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5/5/2021
Good afternoon and welcome to Supernost Pharmaceuticals' first quarter 2021 financial results conference call. At this time, all participants are in a listen-only mode. Later, we will conduct a question-and-answer session. Instructions will follow at that time. As a reminder, this conference call is being recorded. I would now like to turn the conference over to Peter Bozzo, of Westwick Investor Relations Representative for Sopernis Pharmaceuticals.
You may begin. Thank you, Juergen. Good afternoon, everyone, and thank you for joining us today for Sopernis Pharmaceuticals' first quarter 2021 financial results conference call. Today, after the close of the market, the company issued a press release announcing these results. On the call with me today are Sopernis' Chief Executive Officer, Jack Katar, and Jim Kelly, Chief Financial Officer. Today's call is being made available via the investor relations section of the company's website at ir.supernus.com. Following remarks by management, we will open the call to questions. During the course of this call, management may make certain forward-looking statements regarding future events and the company's future performance. These forward-looking statements reflect Supernus' current perspective on existing trends and information. Any such forward-looking statements are not guarantees of future performance and involve risks and uncertainties. including those noted in the risk factors section of the company's latest SEC filings. Actual results may differ materially from those projected in these forward-looking statements. For the benefit of those who may be listening to the replay, this call is being held and recorded on May 5, 2021, at approximately 4.30 p.m. Eastern Time. Since then, the company may have made additional announcements related to the topics discussed. Please reference the company's most recent press releases and current filings with the SEC. Sopernos declines any obligation to update these forward-looking statements except as required by applicable securities laws. I will now turn the call over to Jack.
Thank you, Peter. Good afternoon, everyone, and thanks for taking the time to join us as we discuss our 2021 first quarter results. Since the beginning of 2021, we have made significant regulatory, operational, and commercial progress on a number of fronts. First, In April, we received FDA approval for CalBRI for the treatment of ADHD in pediatric patients 6 to 17 years of age. We are actively preparing for the launch of the product in the U.S., starting later in the second quarter, and are excited by the opportunity to provide this treatment as an important option for patients. Our commercial launch activities are ongoing and include engagement with both physicians and patient groups who have expressed great interest in this unique new alternative for the treatment of ADHD. We will be launching CalBRI with more than 175 sales representatives who have strong expertise in CNS. We are leveraging our heritage in the ADHD space, having created more ADHD products than any other company in the world over the past two decades. Superna's scientists created four different ADHD products using our technologies and expertise in the field. Our leadership in ADHD product development and commitment to the ADHD community is second to none. We are excited about the considerable level of attention Calvary has received since its approval from physicians, patient advocacy groups, and the media because of its unique profile as the first novel non-controlled substance to be approved in over a decade. We will conduct post-marketing commitment studies, including a new study of Calbee in preschool-aged children with ADHD four to five years of age. The completion of these studies is in response to a written request by the FDA and should therefore result in the FDA granting an additional six months of market exclusivity. Regarding the adult population, we are on track to submit a supplemental NDA to the FDA for CalBRI for the treatment of ADHD in adult patients in the third quarter of this year. The adult indication is important to help expand the use of CalBRI as adults represent approximately half of the total ADHD market in the U.S. Turning now to the NDA for the apomorphine infusion pump or SPN830. We recently met with the FDA to discuss the contents of the November 2020 refusal to file letter and the requirements for resubmission. Based on those discussions, we now plan to resubmit the SPN830 NDA in the second half of 2021. Since the last update we gave, we have made good progress on the additional device testing that the FDA has asked for and we are now focused on completing all the remaining activities to have a complete file for resubmission later this year. Regarding SBN 820, our first-in-class orally active mTORC1 activator, we have advanced it towards a Phase II clinical program in treatment-resistant depression following the successful completion of a multiple ascending dose study in healthy volunteers. In the MAD study, SPNA-20 exhibited a favorable safety and tolerability profile across a broad range of potentially therapeutic doses. We remain on track to initiate a randomized phase two clinical study in treatment-resistant depression by the end of 2021. Moving on to the commercial products, we saw familiar first quarter dynamics such as insurance pressure that impacted our brand's performance compared to the fourth quarter of 2020. For Apoken, net sales were also impacted by competitive headwinds for the brand that were initially seen in the fourth quarter of last year. While still early in the second quarter, we believe we are starting to see stabilization in the business and look forward to improving the trend for the remainder of the year. Compared to last year, net sales of Shoken DXR increased 5% in the first quarter of 2021 while net sales of Oxtelrexor grew by 14%. These products continue to report healthy net sales gains, despite the continued challenges from the pandemic, the typical first quarter market dynamics, and the fact that they have now been on the market for nearly eight years. First quarter 2021 prescriptions, as reported by IQVIA, and on an extended unit basis, were flat for Oxtelrexor as compared to the first quarter of 2020, While for CandyXR, first quarter extended unit prescriptions were down 13% as compared to the first quarter of 2020. Finally, regarding corporate development, we continue to be active in looking for strategic opportunities to further strengthen our future growth and leadership position in CNS. With that, I will now turn the call over to Jim.
Thank you, Jack, and good afternoon. As I review our first quarter results, please refer to today's press release. I'll begin with our revenue earnings and a discussion of some unique items in the period and then turn to discuss operating expenses. In summary, our results keep us on track with our 2021 plans. Our team is well prepared for the launch of CalBRI as an important new treatment option for ADHD and pediatric patients. And our cash balance of $808 million maintains our strategic flexibility to in-license or acquire new products. Total revenue for the first quarter of 2021 was $130.9 million, an increase of 38%, over $95 million in the same quarter last year. Total revenue was comprised of net product sales of $128.4 million and royalty revenue of $2.6 million. Net product sales for the first quarter of 2021 included $99.2 million from Trikendi XR and Oxfeller XR, reflecting 7% growth versus the first quarter 2020, and $29.2 million from Apikin, Zadago, and Myoblock. Of note, the continued strength of Trikendi XR and Oxfeller XR was offset by APICM, which saw declines in demand linked to market and payer pressures. Regarding inventory levels, we saw some moderate destocking across the portfolio equal to approximately a million compared to the fourth quarter of 2020. Operating earnings were 13.2 million for the first quarter of 2021 as compared to 29 million in the same period the prior year. Of note in the first quarter of 2021, we recorded a number of non-cash items that were the primary driver of this decline. We recorded a non-cash in-process R&D expense of $15 million related to the equity investment in Navator and non-cash contingent consideration expense of $1 million associated with the 2020 U.S. World Med acquisition. The Navator-related $15 million non-cash expense is the result of the accounting impact of the March 2021 Navator corporate restructuring, whereby we expensed our investment as an acquired in-process R&D asset in the period. In addition, amortization expense for intangible assets was $6 million for the first quarter of 2021, a $4.7 million increase. increase compared to the same period the prior year. Net earnings were $5.7 million for the first quarter of 2021, or 11 cents per diluted share, compared to $21.5 million, or 40 cents per diluted share, in the same period the previous year. Given the magnitude and growing number of the product acquisition-related items, We're considering adding non-GAAP financial measures to future company earnings press releases as we believe they provide greater transparency and can assist investors in understanding and assessing ongoing economics of Sopernos' business and reflect how we manage the business internally and set operational goals. More to come on that topic on our future earnings calls. As of March 31 2021 the company had 807.7 million in cash cash equivalent marketable securities and long term marketable securities compared to 772.9 million as of December 31 2020. I will now provide some more detail related to operating expenses. For SG&A, first quarter of 2021 expenses were $61.5 million, compared to $41.6 million in the same period last year. This increase was primarily due to expenses associated with commercialization efforts for Apican, Zadago, and Myoblock, as well as sales, marketing, and launch activities related to Calgary. With the launch of Calgary in the second quarter of 2021, we expect a step-up of at least $15 million in our quarterly SG&A run rate when compared to the first quarter of 2021. Research and development expenses were $34.3 million for the first quarter of 2021, compared to $18.9 million in the same period last year. Excluding the impact of the previously mentioned $15 million non-cash item associated with our Navator investment, R&D expenses in the period were approximately flat year over year. Turning now to financial guidance for the full year 2021, we continue to expect revenues to range from $550 to $580 million comprised of net product sales and royalty revenue and including approximately $10 million of net product sales of Calgary based on the launch in the second quarter of 2021. For full year 2021, we continue to expect combined R&D and SG&A expenses in the range of $380 million to $410 million and operating earnings between $65 million and $90 million. In addition, we expect full year 2021 amortization of intangible assets of approximately $24 million. New this quarter to our guidance is the full year 2021 effective tax rate of 28 to 31%. This range is above our normally expected effective tax range for this period of 26 to 28% due to a number of discrete tax items in the year. With that, I now turn the call back over to our operator for Q&A.
Thank you, sir. As a reminder, to ask a question, you will need to press star one on your telephone. To withdraw your question, press the pound or hash key. Please stand by while we compile the Q&A roster. Our first question and queue comes from the line of Ken Kashatari from Cohen & Co. Your line is now open, Ken.
Thanks so much for the question. Jack, surprised on the really positive guidance here around the acomorphine pump. Can you provide any additional context? I know you indicated device testing, just trying to better understand what you need to do, and it sounds like you don't need to address any additional clinical data. And then on the Calgary launch, a little bit, managed care has changed even, the environment has changed even since you launched for Kendi and Xtel or XR, so just Any thoughts around progress there? Are we going to be subject to the automatic locks, or could we see some maybe initial wins, maybe any update on progress you're making? Thanks so much.
Yeah, sure. Regarding the pump, we have, you know, while we were discussing with the FDA and trying to clarify some of these requirements, in parallel we were trying to complete some of the environmental testing that we had referred to in previous earnings calls. So those tests have been really progressing very well. So we are happy with the timing of those tests because with COVID and so forth, there were a lot of unknowns as to the timing and whether the suppliers will be able to complete the testing on time and so forth. So we feel a little bit better about the timeline overall right now as to where we stand. And the meeting in March helped us tremendously in clarifying with the FDA exactly the specific items they were looking for. And therefore, you know, we feel very good about the timing. We said the second half of this year, you know, we're working pretty hard to do it as soon as we can in the second half. So as we get closer, hopefully we can give people a little bit more clarity within that second half, you know, as we get closer to filing. But We feel good about it at this point as to where we stand. And yes, I mean, as we mentioned earlier, there were no requirements for any new clinical data behind the product. Regarding managed care, we continue to talk to managed care. I mean, this is an ongoing discussion, as everyone knows. Sometimes it's all the way to the last minute for things to materialize one way or the other. We are clearly trying to avoid any new market block type of policies as we all have seen in a lot of the new market launches. But we're not going to let that stop us. This is a product that is so unique and the excitement behind it, the requests we're getting from the field, from parents, from physicians about the product. When can you come and talk to me about it? I mean, the energy, the momentum we're seeing in the marketplace is incredible. And we're going to let people try this product. We're going to sample it. We're going to give it to them. We're going to let utilization and demand really drive the success of this product. And we hope everyone will partner with us eventually in a reasonable manner as far as managed care is concerned to help everybody get access to this really great option treatment. Thank you.
Your next question comes from the line of David Steinberg from Jefferies. Your line is now open.
Okay, thanks, and good morning. I have a few questions on the Quell boot launch. Jack, you indicated you're going to be sampling aggressively, so just curious. I assume that the actual scripts will be understated for some period of time because the samples will not be included in the paid scripts. What do you think is a reasonable timeframe after the sampling so that the, you know, actual scripts would correspond to what you're seeing in the marketplace. Secondly, in terms of target physicians, I guess how many calls do you think you'd make to the high-decile docs before the action really starts for the back-to-school season? And then are you targeting – is there a difference in the decile between – docs that write the most scripts in ADHD and also the docs that write the most scripts specifically for non-stimulants. And then the final question is, we get asked this a lot because there are a lot of different analogs ranging from, you know, the NEOS reformulation and methylphenidate to Vyvanse, which does over $2 billion in sales. What do you think is the best analog to look at for your launch of Calvary? Thanks.
Okay, I'll see and I'll make sure I'll cover everything. Starting with the first question about sampling and when would you expect to really start reading real prescriptions and so forth. I mean, for the obvious reasons, we're not going to divulge and disclose completely, you know, the full details of our sampling program and for how long and so forth, but clearly As far as prescriptions, you're right. Samples are not picked up by IMS as prescriptions. So when you start seeing IMS prescriptions, these will be real demand, real prescriptions behind the product. Hopefully during that period when there isn't enough data that people would like to see, we will try to provide folks with some other metrics at least to give people a good feel as to how the launch is going, the adoption in the marketplace, physicians coming on board or not coming on board, and so forth. So we'll try to introduce other metrics that hopefully could give people at least a good feel as to how the launch is coming up in the first at least two or three months and so forth until things become much clearer. As far as targeting physicians, I mean, as you know and you've known us in this space, I mean, that's really one of the things we do extremely well and we execute on extremely well. So you can bet on the fact that we will definitely be targeting physicians very precisely, as precisely as possible, using really good data sources here and go after the physicians who are high prescribers on both ends. This is not a product that is just suited for people who use stimulants or people who use non-stimulants. This is a product that is suited for every patient out there. So we're going to go after physicians who are high-volume prescribers, and those physicians are across a wide span of different physician type, starting with pediatricians, child psychiatry, and so forth, as far as ADHD. And of course, back to school, as we all know, That's really the big season for a lot of patient initiations. You know, somewhere around the 40% of prescriptions are initiated during that back-to-school season. So we're going to be there. We're going to be part of the conversation between the physician and the parent and make sure Calvary is one of the options that will be presented to the patients and to parents. And again, back to the profile of Calvary and really the exciting clinical profile we have with this product. You have a product that is so easy to use. You may not even need titration or very minimal titration, and it's not dependent on weight or no weight or any of that. It has a sprinkle option. It can work as early as the first week. It works in both inattention and hyperactivity. a beautiful safety and tolerability profile. I don't know, this is just my opinion, why in the world any parent will put their child on a stimulant or any other product. And we're going to give them a sample to try it and try it for free initially. So the downside, we believe, is extremely low, obviously. So that's why we feel pretty good about being part of that conversation when it occurs during the back-to-school season and that we have a good shot that Most parents will probably give us a shot at trying the product. And then the last question, if I remember, was more, is there a difference between those who prescribe stimulants or non-stimulants? The only really, you know, the overall general rule of thumb, and this is overgeneralizing here, not really. But as far as kids, if you look at the market, about 23% is non-stimulants. In adult, the usage of non-stimulant is much lower as a percent of the marketplace. So you would expect within, you know, the kids' usage, physicians who are treating kids, they are more likely to use non-stimulants versus physicians who treat adults.
Hey, Jack, actually there's one other question I asked. I know I asked a lot of them, which is what do you think is the correct analog? There have been lots of different launches in ADHD. ranging from highly successful ones to duds, what would you point to as the number one or number two analog that you would use for us to look at?
There is really no good analog because this is the first real new chemical entity to be introduced in over a decade. So if you're looking for an analog that is a recent analog, there is really no such thing in the current environment because most of the products introduced in the last 10 years or so are all reformulations of the same thing. Methylphenidate and amphetamines and valoxacin is truly unique on its own as far as its place in the therapy and also the gap it really fills here, a gap that we've been waiting for for years and years. And as you know, we've been in this market for 25 plus years in the ADHD market. We know it extremely well. So There is really no one I can point to. Of course, Stratera at that time also was a new chemical entity, but it was a long time ago, and it also was the first non-stimulant ever. Now, if you can take that as an analog, and if you're looking for a surrogate as to what the pent-up demand can be for a real non-stimulant that actually works, works quickly, you know, within a reasonable timeframe, has a good safety and tolerability, you probably should look at the first six months of Stratera when they first launched. And as you know, in those days, we were back at Shire, you know, defending against Stratera with Adderall XR and so forth. And we saw the penetration and it went up very, very quickly. And I believe, if I'm not mistaken, it reached a market share of 19% of the total ADHD market. So that should give you at least probably a good measure as to how deep and strong that demand could be for a real good non-stimulant. Unfortunately, for a lot of patients at that time, the product started disappointing a little bit and had other issues on the label and so forth. But that 19% maybe is a good measure as to the pent-up demand. But also, again, I'll qualify all that by saying that was the first non-stimulant ever to be introduced at that time. Hopefully that's helpful.
Yep, thank you.
Your next question comes from the line of David Amsalem from Piper Sandler. Your line is open.
Thanks. Hey, just a couple. So first on business development, you have this fairly large commercial infrastructure focused on the psychiatry setting. I know you are focused on Calgary and getting that launch right, but how big of a priority is it for you to bring in an asset that where you can leverage your psychiatry-focused commercial infrastructure. So that's number one, and that's also bearing in mind that you're going to be focused on the adult setting and ADHD in due course. So, again, that's number one. And then secondly, and I apologize if you already have addressed this, can you just talk about how you're thinking about steady state, gross to net status, for Fort Calgary obviously there's some things like sampling and copay assistance and you're fairly aggressive of that on that early in the launch but you know with contracting in place looking out say two to three years what does that look like thank you sure regarding the first question as far as a priority I mean in in in BD as we all know availability is always half the battle and
We are looking for a commercial asset in both areas, neurology, psychiatry, and we will figure out a way. If it isn't psychiatry, and it all depends on the timing, of course, as to when that asset comes on board, we will figure out a way how to give it the right attention and also not to take away from the Calvary launch. Clearly, the Calvary launch, no question, by far is our top, top priority as a company at this time, and then followed later on by the pump, which is extremely important for us as well. So anything we bring in, depending on the timing of that acquisition, if we're lucky and fortunate to be able to land a really good asset, then we'll figure it out and we'll staff it and give it the right resources to do a good job with the new asset as well. So I wouldn't limit ourselves by saying now we're very busy and we don't have the time for something else. Absolutely not. We're fully engaged on the BD side and it will continue to be a priority for us to employ the balance sheet and put it in the right place to give us future growth for the company. As far as the question on gross net and steady state, I mean, we've all seen all the horrible gross to net levels that a lot of products have been launching with and so forth. I sure hope and we will be trying, you know, to work pretty hard to be much lower than, you know, the 60s and the 70s percent gross to net. I don't think that's a very viable long-term strategy for a lot of products to continue with that kind of, you know, trend. So we sure hope to be much lower than that. But it's really hard for us to give you a specific number, given that we haven't finished all our contracts or the contracts and so forth. So we will need a year or so in the marketplace, obviously, to get a good feel as to where long-term-wise, steady-state-wise, we may be able to settle at what level.
Okay, great. Thanks, Jack.
Sure.
Your next question comes from the line of Annabel Samimi from Stifel. Your line is now open.
Hi, everyone. This is Nick Rubino on for Annabel. Thanks for taking our questions. A few from us. First, are you guys currently engaging with physicians in kind of this, I guess, soft launch that you're currently in? And then how are things going to change once you have the product in hand? I know you mentioned kind of sampling programs as being a large part of that and kind of how are you integrating that with physicians and how should we see physicians kind of utilizing that program. Then second on pricing, you guys are at kind of the low end of the range of options. How is that facilitating payer conversations? And lastly, can you just remind us quickly about Velocizine IP in the U.S.? We know it's in NCE, but kind of what's the broad patent portfolio strength like?
Thank you. Sure. I mean, the first question as far as to how the conversation and what kind of conversation you have with physicians initially when you have a soft launch, so to speak, or when actually the product becomes available, clearly, At the beginning, you know, we don't want to jump the gun because we don't want to disappoint physicians. They start writing prescriptions and the product is not available. So the timing is very delicate to make sure that those conversations are happening at the right time with the physicians. Those conversations meaning detailed conversations about the benefits of the product, the unique profile of the product, the type of patient that the product can help, you know, and so forth. those conversations will be more closer to when we know for sure that the product is going to be at the shelf available so that when the patient walks out of the physician's office with a prescription, they can actually fulfill and get that prescription. So clearly, that's always the delicate part of the initial launch between getting the supply, getting the product in the pipeline and the distribution channel, making it available, and then our sales force at the same time doing building the awareness around the product, building the excitement around the product, and when we get closer to having the product available, have the real, real conversation and selling the product to physicians and showing them the benefits of Calvary. As far as the pricing, I can't really make any specific comments other than what everybody knows. Our pricing, we always said we are going to be reasonable in pricing our product. It is priced to make sure we have access and give access to people for the product. One question came up a couple of times. We don't know where the total daily dose is going to end up landing. It could be much higher than 100 or 200 milligrams. That remains to be seen, obviously, as physicians start using the product on a mass scale and trying it to see where the total daily dose will end up being on an average. And then finally, regarding Veloxacin and the IP in the U.S., we have several families of patents here surrounding the API synthesis, surrounding the formulation, as well as surrounding the novel use of Veloxacin in ADHD. And the patents are in the 2029 to 2033 timeframe as far as expiration.
Great. Thank you very much.
Once again, if you wish to ask a question, please press star 1 in your telephone. You have a follow-up question from the line of David Steinberg from Jefferies. Your line is now open.
Okay, thanks. I have two follow-ups. My first is on Quelbry. The pricing came out, and I think you just alluded to this, with a WAC price for the 100, 150, 200 milligram. Given that like half the scripts now in ADHD are adult, And if you look at the $299 to sort of $600 ranging from the 100 meg up to, you know, more than 200 megs, where do you think the average sort of blended WAC price might be? Would it be over $400, if you assume, or well over $400, if you assume that 50% of the users are going to be adult users? And then, Jim, you called out, I just wanted some clarification on this, Apokine came in quite a bit lower or a decent amount lower than you thought in the first quarter, and you called out market and payer pressures. Could you give us a little more clarification on what those pressures are and why you think they're going to get under control? And I think Jack said, you know, get to sort of a normalized situation. Thanks.
Yeah, regarding the Calvary pricing, again, the point I was trying to make is clearly we will need some time to see where physicians end up and the experience they see themselves in the marketplace as far as where the total daily dose will land. In our clinical studies, as everybody knows, we started with 100 milligrams for the young children as a starting dose and then for adolescents with 200 milligrams, and they could go all the way up to 400 milligrams. Of course, with adults, we did the study and we started with 200 going all the way up to 600 milligrams. So clearly, as the actual usage in adult gets in the 400 to 600 milligrams, so clearly that's going to bring your weighted average WAC into the higher range from a pricing point of view. And similarly, even in adolescent, because the adolescent study went up from 200 to 400 milligrams. So clearly, the 400 milligram is going to carry a much higher price price point for that prescription. So all in all, that's why we said the total daily dose, we see it probably trending upward as time goes on for these reasons as people get more experience with the product and as we get also the adult indication on board as well. Could it be north of 400? Probably. I mean, if you run the math pretty quickly, assume, you know, a certain mix, you probably will end up somewhere, yeah, in that range, higher than the $400 for a 30-day prescription. On APOCAN, I can jump in very quickly, and then Jim can add. I mean, the market pressures we talked about, it's really the same that I mentioned in my comments, which is really the market dynamics with the competitive, like in Mobi and Bregia and other products in that sector on demand. therapies that we've seen some competitive dynamics there. COVID continues to a certain extent, continues to hurt that specific patient population because it is Parkinson's initiation. This is an injection that requires a nurse visit. So there is more to it than just prescribing a pill, obviously. So that continues. However, as I mentioned in my remarks, we're starting to see and easing of that, and we started seeing that more a little bit at the end of the first quarter into the second quarter. So we're encouraged a little bit with the improvement on patient initiations and so forth. And then regarding payer pressures, it's really the common is more related, and Jim can jump in, but it's really more related to the insurance issues that you typically see in the first quarter.
And that's exactly right. You see it across all products, and with a specialty product like Ipekin, potentially a little more than others just based on the price point. Reset of insurance and co-pays.
Got it. Okay. So multiplying the first quarter by four would be on the low side for the year then, right?
Hopefully, yes. Yeah. Yeah, I mean, we expect improvement through the year.
Thank you.
And hopefully COVID even gets better and better as time goes on, which I think that will be the case. So we're encouraged with what we are starting to see across different states, reopening and so forth. So we're very encouraged with that.
Once again, if you wish to ask a question, please press star one on your telephone and wait for your name to be announced. A follow-up question from the line of Annabelle Sammy from Stifel. Your line is now open.
Hi, thanks again for the extra question here. We did get an extra question on our end. So with the Turkendi EUTRX is down 13% year over year, you know, we're seeing a big jump in revenue and we're seeing the same dynamic in Axtellar as well with flat EUTRXs and increases in the revenues. But with pricing kind of flat to down, where is that delta and how should we think about that kind of discrepancy?
Thank you. So why don't I start, if Jackie don't mind, I'll jump in here. When you look at Oxteller and you look at, for example, the prior year, some of the ups and downs that we saw in 2020 from, for example, Q1, Q2, and Q3, you'll see that the Q3 number of about 28.4 million is in line with where we are now, but it's shouldered by numbers of about 23, 24. And so what we were witnessing is we definitely noticed that there was some ups and downs and I'll call it the retail channel holdings of inventory as COVID was happening last year. We think that's evening out just based on what we're seeing in the data we use to do our accruals. And so it is creating some year over year comparison issues, primarily from Q4 into Q1. That said, when you look at the year over year on Oxteller itself, we're looking at, you know, about 9% year over year. And we took price of about 8%. So don't get me wrong, sequentially, the journey from Q1 last year to now has some ups and downs. But when you look at just the pricing we've taken and a fairly stable gross to net, it falls in line with the expectations. When you look at Trekendi, you get a year-over-year, let me get my numbers correct here, excuse me, it's about 14% year-over-year on Oxteller with the pricing and then a slight improvement in our gross to net in Q1. When you look at Trekendi, year-over-year of about 5%, you compare that to the extended units being down about 12%. And so we are certainly making up some benefit there on Gristinet as well. Okay, great.
That's very helpful. Thank you.
Sure. There are no further questions in queue. I will now turn the call over back to Jack.
Thank you. We remain focused on the launch of Calvary, a treatment option that is like no other ADHD product on the market. I would like to thank all our employees who have been committed for years to develop Calvary and to make it available to the millions of patients who can benefit from its unique clinical profile. In addition, we continue to advance SPN830 along its regulatory path towards potential approval. Kelby and SPN 830 represent important growth drivers for our company, and we are committed to progressing them towards commercialization and market success. Thanks again for joining us today, and we look forward to updating you on our progress throughout the year.
Thank you, presenters. This concludes today's conference call. Thank you for participating. You may now disconnect.