Phathom Pharmaceuticals (NASDAQ:PHAT) CEO Steven Basta told attendees at the Guggenheim Emerging Outlook Biotech Summit 2026 that the company’s commercial focus over the past year has shifted more heavily toward gastroenterology, a move he said supported continued revenue growth while also enabling tighter operating expense discipline.
Basta said the company’s business is built around VOQUEZNA, which he described as the first-to-market potassium-competitive acid blocker (P-CAB) in the U.S. for gastroesophageal reflux disease (GERD). He framed the commercial opportunity as targeting patients who remain symptomatic on existing therapies, stating that roughly 40% of reflux patients on standard-of-care therapy are still in pain and represent an addressable group for a stronger acid suppression option.
Launch trajectory and profitability expectations
Looking ahead, Basta reiterated the company’s expectation to transition to operating profitability during 2026, adding that Phathom expects to be operating profitably in the second half of 2026 with positive operating profit.
Commercial pivot: narrowing the call point to gastroenterology
Basta said a major strategic change after he joined the company was pivoting the sales effort away from a broad primary care approach and toward gastroenterologists, who he characterized as the “early adopters” and the physicians most likely to see high-need patients. He argued that patients referred to gastroenterology practices for GERD tend to be those still experiencing significant pain despite treatment, making them prime candidates for therapy changes.
He outlined several steps the company took during 2025 to execute that shift while maintaining quarterly growth:
- May: Phathom announced a realignment toward gastroenterology.
- July: The company changed salesforce target lists, adding remaining gastroenterologists and removing what he described as unproductive primary care targets.
- October: Phathom remapped sales territories to better balance gastroenterology targets after identifying that earlier territory designs were built around primary care.
Basta said the company continued to grow through the fourth quarter despite potential disruption from these changes, which he described as confidence-inspiring going into 2026. He added that Phathom has been refilling open territories created by the realignment and expects to reach a “full-strength” sales organization of approximately 300 sales representatives by the end of March.
He also said the pivot allowed the company to reduce spending in areas such as direct-to-consumer campaigns, describing those tactics as expensive relative to the company’s refocused commercial approach.
Seasonality and upcoming guidance
Addressing an observed dip in January prescriptions, Basta attributed the pattern to typical seasonality in a branded product competing in a “highly genericized market.” He cited insurance plan resets, deductible resets, plan changes, and the need to obtain new prior authorizations as factors that can create short-term friction early in the year. He said he did not believe those administrative dynamics changed the underlying demand from physicians to prescribe or patients’ desire to maintain access.
On gross-to-net and 2026 expectations, Basta declined to provide detailed commentary ahead of the company’s upcoming quarterly report. He said Phathom plans to provide revenue and operating expense guidance, along with “color” on gross-to-net, in conjunction with its fourth-quarter call.
Capital raise and balance sheet priorities
Basta said the company’s recent capital raise was intended primarily to “reset” the balance sheet amid what he described as a significant debt overhang. He pointed to investor concerns related to debt coming due in 2027 and noted the company has a “really big interest expense line” on its profit and loss statement.
He said the company hopes to use the raise to improve its capital structure, including potential refinancing or renegotiation of debt terms.
Market opportunity, EoE program, and exclusivity timeline
Basta discussed Phathom’s view of market penetration within gastroenterology. He said the company previously referenced about 3% penetration of PPI script volume within gastroenterology, and he framed the GI setting as a key pathway to scale. He noted that while the overall PPI market is about 110 million prescriptions, approximately 20 million prescriptions are written by gastroenterologists or advanced practice providers in gastroenterology practices.
He said Phathom believes it can convert 20% to 30% of that GI PPI script volume to VOQUEZNA, which he estimated would correspond to roughly 4 million to 6 million prescriptions and about $1 billion in revenue “just coming out of the GI scripts.” He added that stabilization of patients in GI practices can later lead to refills in primary care, which he described as an additional upside opportunity over time.
On pipeline development, Basta highlighted an eosinophilic esophagitis (EoE) program and emphasized that, in his view, the largest economic driver could be potential exclusivity extension. He said first-line therapy for EoE today is PPIs and that a multicenter, well-controlled trial could generate important data for EoE care, with additional benefits including a “halo effect” in GI relationships.
Basta said the company’s discussions with the FDA indicated EoE would be an indication of interest in pediatric patients under 2023 FDA guidance for pediatric exclusivity extension. If the Phase II trial reads out positively and supports moving into Phase III, he said Phathom would expect to discuss including adolescent patients in the Phase III program and potentially obtain a written request that could qualify the company for a six-month exclusivity extension.
On intellectual property and regulatory protection, Basta said the company’s exclusivity is primarily driven by standard new chemical entity (NCE) exclusivity, which he said is extended to 10 years through the GAIN Act because the drug’s first approval was for an anti-infective indication in H. pylori. He said that exclusivity is reflected in the Orange Book and runs through May 2032, which prevents an abbreviated new drug application (ANDA) from being filed until that date. He added that an early generic launch could occur in early 2033 if an ANDA review proceeded quickly, but said multiple review cycles could extend effective exclusivity into 2034. He noted all of those dates could potentially be extended by six months with pediatric exclusivity.
Finally, Basta said Phathom is evaluating longer-term business development opportunities to leverage its gastroenterology-focused commercial infrastructure. He said the company will look over the next one to three years for products with clear human efficacy data at least through Phase II, a primary GI call point, and launch timing before the company’s loss of exclusivity date.
About Phathom Pharmaceuticals (NASDAQ:PHAT)
Phathom Pharmaceuticals is a clinical‐stage biopharmaceutical company focused on developing and commercializing novel treatments for gastrointestinal (GI) diseases. The company’s core mission centers on addressing serious GI disorders by leveraging innovative mechanisms of action to improve patient outcomes. Phathom’s research and development efforts concentrate on conditions such as Helicobacter pylori infection, erosive esophagitis, gastroparesis and other functional GI disorders where significant unmet medical needs persist.
The company’s lead asset is vonoprazan, a potassium‐competitive acid blocker (P-CAB) licensed for use in the United States.
