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spk05: Ladies and gentlemen, thank you for standing by and welcome to Experian Therapeutics Third Quarter 2023 Financial Results Call. At this time, all participants are in a listen-only mode. Following the presentation, there will be a question and answer session. Please be advised that today's conference may be recorded. I would now like to hand the conference over to Alexis Callahan, Head of Investor Relations at Experian. Please go ahead, Alexis.
spk04: Thank you, Operator. Good morning. and welcome to Aspirion's third quarter 2023 earnings conference call. With us today are Sheldon Koenig, President and CEO, and Ben Halliday, CFO. Other members of the executive team will be available for Q&A following our prepared remarks. I want to remind callers that the information discussed on the call today is covered under the safe harbor provisions of the Private Securities Litigation Reform Act. I caution listeners that management will be making forward-looking statements. Actual results could differ materially from those stated or implied by our forward-looking statements due to risks and uncertainties associated with the business. These forward-looking statements are qualified in their entirety by the cautionary statements contained in today's press release and in our SEC filings. The content of this conference call contains time-sensitive information that is accurate only as of the date of this live broadcast, November 7th, 2023. We undertake no obligation to revise or update any forward-looking statements to reflect events or circumstances after the day of this conference call and webcast. As a reminder, this conference call and webcast are being recorded and archived. We issued a press release earlier this morning detailing the content of today's call. A copy can be found on the investor page of our website. We will begin the call with prepared remarks and then open the line for your questions. I'll now turn the call over to Sheldon Koenig, President and Chief Executive Officer.
spk08: Thank you, Alexis, and good morning, everyone. Thank you for joining us today to discuss our third quarter results and the progress we continue to make. We are pleased to report another strong quarter. Total revenue was $34 million, which represents a 79% increase year over year. U.S. net revenue came in at $20.3 million, which represents a 45% increase year-over-year, and was driven by a 33% year-over-year increase in retail prescription equivalents. We are proud of the continued strength of our U.S. business into the second half of the year, and believe this reflects the robustness of our clinical data, the efficacy of our life-saving medications, Nexlatal and Nexlavet, as well as disciplined execution of our commercial strategy. We're also pleased to build upon our momentum in new-to-brand prescriptions in the seven months following our clear outcomes readout at ACC in March, bolstered by the cadence of additional impressive data releases and publications since then, most recently at the European Society of Cardiology Congress in August. From March through the end of September, new-to-brand prescriptions grew 61%, with momentum continuing from the second quarter into the third quarter. Next, let me walk through additional highlights from the quarter. As I already mentioned, we delivered continued RPE growth in the third quarter of 33% year over year, demonstrating consistent growth even with our narrow indication. After submitting our regulatory filings to include cardiovascular risk reduction in Nexatol and Nexazet labels last quarter, we're pleased to announce FDA acceptance of our submission with a PDUFA or approval date of March 31st, which is ahead of when we originally anticipated approval. Lastly, regulatory review of our cardiovascular risk reduction label submission in the EU remains on track, and we continue to anticipate its approval in the first half of 2024. During the third quarter, we continue to disseminate new data from Clear Outcomes to educate the market about the benefits of our product. We presented two new analysis at the European Society of Cardiology in August that further support cardiovascular risk reduction. The first analysis demonstrated that benpidoic acid reduces total major adverse cardiovascular events, reinforcing the value of long-term benpidoic acid use and reducing not just the first, but multiple events over time. The second analysis also demonstrated that benpidoic acid reduces time to first major adverse cardiovascular events in patients with diabetes and does not increase the rate of new onset diabetes, which is a key differentiating feature compared to statins and underscores its safety and efficacy in patients both with and without diabetes. Patients with diabetes who are at increased risk for cardiovascular events constitute a large proportion of the primary prevention population that we studied in Clear Outcomes. So, this finding is important. These analyses continue to demonstrate the efficacy and safety of benpatoic acid, further differentiating it from existing LDL cholesterol-lowering therapies, and highlighting its first-in-class mechanism of action. It is not an overstatement to say that our focus is on expanding our label to include cardiovascular risk reduction, which, as we've always said, is the real growth catalyst. And following that is when we will begin to see accelerated prescription growth. To that end, our entire organization is now focused on preparing for this update, and we've begun laying the groundwork to make changes to our sales organization so that we can hit the ground running the moment we receive approval of our new expanded label. Next, our ongoing conversations with payers are continuing to pay off. With recent wins for improved coverage, and utilization management criteria that aligns with clear outcomes data. It is encouraging to see these types of mid-cycle changes with national and regional payers, which are not common, and we look forward to continued progress. Finally, we announced a strategic collaboration with ACC and Amgen to launch the Cholesterol Screening Campaign with the goal of increasing awareness of the importance of LVL screening to help healthcare practitioners more easily identify patients at high risk of a cardiac event who could benefit from treatment. Based on our clear outcomes data, we believe we have the potential to benefit a much larger group of patients than is characterized by our current label, which is quite narrow and indicated only for a small subset of patients. The label we anticipate receiving in March will add a broad cardiovascular risk reduction indication in both primary and secondary populations, as well as remove current limitations. From a commercial perspective, our addressable patient population will significantly increase when we get our new CVOT label next year. Right now, our therapies are only indicated for about 10 million secondary prevention patients with documented ASCVD or HEFH and who are on a maximally cholerated statin therapy. Our new label that we anticipate by March 31st will reflect our clear outcomes data and enable us to be indicated for an additional 20 million high-risk primary prevention patients. And these 30 million patients in total will be our primary focus. There are another 40 million patients in the US who are untreated and at high risk for an event, and those patients represent additional potential upside. We look forward to being able to address the needs of millions of patients who are currently still unable to achieve their LDL cholesterol goals on current therapies alone. With that, I will now hand it over to Ben Halliday, our Chief Financial Officer, for a more detailed overview of our third quarter performance.
spk10: Thank you, Sheldon. Earlier this morning, we issued a press release containing our financial results for the third quarter, which is available on the investor page of our website. Please note that unless otherwise specified, my comments reflect results for the third quarter ended September 30, 2023. As Sheldon already mentioned, we posted strong overall third quarter results. We're pleased to have delivered another quarter of continued growth in retail prescription equivalents, which increased 33% year-over-year and 8% quarter-over-quarter, which was accomplished even with our narrow indication and promotional footprints. The weekly RPE trend also shows persistent strength, largely remaining above the 10,000 RPE mark and repeatedly setting new weekly highs. Growth also continued globally, not just in the U.S. Our European partner again delivered another strong quarter of sales growth in its territories, which highlights the value our important medicines are bringing to patients worldwide. At the end of August, 158,000 patients have now been treated with our therapies in Europe, representing sequential three-month growth of 26% since May. I'll also note that the bulk of this growth has come from existing territories versus newly launched territories, making it even more impressive. Three additional countries were granted approvals during the third quarter, the Netherlands, Slovakia, and Spain, and we look forward to reaching patients in these new markets in the coming months. Turning to our full financial results for the quarter, We reported U.S. product revenue of $20.3 million, representing an increase of 45% year-over-year. Collaboration revenue, which includes combined royalty and partner revenue, was $13.7 million, an increase of approximately 174% year-over-year. Much of this increase was due to tablet shipments that were pushed from the second quarter to the third quarter, as we mentioned in our last earnings call. Finally, total revenue for the third quarter was $34 million, an increase of 79% year-over-year. Turning to expenses, cost of goods sold for the third quarter was $13.4 million, an increase of 106% year-over-year, also driven by the timing of tablet shipments, as I just mentioned. R&D expense was $14.9 million, a decrease of 49% year-over-year, reflecting substantially lower costs following the closeout of our clear outcome study. SG&A expense was $33.2 million, an increase of 33% year-over-year, reflecting higher legal and promotional costs. We continue to track in line with our guidance, expecting full-year 2023 operating expenses to be between $225 and $245 million, which is comprised of $100 to $110 million in R&D expense and $125 to $135 million in SG&A expense. Finally, cash equivalents and investment securities available for sale totaling $114.8 million as of September 30, 2023, compared with $166.9 million on December 31, 2022. I'll note that we ended the quarter with a higher cash balance than we expected, which reflects a continuing dedication to disciplined expense management, even while we continue to invest in initiatives to prepare us to capitalize on our new label as soon as we receive it. We believe we are currently well positioned to have sufficient cash to continue funding operations and support a full-scale commercial launch next year. We will continue to diligently manage expenses, look for ways to generate efficiencies, and potentially slow spend in certain areas as needed. And with that, let me now hand it back over to you, Sheldon.
spk08: Thank you, Ben. I'll now provide additional corporate updates from the quarter. As some of you may have seen, we filed a Rule 12c motion two weeks ago in our litigation case which asserts that the language in our license agreement is unambiguous and can be ruled solely based on the contract itself and the pleadings filed to date, and requests that ruling accordingly. Permission to file this motion was a prerequisite, and the fact that we were granted permission was a win for us. In terms of next steps, all filings are due by November 22nd, after which a ruling could occur in the days or weeks to follow, which means that we could potentially have an answer by the end of the year. I'll just note that this motion does not affect our current case timeline, and we remain scheduled for trial on April 15th. Next, a reminder of our plan to reach blockbuster status for our franchise, which we have every confidence in achieving. In short, we have robust data generated through a landmark 14,000 patient trial. That data is being used to support a highly differentiated label, which we anticipate approval of by March 31st. In the meantime, we're excited on a strategic plan to continue to drive growth and educate healthcare providers and payers alike ahead of that new label. I'll wrap up our comments today by reiterating that we continue to deliver on the commitment the leadership team has made. We are steadily executing on our strategic plan to unlock the blockbuster potential this franchise is capable of. We have more work to do, but I'm pleased with the progress we've made. I am confident in our ability to succeed and look forward to demonstrating continued progress toward our goals. And with that, operator, we are now ready for Q&A.
spk05: Thank you. To ask a question, you'll need to press star 11 on your telephone. To withdraw your question, please press star 11 again. Please wait for your name to be announced. Please stand by while we compile the Q&A roster. One moment for our first question, please. Our first question comes from the line of Dennis Ding with Jefferies. Your line is now open.
spk06: Hi, good morning. Thanks for taking our questions. Two for me, if I may. Number one, just on the U.S.-based business, Can you comment on some of the underlying gross-to-net trends that may have impacted Q3 and maybe talk about your outlook for Q4? And then question number two is on the litigation case with Daiichi. I'm appreciating that there could be a positive ruling on the Rule 12c dynamic. the milestone actually hit Asperion's balance sheet given Daiichi would likely appeal after that. And we get a lot of investment questions on how long would that appeal process actually take and when could money actually hit Asperion's balance sheet. So maybe just clarify that for us as investors. Thank you.
spk10: Hey, Dennis. It's Ben. Great to talk to you. Thanks for the question. On growth to net, In Q3, we saw some typical seasonality that we'd expect from a product in this market. I'll note we've done a good job improving gross net from last year into this year, and I think we're in a pretty steady state at this point. Going forward, there's still room for improvement and looking into Q4 and beyond. That'll all come with volume, so I wouldn't see that as an immediate term, but over the longer term, we do expect it to continue to improve.
spk08: And Dennis, this is Sheldon. I will take the second as it relates to the litigation. First of all, as a reminder, as you mentioned, we were able to win the motion as related to 12C. That was a few weeks ago. The opposition has until November 22nd to actually file their side of it. And then the court will make a ruling. Again, I just want to express our confidence in the case that we have here. And we feel really good about it as it relates to when we would see money, et cetera. Keep in mind that this milestone was not to be actually recognized until later in the first quarter of 2024, early second quarter. And so, you know, right now, if I think about the timeline, you know, we don't want to guess at this because we have to take every day as it comes as it relates to litigation. But I'm confident that, you know, we remain on that same timeline as it relates to us receiving the milestone.
spk06: All right. Thank you.
spk05: Thank you. One moment for our next question, please. And the next question comes from the line of Tom Schrader with BTIG. Your line is now open.
spk02: Good morning. Thank you for taking the call. I wanted to ask a little bit about slide five. It's kind of striking. You got this big bump at ACC where I think we all knew there was a fair bit of interest, but it's been relatively flat. Does that speak to how hard it is to talk to physicians that aren't converts already? And is that what you think the label will help with? And then maybe if you have any Do you have any way to track physicians who at some level are interested in the drug but won't go through a slightly arduous payment process? Do you collect any of that data interest beyond people who actually get all the way through the reimbursement process? Thanks.
spk07: Hey, Tom. It's Eric. I'll answer your question. So first of all, the ACC pop that we had was tremendous. We've been able to build upon that. So quarter after quarter, we saw an increase in TRPEs of 8%. I want to remind you that the commercial team is unable to talk about the new data. So you're absolutely right. When that label changes, not only will we expand the population, but we'll unlock our ability to actually talk about these data. We've done quantitative research where we show significant changes in prescribers' intent to prescribe. And I believe Sheldon showed at a meeting not too many months ago an ATU that we did that tracks the desire to make our product standard of care. And that tremendously increases once we're able to communicate those data. and once we have the managed care changes that ultimately align with those changes that we'll have from an indication perspective.
spk08: And the conference was the AC Wainwright Conference, Tom. If you want to go back and take a look at that, it's archived. Got it.
spk02: All right. Thank you.
spk05: Thank you. One moment for our next question, please. And our next question comes from the line of Troy Langford with PD Cowan. Your line is now open.
spk09: Hi, congrats on all the progress this quarter and thanks so much for taking our questions. I just have one about the label change next year. So when that does occur next year, exactly how quickly do you think we could start to see that uptick in prescription numbers that you all just mentioned? You know, do you think it will look more like the inflection that we saw right after ACC or Do you think it could take a couple of months after the sales team has the ability to formally promote the data before we see that more substantial increase?
spk07: Well, thanks for your question. It's Eric again. So no doubt the team will be ready. The team has been spending the vast majority of their time now preparing for this label change. So across every function, ensuring that we're a well-oiled machine with these new data and ultimately new indications. There does need to be some payer changes that happen in order to realize the full potential. So I would look for some improvements right away. But as we start unlocking that access that aligns with the broader label is when you can start to see the even greater changes that we anticipate. Joanne?
spk03: Thank you for the question. This is Joanne Pudi, the Chief Medical Officer. The other thing that's really critical as we think about the label is timing. So we've announced that the producer date is March 31st. That precedes the American College of Cardiology. And I think you all recognize how significant this year's American College of Cardiology has been for getting our message out. So we anticipate similarly having the opportunity with the American College of Cardiology in 2024 to leverage not only our new label, but all the noise, We had over a billion impressions from last year's ACC, and we're looking forward to similar uptakes this year or coming year in 2024. Great. Thanks.
spk12: Thank you.
spk05: Thank you. One moment for our next question, please. Our next question comes from the line of Jason Szymanski with Bank of America. Your line is now open.
spk11: Perfect. Congrats on the quarter, and thanks so much for taking our question. I wanted to ask a follow-up on an earlier comment you made. Obviously, the 12 ruling was a win, but as acknowledged by your attorneys in the filing, there's a challenge to litigating indefinitely. And if the proceedings are extended for whatever reason, be it an appeal or whatnot, are there contingency plans in place to support the relaunch? And then a follow-up, if I may.
spk10: Yeah, happy to take that one, Jason. So as far as kind of pushing out our cash runway and being able to help manage both the launch and funding that litigation, we have drivers that are ahead of us. Most of our spend next year hasn't even been contractually locked into. So we can delay spending like on preclinical pipelines, some of our smaller R&D projects, even with the Salesforce ramp up without fully hampering the commercial launch here. We'll always try and walk the fine line of funding the stuff that's going to show us an immediate return, but also, you know, managing that burn rate and managing those expectations from a cash standpoint. But, you know, truthfully, the litigation is, you know, a cost. It doesn't cost as much, frankly, I thought it would, and we can manage to keep that going as needed. Gotcha.
spk11: Thank you for the color. And then maybe as a follow-up on the business, what does a typical patient starting mempidoic acid currently look like? Are they primary or prevention, secondary, and then I mean, how do you expect this to shift when you receive, hopefully, the label update?
spk07: Yeah, Jason. So they're now aligned with their label. They're an ASCBD patient. They're on a documented, maximally tolerated statin dose, and they're not at their LDL-C goal. So that is a typical, approvable patient. Now, I will say that there is a strong desire to prescribe us in a patient that has a primary prevention, so they don't have active ASCBD, but they have risk factors. There's also a strong desire to prescribe us in patients that are unable or unwilling to take statins. So both of those will go away with the new label as we add in the primary prevention and as we remove that dependency on maximally tolerated statins.
spk12: Great. Thanks, guys. Thank you.
spk05: One moment for our next question, please. Our next question comes from the line of Serge Bellinger with Needham. Your line is now open.
spk12: Hi, good morning. I also had a couple of questions on the Rule 12 motion. So you mentioned the trial date in mid-April is still on the calendar. Does that remain on the calendar until there is a decision on this motion. And then in terms of the appeals process here, is it the same with the 12C motion as it would be if it went to PROC?
spk08: Then I have a couple follow-up. First of all, thank you, Serge. And I'm glad you could make the call. So as it relates to the trial date of April the 15th, that will remain on the calendar. As a matter of fact, should the ruling, once the motion is reviewed and heard, if there is no decision, then no harm, no foul. We remain on the same schedule, which is the April 15th trial date. And then your second was as it relates to appeals. As it relates to the appeal process, there is certainly the ability to appeal. Obviously, we've done some research in this area. You know, we just have to take it day by day as it relates to, you know, what would happen in the case of an appeal.
spk12: Okay. And then on the business front, maybe just update us on your prior auth rate and whether you expect any additional formulary coverage ahead of March 31st. Okay.
spk01: Yes, so we've had the opportunity to get to almost 90% of the payers with the CVOT data. I'm pleased to say, as Sheldon had outlined as well, not only have we had new formulary access with very large payers as well as small regional payers, but also the UM criteria has been aligning with the CVOT data already. With that, our approval rates have also increased. been quite well since those presentations and since the CDOT data as well. So I can tell you that we're up to approval rates that are very much almost to the 85% range in commercial and equal to that in Medicare. Thank you.
spk08: And Sarah, just one other note. I was thinking while BJ was answering that question regarding your question about 12 motion. and appeal. You know, as I mentioned, we would have to see how that goes. But I think you would agree with me that, you know, if we win that motion, you know, that's a big win. So we can, you know, worry about appeal as it comes. But it'd be a nice, it's a nice indicator of the case that we have, or the, yeah, essentially the case that we have here.
spk05: And thank you. I would now like to turn the conference back to Mr. Sheldon Koenig, President and Chief Executive Officer, for closing remarks.
spk08: Great. Thank you so much. And again, thank you for everyone for joining today for our Q3 2023 earnings. As you can see, I mean, we're very excited. We have a great story. We have a strong quarter. We really built upon our post-ACC momentum for Nexlozet and NexloTol. These are life-saving medications. We're looking very forward to the PDUFA date or approval date of March 31st. Again, as we mentioned, our litigation remains on track. We hope for a near-term solution. However, again, if not the April 15th trial date, we will continue there. It's important to remember Nexotol and Nexoset are novel therapies with differentiated first-in-class mechanism of action. And again, we're a small company, but we're doing big pharma things, and we continue to deliver on all of our commitments. So, again, thank you, everyone. Have a great day. Maybe see some of you at American Heart, and we'll talk to you soon. Take care.
spk05: This concludes today's conference call. Thank you for your participation. You may now disconnect. Everyone have a wonderful day.
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