Good day, ladies and gentlemen, and welcome to the Ameren Corporation's first quarter 2026 results conference call. At this time, all participants are in a listen-only mode, and a question and answer session will follow the formal presentation. If anyone should require operator assistance during the conference, please press star zero on your telephone keypad, and please note, this conference is being recorded. I will now turn the conference over to your host, Mr. Devon Sullivan. Sir, you may begin.

Thank you for your time and attention this morning as we discuss Amarin's 2026 first quarter financial results. On the call today are Aaron Berg, President and Chief Executive Officer, and Pete Fishman, Chief Financial Officer. Other members of the senior management team will be available as needed during the Q&A session that will follow these prepared comments. Turning to today's agenda, Aaron will provide a state of the company and Pete will walk through the numbers. Before we begin, I'd like to remind everyone that today's press release and related quarterly report on Form 10-Q are available on the Investor Relations section of the company's website, www.amarincorp.com, as will a replay of this call shortly after its completion. please be aware that during this call we may make certain statements related to our business that are deemed forward-looking statements under federal securities laws these statements are not guarantees of future performance but rather are subject to a variety of risks and uncertainties our actual results could differ materially from expectations reflected in any forward-looking statements. Additionally, we assume no obligation to update these statements as circumstances change. For a discussion of the material risks and important factors that could affect our actual results, please refer to our SEC filings, which are available either on our company website or the Security and Exchange Commission's EDGAR system. With that said, I'd now like to turn the call over to Ameren's President and CEO, Aaron Berg. Aaron, please go ahead.

Thanks, Devin. And thank you all for joining us today. The momentum that started to build in late 2025 continued in the first quarter of 2026. Our results and cash generation in the quarter demonstrate our progress in advancing our new business model and expanding the global market for Resipa through our new and more efficient operating platform. We've substantially completed our previously announced global restructuring, and we've remained on track to achieve the estimated $70 million in total operating expense savings by June 30, 2026. Our financial position continued to improve. Our cash balance of $308 million rose from year-end 2025. We reported a second consecutive quarter of positive cash flow and ended the quarter with no debt. 2026 will be the first full year in which we've employed our new and more efficient operating model comprised of two distinct but complementary businesses, a well-established and durable commercial business in the U.S. that continues to generate meaningful revenue and cash flow, and a fully partnered commercial strategy for all other markets. I'll now provide some high-level commentary on each business. Our growth engine is comprised of a fully partnered international commercial strategy that's anchored by our exclusive license and supply agreement with Recordati. This relationship is focused in Europe, where we have IP protection through 2039 and covers 59 countries. European revenue in Q1-2026 rose significantly from Q4-2025, reflecting the promise of this partnership. As of March 31, 2026, Recordati had commenced sales of Eskepa in 10 countries, including a Q4-2025 launch in Italy. overall commercial momentum in europe continues to build driven by growth in in-market demand and key launch markets we remain encouraged by these early performance trends limit management in europe is an increasingly important area of focus given the combination of aging populations significant unmet need evolving treatment standards and attractive long-term market potential. The potential for VASCEPA to address the significant unmet need in cardiovascular disease beyond LDL lowering is similar to what we saw in the U.S. when we launched VASCEPA for cardiovascular risk reduction based on the strength of the REDUCE-IT trial. Recordati recognizes this as well and has prioritized the rollout of VASCEPA in its active markets and those targeted for commercialization. We're also seeing continued growth in the rest of the world, outside of Europe, with our additional international partners in China, Australia, Canada, and the Middle East. Also, as we discussed on our fourth quarter call, we're preparing for early 2027 launches in South Korea and Singapore, are monitoring regulatory reviews of previously submitted applications in Thailand and the Philippines, and following a submission in Vietnam in Q1, 2026, we're on track to submit a new filing in Malaysia in Q2, 2026. Our U.S. team continues to operate the core business, which serves as a cash-generating base. As we've stated, while our U.S. franchise continues to see revenue declines due to the pressures of generic competition, that SEPA remains the clear U.S. market leader across all available icosafed ethyl products more than five years after the introduction of a generic product. The overall IPE market, based on third-party data, rose by 3% in Q1-2026 compared to Q1 2025. Our share of the market rose to 48% at March 31st, 2026, up from 42% in the same period last year. Most impressive is that the SEPA branded prescriptions rose by 17% in Q1 2026 versus Q1 2025. The steps we've taken to right-size our U.S. operations continue to allow our U.S. franchise to deliver efficient and profitable revenue. To that end, we expect to maintain our exclusives with key payers through the end of 2026, while also retaining coverage in our non-exclusive accounts. This remarkable achievement is a testament to the hard work of our team members, the reputation of our brand, and the growing library of supporting scientific evidence that validates that SEPA's ability to reduce cardiovascular events by 25% when added to a stat. In summary, both of our businesses are performing well. I ended last quarter's call by emphasizing the progress we've achieved to date and the important work that remains ahead. That message has not changed. What has changed is the building momentum behind our execution and the tangible progress we've delivered. We intend to continue to advance our organic growth initiatives and execute with a high level of financial and operational discipline. Additionally, we continue to collaborate closely with our exclusive advisor, Barclays, in exploring additional potential pathways to further enhance shareholder value. Now let me talk about some additional VICEPA developments. In late 2025 and early 2026, we highlighted new post hoc analyses from the REDUCED study of statin-treated patients with elevated triglycerides and known cardiovascular disease or with diabetes and other risk factors. In these analyses, treatment with VICEPA on top of statin therapy significantly lowered cardiovascular risk across a diverse range of patient subgroups in the REDUCE study, including in patients with cardiovascular kidney metabolic, or CKM syndrome, in patients with common risk factors like hypertension, diabetes, smoking, and hypercholesterolemia, as well as in patients at extreme or very high risk for cardiovascular events. Another analysis of REDUCE showed that patients treated with viscepa on top of statin therapy experienced fewer total hospitalizations and fewer days lost due to hospitalizations and death during the study, providing additional insights on the effects of viscepa on patient-centered measures of total disease burden. Everything we do as a company is guided by our commitment to reduce cardiovascular disease as the leading cause of death. We're encouraged to see increasing momentum around the importance of addressing the numerous risks associated with elevated triglycerides, driven by the growing body of clinical evidence linking elevated levels to cardiovascular risk, independent of LDL, and by evolving guidelines that formally integrate triglyceride treatments into cardiovascular risk assessment and treatment pathways. In March of this year, the American College of Cardiology, the American Heart Association, and nine other leading U.S. medical associations jointly issued an updated 2026 guideline for the management of lipids, including cholesterol and triglycerides. This updated guideline includes new recommendations based on high-quality evidence from major randomized controlled clinical trials that have been completed and published since the prior 2018 guideline, including our Reducid Cardiovascular Outcome Study of the SEPA. Within this updated ACCHA clinical treatment guideline, icosfin ethyl is positioned as the only primary triglyceride-lowering medication that reduces cardiovascular event risk in combination with statin therapy in individuals at high risk of cardiovascular disease with moderate triglyceride elevations after achieving sufficient LDL lowering. This reinforces that patients on statin therapy can continue to experience residual cardiovascular risk driven by elevated triglyceride levels and underscores the need for complementary therapeutic approaches beyond LDL-lowering therapy alone in these patients. Importantly, the guideline distinguishes therapies intended for pancreatitis prevention from those proven to reduce atherosclerotic cardiovascular disease events, reinforcing that cardiovascular outcomes, not biomarker changes alone, must be the focus of and guide treatment decisions. For patients who remain at elevated cardiovascular risk despite optimized LDL therapy, the guideline supports the addition of evidence-based therapies specifically proven to reduce cardiovascular events, such as icosapenethyl. This position is consistent with guidance from other cardiovascular societies, including the 2025 ESC-EAS dyslipidemia's guideline-focused update, which states that high-dose eicosapenethyl, as in the REDUCED trial, should be considered for high-risk or very high-risk patients with elevated triglyceride levels, despite statin therapy to lower cardiovascular events. Together, these guideline updates reflect growing global consensus around the importance of addressing residual cardiovascular risk beyond LDL-lowering alone. Against this backdrop, and as we've highlighted previously, the introduction of promising new therapies is also elevating awareness of triglyceride-associated risk, catalyzing doctor-patient conversations, changes in behavior, and in some cases, prescribed therapies. As a result, we believe the SEPA is well positioned to benefit from the continued evolution of the lipid management landscape, specifically as it relates to the increasing attention on risks and unmet needs in patients with elevated triglycerides. I want to take a moment to explain why these developments may very well benefit sales of the SEPA by strengthening its inclusion in the treatment flow from physician to formulary to patient. More than 500 peer-reviewed publications validate the science behind VSEPA, including its ability to reduce major adverse cardiovascular events across diverse patient populations, and this groundbreaking therapy has been prescribed more than 30 million times by over 250,000 healthcare professionals. For new patients, treatment often begins with an established, lower-cost therapy that has proven effectiveness with newly approved, premium-priced, sometimes injectable therapies typically reserved for patients who need additional options or fail initial treatment. Coverage approval can reinforce this sequence through step edits, requiring documentation that the preferred therapy was tried first before a costly alternative is authorized. A SEPA taken orally is widely available, well-established, and supported by a clinically proven efficacy and safety profile. While the treatment landscape continues to evolve, our view remains straightforward. Therapies that are accessible today and backed by strong evidence should not be overlooked simply because newer options are gaining attention. Again, we applaud these new discoveries that may over time add to the array of options available to address this widespread health concern in patients at risk. I ended last quarter's call by emphasizing the progress we've achieved to date and the important work that remains ahead. That message has not changed. What has changed is the building momentum behind our execution and the tangible progress we've delivered. We intend to continue to advance our growth initiatives and execute with a high level of financial and operational discipline. With that, I'll now turn the call over to Pete to take us through the numbers.

Thanks, Aaron. Our results for the first quarter of 2026 reflected the continuing traption of our new business model and our global restructuring plan. Given the adoption of our new agreement with Recordati, I will in some cases also compare consecutive quarterly results, Q4 2025 to Q1 2026, to highlight recent progress. Total net revenue in Q1 2026 rose to $45.1 million from $42 million in last year's first quarter. By geography, U.S. was consistent with Q1 2025. While volume was higher due to regaining exclusive status with a PBM beginning in Q3 2025, this was offset by pricing based on annual changes for payers. First quarter product revenue in Europe was $4.9 million under our new partnered model as compared to $5.4 million in the first quarter of 2025 under our previous sales model. Notably, Q1-2026 revenue was generated at a significantly lower cost with improved operating margins when compared to first quarter of 2025. On a consecutive quarterly basis, Q1-2026 European revenue more than doubled, up 113% from Q4 2025 revenue of $2.3 million. European product revenue in the first quarter included $3 million of supply shipments to Recordati, compared to $900,000 of such shipments in Q4 2025, reflecting initial stocking from the transition of our international commercial activities. With the transition now complete, going forward, Europe product revenue will come entirely from supply shipments to record adding. Rest of world revenue in Q1 2026 was $2.8 million, whereas there were no supply shipments to our other partners in Q1 2025. As a reminder, our partnered model will result in revenue variability quarter to quarter, driven by the current scale of operations, as well as the impact of launch timing, in-market demand, and the structure of individual partnership agreements. Cost of goods sold rose by 10.5 million, or 62%, reflecting increased product volumes associated with regaining an exclusive PBM relationship in the U.S., and the effect of shipments to our rest-of-world commercial partners, both of which did not exist in last year's first quarter. Looking ahead on a comparative quarterly basis, we expect our cost of goods sold to continue to be higher until Q3-2026, the anniversary of regaining this exclusive relationship. Our expense profile continues to reflect the success of the global restructuring we commenced in mid-2025. In the first quarter, total operating expenses declined by 31%, or $12.8 million, to $29.1 million. Excluding the restructuring charge of $3.3 million, total operating expenses of $25.8 million declined by 38% from last year's first quarter. Q1-2026 operating expenses were relatively stable compared to Q4-2025. of $25.4 million. SG&A declined by 42% and represented 47% of total net sales compared to 87% of total net sales in last year's first quarter. R&D expenses were in line with our ongoing commitments to global regulatory support and to the science underlying our global branded profit. As noted above, restructuring expenses were $3.3 million, down from $4.1 million in Q4 2025, bringing our total restructuring expense to $39.6 million. We incurred the majority of these restructuring expenses through March 31, 2026, with the remaining nominal expense to be recognized in Q2-2026. Our operating loss in the first quarter narrowed to $11.3 million from an operating loss of $16.8 million in last year's first quarter. Excluding restructuring charges, operating loss in Q1-2026 was $8 million. I also want to point out that despite the increase and cost of goods for the quarter, we are still able to drive down our total OPEX by 31% and, excluding restructuring costs, cut our operating loss by more than 32%. I'll emphasize that it is early, but the Europe Partnership model we adopted in 2025 is working. Turning to the balance sheet, we ended the quarter with cash and investments of $308 million. up from $303 million at year-end 2025, no debt, and working capital of $450 million. We generated positive cash flow from operations of $6.4 million in the first quarter, the second consecutive quarter of positive cash flow. I would like to reiterate that we expect to generate positive cash flow for 2026. The business continues to evolve and improve, driven by key achievements realized over the past year. Under our new operating model, we right-sized the company to support both our U.S. business and our global partners in generating long-term international sales growth with an expense profile that is significantly lower than in prior years, reflecting the approximately $70 million in annualized savings to be achieved by the end of Q2 2026. Thank you again, and I now ask the operator to open the call to questions.

Thank you. Ladies and gentlemen, at this time, we will be conducting our question and answer session. If you would like to ask a question, please press star 1 on your telephone keypad. A confirmation tone will indicate your line is in the question key, and you may press star 2 if you would like to remove your question from the queue. For participants using speaker equipment, it may be necessary to pick up your handset before pressing the star keys. One moment, please, while we poll for questions. Thank you. Our first question is coming from Jessica Fye with JP Morgan. Your line is live.

Hey, guys. Thanks for taking the questions. I was hoping you could talk about the right way to think about the trend in U.S. net price over the remainder of the year. And then also related to the expectation for positive cash flow in 2026, can you talk about the degree to which you see that as sustainable beyond 26? Thank you.

Good morning, and thanks, Jess, for joining us this morning. Right. Pete, why don't you cover both the question, the net price and the cash flow beyond 26? We have confidence going forward and we touch on those.

Right. Thanks, Aaron. And thanks for the question. For the U.S. NSP, as you've seen in past years, the bulk of our year-over-year change occurs in Q1. And as we look forward to the rest of the year, we'd expect the NSP and volumes to be relatively consistent And, you know, as we've said in the past, this is driven by our exclusive contracts. We expect to keep them through the rest of the 2026. However, you know, if there are changes, that would have an impact there. For the cash flow expectations beyond 2026, we are confident that, you know, as we've turned into a cash flow positive position, that that will continue into the future. But that, you know, again, that is driven to how we retain those exclusive contracts. But feel confident that we will continue this trend of a vote.

And can I ask just a couple of follow-ups on the expense side? And I appreciate the commentary you gave on the COGS trend. And so I guess maybe the other side of that is just like the gross margin percentage over the remainder of the year, should that be kind of stable? Is that going to be a little bouncy depending on supply shipments? That's a great way to think about that. And then on SG&A, sort of if we exclude the restructuring charges, is that a good run rate from here? And I know you mentioned restructuring expense would be kind of nominal in 2Q. Does nominal mean a similar size to 1Q, or is that something different?

So, starting on the COGS, as mentioned, a piece of that is the regaining that exclusive. So, as you look into Q2, that will have an impact on the comparative for our COGS amount. And you're right on overall COGS and gross margin. It will be, in part, dependent on the supply shipments to our partners, as you know, in that partnership model, it does have a different margin point than the U.S. business and will have an impact in that. And you saw that, again, in this quarter as we had greater supply shipments compared to Q1 of 2025 and saw that lower margin percentage compared to that comparative year. On the SG&A side, excluding the restructuring, yes, this is a good way to look at that ongoing run rate. We'll continue to have the remainder savings as we've talked about in the past, but this is a good way to look at that run rate going forward. And finally, as far as the restructuring, you should look at that as a pretty nominal amount compared to past quarters and would not be at the same levels that you saw in the Q1 of the three million. It will be lower than that.

Great. Thank you.

Thank you. Our next question is coming from Paul Choi with Goldman Sachs. Your line is live.

Hi. Thank you. Good morning, and thanks for taking our questions. I know it's early days since the most recent guidelines were issued, but Aaron, can you maybe just comment on physician feedback and any change in thought processes with regard to utilizing VAZIPA in light of the guideline changes? And then I had a follow-up as well.

Sure. So, the guidelines, and it's also combined with news we've had over the last, really over the last year, which started the fibrate change. As you recall, we've spoken about, Paul, previously, where the label change and the emphasis on the fact that fibrates do not provide cardiovascular risk reduction, yet they're widely used in combination with statin for cardiovascular risk reduction. So that's one thing that was also noted in the guidelines. And then this increasing focus around triglycerides, patients with elevated triglycerides and the risks of those patients. And as you know, there's a significantly increasing focus, and that also is noted in the guidelines. So qualitatively, what we're seeing from all of this, what we're hearing, is very positive. Right now, it's qualitative. It'll take time, as these guidelines do, and as news does, for it to actually impact growth. And there are a number of dynamics that are related to all of these that are impacting growth, in particular, also, as we've noted previously, now with some of these newer triglyceride-lowering agents, these very good agents for FCS and severely high triglycerides, a lot of the payers are stepping them through existing triglyceride-lowering drugs, proven effective approved drugs like placebo. So that'll also put the wind in our back a little bit. So it'll take time for all these to play out. Hard to quantify exactly what it'll be, but it's all very timely. It's all happening at once, and it's very positive. I've got Steve Ketchum here with me as well, and Steve can speak to the guidelines and what the scientific community is saying about the impact as well.

Yeah, thanks, Aaron. Yeah, and we do see, Paul, these updated guidelines, both in the U.S., you know, from the American College of Cardiology, American Heart Association, that was issued in March 2026. And of course, that they're also consistent with the European equivalents that were issued last August. And although, you know, our reducer results had been published, you know, back in 2018-2019 timeframe, that's when the prior version of this guideline, this dyslipidemia guideline, was released, and it had not yet incorporated the reduced results in other landmark cardiovascular outcomes trials, such as those that showed that fibrates did not add any benefit on top of statin therapy. So, we see these, as Aaron mentioned, as important, timely, and major updates that position icos-penethyl, you know, as an important consideration for patients with elevated triglycerides and at cardiovascular risk. So, we see it as an exciting development. Okay.

Yes, thank you. My follow-up is, you know, as you transition to, you know, consistent cash flow profitability over the coming quarters, just with the stock price where it is, can you maybe just provide maybe your high-level thoughts or maybe the board's thoughts on, in the future, returning some of this cash to shareholders as it starts to accumulate, either in one form or another, possibly? Sure.

That's a topic we talk about on a regular basis. As we've mentioned previously, we've been working with Barclays as our exclusive advisor and looking at strategic opportunities to capitalize on the value of the company. We feel like we've put the company on very short footing, cash flow positive moving forward and sitting on that cash. But clearly there are some things we can do to extract value. What shape or form that is, you have to be determined because we're not in any type of desperate situation. We were being opportunistic and we're focused on value for shareholders. In that context, cash buyback, cash back to shareholders of some sort is a concept that is being discussed and could possibly happen at the right time. But we're thinking more holistically, strategically about the total value of the company. And when we have something tangible to report, we'll certainly do so.

Great. Thank you.

Thank you. Our next question is coming from Michael Ann with Lyric Partners. Your line is live.

Hi. Thanks for taking our question. This is Michael Ann from Juana Ruiz at Lyric Partners. I have two questions today. The first one is, do you have any update on your strategy around launching an authorized generic and what would trigger that decision? And the second question is, what's the underlying growth of demand in the rest of the world market, and are there any milestone payments from the rest of the world market that you're expecting in 2026? Thank you. Hi, Michael.

So regarding the authorized generic, we've done very well maintaining our branded business profitably in the U.S. We're incredibly efficient maintaining the lion's share of the IPE category, and we're doing so with the strategy that we implemented a number of years ago, which is focusing on payers and the exclusives. that's proven to be very beneficial and given that we've been able to maintain the exclusives and we believe we're maintaining those exclusives at least through 2026 then we don't believe that it's in our best interest to launch an authorized generic at this time even though we're ready to do so when the opportunity arises. Once we find we can't compete any longer with this strategy, then that would be the opportunity to launch an authorized generic. But we've said this over the last couple of years and being prepared to do so, but the strategy has paid off. We've been very patient. We haven't overreacted to the market. And that's turned out to be a very wise approach, given how our financial results are and the revenue we're generating in the U.S. by investing very little in the U.S. So that's where we are with the AG. Once we feel the market dynamics turn, then we'll certainly do so. We see that as an opportunity to generate revenue, generate cash into perpetuity, frankly, as long as there's an IP category and we have an authorized generic that can be distributed. We're running growth in the rest of the world in milestone payments. I'll help Pete address what's going on there and tie it to those partnership agreements.

Thanks, Aaron. We have been pleased with the in-market demand growth within each of the regions and our partners. We have seen that consistent growth throughout. It is early stages in most of these markets, so we'll continue to monitor that, and we have been working very closely with each of our partners to support them in that growth. As far as the milestone payments go, we haven't been providing specific guidance around those growths. And there are milestones, as we've talked about with Recordati, for example, based off of in-market sales for them that would trigger milestones. But at this time, haven't been providing specific guidance on that outside of, you know, just that we've been pleased with each of our partners and what they've been able to accomplish today. Yeah, we're at the early stages too, right?

I mean, it's, again, as you said, it's kind of the tail of two companies. The U.S. is at one end of the life cycle, but in so many of these other regions, we're just getting going and we've got very good partners. They've made Vescepa, Vescepa a priority. We're really fortunate to have these partners and our job is simply to execute and support them. But we look forward to what they can do and they're certainly committed.

Great, thank you.

Thank you. As we have no further questions in the queue at this time, this will conclude our question and answer session and I would like to turn the call back over to Mr. Berg for any closing remarks.

I'd just like to thank everyone for participating today. I hope that we've been able to communicate the progress that we've made and our confidence about Ameren moving forward. We look forward to keeping you updated about our progress. And, again, thank you for the continued interest in Ameren. Have a good day.

Thank you. Ladies and gentlemen, this concludes today's call, and you may disconnect your lines at this time. And we thank you for your participation.