharmacy business segment, offset by higher Zipidimeg revenue through Marley Drug. And lastly, higher revenue through the company's pharmacy business segment as well. As at December 31st, 2025, the company had cash totaling approximately $3.8 million. a decrease from December 31st, 2024, where the company had $7.2 million of cash held. The decrease in cash balance for the company in the current year is primarily attributable to the acquisitions of both Gateway Pharmacy and West Olympia Pharmacy during the current year. 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 back over to our CEO, Dr. Albert Friesen, for some additional comments and closing remarks.

Thank you, Horace. Overall, the company's revenue increased from the prior year. The acquisitions of Gateway and West Olympia Pharmacies created additional synergies for the company and also provided some additional channels for the company to market and sell . Medicare's R&D focus, as mentioned, is a Phase III study to seek approval for MC1 as the first FDA-approved therapy for patients with P and PO deficiency, a rare pediatric disease leading to seizures and is ultimately fatal if untreated. Use of Medicare's legacy product, MC1, could lead to a priority review voucher, which we can redeem or sell and provide significant value. Enrollment is currently ongoing with patients receiving treatment with MC1. Medicare has received fast track designation, so expedited review. And the phase three has had two of the patients already complete 12 months in the study, over 12 months. and we're targeting the end of the minimal enrollment by the end of June of this year. Medicare has signed an asset purchase agreement for the acquisition of a patent and intellectual property related to a new chemical entity developing additional therapeutic use. We believe the new chemical entity holds promise to provide significant improvements over existing lead compounds and is aligned with the treatment of diseases being treated by Medi-Cure. And this could provide significant long-term value upon completion of all required pre-clinical and clinical studies. Medi-Cure has yet to announce the clinical target, however the target is large and the pre-clinical and API development is underway. We are still focused 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 staff is to continue to build this business with a stable long-term outlook to generate value for shareholders. And as always, I want to express my sincere appreciation to the outstanding team we have been blessed with. Thank you, our shareholders, for your continued support and interest. And now I'll turn it over to the moderator to entertain Q&A.

Thank you. We will now begin our question and answer session. If you have a question, please press star 1 on your telephone keypad. A confirmation tone will indicate your line is in the question queue and you may press star 2 if you wish 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. Once again, that's star 1 if you have any questions or comments. One moment please while we poll for questions. Thank you. As we have no questions on the lines at this time, I would like to turn the call back over to Dr. Friesen for any closing remarks he may have.

Again, thank you for your time and interest, and we look forward to your participation at the next quarterly report. Thank you, and goodbye.

Thank you. Ladies and gentlemen, this concludes today's conference. Thank you for participating and you may now disconnect.