Medicure Inc.

Welcome to Medicare's earnings conference call for the quarter ended March 31st 2024. My name is Jenny 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 events, results 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 20F. Later, we will conduct a question and answer session. Please note that this conference is being recorded and today's date is May 29, 2024. I would now like to turn the conference over to Dr. Albert Friesen, Chief Executive Officer of Medicare Inc. Please go ahead, Dr. Friesen.

Thank you, Jenny, and good morning to all on the call. We appreciate your interest and participation in today's call. Joining me today for the Q1 2024 financial statements call is Dr. Neil Owens, President and Chief Operating Officer, and Haris Uddin, Medicare's Chief Financial Officer. The net revenue for Q1 2024 was $5.7 million, which is similar to the previous year's Q1 net revenue of $5.6. and a bit of an increase from the previous quarter, that being Q4 23, which was 5.1. The net income for their quarter was $51,000, which is a bit lower than the previous year's Q1, which was $290,000, but significantly better than the previous quarter, that being Q4 2023, which was a loss. Adjusting earnings before interest, taxes, depreciation, and amortization for the quarter was a positive $359,000. In summary, the revenue from Agristat was down slightly, but revenue from both Marley Drug and Zypidemag were up. So just a reminder that the four focuses of a Medicare business are holding and the sales and profits of Agristat, growing Zypidemag revenue and profit, growing the Marley Drug online pharmacy business and investing research and development in the MC1 for the PNPO deficiency. The online pharmacy continues to help grow Zypinamag and is growing and are growing contributor to Medicare's business. We continue to explore acquisitions of additional pharmacies with a promising outlook for the while still focusing on the R&D for long-term growth. We believe the investments and experience over the 27 years positions Medicare on a steady path for continued success. So, now I'll turn over the call to our Chief Financial Officer, Harthudin, to review and provide some of the colour on the financial statements.

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 quarter ended March 31st, 2024 by the end of day-to-day along with previous financial statements on the investor's page of our website. Alternatively, a copy of all financial statements and management's discussion and analysis can be obtained immediately from CDAR.com. I will now provide some key highlights of our financial performance for the three-month period ended March 31st, 2024. Total revenues for the quarter ended March 31st, 2024 were $5.7 million compared to $5.6 million for the quarter ended March 31st, 2023. Net revenues earned from Agristat during the current period totaled $2.3 million, a decrease from the prior year where net revenue from Agristat was $2.7 million. The decrease in Agristat revenue during the current year is the result of a lower volume of units sold as a result of increased competition from generic, tyroside and hydrochloride. Net revenues earned from Zipidimeg through the traditional insurance channel during the current year totaled $777,000, which is an increase from the $640,000 of net revenue earned during the same period in the prior year. The increase in Zipidimeg sales through the traditional insurance channel can be attributed to a higher volume of product sold. For Marley Drug, net revenue during the current quarter totaled $2.7 million, an increase from the $2.3 million earned from Marley Drug during the three-month period ended March 31st, 2023. The increase in Marley Drug sales during the current period is due to an increased volume of sales, including an increased volume of Zepetimac sales through Marley Drug, which is also included within this figure. The company continues to focus on growing Marley Drug and growing the sales of Zepetimac through Marley Drug into 2024 and beyond. Moving on to cost of goods sold, Agrisat cost of goods sold for the quarter ended March 31st, 2024 totaled $403,000, a decrease from the prior year where cost of goods sold totaled $770,000. The decrease in cost of goods sold is a result of a lower volume of Agrisat sold in addition to insurance proceeds received by the company during the current quarter which related to inventory which was damaged and transport in a previous period. Zipidimeg cost of goods sold for the current quarter totaled $315,000, which was consistent with the prior year, where cost of goods sold for Zipidimeg for the quarter ended totaled $317,000. Included within cost of goods sold for Zipidimeg in the current year is $162,000 relating to products sold to customers and $153,000 of amortization of the Zipidimeg intangible assets. The slight decrease in cost of goods sold noted during the current quarter is due to the conclusion of the company's royalty obligation on the sale of Sipinamex, offset by a higher volume of Sipinamex sold through the insured channel in the current period. Marley Drug cost of goods sold totaled $1.1 million during the period ended March 31, 2024, an increase from the period ended March 31, 2023, where cost of goods sold totaled $750,000. The increase in cost of goods sold during the current year is a result of a higher volume and the nature of product sold through both the mail order and e-commerce platform during the current year. Selling expenses totaled $2 million for the quarter ended March 31st, 2024, consistent with the same period in the prior year, where selling expenses were also $2 million. Selling expenses slightly decreased in the current period as a result of less consulting expenses incurred by the company with regards to regulatory reporting on its government contracts, offset by a higher revenue amount earned through Marley Drug in the current quarter. General and administrative expenses totaled $1.2 million for the quarter ended March 31, 2024 in comparison to $905,000 during the same quarter in the prior year. The increase in general and administrative expenses in the current period is the result of higher legal fees in the current period, in addition to higher share-based compensation expense, which is based on the vesting schedule of previously granted stock options to key employees and directors of the company. Research and development expenses for the quarter ended March 31st, 2024 totaled $680,000 compared to $526,000 during the same quarter in the prior year. The increase during the current period is primarily due to the timing of research and development expenditures relating to each development project the company is currently undertaking. The company recorded finance income of $51,000 during the period ended March 31st, 2024. The finance income recorded during the current period consisted primarily of interest income earned on cash held by the company offset by bank charges and finance expenses. on the company's lease obligations. The company recorded a foreign exchange loss of $7,000 during the quarter ended March 31, 2024 in comparison to a foreign exchange loss of $24,000 during the quarter ended March 31, 2023. The change in foreign exchange loss relates to changes in the US dollar exchange rate during the respective years, which led to an unfavorable foreign exchange loss during the current period. Adjusted EBITDA for the quarter ended March 31st, 2024 was $359,000 compared to an adjusted EBITDA of $916,000 during the quarter ended March 31st, 2023. The decrease in adjusted EBITDA during the current period is due to a decrease in operating income which primarily stemmed from decreased revenues from the sale of Agristat offset by higher revenue through Marley Drug and from Cepidemag. In addition, there were also higher higher selling general administrative expenses and higher research and development expenses. As of March 31st, 2024, the company had cash totaling approximately $6.1 million, a slight decrease from the $6.4 million of cash held as of December 31st, 2023. The company 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, Haris, and good morning, everyone. I would like to start with some further details on our barley drug business. For Q1, that revenue increased by 13% compared to the prior year, growing from 2.3 to 2.7 million. This is due to a 33% increase in volume of SubtitleMag products sold through the pharmacy business and a 12% increase in other brand and generic medication sales. We continue to invest in further improvements to the e-commerce website to improve customer experience and through additions to the website, Marley Drug continues to be a leader in search engine traffic results for online pharmacies. Medicare still plans to leverage Marley Drug's reputation for customer service and national distribution in more business partnerships. One example is the start of the sale of Brenzavi tablets through Marley Drug at a low cash price in late 2023. which is an accessible alternative SGLT2 inhibitor to brand Jardiance and Farcega. While still early, we are seeing uptake and growth and will continue to focus on it and other branded solutions in 2024. The company is still focused on growing brand awareness through multiple media channels, and overall, we continue to look for ways to rapidly expand the pharmacy business. Further on, Zipidimac net revenue through insured channels and the standard retail pharmacy model grew by 21% to $777,000 in Q1 2024 compared to Q1 2023. However, patients still have challenges in accessing Zipidimac through their insurance coverage, which is a reason why selling Zipidimac through Marley Drug is such an effective approach. Similarly, due to wholesaler and coverage gap fees, low PBM reimbursement, and product returns. Selling through Marley Drug provides a much higher gross margin. Overall, we continue to build brand awareness through the efforts of our sales and marketing team, and we are focused on lowering our customer acquisition cost and increasing customer retention. The market opportunity remains very large, and we are reinvesting profit into sales and marketing at ZepedaMag. In terms of our Agristat business, net revenue was impacted in Q1 by generic Tire 5N entries, and as a result, revenue fell from $2.7 million in Q1 2023 to $2.3 million in Q1 2024. This decrease is due to both a decrease in volume of products sold and pricing. Medicare remains the only manufacturer of the 3.75 milligram bolus file format which is typically administered before the infusion unit. We continue to provide support to our US hospital accounts and promote the brand in targeted ways in order to maintain market share. Medicare's R&D focus is primarily on its phase three study to seek approval of MC1 as the first FDA approved therapy for patients with PNP deficiency, which is a rare pediatric disease leading to seizures and is ultimately fatal if untreated In parallel to the phase three clinical study, Medicare is conducting several non-clinical studies to support the approval of MC1 as requested by the FDA, most of which are now complete. If successful, use of Medicare's legacy product MC1 could lead to a priority review voucher, which can be redeemed or sold, and provides significant value. The FDA granted approval to start enrollment, and so the company is now in the launch phase of the study. Medicare also recently received fast track designation for MC1 for its intended indication, which will facilitate the review of Medicare's FDA new drug application. However, there are very few patients eligible to enroll, and they are very sensitive to changes in dosing, so Medicare is being careful in the enrollment process to increase our likelihood of receiving FDA approval for the indication. Medicare remains debt-free and for Q1 2024 we are able to report a positive adjusted EBITDA of $359,000 and net income of $51,000 and we continue to invest in marketing and research and development. Our goal is to grow revenue, control our costs and make Medicare a long-term success. With that, I'd like to turn the call back to Dr. Friesen for final comments. Thank you, Neil.

The overall revenue is consistent. It's growing slightly. There are significant developments through the acquisition of Marley Drug, which we think strongly complements Medicare's business, including the sales and marketing . We're still focused on growing the business and diversifying our revenues and the asset base near term through acquisition and long term through R&D, carefully investing to grow our future profitability. My goal and that of our entire team board management is to continue to build this business with a stable long-term outlook to generate in value for our shareholders. And as always, I want to express my appreciation to the outstanding team of employees we have been blessed with. Thank you to our shareholders for your continued support and interest. And now we'll turn it back to the moderator to lead our question and answer and welcome those from the hearers. those listening on the call.

Thank you very much. We will now be conducting our question and answer session. If you have a question, please press star 1 on your telephone keypad. A confirmation tone will indicate that your line is in the queue. You may press star 2 if you would like to remove your question from the queue. For anyone using speaker equipment, it might be necessary to pick up your handset before you press the keys. Please make a moment to ask the poll for questions. Thank you. Your first question is coming from David Bochum, who's a private investor. David, your line is live.

Thank you for taking my call. I had a couple questions. Number one was in regards to Agristat, it's kind of been kind of a slow decline, and I understand why. There's no criticism there. I was wondering, in that regard, if you guys had any rough idea of when you thought kind of the bleeding would stop or at least slow down significantly. And as part of that question, I was just going to ask, as having the only bolus version of Agristat, I was wondering what percent of total Agristat sales the bolus version comprises.

Yeah, those are really good questions. We do see a bottom to the decline in terms of pricing and loss of product volumes sold. That's probably one or two years out. We've only seen two generic entries at this point. We're not expecting any more in the space, which is good news for us. We have been pretty aggressive in terms of contracting with the hospital groups to maintain market share. So we are expecting to actually, if not the majority, we are expecting to have a significant portion of the market, even with generics in the market. In terms of the bolus file sales, it's about 20% of the overall volume. However, all hospitals who use the infusion unit tend to use the bolus file as well. So it's a leverage point for us in terms of negotiating with the hospital accounts to keep using branded Agristat, but it's about 20%.

Thank you for that. The second one I had was just kind of a general question. Would Marley Drug itself at this point, which includes obviously zepidematic sales, would that be profitable at this point as a standalone?

Yes, is the answer.

Yeah, I can add a bit of color to that. So again, Marley Drug has been really helpful for selling Zepidemag, but it still does have quite a strong base in terms of generic and other branded medication sales. So we've been sort of shifting the focus of the pharmacy obviously from after we bought it. But it is still profitable on its own, and as we continue to add other branded products We are really expecting that to really help Medicare overall in terms of revenue.

It's a very good question because the brand, believe it or not, the U.S. pharmacy sales is very complicated and the branded products that we sell through insurance have a lower margin. The cash, believe it or not, have a much larger margin. And our branded products that we sell through cash that we're now adding to the business have a pretty good significant margin. So the generics are actually better margins than the branded because of the insurance process. But yes, it's a profit center and we're trying to develop the mix to further increase the profit center.

Thank you. Thank you. And then my last question that you may or may not be able to tell going forward, I was just wondering, due to the rarity of PNPO deficiency, and I know some other challenges you had just mentioned, Neil just mentioned a little bit ago, regarding that study getting off and running, I think the goal I believe I read was 10 patients and I was curious with the rarity and some other challenges when realistically you thought we would have data on 10 patients. It would seem like it might still be a while.

Yes. You understand the challenges from the questions and the comments. It's very difficult to say, but right now we can say that we probably won't be completed by the end of 25. The question is how far into 26 we're going to go without trying to. And it took us over a year and something focused on trying to find, we found ultimately about 20 patients in the world that qualified. to get and start to enroll to get the 10. And we think there's probably, you know, based on our search, there may only be, you know, 50, 60 throughout the world. And they're not, it's a very challenging disease. And so not everyone would be willing to enroll in the study. So we continue to persist because of the large opportunity at the end.

All right. No, that makes total sense. Okay. I really do appreciate your presentation and your answers. Thank you. Thank you.

Thank you very much. If you have any remaining questions, you can join the queue by pressing star 1 on your phone keypad now. Okay. We don't appear to have any further questions in the queue. Just if anyone else in the audience would like to ask a final question, then just press star one. All right, we have no further questions at this time, so I will now hand the call back over to Dr. Friesen.

Thank you again for being on the call. Thank you for the question, David, and appreciate the support from our shareholders. Thank you. Have a great day. Look forward to the next call.

Thank you ladies and gentlemen. This concludes today's conference. Thank you for participating. You may now disconnect.