Eupraxia Pharmaceuticals, Inc. · TSX:EPRX
Eupraxia Pharmaceuticals — Investor Presentation (July 2026)
41 slides from Eupraxia Pharmaceuticals's investor presentation, July 2026
Slide 1: Upper Endoscopies and EoE Patients
Upper Endoscopies and EoE Patients Understanding how EP-104GI administration fits within Clinical Practice July 2026 NASDAQ: EPRX 0 0
Slide 2: EP-104GI Administration Aligns with EoE Standard of Care
EP-104GI Administration Aligns with EoE Standard of Care EP-104GI • Novel long-acting fluticasone propionate formulation • Currently investigated for the treatment of eosinophilic esophagitis (EoE) as a once yearly administration • Encouraging efficacy and safety data indicating potential for a once
Slide 3: Agenda
Agenda • Introduction • Jeymi Tambiah, MBChB, FRCS, MS, FAPCR, FFPM Chief Medical Officer Eupraxia Pharmaceuticals • Overview of Endoscopies and Administration of EP-104GI • Waqqas Afif MD, M.Sc (Epi), FRCP(C) Associate Professor of Medicine Department of Gastroenterology McGill and MUHC GI and Hepa
Slide 4: Overview of Endoscopies and Administration of EP-104GI
Overview of Endoscopies and Administration of EP-104GI Dr Waqqas Afif, MD, M.Sc (Epi), FRCP(C) Associate Professor of Medicine Department of Gastroenterology McGill and MUHC GI and Hepatology Division Director 3 3
Slide 5: Endoscopy: A Ubiquitous, Standardized Clinical Tool
Endoscopy: A Ubiquitous, Standardized Clinical Tool • An endoscopy uses a thin, flexible, camera-tipped scope to visualize the inside of the GI tract in real time • It is a common procedure used in almost all hospitals • Usually outpatient and performed under sedation. • It includes: • Upper endosco
Slide 6: Endoscopists Both Diagnose and Treat with the Endoscope
Endoscopists Both Diagnose and Treat with the Endoscope Diagnostic Upper GI Endoscope • Direct visualization and grading of mucosa Light Source & Video Processor Irrigation Pump Proximal Control Handle Eyepiece • Targeted biopsy Angulation Knobs Suction Suction Button Button Air/Water Button Therape
Slide 7: Submucosal Injections in the GI Tract Are Common
Submucosal Injections in the GI Tract Are Common Common techniques use multi-site injections Endoscopic Submucosal Injection in patterns into the esophagus wall: Submucosal lift to elevate lesions or polyps before resection Hemostatic injection for bleeding Mucosa India-ink tattooing for lesion mark
Slide 8: The Upper Endoscopy is a Daily, High-Volume Procedure
The Upper Endoscopy is a Daily, High-Volume Procedure Upper endoscopies typically target: The esophagus, stomach, and duodenum, (called esophagogastroduodenoscopy or EGD) Endoscope Esophagus There are ~ 7.3 million upper ~ 7.3 Endoscopies annually in million US adults (2022 figures)* Stomach Typical
Slide 9: The Endoscopy Process for an EoE Patient is Typically a Three Step Procedure
The Endoscopy Process for an EoE Patient is Typically a Three Step Procedure Recovery Endoscopy (EGD) Procedure Intake ~30-60 minutes ~30 minutes ~30 minutes 0 min Performed in a Patient assessment & anesthesia Recovery Bay 5 min Performed in a Includes: Pre-Procedure Bay Standard EGD 15 min • Monit
Slide 10: EP-104GI Administration Integrates Well With Routine Endoscopy For EoE
EP-104GI Administration Integrates Well With Routine Endoscopy For EoE 1. Reconstitution of EP-104GI two components by nurse during endoscopy preparation 2. EP-104GI injections performed efficiently after visual exam and biopsies Intake, assessment & anesthesia Endoscopy EP-104GI Reconstitution Exam
Slide 11: EP-104GI is Injected Using Standard Endoscopic Injection Procedures
EP-104GI is Injected Using Standard Endoscopic Injection Procedures Esophagus wall 1. The needle is positioned and inserted in the submucosa 2. The suspension is injected to form a EP-104GI particle “bleb” that will dissipate after a few minutes EP-104GI submucosal injection 10 10
Slide 12: EP-104GI is Injected Using Standard Endoscopic Injection Procedures
EP-104GI is Injected Using Standard Endoscopic Injection Procedures Video of EP-104GI injections into EoE 60 second video of 3 injections patient following biopsies during RESOLVE study 11 11
Slide 13: EP-104GI Injection Pattern Provides Coverage of the Full Esophagus
EP-104GI Injection Pattern Provides Coverage of the Full Esophagus • Total of 20 injections in pairs spaced by 2cm, 20 Approximate Distance from GE junction (cm) throughout the esophagus length 18 16 14 12 10 8 6 4 2 Model of Esophageal Coverage by EP-104GI Injection Pattern Injection Site 12 12
Slide 14: EP-104GI Administration Should be Easily Integrated into GI Care for EoE Patients
EP-104GI Administration Should be Easily Integrated into GI Care for EoE Patients Upper endoscopies are a common, standardized tool used by GI specialists to both diagnose and treat patients Submucosal injections are a common procedure used by endoscopists when performing endoscopies Administration
Slide 15: Endoscopy Practices in the US – Logistics & Business Model
Endoscopy Practices in the US – Logistics & Business Model Dr Mark DeLegge, MD, FACG, CNSP, AGAF, FASGE Senior Medical Director, GI/Hepatology Center of Excellence, IQVIA Fellowship in Gastroenterology and Nutrition, Medical College of Virginia Board certified in Internal Medicine, Gastroenterology
Slide 16: Gastroenterologists Practice Across Multiple Outpatient Settings
Gastroenterologists Practice Across Multiple Outpatient Settings Site-of-care selection is often driven by case complexity and reimbursement ASC HOPD Office Free-standing facility built for Hospital-based unit with full Procedure suite inside physician's Structure same-day procedures clinical backup
Slide 17: ASC + HOPD Dominate Endoscopy Volumes, with Site-of-Care Driving Reimbursement Variability
ASC + HOPD Dominate Endoscopy Volumes, with Site-of-Care Driving the Majority of Reimbursement Variability Proportion of Upper Endoscopies by Site of Care (US)* • Approximately 94% of endoscopies are conducted in outpatient settings • Based on IQVIA claims data, ambulatory surgery centers (ASCs) rep
Slide 18: Planning, Logistics and Economics for Endoscopies Involves Multiple Stakeholders
Planning, Logistics and Economics for Endoscopies Involves Multiple Stakeholders Stakeholder Role / influence Patient Experiences symptoms, consents to treatment, and adheres to follow-up Gastroenterologist Diagnoses, determines treatment decision and procedure Endoscopy nurse(s) Prepares the patien
Slide 19: Most Endoscopy Practices Handle a Variety of Patient Types in a Typical Morning
Most Endoscopy Practices (HOPD and ASCs) Handle a Variety of Patient Types in a Typical Morning Typical Gastroenterologist’s Morning Most ASCs and HOPD handle both upper and lower endoscopies in the Scheduled Actual same facility Variation is Routine 8 AM 30 min 15 min Standard EGD Case lengths typi
Slide 20: The Revenue Model for EGDs Considers Procedure Payments for Both Facility and Physician
The Revenue Model for EGDs Considers Procedure Payments for Both the Facility and the Physician The amount paid to the physician and Payment for an EGD typically involves facility is set by the payers (Medicare, two major components related to Medicaid, Private) according to the the procedure: proce
Slide 21: Typical Coding Frameworks Used to Support EoE Related Endoscopies
Typical Coding Frameworks Used to Support EoE Related Endoscopies Key Reimbursement Codes & Modifiers Scenario EGD Family Diagnostic endoscopy 43235 - Diagnostic EGD, including brushing/washing Endoscopy with injections 43236 - EGD with directed submucosal injection(s), any substance Endoscopy with
Slide 22: Endoscopy Suites Can Supplement Revenue by Providing Drugs Under Buy-and-Bill
Endoscopy Suites Can Supplement Their Revenue by Providing Physician Administered Drugs Under Buy-and-Bill Buy and bill is a reimbursement model in which a healthcare provider purchases a specialty medication administers it to the patient, and then submits a claim to the patient’s third-party payer
Slide 23: Practice Economics is the Net Sum of Revenue, Cost and Volume
Practice Economics is the Net Sum of Revenue, Cost and Volume Revenue Cost Volume Practice Economics Driven by reimbursement Comprises drug, ancillary, Determined by procedure Per-procedure revenue and mechanics including staffing, physician time, and and injection time, room cost with throughput ph
Slide 24: Primary Market Research on Incorporating EP-104GI into Current GI Practices
Primary Market Research on Incorporating EP-104GI into Current GI Practices Paul Brennan, M.Sc., CLP Chief Corporate Development Officer Eupraxia Pharmaceuticals 23 23
Slide 25: Eupraxia Have Conducted Multiple Separate Projects to Understand How EP-104GI will Fit into Clinical Practice
Eupraxia Have Conducted Multiple Separate Projects to Understand How EP-104GI will Fit into Clinical Practice 1. EoE Commercial Assessment with ClearView Healthcare Partners – Nov 2023 • To seek a commercial assessment for RP-104GI in EoE in particular, defining addressable patient populations and e
Slide 26: Majority of Patients get Endoscopies at Least Once per year
Majority of Patients get Endoscopies at Least Once per year 80% of All Patients Receive Endoscopies at Least Once Every 2 Years Frequency of Endoscopies ~40% of patients get endoscopies ~60% of patients get endoscopies less frequently than once per year at least once per year 30% 25% 20% 15% 29% 28%
Slide 27: Practice Logistics and Economics Market Research with IQVIA
Practice Logistics and Economics Market Research with IQVIA Eupraxia retained IQVIA to: I. (i) perform a primary market research informed assessment of Endoscopy suite workflows II. (ii) determine how EP-104GI will be incorporated into clinical practice, and III. (iii) to determine how its use will
Slide 28: Multiple Stakeholders Were Interviewed for Their View of EP-104GI Adoption Dynamics
Multiple Stakeholders with Expertise Across Different Settings and Facilities Were Interviewed for Their View of EP-104GI Adoption Dynamics Stakeholder Interviews Virtual Sample Sub-quotas Gastroenterologists 8 Variety of sub-quotas represented, including: HCPs - Geography Nurses 8 - Urbanicity - Si
Slide 29: Practice Economics Framework Comparing Revenue, Cost and Volume
At its Essence, Practice Economics can be Evaluated Through a Framework Calculation that Compares Revenue, Cost and Volume ( Revenue - Cost ) x Volume = Practice Economics This framework served as the foundation for the analyses, assumptions, and economic model presented throughout the IQVIA project
Slide 30: Administration of EP-104GI Can Supplement Physician and Endoscopy Suite Revenue Through CPT Coding
Revenue Administration of EP-104GI Can Supplement both Physician and Endoscopy Suite Revenue Through Upgrades to CPT Coding EoE Patient with a Biopsy Same EoE Patient now receiving EP-104GI 43239: EGD with biopsy + 50% of 43236 EGD with injection In combined injection and biopsy sessions, 43239: EGD
Slide 31: Changes to CPT Coding Provide Greater Reimbursement to Physician and Facility
Revenue Changes to CPT Coding – (EGD with Biopsy) versus (EGD with Biopsy plus Injection) Provide Greater Reimbursement to Both Physician and Facility Procedure and Total Cost of Care Reimbursement by Payer Channel and CPT Code (Jan. 2023 – Jun. 2026) HOPD HOPD HOPD ASC ASC ASC CPT Code(s) Procedure
Slide 32: Buy and Bill Provides an Additional Opportunity to Supplement Income
Revenue Buy and Bill Provides an Additional Opportunity to Supplement Income Buy and Bill for EP-104GI is a Likely Outcome for Endoscopy Suites Buy and bill common for higher-cost, provider-administered specialty medications requiring immediate in-office use • During market research the participants
Slide 33: The Potential Revenue from Buy and Bill is Highly Attractive
Revenue The Potential Revenue from Buy and Bill is Highly Attractive EP-104GI likely to be a high value treatment: Single administration expected to provide coverage for full year (WAP for a year of Dupixent is ~$109K) Current margins for Buy and Bill for Medicare are are 4-6% of ASP, 4-6% ~20% Marg
Slide 34: For EoE Diagnosed Patients, Payer Channel Mix is Heavily Concentrated Within Commercial
Revenue For EoE Diagnosed Patients, Payer Channel Mix is Heavily Concentrated Within the Commercial Payer Channel The higher concentration of Commercial payer channel volume observed for EoE patients aligns with analog market findings for EoE patients across other products CPT Code Description 43200
Slide 35: No Incremental Equipment or Overhead Cost
Cost No Incremental Equipment or Overhead Cost, as EP-104GI Layers Onto Infrastructure that is Already Fully in Place Storage Equipment & Capital Administrative Support Training & Onboarding • Storage needs minimal; vial • Procedure rooms, endoscopes, • Practice administrator • Endoscopic injections
Slide 36: Staffing Should be Unchanged; EP-104GI Integrates Into Existing Team Responsibilities
Cost Staffing Should be Unchanged; EP-104GI Integrates into Existing Team Responsibilities Without Requiring New Roles or Additional Headcount Number of Staff Staff Time Estimated Rate Standard EP-104GI EP104GI Driver of Time Increase EGD Impact Incremental Time Room coordination, documentation, and
Slide 37: EoE Procedure Frequency and Scheduling Flexibility Prevent Meaningful Throughput Impact
Volume EoE Procedure Frequency and Existing Scheduling Flexibility Prevent any Meaningful Throughput Impact Existing Suite Capacity within a Standard 30-Minute Booking STANDARD UPPER ENDOSCOPY 0 min 5 min 15 min 20 min 30-35 min Patient Standard EGD Documentation Gastroenterologist Buffer time asses
Slide 38: Adding EP-104GI will have Little Effect on Total Number of Procedures per Day
Volume Due to Patient Type Variability, Adding EP-104GI will have Little Effect on the Total Number of Procedures a Practice can Complete in a Single Day Patient Mix: Variation in case length is routine: Typical Gastroenterologist’s Morning3 Case lengths typically vary from 5 minutes (plus Procedure
Slide 39: EP-104GI has the Potential to Generate Favorable Returns to Physicians, HOPDs and ASCs
Summary Viewed Through the Lens of Practice Economics, EP104-GI has the Potential to Generate Favorable Returns to Physicians, HOPDs and ASCs ( Revenue - Cost ) x Volume = Practice Economics EP-104-GI can be Existing coding & Incremental operating incorporated Into reimbursement costs are limited as
Slide 40: Market Research Feedback
Market Research Feedback “If we’re doing it at an ASC that “If I went over, it's not really a big deal. I’m sure “The additional 10 to 15 minutes, that's we own, we benefit off that I won’t be doing five of them a day. So, if I’m not something that would deter us. profit margin.” just doing one a da
Slide 41: Thank you!
Thank you! NASDAQ: EPRX 40 40
Eupraxia Pharmaceuticals — Investor Presentation (July 2026) on 6ix