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DATE

Monday, May 11, 2026 at 4:30 p.m. ET

CALL PARTICIPANTS

  • Chief Executive Officer — Eef Schimmelpennink
  • President & Chief Operating Officer — Shawn Olsson
  • Chief Financial Officer — Dan Chevallard
  • Chief Medical Officer — Marc Odrich

TAKEAWAYS

  • Net Revenue -- $1.9 million, including $1.7 million in product sales and $0.3 million in license revenue.
  • Paid and Billed Prescriptions -- Approximately 25,000 filled in Q1, representing a 19% increase quarter over quarter from Q4 2025.
  • Total Prescribing Physicians -- Over 10,000 unique prescribers through the first quarter, higher than any recent ophthalmology launch at this stage.
  • Prescribing Productivity -- At approximately 46,000 scripts, prescriptions per prescriber are roughly 70% higher than Vuity at the same launch stage.
  • Patient Persistence and E-pharmacy Dynamics -- Over two-thirds of e-pharmacy volume now comes from three-month prescriptions, a meaningful increase from Q4.
  • Gross-to-Net Discounts -- Blended gross-to-net discount across channels was less than 10%, yielding about $67 net revenue per monthly pack.
  • SG&A Expenses -- $45 million (or $40.7 million, net of non-cash stock-based compensation), up 13% from Q4 2025, driven by direct-to-consumer launch investments.
  • Net Loss -- $41.5 million, with net loss per share (basic and diluted) at $1.32.
  • Cash Position -- Cash, cash equivalents, and marketable securities stood at $258.4 million at quarter-end.
  • Research and Development Expenses -- Zero, consistent with Q4.
  • Contact Lens Patient Segment -- Approximately 50% of users reported using contact lenses as primary distance vision correction.
  • Field Sales Reach -- Field organization expansion to cover about 15,000 targeted eye care professionals by end of quarter.
  • Direct-to-ECP Sales Initiative -- Direct sales to physicians available in about 25 states; net economics are "no meaningful difference" from other channels per management.
  • Direct-to-Consumer Campaign Performance -- Early digital engagement is high, with website traffic peaking at up to 10 times previous levels, and ad recall lift above benchmarks on platforms like YouTube and Pinterest.
  • Manufacturing and Supply -- Transitioning to an FDA-approved, large-scale manufacturing process with improved vial format and tighter formulation specification.
  • International Expansion -- Recent submissions in Europe and the U.K., with ongoing inbound partnering discussions in Europe and Latin America, and existing partnerships across China, Southeast Asia, Canada, and the Middle East.
  • Safety Profile -- Among around 1.2 million doses shipped, zero retinal detachments and two non-causal retinal tears have been observed, both in patients with elevated baseline risk.
  • Direct Quotes on Safety -- Chief Medical Officer Odrich said, "The product is safe, the data support it, and we will continue to be transparent as the real-world experience builds."

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RISKS

  • CEO Schimmelpennink stated, "the pace of new patient starts and routine ECP prescribing was more gradual than we expected it to be."
  • Management noted SG&A and cash burn in Q1 were higher than the anticipated quarterly run-rate for the remainder of 2026.
  • Building an entirely new category will take time, as management repeatedly emphasized that both physician and patient adoption habits have not reached the targeted pace.

SUMMARY

LENZ Therapeutics (LENZ 0.70%) began 2026 with accelerating prescription volumes and growing prescriber engagement, underpinned by strong financial resources and explicit data on patient persistence. Field sales and direct-to-consumer initiatives have expanded the company’s reach, while direct-to-ECP sales are now available in half of U.S. states. Manufacturing improvements and international milestones support the strategy for global growth. Management acknowledged adoption headwinds, highlighting that internal targets for new patient and physician uptake were not yet met and pointing to evolving execution to address these barriers.

  • Leadership explained that approximately half of patients on therapy use contact lenses as their primary vision correction, presenting a scalable opportunity to drive script velocity and retention.
  • Over two-thirds of e-pharmacy purchases have transitioned to multi-month packs, which management interprets as a signal of increased therapy commitment and patient persistence.
  • Management detailed that cost of sales in Q1 was primarily affected by nonrecurring events, including an insured temperature excursion and packaging transition costs unrelated to product sales margins.
  • All R&D expenses were shifted to zero, consistent with previous quarters, as capital deployed moved fully to commercial operations and launch support.
  • Global strategy was reinforced by news of recent European and U.K. submissions, coupled with ongoing partnership expansion across major ex-U.S. markets.
  • Chief Medical Officer Odrich emphasized the differentiated safety profile, as the company’s product had no retinal detachments and only two reported retinal tears among more than one million doses, both in patients with unrelated risk factors, describing this outcome as "fully consistent with the label."

INDUSTRY GLOSSARY

  • ECP: Eye Care Professional; includes optometrists and ophthalmologists, central to prescription and patient management workflows in ophthalmic launches.
  • Presbyopia: Age-related condition causing difficulty focusing on near objects, target indication for LENZ Therapeutics, Inc.'s product candidates.
  • Gross-to-Net: Calculation reflecting total discounts, rebates, chargebacks, and deductions subtracted from gross revenue to arrive at net revenue per unit.
  • FDA-approved Manufacturing Process: A production method for pharmaceutical products that has received regulatory approval for commercial supply and quality standards.
  • NRx: New prescription, referencing scripts written for newly initiated patients, often used as a sales or adoption metric in pharmaceutical launches.

Full Conference Call Transcript

Eef Schimmelpennink: Good afternoon, everyone. In Q1, our performance was consistent with the expectations we outlined on our last call. We delivered approximately 25 thousand paid and billed prescriptions, bringing total monthly units sold since launch to roughly 46 thousand, and generated $1.9 million in net revenue, including $1.7 million in product sales. New patient adoption has continued to grow, but not yet at the pace we are aiming for, and I want to address that directly. We have done the work on the standard dynamics, identified what needs to change, and we are executing on those changes now.

We are continuing to build confidence, as strong fundamentals underlie that top-line number and the strength in the category we are building around this. Our product clearly works in the real world, which is reinforced by consistent feedback from both doctors and patients, underscoring that real-world efficacy is living up to expectations. We have built a growing base of prescribing physicians, with over 10 thousand unique prescribers through the first quarter, and new prescribers writing for the first time every day. We are seeing a very clear productivity signal emerge within our prescriber base.

At approximately the same stage of launch, around 46 thousand filled scripts, this is generating roughly 70% more scripts per prescriber than Vuity, a pattern that holds across all our prescribing cohorts. In other words, we are reaching the same level of script volume with fewer writers because physicians who adopt this are prescribing it more consistently. This is an example of the encouraging dynamics we are experiencing as we build a truly new category. Early adoption builds more gradually, but as prescribing habits develop, it drives consistent uptake. In addition, we continue to see promising patient adoption and persistence.

Once patients move from sampling to purchasing the product, many stay on therapy, which we have seen reflected in early refill data and, importantly, in purchasing patterns. Over two-thirds of our e-pharmacy volume is now coming from three-month prescriptions, a meaningful increase in our e-pharmacy consumer purchasing behavior from Q4 to Q1. This is what we want to see from a sampling-led launch: patients try the product first, convert after experiencing the benefit, and then continue use. Taken together, this gives us confidence that we are building the category on a durable foundation, and we view these metrics as important early indicators which will scale over time.

At the same time, and as we noted during our last call, building an entirely new category will take time, particularly as prescribing habits and patient behavior continue to evolve. Through Q1, the pace of new patient starts and routine ECP prescribing was more gradual than we expected it to be. We are laser-focused on improving that over the coming months, and we will hold ourselves accountable to demonstrating this in upcoming quarters. As we are now several months into our launch, we believe we have identified the key barriers to adoption.

Over recent months, we have focused on these areas in-depth, including through extensive work with advisory boards and direct engagement with both physicians and patients to better understand how to improve both the prescribing process and the patient experience. There are two primary areas where we see clear opportunities to drive adoption. First, on the physician side, awareness is extremely high among ECPs, and this is recognized as best-in-class. However, it is not yet being brought up proactively enough in the patient conversation.

This requires an important behavioral shift as physicians learn to incorporate a new type of treatment into a routine exam flow that has not historically included the integration of a novel pharmaceutical option for the treatment of presbyopia. Second, on the consumer side, the path from awareness to prescription, and ultimately to purchase, is naturally a multi-step one. Surveys and direct feedback have highlighted where the patient journey can be further improved to support conversion. Based on these insights, we are sharpening execution and have already taken targeted actions to accelerate adoption. On the physician side, we are refining how best to introduce this in the exam room to make it simpler and more natural to bring into the conversation.

One example is a renewed focus on contact lens patients, where this provides a clear and immediate value to the practice by helping patients stay in their lenses longer. This serves as a practical entry point that corresponds to a significant part of the patient and revenue base. By highlighting ECP success stories from practices that have integrated this specifically for these patients as examples of real-world wins, we help physicians better understand and use this more consistently to drive real value, and from there expand usage more broadly across the presbyopia population.

Importantly, these refinements are informed by direct work with advisory boards and testing panels of physicians, where we have incorporated real-world feedback on what works and how to improve both the ECP conversation and patient experience. On the patient side, we are evolving how patients get started on therapy. We have introduced tools, including a simple QR-based getting-started experience video that clearly explains how to use the product and what to expect, helping patients complete the initial trial and transition more confidently to ongoing use. Additional materials to support this effort are finalized and will be rolled out shortly. In addition, where permitted, we are enabling physicians to sell this directly to patients in their practices.

This can simplify access and reduce friction in the conversion process. Early feedback on this approach has been encouraging, while we remain mindful that it is not available in all markets. Taken together, these actions are designed to increase both how often this is introduced in the exam room and the conversion from trial to ongoing use. Shortly, Shawn will go into more detail on how we are executing against these priorities. In parallel, as we scale the product, we are also continuing to improve the overall user experience. We are transitioning to an FDA-approved large-scale manufacturing process that will further improve our direct-from-customer supply.

This also allows for a tighter formulation specification and an enhanced vial format, which we expect will further improve both ease of use and comfort on instillation. These are natural advancements as we move from initial launch to broader scale and are part of our ongoing focus on optimizing the patient experience. Our attention is now on execution against the key drivers that I highlighted today. We expect that these actions will drive meaningful and measurable progress in ECP and consumer adoption as we advance through the year. This is a product that clearly works in a large and underpenetrated market, and we continue to see strong validation from both patients and physicians on the value it brings.

At the same time, we are building a new category where both prescribing habits and patient behavior will need to evolve. Importantly, we have a solid, actionable understanding of how we can influence that evolution to accelerate adoption. We have already begun to act on these insights and initiatives. As these actions continue to roll out across the field and the patient journey, we are focused on demonstrating meaningful and sustained script growth over the coming months and quarters. Lastly, in parallel, we are seeing strong momentum outside the U.S., with recent European and U.K. submissions as well as meaningful inbound partnering interest from key markets including Europe and Latin America.

Combined with our existing partnerships across China, Southeast Asia, Canada, and the Middle East, we believe we are building a strong foundation for global expansion. With that, I will hand it over to Shawn, who will go into more detail on how we are executing against the priorities. Shawn?

Shawn Olsson: Thank you, and good afternoon, everyone. As Eef outlined, we are in the early stages of building a new category, and our focus is on translating strong product performance and early adoption signals into consistent and scalable growth. From a commercial perspective, we are encouraged by what we are seeing in the field. Eye care professionals prescribing this are seeing it work in their practices, and that confidence is translating into repeat prescribing behavior. We are seeing a growing number of physicians not only prescribe this, but write it multiple times. In fact, approximately 60% of prescribing ECPs have now written this multiple times, which we view as a strong signal of confidence and early habit formation.

ECP awareness and interest are high, understanding of the product is strong, and consumer interest and awareness are growing. What we are focused on now is how we translate that interest into consistent prescribing behavior and consumer adoption, and importantly, doing so in a way that shows tangible progress in new script growth in this early phase of launch. Focusing on our eye care professional strategy, we continue to see strong engagement and adoption among physicians. Just a few months into launch, aided awareness is in the high 90s, and unaided awareness is over 80%, which tells us this is already well known in the eye care community for the treatment of presbyopia.

We are also seeing that physicians clearly understand the product. They consistently describe it as differentiated, pupil-selective, and sparing the ciliary muscle, while delivering a 10-hour duration. That level of clarity is important because it helps address the major barriers created by comparisons to previous products in this category. Where our focus now is translating that understanding into consistent behavior. This is about helping physicians bring this into the patient conversation more naturally and more frequently, and integrating it into their standard eye exam flow. We are also seeing this translate into prescribing behavior.

As Eef mentioned, at a comparable stage of launch, we are generating significantly higher scripts per prescriber than what was observed with Vuity, and we see that pattern consistently across the prescriber base. What that looks like in practice is that once physicians begin to prescribe and integrate it into their workflows, they tend to prescribe it more frequently compared to what we saw with Vuity at a similar stage. This is not limited to a small group of high-volume writers, but something we are seeing more broadly across the prescriber base. This ties directly to how we have designed the launch.

With sampling, patients experience the product first, and physicians utilize these experiences to build an understanding and confidence in this. That creates a more natural fit in the practice, where prescriptions are written with greater confidence and consistency, and we see this as an early indicator of how adoption can continue to build over time. As we have been working through this in the field, this also helps clarify where we should focus to further accelerate adoption. One of the areas where we are seeing the strongest early traction is in contact lens patients. This is a well-known challenge for eye care professionals.

The contact lens population peaks in the 30 to 39-year-old age range, and as this group ages, up to 71% of patients drop out of contact lenses after the age of 50, often reluctantly, with presbyopia being a key driver. This is not just a clinical issue, but a core contributor to revenue where contact lenses and related services play a significant role. What we are hearing from physicians is that this provides a very practical solution to that problem.

As one physician put it, “This is a way to keep my patients in contact lenses and improve their experience at the same time.” This is a clear example of where ECPs see benefits for their patients, and in their practice, through the regular adoption and prescription of this as a patient satisfaction and retention strategy. That ability to both improve patient outcomes and support the practice makes this a highly relevant and actionable use case. Importantly, this is not just anecdotal. Our most recent consumer survey showed that approximately 50% of users reported they used contact lenses as their primary form of distance vision correction, reinforcing that this is both a meaningful and scalable opportunity to drive adoption.

Turning to our consumer strategy, we are encouraged by the early momentum we are seeing, but most importantly, this is where we see key opportunity to improve conversion and scale adoption. Patients are interested in the product, and we are seeing strong engagement across our channels. What we are focused on now is improving how patients move from awareness to prescription and ultimately to purchase. The journey in a new category for a prescription drug is naturally more complex. A patient sees an ad, learns about the product, schedules an appointment, receives a sample, and then decides whether to move forward with a prescription.

Each step creates an opportunity to either progress or drop off, and our focus is on making that process simpler, clearer, and more intuitive. We are already seeing encouraging signals. Our direct-to-consumer campaign is driving strong engagement, with significant increases in website traffic and early indications that patients are entering the funnel. We are also seeing that when patients convert, they are engaging in a more committed way. In our e-pharmacy channel, which represents more than half of our prescriptions, over two-thirds of the volume is now coming through three-month prescriptions, which is a strong signal of intent and early persistence. At the same time, we are actively refining our approach to improve conversion.

On the messaging side, we have shifted to a direct problem-solution consumer value proposition centered around “tired of reading glasses,” which directly connects with the everyday experience of presbyopia and positions this as a simple alternative. We are also improving how patients get started on therapy. This includes stronger expectation setting around how the product works, clear dosing instructions, and what to expect in the first few days. We have also prepared simple onboarding tools such as QR-based resources that guide patients through the initial experience and help them transition from trial to ongoing usage. In addition, we are continuing to expand and refine our media approach.

This includes testing additional channels such as linear television in select markets, while actively optimizing our creative and media mix based on real-time performance data to ensure we are driving the most effective engagement. We are also seeing increased interest from physicians in directly selling to patients from their practices where permitted. This approach is currently being implemented in select markets and structured in a way that maintains our expected economics while giving practices additional flexibility to serve their patients. We believe this could also offer a significant benefit of convenience for the patient, allowing them to leave the ECP visit with product in hand, reducing the hurdle of pharmacy abandonment.

Finally, these efforts are supported by the expansion of our field organization, which will be fully deployed by the end of this quarter. This increases the reach of our field sales team to approximately 15 thousand targeted eye care professionals, allowing us to respond to inbound demand from physicians outside our initial target group and to build higher-frequency territories. This combination of increased reach and frequency is critical to reinforcing both physician behavior and patient conversion. Taken together, our actions are focused on increasing the number of patients who move from initial interest to trial, and from trial to ongoing usage. Overall, we are encouraged by what we are seeing in the early stages of the launch.

We have strong physician engagement, clear patient interest, and a growing set of levers to drive adoption. At the same time, our focus now is on translating these actions into meaningful and sustained new script growth over the coming months and quarters. We believe we have the right elements in place, and our priority is executing against them with discipline to build momentum from here. With that, I will turn the call over to Dan to walk you through our financial results.

Dan Chevallard: Thanks, Shawn. As both Eef and Shawn have stated, we are encouraged by the performance of the product in the hands of patients and ECPs as we build the presbyopia market. The early signs of broad ECP uptake are there, as evidenced by the over 10 thousand prescribers in the first two quarters of launch, a figure higher than any recent launch in ophthalmology at this stage. Additionally, consumers are emerging with positive real-world experiences every day as product awareness deepens and our early launch efforts begin to take hold.

Our first quarter results were highlighted by approximately 25 thousand paid and billed prescriptions, which was a 19% increase compared to Q4, resulting in approximately $1.7 million in net product revenues. Our units continued to be driven by both the combination of new patient prescriptions and increasingly by monthly refill units, including both single monthly packs and three-month orders, which are available through our e-pharmacy. While it is early at this stage of launch to be declarative about projecting annual refill rates, we are encouraged by what we are seeing in the initial trends.

In Q1, and consistent with last quarter, we noted blended gross-to-net discounts across our distribution channels of less than 10%, resulting in approximately $67 in net revenue per monthly pack. Additional blended costs of the respective distribution channels of approximately $7 per unit were incurred and flow into operating expenses within SG&A, resulting in a net cash per unit of $60 per pack. That is unchanged from last quarter and in line with our long-standing expectations. Additionally, we recognized license revenue in Q1 of $250 thousand from the distribution agreement signed in January with our ex-U.S. distribution partner in the Middle East region.

As I discussed on our Q4 call, there is significant effort underway with our existing ex-U.S. commercial partnerships as we advance towards multiple additional regulatory approvals, and we remain focused on the continued expansion of our global network of commercial alliances. We look forward to reporting additional progress in the months and quarters ahead. Turning now to operating expenses, our cost of sales in the first quarter totaled $1.1 million and was comprised primarily of two nonrecurring events, resulting in charges to cost of sales in the period that were unrelated to product sales. The first was a period cost stemming from an out-of-specification temperature excursion of inventory while in transit from our manufacturer.

We expect recovery from this product loss from our insurance provider in the second quarter. In addition, we incurred a one-time charge for packaging supplies associated with the previously mentioned FDA-approved manufacturing process improvement and transition. Direct product cost of sales related to our Q1 product sales were immaterial, and we anticipate this to trend to approximately a 90% direct product gross margin over time. Total SG&A expenses were $45 million in Q1 2026, or approximately $40.7 million net of non-cash stock-based compensation. This was a 13% quarter-over-quarter increase from Q4 and was driven by our planned DTC launch investment.

Consistent with last quarter, approximately 80% of our SG&A was driven by sales and marketing, with the remainder representing general and administrative expenses. Of note, we anticipate that our Q1 2026 SG&A and the resulting cash burn are higher than our go-forward quarterly run rate over the balance of 2026. Total research and development expenses were zero in Q1, which is consistent with last quarter. Finally, our net loss per share, both basic and diluted, was $1.32 per share in 2026 on a net loss of $41.5 million.

We ended Q1 2026 with approximately $258.4 million in cash, cash equivalents, and marketable securities, and our Q1 2026 net cash burn of approximately $34 million was consistent with Q4 and in line with our budget. As we discussed on our recent year-end call, our current sales force expansion is in our 2026 operating plan, and we will continue to target an allocation of approximately 80% of our SG&A to sales and marketing. In summary, we entered 2026 at an important point in the launch, with a clear operational plan, a strong cash position, and conviction that the actions underway will translate into meaningful growth. With that, I will turn the call back over to Eef.

Eef Schimmelpennink: Thanks, Dan. To conclude, I am incredibly proud of the LENZ Therapeutics, Inc. team and the progress we have made over the first two quarters of our launch. We are seeing what we hoped to see: a product that really works, encouraging early signs of patient persistence, and a growing base of prescribing physicians. At the same time, we are under no illusions about where we need to go. While building a completely new category takes time, enacting changes in prescribing habits and patient behavior is crucial, and we have progressed from diagnosing the early adoption dynamics to actively addressing them. We are committed to demonstrating clear and measurable progress over the coming quarters.

Our focus now is on accelerating new patient adoption through disciplined execution in the field and continued investment behind the category. We believe we are in the early stages of building what can become a significant and durable market, and as we continue to execute our priorities, we aim to translate this into meaningful and sustained script growth. We look forward to updating you on that progress as we move through the year. We will now open the call for questions.

Operator: To withdraw your question, press 1 again. Our first question comes from the line of Stacy Ku with TD Cowen. Please go ahead.

Stacy Ku: Hey, thanks for taking our questions, and we appreciate the detailed launch discussion. We have a few follow-ups. First, it is still early days with linear TV and the first steps of the sales force expansion. Can you go into additional detail on encouraging signs beyond the current prescription trajectory? Are you able to identify a specific type of practice that is prescribing this multiple times? Second, we appreciate the three-month metric from the e-pharmacy; it is very interesting. For the next earnings call, will we be getting specifics on refill dynamics? Third, on sampling and competitive dynamics, Uvezi has now launched. Help us understand what type of counter-detailing we might be seeing in real time.

Do we also expect sampling from both Uvezi and QLOCI? And last, on safety, can you contextualize what we are seeing in the FAERS database now that the product has been on the market for over six months? What are your views on the safety profile, and maybe, Shawn, you could share perspectives from patients and prescribers. Thanks so much.

Eef Schimmelpennink: Thanks, Stacy. Great set of questions. Shawn will start by kicking off with insights on the DTC impact, and I will address the refill question first before we go into samples and competition. Clearly, refills are a key factor that we have been very clear on from the beginning. We will start to share more in the second half of this year. The reason we have always focused on the second half is that we want to see those cohorts of patients mature a little bit over time. For example, Q4 cohorts may have been on that first script before they would reasonably be due for a refill.

We are also seeing that, as we mentioned, the shift to three-packs logically means a reorder at least three months later. It is important to see that behavior mature a bit more, which is why we have indicated we will start sharing refill data in the second half of this year. I will hand it over to Shawn to talk about the DTC impact and sampling and competitive dynamics, and then Marc will address your safety question.

Shawn Olsson: Stacy, thanks for the question about DTC. So far, the early indicators are strong. Engagement with the ads is high. We look at click-through rates and cost per thousand impressions, and we are seeing the numbers we want to see. Our website traffic is up significantly, with peaks of up to 10 times what we used to see. Consumer awareness is building, and we are hearing that the “tired of readers” message is resonating very well. We have a broad digital reach ongoing. That said, awareness is still early overall, so we still have more to do to drive greater consumer awareness, but we have seen an encouraging response from a low base and more patients entering the funnel.

We are seeing great success on platforms like YouTube, forcing ad recall and ad awareness lifts better than benchmarks, and a similar ad recall lift on Pinterest as well. This category is naturally slower to convert because of all the steps required to get to a prescription, but we continue to monitor and actively optimize our campaign to ensure we have the best media mix and refine creative testing as needed. As I said in the opening remarks, we leaned more into the problem-solution marketing of “tired of readers—here is a solution,” which is this product.

Our focus right now is strong conversion improvement, and we expect to see stronger impact over time because DTC typically takes a few quarters to mature. On the competitive environment, we continue to see this as a category where our product is differentiated by its unique MOA. The market can definitely support multiple entrants—there is a large unmet need—and others speaking about the benefits of eye drops in presbyopia benefits the category overall. Trials are very easy, so our sampling strategy is to let the patient try the product. Head-to-head, if you try different products, we believe our product stands alone in terms of 10 hours of efficacy and a broad patient population.

Efficacy ultimately determines the winner, and we feel very strong about our efficacy. Prior products did not really satisfy the market, and this is clearly differentiated with our long duration, different MOA, and pupil-selective mydriasis-sparing profile. Real-world experience is reinforcing that differentiation, and broader category communication helps build awareness, but our focus remains execution on driving adoption.

Eef Schimmelpennink: Two quick additions on competition and sampling. You asked if competitors are sampling—yes, we are seeing new samples being put into the market. If we were to stop sampling, which we are not intending to do, you would see an NRx impact. Sampling has been a core part of our strategy from the beginning and will continue to be. As mentioned earlier, we are seeing exactly the behavior we want: sample, like it, convert to a purchased product, and then persist, which is stickier than if it were only a single sample experience. With that, let me hand it over to Marc to talk about the safety profile and what we have learned to date.

Marc Odrich: Thank you, Stacy, for your question. Safety is genuinely one of the strongest parts of the story so far. Six months in, we have shipped approximately 46 thousand boxes—roughly 1.2 million doses—in addition to widespread sampling. We have created very broad use. What we are seeing in the real world is fully consistent with the label. The non-serious AEs being reported are mostly transient and in line with what we saw in the clinical program. On the retinal side, it is important to start with the natural background rate. In the total population, retinal detachment incidence is about 27 per 100 thousand, with risk increasing with age and level of myopia.

Considering the background incidence rate and significant use thus far, zero retinal detachments and only two retinal tears is much lower than what you would expect. Importantly, both retinal tears occurred in patients with pre-existing retinal risk factors, meaning they carried elevated risk independent of any treatment. Our retina experts have reviewed both cases and assessed them as likely non-causal. Given the number of patients now on therapy and the background rate of around 27 per 100 thousand, you would expect to see more events than this. We believe that two cases at this level of exposure are not a signal but really just non-causal background incidence. I know everyone is looking at what Vuity saw.

At what we believe is a comparable exposure to where we are today, Vuity had about 34 retinal events on the books; 22 of them were detachments. This supports what we have said all along: our active agent is a different molecule than the other miotics on the market, with a different mechanism of action, and we are seeing a really different safety story play out in the real world. This is the only pupil-selective miotic; it does not significantly engage the ciliary body, and ciliary body engagement is the pathway most associated with retinal traction risk in this class.

Across thousands of medical discussions with eye care professionals, the ECP community clearly understands that mechanistic difference, and they consistently associate our product with a lower perceived retinal risk profile than other miotics for presbyopia. As exposure continues to grow, what matters is that the retina-related AE rate stays below background and that we do not see a mechanistic signal. To date, that is exactly what we are seeing. The product is safe, the data support it, and we will continue to be transparent as the real-world experience builds. Thank you.

Shawn Olsson: To add on to the last part of your question on perspectives from ECPs and patients: in the field, doctors clearly understand that our agent is pupil-selective based on the MOA that is in the PI. When people use the product, we continue to hear about the benefit to distance vision, which aligns with sparing the ciliary muscle. The ECP community understands and aligns to the unique nature that is only available through this mechanism. From the consumer standpoint, our focus is on setting the right expectations—transient stinging on instillation or redness that diminishes over time. That is why we have invested in getting-started videos and QR codes, as well as training doctors to set those expectations for patients.

Operator: Your next question comes from the line of Yigal Nochomovitz with Citi. Please go ahead.

Yigal Nochomovitz: Hey, thanks for all the detail. As you move through the first few quarters of the launch, you mentioned that prescribers are not proactively talking enough about the product in their initial patient conversations. Can you expand on that? You mentioned contact lens wearers as an area of focus—are there other categories or aspects of a patient’s profile that would be natural hooks to introduce the concept during the visit? And then earlier, before the launch, you talked about average utilization somewhere in the five months-of-the-year range, varying by heavy versus light users. Is that still a valid assumption, or does it need to be adjusted? Thank you.

Shawn Olsson: Starting with how often prescribers bring this up: we need them bringing it up more often in their standard exam. Their standard exam is pretty quick—around 20 minutes—and they have a regimen they follow. Once you get into that muscle memory, you will do the same thing unless the patient proactively brings it up. We need to help them change how they run through that standard process. We worked on sharpening our message to make it easier for the doctor to bring it up quickly, and part of that is video via a QR code.

Now they do not have to spend as much time walking the patient through expectation setting and how to use the drop; we moved that to a digital video format. That way the doctor can bring it up easily and quickly within the natural exam flow. The product has broad applicability, but in our research we have seen that approximately 50% of our patients on therapy use contact lenses as their primary vision correction. That is a natural benefit for both the patient and the practice. That is why we are leading heavier into the contact lens strategy right now, to create that muscle memory for the doctor—it is clear physician value and a clearly identifiable patient.

By doing that, we help create the cycle of “I can always bring this up, and I can do it quickly.” That is where we are focused to make sure prescribers bring it up more often.

Eef Schimmelpennink: Beyond contact lenses, which is a very important and valuable group—10+ million people—we are also seeing success with patients striving for an active lifestyle, and in “naïve to drops” patients who have never been to an optometrist but come in because they are now experiencing near-vision issues. All those categories play. The contact lens group is one where we can easily help ECPs better understand the value for both patient and practice. On the refill rate, yes, we have spoken about five refills per year as a working assumption, and our commentary today remains consistent with that, with formal data to come in the second half as cohorts mature. Thank you.

Operator: Your next question comes from the line of Biren Amin with Piper Sandler. Please go ahead.

Biren Amin: Yes, hi. Thanks for taking my question. First, you talked about going to physician offices directly to sell in select markets. Can you talk about how this might impact your margin? There would be an economic incentive to physicians, so how does the math work for both the company and for physicians? And what target markets are you expecting to reach out to, and how many of these are in your top 1 thousand ECP prescribers?

Shawn Olsson: For optometrists, generally about half of U.S. states allow optometrists to sell prescription drugs out of their practice. Where it is allowed, we offer the opportunity for doctors to buy the product directly from LENZ Therapeutics, Inc., the product ships to the doctor’s office, and from that point they are able to prescribe it and sell it to patients. From an economic standpoint, you should think of this as the same economics to LENZ Therapeutics, Inc. as product that flows to our e-pharmacy or through a retail channel. Our target markets are those states where this is an option—about 25 of the 50 states.

Dan Chevallard: The revenue transaction aligns with how we talk about gross-to-nets and the net price per monthly unit—roughly $60 net cash per monthly unit to the company. From a modeling standpoint, do not differentiate it materially from other channels. It is simply a different method of selling direct and avoiding some wholesaler or other distribution costs. It is a high-quality revenue transaction because it is direct from us to the doctor. In short, there is no meaningful difference in net economics to the company.

Biren Amin: Maybe one more. At the March update, the company stated that emerging presbyopes were identified as early adopters, and you wanted to expand beyond this group. Can you talk about efforts to expand beyond emerging presbyopes to a broader group over the last six weeks or so?

Eef Schimmelpennink: On our last call, we noted that from an ECP point of view, their initial focus on patient type—partly a carryover from Vuity’s launch and its limited efficacy—was skewed to early, emerging presbyopes. We clearly work in a much broader population. That is part of our sharpening in messaging: continuing to remind doctors that while emerging presbyopes are appropriate, they are just a fraction of the patient population for whom this product works.

Shawn Olsson: Tactically, we developed an additional field piece focused on the broad inclusion from our clinical studies showing we worked just as well in both moderate and advanced presbyopia. We also updated email campaigns and targeted posts to ECPs bringing in peer-to-peer statements—other doctors sharing their successes in non-early presbyopes—to reinforce the message from both peer and advertising angles.

Biren Amin: Perfect. Thank you.

Operator: Your next question comes from the line of Analyst with Leerink Partners. Please go ahead.

Analyst: Hi, everyone. This is Alyssa on for Mark. Thank you for all the detail. A few questions. Could you give a little more color on the ECP direct sales initiative? Would that be timed shipments, or at-will ordering as they deplete inventory? And could you discuss the network TV direct-to-consumer advertising and what markets you are launching in during the pilot period?

Dan Chevallard: Great, thanks for the question.

Shawn Olsson: On the ECP direct sales initiative, these are engagements we enter into with the doctor via a contract that outlines the rules and model. Ordering is at-will. They order a case at a time; we invoice and collect payment prior to shipment, then ship directly to the office. From there, they prescribe and sell the product to the patient where permitted. It is a simple model—at-will ordering under contract, minimum one case per order. On network TV, we have started linear TV in select key markets across the U.S. to observe signal in those geographies.

We are only a few weeks into it, so it is too early to provide details on performance by market, but we will evaluate and optimize as data accumulate.

Operator: Your next question comes from the line of Lachlan Hanbury-Brown with William Blair. Please go ahead.

Lachlan Hanbury-Brown: Thanks for the questions. On the direct-to-ECP sales approach, should we read that you are seeing abandonment between writing the script and patients actually filling it, and that this will hopefully reduce that issue? Or is this more about getting the decision top of mind for physicians if they are seeing it in their office every day? And second, on the DTC campaign, you mentioned a change in the name or framing. How much of the actual content has changed with the new problem-solution approach?

Shawn Olsson: The direct-to-ECP program came out of pure ECP demand and consumer convenience. We want to make the process as easy as possible. It did not come out of an abandonment issue; rather, doctors had requested this capability for a while, and we now have the infrastructure in place to support it. On DTC content, “tired of reading glasses” with the product as the solution brings direct alignment between frustrated readers and our solution. It does not require an overhaul of core creative—our hero creative remains strong and continues to test well. It is more about creating that direct connection right off the bat when people see the ad.

Leaning into contact lens and LASIK populations maps well because many of them reach for readers; we are tightening the value proposition connection.

Lachlan Hanbury-Brown: One more on direct-to-ECP. Do you have clauses in those contracts to ensure pricing discipline—ceiling or floor on what they can charge?

Shawn Olsson: We set the price we sell to the doctor, and then the doctor sets the final price to the patient. The guardrails come from very clear market cues in our materials: for $79, you can buy via e-pharmacy, GoodRx is $79, and we have the retail structure in the background. Those natural pricing pressures hone in the price for the ECP.

Operator: Our final question comes from the line of Matthew Caufield with H.C. Wainwright. Please go ahead.

Matthew Caufield: Hi, thank you. Regarding refills, any further color on switching from one-month to three-month dynamics, and is that something you could have greater clarity on in the second half of 2026? Additionally, with R&D dropping to zero for the quarter, is that anticipated to remain for the foreseeable future, with OpEx essentially concentrating on SG&A for the launch?

Eef Schimmelpennink: On refills, yes, we definitely see patients move from a one-pack initially to a three-pack if they like it, and then continue with that. In e-pharmacy—which represents the majority of our volume—you see that three-month format now drives about two-thirds of volume. As noted earlier, we anticipate providing more color with actual statistics around refills in the second half as cohorts mature.

Dan Chevallard: On R&D spend, the short answer is yes, you should expect R&D to be substantially zero. We signaled a capital allocation shift with the completion of the CLARITY studies early last year and our movement toward commercial execution. You would have seen R&D be effectively zero in Q4 and again in Q1, and that is the expectation for the foreseeable future.

Matthew Caufield: Got it. Thanks, and congrats on the progress.

Operator: That concludes our Q&A session. As I am showing no further questions in queue, thank you for your participation. We will now conclude today’s conference call. You may now disconnect.