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Lantheus Holdings, Inc. (LNTH)

Q4 2025 Earnings Call· Thu, Feb 26, 2026

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Transcript

Operator

Operator

Good morning. Welcome to Lantheus Holdings, Inc.'s fourth quarter and full year 2025 conference call. All lines have been placed on mute. This call is being recorded. A replay will be available in the Investors section of the company's website approximately two hours after the completion of the call, and will be archived for at least 30 days. I will now turn the call over to Mark Guarnieri, Vice President of Investor Relations. Mark?

Mark Guarnieri

President

Thank you. Good morning. With me today are Mary Anne Heino, our CEO and Executive Chairperson, Amanda Morgan, our Chief Commercial Officer, and Bob Marshall, our CFO. We will begin with prepared remarks and then take your questions. This morning, we issued a press release, which was furnished to the SEC under Form 8-K, reporting our fourth quarter and full year 2025 results. The release and today's slide presentation are available on the Investors section of our website. Any comments could include forward-looking statements. Actual results may differ materially from these statements due to a variety of risks and uncertainties, which are detailed in our SEC filings. Discussions will also include certain non-GAAP financial measures. Reconciliation of these measures to the most directly comparable GAAP financial measures is included in the Investors section of our website. I will now turn the call over to Mary Anne.

Mary Anne Heino

CEO

Thank you, Mark, and good morning, everyone. It is a pleasure to be back with you as CEO at an important moment for the company. I want to start by recognizing Brian for his leadership and for ensuring a smooth transition. While my role as CEO will be interim as we complete the search for the next Lantheus Holdings, Inc. CEO, I am thrilled to be back in the operational leadership role with the same passion and commitment that those who work with me will remember. I have taken time to meet with shareholders over the past months and appreciate the ongoing opportunity to listen to your feedback. My intent is to seamlessly transition our strategy and the execution of that strategy to the incoming CEO. I will note, the board and I are successfully progressing our CEO search, and I am pleased with the candidates we have met thus far. Before I offer comments about our business achievements for 2025, I would first like to share that Lantheus Holdings, Inc. products helped impact the lives of approximately 7 million patients in 2025, underscoring the real-world importance of the work our teams do every day. Now, turning to the results, I would like to start by highlighting the important progress we made in 2025 to shape our strategic focus within the radiopharmaceutical industry. The decisive actions we took in 2025 include: We closed 2 complementary transactions that diversified and will accelerate our near-term revenue stream across our commercial radiodiagnostic portfolio. First, the acquisition of Neuraceq, our beta-amyloid-targeted PET radiodiagnostic, which now serves as the commercial cornerstone of our Alzheimer's disease portfolio. We are excited both about the growth potential of Neuraceq and the expanding amyloid PET imaging market. In 2026, we expect Neuraceq's growth will exceed that of the overall…

Amanda Morgan

Management

Thank you, Mary Anne. We are positioning the business for its continued growth by driving commercial readiness ahead of multiple upcoming launches, beginning with our new PSMA PET formulation. First, let us discuss our fourth quarter results and priorities for 2026. I will begin with PYLARIFY, our market-leading agent, which posted solid performance in the fourth quarter in a highly competitive market, with volume up approximately 4% year over year. Our continued successful commercial execution and pricing discipline were the drivers of this performance. Notably, the vast majority of our annual volume in 2025 came from long-standing accounts, demonstrating the resilience and commitment of our customer base and the clinical value of PYLARIFY. As a reminder, pricing concessions provided late in the second quarter of 2025 reset 340B pricing in the fourth quarter. Our best price, which determines what is offered as 340B pricing, was unchanged in the second half of 2025. There will be no further change to our 340B pricing in the first half of 2026. We believe we have the broadest end-to-end coverage of PSMA PET imaging value chain, delivering consistent availability, reliability, and dependability to our customers. This level of operational excellence is a clear source of competitive advantage. We will extend this proven capability across each product we launch into the radiodiagnostic market, with the intent to accelerate adoption and drive both mid and long-term growth. I will highlight performance of our commercialized Alzheimer's imaging product. Neuraceq contributed $31 million for the quarter, driven by strong commercial execution. In 2026, we will further support that execution with the onboarding of six additional PMF sites. We are excited about the potential of Neuraceq in Alzheimer's disease PET imaging market. As the already second-most utilized and fastest-growing beta-amyloid PET imaging agent, Neuraceq addresses a large and expanding…

Robert J. Marshall

Management

Thank you, Amanda, good morning, everyone. I will provide details of the fourth quarter and full year 2025 financials, focusing on adjusted results with comparisons to the prior year quarter, unless otherwise noted. Revenue for the fourth quarter was $406.8 million, an increase of 4%. Revenue for the full year was $1,541.6 million, an increase of 0.5%. Turning to the details, radiopharmaceutical oncology, currently comprised solely of PYLARIFY, generated fourth quarter revenue of $240.2 million, flat sequentially and down 9.7%. For the full year, PYLARIFY delivered $989.1 million, down 6.5% from the prior year period. The result was above expectation, with price and volume favorability as compared to our previous estimates. Precision Diagnostics delivered fourth quarter revenue of $143.2 million, representing a 22% increase. The category was driven by net sales of DEFINITY at $85.3 million, or 1% lower, due to the prior year competitor supply challenges, which drove higher than expected revenue during Q4 2024. For full year, results were $330.2 million, up 3.9%. Neuraceq delivered $31 million in the quarter and $51.4 million since the acquisition in late July. TechneLite and other SPECT revenue for the quarter was $26.9 million for the fourth quarter and $111.4 million for the full year. Strategic partnerships and other revenue was $23.3 million, up 203.3%, due to a strong quarter for MK-6240, as well as the recognition of a $6 million milestone receipt relating to an out-licensed asset. Full year revenue was $59.4 million, with MK-6240 contributing slightly less than half of that amount. Gross profit margin for the fourth quarter was 65.1%, down 289 basis points from the fourth quarter 2024, due mainly to year-over-year decreases in PYLARIFY net price and the inclusion during 2025 of the Evergreen manufacturing facility and Neuraceq volumes, which were not in the comparative period, all…

Mary Anne Heino

CEO

Thank you, Bob. While we focused in 2025 on the competitive dynamics experienced in the PSMA PET imaging market and our work to successfully integrate acquisitions, we are now taking purposeful steps to sharpen our focus on our strategic priorities, especially in the diagnostic space, and leverage both our capabilities and portfolio in 2026 and beyond. Allow me to again state our priorities for 2026. Maintain our market leadership in PSMA PET by sustaining PYLARIFY volume growth. Execute a seamless transition to the new PSMA PET formulation beginning in the fourth quarter. Increase momentum for Neuraceq by expanding our manufacturing footprint and driving deeper penetration in existing accounts and accounts where a strong PYLARIFY relationship already exists. Advance our assets currently under FDA review through regulatory approval milestones and effect fit-for-purpose launch activities with those assets that offer the earliest and best revenue return. Selectively develop other pipeline assets towards key stage gates and decision points, and allocate capital with discipline, prioritizing radiodiagnostics, seeking to optimize the value of our radiotherapeutic pipeline, and maintaining financial flexibility while committing to a leveraged P&L that delivers value to our shareholders. We enter 2026 with confidence in our strategy and our ability to deliver, recognizing this represents a year of intentional investment and portfolio prioritization that will position the company for solid financial performance and durable value creation. We do so, we remain focused on the patients we serve, having helped impact the lives of approximately 7 million patients in 2025. I want to thank our shareholders, employees, and our loyal customers for their continued support and dedication. I will now turn it over to Q&A. Operator?

Operator

Operator

Thank you. As a reminder, to ask a question, please press star one one on your telephone and wait for your name to be announced. To withdraw your question, please press star one one again. Please limit yourself to one question per person. One moment for questions. Our first question comes from Anthony Petrone with Mizuho Cap Financial Group. You may proceed.

Anthony Charles Petrone

Analyst · Mizuho Cap Financial Group. You may proceed

Thank you, hi, Mary Anne, welcome back. Hope you are doing well. Hi, Bob, Amanda, Mark, hope everyone is doing well. Maybe I will start off with 2 quick ones. Just know a lot of folks are on the line here, but start with, you know, just the March 6 PDUFA date for next gen PSMA PET imaging agent. Thanks for the updates there on a fourth quarter rollout. When we think about taking a glass half full approach, assuming, you know, the PDUFA date goes as expected, and we get clearance, you know, what will be the timing when we do secure coding, you know, when we get realization on what the TPT sort of reimbursement rate will be, and maybe a little bit of detail on how you will begin that transition, specifically with long-term contracts that are out there, and I will have one quick follow-up. Thanks.

Mary Anne Heino

CEO

Anthony, I will take that, thank you so much. It is, as I said, great to be back in my operational role here. As you noted, it is absolutely a glass wonderfully half full about our new PSMA PET formulation. Let me review some of the dates we are assuming here, that will also then, I think, explain our strategy as we move forward. As you noted, our PDUFA date is March 6. The two items that Amanda referenced that are important with the launch of any PET-based product, is you need to ensure that you have secured a HCPCS code as well as transitional pass-through status, those are two separate activities. We would anticipate that we would have in place by October 1, our HCPCS code, and that for having submitted our transitional pass-through application by June 1, that will also be in place by October 1. It is very important that those events precede your commercial entry into the market. That is why you hear us referring to late 2026, or specifically the fourth quarter, for the operational rollout of the PMF. As you can remember from our PYLARIFY launch and from the other launches of F-18-based assets into this category, you have to stand up or get approved each PMF separately because they each represent a GMP-approved manufacturing site. Our goal is to make sure that we never have disruption of product Lantheus Holdings, Inc. product availability in that market. We have chosen a regional-based rollout, allowing for duplicity so that we absolutely still have service in place to flip from PYLARIFY to our new formulation, which we will offer a name and start using as soon as it is approved. And we anticipate for making sure that that is the risk, that will take us the fourth quarter to accomplish. Coming out of the fourth quarter, we will have a network as broad as we have in place currently for PYLARIFY in place for our new formulation, and that is why we keep referencing to say that significant revenue related to that product will really occur beginning in 2027 and not as much in 2026. We feel like we have got all bases covered here. We are all, you know, waiting for the March 6 date. It is right in front of us now, and you can certainly imagine that there will be a press release, around that date, to communicate what we have heard from the FDA.

Anthony Charles Petrone

Analyst · Mizuho Cap Financial Group. You may proceed

Excellent. Just a quick one is just the market dynamics for PYLARIFY, as is today, down 8%-10%. We know that there is a study out there, POSLUMA versus PYLARIFY, a head-to-head study. I believe it reads out at ASCO. Maybe what is baked into the negative 8%-10% per share shift? How does the outcome of the study play into that? Thanks again. Welcome back.

Mary Anne Heino

CEO

Thanks, Anthony. Kind of interesting to talk about that study, because I will be honest and say we do absolutely have some concerns regarding the study design that was used. First and foremost, there is no randomization in the study. If you read the protocol and you see how it was executed, the PYLARIFY images were always captured first. In a fully randomized trial, you would probably expect to see something different. Also what is concerning, there is no truth standard. If you look at the design of the study, they are really measuring just SUV and detection rate. The kind of the odd thing about that is, when you measure detection rate that way, you actually give yourself credit for false positives. The high detection rate may be due to the false positives that are already noted in that product package insert. Also, if it is just from a math perspective, the study was not powered to show statistical significance. From a clinical perspective, there is really two relevant comments here. First, bladder SUV values do not impact diagnostic performance, and that is what the study is really measuring. Second, and very much not in line with current clinical practice, the men in the study, because of course it was all male patients, were not allowed. They were actually prevented from voiding prior to having their scan done. That is very much the opposite of what happens in clinical practice today. I will say we are glad to see continued scientific investigation into this incredibly important class, but we also would very much hope that it would be rigorous scientific evaluation. I will share with you, because you referenced, how did that bake into our forecast? The results of that study really do not bake into our forecast.

Operator

Operator

Thank you. Our next question comes from Richard Newitter with Truist. You may proceed.

Richard Samuel Newitter

Analyst · Truist. You may proceed

Hi, thanks for taking the questions. I just wanted to put a finer point on what your kind of pricing and unit growth played out, how that played out in Q4 2025. You were at 3% unit growth, I think you said. In the third quarter, you had about a 500 basis point, 340B driven price headwind to contend with in the fourth quarter. I am getting to, like, a high single digit unit growth rate in Q4. Is that right? You know, what was behind that? Did the market improve? Did you just call back some share, if that is in fact right? Maybe, Bob, can you give us a little more on what the market assumptions are for 26 for PYLARIFY and kinda what your unit and price assumptions kinda are within that? Thank you.

Robert J. Marshall

Management

Rich, I will take that. In terms of growth, I mean, listen, it was a great quarter from a PYLARIFY perspective. Obviously above our expectations. It was both volume and a little bit of benefit actually coming from the gross to net price change. You know, I think when we talked about it during kind of the fourth quarter, you know, following our call and whatnot, we had sort of pegged it at sort of the mid-teens, and that is effectively what we saw. That was maybe slightly more favorable than the actual teens growth that we were kind of thinking. You know, as I think Amanda pointed out, I think it was like 4% volume growth, and it did turn out to be our single greatest sort of volume performance in the quarter. I mean, excuse me, for the full year. When I think about assumptions going into how we are playing out 2026, we are thinking sort of a similar sort of low single-digit volume growth for the year. Much not too dissimilar from 2025. From a pricing perspective, what we have done is that while we have seen a lot of consistency in the market from a pricing perspective over the last couple of quarters, you know, as we think about one of those competitors losing pass-through, that they may actually look to try to use pricing as a mechanism to drive share. We have been really pretty disciplined, and we have been really explicit that as we think about executing our strategy, that we are going to stay disciplined. We are not going to chase business that is not good for the medium to long-term value of that franchise. The guide assumes that we see sort of a continuation of some, you know, incremental price that would sort of move us from sort of the mid-teens of where we are now to, you know, maybe the high teens as we progress through the year from a gross to net adjustment perspective. That is why you see sort of what I have laid out as sort of a sequentially net revenue, sort of neutral outcome for each of the quarters throughout 2026.

Mary Anne Heino

CEO

Rich, this is Marianne. Does that answer your question?

Richard Samuel Newitter

Analyst · Truist. You may proceed

Yeah, it does. It sounds like you are not seeing any dramatic changes to the pricing environment currently. To be prudent, you are because this is what took you by surprise and all of us by surprise last year, you are embedding that assumption that there will be another kinda regular way price price erosion situation, or you will have to walk away from that business incrementally. That is a placeholder in your guide, and you do not really assume any contribution from two-point-o. There could be upside if those things do not play out that way, and you start to get some benefit from two-point-o, if all goes well next week, and you can execute on the transition faster. Is that a fair way to look at these numbers?

Mary Anne Heino

CEO

Yep. Rich, absolutely. I have to say, it is such a great pleasure to have analysts like yourself monitoring our business where you know the market so well and also understand our strategy. You are really spot on with how we are thinking about the market.

Richard Samuel Newitter

Analyst · Truist. You may proceed

Okay. Thank you, guys.

Operator

Operator

Thank you. Our next question comes from Roanna Ruiz with Leerink Partners. You may proceed.

Roanna Clarissa Ruiz

Analyst · Leerink Partners. You may proceed

Hey, morning, everyone. Was curious, could you elaborate a bit more on one of your comments about pursuing value-maximizing alternatives for radiotherapeutic assets to support long-term growth? It made me think about, are you thinking about different features of products that you are looking for? Could this be part of near-term BD? I know you mentioned on the comments, possible tuck-ins this year, I was just curious if you could explain a bit more there.

Mary Anne Heino

CEO

Absolutely. I am glad that everyone is kind of picking up on the comments that both Bob and I made about this intentional focusing of our strategy. We really see it as the natural outcome of all the activity that we had in 25 and even 24. We have now a very broad portfolio of both diagnostic and therapeutic assets, our intent is to, and we think our obligation to our shareholders, is to make sure that the value of each of those is considered. We certainly could not handle or accomplish the advancement of that entire portfolio. We have chosen to focus in on the diagnostic asset then. As you will see, I had a pipeline slide in the middle of my presentation, it will also show it again at the end. It really is a very broad portfolio there. When we refer to the therapeutic assets, what we are referring to is, and we have undertaken a full review of our whole portfolio, but looking really at what are the stage gates for the therapeutic assets that really define value for them, so that as we consider how they should be then driven further, and it will be through external or alternatives or partnered alternatives, how is it best for us to present the value and the clinical utility of these products? A lot more to come, a lot more to come on that as we talk throughout the year. I will mention, and it really comes back to what you mentioned with tuck-ins, further tuck-ins for diagnostic opportunities. If we find them and they fit, then, yes, absolutely, we will consider them. Even as we talk about the therapeutic assets, I probably should be clear to say that when I talk about that, I am not talking about PNT2003. That product is right before us as far as regulatory approval opportunity. It is a natural fit into our portfolio of products and, again, our customer base. We are already committed to what we believe will be a very successful launch of that product.

Operator

Operator

Thank you. Our next question comes from Matt Taylor with Jefferies. You may proceed.

Matthew Charles Taylor

Analyst · Jefferies. You may proceed

Hi, good morning. Thanks for taking the question. I guess I will ask one on Neuraceq. It came in nicely in Q4, and your guidance, you said, it was, I think, at least triple-digit growth. You know, I guess, not that that is a bad growth rate, but why could not it actually be higher than that, given the momentum that you have and also the sequential growth that we are seeing in some of these Alzheimer therapeutics?

Mary Anne Heino

CEO

Matt. We absolutely do see... triple digits, pretty good to hear, Matt. I think what you are also hearing from us, again, we inherited that product as of, we will call it, midyear last year. One of the things, again, this comes back to F-18-based products in this market, you have to have the manufacturing footprint to be able to bring your product broadly to patients. I will say, I think the numbers have been discussed before, but the number of standing PMFs for Neuraceq at the time we acquired it was, call it, mid-20s. We added a few, and someone might correct me if I am wrong there, but we added a few, and then our intent is to add six more this coming year. Therefore, we will start to approach having what we consider a broad geographic footprint for that product. I am sorry, I have been corrected. The starting number of PMFs when we inherited the product was 16, and again, we will continue to add. That really is our the way that we measure how far we can take the product into new areas. The other part of our, what we think is a very promising forecast, is our ability to take the product deeper into the accounts where it already is based on some changes in guidelines and the broadening that we saw in the PIs last year, as well as by also leveraging the relationships that we have in accounts with other Lantheus Holdings, Inc. products. Happy to be wrong here and have it even further exceed what we have, but I think we have been very practical, optimistic, but practical with our forecast. Bob, do you want to add something there?

Robert J. Marshall

Management

I do, because well, people can figure this out from a mathematical situation. By triple digits, we are talking certainly in, like, call it the 140%-150% range of inorganic growth off of what was a very good fourth quarter, which was the first full quarter that we actually had the asset in the portfolio commercially.

Operator

Operator

Thank you.

Mary Anne Heino

CEO

Does that answer your question?

Operator

Operator

Our next question comes from Paul Choi with Goldman Sachs. You may proceed.

Karishma

Analyst · Goldman Sachs. You may proceed

Hi, thank you for taking our question. This is Karishma on for Paul. If the upcoming Biogen data shows meaningful tau reduction, but no benefit on cognitive measures, how does this affect your go-forward investment in your tau program? Thank you so much.

Mary Anne Heino

CEO

I am sorry, could you repeat what you are referring to? No, the study. Can you repeat the first part of your question, please?

Karishma

Analyst · Goldman Sachs. You may proceed

Yeah, sorry. If the upcoming Biogen data shows meaningful tau reduction, but no benefit—

Mary Anne Heino

CEO

Oh, yes.

Karishma

Analyst · Goldman Sachs. You may proceed

—on cognitive measures, how does this affect your go-forward investment in your tau program? Thank you.

Mary Anne Heino

CEO

Okay. I am sorry, there was, we just did not hear the first part of your question, but it makes the perfect sense. We will, of course, are very eagerly awaiting those data, but I think there is very, very strong scientific evidence already that the presence of tau and the quantification of tau is aligned with cognitive performance of patients. That really is something that is slightly different than the role that amyloid plays. Amyloid, and, you know, to think about it, I guess, bluntly, amyloid comes early, but it does not always match to cognitive change in patients, where there is a much stronger correlation between rise of tau, especially in certain areas of the brain, and unfortunately, related cognitive defects for patients. I think what we are seeing in this market, and we are kind of all seeing it in real time because that is the wonderful thing that is happening around us. There really is now a market that is willing and acting on taking these products that are disease-modifying and starting to use them in patients. The kind of complementary use increased use of imaging, both amyloid and tau, will come along with that. I will not speculate on data that are not out yet, other than to say we are, from a scientific perspective, we are fairly confident in the role of tau in the market. As you heard, Amanda mention, in our biomarker business, tau is our product, MK-6240, is the number one product that is used in what we see as the 17 underlying, the ongoing studies in the market.

Operator

Operator

Thank you. Our next question comes from Larry Solow with CJS Securities. You may proceed.

Lawrence Scott Solow

Analyst · CJS Securities. You may proceed

Great, thank you, I echo the welcome back, Marianne. It sounds like the CEO search is progressing though. You know, is this gonna be like a, do you feel like it is a 6-month, 12-month type of thing? Any thoughts on just timing?

Mary Anne Heino

CEO

It, it is progressing, Larry, and it is good to be talking with you again. I am gonna say two things that I think are in our favor. I think this is an incredible opportunity for someone to step into what the future of our company and where we are going to be taking this company. I think as exciting as that is to me, I think it is also something that is exciting to the candidates we are talking to. The other thing I will say is, as everyone knows, we sit fairly adjacent to what is an incredibly active market in the United States, and that is the life sciences market in Cambridge. That is also, I think, been very much a boon for us in our search. I will say, this will not be a surprise to anyone, that the potential slate of candidates for us who are purely radiopharmaceutical or have radiopharmaceutical, is very narrow. This is just not a large industry. There, just from a history perspective, there have not been a lot of CEOs in this industry. As you can imagine, those of us who are here probably have competitive blocks from going to competitors in a role as significant as the CEO. Having said that, I will reiterate what I said, I am very pleased with the candidates that we have met, and to me, it is also a declaration or a demonstration of how far radiopharmaceuticals have come, and what they mean and represent in overall life sciences now.

Operator

Operator

Thank you. Our next question comes from Yuan Zhi with B. Riley. You may proceed.

Yuan Zhi

Analyst · B. Riley. You may proceed

Good morning. Thank you for taking our questions. Maybe to Mary Anne, when comparing Neuraceq to the number one leader in that space, where do you see improvement opportunities to catch up in market shares? Is it availability, guidance, difference, or pricing? Any additional color will be appreciated.

Mary Anne Heino

CEO

Sorry, your voice was actually very muffled, while you asked your question, and we are going to have to ask you to repeat it.

Yuan Zhi

Analyst · B. Riley. You may proceed

Yes, I am sorry. When comparing Neuraceq with the number one leader in that space, where do you see improvement opportunities to catch up in market shares? Is it availability or guidance or pricing? Anything you see opportunities in?

Mary Anne Heino

CEO

Very well understood now. Thanks so much. Let me first start by correcting. Neuraceq is the second most utilized beta-amyloid imaging agent in the space. The product with the highest market share in the space right now is actually Lilly's product, Amyvid. As far as where we see the growth opportunities, growth opportunities for Neuraceq in the market, short, mid, and long term is, first and foremost, there have been some changes to the guidelines regarding the use of beta-amyloid imaging for diagnosis of patients with different levels of Alzheimer's disease. That is the first, and it is very much testament to that. I think the launch and now that what we see is continued uptake of the DMTs, the drug modifying therapies for Alzheimer's disease, come with what will be associated imaging, not only to validate that the patients would be eligible for those therapies, but then there is also the potential to monitor those patients during therapy. All of those, both of those activities would add volume to the amyloid imaging market. Finally, very specific to Neuraceq, this is not a price play. You mentioned, is this gonna come from purely from price or growth? The answer to that is no. It really is driven by two factors. The first is, and most important, broadening the geographic footprint from which Neuraceq is available for distribution to all of the centers that do amyloid based PET imaging. The second is, within those accounts, and especially accounts with this already a PYLARIFY relationship, deepening the penetration of Neuraceq use in those areas. You heard me refer several times throughout my comments to the nuclear medicine customer base. We feel very strongly that we have a key advantage in our relationship there. Long, longstanding history, that has been the central focus of Lantheus Holdings, Inc.'s commercials efforts since we were essentially launched as a company back in the late 50s. It is a long relationship, it is a deep relationship, and it is a very trusting relationship for having brought them all the products before, but certainly PYLARIFY. Where we find ourselves now, very fortunately, which we absolutely intend to take advantage of, is that we have the ability to bring a portfolio of products into this customer space. One of those will certainly be Neuraceq. I would also like to clarify a comment that I made before, regarding the POSLUMA versus PYLARIFY head-to-head study about the final point about patients not being allowed to void. That is not an accurate statement. What I should have said is that while patients were encouraged to drink, they and they were encouraged to drink, they were not instructed to void, or did not, were not, you know, made to void. I apologize for that error in how I presented it.

Operator

Operator

Thank you. Our next question comes from Justin Walsh with JonesTrading. You may proceed.

Justin Howard Walsh

Analyst · JonesTrading. You may proceed

Hi, thanks for taking the question. In the medium to long term, can you comment on your expectations for the relative revenue contributions for your product portfolio segments? Just wondering how important prostate cancer is versus other solid tumors versus neurology and PET imaging.

Mary Anne Heino

CEO

I absolutely am happy to comment on that, I hope also that kind of came through in our comments to say that while we are incredibly fortunate to have up to four approvals this year, I think I was repetitive, as was Bob and even Amanda, in sharing that we expect revenue uptake to begin significantly in 2027. That really is related to the nature of how these products come out into the market. The very important considerations of ensuring that you have access and coverage, as well as insurance coverage, but here we are talking about market coverage as well, in place before you commercially, you put your commercial effort really behind it. It does not mean we are not getting ready for the launches; it just means that we will not execute the launches, and see the return for them, we are saying largely in 2027. From a revenue perspective, I hope you appreciate how much effort we did throughout end of 2024, all through 2025 to diversify our revenue base. Going forward, it is safe to assume that revenue derived from our prostate cancer franchise of products will be the main driver. We see lovely contribution from Neuraceq. We have, absolutely have strong expectations for contribution from our other launch products that we will be taking to market. Fair to say that the cornerstone and the majority of our revenue will be from PYLARIFY. That is why for 2026, we... We again repeated this several times, we are laser-focused on the transition to and introduction of our new PSMA PET formulation.

Operator

Operator

Thank you. Our next question comes from Andy Hsieh with William Blair. You may proceed.

Tsan-Yu Hsieh

Analyst · William Blair. You may proceed

Great, thanks for taking our question. Like a Neuraceq, you are going to be launching into markets with incumbents with Pluvicto and the therapeutic 2003. Can you outline some product-specific and commercial infrastructure differentiations that you can leverage to gain an upper hand as you launch these two products, you know, in the future? Thank you.

Mary Anne Heino

CEO

Yes, the very good question. Just to clarify, of course, Neuraceq is already in the market. We did not launch Neuraceq. Those products have been in the market for over a decade. I will say that Neuraceq is the second most utilized product in what is a 3-product market. Important notes about the other products that you mentioned, we will put PNT2003 aside because that is a therapeutic. As Amanda mentioned in her comments, Pluvicto, one of the important considerations of Pluvicto is that it will have transitional pass-through status and reimbursement, as will our new formulation in the PSMA franchise. That will be an important consideration and is an important consideration for many customers, especially given that the Pluvicto market is approximately 80% hospital-based. As everyone is aware, the concept of transitional pass-through payment is really applicable for traditional Medicare patients who are seen in the hospital setting. We see that as a key advantage as we take that product to market. From MK-6240, which also has, you know, an approval and a PDUFA date later this year, that is a product that is already well established through our biomarker solution business, and there we will continue to support that its role as being the number one tracer used in what are the wealth of clinical trials being undertaken by pharma in the study of tau and amyloid-based Alzheimer's disease.

Operator

Operator

Thank you. As a reminder, you may reenter the queue after you ask your question. Please press star one one on your telephone to ask a question. Our next question comes from Kemp Dolliver with Brookline Capital Markets. You may proceed.

Brian Kemp Dolliver

Analyst · Brookline Capital Markets. You may proceed

Thanks. Quickly, for Bob, could you go through the comments again on the sales and marketing guidance for 2026?

Robert J. Marshall

Management

All right. That is fine. I can manage that. More or less what we are thinking of in terms of like total OpEx, you are gonna see two of our sort of three sort of OpEx categories, sort of increase in spend. I did note specifically that we would see R&D up around that 10%-11% mark. With regard to sales and marketing, and I do think that this is when I look at consensus files, this is, I think, the one sort of like underappreciation for the work that we need to put in front of 20, you know, the different products that we are hoping to launch, you know, going into 2027. The work and it mirrors almost what we did with PYLARIFY back in, when was that? 2021.

Mary Anne Heino

CEO

Mm-hmm.

Robert J. Marshall

Management

From that perspective, I think you are gonna model it somewhere in, call it the 12-ish, 12.5% range of revenue. That, I think, together with a flat G&A, you know, again, keeping some leverage in those functions that are supporting, but really kind of putting the money in the investment where we hope to see a solid return for shareholders. That is how you should model things.

Mary Anne Heino

CEO

Oh, sorry. I just did want to add a comment there, that kind of finishes out Bob's thought. I think also what we were also trying to communicate that is important here is that we have leverage as we take these new launches through, and certainly sales and marketing expense is part of that, as we take these new launches out to the market, that one of the great opportunities we have is leverage, as we have already got a full voice and presence, with those, that customer base. You heard me say, and I will repeat it again, fit for purpose investments commensurate with the opportunity, but also with the investments we have made, prior in those same customer bases. I would say overall in the channel.

Operator

Operator

Thank you. Ladies and gentlemen, there are no further questions at this time. Thank you for participating in today's conference. This concludes the program. You may disconnect and have a wonderful day.