Post ATS Takeaways with Mgmt: Brinsupri's Healthy Launch; TPIP, Arikayce Upside

Research evidence excerpt

Post ATS Takeaways with Mgmt: Brinsupri's Healthy Launch; TPIP, Arikayce Upside

gement also noted that hypertension, which was discussed by 1 KOL at ATS,

was already observed in trials at low rates (3% PBO vs 2% 25mg brenso), is reflected in the label

and is endemic to older patient populations.

From a commercial perspective, the company remains confident in a stable and durable

Brinsupri launch trajectory, noting their internal tracking remains in alignment with Symphony

TRx data and guiding to ~6,300 net NRx adds per quarter going forward. They indicated they

have not seen recent payer tightening of coverage requirements, noting that approval rates

remain >90% through specialty pharmacy channels, with only a modest decrease (in the low

single-digits) expected as the launch matures. Few to no prior authorizations outside of Phase 3

inclusion criteria appear to have been instituted.

ATS Discussion: TPIP is a Differentiated Prodrug, Not Just Another Treprostinil

Management was particularly enthusiastic on TPIP following ATS. The core message was that

KOLs view TPIP as a new molecule/prodrug rather than simply another treprostinil formulation,

with preclinical and early clinical rationale supporting higher dose delivery, reduced upper

airway irritation/cough, prolonged PK, and more convenient once-daily administration.

The strongest message from INSM management on TPIP was their conviction that TPIP’s

prodrug biology could enable a fundamentally different efficacy/tolerability profile than existing

treprostinil products. Management argued that because TPIP does not release active treprostinil

in the pharynx like other inhaled treprostinil therapies, it avoids the cough/upper airway

irritation that often limits tolerability and compliance with inhaled treprostinil.