Insmed, Inc. 12th Annual Cantor Fitzgerald Global Healthcare Conference

Yeah, thanks so much for hosting us.

Well, thanks for the question, and again, thanks for hosting us and having us here. Little old Insmed put up $14 billion in peak sales, is our estimate between our three, either commercial or late-stage products. So really tremendous, and our level of conviction is very, very high in those numbers, obviously. Specifically, why did we do the update now? As we go through our own internal processes, we do an annual, we call it our strategic plan every year. We do our annual strategic plan in the July, August timeframe, share that then with the board in August during our strategic offsite with the board. We had all of this new information to share.

We had almost a year of launch now under our belt with BRINSUPRI, and while we had a ton of conviction in the $5 billion number that we were able to put out, which was obviously a monster number, we learned more about some of the underlying assumptions. We had shared previously throughout the journey of the launch up to that phase that we were either meeting or exceeding or doing better than our own internal sort of assumptions and benchmarks. You see us pull that through in our revenue model and in the guide that we shared with all of you by increasing from $5 billion to $7 billion. So that's a 40% increase in our conviction in BRINSUPRI. I'll just put a pin in, that is the base launch.

That does not account for this sort of secondary launch that I'm sure we'll touch on in potentially under-diagnosed patients that have COPD and/or asthma today. As we think about TPIP, previously, we had a $2 billion number out there for TPIP for two indications. It was for PAH-ILD and PAH. We had put that number out before we even had our phase II data in hand because it was a proven, a known mechanism action. Now with the strength of the phase IIb PAH data, the while small but very encouraging phase IIa PAH-ILD data, and then most recently, the OLE data for PAH. We now had, again, more new information, as well as have made the decision internally, and shared with all of you, to progress into two additional large indications, PPF and IPF.

So that update from $2 billion to $6 billion for TPIP reflects all four indications, each of which we believe could be a blockbuster in and of itself. ARIKAYCE, we had always assumed for the success of the label expansion, and that was already embedded in the $1 billion. So, yeah, tremendous amount of revenue potential, and that obviously doesn't take into account some of our earlier stage pipeline.

Yeah. So maybe we'll actually rewind and think through before we launched BRINSUPRI, we were putting out analogs for the best specialty respiratory launches that existed. We looked at OFEV and TEZSPIRE and DUPIXENT and FASENRA, and in their first year of launch, they put up about $500 million to $700 million in revenue. That's what really, really successful respiratory launches that I think we would all sit here and agree have been game changers in their space. As we have now launched BRINSUPRI and put up the very impressive revenue numbers that we have from an actual basis, and have been able to previously had the billion-plus guide for this year, and then most recently updated our revenue guide to the $1.25 billion to $1.4 billion this year. That is double plus what really successful specialty respiratory launches look like. Right? Our execution, the operational excellence that our commercial team has been able to show in the early days of the launch is absolutely tremendous, and you see that being pulled through in the actuals and the revenue guide for this year, and we needed to continue pulling that through in our peak sales estimate now that we have this level of conviction in the launch.

Yeah. So a lot of sort of unsung heroes in this launch. The team has just been kicking it out of the park. I'll remind you, we started disease state awareness for this launch, thank you to everyone that supported us financially to be able to do that, three years before the launch. That has really shown to be successful. Right? This is a first in mechanism, first in disease launch. There was a needed education to set the foundation going into the launch, and you're seeing sort of the fruits of those labors in the actuals. The team that's on the ground executing, educating compliantly on if it's a therapeutic specialist, if it's the field access managers, if it's the case managers, if it's the field-facing medical team, they are all hitting it out of the park with their execution. A lot of, like I said, unsung heroes.

The pricing reimbursement and access side of this is going wonderful. We have commented about 90% payer approval. Patients are getting their drug within about a week. Those are very high marks to be meeting. Patients are feeling better. They are starting to get that feedback loop in the physicians' offices and the medical offices. A lot of really strong opportunity there. We are seeing depth and breadth. We are seeing increases in the amount of writers. You saw that continue to increase in our Q2, where we went from about 5,000 prescribers cumulatively to about 6,300 cumulative prescribers from Q1 to Q2. You saw us grow in how many scripts folks had written. Previously, it was about 20% of the physicians had written five or more, and we were able to, while adding new writers, increase that to about 30% have written five or more. Really, really impressive. We still have a lot to go.

We now have, if you add up all the new patient start numbers, a little over 26,000 as of Q2, new patients on drug. I will remind you, there is 500,000 diagnosed patients today with bronchiectasis. That is data that is a couple years rear in the facing, and about half of those are two or more. We have just started to scratch the surface on patients that could be impacted positively with this medication, and there is over 20,000 prescribers. About 28,000 prescribers. Again, have a ways to go. We have done really well on all of those metrics, but still more opportunity.