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spk11: Good morning all. I would like to welcome you all to the series Biopharma second quarter 2023 financial results call. My name is Prika and I will be your moderator for today's call. All lines are on mute for the presentation portion of the call today with an opportunity for questions and answers at the end. If you would like to ask a question, please press star then one on your telephone keypad. I would now like to pass the conference over to your host Alison Way, Senior Vice President of Investor Relations and Corporate Communications to begin. So Alison, please go ahead.
spk00: Thank you, Brika. Good morning and welcome to Xeris Biopharma's second quarter financial results conference call and webcast. A press release with the company's financial results was issued earlier this morning and can be found on our website. We are joined this morning by Paul Edith, Chairman and CEO, and Steve Piper, our CFO. Paul will provide opening remarks Steve will provide details on our financial results, then we will open the call for Q&A. Before we begin, I would like to remind you that this call will contain forward-looking statements by which they include but are not limited to statements concerning our business practices, future expectations, plans, prospects, clinical approvals, commercialization, corporate strategy, and performance, which constitute forward-looking statements within the meaning of the Private Securities Litigation Reform Act of 1995. Actual results made different materially from those indicated by the forward-looking statements made during this call as a result of various factors, including our financial position and need for financing, including to fund our product development programs or commercialization efforts, whether our products will achieve or maintain market acceptance in a competitive business environment, our reliance on third-party suppliers, including single-source suppliers, our reliance on third parties to conduct clinical trials, the ability of our product candidates to compete successfully with existing and new drugs, adverse effects of macroeconomic conditions on our business operations and clinical activities, and our and our collaborators' ability to protect our intellectual property and proprietary technology, as well as other risk factors set forth in our filings with the Securities and Exchange Commission. Any forward-looking statements on this call represent our views only as of the date of this call, and should not be relied upon as representing our views as of any subsequent date. Subject to obligations under ethical law, we disclaim any obligations to update such statements. I'll now turn the call over to Paul.
spk05: Thanks, Alison. Good morning, everyone, and thank you for joining us today. For the past several quarters, I've started by reiterating what kind of company we're building at Ceres. I'm excited to once again say that the entire organization continues to execute, performing at a high level, and absolutely delivering on our vision. What I hope you take away from today's call and our continued positive performance is that everyone at Xeris remains intensely focused on delivering for patients by continuing to build a substantial patient-centric, commercially focused, and self-sustaining biopharma enterprise. I believe that all three pillars of our business, multiple growing commercial products, a highly targeted development pipeline, and value-added technology partnerships are contributing to our vision and will result in long-term shareholder value. I'll start with key highlights of another record quarterly performance. We recorded total revenue of $38 million in the second quarter, a 50% increase from second quarter of 2022, and a 14% increase from first quarter of this year. This is our third consecutive quarter of at least 50% revenue growth year over year. We ended the second quarter with over $80 million in cash, cash equivalents, and short-term investments, a very healthy cash position to support our continued growth. Based on our performance year to date and our outlook for the rest of 2023, we have tightened our full year 2023 guidance as well. Our revised guidance for 2023 is total net revenue of $145 to $165 million, cash utilization of between $57 and $67 million, and 2023 year-end cash balance of between $55 and $65 million. Importantly, we remain on track to hit a cash flow break-even point by year-end 2023 and will continue to be a self-sustaining company thereafter. Steve will get into more of our financial performance in some detail later on. On to the first pillar of our business, our growing commercial products. All three products, GVOTE, Cabeas, and Recorlev, showed strong growth, collectively generating approximately $37 million in net product revenue in the second quarter, an impressive 46% increase over second quarter last year, and a 14% increase over first quarter 2023. Let me break it down in one product at a time. First, GVOC. GVOC had another record quarter of net revenue in prescriptions, totaling $15.6 million in net revenue, a 36% increase compared to second quarter of 2022. Total prescriptions for the second quarter were over 51,000, growing 50% compared to the same period last year and a 12% increase from first quarter 2023. Throughout the second quarter, GVOC has averaged approximately 4,000 prescriptions per week and has recently hit a new all-time record of over 4,500 prescriptions in the most recent weekly data. Market growth for glucagon products is back to consistent double digits. GVOC continues to outpace all other products by driving the majority of the market growth. We also continue to capture market share. At the end of July, GVOC market share of new and total prescriptions in the retail glucagon market grew to approximately 31% and 29% respectively. The new ready-to-use glucagon products now represent 79% of new prescriptions and over 77% of total prescriptions. We are in back-to-school season now, and with the latest weekly record high, we believe we are starting to see the bump in weekly prescriptions that recurs annually during late July and August, accompanied by an uptick in overall market growth. To build on GVOC's momentum later this year and going into 2024 in the now double-digit growing Lufthansa market, we are investing in another modest expansion of our inside sales force. We'll be adding 20 inside sales reps in the fourth quarter of this year, bringing that force to a total of 50. We've proven this group can be highly productive rather quickly in generating GVOLC awareness, fueling market growth, and gaining GVOLC share. Also, you may have seen last week GVOLC hit a major milestone. Over 1 million GVOLC units have been shipped since its launch in late 2019. We are extremely proud of this achievement. However, we are just scratching the surface of this opportunity. There is a long way to go until 15 million people with diabetes who are at increased risk of a severe low blood sugar event are carrying a ready-to-use glucagon, such as Givo Kypopen. The key to a major change in this situation is the healthcare professionals who manage these patients. To address this critical situation and motivate healthcare professionals to do more, the ADA, the Endocrine Society, the Association of Clinical Endocrinology and other professional societies have revised their guidelines or algorithms in some manner to advocate that the standard of care for all insulin and sulfonylurea treated patients should be that they are also prescribed a ready-fused glucagon so they are protected against a potentially life-threatening severe low blood sugar event. Based on the latest available data, there are still over 240,000 emergency department visits 60,000 hospitalizations, and tens of thousands of deaths annually due to severe low blood sugar. These are avoidable with the new innovative ready-to-use glucagon products, as are the associated healthcare costs.
spk09: On to Recorlove.
spk05: Recorlove generated $7.2 million in net revenue for the second quarter. an increase of over 640% from the same period in 2022, which was its first full quarter since launch, and an increase of 60% over the first quarter of this year. We're very pleased with the steady increase in the correlative revenue quarter over quarter. Patient referrals and average number of patients on drug grew 37% and 33%, respectively, over the first quarter. Even more impressive is that we're increasingly seeing the correlative being prescribed as a patient's first drug therapy for a growing number of current referrals. This means that healthcare professionals are seeing some positive results from therapy and using Recorlev and increasingly valuing Recorlev as a first-line treatment for Cushing syndrome post-surgery. Again, building on our momentum of accelerating referral rates, rising conversion rates, and with the expected growth in the market, we will also be further invested in expanding of sales force to approximately 30 in the fourth quarter to take advantage of our momentum going into 2024. Moving to Cabeas, Cabeas had another great quarter in terms of revenue, new referrals, and patients on therapy, despite the fact that there has been an approved generic since the end of last year. Second quarter revenue for Cabeas was over $14 million, which represented an increase of 10% compared to the same period in 2022. Excuse me. Our referral rates have also continued to grow approximately 8 to 10% compared to the second quarter of 2022 as we continue to identify new patients. The average number of patients on Cabeus grew about 11% compared to the second quarter last year. To date, we have seen how generics may impact the payer process and have taken measures to maintain and support our patients. We know it takes more than dichlorophenamide to treat patients' primary periodic paralysis. There is a heightened focus on the value of our Xeris Care Connections team, patient advocates, and mentors to support our PPP patients and healthcare providers through screening, reimbursement, authorization, initiation of therapy, and the long process of titration to most effective dosage. On to the second pillar of our business, pipeline development. In the second quarter, we began enrolling patients in the phase two study of our Xerosol Levothyroxine, a potentially once-weekly sub-Q injection And that study is now about 25% enrolled. As we've said previously, the study will be rather slow to fully enroll. The study design required subjects to be on a stable dose of oral levothyroxine for at least three months with normal thyroid laboratory tests, such as TSH and T4. As expected, while we have screened many subjects taking chronic oral levothyroxine, a significant number have failed to meet the standard for stability over three months. further to the evidence that the challenges associated with oral thyroid hormone replacement therapy, which speaks directly to the unmet need we aim to address with our once-weekly sub-Q. To enhance our pace of enrollment, we're currently adding additional clinical research sites in order to maintain our goal of completing the study in the first half of next year. Data from the Phase II study, as we've said previously, will help inform our proposal to the FDA for a pivotal Phase III program. We believe that our once-weekly subcutaneous levothyroxine, if approved, will compete in a potential $2 to $3 billion market segment calculated at current brand prices. Now on to the third pillar, our Xeris Technology partnership business. The three Xerojet partnerships that we have with Merck, Horizon, and Regeneron are all in various stages of development and continue to meet or exceed our partners' expectations. First, for Merck, we have completed several rounds of Xerogec formulation and formulation optimization. We have met 100% of the agreed upon specifications and stability requirements for their molecule and have delivered all required data as defined by the joint development program. Work plan. Although our formulation work exceeded their expectations, Merck has chosen not to move this particular preclinical asset forward into clinical development given their other preclinical pipeline priorities. We have a great relationship with Merck. They remain impressed with our team and technology, and we continue to explore other potential opportunities to work together. I would also note that even though this program is not progressing, there was a huge side benefit to our Xeroject program as a result of the Merck collaboration. One of the deliverables that needed to be achieved was a detailed, validated plan and timeline for potential manufacturing scale-ups. As part of that plan development, the team worked incredibly hard within a very short time window to successfully complete our first manufacturing scale-up engineering batch using our own biologic material. A huge step forward in our Zero-Jet program that can benefit all current and future collaborations. For Horizon, considerable progress has been made and work continues with formulation and optimization of the sub-Q version of TPEZA. We're very confident we'll meet the agreed upon target product profile and deliver three months of positive real-time stability. Once achieved, we'll receive a $6 million success payment from Horizon. We expect Horizon will, soon thereafter, also inform us as to whether they will execute their license option and whether they plan to proceed with further development and potential commercialization. Since announcing the Regeneron collaboration in late March, Regeneron has already nominated the first two molecules in the platform program. We're well into formulation work on the first of the two molecules and expect to begin formulation work on the second very soon. As we reported previously, Regeneron also has the option to nominate additional molecules for formulation development. Each of our technology partnerships highlight the unique value proposition of our proprietary seroject and Xerosol formulation capabilities and their potential for long-term value creation. Hopefully, as you've just heard, we have You take away that we have another great quarter and first half of 2023 with each of the three pillars of our business continuing to perform. Through continued revenue growth, prudent allocation of resources, and disciplined expense management, we expect to hit the cash flow break-even point before year-end. This milestone should demonstrate to our shareholders that we can be a growing, self-sustaining biopharmaceutical company without the need for additional equity capital to fund our operations. I'll turn the call over to Steve for additional details on our second quarter financial performance.
spk04: Thanks, Paul, and good morning, everyone. We had another great quarter driven by the continued growth of all three products, both in net revenues and underlying market demand. Coupled with our disciplined cash management, we exited the second quarter with an extremely healthy cash position and are on track to hit cash flow break even in the fourth quarter. For the second quarter, total revenue was a record $38 million, representing a 50% increase over the same quarter last year. It's worth highlighting that this is the third consecutive quarter of at least 50% revenue growth. Strong underlying patient demand for all three products, coupled with revenue from our collaboration partnerships, drove this growth in total revenue. Let's start with Recoralev. as we are excited by the momentum we are generating with this product. Recorlev net revenue was $7.2 million for the second quarter and $11.6 million on a year-to-date basis. Compared to Q1 23, net revenue increased by $2.7 million. This growth is the result of an increase in the number of patients on therapy growing 38% quarter over quarter. We expect these strong results to continue as we are generating high quality referrals and providing full service support to help patients start and stay on therapy. CHEVOC net revenue for the quarter was a record $15.6 million, representing a 36% increase compared to the same period last year. Year-to-date net revenue was $30.7 million, representing a 28% increase compared to last year. In the quarter, GVOC prescriptions topped 51,000 for the first time, a 50% increase compared to the same period in 2022. In the second quarter, the total glucagon prescription market grew 1% compared to the first quarter. Notably, GVOC total prescriptions grew 12% in the same period, ending the quarter with total retail market share of approximately 29%. GVOC continues to significantly outpace the market. Moving to Cabeas. Cabeas net revenue for the quarter was $14.1 million, representing a 10% increase compared to the same period last year. Year-to-date net revenue was $26.8 million, representing a 21% increase compared to the same period last year. This revenue growth was driven by an increase in the number of patients on Cabeas. This proves our strategy to continue to invest in CAVEAS has been successful to date in defending against generic competition. We will continue to invest in CAVEAS and Xeris Care Connections as they offer the best in class therapy and support for PPP patients. Looking ahead for the full year 2023, based on our overall year-to-date results and confidence in our products and technology partnership collaborations, We are raising the low end of our previously issued guidance, which as a reminder was $135 million. We are raising this low end to $145 million, which now takes our new total revenue guidance range from $145 to $165 million. Moving down the P&L, cost of goods sold in the second quarter was $7.6 million, a 57% increase compared to the same quarter last year. This increase is mainly driven by higher sales. Research and development expenses were $6.1 million for the quarter, a $2.4 million increase compared to the same quarter last year. This increase is consistent with our comments from our guidance earlier this year. We continue to expect a modest year-over-year increase in R&D expenses in order to fund our Phase II Levothyroxine clinical trial, the completion of our Recurlive Optics study, and continued development work of our proprietary formulation science. Selling general and administrative expenses were $37.6 million for the quarter, a $4.7 million increase compared to the same quarter last year. This increase was driven by an increase in personnel costs from last year's fourth quarter Salesforce expansion, timing of marketing expenses, and rent expenses related to the new lease that commenced in April. On a year-to-date basis, SG&A increased slightly by 3% compared to last year, which is again consistent with our previous guidance that SG&A would be relatively flat for the year compared to 2022. Given our strong commercial performance to date and our revised outlook, as Paul previously mentioned, we are expanding our GVOC and Recurlab sales teams in the fourth quarter to build on our momentum. It's worth noting that this expansion has been factored into our revised year-end cash guidance. We ended the quarter in a strong cash position. As of June 30th, we had total cash of approximately $81 million compared to $95 million at March 31st, 2023. We are executing on our strategy, and as we mentioned previously, we expect cash utilization to moderate throughout the middle of 2023. until the fourth quarter when we expect to achieve cash flow breakeven. Based on our strong year-to-date performance, we are increasing the low-end of our previously issued year-end cash guidance, which as a reminder was $45 million. We are raising this to $55 million, which takes our new year-end cash guidance to $55 to $65 million, which results in a revised and improved full-year cash utilization of $57 to $67 million. I'll now turn it over to the operator. Please open the line for questions. Thank you.
spk11: Thank you. If you would like to ask a question, please press star followed by 1 on your telephone keypad. If for any reason you would like to remove that question, please press star followed by 2. Again, to ask a question, please press star then 1. We have our first question on the phone lines from Orion Levinat of HC Wainwright. You may proceed.
spk08: Thanks. I have a few.
spk07: On GVOC to start, I think we've seen some flattening of the share, I guess, since mid-May. And I think that's a pattern we've seen every year since launch in the summer into early September, some flattening, or actually in prior years, even decline in share. Can you just remind us what the dynamics are there and how confident you are, not just market growth going forward, but a reacceleration in September and beyond of market share?
spk05: Hey, Oren. What you see is that little bit of seasonality. When we start to get into the back-to-school period, usually mostly July and August, our share doesn't accelerate as fast as vaccinee, for example. Back-to-school is really a pediatric endo business, and Lilly has been historically, and still is, extremely strong in pediatric endo. So our business continues to increase. The sales of GEVO continue to increase, but the share capture slows a little bit. It's an annual phenomenon. You can see it every year since launch.
spk07: Is there any difference with Amphistar promoting this product now versus Lilly, and not just on their promotional or infrastructure side, but maybe on... You know, I noticed your prescriptions were up 12%. I do highlighted quarter-over-quarter. Sales were a little flatter. So is there any underlying change there, or is that just noise quarter-to-quarter in terms of gross to net or inventory boost?
spk05: It's noise quarter-to-quarter. And we have seen – we haven't seen any commercial activity to speak of at all on vaccinee. We actually are hoping that Amphistar – has a strong commercial effort to continue to accelerate market growth. You know, having both Lilly and Xeris in the game early on was really important, and we hope that, you know, that that continues. But in no contracting activity at all.
spk07: Okay. I just, and I'll get in queue after this one again, but on Coveas, you had a record sales and up 10%, I think, quarter over quarter, despite, I guess, some of our anxieties about the presence of a generic in the market. I guess, how did that happen? What are you seeing with regards to any impact of a generic? And are you still expecting potentially a second entrant this year?
spk05: I'll start with the second question first. Planning scenario was we always expected from the get-go a second entry. We haven't seen one yet. We'll cross that bridge when we come to it. But our strategy has been the same as what we said we were going to do. Our care connections is extremely important to our physician customers and very, very helpful to patients. And that's a big part of why we're able to continue to keep people on the branded product. Physicians are willing to fight for brand. Patients are willing to fight for brand because they get tremendous support in terms of negotiating reimbursement. Our patient assistance managers are constantly in touch with patients and helping them with whatever their needs are. We have patient mentors, which are patients who have been on Cabeas for a long time, helping patients who are new to Cabeas through their titration period. It's a very, very white glove, hands-on service. And we think that's had a great deal to do with our ability to maintain the business. We're also continuing to add patients. We're growing referrals and we're growing patients quarter over quarter. You know, obviously, you know, if there are multiple generics in the future, will pricing erode a little? Yes. Might we lose some patients in the future? Yes. But as we've said, we're going to defend this business and continue to invest for as long as necessary.
spk07: Oh, and if I may, just speaking of your white glove services per se, on the Recorlev front, you know, how is that hub working versus expectations on not only getting Recorlev patients on therapy, you know, from referral to paid therapy, you know, timeline-wise and success rate-wise, but also keeping them on that. You know, I understand that a lot of, you know, you're still early in the launch, but Some of these plans, I understand, require recertification or reauthorization quite frequently for these expensive drugs. You know, how's your experience been on getting patients on and keeping them on drugs?
spk05: It's been excellent. So once again, these are rare disease products, and it's a negotiation one patient at a time. So you're not getting, you know, contracted drugs. formulary additions and things like that. If you were to compare the success rate that we have with getting patients approved for recorlif therapy, it's as high as you would see if you were in a normal therapeutic category trying to get formulary access. We have tremendous success. We're getting great access. Denials are relatively low. And we apply the similar care connections to Record Lab that we have for Cabeas. And keeping people on drug has been very successful. As you know, they have to titrate over time, and we kind of hand-hold them through that process. There is a little bit of a correction in the first quarter of every year in terms of people getting reauthorization of their insurance, but that has not been an obstacle at all.
spk08: All right, thanks. I appreciate it. Congrats on the good quarter.
spk11: Thank you. Thank you. Your next question comes from David.
spk06: Hi, thanks. This is Skylar on for David. Two questions here. Can you speak to the typical patient that is receiving RecorLive or more broadly the patient mix? particularly in terms of prior exposure to racemic ketoconazole? And in that vein, what does the payer landscape look like for those who want to use RecorLib in the first line? Are you hearing that payers are requiring patients to step through ketoconazole? Thanks.
spk05: So the patient mix is not dominated by ketoconazole at all. We're getting patients from all over. We're getting post-surgical de novo patients, So, you know, the first line therapy doesn't require a step through. That's what's really exciting about it. The fact that we're getting a lot of, an increasing number of patients who are being referred to Recoralev straight after surgery is unusual this early in the game. And we're getting patients from all of the other branded products, including, well, and some are coming from keto, but it's not an outsized number at all.
spk02: Got it. That's helpful. Thank you.
spk11: We now have Glenn Santaglia of Jefferies. You may proceed.
spk01: Oh, yeah. Thanks for taking my question. Hey, Paul, I just want to follow up on a couple of points that you discussed. You know, obviously a good quote on record living is, but I wanted to dig into GVOC a little bit because it seemed to suggest The IQVIA data seemed to suggest that maybe revenues would have been a little bit higher than what they were, which I guess is sort of just based on the script number. And it kind of feels like a little bit of the same scenario from last quarter where you're maybe making a little bit less money on a per script basis. Could you just unpack that, you know, the GVOC revenues a little bit and give us a better sense for what's happening on the script and pricing side?
spk05: Yeah, Glenn, that requires a little bit of math, which I'll turn over to Steve to answer.
spk04: Yeah, Glenn, good question. So yeah, I think if you just did the math and assumed that the IQVIA data would extrapolate to net revenues, that would suggest that our GVOC revenues would be about $1 million higher. I think what we saw, again, in the second quarter was a further tightening of wholesaler uh channel inventory levels uh by about a half a week you know it's not necessarily a bad thing that there's there's a tighter correlation i think between what's going on in the channel in terms of the inventory levels in the true demand that we you know see in the the iq via data so again that that you know was a bit of a drag on net revenue If you look at kind of historical averages over, you know, the last three years, you know, it can go up a couple weeks in terms of the inventory levels and down a couple weeks. And so, you know, the first half, it's been a bit of a drag on that revenue. But I would say, look, the underlying demand, the underlying patient demand is what's going to carry the day, you know, at the end of the day. And that continues to be, you know, really strong. And that, you know, the inventory levels in the channel should follow that. Okay, perfect.
spk01: That makes sense.
spk04: Where there's a back to school.
spk01: Yep. Yep, yep, perfect. All right. I appreciate that. Just two quick financial ones. With respect to the Horizon contract, you know, Paul, you mentioned the $6 million success payment that you were hopefully going to receive. Do you have any idea – or when you're expecting to receive that? And I'm kind of curious if any of that's embedded within this year's guidance.
spk04: Yeah, so good question, Glenn. This is Steve. I'll take that one. So based on the work plan and our current progress, we expect to complete that work plan in the fourth quarter. So yeah, that is factored into our guidance, both from a revenue and cash perspective.
spk01: All right. And then last question on the cash flow, Steve. I mean, you mentioned a number of times how you expect to be a cash flow break even by the end of this year. And I just want to reconcile that based on the guidance that you're sort of putting out there, right? Because you generated $71 million in REVs in the first half, which to hit the midpoint, you need to generate $84 million in the second half, which is a nice step up. But it also feels like your expenses are going up. You You know, obviously with your revenues, you also mentioned that you're expanding the GVOC Salesforce by 20 reps, and you said you're expanding the RecurLiv Salesforce to 30. I'm not sure how many incremental additions there are, but just looking at the, you know, the loss from operations this quarter, trying to forecast the incremental revenues in the back half with an anticipated increase in expenses, I'm just trying to reconcile all those data points and think about that path that cash flow break even by the end of this year. And I'll stop there.
spk04: Yeah, good question. So, you know, as Paul mentioned, the expansion, at least on the GVOC side, is very modest with the inside sales expansion. So most of those folks, you know, it's not as costly as an expansion as a traditional field expansion is. We do have, as I just mentioned, the six million from Horizon in our guidance as well in the fourth quarter. That certainly helps some other one-timers. I would say, you know, in general, our SG&A should be relatively flat year over year. So, you know, we saw an increase in this quarter. Some of that was just timing of marketing expenses, you know, just preparing for the back-to-school push in the third quarter for GVOC. But on a year-over-year basis, it should be relatively flat. So I think that all kind of points to it. And we feel, again, very confident about hitting cash flow breakeven in the fourth quarter. Very confident.
spk01: Okay. Thanks for the details.
spk11: Thank you. We have a final question on the line from Rana Raze of SVB. You may proceed with your question.
spk10: Hi, everybody. Good morning. This is Nick Gassick on for Rowan. Thanks for taking our question. Maybe first, maybe a bigger picture question. What are some of the pushes and pulls of getting closer to the high end of your new guidance? Which of your commercial products do you think are most likely to drive you towards the higher end of this range? I have a quick follow-up.
spk04: So, good morning, Nick. This is Steve. I'll take that one. So, one, I think it's been a pretty resilient first half for Cabeas in the face of generic. So, that's given us increased confidence. And I think where we saw Rekorlev exiting Q2 also gave us really good confidence in terms of raising that low end. You know, GVOC will continue to perform. You know, that's been on our bag for nearly four years now. So, we have pretty good confidence in how that will perform, particularly in the second half. But I think, you know, what's happened with Cabeus and how resilient it's been in the first half of this year, and the growing momentum with Recoralev, getting those patients started and staying on therapy. gives us confidence to raise the low end of the revenue range.
spk10: Scott, that's very helpful. And just a quick follow-up on Jivo. You talked a little bit about pricing. I'm curious if you could share your outlook on gross to net dynamics in the back half of the year. Do you expect these to stay generally stable or potentially pick up? Or how should we think about those dynamics in the back half?
spk04: yeah as i think even going back to the second half of last year we said we've said that you know gross and nuts have have stabilized um so we don't anticipate any uptick uh in the second half uh from a gross to that perspective at all got it very helpful and if i may uh one more question on record how should we think about um you know
spk10: growth in new patient additions into next year? And maybe, I know you mentioned this earlier, but what are you hearing from physicians in the field on the dose titration process? And, you know, how are patients doing on the drug overall? Could you talk a bit more about that?
spk05: This is Paul. I'll take that one. Patients are doing very well. I think part of the reason that doctors are starting to get comfort starting patients first line is because of the performance of the patients they've already put on the drug in terms of efficacy and low and manageable side effects. We expect patient acquisition, referrals, and patients on drug to continue to grow at a similar pace. You know, going into the fourth quarter, the second half of the year and toward the end of the year, you know, we're not going to really give any guidance for 2024 yet, but, you know, we expect continued momentum. And we're seeing great response from physicians.
spk02: Very helpful. Thanks, Paul.
spk11: Thank you. You know, I have another follow-up question from Lauren. There's an app. Please go ahead.
spk07: Thanks for the follow-up. Just two real quickly. On CAVEAS, is there any update on the patent front? And on LIVO, your guidance for data by first half next year sounds, I guess, a little faster than the conservative expectations you sort of gave us before about how hard it is to find patients and sort of reiterated the challenge there. That 25% enrollment so far, are you running ahead of schedule despite the screen failures that you do and expected to see? Are things going a little faster? Thanks.
spk05: I wouldn't say things are going faster. Screen failures are high, as we anticipated, because finding patients that are stable on Levo for three months is proving to be what we anticipated as hard. We didn't know what we didn't know going into the study in terms of timing, so I think being conservative in terms of enrollment when we first started out in terms of what we anticipated and what we conveyed to you. Adding a couple more sites I think is going to help us to continue to push the enrollment. And I think the first half is still achievable. Correct. And on the SKVS patent front? Oh, the patent. We did have our, as you know, there are several layers of appeal in the patent process. As we've discussed, you go through a direct appeal, then you go to an appeals board, and you have to get through all of that before you end up, you know, with the ability to potentially go to court. As we anticipated that appeal to the patent trade appeals panel, They upheld the examiner's decision. So the next step is Federal Circuit Court, and that's where we're headed next.
spk08: All right. Thanks for the update.
spk11: Thank you. I'd like to hand it back to Mr. Edick for some closing remarks.
spk05: Thank you, operator. Thanks again to everybody for joining us today. We're very proud of what we're building here at Xeris to service our patients and our healthcare professional customers. I'm especially proud of our team's performance and all we've accomplished to date. Three consecutive quarters of at least 50% revenue growth is not something that a lot of companies can brag about today. And I'm excited for us to build on the first half of the year for the remainder of 2023. I also want to thank our many loyal investors who see the potential Xeris possesses and continue to support us as we build a special kind of company. Thanks again for joining our call.
spk11: Thank you all for joining. I can confirm today's call with Xeris Biopharma has now concluded. Please have a lovely rest of your day and you may now disconnect your line.
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