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Q1 performance was impacted by severe weather in January that disrupted elective surgeries, a trend management noted was consistent across the surgical industry.

Management attributes the 22% year-over-year demand growth for ZYNRELEF to the success of the IGNITE incentive program with orthopedic distribution partners.

APONVIE's 68% demand growth was driven by its inclusion in the fifth consensus guidelines for PONV management, which serves as a critical clinical endorsement.

The company is maintaining a disciplined pricing strategy across all products, choosing to protect long-term franchise economics rather than chasing volume through price concessions.

CINVANTI demonstrated resilience with a stable 25% market share despite high category volatility and competitive pressure in the NK1 market.

Operational recovery was evident in March, with net sales exceeding $15 million, signaling a return to the underlying business strength following early-quarter disruptions.

Management reaffirmed full-year 2026 guidance, assuming that deferred elective procedures from Q1 will be rescheduled throughout the remainder of the year.

A significant sales force expansion is planned for Q3 2026, targeting geographies where formulary access and payer coverage are already established.

The IGNITE 2.0 program has expanded to 3,109 accounts, a 38% increase intended to deepen ZYNRELEF penetration through concentrated distributor focus.

The ZYNRELEF prefilled syringe program remains on track to generate 12-month stability data in Q1 2027, addressing the market shift toward ready-to-use systems.

Gross margins are expected to normalize to the mid-70% range after the next two quarters as high-cost inventory from a secondary supplier is exhausted.

Temporary gross margin pressure (69% in Q1) resulted from contractual obligations to a secondary CINVANTI supplier whose production costs are 3x higher than the primary source.

The NOPAIN Act framework and the permanent J-code for ZYNRELEF have streamlined reimbursement across approximately 110 million commercial lives.

A new $10 million annualized revenue pipeline for CINVANTI has been identified through the REIGNITE program focusing on major teaching hospitals.

The company expects to return to positive adjusted EBITDA as weather-related revenue softness and temporary margin pressures subside.

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Management stated that the primary challenge is not a lack of desire to use ZYNRELEF, but the need for greater 'share of voice' to reach more accounts.

The Q3 sales force expansion is specifically designed to address this by increasing the frequency of account interactions.

While NOPAIN primarily aids Medicare reimbursement, it has catalyzed conversations with commercial payers to move ZYNRELEF outside of surgical bundles.

Coverage is now widespread across the U.S., with only small pockets where the product remains bundled.

The partnership has reached 90% alignment, meaning most targeted accounts now have both a Heron and a CrossLink representative present.

This 'triple threat' of sales presence, distributor focus, and payer coverage is the core driver for the 2026 growth targets.