Summary of Crinetics Pharmaceuticals FY Conference Call Company Overview - **Company**: Crinetics Pharmaceuticals (NasdaqGS:CRNX) - **Founded**: 2008 with a mission to be the world's leading endocrine company - **First Drug**: Approved for acromegaly, launched in 2025, generating $5.4 million in revenue from over 200 start forms [4][6] - **Pipeline**: Diverse pipeline including drugs for carcinoid syndrome, congenital adrenal hyperplasia (CAH), and Cushing's disease [5][19] Key Points Product Launch and Revenue - **PALSONIFY**: First drug launched, expected to be the standard of care for acromegaly, with strong early demand and over 200 enrollments [6][8] - **Revenue Generation**: $5 million in product revenue in the first quarter, with a pricing of $290,000 for a year of therapy [9][37] - **Reimbursement Process**: Over 50% of patients quickly reimbursed through medical exemption forms; average duration for prior authorizations is about 12 months [9][30] Clinical Trials and Pipeline - **Atumelnant**: An ACTH receptor antagonist in advanced clinical trials for CAH and Cushing's disease, with promising phase 2 data [7][19] - **Paltusotine**: Being studied for carcinoid syndrome, with phase 3 trials initiated; aims to simplify treatment compared to traditional painful injections [20][22] - **CRN09682**: A novel small molecule targeting neuroendocrine tumors, currently in first-in-human phase 1 dose escalation [24][80] Market Potential and Strategy - **Market Size**: Global market for somatostatin receptor ligands (SRLs) is approximately $2.5 billion, with $800 million to $900 million attributed to acromegaly [54] - **Patient Retention**: 80% of patients on SRLs discontinue or switch within five years, indicating a significant opportunity for PALSONIFY to retain patients [64] - **European Approval**: Positive recommendation from CHMP for European approval expected by mid-2026; plans to launch country-by-country [39][40] Future Milestones - **Upcoming Data**: Additional data from ongoing studies expected throughout the year, including updates on atumelnant and CRN09682 [25][81] - **Preclinical Programs**: Progress on TSH receptor antagonist and PTH receptor antagonist, with potential IND filings anticipated next year [84] Additional Insights - **Patient Experience**: Paltusotine offers a once-a-day oral administration, significantly improving patient experience compared to traditional therapies [20][41] - **Regulatory Landscape**: The company is navigating a changing regulatory environment, particularly concerning pricing and reimbursement strategies [39][40] - **Market Execution**: The success of PALSONIFY's launch and the ability to convert patients to paid drug status will be critical for market capture [61][62]

Core Insights - Crinetics Pharmaceuticals is experiencing early commercial momentum with its product PALSONIFY, which has been adopted by over 125 unique prescribers and has received more than 200 enrollment forms from clinical studies [1][6][2] - The company is transitioning from building a pipeline to establishing a commercial business, with PALSONIFY being its first commercial product launched in the U.S. [2][3] - Crinetics plans to initiate a global phase II/III study for atumelnant in ACTH-dependent Cushing's syndrome, which is characterized as a rare and difficult-to-treat condition [5][12] Commercial Performance - In Q4 2025, Crinetics reported total revenue of $6.2 million, with $5.4 million coming from PALSONIFY [4][16] - The company has seen encouraging formulary momentum, with several top payers adding PALSONIFY to their formularies, often with label-aligned prior authorizations and no step edits [1][6] - Approximately half of the patients are currently reimbursed through commercial or government coverage, while the other half are utilizing the company's Quick Start program [7][6] Financial Overview - Crinetics utilized $326.2 million in cash during 2025, which was favorable compared to the guidance range of $340 million to $370 million [19] - The company ended 2025 with over $1 billion in cash and investments, and after a public offering in January 2026, this amount increased to approximately $1.4 billion [20] - For 2026, the company expects GAAP operating expenses to be between $600 million and $650 million, reflecting increased clinical trials and commercialization activities [21] Pipeline Developments - Atumelnant is the first ACTH receptor antagonist tested in humans and has shown rapid and significant reductions in 24-hour urinary free cortisol in preliminary studies [5][10] - The upcoming EQUILIBRIUM ADCS trial will evaluate safety and efficacy across a range of doses, with a focus on establishing a glucocorticoid replacement strategy [12][13] - Crinetics is also advancing other candidates, including paltusotine for carcinoid syndrome and CRN09682 in oncology, with ongoing clinical trials [14][22] Regulatory Updates - Crinetics received a positive opinion from the CHMP in Europe for PALSONIFY, marking a significant milestone in its global regulatory strategy [22]

Financial Data and Key Metrics Changes - In Q4 2025, the company recognized $6.2 million in total net revenue, comprising $5.4 million from the U.S. launch of PALSONIFY and $0.8 million from a licensing agreement with SKK in Japan [25] - Total revenue for the full year 2025 was $7.7 million, with a cost of product revenue of $1.1 million in Q4 [25][26] - The company ended 2025 with over $1 billion in cash equivalents and investments, excluding $380 million from a public offering in January 2026, bringing total cash to approximately $1.4 billion post-offering [28] Business Line Data and Key Metrics Changes - The launch of PALSONIFY has seen over 200 enrollment forms received in Q4, with more than 125 unique prescribers involved [8][9] - The company is focusing on building a commercial enterprise around PALSONIFY, with a fully integrated team in place to support its launch [10][11] Market Data and Key Metrics Changes - The company is experiencing encouraging formulary momentum with payers, securing wins with top plans in the U.S. for PALSONIFY [9] - Approximately 50% of claims have been pre-reimbursed, with 60% moving into the QuickStart program [63] Company Strategy and Development Direction - Crinetics is transitioning from building a pipeline to establishing a commercial business, aiming to become a leading endocrinology company [7] - The company is focused on launching multiple innovative pharmaceuticals from its pipeline, including paltusotine and atumelnant, while also advancing its nonpeptide drug conjugate program [11][30] Management's Comments on Operating Environment and Future Outlook - Management expressed optimism about 2026, highlighting the successful launch of PALSONIFY and ongoing clinical trials for other products [31] - The company is committed to transforming the lives of patients with endocrine diseases and creating long-term sustainable value for stakeholders [31] Other Important Information - The company expects GAAP operating expenses for 2026 to be between $600 million and $650 million, reflecting ongoing investments in clinical trials and commercialization activities [29] - The anticipated increase in operating expenses is due to a full year of commercialization activities supporting PALSONIFY [29] Q&A Session Summary Question: Insights from Phase 2/3 design and previous studies - Management indicated that the structure of the Cushing's disease study is well established, with normalization of urine-free cortisol as a primary endpoint [36][68] Question: Trends in PALSONIFY prescriptions - Management noted positive feedback from prescribers and patients, but refrained from providing specific quantitative trends for the quarter [41][44] Question: Enrollment forms and commercial therapy timeline - Management stated that it is premature to extrapolate the 200 enrollment forms as a consistent run rate, with 50% of patients reimbursed and the other 50% on QuickStart [49][50] Question: Payer dynamics for PALSONIFY - Management reported no significant barriers to treatment access, with most coverage based on labels and a commitment to expedite the QuickStart process [63] Question: ADCS study design and endpoints - Management confirmed that the primary endpoint for the phase 3 study is set by the FDA, focusing on the percentage of patients achieving normal urine-free cortisol [68]

Financial Data and Key Metrics Changes - In Q4 2025, Crinetics Pharmaceuticals recognized $6.2 million in total net revenue, comprising $5.4 million from the U.S. commercial launch of PALSONIFY and $0.8 million from a licensing agreement with SKK in Japan [26] - Total revenue for the full year 2025 was $7.7 million, with a cost of product revenue of $1.1 million in Q4 [26][27] - The company ended 2025 with over $1 billion in cash equivalents and investments, excluding $380 million from a public offering in January 2026, bringing total cash equivalents to approximately $1.4 billion post-offering [29][30] Business Line Data and Key Metrics Changes - The launch of PALSONIFY has seen over 200 enrollment forms received in Q4, with more than 125 unique prescribers involved [8][9] - The company is focusing on building a commercial enterprise around PALSONIFY, with a fully integrated team in place to support its launch [10][11] Market Data and Key Metrics Changes - The company is experiencing encouraging formulary momentum with payers, securing wins with top plans in the U.S. for PALSONIFY [9] - Approximately 50% of claims have been pre-reimbursed, with 60% moving into a Quick Start program [64] Company Strategy and Development Direction - Crinetics is transitioning from building a pipeline to building a business, aiming to establish itself as a leading endocrinology company [7] - The company is focused on launching multiple innovative pharmaceuticals from its pipeline, including paltusotine and Atumelnant, while also advancing its nonpeptide drug conjugate program [11][12] Management's Comments on Operating Environment and Future Outlook - Management expressed optimism about the growth trajectory for PALSONIFY and the potential for Atumelnant to address significant unmet needs in treating Cushing's disease [11][25] - The company anticipates that existing cash and investments will be sufficient to fund operations into 2030, allowing for continued investment in clinical trials and commercialization activities [30] Other Important Information - The company has received a positive CHMP opinion for PALSONIFY in the treatment of acromegaly, marking a significant milestone for its European regulatory path [32] - The EQUILIBRIUM ADCS study is designed to efficiently assess the safety and efficacy of Atumelnant in treating ACTH-dependent Cushing's syndrome [25] Q&A Session Summary Question: Insights from phase II/III design and previous studies - Management noted that the structure of the Cushing's disease study is well precedented, with normalization of urine-free cortisol as a primary endpoint [34][37] Question: Trends in PALSONIFY prescriptions - Management expressed satisfaction with the launch and noted positive feedback from prescribers and patients, but refrained from providing specific quantitative trends [41][42] Question: Enrollment forms and commercial therapy timeline - Management indicated that it is premature to extrapolate the 200 enrollment forms as a run rate, and about 50% of patients are reimbursed for commercial therapy [49][50] Question: Payer dynamics for PALSONIFY - Management reported positive progress in market access with no significant barriers to treatment, and ongoing engagement with payers [63][64] Question: ADCS study design and endpoints - Management confirmed that the primary endpoint for the phase III study is set by the FDA, focusing on the percentage of patients achieving normal urine-free cortisol [68][69]

Financial Data and Key Metrics Changes - In Q4 2025, the company recognized $6.2 million in total net revenue, with $5.4 million from the U.S. commercial launch of PALSONIFY and $0.8 million from a licensing agreement with SKK [24] - Total revenue for the full year 2025 was $7.7 million, with a cost of product revenue of $1.1 million in Q4 [24][25] - Research and development expenses for Q4 were $85.1 million, down from $90.5 million in Q3, while selling, general, and administrative expenses were $53.7 million, relatively stable compared to $52.3 million in Q3 [25] - The company ended 2025 with over $1 billion in cash equivalents and investments, which does not include $380 million from a public offering in January 2026 [26] Business Line Data and Key Metrics Changes - The launch of PALSONIFY has seen over 200 enrollment forms in Q4, with more than 125 unique prescribers involved [6][7] - The company is focusing on building a fully integrated commercial enterprise to support PALSONIFY, including sales professionals and patient support services [8][9] Market Data and Key Metrics Changes - The company is experiencing encouraging formulary momentum with payers, securing wins with top plans in the U.S. for PALSONIFY [7] - Approximately 50% of patients are reimbursed for commercial or government payers, while the other 50% are utilizing the QuickStart program [48][62] Company Strategy and Development Direction - The company is transitioning from building a pipeline to building a business, aiming to establish PALSONIFY as the new standard of care for acromegaly [5][10] - The focus is on expanding the commercial business and advancing clinical trials for other pipeline candidates, including atumelnant for CAH and Cushing's disease [10][30] - The company received a positive CHMP opinion for PALSONIFY in the EU, reflecting the strength of their data [30] Management's Comments on Operating Environment and Future Outlook - Management expressed optimism about 2026, highlighting simultaneous execution across the portfolio and ongoing advancements in clinical trials [30] - The company believes existing cash and investments will be sufficient to fund operations into 2030, providing a significant runway for commercialization and clinical development [27] Other Important Information - The company is committed to transforming the lives of people with endocrine diseases and creating long-term sustainable value for stakeholders [30] - The EQUILIBRIUM ADCS study is designed to assess the safety and efficacy of atumelnant in treating ADCS, with a seamless transition from phase 2 to phase 3 [20][23] Q&A Session Summary Question: Insights from Phase 2/3 design and learnings from other studies - Management noted that the structure of the Cushing's disease study is well precedented, with normalization of urine-free cortisol as a primary endpoint [34][66] Question: Trends in PALSONIFY prescriptions - Management is pleased with the launch and early positive experiences from prescribers and patients, but refrained from providing quantitative comments on trends [40][43] Question: Enrollment forms and commercial therapy timeline - Management indicated that it is premature to extrapolate the 200 enrollment forms but expressed satisfaction with the number [47] Question: Payer dynamics for PALSONIFY - Management reported positive progress in market access with no significant barriers to treatment, and most coverage is based on the product's label [62] Question: Phase 3 endpoints for ADCS study - The primary endpoint for phase 3 is set by the FDA, focusing on the percentage of patients achieving normal urine-free cortisol [66]

February 26, 2026 Fourth Quarter and Full Year 2025 Financial Results and Business Update Forward Looking Statements This presentation contains forward-looking statements. Crinetics Pharmaceuticals, Inc. ("Crinetics," the "company," "we," "us," or "our") cautions you that all statements other than statements of historical facts contained in this presentation are forward-looking statements. Such forward-looking statements include, but are not limited to, statements regarding: our ability to effectively comme ...

Core Insights - Crinetics Pharmaceuticals reported a significant increase in revenue for Q4 2025, with net product revenue of $5.4 million from the launch of PALSONIFY, marking a notable growth compared to previous periods [4][5][6] - The company is set to initiate a seamless Phase 2/3 study of atumelnant for ACTH-dependent Cushing's syndrome in the first half of 2026, indicating ongoing commitment to expanding its clinical pipeline [5][10] - Crinetics aims to build a multi-product company in the endocrinology space, leveraging its commercial infrastructure and pipeline depth [2] Financial Performance - Total revenue for Q4 2025 was $6.2 million, compared to $0.0 million in Q4 2024, and for the full year 2025, revenue reached $7.7 million, up from $1.0 million in 2024 [4][10] - The cost of product revenue for Q4 2025 was $1.1 million, primarily related to expanding commercial manufacturing capacity [10] - Research and development expenses increased to $85.1 million for Q4 2025 and $332.1 million for the full year, compared to $66.6 million and $240.2 million in 2024, reflecting ongoing investments in key programs [10][21] - Selling, general, and administrative expenses rose to $53.7 million for Q4 2025 and $191.3 million for the full year, compared to $28.2 million and $99.7 million in 2024, driven by the build-out of the commercial organization [10][21] - The net loss for Q4 2025 was $122.8 million, compared to a net loss of $80.6 million in Q4 2024, and for the full year, the net loss was $465.3 million, up from $298.4 million in 2024 [10][21] Product Development and Pipeline - PALSONIFY received FDA approval on September 25, 2025, as the first and only once-daily oral somatostatin receptor ligand for acromegaly, with over 200 enrollment forms submitted by the end of December 2025 [5][10] - The company initiated three pivotal trials, including the CAREFNDR Phase 3 trial for carcinoid syndrome and the CALM-CAH Phase 3 trial for congenital adrenal hyperplasia [5][10] - Positive data from the Phase 2 study of atumelnant showed that 88% of participants reduced glucocorticoid doses to physiological levels, supporting its potential as a leading oral ACTH antagonist [5][10] Cash Position and Future Outlook - As of December 31, 2025, Crinetics had $1.0 billion in cash, cash equivalents, and investment securities, down from $1.4 billion a year earlier [10][21] - The company completed a public offering on January 8, 2026, raising approximately $380 million, which increased its cash position to about $1.4 billion [10] - For 2026, Crinetics expects GAAP operating expenses to be between $600 million to $650 million, with non-GAAP operating expenses projected between $480 million to $520 million [10][21]

Core Insights - Crinetics Pharmaceuticals, Inc. will participate in two upcoming investor conferences, providing opportunities for 1x1 meetings with management [1][2] - The company focuses on transforming the treatment of endocrine diseases and related tumors through innovative therapies [3] - Crinetics' lead product, PALSONIFY™ (paltusotine), is the first oral treatment approved by the U.S. FDA for acromegaly, with additional programs in development for various endocrine conditions [4] Group 1: Upcoming Events - Crinetics will attend the TD Cowen 46 Annual Health Care Conference in Boston on March 4, 2026, with a fireside chat scheduled for 1:50 p.m. Eastern Time [1] - Management will also be available for 1x1 meetings on March 4, 2026, and at the Leerink Annual Global Healthcare Conference in Miami on March 11, 2026 [1] Group 2: Company Overview - Crinetics Pharmaceuticals is dedicated to discovering, developing, and commercializing novel therapies targeting G-protein coupled receptors (GPCRs) [3] - The company has a pipeline of over 10 disclosed programs, including late-stage candidates for congenital adrenal hyperplasia and ACTH-dependent Cushing's syndrome [4] - Additional discovery programs address various endocrine conditions such as Graves' disease, polycystic kidney disease, and GPCR-targeted oncology indications [4]

Core Insights - Crinetics Pharmaceuticals, Inc. will report its fourth quarter and full year 2025 financial results on February 26, 2026, after market close, followed by a conference call at 4:30 p.m. ET to discuss the results and provide a business update [1]. Company Overview - Crinetics Pharmaceuticals is a global pharmaceutical company focused on transforming the treatment of endocrine diseases and related tumors through patient-centered science [4]. - The company specializes in discovering, developing, and commercializing novel therapies, particularly targeting G-protein coupled receptors (GPCRs) with small molecules [4]. Product Pipeline - Crinetics' lead product, PALSONIFY™ (paltusotine), is the first once-daily oral treatment approved by the U.S. FDA for adults with acromegaly who have had an inadequate response to surgery or for whom surgery is not an option [5]. - Paltusotine is also in clinical development for carcinoid syndrome associated with neuroendocrine tumors [5]. - The company has a deep pipeline of over 10 disclosed programs, including late-stage investigational candidate atumelnant for congenital adrenal hyperplasia and ACTH-dependent Cushing's syndrome, and CRN09682, a nonpeptide drug conjugate for treating SST2 expressing neuroendocrine tumors and other solid tumors [5]. - Additional discovery programs target various endocrine conditions such as Graves' disease, polycystic kidney disease, hyperparathyroidism, diabetes, obesity, and GPCR-targeted oncology indications [5].

JANUARY 2026 Beyond Innovation to Impact: Building the Premier Endocrinology Business J.P. Morgan Healthcare Conference Angela Living with Acromegaly Forward Looking Statements and Legal Disclaimers Forward Looking Statements: This presentation contains forward-looking statements. Crinetics Pharmaceuticals, Inc. ("Crinetics," the "company," "we," "us," or "our") cautions you that all statements other than statements of historical facts contained in this presentation are forward-looking statements. Such forw ...