Medicure Inc.

Good morning and welcome to Medicare's Earnings Conference Call for the year ended December 31, 2021. My name is Chris and I will be your operator for today's call. At this time, all participants are in a listen-only mode. Before we proceed, I would like to remind everyone that this presentation contains forward-looking statements relating to future results, events, and expectations which are made pursuant to the safe harbor provisions of the U.S. Securities Litigation Reform Act of 1995. Forward-looking statements involve known and unknown risks and uncertainties, which could cause the company's actual results to differ materially from those in the forward-looking statements. Such risks and uncertainties include, among others, those described in the company's most recent Annual Information Form and Form 20-F. Later, we will conduct a question-and-answer session. Please note that this conference call is being recorded, and today's date is April 28, 2022. I would now like to turn the conference call over to Dr. Albert Friesen, Chief Executive Officer of Medicare, Inc. Please go ahead, Dr. Friesen.

Thank you, Chris, and good morning to all on the call. We appreciate your interest and participation in today's call. Joining me today is Dr. Neil Owens, President and Chief Operating Officer, and Horace Uten, providing consultation for the preparation of this year's financial statements for 2021, which are the statements we will be discussing this morning. We're pleased with the positive trend of revenue and increased EBITDA quarter over quarter. Sales of Agristat have remained steady with some further growth over the previous year. We're pleased with the position of our December 2020 acquisition of Marley Drug which has helped accelerate the growth of Zypidemag sales. We're hopeful that the launch of our e-commerce platform will further enhance both sales of Zypidemag and other pharmaceuticals provided through home delivery. One of the reasons we acquired Marley Drug, a pharmacy uniquely positioned to dispense medications to Americans in all 50 states and territories through mail, was to expand our sales Reach for Zypidemag. This acquisition also gives us the opportunity to provide all FDA-approved medications at affordable prices. We believe the best way to do this is through a direct-to-consumer approach through an e-commerce platform coupled with our existing infrastructure. So far, it's working well. The goal of the platform is to bypass the traditional framework run by health insurers and pharmacy benefit managers that has made access to affordable medications too expensive for many Americans including both generic and branded drugs such as . More than 120 million uninsured and underinsured Americans struggle to access affordable medications and are looking for trusted and convenient source to fill their prescriptions. Marley Drug will offer industry-leading pricing on more than 100 of the most commonly prescribed generic chronic care medications with free nationwide delivery. Additional medications will also be on the platform. The platform will focus on ease of use and customer service, and it's differentiated by being able to ship to every state. That being said, the sales and marketing of Agristat franchise continues at as does our dedication to grow the Zypidemag business with our direct marketing to patients. Agristat continues to hold the majority of the patient market share in this class with the sales for 2021 of 11.6 million compared to 10.6 for the previous year. Sales of Zypidemag continue to increase to 3.2 million for 21 compared to less than half a million in the previous year. And together with Marley Drug revenue of 6.9 million results in an annual net revenue of 21.7 million compared to 11.6 million for the previous year. We believe the investments in the past several quarters in our programs and onboarding of new products has and will continue to provide the growth in revenue and profits for the coming quarters and years. It takes time and persistence. Medicare has a good cardiovascular product portfolio, a track record of growing sales, and a great team with energy, talent, and experience to build a strong, growing company. I would now like to turn the call over to our financial consultant, Haris Hooden, to review and provide some color on the financial results for 2021.

Haris Hooden Thank you, Dr. Friesen. A couple of quick items to note before I start. All dollar figures are in Canadian dollars unless otherwise noted by each presenter. And as a reminder, you will be able to obtain a complete copy of our financial statements for the year ended December 31st, 2021 by the end of date today along with previous versions of the financial statements on the investors page of our website. Alternatively, a copy of all financial statements and management discussion analysis can be obtained immediately from CDAR.com. I will now provide some key highlights of our financial performance for the year ended December 31, 2021. Total revenues for the year ended December 31, 2021 were $21.7 million compared to $11.6 million for the year ended December 31, 2020. Net revenues from Agristat for the year ended December 31, 2021 totaled $11.5 million, which is an increase in net revenues from Agristat for the year and December 31st, 2020 of $10.6 million. The increase in revenues when compared to the previous year is primarily a result of an increased volume of Agriseps sold in 2021 and a decrease in pricing pressure from generic Integra on competition. The company earned net revenues from Zipidimeg in 2021 of $3.2 million, which is a significant increase from the net revenues earned during 2020 of $453,000. The company continues to focus on Zepidimeg and expects revenues to continue to grow throughout the remainder of 2022 and beyond. The company earned $6.9 million of net revenue during 2021 from Marley Drug and 2021 also represented the company's first full year of operation of operating the entity. Turning to cost of goods sold. Agristat cost of goods sold for 2021 totaled $4.1 million compared to $3 million for 2020. Included within cost of goods sold for 2021 was a $1.1 million write-down of expired or unusable inventory and excluding the write-down of inventory in the current year, cost of goods sold was consistent between 2021 and 2020. Zepidemeg cost of goods sold for 2021 totaled $2.4 million and includes $311,000 relating to products sold to customers, $1.8 million from amortization of the Zepidemeg intangible asset, $165,000 relating to our write-down of inventory, and $62,000 related to royalties on the sale of Zepidemeg resulting from the acquisition of the product in September of 2019. As a result of the acquisition of Murley Drugs, the company recorded cost of goods sold of $2.4 million during 2021 pertaining to the cost of products sold by Murley Drugs in its store and mail order pharmaceutical business. Selling expenses totaled $10.3 million for 2021, up from $5.3 million for 2020. The increase in selling expenses when compared to the prior year is primarily due to the acquisition of Marley Drug and an increase in marketing spend. General and administrative expenses totaled $2.7 million for 2021, down from $4.6 million in the prior year. The decrease in general and administrative expenses is primarily related to lower legal costs associated with the company's patent challenge, which was settled in the fourth quarter of 2020, and cost reductions implemented by the company during 2021. During the year ended December 31st, 2021, the company recorded other income of $1.8 million as a result of the re-evaluation of the contingent consideration pertaining to the Merle drug acquisition from prior year. The re-evaluation of the contingent consideration was assessed by management using probability weight scenarios during the year ended December 31, 2021. Research and development expenses for 2021 totaled $1.7 million compared to $3.2 million for 2020. This decrease is primarily due to the timing of research and development expenditures relating to each development project and a declining research and development budget. In addition, the company recognized a recovery of $491,000 through research and development expenses in relation to the de-recognition of the license fee payable for Prexartan, which was reversed in the current year as the company's legal counsel determined that the counterpart to the original contract was in breach of the licensing agreement. The company recorded finance expense of $525,000 for 2021. This relates to accretion on the company's EGRSTAT royalty obligation and accretion on this epidemic acquisition payable. This compares to finance income for 2020 of $765,000 which primarily relate to the re-measurement of the company's royalty obligation partially offset by the accretion on this epidemic acquisition payable. The company recorded a foreign exchange gain during 2021 of $31,000 compared to a gain of $497,000 for 2020. The change relates to changes in the U.S. dollar exchange rate during the respective periods which led to a favorable foreign exchange during the current year. Adjusted EBITDA for 2021 was $2.1 million compared to adjusted EBITDA of negative $3.9 million in 2020. The change is primarily due to increased revenues as a result of the operations of Marley drugs being included for the full 2021 year compared to a two-week period in 2020. In addition to increased epitomeg revenue and reduced general and administrative expenses and also reduced research and development expenses. This is partially offset by higher cost of goods sold and selling expenses as a result of the full year of Marley drug operation. As of December 31, 2021, the company had cash totaling approximately $3.7 million and increased from $2.7 million as of December 31, 2020. As of December 31, 2021, the company had net working capital of $4 million compared to net working capital of $3.4 million at December 31, 2020. The company currently does not have any debt on its books. I want to remind you that there will be an opportunity at the end of today's call for you to ask questions regarding the financial results of the company as a whole. And with that, I would like to turn the call over to our President and Chief Operating Officer, Dr. Neil Owens, for some additional commentary regarding our operations.

Thank you, Harris, and good morning, everyone. As the COVID-19 pandemic has evolved, Medicare sales team has been able to return to in-person meetings and conference attendance in the United States. in addition to virtual meetings with healthcare professionals, while still putting an emphasis on implementing innovative marketing strategies. Mostly we are limited in our ability to visit hospitals as compared to clinics, and therefore there has been a greater impact on meeting with interventional cardiologists in the cath lab regarding Agristat. Due to efforts of our sales and marketing team, Agristat continues to see consistent demand with a 7% increase in units sold in 2021 compared to 2020. There was also a 9% increase in net revenue in 2021 compared to 2020. We will continue to foster our relationships with health care providers and strengthen our brand. Turning to ZepedaMag, we continue to see consistent growth in prescriptions filled through Marley Drug, including a 29% increase in units dispensed in Q4 2021 compared to Q3, which relates to a sevenfold growth in net revenue in 2021 compared to 2020. The improvement in net revenue is also attributed to lower returns and fees to wholesalers and reduced fees to pharmacy benefit managers, and importantly, an improvement in fill conversion rate via Marley Drug. However, we are still not satisfied and continue to push and do expect to see continued growth through the cash flow route, as the response from providers is still very positive towards the ease of access and certainty of filling prescriptions through Marley Drug. Medicare was able to diversify its product portfolio with revenues from the Marley Drug business of $6.9 million in 2021. In 2022, we announced the launch of an e-commerce platform to fill generic and branded medications to all 50 states and a partnership as an exclusive mail order fulfillment pharmacy. Our goal is to provide best in class experience for customers and to meet the demand for home delivery of medications. We continue to evaluate branded products and products with high market share potential to add to Medicare's portfolio and those that would align well with our focus on contacts in the U.S. market, especially those that can be sold through Marley Drug. In Q4 2020, Medicare announced the filing of an IND for a pivotal Phase III study to find the first FDA-approved therapy for patients with PNPO deficiency, which is a rare pediatric disease leading to seizures and is ultimately fatal if untreated. Despite a delay in study start, we expect to kick off in late 2022. If successful, use of Medicare's legacy product MC1 could lead to a priority review voucher, which can be redeemed or sold to obtain priority review for any subsequent marketing application. Medicare continues to work to develop additional cardiovascular abbreviated new drug applications, or ANDAs, for in-hospital use. However, the regulatory review process has resulted in a delay in approval of one of our ANDAs due to deficiencies reported in Medicare's contracted manufacturing partner. Medicare expects to receive approval in 2022. We are pleased to report a positive EBITDA in 2021 of 2.1 million. compared to a negative EBITDA of $3.9 million in 2020. Our team wants our investors to know that we are driven and dedicated to growing revenue, controlling our costs, and making Medicare a long-term success. With that, I would like to turn the call back to Dr. Friesen for final comments.

Thank you, Neil. There was considerable learning in 2020 and 2021 and significant developments for the company, including the acquisition of Marley Drug which we think strongly complements Medicare's business, including the sales and marketing . We're thankful for continued strength in Agristat, market share, and a strong balance sheet. We're still focused on growing the business with a pipeline of cardiovascular products that will further diversify our revenue and asset base, carefully investing to grow our future profitability. My goal and that of our board, management, and staff is to continue to build this business with a stable, long-term outlook to generate value for our shareholders. And as always, I want to express my appreciation to the outstanding team of employees we've been blessed with. Thank you, our shareholders, for your continued support and interest. Chris, I'll turn it back to you to lead us through the question and answer portion.

Thank you. Ladies and gentlemen, we will now begin the question and answer session. Should you have a question, please press star followed by one on your touchtone phone. You will hear a three-tone prompt acknowledging your request, and your questions will be polled in the order they are received. Should you wish to decline from the polling process, please press star followed by two. If you are using a speakerphone, please lift the handset before pressing any keys. Your first question comes from Alan Pasnick, Pasnick Management. Alan, please go ahead.

Yeah, thank you very much. I'm curious, for the EBITDA, the adjusted EBITDA number of 1.6 million for the three months ended December 31st, were there any unusual items in that? Or can you take that 1.6 million and sort of annualize that number going forward?

Hi, Alan. This is Har speaking. Yeah, so the adjusted EBITDA number, the I guess the main adjustments would have been there was a, as mentioned in the call, there was a write-off of inventory of about $1.1 million. In addition to, there was also the reevaluation of the contingent consideration. This would have been for about $1.8 million. Lastly, there was also a recovery recorded in relation to the $491,000 with respect to the Percsartan license, which was Percsartan license liability, which was recovered during the current year. However, again, a big portion of why EBITDA was strong this year was due to the Marley drug acquisition and the increasing sales as epitome throughout the year.

Okay. If I look at the... With respect to Marley Drugs, I think you provided an annual number, $6.9 million in sales. Is that trending upwards? How would you look at the cadence of the increase in sales over the course of the year for Marley Drugs?

Yeah, this is Neil speaking. It's a good question. I would say it's flat or declining over the year. However, that is attributed to the legacy business, whereas Zipidimic is growing. And we think that the launch of the e-commerce business will actually help to grow sales through Marley Drug because we think that, again, that's a great way to reach customers. But I think that's kind of what we're seeing right now for 2021.

Okay. If you look forward on Zipidimic, What sort of projections do you see with respect to gross margin for 22 and 23?

It's a good question. We've tended to resist forecasting, but what we can say generally is that, as Neil had mentioned, the Marley drug has really helped acquisition, helped us grow the business, and the margins generally are very good. So it's really, we think the sales will continue with a fairly good margin and over the next two or three years or on the ongoing basis. And then the other part of our growth in Marley Drug is the e-commerce business. As Neil said, the traditional or historical Marley Drug business has been flat to slightly declining.

I was just going to add that the margin via Marley Drug is helped by the fact that we don't have the PBM fees or the wholesaler fees, which is something that we think is pretty interesting and, again, pretty innovative in terms of the industry.

I see. With respect to R&D expense, it was down for 2021. What sort of numbers are you looking at for R&D this year?

We do expect that that will be higher in 2022. That's the year you're referring to. And it just had to do with timing of some of our expenses.

I see. Now, just looking at the cash balance at the end of the year, I think you said it was about $3.7 million. So there was pretty good generation over the course of the year. Do you have any specific targets, acquisition targets? Are you looking at anything or are you looking at buying back stock or maybe issuing a dividend?

So right now what we're focused on is growing the revenue and profit. And so we expect to grow the cash. We are not buying back stock at the present time. We are reviewing and continue to review a number of potential acquisitions. Having said that, although we have very good positive cash flow and cash, the acquisitions are what I would call of a smaller nature, not tens of millions, but certainly we continue to look at some. And we're looking at innovative ways of also making the acquisitions. When we bought APICOR, we bought it with no money. So we like that approach.

I see. Okay, that's great. Thank you very much.

Thank you. Ladies and gentlemen, as a reminder, should you have a question, please press star 1 on your touchtone phone. There are no further questions at this time. Please proceed.

Thank you very much for all that attended this call. We appreciate your interest and look forward to reporting on continued growth in the coming quarters. Again, thank you and have a great day.

Thank you. Ladies and gentlemen, this concludes your conference call for today. We thank you for participating and ask that you please disconnect your lines.