Akili, Inc.

Q4 2022 Earnings Conference Call


spk_0: greetings and welcome to the achille fourth quarter two thousand and one into earnings call at this time all participants are listen only mode a question and answer session with all the formal presentation and i was a require operator assistance during the conference please press stars euro on your cell phone keypad as a reminder discovered is being recorded i would now like to turn the converts over to your host julie decarlo senior vice president of communications
spk_1: thanks show good afternoon and welcome to achilles earnings conference call for the fourth quarter of two thousand and twenty two after the market closed today we issued our earnings release which can be accessed on the investor relations section of our website additionally we posted earning five of our on our our website that will reference during today's call they've called being recorded and a replay of the teleconference will be available on our i our website at the conclusion of today's event during today's call will make fault forward looking statements regarding future events expectations plan prospect or the financial performance of the company the forward looking statements are based upon estimates and assumptions that while considered reasonable by the company's management involved certain risks and uncertainties the company the actual results may differ mature early from those express or implied by any such forward looking statements as a result of various important factors factors that might cause such differences include but are not limited to those risks and uncertainties set forth and are form can't you filed on november fourteenth as well as other subsequent filings with the up a the information provided on today's called reflect our views only other today march seventh and should not be relied upon as representative of are viewed as have any subsequent date with flippantly disclaim any obligation to update or revise and bored looking statements or our outlook also during today's call will refer to certain non gaap financial measures management does not intend the presentation of these non gaap financial measures to be considered an isolation or as a substitute for results prepared in accordance with gap but at the compliment to provide greater transparency the reconciliation of the historical non gaap financial measures to our got finance oh measures include not earning flies and in our earnings relief if you're following along with the flight please turn out to the agenda with me on had a call or kelly ceo eddie margie our president and chief operating officer matt franklin our chief medical officer got collins and our chief financial officer santo schanberg now please turned applied for of a hammer call over to eddie for his prepared remarks eddie
spk_2: really hello everyone thank you for joining or call to discuss our business performance and que por of last year and our overall summary of twenty twenty two the radio hear from a gun photos on very detailed aspects of our business group and but we're excited about our evolving the business and thing the increasing traction of endeavor and more generally progress of our business model with move that we announced an early que one of the fear to restructure the business or now operating with a more efficient capital footprint so that we can execute against the most important business goals and have gas that we expect roof on the burglars in the queue on twenty twenty five with are heightened focus on endeavor acclimated the marketplace will have to prove out that a digital treatment can indeed scale like a drug i believe and i has the potential to be the first example of this new paradigm and the entire kelly theme is passion and focus on making that happen i'm excited with the early impact of ourselves horse investment where we're seeing a positive increased and most commercial metrics we're also seeing the strong willing to pay out of pocket by patients as expected we haven't seen ensures that up the broader coverage and this was the continued area of focus for us and we continue to push the cutting edge of a patient experience in madison with multiple enhancement the both or treatment product and are caregiver got a caregiver companion product over the last quarter in terms of getting into work to all of the idiots the patients we believe can benefit from our product we were extremely excited to announce positive outcomes from our stars eighty hd adolescent trial earlier than anticipated in january of this year with the needs around mental health and pins and the ongoing hd medication shortage we're putting urgency around our plan that the admission this year for review of an expanded label for and of x to include adolescent over twelve years of age it's successful that expanded label would essentially double our current addressable market based on our estimates overall i believe we've made good progress the and the year and i'm even more pleased with our teams increased focus and execution mindset here in the early part of twenty twenty three are now turn it over to our president and ceo matt franklin to give you a deeper look into our core business progress that
spk_3: think that he
spk_4: during our third quarter earnings call we outline to a strategic air the bogus were business these are outlined on like thought the first driving awareness and adoption of endeavor actually the addition the first wave of our direct sales force and thirteen priority territories coburn roughly twenty percent of the estimated us market opportunity when deborah
spk_2: the second is really barriers to dobson but driving expanded coverage for and that are at third be a to continually improve our treatment in the fourth quarter make good progress with expanding adoption including tweeting experience
spk_4: as expected peers continue to be slow to act in coverage remained the challenge that we're addressing at on let's look at each of these areas starting with adoption the third quarter we deployed the first wave of are still team to thirteen and national geographic territories of the approximately seventy priority territories to be identified and us we're encouraged by the initial progress with he it's territories the the end of two thousand twenty two growth and field occupied territories out formed white states or unoccupied ya
spk_2: that is in overall prescription growth
spk_4: overall number about active prescribers and the number of prescriptions per prescriber we continue to add more than one hundred new prescribers per month and queue for while simultaneously expanding the number of repeat prescribers meaning prescribers with written multiple prescriptions overtime with luckier a bogus worst the team and you to repeat prescribers go but sixty percent of two three two thousand and one to ensure we bleed there was a strong correlation between directly over you gave me an accelerated growth across key adoption performance metrics in addition to feed initial impact of i direct sales force on the man to and up going to for we also saw retail push buttons grow more than two hundred percent over the third quarter of two thousand and twenty two it's growth was driven by the successful transition of double from and ninety days to appeal to the derby day prescription were with initiated in august during this transition be maintained established four hundred and fifty dollar list price which now applies to the thirty day to be course even with the tire active per month price we saw on the a twenty five percent reduction and prescriptions dispensed on prior quarter giving a competent that the thirty day prescription model is working in that endeavor at the this is an ongoing periodic therapy
spk_0: in these early indicators a commercial traction we're expanding our sales force and expect to be an possibly fifteen additional us market by the end of this quarter
spk_4: moving out coverage
spk_2: he key for we continue to see families willing to pay out of pocket for deborah while this is encouraging we acknowledge that they always been expanded access to be non bombs due to go treatment options more rapidly than pairs are currently providing and we continue our work to break down this failure to them finally and treatment experience as we shared last quarter we have unique opportunity with endeavor x to rapid the iterative the product to drive engage be in compliance enabled by the adaptability of digital be repeated the dynamic nature a video games were able to a ball the gameplay experience for patients while preserving the regulated core technology the product we also continue to update and optimize the treatment experience surrounding the products including a containing application to caregivers direct inside
spk_4: good for our news me too focused on improving the patient onboard and explain optimizing core gameplay to maximize player engagement in implementing progress rocking teachers to provide caregivers and healthcare providers increased visibility into patient progress during treatment this is part of our ongoing commitment to deliver amazing experiences to er patients and their family turning out to slide thick let's look at the numbers first on prescription more than forty five hundred prescriptions written for endeavor wrapped in two thousand and twenty two during the fourth quarter saw about eighteen hundred prescriptions written for endeavor at a thirty seven percent increase of acute really two thousand twenty two and a one hundred and seventy six posts not increase of a for two thousand and twenty one there were one thousand people a new prescriptions written during that period similar to the number written and cute three two thousand and twenty two despite eight you are selling days during the period representing and more than one hundred percent increase in cute or two thousand and twenty two over cute war two thousand and one one on rico as mentioned earlier we also saw significant increase in the number be built on the pinch written during the period there were seven hundred and thirty seven prescription beatles written during cube or two thousand and twenty two up about two hundred percent from t three two thousand and twenty and up more than four hundred percent over keep for two thousand and twenty one on prescribers issued for the total number of prescriptions were written about eight hundred you beat prescribers representing a two percent increase over two three two thousand twenty two the increase it eighty percent or que por two thousand and one one the number of new prescribers was down twenty nine percent from two three two thousand and twenty two but this decline was more than offset by growth in the number of repeat prescribers a key area topless bars guilty which grew more than sixty percent from que three two thousand and twenty two forty percent a new prescriptions written into forward were dispensed during the quarter down from fifty two percent in two three that up from thirty three percent we saw and keep for two thousand and twenty one we believe this was driven by two factors the transition from a ninety day to thirty day prescription and the impact of the december holiday during queue for will receive payment for ninety eight percent of dispensed prescription ninety six percent of distance prescriptions were paid or potter by caregivers two percent were reimbursed and two percent are provided free of charge qualifying families and under oppression assistance program now turned over ducks got collins or chief medical officer will provide an update on a clinical programs
spk_5: thanks map
spk_6: hello everyone i'm excited to be joining my first earnings call since joining a kelly on december first before i get started a quick note on my transition to the company i've spent nearly my entire twenty five year career studying new treatments for eighty the including reading the duke university eighty eighty program for eighteen years and i've grown impatient up fact that we've not provided new options to patients and decade the standard of care has not changed since i finished graduate school
spk_2: it never are ex we now have and ft i authorize product that can change that and i'm excited to be leading the medical and scientific aspect of the kelly as we worked to get this product into the hands of everyone who can benefit broadly the current strategy for my team will focus primarily on supporting our commercial efforts by continuing to generate and disseminate high quality evidence of the affair
spk_6: activists and safety of endeavor are acts as an important component of eighty hd clinical care as a reminder we made a strategic decision to focus our resources on the growth of our endeavor are ex product for eighty hd and subsequent clinical development activities will coincide with additional capital raise are built a development opportunities turning out slide seven or provide an update on where we are with our eighty hd clinical programs as we reported in early january this year with our top topline result from the stars hd adolescent pivotal trial of endeavor rx or label expansion study in one hundred and sixty two patients with a d h d h thirteen to seventeen
spk_5: results strongly support the efficacy and safety of endeavor are acts in adolescence
spk_6: as you can see on the fly the magnitude of effect across a range of outcome measures including objective measures of attentional functioning and eighty to the symptoms or equal to or greater than those with seen and two previous pivotal studies than younger children be findings are timely given the current and growing mental health crisis in our country that is disproportionately affecting teenagers where in the process of preparing result from the study from presentation to future scientific meeting and for submission to a peer reviewed journal we're on track to use the adolescent study findings to spotify ten case submission to be a the here to potentially expand our label for endeavor rx referring to our pipeline a slight a we alter previously reported that we stopped enrollment for stars eighty hd adult or pivotal study of endeavor are ex an adult with eighty hd
spk_0: we shared on our laughed earnings call that the study was recruiting more slowly than expected
spk_6: given the strong clinical data in adolescence that i just described we closed in rome and this adult study to preserve capital and analyzed the data the study and two hundred and twenty three patients which was more than the number enrolled in the adolescent study
spk_2: data analysis for this adult study is ongoing and we stated that we expect our top line results from this adult study in the second half of twenty twenty three
spk_6: we expect to make a decision later this year about a regulatory strategy as it relate to the stars eighty hd adult day
spk_2: in addition to the completion of our adolescent an adult pivotal studies are also actively and rolling participants into a real world registry that will allow us to collect data to support other regulatory and market access initiatives
spk_4: and announced in january outside of eighty hd were chosen to be prioritized other clinical programs that would require additional significant investment we are continuing previously launched investigator initiated and collaborative studies which include to studies of endeavor are to treat cognitive impairments and patients following coven infection
spk_6: data analysis for one of these studies that in the process of being finalized and we expect the second study to complete enrollment and que tu as such we expect data from both studies to read our the and of key you
spk_4: oh headed over now two hours depot center shen back
spk_7: thank you scott and hello everyone
spk_8: now onto the financials and plate number nine
spk_2: we continue to seek all recorded grew up in democratic revenues and as matt mentioned earlier we're also seeing the positive impact of the first wave of i feel left in the field added feel the in the fourth quarter of twenty twenty two and democratic seven use grew to one hundred and eleven thousand dollar representing a thirty five percent growth over third quarter of twenty twenty two and seventy six within growth over the fourth quarter of twenty twenty one similarly truly or twenty twenty two and democratic revenue grew to three hundred and twenty three thousand dollars up from a hundred and eighty six thousand and twenty twenty one note that the total revenues and twenty twenty one and you fall off twenty twenty one included an additional three hundred and fifty two thousand and ninety eight thousand dollars respectively of revenue the associated with as you know the collaboration from an expensive expected we incurred approximately ninety one million of gap total operating expenses and about seventy eight million of non gap total operating expenses and twenty twenty two
spk_7: the growth of expenses compared to the third quarter of twenty twenty one was primarily driven by expenses related to the commercial launch support of and balearics the eighty hd label expansion teddy and also the costs associated with the business combination and operating at the public company similarly we incurred approximately twenty two million of gap too low operating expenses and twenty million of non get are being expenses in the fourth quarter of twenty twenty two the growth inexpensive compared to the third quarter of twenty twenty do was primarily driven by business expenses related to commercial launch the board of and every arctic and last but not least from the capital perspective we ended the year with approximately huh
spk_2: hundred and thirty six million dollars of cash cash equivalent and short term investment now onto guidance on played number ten via reaffirming i'd expect guidance from january that we expect that twenty twenty three non gap total operating expenses to be between fifty five and sixty million dollars this represents a reduction compared to the twenty twenty two non gap total operating expenses off a girl from it you can mediate million in february of to a twenty three operating planned the company underwent a reduction in work for with impacting approximately thirty percent of employees across the organization we estimate that we will and good about one and a half to two and a half million of severance and domination related costs related to this action and expected a god these judges during the current quarter que one
spk_7: please note that be severance and termination related costs in addition to stock based compensation are excluded from the projected folio twenty twenty three non gaap total operating expense guided
spk_2: it brings me to a capital plans we are also reaffirming the cash and the guidance that we previously announced in january we expect that guess position at year and twenty twenty two of approximately hundred and thirty six million dollars to be able to fund our current and planned operation into the first quarter of twenty twenty five i'll call them the financial up a with this i twenty twenty three operating plan lot the to one focus our resources primarily on endeavor arctic commercialization and eighty is the label expansion and to preserve capital especially in the current capital market conditions
spk_6: but that and hundred back over to eddie eddie
spk_2: thanks i if it all like to turn to slide eleven you can see our key take away from this quarter overall i think we had a strong quarter or excited by the increasing traction were thing with and acts we announce positive topline data from our first a little trial designed to expand the end of our act label and were moving forward with the regulatory commission and obviously as noted restructure the business to give us catherine way into twenty twenty five with that are handed back to the operator and we're happy to take questions
spk_0: thank you ladies and gentlemen if you like after question please press star one on your cell phone keypad and a confirmation times your lungs and the queue you may press start to if you like to remove your question from que for participants using speaker equipment and may be necessary to pick up your handset before pressing the starkey one moment please only poll for questions
spk_9: a first question comes from the line of judo frommer with christmas please proceed hey guys this is nick on for judah from credit for thanks for take our question congrats on the progress
spk_6: the topic if you guys could provide some incremental and say on refills
spk_4: i'm able to share just kind of patients are getting repelled how many there are they getting on average and it's ernie time gap between prescription back
spk_2: yeah i think this is that proceed the question a couple of comments their posts meet you as we announce we need to significant business changes in que three in queue for first with the change from ninety day to thirty day prescription and the addition of our direct sales force were were engaging in discussions around retail prescription so with those two significant business changes we'd love to get a low that more time to see how the refill patterns of ball so we're not at this point providing a specific guidance i can
spk_4: date however and share that the vast majority of prescriptions that are written are written with multiple retail so a new prescription for a child is often written with initial cycle of treatment and that includes multiple retail the to three or more overtime so we do expect to see
spk_2: continued increases in riddles overtime and and like i'll just add add the you at the question of the very end about kind of sequential nature how quickly as we said before endeavor is meant to be a an ongoing episodic treatment made something that you'd ongoing and may come sequentially or are immediately or may pounds in and out and we are seeing that and the market so without getting into specifics and metrics we do see some immediate refill behavior and then we do see in terms of or he felt patients who come back after a gap in time and when they're reassessing their symptoms with their doctor so i think this is something that will evolve given this is a really new treatment modality with new dynamics
spk_9: it'll evolve as we continue to scale
spk_10: got it thanks again and congrats on the progress
spk_0: great thanks
spk_11: or next question comes from the line of michael journey with bank of america please proceed ah evening and pics taking the question yeah maybe if we can dive into a bit more of to prescribe or dynamics especially you think about retrenching the business focusing on we're that the corporate accounts how do you think about that strategic balance of going after new dogs vs going after existing toxin and what is
spk_12: i guess you don't have twenty three revenue games per se but what is incorporated terms of your expectations for how each one of those gets penetrated
spk_4: retention the for returning doctor cetera a is my go against is matt i'm happy to take the first crack at bad so present the question in keyboards we deployed or salesforce are is is you can guess our initial focus here is on driving overall prescription growth so one of the area that we focused on and usually with the filthy engaging with those prescribers in there was new the populated territories we're going back in we engaging with those historical providers so we did in generally plate an emphasis on the engaging historical providers when you saw the the benefit of that strategy with a significant increase sixty percent growth in bp prescribers we saw that universe and jump in retail prescription so
spk_2: we were pleased with the results of that unusual strategy now the team than in the field
spk_11: for a quarter we've taken a more balanced approach so balancing the time we spend service thing those existing writers and balance and that with engaging educating new providers and we do expect to see a new prescriber and new prescriptions grow over time thanks and and if i could just type in a bit on the coverage side
spk_12: how do you think about the milestones should look for as you to focus on covered expansion given that yoshi have of see it can it can it's in the pipeline relative to coverage for the commercial side but also your evident redefine a new model given that it'll therapeutics general talent show the have broad coverage
spk_2: within the current pair landscape shore up thanks bye go through that he so i think you're right that this the real therapeutics prescription the door therapeutics as a class on kind of hadn't seen broad coverage at absolutely on we're pleased with the interactions we have when we have our team mr again with tears were saying engagement were saying that the clinical data is selfish and and generally we get feedback that and are impressed with the level clinical data obviously because we run multiple perspective trials for this conical program so we're not guiding on you know and we don't announce individual coverages were not guiding on get our expectations are number of coverages there are and covered lives or things like that on from our perspective the milestones are really doing the work to essentially educate the pair landscape on this product i think broadly what i see as that pairs here
spk_13: arch like very generally surface level aware more and more they are going deeper product by product into the data and that's where we believe we're going to start to save a success because of our investment in our data because of our outcomes to date so it's really doing an internal mild the hundred really stacking up those meeting doing the work to go deep
spk_14: with each of these pairs which takes time
spk_0: okay thanks
spk_15: or next question comes from a line of rahul rock with my side capital please proceed oh yeah thanks to your question ah during the pretty impressive adolescent that i was wondering what the feedback was from your existing prescriber base
spk_6: in for that feedback how do you think that ultimately shaped adoption amongst the adolescent patients you know upon clearance and and commercial launch the their whole this god so you know it's early we've just where yeah we just announced then we haven't presented the data yet or published but the general reaction from providers as well as you know everybody else are we talking very positive i mean this is a this is a very underserved populations it it's going to double the know
spk_15: nber a kid that can get access to a to an effective treatment so the are you know the reaction has been overwhelmingly positive got it right there are terrible and then you know at a guy you are expanding the shelter joy
spk_4: in terms of abiding which territory expanding to yale you're thinking around going into the areas with existing reimbursement coverage or you just trying to cat is one of the mad as possible terms of driving script grip yeah a real mad yet number of factors that we consider i would imagine it's similar to other pharmaceutical biotech me medical device launches we look at you know overall opportunity in terms of address and addressable patient population we look at prescriber density we look at geographic boundaries as well making sure that these are small enough where we can get to these additions on a frequent basis right to to really meeting that reach and frequency so you know i think we're looking at it in terms of opportunity and the one thing we do
spk_2: we do do is we do integrate our market access with our sales strategy so we are engaging with a commercial plans
spk_4: in those areas that we'd have existing sales was there were able to pull it through for example you know last call we talked about hi mark we do have active sales presence in pennsylvania
spk_15: so it's an example again our integrating all these different aspect of a commercial to
spk_2: got it at your lbj legacy one more may also you can't touch on portion new patients that are coming through the telemedicine platform for your website versus years salesforce on the ground
spk_16: yeah we haven't provided to the guidance telemedicine continues to be a what as a modest but that meaningful contributor to our prescription volume we're pleased that we have that capability think it may be more important as we expand into the adult population so
spk_15: you know more to follow on that
spk_17: god maybe she added
spk_0: actually i got thanks or next question comes from the line of the groom pero with more recently was proceed
spk_18: a good afternoon exiting our questions
spk_0: to from our side both on your commercial efforts with endeavor rx so i guess first what is the typical pete profile of patients that are demonstrating receptivity to direct in terms of their predicament status and that it of their condition overall when they present to the providers were eventually and to prescribing them under rocks and secondly
spk_19: which aspects specifically of your commercialization of messaging efforts do think are helping drive through that the quarter over quarter increase script the reported it for que
spk_4: i mean when you reflect on the initial phase of your commercialization effort like what's resonated what do you think really has its or for i her head
spk_0: id and mad think so the question and i'll do my best to address a multipart question keep me on as mature i don't forget any i think first on the patient profiles one of the things that i really appreciate about and of our act and the investment the teams made in the clinical pipeline is that it has been studied in been demonstrated to be adapted as both a standalone to
spk_4: remained as well as combination with medical therapy and it can fit seamlessly into any child's treatment plan right in you know in conjunction with the tradition and and the caregivers you know employed so it's very flexible with that said we do see in our early engagements to patient profiles really stand out the first his newly diagnosed patients are those who have recently been diagnosed who are interested in exploring or a caregiver is it is interested in exploring non pharmaceutical three and so that's the first decade area that we're seeing a lot of demand is for those patients that are not well controlled on medical therapy they may be experiencing side effect that often come with these prescription drugs and stimulants and are looking to explore alternate non pharmaceutical option so those are really the two areas those use cases if he will er patient profiles
spk_20: as we discussed those with traditions have been an area of interest and uptake though i think you know going through the clinical data demonstrating the flexibility demonstrating the impact of our treatment a in conjunction or as a standalone therapy i've been buried compelling
spk_0: so i would just highlight those are are sort of the initial the be back we're getting from the team
spk_21: gotta thank you or next question comes from the line of murray people with btg please proceed hi thanks for taking the question for afternoon i'm one of the asked my first here on the conversion rate i know that you mention a couple had one here in the fourth quarter that come
spk_2: kerr that right down to forty percent want to understand the are you expecting that to improve and que one i now certainly we won't have a holiday like we didn't care for but then the thirty day refill
spk_4: the thirty day prescription factor is still there and also wanted to understand how you're thinking about conversion rate in their refill face it certainly looks like that's a knife hi ninety percent or so by our math of how should we be thinking about conversion for refills going for
spk_22: yeah things we we we have not provided guidance or bore gas regarding the conversion as you mentioned there were two business changes the biggest been that migration from ninety two thirty day prescription while holding their pricing confident that was in in back the know how it is another impact of course that way
spk_2: not persist again and que one
spk_4: with that said this is also an area of emphasis for our sale teams are in those areas where we have the ability to engage with conditions were talking about the importance of follow up and making sure that patients and caregivers are prepared so we are doing are
spk_21: our best to continue to to message an educator on the importance of the doing those prescriptions but as far as giving guidance
spk_4: we're not prepared to do that at this time
spk_21: okay to summary health i know it is early but given that those are sort of built in cover initial prescription should we expect something around that high you know high nineties is is it reasonable range again early days mean he asked me the to business changes so were hesitant to provide guidance on that okay fair enough and and then maybe i'll ask for their question sort of on the sale for was your think about adding the next wave here and that in the first quarter how should we think about the maturation of the hell forces this kind of a six month
spk_4: a year long process for these it fails rapidly as they enter new territories and what what of kind of that the he learning on on who was the right prescriber profile who has the right kind of caregiver profile to target yeah
spk_23: thanks to that question and the i can sit there with any product launch particularly in a situation where defining a new category as we are with never out there is absolutely a loony and experience curve and still relatively early days the team is really been in the field for several months with that said we are very pleased with the prague
spk_4: refs were seeing as as we mentioned we're seeing accelerated growth on all of their critical commercial and adoption metrics in those fields territory so pleased with what was he initially we will continue to see we expect it gives you need improvement there so i wouldn't say we're there yet we're continue to learn and glow that learning curve we're all working do that
spk_0: effectively
spk_24: as far as
spk_25: he pitched the the physician profile yeah consistent with our initial indication eight to twelve year old not surprising we're focused on pediatric specialties or pediatric like hydrous pediatric neurologist i'm in addition to general pt attrition that that he a large number and are responsible for monitoring a number
spk_0: these patients overtime so really focus on sort of those integrated behavioral health centers where their multidisciplinary practices dealing with each complex cognitive impairment on a day in day out basis so that focus was consistent and are unusual perspective and remains appointed until
spk_9: as worse okay thank you
spk_6: and our next question will come again from a line of judah frommer with christmas please proceed he added if on concord judah again i'm just gonna go back to be analyzing data any initial thoughts on why the effect on attention was with higher in that population versus the initial eight to twelve year old than our was coming to do with trial designer or justice educated population and how do you think that africa in my translate into law into adult bank yep a necklace the scott thanks for the question yeah it a it's very good one we have a couple abroad i policies of our why we might have seen the greater magnitude of that can adolescent the first to their big maybe they're maybe there is not something to do with the composition of the sample compared the pediatric population that's pretty easy to look out and at least in the top line it doesn't look like things like that the gender differences the break down and in you know racial or ethnic the sub groups and is going to make much of a difference but we are are going to interrogate that further where where i would think we're we're likely to uncover some understanding of that fact is with looking at the the way that the participants engaged with the treatment
spk_26: the older kids might just be more motivated and be more and good for treatment and therefore derive more benefit
spk_0: so that is that it an area that as we prepare the data for presentation and publication that we're going to be diving into further and as far as the a will how we think that my extrapolate it is unknown and we'll we'll know when we when we get top line data from the adult study
spk_27: current that helpful thanks

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