Oyster Point Pharma, Inc.

Good evening and welcome to Oyster Point Farmer's fourth quarter 2021 earnings conference call. My name is Valerie and I'll be your operator today. After the company's formal remarks, there will be a question and answer session. At this time, I'd like to turn the call over to Mr. Daniel Lochner, Oyster Point Farmer's chief financial officer. Please go ahead.

Good evening, everyone, and welcome to Oyster Point Farmer's fourth quarter earnings conference call for the three months ended December 31st, 2021. This evening, we issued a press release containing our fourth quarter and full year-ended December 31, 2021 financial results and recent business highlights. In addition, our earnings press release and our Form 10-K, which were filed with the SEC after the close of market today, are available on our website under the Investor News section at www.oysterpointrx.com. Joining us on our call today are Dr. Jeffrey Now, President and Chief Executive Officer of Oyster Point Pharma, and John Snizerenko, Chief Commercial Officer. Following Dr. Now, Mr. Snizerenko, and my prepared remarks, we will open up the line for questions. During the call today, we will be making forward-looking statements regarding potential future events, including statements regarding Oyster Point Pharma's potential future financial status and results of operations, and our plans and potential for success relating to commercializing tiered bias. These forward-looking statements involve known and unknown risks, uncertainties, and other factors that may cause our actual results to differ materially from any future results, performance, or achievements expressed or implied by such statements. For a description of these factors, please see our annual report on Form 10-K for the year ended December 31, 2021, filed with the SEC after the close of market today. I will now turn the call over to Dr. Jeffrey Now, President and Chief Executive Officer of Oyster Point Farms.

Thank you, Dan. Good evening, everyone, and thank you for joining us on our call today to discuss our fourth quarter 2021 financial results and recent business highlights. This is a particularly exciting time for Oyster Point. This is our very first earnings call where we are pleased to be reporting partial revenues from the commercial launch of tear via nasal spray for the treatment of the signs and symptoms of dry eye disease in the United States marketplace. Today, you will learn more about how we are delivering these encouraging commercial results on the launch of tear via nasal spray. But first, let me provide the company's 2021 business highlights. In October of 2021, we received FDA approval of tear via nasal spray for the treatment of the signs and symptoms of dry eye disease. Dry eye disease is a chronic condition that impacts an estimated 38 million people in the U.S. and is growing in prevalence. The dry eye market is now being introduced to the first nasally delivered pharmaceutical dry eye therapy, and we believe that given the high level of patient and physician satisfaction that we are seeing in the field with Tear Viya, that significant growth remains ahead. You will be hearing more shortly from John Smezarenko, our Chief Commercial Officer, about the details of the launch of TIRVIA Nasal Spray, but I'm happy to state that we had a great partial fourth quarter commercial performance in 2021. We're happy to report that TIRVIA Nasal Spray had a net product revenue of 1.2 million in Q4 of 2021. In addition, we recognized 5.4 million from our license agreement with Jijing Pharmaceuticals. We are now entering 2022, having demonstrated the ability to achieve the successful commercialization of TIRVIA as well as drive strong execution across multiple areas of our business, including our exclusive license agreement with Jijing to develop and commercialize OCO-1 and OCO-2 in Greater China, securing non-dilutive funding, and pursuing additional treatment advancements in the clinic as well as in the R&D laboratory for patients with ophthalmic diseases. This week, we publicly announced an early commercial win with one of the largest commercial payers, Our press release from Tuesday announced that TIRVIA nasal spray is now covered by Express Scripts, effective on February 19th. This is a fantastic accomplishment for our market access team in achieving the addition of 26 million covered lives, and more importantly, this early in our first full quarter since launch. Patients are increasingly gaining access to TIRVIA in the U.S. for a disease state that up until 2021 we believe experience very little innovation for the current large unmet need in dry eye disease. Tervia is a first-in-class cholinergic agonist nasal spray that is highly differentiated from the other pharmaceutical products in the dry eye space and includes the following potential advantages. Tervia nasal spray is a differentiated mechanism of action, as it is believed to activate the trigeminal parasympathetic pathway via the nose, resulting in increased production of basal tear film as a treatment for dry eye disease. Basal tear film is responsible for lubricating, nourishing, and protecting the cornea. Tear Vita is the only ocular surface-sparing pharmaceutical therapy for dry eye patients. For those patients with a compromised ocular surface, increasing tear production without the burden of administering a topical medication may provide a welcome method to treat their disease. For the first time, dry eye disease patients have an FDA-approved pharmaceutical treatment options that is not administered as a topical eye drop to an already irritated ocular surface. Although we are focused on the critical launch of TIRVIA nasal spray and continue to execute plans for the lifecycle development of the TIRVIA franchise, our R&D team remains committed to multiple exciting pipeline projects aimed at bringing additional innovative therapies to address diseases like neurotrophic keratopathy and severe allergic or vernal keratoconjunctivitis. In 2022, we will continue to advance our enriched tear film gene therapy platform, as well as our research and development collaboration with companies like Adaptive Phase Therapeutics. We remain excited about the ongoing Olympia Phase II study of OCO-1 nasal spray in stage 1 neurotrophic keratopathy. We're expecting a readout in the second half of this year. NK is a disease that is currently underdiagnosed or misdiagnosed in many patients, with ocular surface disease. We feel that stage one neurotrophic keratopathy could represent a meaningful indication for OCO-1 nasal spread. Our vision and focus is clear. The world needs an innovative leader that can bring innovative and transformative ophthalmic disease treatments, and we aim to be that leader. We believe that we're building OysterPoint into a best-in-class eye care company. I would now like to turn the call over to John Snizerenko, Oyster Point's Chief Commercial Officer, to discuss our ongoing commercial launch of Tear Via nasal spray for the treatment of the signs and symptoms of dry eye disease.

Thank you, Jeff. As we have previously communicated, the dry eye disease segment is a large market, with over 17 million people diagnosed in the United States alone. Only a small proportion of these patients, approximately 2 million, are currently being treated with a branded therapeutic. And over 7 million people diagnosed with dry eye disease have tried and abandoned the other available options. We believe that TIRVIA nasal spray is a new treatment option for the large patient population that exists in the dry eye disease marketplace, including the refractory patients, as well as those who are newly diagnosed. As Jeff highlighted previously, we are incredibly excited to have initiated the U.S. launch of TIRVIA nasal spray on November 1st. We are pleased to report that as of the quarter ending December 31st, 2021, data indicates that approximately 5,500 prescriptions for Truvaya have been filled, written by over 1,900 unique prescribers. These encouraging metrics were achieved in less than nine weeks from the launch, including holiday periods. In this short time, Truvaya is quickly establishing itself in the market as an exciting new option for dry eye patients. Regarding market access, A core part of our commercial strategy is to promote accelerated payer adoption of Tervaya to the top payer organizations. Our market access team has done a great job in securing coverage for Tervaya with Express Script's national preferred, basic, and high-performance formularies, effective February 19th. With this latest formulary addition, we now have coverage for a total of 43% of U.S. commercial lives for an aggregate total of approximately 84 million lives. We are incredibly pleased with this level of coverage so early in our launch, and we look forward to further growing our market access coverage in 2022. Oyster Point remains very committed to offering comprehensive patient services that help provide access to Turbaya for appropriate patients. We have launched a comprehensive set of technology-driven patient services offerings aimed at enabling patients to successfully navigate the patient journey and procure Turbaya. Our patient support program is called Team Trivia, and for more information on this program and how to enroll, please visit the website, trivia-pro.com. We've been quite diligent with the sizing of our field force, which enables us to target 20,750 eye care practitioners, covering both optometrists and ophthalmologists, and representing approximately 94% of the dry eye prescriptions in the market today. helping us in our efforts to achieve the full commercial potential of Tervaya. In the first nine weeks of launch, our Salesforce was able to introduce Tervaya to more than 50% of the targeted prescriber base. On the marketing side, we're leveraging the latest technology, including sophisticated analytics, in-person as well as virtual detailing, best-in-class digital and social media efforts and partners, as well as utilizing a digital online pharmacy to enhance communication and delivery of Tervaya to patients. We will continue to adopt the latest media and technology-driven marketing approaches to maximize Tervaya's share of voice and impact in the market. Our focus continues to be on broad eye care provider and patient education and marketing efforts with targeted direct-to-patient digital campaigns leveraging Tervaya's differentiated MOA and nasal spray route of administration to drive a positive patient marketing experience. I am so proud of our commercial team's collective efforts during this early phase of our launch, especially in these challenging times with the pandemic. I will now turn the call back over to Dan Lochner, OysterPoint's Chief Financial Officer, to discuss our fourth quarter financial results.

Thank you, John. I will now provide a brief overview of OysterPoint Pharma's fourth quarter financial results. Additional detail about our fourth quarter, as well as our annual financial results, can be found in our Form 10-K that was filed with the SEC this evening. For the fourth quarter of 2021, Oyster Point Farmer reported a net loss of $42.1 million compared to a net loss of $22.2 million for the same period in 2020. As of December 31st, 2021, cash and cash equivalents were $193.4 million compared to $192.6 million as of December 31st, 2020. Based on our current business plan, we believe the company's available cash and cash equivalents will be sufficient to fund the company's planned operation for at least 12 months from our 10-K filing this evening. Net product revenues for the fourth quarter of 2021 were approximately $1.2 million following the FDA approval of Tier 5 nasal spray on October 15, 2021, and our subsequent commercial launch in the U.S. in November 2021. Approximately half of the TIRVIA net product revenue was attributable to channel building by distributors upon launch of the product. In addition, pursuant to our license agreement with Zhejiang, the company also recognized $5.4 million in milestone and license revenue following the FDA approval of TIRVIA nasal spray, which includes the non-cast consideration of Zhejiang's senior common shares. The company did not generate any revenues during the third quarter Three months ended December 31st, 2020. Cost of product revenue for the three months ended December 31st, 2021 was $1.5 million and consisted mainly of third-party manufacturing costs, which included pre-approval costs, reserves for inventory obsolescence and damaged goods, and product royalty expense related to Pfizer. The cost of product revenue included a reserve for inventory obsolescence of $0.9 million. The inventory manufactured prior to FDA approval of PureVine nasal spray was charged to R&D expense, and as a result, the company expects the unit cost of product revenue will be lower until the company fully utilizes this product that was manufactured pre-FDA approval. The company started expensing pre-approval inventory in 2020 and recorded an R&D expense of approximately $4.3 million for pre-approval inventory during the year ended December 31, 2021. The company anticipates selling the remaining pre-approval inventory by the end of 2022. The company's sales and marketing expense increased by $21.8 million during the three months ended December 31, 2021, compared to the same period in 2020. The increase was primarily due to higher payroll-related expenses of $11.7 million, inclusive of sales commission expense. as well as an increase in stock-based compensation expense of $0.5 billion, both of which were primarily driven by onboarding a commercial field force in the second half of 2021. The company also incurred higher marketing, market access, commercial, and other expenses of $10.1 million in anticipation of and in connection with the U.S. launch of Tervaya Nasal Spray. The company's general and administrative expenses increased by $6.2 million during the three months into December 31st, 2021, compared to the same period in 2020. The increase is primarily due to higher G&A expense of $3.8 million related to accounting, consulting, legal, and other professional expenses incurred in connection with the credit agreement, as well as the company's transition from a clinical stage to a commercial stage company. The company also incurred higher payroll-related expenses of $2.4 million, including recruiting expense due to an increase in headcount to support an ongoing effort to commercialize tier bias. The company's research and development expenses decreased by $6.2 million during the three months into December 31, 2021, compared to the same period in 2020. The company's decrease in R&D expenses, primarily due to the company receiving FDA approval of TureBio Nasal Spray in October 2021. The company expense inventory prior to receiving FDA approval and expense approximately 3.5 million as R&D during the three months ended December 31st, 2020. The company also incurred a fee of 2.9 million in connection with the new drug application submitted to the FDA in December 2020. The company incurred interest expense of $2.6 million during the three months into December 31st, 2021, primarily related to the credit agreement with OrbiMed. Interest expense included contractual interest of $1.7 million, as well as non-cash expense of $0.9 million related to the amortization of loan commitment fees and accretion of other long-term debt-related costs. the company had no interest expense during the three months ended December 31st, 2020. Now, as we turn to our outlook for 2022, our goal is to continue to achieve broad ECP and patient experience with Tier VIA, including both optometry and ophthalmology offices, in order to reach the total addressable dry eye market opportunity of Tier VIA nasal spray. We anticipate the three large national commercial plans will make their coverage determinations by the midpoint of the year. While we await such coverage determinations, we will continue to provide patient-assisted programs to support eligible commercial patients in gaining access to Tier 5. With that overview of our financials, I will now turn the call back over to the operator to open up the line for questions.

Thank you. As a reminder, to ask a question, you'll need to press star 1 on your telephone. To withdraw your question, please press the pound key. Please stand by while we compile the Q&A roster. Our first question comes from the line of Ken Cacciatore with Calwin. Your line is open.

Hey, team. Looks like a really good and clean initial launch. I was wondering if you'd want to help us a little bit with maybe the revenue pacing. I know consensus, I believe, is around 30, and I know there's only a few of us analysts that are formally involved in the consensus, but I think it's around 30 million. So I was wondering if you'd just kind of hold hands with that number, how we should be thinking about it. And then also, we've been doing clinician checks and getting very good feedback, but I guess you could help us as you would have a better sense of the early retention metrics, maybe to be able to definitively let us know how you're seeing some of the retention numbers and patients returning. So those are my first two. I'm going to ask one more if I could, though. Could you talk, John, a little bit about any refinements or learnings of your patient support system? Obviously early days, but wondering if you're already tweaking it a bit, anything that seems to be working very well or you've needed to change? And with that, I'll go back in the queue. Thanks so much.

Great. Thanks, Ken, for the for the questions and very thoughtful. So maybe what we could do is we'll just take those in order. So I'll turn it over to Dan to just talk about the numbers for the year. And then we'll go into retention and have a discussion about John's experience with the bridge programs and the different patient services.

Yeah, great. Hi, Ken. I would say on revenues, you know, while we haven't really provided official revenue guidance, I would say, you know, we think about a very operationally focused in terms of, you know, our sales reps that are out in the field doing a great job. And I would say the focus very early on and throughout 2022 will really be about growing that eye care practitioner account and we have goals internally for what we expect to achieve on a weekly and monthly basis. And so I think it really starts with getting those ECPs on board on a monthly sequential basis and then starting to look at what their right pattern is on an inter-ex basis per month, and then what we then start observing on that pull-through on resale rate. And so to kind of wrap that all up, we see it sequentially building through the quarters for the entire year as we start working through that total target population that we've identified, which is roughly 20,750 targets. And I think it'd be great to have John kind of speak about how we're really going after that target base and how that's been building through the quarters. And I think what you'll see at least for Q4, we've hit about 1,900 of those ECPs, you know, in respect to the 20,750. And we'll continue to really work through that population of ECPs and really build that NRX and resale rate, the TRX, and then really playing out on revenue. The other dynamic, of course, is always on gross to net. And while we're not providing official guidance on gross net, because our focus really is on that volume and share component throughout 2022, I would say there is that first half component related to the majority of patients in the first half expecting to be on that bridge program, which has a discrete impact to gross the net. And then with our guidance, which is focusing on coverage determinations for the big three PBMs by the midpoint of the year, that transition from bridge over to commercial insurance will have a positive benefit discreetly on that line in relation to gross and net, which would kind of tie out to your question on kind of how revenues would flow from a price and volume perspective through the year.

Yeah, thank you, Dan. This is John. Hi, Ken. You asked a question around retention rates and refill rates. We've been very, very pleased to date with the metrics we've been seeing in that space. Even patients that had been prescribed in early November, we started seeing early refill rates. I could quote that if you look at our blended refill rates with retail pharmacy and our digital online pharmacy, they're hovering around 64%, 65%. So we're very pleased with patients that are coming back and getting their refills. We're getting very, very nice physician as well as patient feedback. And we're hoping to continue that trend throughout 2022. I think part of that as well as your third part of your question around patient support programs, we, out of the gate, wanted to really employ a lot of technology around our patient services, Tim Turbaya. So we were trying to make it very easy for that patient to navigate that journey through the prior Austin and then benefits and guest investigations to get them to enroll into the program through QR codes in the offices online as well as other digital means. So because of that, we've been getting very, very good high enrollment rates and good fill rates that come through that program. So in terms of tweaking you know, we're continuing to put out more patient materials to, you know, to surround sound the patient with different ways to enroll into the program. But overall, we're very, very pleased with how the program's been going. If the patient is deemed insured but not covered, they automatically popped into our bridge program if there were appropriate patients, and they were able to get that script filled and get experience with Trivia. So we'll keep monitoring the patient services program, but so far we've been very, very pleased.

Great. Thanks so much, Tim. Appreciate it. One thing I will add on Ken's comment there is, you know, as we think about TIRVIA as a product, when we think about the current marketplace and what it offers to patients, from an immunomodulator perspective, you know, patients will go on a course of an immunomodulator. If they're not happy with the outcome at the end of that course, they're transitioning off and they're likely either going on to another product or another device or another modality, but very rarely are they coming back. So we see a very low number of patients come back to the original therapy. I think that the one thing to really keep in mind with Tervia is it works so quickly to provide the patient relief, and it has such a differentiated mechanism of action that we are excited to look forward into the future to see how patients interact with the product. It's going to be a very different interaction than you would see with an immunomodulator because I do think not only will we have solid refill rates, but we will have people coming back to the product in those later years. And so we're excited about that. And then I'll just throw one comment out there for my team back at the office. You know, our patient services program is, bar none, one of the best I've ever seen. And it is going very well in the field. And so kudos to the team for putting together such a great program.

Great. Thanks so much.

Thank you. Our next question comes from Joe Catazzaro with Piper Sandler. Your line is open.

Hey, guys. Thanks so much for taking my questions, and congrats on the progress here. So maybe just to follow up, I think, Dan, you mentioned you guys had some internal benchmarks, I'm sure, on a bunch of things, but wondering if you could maybe help put into context the early penetration in terms of the number of unique prescribers you've seen relative to your target ECP pool and and where your early expectations were there. And then I'm wondering, you know, what aspect, and maybe it's something you just alluded to, Jeff, you know, what aspect of the product profile do you see as resonating the most, and how do you go about fully leveraging that? Thanks, and maybe have a follow-up as well.

Yeah, maybe I'll start with it on my end. As you saw in the press release, we had achieved 1,900 unique writers in the quarter, which is just under about 10% of the targets that we're going after with our sales force of 162 sales reps. And so I think we had great progress in the quarter, just under about nine weeks. And so as we look at benchmarks of prior sales therapies that have come to market more recently, I think we're in a great place for where we had expected us to land. Of course, we also understood that this is a new way of treating dry eye disease. So really communicating the benefits with a nasal spray. And so I think we're quite pleased with where we landed and, you know, continue to work towards that 21,000 target count as we progress throughout the year.

And maybe what I'll add on to the second part of the question there is some of the things that are resonating. I think one of the things that's really been exciting about the launch of this product is patient feedback has been really great. And so we've been excited to not only hear stories from the field, see posts on social media of patients going out on their own and talking about the product, and Just really, it's a great product to launch where you're having that patient feedback come back to the teams and to those folks that have put such hard work into getting the product out there into the marketplace because it's really why we do this and it really drives the team. So I think one of the things that we hear that is something that's really encouraging is just that the patient stating that they really like the profile They like the way it's making their eyes feel, and it's just differentiated in the way that it's able to be used. So we do hear stories back of people who are unable to deliver, you know, a topical eye drop, and this is another option for them because maybe they don't have the dexterity or they're elderly and they're just not able to put a drop into their eye, and so they're able to use nasal sprays. And the other thing that we hear in the field often is the physicians are not getting patients calling back and complaining. And so that's also really important for us. But again, we're very early in the launch. So we have many patients that, you know, haven't been on the product for more than a few months. So we're excited to see how the long-term feedback is. But for the moment, we're really encouraged by the feedback or sometimes lack of negative feedback coming back from the patients.

Right. And if I maybe just squeeze in a quick follow-up, I think you said you guys have maybe covered about 50% of your target ECPs. Can you maybe speak to what percent of those have been given a sample, and how soon after sampling are you seeing ECPs write a script? Thanks.

Yeah, no, thank you, Joe. Great question. Part of our strategy is really to introduce Tervaya into the office practice with the prescriber base, the technicians involved, the staff that are involved with training the patients and so on prior to actually sampling because we want to make sure that the product is taken appropriately and the patient gets the best possible experience they can with the nasal spray. So we've handed out quite a few samples, probably over 100,000 samples since launch, but we want to make sure that we hand them out appropriately and that installation with that office is actually taking place before that sampling is initiated. So, so far that's worked well for us because we've seen, you know, a higher proportion of patients that try to sample, see if it works for them before they're getting into our patient hub and actually getting that prescription filled. So that kind of connection has been very, very positive with that approach.

Okay, that's helpful. Thanks again for taking my question.

Thank you. Our next question comes from Patrick Dolezal with LifeSide Capital. Your line is open.

Hi. Thanks for taking the questions. I'm just curious how the availability of generic cyclosporine has impacted discussions with payers, if at all. Were there any modifications to negotiations with Express Scripts as that approval came to light? I'm just curious if you expect any impacts going forward as you onboard other payers. And then I have a follow-up as well.

Yeah, Patrick, thanks for your question. You know, we've seen kind of early mixed reactions from the payer community on how they're going to manage the generic entry of cyclosporine. And, you know, with the early listing with ESI, they're actually covering Tervaia across their formularies with only a traditional step-through of an artificial tier. So that's what I mean by mixed. Some of the payers are kind of waiting until more than one generic comes out and they'll take a look at the dry ice space or they're not really managing the dry ice space as closely. And others are going to evolve a little quicker. So we're, you know, we're able to modify our approach. We were ready for generic to be on the market or not with. And, you know, that's the way our negotiations are going with the major PBMs. And, you know, our goal is to get access for Chivaya, you know, on a level playing field with the brand of therapeutics. And, you know, our differentiation along with our strategic contracting will help us get there.

And one other comment, Patrick, as you well know, you know, generic entry into the marketplace doesn't change the dynamic that exists where patients cycle off many of these drugs, whether it be for lack of effect or side effects or whatnot. And so that certainly will not change. So we were planning on generic entry coming. I think we've been planning for a long time, but it's been always in the back of our mind, and so the team's ready.

That's helpful. Thanks. And as it relates to just drug launch surrogates, there's not a ton in the dry ice base really, but obviously we do have Zydra. Just curious to hear any similarities and differences that might be worth pointing out, and just if you could comment on the role of coverage and driving drug adoption in the dry ice space generally, that would be helpful. I'm curious if there's a tipping point where you feel that the amount of coverage really will drive adoption, you know, 50%, if it's a bit more. I would love to hear your thoughts there. Thanks.

Yeah, Patrick, in regards to the Zydra launch, we did see a very quick update. This was back in 2016. They had very early access to the commercial insurers, and they launched with 280-plus reps. You know, we're very pleased with the number of reps we have and the trajectory we're seeing with Turbaya. We're on track in regards to the payer negotiations, and, in fact, the ESI listing was an early listing for us. You know, we will get to that point that we're expecting in terms of broad base of writers, you know, the eye care professionals prescribing Tervaya. We just won't be out of the gate as quickly as you saw with the Zydra launch. I can tell you versus the latest two launches, we're very, very pleased with how our trajectory is going versus, you know, kind of the more recent entries. But it was a different space back in 2016, less managed and also less They were second entry at the time after Restasis.

Definitely makes sense. Thanks for taking the questions.

Thank you. Our next question comes from Chris Mayer with J.P. Morgan. Your line is open.

Great. Thanks for taking the questions. So first one for me is just wanted to get a bit more details on the Express Scripts contract. Really just thinking about what's the mix between preferred and non-preferred coverage within those 26 million lives that you had estimated? And within the Express Scripts plan, is there potential for additional pickup of patients and additional contracting that would either add additional patients or move more patients towards preferred access? When talking about that kind of mix of customers, what type of co-pays should we be thinking about for most of these patients? I think I'll have a couple of follow-ups after that.

Yeah, Chris, no, thanks. In regards to ESI, whether preferred or not preferred, in terms of access, whether you're listed preferred or not preferred, the key criteria is you have to have tried and failed on an artificial tier for all of the branded products here. So as you mentioned in the last part of your question, the out-of-pocket is the difference between the Tier 3 and the Tier 2. And, you know, for the appropriate patients, commercial patients, we definitely, you know, buy down that out-of-pocket to be very competitive with the leading branded product out there. So we feel our 26 million lives that are covered are on a level playing field with regards to the leaders out there. And those are the majority of the larger plans within ESI, but we will continue to work with signing on some of the downstream plans that ESI covers, sorry, that Ascent covers as well and through ESI. So the tiering for us is not a disadvantage. We feel we're going to be very competitive with the two major brand leaders out there.

Great. That's helpful. And then you kind of touched on the refill rates and also maybe you could just discuss your confidence in being able to hit that commercial coverage for CVS Caremark and UnitedHealth by the middle of this year. And then aside from maybe overall script trends, any other KPIs that we should be watching for the launch in the coming weeks and quarters?

Yeah, no, Chris, in regards to the refill rates, you know, we've been very pleased with the kind of 60%, 65% rate of refills we've been seeing. We feel that's based on the product profile as well as, you know, the services we offer to make sure that, you know, both the prescriber base as well as the patients are supported through the clinical experience with Turvaya. In regards to some of the other PBMs, we're in the middle of negotiations with them. We are still on track. to have coverage determinations by mid-year. And, you know, we are ready to negotiate whether they're going to be managing the generic space or not. We feel we're going to be very, very competitive to be able to get Trevia listed and get the majority of those commercial lives covered by mid-year of 22. Perfect.

Appreciate the questions.

Thank you. And I'm currently showing no further questions at this time. I'd like to hand the conference back over to Dr. Now for any closing comments.

Thank you, Operator, and thanks to everyone for joining the call with us today. As I mentioned in my opening remarks, we are extremely pleased to announce that Tear Via Nasal Spray, indicated for the treatment of the signs and symptoms of dry eye disease, is currently in its first full quarter of launch for patients and eye care providers in the U.S. We're extremely excited for the potential of significant growth that remains ahead. Our vision and focus on bringing innovative and transformative ophthalmic disease treatments to patients and building Oyster Point Pharma into a best-in-class eye care company remains our primary goal as a company. In closing, I want to thank everybody for joining us tonight and to have a great evening.

Ladies and gentlemen, this concludes today's conference call. Thank you for your participation. You may now disconnect. Everyone have a wonderful day.