Aquestive Therapeutics, Inc.

Good day and thank you for standing by. Welcome to the Equestria Therapeutics first quarter 2025 earnings conference call. At this time, all participants are on a listen-only mode. After the speaker's presentation, there'll be a question and answer session. To ask a question during the session, you'll need to press star 1-1 on your telephone. You will then hear an automated message advising your hand is raised. To withdraw your question, please press star 1-1 again. Please be advised today's conference is being recorded. I would now like to turn the conference over to your host today, Brian Korb. Please go ahead.

Thank you, Operator. Good morning, and welcome to today's call. On today's call, I'm joined by Dan Barber, Chief Executive Officer, and Ernie Toth, Chief Financial Officer, who are going to provide an overview of recent business developments and performance for the first quarter of 2025, followed by a Q&A session. During the Q&A session, the team will be joined by Dr. Carl Krause, Chief Medical Officer, and Sherry Korchinski, Senior Vice President, Sales and Marketing. As a reminder, the company's remarks today correspond with the earnings release that was issued after market closed yesterday. In addition, The recording of today's call will be made available on Equestria's website within the Investors section shortly following the conclusion of this call. To remind you, the Equestria team will be discussing some non-GAAP financial measures this morning as part of its review of first quarter 2025 results. A description of these measures, along with a reconciliation to GAAP, can be found in the earnings release issued yesterday, which is posted on the Investors section of Equestria's website. During the call, the company will be making forward-looking statements. We remind you of the company's safe harbor languages outlined in yesterday's earnings release. as well as the risks and uncertainties affecting the company as described in the risk factors section and other sections included in the company's quarterly report on Form 10-Q filed with the Securities Exchange Commission on May 12, 2025. As with any pharmaceutical company with product candidates under development and products being commercialized, there are significant risks and uncertainties with respect to the company's business and the development, regulatory approval, and commercialization of its products and other matters related to operations. Given these uncertainties, you should not place undue reliance on these forward-looking statements. which speaks only as of the date made. Actual results may differ materially from these statements. All forward-looking statements attributed to Equestiv or any person acting on its behalf are expressly qualified in their entirety by this cautionary statement and the cautionary statements contained in the earnings release issued yesterday. The company assumes no obligation to update its forward-looking statement with the date of this conference call, whether as a result of new information, future events, or otherwise, except as required under applicable law. Now I would like to turn the call over to Dan.

Thanks, Brian, and good morning, everyone. We are now over a month into our FDA review for anafilm epinephrine sublingual film, which, if approved by the FDA, will be the first and only oral medication indicated for the treatment of severe allergic reactions, including anaphylaxis. As a reminder, we believe that in the years to come, the rescue medication market for severe allergic reactions will grow into a multibillion-dollar opportunity. We anticipate receiving our FDA acceptance letter next month with an FDA-assigned action date in late January or early February of 2026. This is truly the most exciting time in the history of Equestiv, and we have officially entered the commercial prelaunch phase for Anifilm. As the review clock ticks toward approval, we are shifting more and more of the company's attention towards ensuring a successful commercial launch in the first quarter of 2026 if approved by the FDA. The first area of focus is ensuring we have the right people with both significant experience in the allergy space and the right commercial experience to launch NFL. I'm pleased to say that we have the marketing team that built EpiPen to over a billion dollar brand, and we have added colleagues with decades of market access and commercial launch experience. I am thrilled by the team we have put in place. Our second area of focus is awareness of anaphylaxis and our clinical data among healthcare professionals. As we are in the pre-launch phase, This work is conducted by our medical team through outreach to healthcare providers. We are very active in attending allergy conferences, both national and local, where we present our posters and our publications. I'm proud to share that by the end of this year, we expect to have attended 25 conferences and published 16 posters and manuscripts. By our anticipated FDA action date, we will have published almost 30 posters and manuscripts over the life of the anafilm development program. As a comparison, the sponsor of the recently approved nasal spray published approximately 20 posters and manuscripts before their approval. It is work like this that has me confident that we are well positioned to continue to increase our prelaunch awareness. The third area of focus is payer engagement. As I mentioned in March, we now have in-house market access expertise, and we are actively working with payers, given the FDA rules that allow us to engage with payers in advance of anticipated approval. We will benefit from the distribution and payer contracts that were set up during our marketing of Libervin. These contracts remain in place and we will be able to utilize them for ANIFILM. Critically, these will save months and months of startup time and add to our launch efficiency. Our positioning and advertising materials are well ahead of schedule for a launch in early of 2026. We have been clear about our positioning for quite some time. Among patients and caregivers, we will focus on the ability to easily carry anafilm. We believe anafilm is the only product that if approved by the FDA, allows for not just one, but two doses to easily fit on the back of your phone, into a wallet or a small purse, providing patients with an epinephrine product that can be with them anytime, anywhere. This clearly resonates across the stakeholder spectrum and I am genuinely excited about the progress our marketing team has made. We remain very active on the advocacy front as well. We have significant engagement with all four of the national allergy advocacy groups. We continue to sponsor several important patient programs with these groups, and more recently, have become involved in shaping state-level legislative actions geared towards ensuring patients have access to all pre-measured forms of epinephrine. So, from a commercial preparedness perspective, we have built a team of the right people, developed a robust pre-launch awareness platform, utilized our existing payer relationships to prepare for anti-film, built our product messaging and advertising, and established significant relationships with the key advocacy groups. This, to me, positions us incredibly well for a fast start in 2026. Now let's dig a little deeper into exactly how patients will experience anafilm. Think about your phone for a minute. Think about the incredible power that you hold in your hand every single day. From your phone, you can check the security at your house, start your car, track your heart rate, Search the web for any piece of information on the planet, and now, thanks to Anifilm and our FarmFilm technology, it can act as your medicine cabinet. Now that's transformational. In fact, the mom of a teenage patient recently told us, and I quote, my kid never takes his current device with him. But while there are times I have no idea where he is, what he's doing, what he might be eating, I do know I see his epinephrine device sitting at home on his bedroom dresser, which puts me into complete stress mode. The other thing I know is that without fail, he has his phone with him. How comforted I would be knowing that two doses of epinephrine were tucked into the back of his phone. In other words, he would never leave home without it. End quote. It is realizations like this one that we believe drive caregivers and patients to show a two-to-one preference for anafilm over the existing medical devices. And that is also why, with anafilm, seeing truly is believing. When we have the opportunity to show our technology physically, we find excitement and growing interest in prescribing opportunities. In fact, almost 100% of healthcare providers we have surveyed, and we've done a lot of surveys, believe their patients will be interested in antifilm. We also know that direct-to-consumer, or DTC, engagement is a significant element to awareness in this disease state. DTC efforts cost money, and we will need to strengthen our balance sheet ahead of launch to use this part of our strategy effectively. While Ernie will give you more specifics on our financials, I'd like to share how I think about our cash position. First, we announced last night that we will de-emphasize our AQST 108 studies during this launch period. While we are as committed as ever to 108, this frees up significant capital for commercial activities. Similarly, While we were unhappy with the court outcome on Libervin, and we think this ultimately harms patients, this also allowed us to shift cash from supporting Libervin to the launch of Anifilm. We will opportunistically look to strengthen our balance sheet through ex-US out-licensing of Anifilm and potentially refinancing our debt. These pathways could provide adequate runway for the support of Anifilm, not just through launch, but through the first year of launch and into 2027. We also continue to engage with potential sales and marketing partners in the U.S. However, as I've said before, the conditions have to be just right for this to be our path forward. Now, let me turn to the FDA review of ANIFILM. We are pleased to say that we have already had engagement with the review division regarding our application. As of today, we believe everything is on schedule for receipt of our 74-day acceptance letter in mid-June. We also believe our reviewers remain employed at the FDA, though we do know that Sally Seymour, the division head for pulmonary allergy and critical care, recently announced her retirement. We do not believe this has an impact on our application. We continue to prepare for an advisory committee meeting should the FDA require one. This work remains on schedule, and we continue to believe we will be fully prepared for an adcom well ahead of schedule should it occur. Our regulatory team is also turning its focus to international markets. As I've mentioned before, we expect to engage with Canada, the United Kingdom, and the European Medicines Agency, or EMA, prior to approval of anafilm in the U.S. These activities are in support of strengthening our balance sheet through finding a strategic ex-U.S. partner. Now let's turn to the macro environment for public life sciences companies. For most companies, the last few months have been very difficult. The long-term prospect of tariffs and economic uncertainty has created volatility in many ways, including revenue streams, supply chain, and long-term outlook. In this environment, I am pleased to say we are well positioned. We have examined our supply chain and see minimal risk to price or supply volatility. Importantly, we also house our intellectual property here in the U.S. Simply put, we believe we are well positioned to weather the economic storm that has been impacting small businesses and the life sciences industry. Finally, I want to acknowledge and honor the previously announced recent passing of Dr. Steven Wargathy, our Chief Science Officer. Steve and I worked together for over a decade, and he was not only a brilliant scientist and a colleague, but also a friend. He was a major contributor to the scientific advancement of anisome, and we will honor his memory as we seek approval of anafilm around the world. While we are fortunate to have his mentor, the former chief technology officer and founding CEO, Mark Schoble, take over interim oversight of R&D, Steve will be profoundly missed by all of us. So, as we move forward, our focus over the coming months will be engagement with the FDA on the review of our application engagement with ex-U.S. regulatory bodies on ANIFILM, strengthening our balance sheet through partnerships and potentially debt refinancing, maintaining our strong position in relation to tariffs and economic uncertainty, and more than anything else, having laser-like focus on our commercial launch of ANIFILM. With that, I will turn the call over to Ernie.

Thank you, Dan, and good morning, everyone. By now, you will have seen our financial results in our earnings release that was issued last evening. As we typically do, we will address most of the discussion related to the first quarter results in the Q&A. During the first quarter, we continue to execute on our strategy to support the continued development of the recently filed NDA for NFL, our lead product candidate that has no needle, is not a device, is orally administered and is easy to carry. This included strengthening our balance sheet with additional capital through our ATM facility and pre-commercial launch activities for Anafilm to increase awareness among physicians, payers, and the advocacy community. Equestria's manufacturing business remained steady with a gradual decline of Suboxone being partially offset by growth across newer collaborations, including for the licensed products Andif, Simpazan, and Emilis. Equestria's manufacturing facility continues to diversify its operations to support a broader range of products and collaborations. In addition, being a U.S.-based manufacturer with intellectual property domiciled in the U.S., Our supply chain currently remains largely unaffected by both implemented and proposed tariffs, providing continued reliability and stability in production and global distribution for the near term. Now let's turn to the first quarter results. Total revenues decreased to $8.7 million in the first quarter of 2025 from $12.1 million in the first quarter of 2024. This 28% decrease in revenue was primarily driven by decreases in manufacturer and supply revenue and license and royalty revenue, partially offset by increases in proprietary product revenue net. Manufacturer and supply revenue decreased to $7.2 million in the first quarter of 2025 from $10.5 million in the first quarter of 2024 primarily due to decreases in suboxone revenues partially offset by an increase in UNDIF revenues. License and royalty revenue decreased 30% or $.3 million in the first quarter of 2025 compared to the same period in the prior year. This decrease was primarily due to lower as tar as royalty revenues and lower license revenues associated with the termination of a licensing and supply agreement in the prior year. Co-development and research fees in the first quarter of 2025 remained relatively unchanged compared to the same period in the prior year. Research and development expenses decreased to $5.4 million in the first quarter of 2025 from $5.9 million in the first quarter of 2024. The decrease in research and development expenses was primarily due to lower clinical trial costs associated with the continued advancement of the antifilm development program, partially offset by increases in product research and preclinical expenses, higher personnel costs, and higher share-based compensation. Selling, general, and administrative expenses increased to $19.1 million in the first quarter of 2025, from $10.7 million in the first quarter of 2024. primarily due to regulatory fees of $4.8 million, including the NFL PDUFA fees, higher legal fees of $2.3 million, higher commercial spending of approximately $2.1 million, higher personnel costs of approximately $0.4 million, and higher share-based compensation expense of $0.3 million, partially offset by decreases in severance costs of approximately $1.1 million and lower insurance expenses of $0.2 million. Equestria's net loss for the first quarter of 2025 was $22.9 million, or 24 cents, for both basic and diluted loss per share, compared to the net loss for the first quarter of 2024 of $12.8 million, or 17 cents, for both basic and diluted loss per share. The increase in net loss was primarily driven by the previously discussed changes partially offset by increases in interest income and other income. Non-GAAP-adjusted EBITDA loss was $17.6 million in the first quarter of 2025 compared to non-GAAP-adjusted EBITDA loss of $7.2 million in the first quarter of 2024. Cash and cash equivalents were $68.7 million as of March 31, 2025. Equestrian has revised its full-year 2025 financial guidance as a result of the change in regulatory status of LibraBand and pausing sales and marketing activities for the product. The company now expects total revenue of $44 million to $50 million and non-GAAP-adjusted EBITDA loss of $47 million to $51 million. Our revenue guidance for 2025 no longer includes revenue for LiberVant for ages between two and five years. As a reminder, our 2024 revenue included one-time non-recurring recognition of deferred revenue related to the termination of certain licensing and supply agreements. Our non-GAAP-adjusted EBITDA loss guidance for 2025 includes significant pre-commercial spending for anafilm, costs associated with the recent submission of the anafilm NDA and related filing fee, completion of the anafilm pediatric clinical trial, and preparations for a potential advisory committee meeting, if required by the FDA, for approval of anafilm. With that, I will now turn the line back to the operator to open the line for questions.

Thank you. Ladies and gentlemen, if you have a question or a comment at this time, please press star 1-1 on your telephone. If your question has been answered, you wish to move yourself from the queue, please press star 1-1 again. We'll pause for a moment while we compile our Q&A roster. Our first question comes from Rowena Ruiz with Lyric Partners. Your line is open.

Hey, morning, everyone. So a couple from me. I was curious if you could update us on where you are in your commercial readiness efforts, including CMC, manufacturing, scale-up, et cetera, for anafilm. And I also wanted to see if you refined your goals for hiring a field force for anafilm, including how many physicians would they target out of the gate?

Morning, Rowana. So I'll take the – this is Dan.

I'll take the first. part of your question, then I'll hand it over to Sherry to talk about the Salesforce and how she thinks about it. One of the highlights or things that we're proud of and think is a strength for our company is the fact we have the manufacturing in-house. So as you know, CMC, manufacturing, Scallop, that is all well within our capabilities. And something we've done several times before without issue. So we believe we're very well prepared on that side. We'll have products ready to go day one and that those plans are in place and being worked on. So I'll pass it over to Sherry to talk about the sales force.

Hi, Ruana. Nice to hear your voice this morning. I have to say I'm so excited to be chatting with everybody this morning as we are very focused on a on a successful launch. As you know, I built the team that built EpiPen to over a billion dollars. And as I reflect upon that build, one of the things that I've been looking very closely at is the number of salespeople. And so we will probably start at around 50 sales representatives and focus on the top Epinephrine prescribers, as I'm sure you can imagine, that will include about 4,000 or 5,000 of the top allergists and pediatricians, as well as the NPPAs, the staff that really support the physicians and the allergists in the office. And so that's where we are right now. We're in the process of conducting segmentation and ensuring our marketing mix model works very smart for us.

Yep. Very helpful. And one follow-up for me, I was thinking ahead to the Anifilm launch. Could you explain a bit more about your key goals and interacting with payers to set up broader favorable access for Anifilm? And do you have any idea of the timelines it would take to set up this access in the best case of favorable coverage for Anifilm for a majority of patients?

Right. Well, I'll let Sherry give you her thoughts in a second here, but I just want to reiterate

As you just heard in my comments before, with the work we did on Liberman, one of the great benefits is the contracts that we now have in place, both from a distribution and a payer perspective. So those remain open, and we will definitely be able to leverage those as we go into this launch period. But Sherry can talk more about her specific thoughts on her goals.

Sure. As Dan mentioned, we have hired VP of Market Access, And we took our time to make sure we hired the right person. And so we brought on someone who has experience in small pharma and very large pharma, who knows the payers personally and has extensive experience in launching products. And so we're very excited about her and the team that she is bringing on. As Dan mentioned, we have been working with the payers, both on LiberVant and messaging around AnnaFilm, given the guidance that permits us to do that. And so when we think about the access, as you know, we will be entering a period now of furthering those conversations, and upon approval, be ready to have our contracting strategy implemented. Now, if you take a look and you can just use our competitor as an example, there is timing associated. The payers do require a rather significant amount of time, several months, before they will consider adding to formulary. So I would think about it as kind of the first six months of launch we will be ensuring that we have upwards of 80% coverage by the end of that six months. With Triana, we would take us right into the back-to-school season. So I feel very confident in the team I have to implement and drive that success from a market access perspective.

Sounds good. Thanks a lot.

One moment for our next question. Our next question comes from David M. Sullivan. Piper Stanley, your line is open.

Thanks. So a couple for me. First, can you talk to any learnings that you've gleaned from the launch of NEFI? I know it's fairly early days, but maybe you can talk to the extent to which that product is expanding the market and what you think that could mean for Annafilm. So that's number one. And then number two is on the potential for an adcom. Maybe give us a reminder of that, how you're thinking about that. In other words, what do you think are sort of the key salient topics that would come up in an adcom to the extent there is one? Thank you.

Sure, David. So I'll hand it over to Sherry in a second here again.

obviously, her and her team are on a daily basis watching the market. But I will say to you, we do see the expansion in the market occurring that we would expect. In Q1 of this year, volumes were up 5% over last year. And we do expect, as you've heard me say many times, this market to at least double over the years to come. So I'll let Sherry give you her thoughts, and then I'll address the adcom for you as

Hi, David. A great question. Again, I go back to my EpiPen days. Whenever I took over that brand, we were at about $150 to $200 million in sales. I think one of the things that we learned very quickly is the absolute critical nature of market expansion. And we were able, through market expansion efforts, disease state awareness, patient engagement, and calling on the HCPs And that you're able, this market is promotionally sensitive. And so we saw increases of 25% back in kind of the mid-2010, 11, 12 mark. And so look, at the end of the day, NEFI is doing the same, as Dan mentioned. The more messaging that's out there, the better for all of us. And so I think that they're doing absolutely the right thing. They went out to the physicians first as they're gaining payer access to drive demand, and now you're seeing more patient engagement, social media marketing, and they've announced publicly that they're launching a big DTC campaign. Again, that is fantastic. What is the saying? A rising tide rises all boats, and I think it will benefit all of us.

Thanks, Sherry.

I'll hand it over to Carl in a second for his thoughts on the ADCOM. What I would say in terms of the topics, the specific topics, obviously we don't know, but I would just remind you we've had extensive interaction with the FDA. We've been very transparent about the discussions we've had with the FDA, so I think the issues or topics that we would expect at the ADCOM, I think, are pretty well documented. But Carl can give his thoughts on how we're preparing and

where we are at work. Yeah, thanks, Dan, and David, thank you for the question. It's an important question, and I would just state that this is probably the most robust data set conducted to date for an epinephrine product. We've had over 930 or so dosings, probably 800 plus singles, and 125 repeat doses. It's a comprehensive NDA that was submitted. Difficult to know what the FDA may request of us, but we are those questions may be, and we are in the midst of aggressively preparing for anything that they may want further information on. I would say that this is the first oral epinephrine product, so depending on how they get excited by that and what kind of questions they may have, we'll be happy to respond in due course.

Okay, I'll leave it there. Thank you.

One moment for our next question. Our next question comes from Kristin Kluska with Cantor Fitzgerald. Your line is open.

Hi, good morning, everybody. Wanted to ask how you envision a new division head for this pulmonology allergy space could potentially influence both an adcom and the review process, and outside of Dr. Seymour, of the people you've been engaging even before you filed, as you currently filed, would you say that there are other changes as well?

Sure. Good morning, Kristen.

So, we in our interactions have not dealt with the division head. We have had the deputy division head as the person who oversaw the interactions. And as of today, and obviously the FDA is an evolving organization in today's environment. But as of today, the review team and the deputy director all remain the same for our program, and those were also the same people for the program that came before us. So from a review process standpoint, all the interactions we've had so far suggest that things are in a normal state, which is positive, we believe. In terms of the ad comms, As we've stated before, the best I can tell you is we are ready. We want to have an ad come. We are ready. We hope it happens. I do have some doubts, I will tell you, on whether the government is in a position to make things happen for an ad come, but we will be ready, and we hope it does happen.

Thank you so much.

One moment for our next question. Our next question comes from Jason Butler with Citizens JMP. Your line is open.

Hi, thanks for taking the questions. Two for me. First of all, can you just talk about where you think awareness of Anafilm with providers is today and how you're measuring or assessing how that awareness is building throughout the year or heading into the launch? And then secondly, when you think about the seasonality of the market as well as time taken to get payer access, How should we think about the adoption curve in the first few months of the launch? Thank you.

Sure. So I'll pass it over to Sherry for both of those items.

Good morning, Jason. You know, as we think about Anafilm and knowing that we certainly have created a transformational epinephrine for patients and their caregivers. As the only non-device oral epinephrine, physicians are very, very excited about the product. So we've done upwards of a thousand interviews with patients and HCPs alike. There continues to be incredible excitement. As Dan mentioned, we are, from a medical perspective, engaging heavily with KOLs and the allergy community. So I believe our awareness is growing significantly. We did conduct a baseline ATU trial at the end of December, and so we are measuring how that awareness continues to grow. But that is where all of our focus is right now, as again, Dan and Carl's team have really been engaged in being at a variety of not only the big conferences, the big allergy conferences, but also state and regional conferences to share the exciting brand that we have for patients suffering from severe allergic reactions. So I feel really good about the awareness and how it is growing to prepare us for a fantastic launch in COVID. early Q1 of 26. As it relates to your second question, how do we think about seasonality? This market is pretty tried and true. You start to see the pickup in the April-May timeframe. It really peaks, again, August and September in that back to school timeframe. And so, as we've mentioned previously, we are engaging with the payers now. As soon as there is approval, we will work to have the contracting complete as quickly as possible. I do think that you can look to the NEFI curve to a certain degree to say it will probably follow this similar uptake. The payers take their time. Some have time. blocks for the first handful of months, but we will have other ways for patients to access the medication. Now, with that being said, I do feel super confident. By that back-to-school season, we will have the majority of the market covered for our access, and that will be the most important time, so that August, September, October timeframe. Does that answer your question?

That's great. Thank you very much. One moment for our next question. Our next question comes from Ram Salvaradu with HC Wainwright. Your line is open.

Thanks very much for taking my questions. Firstly, on Anafilm, I wanted to ask if you could comment on your thoughts regarding direct-to-consumer advertising strategies that would be most appropriate to support this product, what those might look like, specifically how they might be similar to, analogous to, or differ from the DTC advertising that's been used in support of NEFI so far. And also, if you could give us a sense of when in the launch trajectory you consider it most appropriate to deploy such strategies. Thank you.

Right. Good morning, Rob. I'll hand it over to Sherry in a second to talk about is important for awareness, right? It is a great way to drive awareness around the disease state and to drive people to their physician to ask about what they should be doing. If you listen and watch a lot of DTC advertising, oftentimes the product isn't as prominently focused in that DTC as it is the awareness of the disease. So we actually believe And I'll borrow from Sherry's statement before. We firmly believe that a rising tide raises all boats in this particular market. This is a very large market. It's an expanding market. And we believe that the DTC efforts of anyone in this market helps the overall group. So in terms of our positioning, look, if you take away anything from today's call, it should be that we are focused. physician's offices where we can win, where we can make sure our scripts start to flow, and that will be the number one priority. DTC, well, I don't want to steal Sherry's thunder, so I'll let her talk about where we would layer in DTC.

Yeah, it's a great question, Rob. So, again, when you think about a launch, first and foremost, physicians have to be aware of the product. And so the focus is typically heavy physicians for the first several months, while you're also in parallel beginning the DTC effort. So social media, digital advertising, working very hard with the patient advocacy groups that can make patients aware. So if you think about kind of the... as I'm thinking, I should say, of the launch of Anafilm, I'm thinking of it in three buckets. One is awareness, the second is preparedness, and the third is access. So awareness is critical. Awareness of the HCPs is critical. A physician has to be aware of the product, know how to write the product, know what to expect. And so, again, that's what you've seen with our competitor. That's what you see, really, with most pharma brands that are very DTC-focused. While that is happening, patients are also being made aware through, again, social media, digital advertising, print advertising, and now radio advertising has come back on the market. And so patients are becoming aware. So you have an intersection where the patients are in the offices, they are speaking with the physicians, You have the sales reps out there. We're working to make more and more physicians aware of the product. And so you have this intersection where a physician is ready to prescribe and the patient is ready to receive. So again, first and foremost is that HCP promotion. You start to layer in more and more DTC promotion as your coverage, your market access coverage increases. And so you would expect that, and just like you're seeing with our competitor, They'll be out eight months. They're starting to talk about their heavy DTC campaign. That's how really big brands think of direct-to-consumer, and that's based on my experience as well.

Thank you. And then just following on from that, I was wondering if you could just describe for us the distribution infrastructure and the channel that's likely to be used in support of Anafilm as and when the product gets approved for the U.S., and also if you could talk a little bit, particularly in the context of the most favored nation pricing construct, how you are thinking about optimizing the opportunity for anafilm outside the United States and what you currently consider to be the highest value territories for the product ex-U.S.

Sure, Rob. Let me go in almost reverse order, so I'll leave. Let me address the most favored nation comment you made, which I think is in reference to the executive order that we saw come out yesterday from the White House. From our perspective, for companies like us who are up and coming, are agile, are looking to be disruptive and different, there's nothing but opportunity in some of the different ways that things seem to be evolving. As you saw in that executive order, there was actually a mention of finding ways to cut out the middlemen. We would love that, right? I don't know if it's completely practical in today's world, but those are things that we as a smaller, flexible company love and would like to take advantage of as time goes on. In terms of outside the U.S., and Ram, as you know, that's really just data and data is public. The biggest markets to focus on are Canada, the UK, and Germany. So that's why we've said that our international interactions this year with regulatory bodies will be Canada, the UK, and EMA. So we've lined those up with where we see the value XUS. With that, I'll let Sherry take on the distribution.

Sure. And as you know, NFL is absolutely transformation, will be transformation. upon approval, absolutely transformational for patients and caregivers alike. What we do know is this is still predominantly a retail-driven product at the corner of health and happiness, distribution through the retail channel. However, our market access lead, who we brought on specifically based on her experience looking at and using alternate distribution channels and models. And so we are assessing the different ways in which a customer, a patient, or a caregiver can access Anifilm. And so, yes, you would expect it to be in your local CVS and Walgreens, but you can also expect to see other ways in which a patient will be able to access Anifilm.

Thank you. One moment for our next question. Our next question comes from Gary Nespin with Raymond James. Your line is open.

Hey, guys. Good morning. This is Dennis Resnick on for Gary Nespin. Thanks for taking our questions. So first, for Anifilm XUS, if you're looking for a partner there, would you want them to do the regulatory submissions in those international markets, or would that be something that you would take on your own? And then is an XUS partnership something that we could hear about this year? And then when we think about the U.S. commercialization and launch, Can you just talk a little bit more about what your ideal early adopter prescriber of anaphylone looks like? And then I've got one follow-up.

Thanks, Dennis.

So I'll let Sherry in a minute talk about how she thinks about HCPs in patients and the ideal adopters. In terms of the ex-U.S. regulatory submission strategy, that is definitely partner-dependent. But I would say this. We have an excellent regulatory team that does a phenomenal job, not just here in the U.S., but in our interactions around the world. As you know from our previous engagements and partnerships, we have extensive experience at XUS. And so the engagement with regulatory bodies and even submitting XUS is not an issue for us to support. Again, that would be more partner-based on what the right setup would be. In terms of timing, Dennis, I learned long ago in this role that timing is a dangerous thing when it comes to partnerships. What I would tell you is that we are very active on engaging on that front and that as we learn more and as we understand how that will evolve, we'll communicate as we can. With that, I'll let Sherry take on the number.

Good morning, Dennis. Thanks for the question. It's a great question. As we have done more than a thousand interviews with HCPs and patients, even most recently, what we continue to hear is that there is still an enormous unmet need for a non-device that is discreet, convenient, easy to carry, and easy to use. And so while there are more choices now, there is still a tremendous unmet need. As Dan mentioned in his earlier comments, it is not atypical for us to have parents, teenagers, and physicians come up to us at the conferences and say, oh my gosh, I would absolutely carry this. I can put it on the back of my phone. It's like an extension of myself. And so Anafilm will fit into patients' lifestyles, I believe, better than any product. that is currently on the market. And so as we think about who our early adopters will be, what we're thinking is that, first of all, it's the physicians that are seeing the majority of patients. It's the physicians that are hearing from their patients or their patients' mothers that my kid still doesn't carry. My kid doesn't want a device. And so we believe that the adoption will be in early prescribers of our competitor, as well as then those physicians who continue to hear that patients want an oral medication. And I'll just leave you with this. In some of our market research that we did with physicians, 95% of physicians believe that a film dosing option fills an unmet need in the epinephrine market. 9.5 out of 10 physicians. That's a lot of doctors. And 85% have told us that they will prescribe a film dosing option, and they expect their prescriptions to increase. And so while I'd love to boil the ocean and be able to impact tens of thousands of physicians, we are going to have a very targeted, very focused approach to call on the highest decile prescriptions in order to drive that early adoption and that early revenue stream. Does that answer your question?

Yes, that is super helpful. Thanks so much. And then just one quick follow-up on the top line pediatric data that you had previously presented. When we look at the geometric mean adjusted epinephrine concentration between the pediatric and adults, can you just provide a little bit more color as to why the pediatric patients perhaps saw an increase earlier than the adults, and then why they didn't reach the same high concentration? Thanks for all the color, guys.

Yeah, I'm going to pass it over to Carl, but just to reiterate our view on the pediatric data, we think that pediatric data is exactly in line with expectations and is supportive of the product having a label down to 30 kilos and up. But I'll let Carl give you some more specific thoughts.

Yeah, no, appreciate the question. I would just remark that the data that we've evaluated is completely in line with what we had expected and hoped for based on the known characteristics of the adult dosing and So I appreciate the observation, but when you look at the data in detail, it's completely in line with our hopes and our expectations. We are very excited about this data.

Great. Thanks so much, guys.

One moment for our next question. Our next question comes from Nelson Cox with Lake Street Capital Markets. Your line is open.

Great. Thanks for taking questions, Nelson. On for Thomas. First one, just wondering maybe quickly if you can talk about the cash you believe you'll need for the launch of Anafilm. Just any commentary there I think would be helpful. Sure.

Well, I'll pass it over to Ernie in a second. But let me just frame cash because that's a really important piece for launch, right? First, I would remind everyone, especially as this company has evolved over the last few years,

we have something of incredible value, and we are focused on making sure that we maximize that value for our shareholders. So we're actually very excited about where we are, especially from where we've come from, and we think we have a lot of optionality that we did not have when I look back several years ago. But I'll let Ernie give you a little bit more specifics around that.

Sure, Nelson. We have, as Dan said, something very valuable. And with that, we have a number of paths to help finance the launch. And just to reiterate, we have said we are not hiring one sales rep until we have approval. We will do all the preparatory work, we'll do all the pre-commercial work this year, but we will not spend money on sales reps until we have approval and then we will ramp up to be prepared to sell as soon as possible. Our cash provides us runway through this year and the initial stages of that launch next year. But we have a number of levers to pull on how rapidly we spend our cash. And also, as previously mentioned, opportunities to partner Anafilm outside the U.S., refinancing our debt, all these non-dilutive ways to help fund the launch. So we feel we're in a good position to be prepared for next year.

Perfect. That's helpful. Thanks. And then maybe just a two-parter quick. Will you recognize any Librevent revenue in the second quarter? I know it would probably be minimal, but any commentary there? And then When is the earliest you might know about an advisory committee meeting?

The revenue for LiberVant in the second quarter is minimal. And just to reiterate what I said in my comments, our guidance for this year, revised guidance, we've essentially taken out LiberVant completely for the rest of the year. revenue we reported even for the first quarter is not significant, even though we were making great progress on ramping up Liberman, but we're not reporting a significant amount of revenue for this year for Liberman. But importantly, we are taking out expenses that will add incrementally to our cash for the rest of the year.

And Carl, do you want to take your thoughts on when we would know when an ad comes? Sure. So the FDA, the division in particular, clearly has liberty to alert us at any time, but we are certainly hopeful they would do so by day 74, but obviously it's at their discretion.

Great. Thanks for taking the questions, guys. One moment for our next question.

Our next question comes from James Malloy with Alliance Global Partners. Your line is open.

Hi, guys. Matt Venezia on for Jim. Thanks for taking the questions. So about the potential partnership XUS for distribution of anafilm, how would you characterize the partnership environment currently? And in terms of AQST-108, when would you anticipate potentially reprioritizing that clinical development. Should we look at it in sometime in 27 post-launch of Anafilm? Thanks.

Thanks, Matt. Let me go in reverse order. I just want to reiterate, and I made this comment earlier, but I want to make sure I make it clearly. I believe 108 is a great product. I believe there's a big opportunity for the company there area. So in no way are we backing away from how much we like 108, but there's millions of dollars that we were going to spend on 108 this year that are better off in the hands of Sherry and our Annafilm launch. So my goal, my desire is to get back to prioritizing 108 as soon as possible, but we will not do that in any way that sacrifices any ability to launch Annafilm the best way we In terms of the partnership environment outside the U.S., I would say it's active. You obviously saw our competitor have a deal in Europe with another company. There are other companies that are interested in being in that market, and we're in discussions with the right people. So we'll continue to push that along, and we'll tell you more as we know more.

Great. Okay. Thank you guys for taking the questions.

And I'm not showing any further questions at this time. I'd like to turn the call back over to Dan for any closing remarks.

Thanks, Kevin. And hopefully the theme you heard from us today came through loud and clear, which is we are focused on the launch of Anifilm. And that's the right place to be for this company at this time with the filing in at the FDA and the launch clock ticking down. We appreciate you joining us this morning. And I look forward to updating you, everyone, as we progress through our NFL and FDA review period and as Sherry and her team continue to prepare for launch. With that, I wish all of you a great rest of your day.

Thank you, ladies and gentlemen. This thus concludes today's presentation. You may now disconnect and have a wonderful day.