Highlights from the RBC Healthcare Conference

Research evidence excerpt

Highlights from the RBC Healthcare Conference

in the interim and is finding good pull-through in Medicare, which

it estimates represents ~30% of the overall market.

Differentiated product profile. Management emphasized Tonmya's positioning as a non-opioid, non-

DEA-scheduled analgesic for a chronic pain condition as an important differentiator for patients,

physicians, and payers. Management highlighted that despite clinical guidelines advising against opioid

use in fibromyalgia, claims data show opioids are commonly prescribed in the first 18 months post-

diagnosis. Tonmya also benefits from having no scheduling burden (unlike Lyrica, which carries the

lowest DEA schedule), potentially reducing prescribing friction. Management noted oral/sublingual side

effects occurred in ~25% of trial patients but generally do not interrupt therapy continuation; feedback

from patients and social media channels is consistent with trial experience.

Large and potentially expanding TAM. Management highlighted a pre-pandemic addressable

population of ~10MM U.S. adults with fibromyalgia. Post-pandemic, the company notes an estimated

20–30MM Americans have long COVID, and the company's claims data analysis suggests approximately

half may have diagnosable fibromyalgia (supported by a National Academy of Sciences determination

that fibromyalgia is a diagnosable condition within long COVID) potentially doubling the addressable

population. Tonmya is a nightly bedtime medication designed for long-term use, and management

believes its tolerability profile supports sustained adherence. Management also noted that the scientific

acceptance of fibromyalgia has strengthened significantly since Lyrica and Cymbalta launched in