United Therapeutics Corporation

United Therapeutics Corporation

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Q1 FY2026 · Earnings Call TranscriptMay 6, 2026

Operator

Good morning, and welcome to the United Therapeutics Corporation first quarter 2026 corporate update. My name is JL, and I will be your operator today.

All participants on the call portion of this webcast will be in listen-only mode until the question-and-answer portion of this earnings call. If you would like to ask a question during that time, simply press *, then the number 1 on your telephone keypad.

If you would like to withdraw your question, simply press *, and the number 1 again on your telephone keypad. Please note that this call is being recorded.

I will now turn the webcast over to Harry Silvers, Investor Relations at United...

Harry Silvers

Thank you, JL. Good morning.

It is my pleasure to welcome you to the United Therapeutics Corporation first quarter 2026 corporate update webcast. Remarks today will include forward-looking statements representing our expectations or beliefs regarding future events.

These statements involve risks and uncertainties that may cause actual results to differ materially. Our latest SEC filings, including Forms 10-K and 10-Q, contain additional information on these risks and uncertainties.

We assume no obligation to update forward-looking statements. Today's remarks may discuss the progress and results of clinical trials or other developments with respect to our products.

These remarks are intended solely to educate investors, and are not intended to serve as the basis for medical decision-making, or to suggest that any products are safe and effective for any unapproved or investigational uses. Full prescribing information for the products is available on our website.

Accompanying me on today's call are Dr. Martine Rothblatt, our Chairperson and Chief Executive Officer; Michael Benkowitz, our President and Chief Operating Officer; James Edgemond, our Chief Financial Officer and Treasurer; Dr.

Leigh Peterson, our Executive Vice President of Product Development and Xenotransplantation; and Patrick Poisson, our Executive Vice President of Strategic Development. Note that James Edgemond and I will participate in a fireside chat and one-on-one meetings at the RBC Global Healthcare Conference in New York on May 19th, as well as the Jefferies Global Healthcare Conference in New York on June 3rd.

Our scientific, commercial, and medical affairs teams will be present at the American Thoracic Society International Conference in Orlando, May 15th to the 21st. Now, I will turn the webcast over to Martine for an overview of our development pipeline and business activities.

Martine?

Martine Rothblatt

Thank you, Harry. Folks.

It's going to be a great and exciting call today. UT is doing so freaking amazing that it is hard to imagine any other mid-cap biotech right now with prospects as good as ours.

Here's what I mean. We just proved, beyond a shadow of a doubt, with a p-value of less than .0001, that we have two different therapeutics in two different diseases of substantial size, each of which has been shown to produce better clinical outcomes than any other drug ever approved for either indication.

Wow. That's got to sink in.

I personally have not seen anything like that from a single pharma company, all accomplished within six months. The two diseases we will be the best therapeutic for, based on the completed Phase 3 trials, are IPF with Tyvaso and PAH with ralinepag.

Each of the two products will exceed our total revenues of today, a revenue run rate of $3 billion going to $4 billion by the end of 2027. Let's take ralinepag first.

Every patient with PAH should be prescribed that once-daily pill because it actually gives them their best shot at clinical improvement. Specifically, we showed a threefold reduction in disease progression compared to background therapy.

Ralinepag hit this and all other primary endpoints with better hazard ratios than selexipag and durably through four years. Frankly, this is the drug I dreamed of in starting United Therapeutics.

This is why we've been calling ralinepag a super-prostacyclin. There is simply no reason that virtually every PAH patient shouldn't be on it.

Hence, I fully expect within two years of launch, it will double our number of PAH patients to over 30,000 total. Next, let's look at Tyvaso for IPF.

I said this will become the most prescribed drug for IPF because it improves forced vital capacity far more than the three existing drugs. It, and only it, boosted FVC to over 100 mL of oxygen, and it did so quickly, and it did so durably.

With tens of thousands of PAH patients and tens of thousands of IPF patients, it is nearly certain that these two drugs, once approved, will lap our 2027 $4 billion revenue run rate twice over. Coming right behind Tyvaso for IPF will be Tyvaso DPI for IPF, and right behind that, Tyvaso SMI for IPF.

Our goal is to leave no IPF patient behind, regardless of how their particular body best absorbs Tyvaso. Now, let's take a breath and reflect back on United Therapeutics.

UT has been ahead of schedule as a habit. We were ahead of schedule on OUTCOMES unblinding.

We were ahead of schedule on TETON unblinding. Today, I am excited to announce another ahead of schedule: the next blockbuster product to emerge from stealth mode in our Skunkworks division, an inhaled formulation of our new chemical entity, ralinepag, called Ral-DPI, R-A-L-D-P-I.

In stealth mode a few months ago, we activated our exclusive option with MannKind for a second DPI. We now feel confident, based on subsequent PK, computational biology via our proven Clyme digital lung model, and the results of the OUTCOMES and TETON studies, that this will be our biggest product ever.

As you can see in the distributed market capture graph, we foresee our Ral-DPI product rising to tens of thousands of treated patients through PAH, ILD, IPF, and PPF. Indeed, we will need all the capacity of the Danbury, Connecticut MannKind production plant, and all the capacity of the new United Therapeutics North Carolina DPI facility to keep up with the Tyvaso DPI and Ral-DPI demand.

Now, let's delve into the science to better appreciate what a generational product Ral-DPI will be for IPF. Ralinepag is the most potent member of the class of drugs that includes treprostinil.

This is super clear from the extraordinary results of the OUTCOMES study. Second, it is now indisputable that this class of drugs, via inhalation, has significant antifibrotic effects, as we proved in the two TETON trials.

Ergo, we very reasonably and scientifically expect Ral-DPI to show, after further clinical trials, that it is the best-in-class treatment for IPF and PPF. The scientific reason lies in the chemical differences between the new ralinepag molecule and the old treprostinil molecule, both of which are digitally mirrored in our Clyme predictive computational biology model.

Ralinepag has eight fewer hydrogen atoms than treprostinil, but instead has a key nitrogen and a key chlorine atom that treprostinil lacks. These changes in molecular chemistry make all the difference in the world for pharmacodynamics and pharmacokinetics.

Now, treprostinil is a very, very good molecule, delivering very, very good results. Not our treprostinil, not Insmed's, not Liquidia's treprostinil, none of these can ever be the super-prostacyclin that is ralinepag.

It is just not in their chemistry, but it is in ralinepag's chemistry. It is this change in chemistry that makes ralinepag a generational product for IPF.

In summary, UT's long-standing multiple-shots-on-goal strategy has now yielded its greatest reward: a proven once-daily NCE in PAH, formulated to use a proven DPI drug device for the best in disease treatment of the largest indications to which we aim. As we march to this summit, we are rising through a series of great product stages that give us ever greater reach into the PAH and IPF community.

Namely, we are rising through Tyvaso for ILD and IPF, Tyvaso DPI for ILD and IPF open-label extension, Tyvaso SMI, or Trezsmi, for PAH, ILD, and IPF, and many more such combinations of products and diseases to treat, which are still in stealth mode in our Skunkworks division. Each incremental product indication platform that I just mentioned, each of these, we are now aggressively developing for new and existing markets, and each of these brings UT ever closer to the ultimate goal depicted in the forecast chart released today.

Thanks for listening and digesting all of this great science and great clinical development work. Now I'll turn to Michael to describe how the demand for our existing products from doctors and patients is strong as ever.

Mike?

Michael Benkowitz

Thank you, Martine. That's a tough act to follow, but I'm going to do my best.

Good morning, everyone. For the first quarter of 2026, we recorded $782 million in total revenue.

Typical historical seasonality trends persisted in the first quarter, in addition to severe winter weather and pharmacy operations issues that slowed starts during the quarter. These have since been rectified, but it did impact our sales in the quarter, particularly in February.

As discussed on our last earnings call, we expect to return to sequential growth in the near term. Turning to Tyvaso, total revenue for the first quarter was $458 million.

While sales of nebulized Tyvaso lagged a little bit over the quarter, Tyvaso DPI contributed 9% year-over-year growth, driven by an increase in patient demand. Looking at the competitive landscape, it's clear the market for inhaled prostacyclins is attractive and growing.

We built and lead this market and expect our proven expertise to continue to win in the long term. We see this competitive dynamic as fuel for sharper execution across the organization, enhancing our strategic focus while operating with greater tactical intensity as we continue to shift momentum back in our favor.

Speaking of momentum, we are seeing favorable trends in our underlying demand metrics. Coming out of the quarter, Tyvaso referrals or prescriptions rates are at approximately the same level they were before Yutrepia launched.

Patient shipments have grown for the last five months. Prescriber breadth and depth continue to grow, and we've seen a steady increase in patients graduating to higher doses of Tyvaso DPI with the launch of the 80-microgram single capsule and the 96-microgram and 112-microgram combination kits.

Going forward, we're doubling down on what has always driven our success: relentless innovation, proven experience, and patient obsession. Additionally, the sales force investments we're making in anticipation of the ralinepag and IPF approvals will be deployed in the middle of this year to focus on expanding our reach and capturing more of the large, addressable, but yet uncaptured market in PH-ILD, and expanding share in PAH with our existing commercial portfolio.

We've built a durable, high-performing commercial engine, and we're confident in our ability to expand our core business while driving the next wave of growth in Trezsmi, ralinepag, and IPF. To once again quickly recap, as Martine mentioned, both the TETON 1 and TETON 2 trials of nebulized Tyvaso in IPF were a resounding success and exceeded our highest expectations.

We look forward to filing a supplemental new drug application by the end of the summer, and believe the highly compelling body of evidence across both the TETON studies could warrant an expedited approval through priority review to bring this therapy to those patients in need as quickly as possible. If we receive a standard review timeline, we would expect to launch by Q2 of next year, and in parallel, we have already embarked on preparations for a product launch.

Following IPF approval, we'll work with payers to secure coverage for the new indication as soon as possible. We recognize the substantial market opportunity that lies ahead, and we're fully prepared to seize it.

Coming back to ADVANCE OUTCOMES, the unprecedented top-line results suggest ralinepag has the potential to revolutionize the treatment of pulmonary arterial hypertension as the first true once-a-day oral prostacyclin agonist. We believe this advancement could fundamentally shift the treatment paradigm, potentially positioning prostacyclins for earlier line usage in conjunction with ERAs and PDE5s.

With a differentiated clinical profile, combined with its convenient once-daily dosing, we foresee a multibillion-dollar opportunity in the market for oral ralinepag, where we expect to launch mid-next year, assuming a smooth FDA approval on a standard review timeline. In summary, our goals over the near to medium term are to drive further growth in Tyvaso, the most prescribed inhaled prostacyclin, and after anticipated FDA approvals, for ralinepag to become the most prescribed prostacyclin for PAH, and for nebulized Tyvaso to become the most prescribed therapy for IPF.

To close, I want to recognize the intensity, discipline, and patient-first commitment our commercial and medical affairs teams bring every day. We remain confident that our business is positioned to deliver sustained double-digit long-term growth.

With that, I'll pass the call back over to Harry to start the Q&A session.

Harry Silvers

Thanks, Michael. Operator, if you want to assemble the roster and start with the first question.

Operator

Thank you. If you have a question, please press *1 on your telephone keypad.

If you wish to remove yourself from the queue, simply press *1 again. One moment, please, for your first question.

For today's session, we do ask that you restrict yourself to one question. Your first question comes from the line of Ash Verma of UBS.

Your line is open.

Ash Verma

Hi. Thanks a lot for taking our question, and congrats on all the progress.

Maybe just on the IPF regulatory filing and how you're positioning yourself in the market. I know you had previously mentioned that you would do bridging study for the DPI, and where are we on that, and do you think that by the time that you launch the IPF, you would have the DPI format available?

Just as a quick follow-up, I wanted to understand just your thoughts on the Jascaid or nerandomilast launch metrics that are looking particularly strong. Do you think that is kind of like a indication of the pent-up demand in this market given there isn't much of good options available, and how does Tyvaso get positioned compared to Jascaid when you launch it?

Thanks.

Harry Silvers

All right. Thanks, Ash.

Everybody, please try to keep it to one question. Leigh, if you want to take the DPI to IPF component, and then maybe Michael can follow up on Jascaid.

Leigh Peterson

Yep, thanks. We're actually working with FDA to come up with our bridging strategy for IPF with the Tyvaso DPI.

I think we've been discussing that before. We will likely do a healthy volunteer PK comparability studies, and as well as patient studies to demonstrate safety and efficacy.

As far as the sample size and duration of those studies, again, we're still working with FDA to come up with a clinical development plan.

Harry Silvers

Thanks, Leigh.

Michael Benkowitz

Just on the Jascaid front-- Go ahead. Wait, I think I'm going to address the question that Ash had on Jascaid.

Go ahead. Yeah.

Ash, obviously, we're following that very closely. I do think that's a good proxy or good analog and does suggest that there is a lot of pent-up demand for new therapies in IPF given what's currently on the market.

I guess the short answer is we agree with you, and that's really kind of how we're starting to think about a potential launch curve. We're starting to have conversations with physicians now.

It's still a little bit on the early side because we were somewhat embargoed in what we could talk about with the New England Journal publication. Now that that's behind us, we're able to have those conversations, and I think we're hearing from the physicians that they're very impressed by the data, very excited about bringing Tyvaso to market.

I think we had an advisory board about a month or so ago where we had some of the top 15, I think, IPF treaters in the country, and we were asking the question around where are you going to use Tyvaso? You going to use it first line, or use it after Jascaid?

How do you think about this? They all said it's going to be patient-dependent.

In some cases, they'd use Tyvaso first. In some cases, they may start Jascaid.

At the end of the day, it doesn't matter because they fully expect that this disease is going to look a lot like what we see in PAH, where it's combination therapy. Even if they're starting Jascaid first, they're going to add Tyvaso on very quickly thereafter.

We think the potential is, as Martine said in the beginning, just enormous in IPF.

Harry Silvers

All right. Operator, next question.

Operator

Thank you. Your next question comes from the line of Roanna Ruiz of Leerink Partners.

Your line is open.

Roanna Ruiz

Great. Good morning, everyone.

I was curious, how does your overall commercial strategy and peak sales and timing expectations changed now that you're focusing on a few different levers, like the triple combo pill for ralinepag, a DPI for ralinepag, and also thinking about the SMI?

Harry Silvers

Thanks, Roanna, for the question. Good to hear your voice this morning.

Michael, you want to take that one?

Michael Benkowitz

Sure. I think we'll provide some more granularity as we start to kind of build out our forecast.

We start to have more conversations with physicians about the different products and where they expect to use them. I think high level, what Martine said in her opening remarks is right.

If we're turning towards $4 billion by next $4 billion run rate by next year, we think certainly with just ralinepag and the IPF indication regardless of the delivery device, that puts us on a path to more than double revenues over the next few years. That's what we're building for and aiming for.

How that breaks out between the different indications, different devices, like I said, I think we'll provide some more granularity on that as we get later in the year and build out our models.

Harry Silvers

All right. Operator, next question.

Operator

Your next question comes from the line of Jessica Fye of J.P. Morgan.

Your line is open.

Jessica Fye

Hey, guys. Good morning.

Thanks for taking my question. Wanted to focus on ralinepag DPI.

Can you just confirm this product coming out of stealth mode, is that the once-daily inhaled product you've been alluding to in prior quarters? When should we expect that Phase 1 healthy volunteer PK/PD data comparing that product to oral ralinepag?

What led you to decide for DPI over SMI for ralinepag's new formulation? Thank you.

Harry Silvers

Thanks, Jess. Good to hear from you.

Welcome back. We'll kick that over to Pat to answer on ralinepag DPI plans.

Patrick Poisson

Thanks, Harry, and thanks for the question. First, let me say we are excited to work with the MannKind development team again.

What we were able to do together with Tyvaso DPI, which was approved in less than four years from our engagement while contending with the pandemic, was really nothing short of incredible, and we expect an even better encore with Ral-DPI. As mentioned in the MannKind press release this morning, we began work on Ral-DPI about six months ago, and we made great progress with the completion of formulation development and the transition to manufacturing tox study supplies.

We've had a very positive pre-IND engagement with FDA, and we'll shortly be moving into some minimal nonclinical testing, which will be quickly followed by an IND and a Phase 1 study, which we believe will be completed before the end of the year. We believe the half-life of ralinepag, along with some other characteristics we are investigating, are very promising for this to be a once-a-day product.

Important to note that this will be without the addition of any release-controlling materials, which need to be carefully studied for safety when used chronically. I'll finish with, as they say in IndyCar racing, we are staying with hard tires and not making any pit stops.

Harry Silvers

Thank you, Pat. That was a great answer.

Operator, next question, please.

Operator

Your next question comes from the line of Joseph Thome of TD Cowen. Your line is open.

Joseph Thome

Hi there. Good morning.

Congrats on the progress, and thanks for taking my question. Maybe just to extend a little bit on the development program for Ral-DPI, maybe how quickly can this move?

Is the availability of the data for oral ralinepag helpful at all, maybe specifically for PAH? Could you go right into registration?

Just trying to think about timelines relative to some competitors in the space. Thank you.

Harry Silvers

Hey, Joe. Thanks for the question this morning.

I think we'll kick that back over to Pat again.

Patrick Poisson

Another great question. Of course, the ADVANCE OUTCOMES data was off the charts incredible.

That's very encouraging that Ral-DPI will be very effective to treat PAH, PH-ILD, and IPF and PPF. As far as the timing, I think long term, we're going to be able to move into PAH fairly quickly relative to our world in pharma, as we'll be pursuing that approval with the solid dose.

Certainly, the solid dose has been a big contributor to our engagement with FDA and really, the minimal amount of pre-IND work that we have to do for Ral-DPI. I anticipate we'll complete the initial Phase 1 study by the end of the year, and we'll rapidly be able to kick off studies for PAH efficacy as well as PH-ILD, IPF, and PPF.

Each of those will progress at different paces, but initially, PAH will be the first approval.

Harry Silvers

Thanks again, Pat. Operator, you can go ahead.

Operator

Your next question comes from the line of Lisa Walter of RBC Capital Markets. Your line is open.

Oh,

Lisa Walter

good morning. Thanks for taking our question.

On the 1x daily ralinepag DPI, just wondering if you can share more color on the formulation. Should we think of this as a ralinepag prodrug or another formulation with a lung-targeting ligand, or are relatively little additional flourishes needed to make ralinepag inhalable?

Any color here would be helpful. Thanks so much.

Harry Silvers

Thanks, Lisa. Good to hear from you.

Pat, you're the star of the show today.

Patrick Poisson

All right. Thanks, Harry.

We'll be leveraging MannKind's crystal carrier IP for ralinepag, very similar to what we have for treprostinil. It is not going to be a prodrug.

Now, perhaps we investigate other polymorphs of ralinepag in the future, but initially, it's going to be the ralinepag molecule that we investigated for solid dose. Again, very similar formulation to the current treprostinil in using MannKind's crystal carrier IP.

Harry Silvers

All right. Thanks, Pat.

Operator, you can move to the next question.

Operator

Your next question comes from the line of Olivia Brayer of Cantor. Your line is open.

Olivia Brayer

Hi. Good morning, guys, and thank you for the question.

Now that you are committing to developing a number of different formulations in IPF going forward, can you maybe just talk about which you think have the highest chances for success, and how you're thinking about nebulized versus DPI versus SMI, and then also Tyvaso versus ralinepag for IPF patients specifically? Just kind of following up on that from a regulatory strategy perspective, anything you can say yet in terms of what that strategy is for getting some of these next formulations to patients?

It sounds like a bridging study for DPI, but what about the SMI formulation? Then when could you realistically start those ralinepag studies in IPF and PPF?

Thank you.

Harry Silvers

Thanks, Olivia. Perhaps from a broader strategic standpoint, Michael can take that question, and then maybe Leigh could follow up on the regulatory side.

Michael Benkowitz

I think from a strategic standpoint, our approach to IPF is very similar to what you've seen us over the last 30 years do in PAH, which is taking a multiple-shots-on-goal approach. We started with Remodulin IV.

We thought Remodulin subQ could be a better version of Remodulin, just in terms of dealing with the potential for infections. Then we progressed to Tyvaso, we progressed to Orenitram, and then we looked at Tyvaso DPI, and now ralinepag.

I think the point of all that is that I think what we've uncovered in PAH, and we think this is true in IPF, is that patients are like snowflakes, right? They're not this homogeneous group of people that all respond to the same drug delivery approach.

There's a role for all of these products in PAH, and I think that's what we're going to see in IPF is we take multiple shots on goal, and I think we're very optimistic and confident in our ability to bring all of these products to market. We think they're all going to have a role, right?

I think there's going to be some patients that they're going to respond well to DPI. You look over in PH-ILD, I think you have a significant number of patients that are still on nebulizer even though you have the convenience of the DPI.

Patients are unique. They all respond to different drugs in different delivery devices in different ways.

The approach has always been multiple shots on goal. We give patients options in terms of the way they can receive the drug.

Then from our standpoint, we're really kind of agnostic as to which one they choose, as long as they're choosing one of our products. Strategically, that's how we think about these different devices and different NCEs in IPF.

Leigh, I don't know if Pat, you guys want to talk about the regulatory path?

Leigh Peterson

Actually, I just wanted to add on a little bit to a little bit of color to what you said. With the patients or people are snowflakes, just keep in mind that with, we have different the different sort of categories: we have the the inhaled route versus the oral route.

Now, we know that oral for patients, especially if it's once a day, tends to be more convenient, but we also know that systemic vasodilators are generally contraindicated in patients with like PH-ILD or or IPF given that the potential for worsening of ventilation-perfusion mismatch, V/Q mismatch. That kind of, separates that right there as to, we we we imagine the inhaled would be more for this other population.

Then as far as the powder versus the SMI, some patients, it could be a convenience thing or a cough. Some patients might be more sensitive to the powder versus the nebulizer, and so that's, where where that might fall out.

Then as far as, this is something we haven't really talked about too much, but, even though treprostinil and ralinepag are both in the same class of drugs, they they do bind, Martine went through the chemistry of of the actual molecular structure between the two, and as such, they they bind their receptors, differently. Ralinepag is a really, really potent IP receptor agonist, whereas treprostinil binds multiple receptors: IP, EP2, and DP1.

There may be some differences with regard to efficacy there based on, patient genetics. All of these things, again, just to to reiterate that they they really give us, this this really allows individual patients to get the absolute best treatment possible.

As far as the IP receptor goes, there's some recent data that preclinical data that IP receptor activation promotes alveolar regeneration during lung repair. In and this is if you want to really get into the molecules and the pathway, it's versus this Jun/p53 pathway.

There's there's coming out more and more evidence for these things and these type this class of molecules versus different mechanisms of action in these indications, whether it's PAH or PH-ILD or ILD or IPF or PPF or through all of them. Anyway, just wanted to add a little bit more there, and then maybe Pat would want to talk about the regulatory aspect?

Patrick Poisson

I think the regulatory strategy would proceed kind of as expected. We'll have nebulized approved in IPF, and we'll conduct whatever agreed-upon bridging study is necessary, and then proceed directly with the filing from there.

I don't anticipate anything unusual.

Harry Silvers

Thank you, Pat, Leigh, Michael, three really wonderful answers. Operator, I think one more question we have time for.

Operator

Your last question comes from the line of Roger Song of Jefferies. Your line is open.

Roger Song

Great. Congrats for the call, and thank you for squeezing me in for the last question.

Maybe I think in the update, you also have the PH-COPD Phase 2 about to start this year. Curious about how should we think about the market opportunity, and then also what the product formulation, potential sequence for that indication, given we haven't talked about a lot of the combination device and the drug?

Thank you.

Harry Silvers

Thanks, Roger. Leigh, perhaps you want to share a little bit of color on the PH-COPD study?

Yeah.

Leigh Peterson

As far as the formulation, we're we're planning to use treprostinil SMA, SMI, excuse me, for this, and for PH-COPD. We're planning on doing it the study in a couple of phases.

We obviously have our Phase 1, where that's already ongoing with the treprostinil SMI in healthy volunteers, and then we're planning a Phase 2 study with PH-COPD patients, and that'll be followed by a Phase Phase 3 PH-COPD study. We've have several learnings through over the years that are being considered here with regard to patient populations, and and we're really looking forward to starting these studies with these sort of enriched patient population eligibility criteria.

Harry Silvers

Thank you, Leigh. Operator, you can go ahead and close the call.

Operator

Thank you for participating in today's United Therapeutics Corporation earnings webcast. A rebroadcast of this webcast will be available for replay for one week by visiting the Events and Presentations section of the United Therapeutics Investor Relations website at ir.unither.com, that is, ir.unither.com.

This concludes today's conference call.