BioDelivery Sciences International, Inc.

Good day, and welcome to the Biodelivery Sciences First Quarter 2020 Earnings Call. Today's conference is being recorded. At this time, I'd like to turn the conference over to Ms. Terry Coelho, Chief Financial Officer of Biodelivery Sciences. Please go ahead, ma'am.

Thank you, and good afternoon, everyone. Welcome to our First Quarter 2020 Earnings Conference Call. Leading the call today is Herm Kukier, Chief Executive Officer. We are joined by Scott Fesha, President and Chief Commercial Officer. Following our prepared remarks, we will conduct a question and answer session. After the market closed today, Biodelivery Sciences issued a press release announcing its financial results for the first quarter 2020. A copy of the release can be found on the investor relations page of the company's website. Before we begin, I would like to remind everyone that certain statements may be made during this call, which may contain forward-looking statements. Such forward-looking statements are based upon current expectations, and there can be no assurances that the results contemplated in these statements will be realized. Actual results may differ materially from such statements due to a number of factors and risks, some of which are identified in our press release and our annual, quarterly, and other reports filed with the SEC. These forward-looking statements are based on information available to BDSI today, May 7, 2020, and the company assumes no obligation to update statements as circumstances change. An audio recording and broadcast replay for today's conference call will also be available online in the investor section of the company's website. With that, I'd like to turn the call over to Herm Kukier. Herm?

Thank you very much, Terri, and welcome, everyone, to our company's first quarter 2020 earnings call. I recognize these are extraordinary and challenging times and hope you and your families are well and healthy. With regard to the first quarter performance, I am very pleased to report that we once again established an all-time high for total company net sales of $38.3 million, representing growth of 94% versus the first quarter of 2019. Belbuca Ensign product prescriptions grew 52% and 19% respectively year over year during the first quarter. These strong results were fueled by positive momentum for both products through the early part of March, at which point we began to experience the impact of the COVID-19 pandemic. Nonetheless, through the hard work and dedication of our employees, we were able to rapidly transform our commercial approach and successfully finished the quarter with record-level performance. Turning to the COVID-19 situation, I am very proud of how our employees responded to this unprecedented challenge. Our focus has been and remains on our greater mission of helping support patients suffering from chronic pain while also ensuring the health and safety of our employees and customers. As the pandemic materialized, our number one priority was to meet the needs of patients and the healthcare providers we serve. We acted quickly and swiftly on three fronts. First, we ensured constant supply of our products as they provide important clinical relief for patients suffering from chronic pain. Second, we transitioned our customer engagement to virtual support and launched an array of new customer and patient service programs. And third, we established an internal COVID-19 cross-functional committee to vigilantly assess the market trends and dynamics, benchmark best practices across the industry, and ensure hyper-focus to navigate through this unprecedented situation. We believe these actions are having a beneficial impact based on the brand trends we see in the second quarter thus far, and believe they will be important components for renewed momentum as our customers return to more normal operations. In addition to the successful customer initiatives and services, which we launched since the start of the pandemic, the organization continues to make important progress on many other aspects of the business. One of our stated objectives has been to expand Bobuca access for Medicare and major regional commercial plans with the aim to match the level of success we've achieved across commercial national plans. To that end, I am very pleased to share that we have recently gained preferred position within multiple Medicare plans, expanding access to several million covered lives. In addition, we have expanded access within several prominent regional institutions, which offer both their own covered lives, as well as potential influence on clinical practice within their metropolitan communities. On the supply side, we have continued to increase our supply of finished goods to approximately four to six months of inventory on hand for all seven doses of Belbuco. This represents a significant increase since the start of the pandemic. We have also secured sufficient materials to continue production into 2021. Our ability to make investments in the new customer programs, building further inventory of supply, and continuing successful operations in the organization is a result of the key immediate reorientation and action by the company as the pandemic surfaced. We began the year with a strong balance sheet and were able to further strengthen our position with a very successful first quarter. Ensuring financial durability is a key strategic priority for BDSI, and we are prudently managing our spend during this period to protect and steer the business through this near-term disruption while continuing to invest towards long-term sustained growth. The COVID-19 pandemic is an unprecedented and fluid circumstance with significant near-term uncertainty. We had a great deal of confidence in the growth momentum of our portfolio, which led us to provide full-year guidance in November of last year. The performance during the first quarter, with some puts and takes, exemplifies the potential for sustained momentum in the brand. While we remain confident that differentiated clinical benefits of our products and the underlying demand we were seeing from physicians and patients, the near-term uncertainty around the pandemic leads us to withdraw guidance for 2020. We remain hopeful that as states begin to remove stay-in-place orders, physician offices and clinics will resume more normal patient care activities with corresponding market performance. We look forward to providing updates as events in the country unfold over the next few months. To conclude, I am very pleased by the success of the first quarter as well as how the organization has responded to the challenges presented by the COVID-19 pandemic. We have therapeutically important products, a strong balance sheet, and a talented and committed team of employees. We remain poised to successfully navigate through the short-term uncertainty and achieve our ambition of long-term sustained growth. With that, I will turn the call over to Scott to provide more details of our performance during the first quarter and our new promotional tactics in 2020. Scott?

Thank you, Herm. As Herm mentioned, during Q1 2020, we reached another record for Belbuca prescriptions of more than 99,400 retail TRXs. This represents a 52% increase in Belbuca TRXs compared to the first quarter of 2019 and and a 3.5% increase over the fourth quarter of 2019. We were building momentum during the quarter, and our trends supported Delbuca exceeding expectations in the first quarter and beyond. The early momentum we built was slowed toward the end of the first quarter by social isolation measures began to be implemented nationwide in March. During this slowing of growth, Delbuca Q1 TRX market shares increased to 3.6%, from a Q4 2019 market share of 3.3%. It's also encouraging to see Balbuca market share increased to 3.8% through the first three weeks of April. During the first quarter, Balbuca's new-to-brand market share of 7.3% held steady from the fourth quarter, and March finished at 7.8%, well above the TRX share of 3.6%, and there's still significant opportunity to grow total prescription share as these metrics historically converge. Our Belbuca prescriber base continued to grow in the first quarter, a testament to the execution by our sales team. We grew our Belbuca prescriber base in the fourth quarter by over 1,100 new prescribers, the fifth quarter in a row where we added more than 1,000 new prescribers, reaching over 7,600 total unique prescribers in the quarter, an increase of 28% versus the same period a year ago. As we entered Q2, we were able to improve Delbuca coverage from non-formulary, not covered, to covered or preferred status in over 2 million Medicare Part D lives within Express Scripts, Select Health, and UPMC Health. Furthermore, we believe that with additional work, we have the potential to add several million more Medicare lives as we head into 2021. On the commercial side, we improved our coverage within two prominent commercial plans, Highmark Blue Cross Blue Shield and UPMC. While we were previously covered within Highmark, patients will no longer be required to fail two long-acting opiates before accessing Belbuca. Importantly, UPMC has moved Belbuca from a non-formulary, not covered status to covered with a typical class prior authorization. The BDSI commercial team has a proven track record of pulling through market access wins and is focused on maximizing these opportunities. This is displayed in the results we've seen in Prime Therapeutics since this win was put in place during Q4 and Q1. We have seen Bell Buca TRX market share within Prime go from 3.9% in Q3 of 2019 to 4.7% in Q1 of 2020. Simproic Q1 retail prescriptions reached over 16,100, representing a 19% increase year-over-year compared to Q1 2019. During Q1 2020, we generated a 13.3% NREC share and 11.7% TRX share, representing the highest market shares to date. We expect continued TRX and revenue growth for Simproic as its NRX share has consistently exceeded total Rx share since May 2019 and was 13.8% in the month of March. In the first quarter, we successfully added 1,170 new prescribers for Symproic, which helped the brand reach a new quarterly high of almost 5,000 prescribers. We continue to view Semproic as an extremely promising brand and believe our early 2020 market access wins within Prime Therapeutics and CVS will be catalysts for growth in 2020 and beyond. The BDSI sales force has done a strong job taking advantage of these wins as improved our TRX market share within Prime Therapeutics from approximately 20% in Q4 to 44% in Q1 and from 10.5% to 13.7% within CVS Caremark. We are very proud of these results that our team generated during Q1, especially with the headwinds that we faced due to the COVID-19 pandemic. While the influx of new patients to our products has slowed, much like we're seeing in the broader markets, we are encouraged by the refill rates we are seeing and the steady TRX trends. As the impact of COVID-19 grew, our primary focus was to support our HCPs and their patients. We accomplish this by reinforcing the many resources available to patients and HCPs and the unique attributes our products possess. As Herm highlighted, our commercial team rapidly pivoted to a new virtual promotion environment in the quarter. We continue to implement new ways for our territory managers to remain engaged with their target physicians and office staff, and for doctors to maintain a dialogue with the company and their peers about Belbuca and Semproic. We have now implemented a new virtual engagement platform, an enhanced email communication portal, and virtual speaker programs. These initiatives have resulted in the sales force having over 5,500 touch points with HCPs and their staff each week, a meaningful increase over the typical number of interactions in any given week. It's also been encouraging to see the high interest HCPs have exhibited in learning more about Balbuca from their peers through our virtual speaker programs, where we have averaged well over 15 attendees per program. We also promptly recognize that patients may face disruptions in insurance coverage and income during the pandemic, and have created initiatives to help secure and preserve access. First, we are in the process of implementing a hub service which should be fully functional by the end of May or early June. This service will assist with prior authorizations at a time when the pain practices we support may be short staffed and not have the same capacity to assist patients with the prior authorizations their insurance providers may require. Secondly, recognizing that current patients and potential new patients may experience changes in their insurance coverage During this challenging time, we've recently expanded the co-pay assistance program for Bell Buca. We've begun offering a maximum out-of-pocket amount for commercial patients that may now be uninsured or underinsured. Our goal is to make Bell Buca more accessible during these difficult times. Taken together, we hope that these initiatives will help keep our brands relevant and available to our customers and patients. and will maintain our position as a key partner in the treatment of chronic pain and opioid-induced constipation. We had a very successful Q1 that resulted in another record quarter for revenue and many other important growth metrics for Belbuca and Semproic. Our Q1 results supported the growth trends we had in place prior to our momentum being slowed by the impact of the COVID-19 pandemic. We also believe that our recent market access wins for both brands, and our successful track record of executing against these wins will support the growth of Albuquerque and Semproic. In concluding, I'm particularly proud that our sales and marketing team pivoted so quickly to effectively implement new initiatives to support our healthcare professionals and the patients they support during these challenging times. With that, I'll turn the call over to Terri to provide an update on the financials. Terri?

Thank you, Scott. As Herman Scott discussed, we are very excited to report outstanding first quarter results, which have once again exceeded expectations across the board for both sales and profitability. Total net revenue for the first quarter 2020 was $38.3 million, an increase of 94% compared to $19.8 million in the first quarter of 2019. In addition, total revenues in this first quarter increased by 21% compared to $31.6 million in the fourth quarter of 2019. Belbuco net sales in the first quarter were $33.5 million, an increase of 79% compared to $18.7 million in the first quarter of 2019. The net sales growth of 18% in the first quarter versus the fourth quarter of 2019 was primarily driven by the continuing growth in prescriptions, which Scott shared, favorable gross-to-net deductions, and higher average price driven by the favorable dose mix and the impact of the price increase enacted in January. Proic has been an ideal complementary product for BDSI, as we were able to effectively integrate it into our product portfolio and take advantage of the substantial overlap in the target prescriber base. Proic net sales in the first quarter and at March 31, 2020, were $4.2 million, an increase of 54% versus the fourth quarter of 2019, driven primarily by favorable gross-to-net deductions and the impact of the January price increase. We were pleased to see that we were able to end the first quarter with wholesaler inventory levels comparable to previous quarters for both Elbuca and Syncroic. Bunavale net sales for the first quarter were $100,000 compared to $1.1 million in the first quarter of 2019. In March of this year, the company announced the planned discontinuation of marketing of Bunavale in 2020. Royalty revenues for ex-U.S. sales of Painkill and Brakehill totaled $563,000 for the three months ended March 31, 2020, a decrease of $600,000 when compared to the fourth quarter of 2019. Total gross margin for the quarter was 85% as compared to 80% in the first quarter of 2019 and 77% during the fourth quarter of 2019. The increase versus the fourth quarter of 2019 was primarily due to the fourth quarter one-time impact of approximately $3.8 million in costs associated with the planned discontinuation of marketing of BunaVale. Gross margins for both Belbuca and Semproic were approximately 87% in the quarter, in line with the fourth quarter of 2019. Total operating expenses in the first quarter of 2020 were $26.7 million compared to $17 million in the first quarter of 2019 and $23.8 million in the fourth quarter of 2019. The year-over-year increase is primarily driven by the impact of the expanded sales force and market access teams, as well as the establishment of the medical affairs and MSL team, together with the introduction of Symproic into the company's portfolio. The quarter-over-quarter increase reflects the impact of planned marketing investments and the phasing of key initiatives. Gap net income for the first quarter was $5 million, or a net income of 5 cents per share, compared to a gap net loss of $3.8 million in the first quarter of 2019, or a net loss of 5 cents per share. The first quarter's net income reflects our overall revenue growth, coupled with improving gross margins, as well as our improving operational efficiencies. EBITDA in the first quarter of 2020 was $7.8 million, or 20% of net sales, compared with $100,000 in the first quarter of 2019 and $4.1 million, or 13% of net sales, in the fourth quarter of 2019. Non-GAAP net income for the first quarter was $8.3 million and reflects GAAP net income, excluding stock-based compensation and non-cash amortization of intangible assets. This compares to non-GAAP net income of $6.4 million in the fourth quarter of 2019, excluding stock-based compensation, non-cash amortization of intangible assets, and the one-time non-recurring impact of the discontinuation of marketing of BunaVale. At March 31, 2020, BDSI had cash and cash equivalents of $70.6 million, as compared to $63.8 million at December 31, 2019. Operating cash flow in the first quarter was $6.4 million, with overall cash flow in the quarter of $6.7 million, compared to $8 million in the fourth quarter of 2019. We are pleased to have entered 2020 and the second quarter with a healthy balance sheet. This strong financial foundation positions us well to manage through the current period of uncertainty. As Herm shared already, we are managing our expenditures prudently, ensuring continuation and prioritization of key initiatives. I'm very proud of the BDSI finance team who rapidly transitioned to remote working and closed the quarter seamlessly. Overall, as a company, we are proud of our resilience and the team's ability to very effectively adapt over the past quarter, and look forward to continuing to bring meaningful clinical value to our patients. We'd now like to take your questions. Operator?

Absolutely. If you'd like to ask a question, please signal by pressing star 1 on your telephone keypad. If you are using a speakerphone, please make sure your mute function is turned off to allow your signal to reach our equipment. We'll go first with Brandon Foulkes from Kentor Fitzgerald. Please go ahead.

Hi, thanks for taking my question, Dan. Congratulations on the quarter. Firstly, maybe one on the quarter. You talked about a favorable gross to net. This will call out the potential for the increased co-pay assistance for the rest of the year. Can you just help us think about gross to net for the remainder of the year? And then maybe can you provide some color in terms of what you're seeing in April with new-to-brand patient stocks And secondly, are you seeing any signs of persistency creep up as patients push off elective surgeries? Or could you maybe provide any color in terms of what percentage of patients on Bob Bucher may be managing their pain ahead of an elective surgery? Thank you.

Hey, Brandon. Thanks for the questions. I'll start out and then I'll pass it over to Herm to build upon that. So, first of all, on the gross to net, I think we do see typically in the first quarter of most years you have some favorability. You don't have the Medicare donut hole impact, which tends to increase as the year moves along. So that's certainly one of the drivers as we look at the phasing throughout the year. I think overall our growth to NETs have been pretty stable now for about a year, and I would expect at this point that it would probably stay in or about that same range, knowing that as the year progresses, you do have the Medicare, and particularly have the Medicare donut hole impact. I guess, Herb, do you want to take the second part of his question?

Actually, Terry, I think I'll take it. This is Scott. Thanks for your question. So first, regarding the new-to-brand, Great insight because obviously the exposure, the amount of patients going into offices now has been reduced. What we're seeing is a new-to-brand impact that's comparable to the marketplace. It's basically down 20% to 25% at this point in time. And so as we look at that, I think tying it into things like persistency, I think persistency right now, you have to look at persistency over three to six months. typically. So we really don't have the data to look at that and long-term know if it's going to be stickier over time. One thing that are encouraging is that the Nudibrand has been pretty flat within the market and for Belbuco over the last four weeks. So it's been steady, much like our TRXs. The thing we are seeing is repeat prescriptions actually staying fairly well on trend at this point. So kind of the refill rates staying in line and being consistent as well. One thing, another thing you might be thinking about is adherence. One of the things we're seeing across the entire pharmaceutical industry is a higher adherence rate for brands. We don't have data yet down to our level to look at that. But in fact, patients are not abandoning scripts at the rate they used to, so they're more likely to get them filled.

Great. Thank you very much, and congratulations to everyone on the quarter.

Thank you.

Thank you, Brandon.

Thank you. We'll next go with Greg Frazier from FundTrust. Please go ahead.

Thank you. It's Greg Frazier on for Greg Gilbert. I'm not sure I missed this, but was there any stocking of note in the quarter for Delbuca?

Hey, so, no. Actually, as I commented, we were really pleased to see that the quarter ended with very consistent wholesaler inventory, as we've seen in all the prior periods for the last year or so.

Got it. And then you mentioned that you expected gross to net to stay in the same range. I guess that means you're not anticipating material pressure on gross nets from the new patient support programs?

I mean, I guess what I would say is we've looked at it. Certainly, Scott and I have spent a lot of time on it, and we think it will balance. And when I say consistent, remember, as I mentioned before, you do have a little bit of inching up as the year goes on because of the Medicare impact. But overall, you know, we've talked about low 50s for Belbuca and low 60s for Semproic, and I still feel that those are good ranges to be thinking about.

Okay. Got it. Then on expenses... you're managing expenses prudently. Can you speak just generally about expense cadence in the coming quarters? Not a guidance question, but clearly some costs are coming down for you and others, other costs may be going up. Is there any additional color you can provide on spending? That would be helpful.

Yeah, I think, Greg, what we've indicated for this year and what we put in place for our plans for this year has been spend in the, let's say, the mid-20s on average, with some fluctuation always when you move from quarter to quarter. I think you're right that it's most likely that our T&E spend in the second quarter will be lower than we would have planned, but we're also obviously investing in some of the virtual programs that we're doing. So overall, I think that's still a good range to be thinking of. You know, we do have fluctuation from one quarter to the next, but those mid-20s is the right way to be thinking about it.

That's helpful. My last question is on business development and whether you're still actively evaluating opportunities or have things sort of slowed down on that front, given all the uncertainty with respect to COVID? Thank you.

Hi, Greg. This is Herm. Thank you very much for your questions. And obviously, as we said during our presentation today, our primary focus is on patients and the customers that we serve. And We've been hyper-focused on ensuring that they have everything they need to get through this extraordinarily difficult time. I think the long term for this organization, we continue to be one that focuses on continued growth. As Terry highlighted, we have a very strong balance sheet. We're going to continue to find ways to invest in driving top-line growth, and that will remain our focus. But to your point right now, I think everyone is appropriately focused on navigating through the uncertain times of the pandemic and ensuring that our customers have what they need and that we can service them as best as possible.

Thank you. Thank you.

We'll next go with Tim Chang from Northland Securities. Please go ahead.

Hi, thanks. Really just two questions. Obviously, you guys have had a strong history of execution. And it looks like you've had another strong first quarter. And obviously, you've taken guidance away. And I guess, you know, my first question is sort of, you know, how do you sort of see this year progressing? You know, obviously, it's kind of hard to predict how good you can do. But it looks like you've got a lot of momentum behind both products. You're getting good insurance coverage. You know, what can you do in this type of environment to sustain this type of growth?

Thank you very much for your question. Maybe I'll start with that, Scott, and maybe you can build upon that from maybe emphasizing some of the programs that we put in place. Because I think some of the programs that Scott highlighted, and maybe we'll emphasize in the second component of the answer to this question, are ones that are very acutely important now, but actually we believe have real value and merit to our customer base, and ones that we were looking at in terms of elements of helping us continue to drive further growth into the future. And so a lot of these programs, you know, we think will have quite a bit of runway, even as, you know, hopefully the country, you know, begins to come out of the acute pandemic situation. But to your question, yeah, I think, you know, right now we are very pleased by the momentum that we saw in the first quarter of this year, especially, you know, heading into the early part of March. where we're really seeing quite a pickup, as we typically see in the cadence of the script patterns with a product like Bobuca and Synchro. Obviously, the pandemic, as Scott correctly pointed out, has had somewhat of an impact, but we are very pleased by the script patterns relatively that we're seeing during the early part of the pandemic. Again, we're very hopeful that as the country begins to open up, as states begin to remove or let expire their stay-in-place orders, that our doctors can begin to have the same traffic of patients that they had previously and begin to provide the same kind of service to patients and that market performance follows accordingly. So we absolutely believe that our products provide very important therapeutic value to our patients. and we remain very optimistic about the long-term opportunity of these products. Scott, maybe you want to talk just a little bit about some of the other programs that we believe will continue to add value moving forward as well.

Yeah, thank you, Herm. I had mentioned in my prepared comments that we initiated a virtual speaker program, and we were already considering putting speaker programs back in place the back half of the year. So very quickly pivoted and pulled out that forward and obviously are doing them virtually now. And as I mentioned, to have over 15 HCPs on a call just speaks to the interest of the product. The other thing we've looked at is providing the PA support, prior authorization support. And I think right now it makes a lot of sense with again, short-staffed offices that may be stretched that cannot do all the work right now. Maybe they would have been able to previously to help patients attain product. And then the other thing is I'm looking to pull down abandonment rates for commercial pay patients, and especially if they're being stretched right now economically or maybe are underinsured or uninsured. as we go forward here. I think those are going to be really important. I think also there's the right thing to do for patients and for our HCPs. I think the other thing as far as growth goes is we have been very focused on the mid to high deciles. And as we look at our prescriber base, our top prescribers, in fact, are holding up very well during this pandemic. And the other thing I think is interesting is as we look at our The states that are opening up by this weekend, basically two-thirds of our prescriptions come from those states, and then a total of about 80%. When you look at states at this point, anyways, are looking to open up by mid-May or end of May, about 80% of our prescriptions are captured there. So as those open up, our programs layer on top of all this. I think it would be helpful to our brands going forward.

Oh, that's great. I know you guys, just one follow-up. You mentioned two regional plans. What parts of the country do those two regional plans cover?

Yeah, I'm happy to answer that. So they're UPMC and then Highmark Blue Cross Blue Shield. They're very prominent and I guess I'll use the word prestigious plans within the area. of Pittsburgh specifically. They're predominantly New York, but the Pittsburgh market in particular is influenced greatly by them. As Herm mentioned in his remarks, they're not only meaningful as far as number of lives, but they also have an influence just on how things are perceived if they're covered. They're not easy to attain formulary coverage. We're pleased to be able to move them improve their coverage in both those plans.

Okay, great. Thanks a lot. You're welcome. Thank you very much for your questions.

We'll next go with David Amselin from Piper Sandler. Please go ahead.

Hi, this is Zach. I'm for David. Congrats on the quarter and thank you for taking my question. I was hoping that you could speak to the importance that Robluca is a schedule-free product to move this pandemic and what in-demand research has revealed and what the market research has revealed regarding the extent to which this Schedule III designation is influencing prescribing behavior lately. Thank you.

So I'll go ahead and take that question. One of the first things we did the first week of the pandemic after we had pulled our sales force is we wanted to make sure that The HCPs that we support were very aware of the attributes of Schedule III products, specifically the ability to call in prescriptions, so anything that could lower their burden during this time. The ability to call in prescriptions, the fact that they can actually get five refills as well was very important. And then also we provided them with all the phone numbers and contacts for all the mail order pharmacies as well, a larger change, and so that they had that access available to them, something that, you know, all these attributes that would separate us from the Schedule 2. There's really no specific market research we've done at this time during the pandemic to pull out Schedule 3 versus Schedule 2 as far as prescribing habits.

Okay, that's helpful. Thank you.

You're welcome.

Thank you. We'll next go with Matt Kaplan from Leidenberg Dolmen. Please go ahead.

Hi, guys. Good afternoon. Just wanted to dig in a little bit more to the market access wins you've had. It seems like you've had really good success there lately. And can you give us a sense in terms of where you think you could continue that momentum in terms of it gaining momentum even more Part D lives or more commercial lives to really help facilitate the uptake of Belbuca?

Hey, Matt, it's Scott again. I'll take that question. Appreciate it. So as you know, we've done a really nice job. The team's really executed on the market access side to be able to improve Belbuca coverage on a national level. So we've pretty much checked all the boxes on the larger payers on the commercial side of the business. And I think we've stated for the last few quarters that we're really going to start focusing in on some of these tougher regional plans. And in fact, we've done that with this announcement with UPMC and Highmark. So we have that. And as we benchmark and we go back, we're about 60% preferred and 95% covered now on the commercial side. So we've done a really nice job there. So where we can, we'll continue to try to work to even improve our status, maybe even against the other buprenorphine products. And then the other thing we've basically stated is that the Medicare side is an important focus for us going forward. So that's why we're excited to announce that almost over 2.1 million lives, or close to 2.1 million lives, were added on the Medicare side through ESI and then UPMC again and SelectHealth. And these plans were formerly not covered previously. And about 70% of them are at a preferred level. So we've done a nice job here in pulling them through. We're having very meaningful and, I think, productive conversations with other Part D payers. Hard to time when things are going to happen. As you know, I think typical ads happen in January for Medicare. We'll do everything we can to pull things forward like we did this ESI win. Again, we're encouraged by the conversations we're having, but our focus, our number one priority, is opening up access to Medicare going forward. We'll continue to focus on that on the market access side.

That's helpful. In terms of Simproic, it seems like you had really good success versus fourth quarter, 54% growth. What What do you see driving that growth? Where are you taking market share from in the opioid-induced conservation market?

No matter. Scott again. So specifically in my prepared comments, we've done a really nice job in pulling through our market share in both Prime Therapeutics, which was our win that we announced in Q4, but the majority of the lives are in Q1. And then CVS Health was the other one. And so we've done a really nice job in those. And really the market leader here is Movantic. So they have mid-70% of market share. So it's really for us to grow, the business has to come from Movantic to really have meaningful growth. So that's where we're focused on trying to gain share.

And then just the last question, in terms of you mentioned that there were price increases taken early in the quarter. What were the magnitude of those price increases, and do you expect additional price increases throughout the year?

Do you want to take that, Terry?

Yep. Yeah, so thanks, Scott. Hi, Matt. So I think what you can assume is about a 5% net price impact across both the products, Belbuque and Simproic, that we took January 1st.

And then any plans for the remainder of the year? No, no plans.

We feel that was the appropriate level that places us appropriately in the marketplace.

Cool. Well, thanks for taking the questions, guys.

Thank you, Matt.

Good to talk to you.

Thank you. We'll next go with Esther Hong from Janie. Please go ahead.

Hi. Congrats on the quarter. I wanted to ask what you're seeing in terms of patients losing commercial health care coverage. How are you thinking about this moving forward? And then, Scott, can you speak on specific details on the programs you mentioned with regard to these patients? What sort of assistance are you providing to these patients? Thanks.

Thanks, Esther. I appreciate the question. So I think it's really early now to truly understand the impact on commercial insurance. I think it will go down. We may see a little bit of a migration to even some Medicaid as that happens. But I think there are going to be people who just are kind of uninsured for a while. And I think one of the reasons we wanted to step up as a company and try to help patients in that situation what was to help and make sure people have access to Bell Buca if at all possible. So we did implement, it can only be within the commercial side of the business, any kind of copay card assistance, but basically it's a pay no more than type situation at a point where we feel that patients would still be able to afford it and be able to go forward with it. And then the prior authorization side of things, there are patients that still have to do PAs. We've done a really nice job of adding market access. So the hurdle's fairly low across most plans, but there still remains some challenges. It makes it a little bit harder, like in Medicare, for example, where we still have almost 75% of lives are not covered, and there may be step edits. we feel that that will be an area that will be very helpful until we can secure future Medicare access.

Great. Thank you. Thank you. We'll next go with Team Lugo from William Blair. Please go ahead.

Hi, guys. This is John. Thanks so much for taking my question. I was just wondering if you guys are seeing any pull-through numbers of customers maybe ordering two versus one script due to the ongoing pandemic, and how you guys are kind of thinking how prescribing patterns might change as we move into the summer and we can return to some sort of script.

Tim, I apologize. It was a little bit hard to hear your full question. Do you mind repeating it?

Oh, hold on one second. I'm so sorry. I was on a Bluetooth headset that might be, it wasn't working very well. Um, yeah, this is John on for Tim. Uh, I was just wondering if you guys are noticing any pull through in numbers with customers, maybe ordering two versus one scripts to the ongoing pandemic and how you might be thinking about how prescribing patterns might be changing, uh, as we start to return to normal throughout the summer.

Hey John, it's Scott again. So, um, We haven't really seen a two versus one. I think most plans will only allow so many scripts filled at one time. So what we have seen is a slight increase, I mean very minimal, in the average script size, we'll say. So the number of films or tablets per prescription has gone up. And I think that's consistent with what the whole market is saying. I think we've seen some numbers from IQVIA that they're seeing a general, you know, patients will get a fuller script if possible instead of maybe, let's say, usually they would have gotten 40 and they were allowed 60, but were allowed 60, they may be more likely to get to 60 now. So they are filling bigger scripts, and I think that's not just us. It's across the whole industry. And as far as getting back to prescribing, I think... You know, we are hearing from, we have obviously strong relations to their customers, and we do believe that there is some, you know, pent-up demand out there for new patients that just haven't been able to get into offices, you know, to see HCPs. And I think, especially in the opioid space, it's important a lot of times for the HCPs to have them the first time they, especially pain management, to, you know, if they're going to initiate therapy, change therapy, and see them for the first, see that patient, for the first time, they're more likely to do it face-to-face versus over telemedicine. So I do think that that is something to keep an eye on as we go into the rest of the year and how it might impact prescribing and our brand specifically.

All right, great. Thanks, and congrats on the quarter again.

Thank you.

Thank you. There are no questions at the moment.

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