NASDAQ:APLS Apellis Pharmaceuticals Q3 2024 Earnings Report $45.40 +0.48 (+1.07%) Closing price 04/17/2025 03:59 PM EasternExtended Trading$45.40 0.00 (0.00%) As of 04/17/2025 04:07 PM Eastern Extended trading is trading that happens on electronic markets outside of regular trading hours. This is a fair market value extended hours price provided by Polygon.io. Learn more. Earnings HistoryForecast Power Integrations EPS ResultsActual EPS-$0.46Consensus EPS -$0.32Beat/MissMissed by -$0.14One Year Ago EPS-$1.17Power Integrations Revenue ResultsActual Revenue$196.83 millionExpected Revenue$200.00 millionBeat/MissMissed by -$3.17 millionYoY Revenue Growth+78.30%Power Integrations Announcement DetailsQuarterQ3 2024Date11/5/2024TimeBefore Market OpensConference Call DateTuesday, November 5, 2024Conference Call Time8:30AM ETUpcoming EarningsApellis Pharmaceuticals' Q1 2025 earnings is scheduled for Tuesday, May 6, 2025, with a conference call scheduled at 8:30 AM ET. Check back for transcripts, audio, and key financial metrics as they become available.Q1 2025 Earnings ReportConference Call ResourcesConference Call AudioConference Call TranscriptSlide DeckQuarterly Report (10-Q)Earnings HistoryCompany ProfileSlide DeckFull Screen Slide DeckPowered by Apellis Pharmaceuticals Q3 2024 Earnings Call TranscriptProvided by QuartrNovember 5, 2024 ShareLink copied to clipboard.There are 18 speakers on the call. Operator00:00:00Good morning, ladies and gentlemen. Thank you for standing by, and welcome to the Apellis Pharmaceuticals Third Quarter 2024 Earnings Conference Call. At this time, all participants are in a listen only mode. After the speakers' presentation, there will be a question and answer session. Please be advised that today's conference is being recorded. Operator00:00:30I would now like to turn the call over to Meredith Kaya, Senior Vice President, Investor Relations and Strategic Finance. Please go ahead. Speaker 100:00:40Good morning, and thank you for joining us to discuss Apellis' Q3 2024 Financial Results. With me on the call are Co Founder and Chief Executive Officer, Doctor. Cedric Francois Chief Operating Officer, Adam Townsend Chief Medical Officer, Doctor. Caroline Baumel and Chief Financial Officer, Tim Sullivan. Before we begin, let me point out that we will be making forward looking statements that are based on our current expectations and beliefs. Speaker 100:01:03These statements are subject to certain risks and uncertainties, and actual results may differ materially. I encourage you to consult the risk factors discussed in our SEC filings for additional detail. Now I'll turn the call over to Cedric. Speaker 200:01:15Thank you, Meredith, and thank you all for joining us this morning. Over the past few months, we have made meaningful progress towards our long term goals, reaching key milestones such as generating continued growth in value demand for say full brief and presenting the groundbreaking Phase 3 valiant results with EmbaReady at C3g and ICMPGN. These data underscore the power of C3 and reinforce our belief that targeting C3 is the optimal way to treat complements mediated diseases. During the Q3, commercial vial demand for SYFOVRI grew by 7% quarter over quarter and SYFYVI maintained its market leadership with 84,500 commercial vials shipped to physicians. 3rd quarter SYFYVI net product revenue of $152,000,000 were more than double the same period last year. Speaker 200:02:08However, we recognize that revenue fell short of expectations declining by 1.7% relative to the last quarter. This was partially due to higher gross to net adjustments which Adam and Tim will speak to shortly. Importantly, we expect gross to net to be stable going forward with more modest quarterly adjustments typical of a buy and build model. Also affecting our performance this quarter was an overall slowing within the GA market. Total tile demand did grow quarter over quarter, but at a slower pace than in previous quarters. Speaker 200:02:46Market growth is now being driven by the next group of retina specialists who often need more time to appreciate the benefit risk profile of complement treatments and therefore take longer to decide to treat their GA patients. To support meaningful growth going forward, we need to continue building awareness of SYF-four forty's strong clinical profile. We have launched several key initiatives aimed at increasing our share of new patient starts, strengthening our market leadership and accelerating growth in the overall GA markets. Early science suggests that these efforts are delivering positive results, but their impact on the GA market and Xiphobri demand will take time. Considering this, we remain conservative in our near term expectations for growth anticipating low single digit percentage value growth for the remainder of 2024 with flat to modest net revenue growth in the Q4. Speaker 200:03:46We plan to provide further insight into the GA market dynamics and our growth expectations for 2025 in the coming months as we gain visibility into the impact of our new commercial initiatives. It is important to remember that we are still in the early stages of the launch. We estimate that only about half of OGA patients are diagnosed and seen by an eye care professional and of those an estimated 15% are currently being treated. GA patients are on an irreversible path to blindness and TYPHORI has a significant impact on slowing disease progression and potentially preserving patients vision for longer. We see tremendous opportunity over the long term, but expect the sales ramp to be more gradual going forward. Speaker 200:04:36Importantly, we continue to believe CIFOVRI remains on track to become a blockbuster drug. Quickly touching on Europe, we were disappointed with the negative CHMP opinion despite multiple analyses showing that treatment with Cyfobri preserve visual function. We do not have plans to pursue EU approval further at this time. And then moving to Empavily, we were extremely pleased to share the full results from the Phase 3 VALION study in C3 gs and primary ICMPGN at Kidney Week last month. I will let Caroline discuss these results further, but we believe EMPOWITY has the potential to become a best in class treatment for these rare kidney diseases, redefining the current treatment paradigm for patients with C3G and ICMP Gen. Speaker 200:05:28At Apenis, we have spent the last 2 decades investigating C3 as a therapeutic target because we believe in the significant benefit of targeting C3 as compared to other targets within complement. These positive valued results suggest once again that Avelis' C3 targeted therapies are particularly effective across multiple therapeutic areas now including PNH, geographic atrophy and C3 gs and ICMPGN. We received feedback from the FDA last week that our submission proposal has been accepted which means that we remain on track to file our supplemental NDA early next year in both C3G and ICMPGN based on our positive 6 month data. Importantly, the FDA did not require us to file with the full 52 week data. Our ex U. Speaker 200:06:22S. Partner Sobe expects to file a regulatory submission in the EU in early 2025 followed by a submission with the Japanese health authorities later in 2025. The Valyant data also unlocked additional opportunities within nephrology that we are evaluating and plans to provide detail on soon. On the commercial front, Embavetti generated $24,600,000 in U. S. Speaker 200:06:49Product revenue in PNH in the 3rd quarter, up 3% as compared to the same period last year. The 97% compliance rate supports the substantial benefit that these patients are receiving. In closing, our strong fundamentals position us well for the future. Aperis has 2 commercial products, each with blockbuster potential which are already making a meaningful difference in patients' lives. Our emerging pipeline holds exciting products and we look forward to sharing more on this soon. Speaker 200:07:25We are on a clear path to profitability and continue to believe we can independently fund our core business. And with that, I will now turn it over to Adam to discuss our commercial activities. Thanks, Speaker 300:07:39Cedric, and good morning, everyone. I will begin with Cyfobri. In the Q3, we delivered approximately 84,500 commercial doses, a 7% increase compared to Q2 and approximately 4,000 samples of SYFOVRI. The growth in demand seen during the quarter reaffirms SYFOVRI's leadership in the market. SYFOVRI closed the 3rd quarter with approximately 65% market share as defined by injections and approaching half of new patient starts. Speaker 300:08:13As of September, more than 2,200 sites of care have ordered Cyphobury. As Cedric mentioned, the increase in demand was offset by adjustments to our gross to net, including contracting that affected overall net revenue. As a reminder, contracting with physician practices is common within the buy and bill space. At the end of 2023, we made strategic contracting decisions to remain competitive that impacted Xiphovery's average sales price or ASP reimbursement in the Q3 of 2024. We also recorded higher rebates this quarter due to some incremental contracting decisions that took effect on July 1. Speaker 300:09:00While this quarter was particularly impacted, to be clear, we have not chased large rebates or deep discounts nor do we intend to in the future. Our strategy has always been to maximize access to Cyfovir for patients while preserving long term economics. We recognize the importance of staying competitive and have balanced these economics with the efficacy that Xiphobri offers. Turning back to demand, we are encouraged by the continued demand growth for SYFOVRI, but we know there's more work to do to sustain this growth moving forward. To that end, we've launched several initiatives as part of Phase 2 of our commercial strategy to help shift the dialogue with ECPs towards Xiphobri's robust efficacy profile, including its increasing effects over time up to 42% in non subfovial patients, multiple analyses demonstrating preservation of visual function and well documented safety. Speaker 300:10:08Key initiatives include leveraging medical congresses and other key forums to reinforce Xiphobry's unique benefits, actively engaging with younger retina specialists who tend to treat a higher share of new patients, Expanding our engagement with non injecting ECPs such as optometrists and general ophthalmologists so that patients with GA seek treatment with a specialist. Generating new clinical data and real world evidence to further reinforce Xiphobry's clinical profile. We introduced the new injection needle making the user experience even easier by reducing injection force. And we continue to educate payers on the strong value proposition for XIFAVERY. We are pleased to already see some early indications of positive momentum. Speaker 300:11:03For example, after seeing a slight decline in new patient share at the start of Q3, SYFOVRI rebounded in the last half of the quarter, closing the quarter approaching 50%. Additionally, market research shows the efficacy messages are resonating. Surveyed ECPs recall Xiphovi's efficacy as the leading discussion topic from their last Apellis interaction, up from 46% in April to 73% in September. And lastly, a large Medicare Advantage plan recently made Xiphobry the only preferred product on their formulary, effective January 1, 2025. This adds to the 2 large national PBMs that place Xiphofri as the only preferred product on their commercial plans in July. Speaker 300:11:56Looking ahead, we plan to launch Phase 2 of our branded DTC campaign soon, which brings back Henry Winkler. This campaign is intended to educate patients on Xiphofri's profile, increasing patient awareness and driving Xiphori conversations with ECPs. Xiphori's market share has been stable at roughly 65% since September. This combined with the uptick in new patient share in recent weeks suggests that our initiatives are starting to have an impact. While we are encouraged by the positive momentum, it will still take time for these to gain traction, which is why we must be prudent in our guidance for the remainder of 2024. Speaker 300:12:43Market research shows that questions about safety continue to delay more meaningful discussions about the benefits of cyphovary and those benefits that are offered to patients. It can take at least 6 conversations with an ECP before the efficacy messages truly resonate. That said, our long term outlook for Xiphobry remains strong. We have only scratched the surface of SYFOVRI's market potential and there is a significant opportunity for further growth. We anticipate growth moving forward will be gradual, but with only 2 available therapies in a large category and no new competition expected for at least the next 4 years, we are confident SYFOVRI will remain the leading GA product in the U. Speaker 300:13:33S. For many years to come. Beyond cyfovary, I'm excited about the opportunity for Empervelate to expand into C3g and ICMPGN. We believe the commercial opportunity for these indications is significant. We estimate approximately 5,000 patients in the U. Speaker 300:13:54S. But also believe that these diseases are likely under diagnosed because there are no treatments currently available. Feedback from physicians has been resoundingly positive that the severity of these diseases warrants use of the most efficacious treatment option available. Across the board, nephrologists' feedback is that Emper Valley data are significantly differentiated from other compounds in development with the enthusiasm amongst physicians exceeding even our highest expectations. If approved, we believe we are in a strong position to capture a significant proportion of this market and generate meaningful growth for Emperveli. Speaker 300:14:37Now, let me shift to Emperveli and PNH. In the Q3, Empervali generated approximately $24,600,000 in U. S. Net product revenues. Compliance rates remain high at 97% and the safety profile remains consistent with our previous updates. Speaker 300:14:56With that, I will now turn the call over to Caroline. Caroline? Speaker 100:15:01Thanks, Adam, and good morning, everyone. As Adam mentioned, we are starting to see multiple instances of meaningful real world presentations, reaffirming Xiphofri's robust efficacy and we expect the first paper from a third party on Xiphofri to be published soon. These real world data reinforce Xiphobry's unprecedented effects, adding to the largest body of evidence supporting Xiphobry treatment and allowing us to further strengthen our message around efficacy. Moving to Empivelli, the feedback on the full Valyant data set that was presented at Kidney Week last month was remarkable. In these diseases, physicians are focused on 3 key markers of disease activity when evaluating a potential treatment. Speaker 100:15:55These are proteinuria, EGFR and C3C staining. As detailed in our full data set, pegzetacopalan showed positive effects on all three in just 6 months. This included a statistically significant 68% reduction in proteinuria with reductions observed as early as week 4 and effects that were consistent across all subgroups of patients regardless of disease type, age and transplant status. A stabilization of eGFR, a key measure of disease function and a substantial reduction in C3C staining with over 70% of pegzetacoplin treated patients having achieved 0 C3C staining intensity indicating complete clearance of C3C deposits. There are no approved treatments for C3G or ICMPGN and the unmet need given the severity of these diseases is extremely high. Speaker 100:17:09The totality of the efficacy data from Valyant shows that pegcetacopalan rapidly, significantly and consistently improved key outcomes for patients with C3G and ICMPGN. We are ecstatic about what the results mean for the patients, physicians, caregivers and everyone else within the C3G and ICMPGN communities. Finally, we are continuing to advance our earlier stage pipeline, such as our C3 siRNA that is currently in Phase 1 development and our BEAM collaboration. We are excited to share more details about our pipeline programs with you in the future. I will now turn the call over to Tim for a review of the financials. Speaker 100:18:02Tim? Speaker 400:18:03Thank you, Caroline. I will now provide an overview of our financials. Additional details are available in the press release that we issued earlier this morning. Total revenue for the Q3 of 2024 was approximately $197,000,000 including $152,000,000 in SIFO REIT and $24,600,000 in Emba Valley U. S. Speaker 400:18:24Net product revenue. This compares with $110,000,000 in total revenue in the Q3 of 2023. Turning to the rest of the P and L. For the Q3, cost of sales was $33,600,000 R and D expenses were $88,600,000 SG and A expenses were $122,000,000 and we reported a net loss of 57,400,000 dollars Cash operating expenses, which excludes stock based compensation and depreciation and amortization were approximately $180,000,000 for the Q3. We continue to expect total cash operating expenses in 2024 inclusive of R and D and SG and A expenses to be less than our total cash expenses in 2023. Speaker 400:19:14As Adam mentioned, there was an increase in our in Xiphobry's gross to net percentage this quarter as compared to previous quarters. This is a result of 2 factors. The first was due to contract decisions resulting in higher discounts to physicians. The second was related to a true up of certain fees from prior quarters included in gross to net in Q3. Looking ahead, we expect gross to net to continue to be impacted by ASP erosion and required contracting, but we expect that erosion to be modest and not at the rate we saw in the Q3. Speaker 400:19:49We now expect gross to net through 2025 to be in the low to mid-twenty percent range. With $397,000,000 in cash and cash equivalents as of September 30, we remain confident in our strong financial position. We expect our existing cash combined with our future product sales to be sufficient to fund our core business to positive cash flow. I will now hand the call back over to Cedric for closing remarks. Speaker 200:20:15Cedric? Thank you, Tim. We are focused on building out the GA market and realizing the opportunity in front of us in C3G and ICMPGM. With 2 potentially blockbuster commercial products, a pipeline of innovative programs in development and a strong financial position to support the business, we are confident in our ability to continue to create significant value for our patients and our shareholders. With that, we will now go over to the Q and A session. Operator00:20:49Certainly. Our first question will be coming from John Miller of Evercore. Your line is open. Speaker 500:21:12Hi, guys. Thanks so much for taking the question. I would love to spend my one question talking about the evolution of market share in 3Q and beyond. Obviously, we all heard your competitor talking about increased market share in 3Q and their expectations for, well, in their mind, continuing dominance from here. So what are Speaker 600:21:37the pushes and Speaker 500:21:38pulls, you versus them on who's going to end up with the dominant market share? And to what extent do you think that the actions you're taking to drive patients into the retina physician practice out of those ophthalmology offices? To what extent are those going to deliver patients to you as opposed to the competitor? Speaker 200:22:00Thank you, Soren. Great hearing you. So look, as we've always said, the benefit of SYFYVI lies in its differentiated efficacy profile, right. It is also the only drug that has shown increasing effects over time that has shown efficacy with every other month dosing both in foveal and sub foveal patients. That differentiated efficacy profile is really what stands out and what we will be building the market on now. Speaker 200:22:30So Adam, I'll hand it over to you to clearly add Speaker 400:22:32a couple of thoughts. Speaker 300:22:33Yes. Thanks, John. So obviously, as we're heading into year 3 of the launch, we're now calculating market share based on injections versus based on patients. We actually believe this is similar to the way our competitor calculates market share. We think it's a really important metric and we believe that we are a market share of 65%. Speaker 300:22:57Now, if we were still to use a market share based on patients as we have previously reported, that market share would be approximately 70%. Injection share incorporates factors such as dosing frequency, bilateral usage compliance and active patients. That's why we think it's a really valuable metric. Now, as per new patient starts, after seeing a slight decline in new patient starts at the start of Q3, XIFAVU rebounded in the last half of the quarter, closing the quarter, approaching 50%. The reason we believe is that this is an efficacy driven market and we have the strongest efficacy profile and we're executing our plan to bring new prescribers and young prescribers into the market. Speaker 200:23:52Does that answer your question? Speaker 500:23:57Yes, that helps. Thanks very much. Speaker 200:23:59I'll hop back in the queue. Queue. Operator00:24:02And one moment for our next question. Our next question will be coming from Tazeen Ahmad of Bank of America. Your line is open. Speaker 700:24:14Hi, guys. Good morning and thanks for taking my question. I maybe wanted to stay on topic with SYFOPRI. Your competitor has been wanting, it seems to provide a lot of detail about the cadence of their launch, providing a first stab at guidance and then revising it at their last call upward. I know a question that investors had is when Appellus would feel comfortable providing guidance on sales. Speaker 700:24:41And I think that's also tied to how people think you think the rate of growth of the market is going to be. I think there's some questions about the size of GA with the 2 products currently approved. So what are you feeling that you need comfort on in order to provide, let's say, full year sales guide on a go forward basis? And how are you thinking that's going to be reflected about how you're thinking about the size of the overall opportunity? Thanks. Speaker 400:25:09Thank you, Tazeen. Look, we're considering providing guidance for next year and we haven't made a decision on that yet. A couple of things, we have these initiatives we've discussed and there are certain market dynamics that we think will settle out over time. We'd like to see how those evolve. And for the moment right now, we're focused on fortifying our position as the market leader and then growing the GA market overall. Speaker 400:25:30But once I think we feel we have a little better understanding of that, I think we would feel comfortable doing some sort of guidance. But at this point, it's under consideration. Operator00:25:44And one moment for our next question. Our next question will be coming from Anupam Rama of JPMorgan. Your line is open. Speaker 600:25:55Hey, guys. Thanks so much for taking the question. Do you think your sales team is sort of right sized to get to that next tier of docs that you're talking about in terms of prescribing Cyfovary and a complement inhibitor? And any trends we should think about in terms of sampling for that next tier of physicians relative to what you kind of disclosed in 3Q? Thanks so much. Speaker 300:26:19Hey, Adam, Pam, it's Adam. Thanks for your question. So we analyze our sales team and our infrastructure on a regular basis based on our target audience. And at the moment, we believe that we have the right feel force structure to execute and grow a depth and a breadth strategy across the market. We have made a couple of new initiatives to drive more patients and patient referrals. Speaker 300:26:45So we are in the process of putting an ophthalmology field team in place to educate on geographic atrophy for non injecting ophthalmologists to help refer patients to Xiphobia users. And we also have a digital, virtual optometry team to also fuel more and more referrals to injecting retina physicians. As it comes to sampling, obviously with our commercial vial demand growing at 7% and given that this is a buy and bill commercial model, we now have a J code, we have well established payer coverage and over 2,200 sites of care. We believe that sampling has less significant role at the moment. But we still believe that samples will make up approximately 5% of Xiphobri's total vial demand moving forward. Speaker 300:27:41You would expect that new prescribers will use samples as part of this market as they get more and more experience of SIFOFRIN. Operator00:27:52And one moment for our next question. Our next question will be coming from Salveen Richter of Goldman Sachs. Your line is Speaker 800:28:02open. Thank you. Good morning. You noted that market growth is now being driven by the next group of retinal specialists. Could you just elaborate on who these specialists are and how large that group is? Speaker 800:28:16And if I could just also just go back to this flat to modest revenue growth in 4Q, can you just help us understand what this accounts for in terms of gross to net? Speaker 200:28:29Thank you so much, David. I will answer the first part of the question and then hand it over to Tim. So I think the retina community and I think this is not just typical to the retina community, but any type of launch. You have the initial wave where you have patients that have been waiting on the sidelines for something to be approved with retina doctors that are enthusiastic to be first movers. So then you have a whole swatch of the next wave of physicians as well as patients in a disease that is slowly progressing. Speaker 200:29:03That kind of wait for the dust to settle of that first wave to then engage and slow down this devastating disease. So that's really where we currently are and what we are seeing in the marketplace. Carolyn, I don't know if you want to add something to this. Speaker 100:29:18Sure. Thank you. Hi, Salveen. I think that many trainees and younger retina doctors also have only been in practice for a limited time, so have maybe not seen the full effects of geographic atrophy on their patients. But they're very, very motivated to learn about geographic atrophy and how to treat these patients. Speaker 100:29:40So we really would like to make sure that we don't forget any of these new young trainees and with more and more physicians training in retina that they have available to SYFOVRI. Speaker 400:29:54Thank you, Selene. In terms of the guidance that incorporates our gross to net that I mentioned in the prepared remarks, which was going forward through 2025, we believe that gross to net will be in the low to mid-20s. Obviously, this quarter, we had a relatively large gross to net jump. That's a function of certain launch dynamics that all came together in this Q3. So we don't expect anything remotely like this going forward and gross to net to evolve in a more modest sense as ASP sort of steadily erodes as we discussed. Operator00:30:28And one moment for our next question. Our next question will come from Yigal Nochomovitz of Citigroup. Your line is open. Speaker 500:30:38Yes. Hi, guys. Thank you. So for my one question, I guess I'll ask a 2 part question. Just could you just provide a little more clarity on this impact to the ASP? Speaker 500:30:48Sounds like there was something related to maybe a discount trigger in the contract related to order volume that may have just all lined up in Speaker 600:30:57the Q3, if you could clarify that. And then regarding the duration and persistence of therapy, I'm curious Speaker 500:31:02if you've collected any data, Adam, in terms of the percent of patients that are staying on the therapy and then the percent that may be taking a break or don't return on schedule? Thank you. Speaker 400:31:16So sure. Thanks, Yigal. I will start with the gross to net part of Speaker 900:31:20the question. So the impact in Speaker 400:31:22the Q3 was really a result of 3 things. I know we mentioned 2 in the prepared remarks, but I'll dig in and divide this first one into 2 parts. And this ultimately sort of created the perfect storm for just this quarter. The first one, which is again these two parts, is the strategic contracting decisions that we actually made in late 2023, and that resulted in a lower ASP starting in Q3, okay? Beyond that, we had certain rebates provided as a result of incremental contracts within the Q3. Speaker 400:31:52And then the final piece, which was not insignificant was a true up of certain fees and expenses from prior quarters. So as I said, we now expect gross to net through 2025 to be in the low to mid-twenty percent range. Speaker 300:32:06Hey, Gal, it's Adam. You also asked a question on discounts. So obviously, at the moment, we're happy with the feedback from physicians on patient adherence. We're seeing persistence and discontinuation rates similar to what is seen with the anti VEGFs in wet AMD. A key driver of compliance is patient motivation. Speaker 300:32:29These patients are really committed to staying on drug to preserve their vision. Every other month dosing provides meaningful flexibility to those patients and we believe that also drives strong compliance with the efficacy you also see with every other month dosing. Speaker 500:32:47Thank you. Operator00:32:48And one moment for our next question. Our next question will be coming from Steve Seedhouse of Raymond James. Your line is open. Speaker 400:32:58Hi, thank you. This is Nick on for Steve. Just a quick one for us. Are you able to comment on which renal indications you like for testing at the Velonex? Or do you have a timeline set for when you'd articulate further clinical development in kidney? Speaker 400:33:12Thank you. Speaker 200:33:14Thank you so much for that question. So not yet, just a short answer. But we're working hard in the next couple of months, we will provide more clarity. Speaker 400:33:27Great. Thank you. Operator00:33:28And one moment for our next question. Our next question will be coming from Phil Nadeau of TD Cowen. Your line is open. Speaker 1000:33:37Cowen. Speaker 1100:33:40One follow-up and then one extra question on us from us. Tim, you've been very clear where gross net is going. I'm still not entirely clear where gross net actually was in Q3. Could you quantify what the gross net was in Q3? And then in terms of going forward, there's been some reports of Vasculitis for IZURVEY in the adverse event database at the FDA. Speaker 1100:33:59Has that had any impact on prescribing the market from what you've seen? Curious to get your feedback from your feet on the street on those reports. Thanks. Speaker 400:34:10Yes. Thank you, Phil. So, we previously had guided from the beginning of the launch of gross to net in the 10% to 20% range. And we had sort of earlier on been kind of in the middle ish of that range. And in this quarter because of what we described as the perfect storm, we were at the high end of that. Speaker 400:34:29And that's about all probably going to give in terms of accuracy there. Speaker 1100:34:34Got it. Thank you. Speaker 200:34:34Thank you. And then sorry. Bill, you had a follow-up to that? Speaker 1100:34:40No, no, I was just saying thank you. That's very helpful. Speaker 200:34:44As it relates to Vasculitis, so we're not going to comment on our competitor safety. But again, as we mentioned earlier, we believe that the only and real difference between the two products is on the efficacy profile, where St. Forgery stands out head and shoulders. We are the only product with increasing effects over time with every other month dosing and with both 4th year and SIT4VIA patients included in our data set. Speaker 1100:35:12Great. That's helpful. Thank you. Speaker 400:35:14Thank you. Operator00:35:17And our next question will be coming from Akash Tewari of Jefferies. Your line is open. Speaker 700:35:23Hi. This is Cathy on for Akash. It seems like your competitor is spending on promotional efforts for IZURVEY with an increase in SG and A spend associated with IZURVEY of $127,000,000 for 6 months of sales of $185,000,000 So during a similar time period for SysoVry's launch, like around 1 year of approval, what was your return on investments? And then in the long term, what are the ROI levels you're targeting? And more specifically for your DTC spend in 2025, do you think it will be much different from the spend this year since you're investing in BDC this year already? Speaker 700:36:01Thank you. Speaker 400:36:02Yes. So thank you. I'll quickly start out, and I'll turn it over to Adam. So we don't actually break out exactly what we're spending specifically on commercial for SYFOVRI. Obviously, we work hand in hand with Adam on those amounts and we really haven't as a finance group haven't really constrained those efforts. Speaker 400:36:23We've just tried to be as efficient as possible based on things like metrics like ROI. And for that answer, I'll turn it Speaker 300:36:29over to Adam. Yes. Thanks, Kathy. So we look at every initiative from an ROI perspective. So we analyze it internally on a regular monthly cadence and take a big initiative like disease state education pivoting to DTC with Henry Winkler. Speaker 300:36:46We do a robust ROI analysis on that. We actually believe that that's a really, really sound sophisticated business approach for us and it drives many, many more patients in. So it's a very positive ROI for DTC. So that's the type of analysis we do. This is a really, really big market and we've only just started to scratch the surface. Speaker 300:37:11So the more effective we are in executing our plan and balancing what that looks like from an ROI perspective, the better the results will be. Speaker 700:37:22Okay, great. Thank you so much. Operator00:37:25And one moment for our next question. Our next question will be coming from Ellie Merle of UBS. Your line is open. Speaker 1200:37:33Hey, guys. Thanks for taking the question. I want to talk a little bit more about the volume trends that you're seeing. So specifically, you said that you expect the sales ramp to be more gradual going forward. Just in terms of vials shift, does that mean we should expect similar vial growth in 4Q as in 3Q? Speaker 1200:37:51And just any more details you can give us on the volume trends you're seeing so far in October? Thanks. Speaker 900:38:00So I think that we did Speaker 400:38:03give some guidance in the prepared remarks on the vial growth and we sort of said mid percentages roughly is what to expect, low to mid percentage vial growth, right? So beyond that, I don't think we're planning on guidance for the quarter. Speaker 100:38:19Okay. Thanks. Operator00:38:28And our next question will come from Annabel Samimy of Stifel. Your line is open. Speaker 1000:38:34Hi. Thanks for taking my question. So, I guess from the initial launch, it looks like you got a lot of low hanging fruit. Now it's a bigger push to get more. What are you seeing in terms of dynamic referrals? Speaker 1000:38:48Like when a patient comes into the retinal specialist, from the ophthalmologist to the optometrist, are they coming in for monitoring now or treatment? Are they typically severe enough to treat or are they still in a watchful waiting mode? And then you mentioned 6 conversations to convert a retinal specialist who wasn't an early adopter. Does this get worse as these patients from the optometrists and the ophthalmologists come in because there may be less severe? I just wanted to understand the dynamic there of what types of patients you're starting to see from those specialists from those from that group? Speaker 200:39:28Thank you, Neville. So that's a really important and good question, right. So I think what was actually really great in the last few months is that kind of the uncertainties, people not knowing how to think about efficacy, how to think about safety, etcetera, that is slowly dissipating, right? So we're going to end up next year in a situation where kind of from a with a lot of data available to us, both from our trials but now also as Caroline alluded to from the real world and that data looks very good, the states where physicians and patients can make an educated decision on treatment and that's something that we really look forward to. Carolyn, I don't know if you want to add something to that? Speaker 100:40:13Sure. I can add from what my colleagues are telling me and from what I'm seeing myself. This is a novel mechanism of action and we have a new treatment paradigm. And there's still many patients who are coming into the office. We're always having patients referred with macular degeneration, of all types, whether it's early or they're patients who have later stages of the disease. Speaker 100:40:40And, so we're still seeing a whole host of different types of patients. I think that physicians are having conversations with their patients and they really center around efficacy. Now of course, whenever we have a treatment, safety also plays a role, but patients, are really driven by efficacy and the flexibility of dosing with 6 injections a year. And then I think the other thing that moves the needle for physicians is we have a lot of long term robust data. In addition to GALE, where patients have already had 5 years of full treatment, we have a real world Garland study. Speaker 100:41:17And then there are 4, real world studies done unrelated to a pellet. And that really in many ways speaks more to physicians. One of those studies has over 12,000 patients and those studies have shown robust reductions in GA lesion growth, photoreceptor preservation and all of the things that we have found. So just confirming our data. Go ahead, Alex. Speaker 300:41:41Hey, Annabel, it's Adam. Just on the final part of your question. So we are educating optometrists and ophthalmologists so that the patient also is aware as they progress to a retina physician about their disease and what treatment could possibly look like. We are actually hearing a lot from the field that patients go in saying, I want the Henry Winkler drug and that type of activity. So these patients are educated and are learning about the disease. Speaker 300:42:09We find it takes between 6 to 9 conversations to get a new physician on board with the efficacy and the benefit risk for Xiphofri. So we have the capability of getting time with these physicians, access is not a problem and we'll continue to execute as flawlessly as we can. Speaker 100:42:30Thank you. Operator00:42:32One moment for our next question. Our next question will be coming from Francois Brisebois of Oppenheimer. Your line is Speaker 400:42:42Hi, this is Dan on for Frank. Thanks for taking our questions. Just a quick one from us. I'm sorry if you touched on this, but the uptick in new patients in the recent weeks. Could you give us any color in terms of what factors may have contributed to that, anything around that recent uptick? Speaker 400:43:01Thanks. Speaker 300:43:04Thank you, Austin. Yes. Thanks, Sam. Yes, so we continue we did dip below and we're below 50 and we're back and stable at approximately 50%. And that uptick has been stable. Speaker 300:43:16I think it's down to us executing our plan on the benefits that the efficacy that SYFY can bring, increasing effects over time, flexible dosing, well documented safety and the significant real world experience. And I think that's starting to resonate with our current prescriber base, but also all of these new physicians that we're targeting. So we will continue to execute as flawlessly as we can. Operator00:43:45And one moment for our next question. Our next question will be coming from Douglas Tayo of H. A. Wainwright. Your line is open Douglas. Speaker 1300:43:55Hi, good morning. Thanks for taking the questions. Maybe Adam, just as a follow-up on that. I'm just curious in terms if you could provide some color in terms of the messaging and what resonated with physicians to drive the rebound in share? Was it really that physicians had simply weren't aware of some of these efficacy differentiation points? Speaker 1300:44:18Had they lost focus on it? Perhaps were they sort of under a mistaken impression on the rate of vasculitis events? Speaker 300:44:29Yes, great question, Doug. We did see a lot of what you've described. So we have simplified our efficacy messages so that we can hit them across field based interactions and digital interactions around the strong efficacy up to 42% in non subfovial patients, flexible dosing and well documented safety. We have been very transparent on our safety and we have communicated that to physicians to make sure that people understand the fact base behind our efficacy as well as our safety. And that's what we will continue to hit and that's I think part of the plan of what's leading to the stability that we're seeing in the market. Speaker 300:45:11Caroline, I don't know if you want to add anything from a physician perspective. Speaker 100:45:15Thank you, Adam. I think another important thing is that we're very aligned with the rest committee and the ASRS. And that is an organization that's retina physicians run by retina physicians, it's their organization. And physicians really take confidence in that we're working with them, the rate hasn't changed and they've seen no unsuspected events. So that based and the real world data that's come into play has really increased confidence amongst retina doctors. Speaker 100:45:47And I guess this Speaker 1300:45:48is a follow-up. I mean between all those factors that you mentioned and Caroline, I mean was there one in particular that you thought was perhaps where you've gotten feedback was misunderstood in the marketplace and as your reps have gone out sort of has been corrected? Speaker 300:46:05Yes, Doug. We've been consistent that we believe that Speaker 200:46:08this is a market that's going Speaker 300:46:10to be driven on efficacy. And we get some incredibly positive recall data and knowledge from physicians on the efficacy messages once we've hit them. And it does take a little bit of time for them to resonate. So we think efficacy is changing the curve. Speaker 1300:46:28Okay, great. Thank you so much. Operator00:46:31And one moment for our next question. Our next question will be coming from Lachlan Hanbury Brown of William Blair. Your line is open. Speaker 1400:46:41Hey, thanks for taking the question. We've already had a few questions this morning around the October trends for Xiphobri. It sounds like you've recovered new petroidshare and you're seeing decent growth, but you're also guiding to sort of lowtomidsingledigit volume growth in the Q4. So can you just sort of reconcile some of those October trends that you've talked about with the full quarter commentary? Speaker 400:47:06Sure. Listen, I'll just start out and then I'll turn Speaker 900:47:08it over to Adam. Adam said is what Speaker 400:47:10we can obviously what we've seen. We've seen new patient share approaching 50%. We've also seen, as you can see, the market is still growing, but it was growing at a little bit of a slower rate in the last quarter. So I think our confidence over the long term is quite strong that the efficacy profile of SYFOPRI will dominate over time, but in the short term these dynamics take some time to take effect, right. We have certain initiatives we're putting in place like DTC and others that we've described as Adam talked about, those don't have an immediate impact. Speaker 400:47:40So from the perspective of what we can see this quarter, I think it was for you to take that approach and to say, look, low to mid single digit growth in the bio basis and flat to moderate growth on a revenue basis. I don't know if you want to comment more on this. Speaker 300:47:55No, I think you said it really well. Thanks. Operator00:47:59And one moment for our next question. Our next question will be coming from Derek Archila of Wells Fargo. Your line is open. Speaker 1500:48:10Hey guys, thanks for taking the question. So just I wanted some help reconciling your comments on reaching profitability with current cash while anticipating flat to modest sales growth. I guess, what type of growth does that imply for SYFOVRI in 2025 beyond? And I guess maybe on the flip side, what levels of OpEx? And then another just to squeeze in, I guess should we assume the sale of receivables is part of that funding strategy to profitability? Speaker 1500:48:37Thanks. Speaker 400:48:38Sure. Thank you. That's a great question. So look, we ended the quarter with about $400,000,000 in cash. That included a sale of roughly $57,000,000 in receivables. Speaker 400:48:48So that was obviously you've read the Q. So congratulations, Megan. Look, when you look at our operating expenses on a cash basis, if you exclude one time items of about $15,000,000 Speaker 900:49:02on the COGS line, and Speaker 400:49:04then our cash OpEx of roughly $180,000,000 on the SG and A and R and D lines, You get to the fact that we're basically neutral on a net revenue to cash operating expenses basis. And beyond that, we had net interest of around $10,000,000 So you're looking at kind of $10,000,000 in operating Speaker 900:49:23burn and Speaker 400:49:23the rest of this sort of cash usage relates to working capital. And for that, we put in place this ability to monetize our receivables a little bit earlier because we extend these receivables quite significantly as much as 5 months, 4 to 5 months. So from our perspective, that's really just bringing in cash that's ours a little bit early. And but you can see from an operating level, we are pretty much nearing, if not around breakeven. So our perspective is it doesn't take much growth to make us cash flow positive. Speaker 400:49:56And obviously, we have a lot of faith in the long term of this product as we've talked about. We also have C3G coming on. So we don't see any immediate feed or risk from a capital perspective. Speaker 1500:50:09Got it. Thank you. Operator00:50:11And one moment for our next question. Our next question will be coming from Biren Amin of Piper Sandler. Your line is open. Speaker 1600:50:21Yes. Hi, guys. Thanks for taking my questions. Can you maybe talk about how many switches you're seeing from IsoVe as part of the new patient share growth that you're experiencing in the last half of Q3? And for 2025, what's the SG and A increase that we should expect for C3 MPGN? Speaker 1600:50:39I think Novartis mentioned that they have about 100 plus person sales force dedicated to nephrology. Thank you. Speaker 300:50:48Hey, Barrett. Yes, it's Adam. So switching first on cyfovirate. So obviously, our data analysis suggests that switching does occur, but we actually think it doesn't happen that frequently. So hence we're executing our plan to grow depth and breadth in accounts and bring on new young prescribers to our business. Speaker 300:51:08We think that's what's really going to move the needle forward. When it comes to infrastructure for the nephrology indications, so we're doing that homework now. We obviously have a really small but mighty PNH infrastructure, which we will leverage to move into the kidney. So we're doing our homework there to look at the target population and what field force structure that we would need to compete to get those patients with the great profile that Emphyrately is showing. Thank you. Speaker 300:51:40And maybe adding one thing to that or Speaker 200:51:42two things to that. On the switches, there are switches occurring in both directions, right? I mean, as again this field will settle and there's a couple of things still that we need to see materialize in the next couple of months and go in both directions. The other aspect is as it relates to C3GNIC and PGN, again reiterating the fact that we were not asked to submit the 12 month data, but the 6 month data was sufficient. We had a pre NDA meeting that was scheduled with our team in Washington. Speaker 200:52:15Meeting got canceled because all questions were answered. So again, very exciting program for us that we think will add meaningfully to what we are doing. Speaker 1600:52:26Great. Thank you. Operator00:52:28And one moment for our next question. Our next question will be coming from Lisa Walter of RBC. Your line is open. Speaker 1000:52:38Great. Thanks so much for taking my questions. Maybe just one on CIFOVRI and given the recent negative CHMP opinion and also your competitor withdrawing from filing in the EU, how are you thinking about the possibility of potential approval in other ex U. S. Geographies, particularly the UK, Australia, Canada, Switzerland? Speaker 1000:53:00And also beyond those four countries, are there any other large foreign markets that are also on your radar? Thanks for taking the question. Speaker 300:53:10Hey, Lisa, it's Adam. Yes, thanks for your question. So, obviously, we still progress with the UK, Switzerland, Canada and Australia. Those are countries that are outside of EMIS guidance. They used to be within something called the Access Consortium. Speaker 300:53:27So we continue to have positive and robust conversations with those geographies. We also will move forward in areas where the U. S. File is required. So we've started to build a lean infrastructure in Brazil to get ready for those regulatory interactions. Speaker 300:53:45And we have distributors who will help partner with us to get to other smaller markets where the U. S. Filing is accepted. So we still see a really large unmet need outside of the U. S. Speaker 300:53:58When it comes to geographic atrophy and we're executing country by country. Speaker 1000:54:04Got it. Thanks so much. Operator00:54:07And one moment for our next question. Our next question will be coming from Greg Harrison of Scotiabank. Your line is open. Speaker 500:54:16Hey, good morning. Thanks for taking the question. Looking at the feedback from ASN, everything was very positive there. Are you able to provide any additional color on physician feedback now that they've had some time to digest the data from the conference? And how are you thinking about your competitive positioning in those indications in the shorter and longer term? Speaker 500:54:40Thanks. Speaker 200:54:42Thank you so much, Greg. Thank you for asking a question about the kidney, something we're really excited about. And to your point, Essent it was a very pleasant conference for us to attend. The reality here is that if you are a teenager with C3G or iCMP Gen and with the data that we have, we believe that you have an opportunity to never have to worry about being on hemodialysis or requiring a transplant. Think about that, right. Speaker 200:55:10I mean that is what these data really represent. So really excited about that competitively. As I mentioned before, we are we have very different profile on 3 important endpoints on proteinuria reduction of course, but also on EGFR stabilization and importantly on C3C staining where we saw these dramatic effects. And Carolyn, maybe you want to add something to that? Speaker 100:55:33Sure. Thank you. Well, it was my first nephrology meeting. And I can say across the board, the clinicians were so excited about these findings. I mean, to see this sort of effect is really remarkable. Speaker 100:55:49And I think one thing that was really important for them was that the effects started as early as 4 weeks in these patients. And as a physician, why wait for kidney disease to get worse? It might get worse to the point that it's irreversible, right? And these patients are often young. In our studies, the mean age were patients in their 20s. Speaker 100:56:14So they were really excited to give them something that worked and worked quickly and could prevent them from having a negative outcome. So, across the board, everyone was very excited for this. Operator00:56:30And one moment for next question. And our next question will be coming from John Miller of Evercore. Your line is open. Again, John Miller of Evercore, your line is open. Moving forward to our next question. Operator00:57:01Our next question will be coming from Greg Savino of Mizuho Securities. Your line is open. Speaker 1700:57:10Good morning. Thanks for taking my question. My question is, on your longer term and perhaps aspirational view around potential peak penetration of the complement inhibitor class, You've been great about providing granularity on current penetration, which I believe you said earlier might be at about 15%, but longer term, where do you think 15% can go and how long do you think it might take to get there? Thanks. Speaker 200:57:36Thank you, Greg. Caroline? Speaker 100:57:38Well, I think that no one should be deprived of this treatment. And our patients are only getting older. These patients come in whether it's for AMD, for cataract, we have so much education that we can do not just with optometrists, but across the eye care, provider market, which is more than just optometrists and retina. So I think that hopefully we will continue. So chronic disease will continue to have the penetration go up. Speaker 100:58:07We're just really at the start. Operator00:58:18And one moment for our next question. Our next question will be coming from Laura Chico of Wedbush Securities. Your line is open. Speaker 1000:58:32Good morning. Thanks very much. Two clarifications for me. Just following up on the cash runway guidance, just wanted to clarify, does that incorporate a C3 gs launch and revenue contribution? And then second, I think I might have missed it, but the average number of injections per patient, how has that changed over the course of the launch here? Speaker 1000:58:49Thanks very much. Speaker 400:58:53Thank you very much, Laura. I'll take obviously the first question. It absolutely does. The incremental cost for a C3 gs launch would not be massive in terms of expenditure relative to where we are. And so that absolutely does. Speaker 300:59:08Hey, Laura, it's Adam. To your second part of the question, so every other month dosing or that flexibility to push to every other month dosing has been really stable at 80% to 90% of all of Xiphobry's prescriptions. Physicians and patients believe in the efficacy and the flexibility of every other month's dosing. So we expect that to stay the same as we move forward. Operator00:59:37One moment for our next question. Our next question will be coming from John Miller. Your line is open. Speaker 500:59:45Hi, guys. Thanks for taking my follow-up here. I'd love to ask more on the kidney indications. How do you expect obviously, it's a little early to discuss eventual label, but given you've got data in C3gIC MPGN, both pre and post transplant, how do you expect your potential label to look relative to Novartis' considering the differences in trial design? And do you expect that proteinuria efficacy differences aside, is the patient population going to be materially broader for you guys? Speaker 201:00:25Thank you, John. So that is we're not going to comment on what we expect in the label. But to your point, we studied pediatric adults, pre transplant, post transplant, C3G and ICMPGN and all levels of C3 concentration in the blood, right. I mean our competitor studied only patients with C3G only in adults, only pretransplant and only in patients that had C3 depletion. So it's really a very narrow population compared to what we studied in Valyant where across the board we saw the same efficacy profile. Speaker 201:00:58And again the benefit of being able to file with the 6 month data is reflection of the robustness and the quality of what we were able to establish. So again, we believe that this is a treatment that may offer the possibility to an adolescent to never have to worry about hemodialysis or a transplant. And there are at least 5,000 patients we believe in the U. S. With this condition of which already 1,000 to 1500 are transplanted and at risk of relapsing. Speaker 201:01:26So really important indication and we believe a tremendous first line and all encompassing solution for these patients. Operator01:01:39And I would now like to turn the call back to Cedric for closing remarks. Speaker 201:01:44Thank you so much and thank you everyone for joining us this morning. If you have any follow-up questions, feel free to contact Meredith and we look forward to speaking with many of you today. Thank you so much. Operator01:01:54And this concludes today's conference. Thank you for your participation. You may now disconnect.Read morePowered by Conference Call Audio Live Call not available Earnings Conference CallApellis Pharmaceuticals Q3 202400:00 / 00:00Speed:1x1.25x1.5x2x Earnings DocumentsSlide DeckQuarterly report(10-Q) Power Integrations Earnings HeadlinesTanfield reports Snorkel's sales dip and EBITDA lossFebruary 7, 2025 | msn.comTanfield brothers in race against clock to form new UCI Continental teamDecember 2, 2024 | msn.comNow I look stupid. Real stupid... I thought what happened 25 years ago was a once- in-a-lifetime event… but how wrong I was. Because here we are, a quarter of a century later, almost to the exact day, and it’s happening again. 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The company provides a range of alternating current to direct current power conversion products that address power supply ranging from less than one watt of output to approximately 500 watts of output for mobile-device chargers, consumer appliances, utility meters, LCD monitors, main and standby power supplies for desktop computers and TVs, LED lighting, and various other consumer and industrial applications, as well as power conversion in high-power applications comprising industrial motors, solar and wind-power systems, electric vehicles, and high-voltage DC transmission systems. It also offers high-voltage diodes; InnoSwitch IC for electric vehicles; high-voltage gate-driver products used to operate high-voltage switches, such as insulated-gate bipolar transistors and silicon-carbide MOSFETs under the SCALE and SCALE-2 product-family names; and SCALE-iDriver for use in powertrain and charging applications for electric vehicles. 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There are 18 speakers on the call. Operator00:00:00Good morning, ladies and gentlemen. Thank you for standing by, and welcome to the Apellis Pharmaceuticals Third Quarter 2024 Earnings Conference Call. At this time, all participants are in a listen only mode. After the speakers' presentation, there will be a question and answer session. Please be advised that today's conference is being recorded. Operator00:00:30I would now like to turn the call over to Meredith Kaya, Senior Vice President, Investor Relations and Strategic Finance. Please go ahead. Speaker 100:00:40Good morning, and thank you for joining us to discuss Apellis' Q3 2024 Financial Results. With me on the call are Co Founder and Chief Executive Officer, Doctor. Cedric Francois Chief Operating Officer, Adam Townsend Chief Medical Officer, Doctor. Caroline Baumel and Chief Financial Officer, Tim Sullivan. Before we begin, let me point out that we will be making forward looking statements that are based on our current expectations and beliefs. Speaker 100:01:03These statements are subject to certain risks and uncertainties, and actual results may differ materially. I encourage you to consult the risk factors discussed in our SEC filings for additional detail. Now I'll turn the call over to Cedric. Speaker 200:01:15Thank you, Meredith, and thank you all for joining us this morning. Over the past few months, we have made meaningful progress towards our long term goals, reaching key milestones such as generating continued growth in value demand for say full brief and presenting the groundbreaking Phase 3 valiant results with EmbaReady at C3g and ICMPGN. These data underscore the power of C3 and reinforce our belief that targeting C3 is the optimal way to treat complements mediated diseases. During the Q3, commercial vial demand for SYFOVRI grew by 7% quarter over quarter and SYFYVI maintained its market leadership with 84,500 commercial vials shipped to physicians. 3rd quarter SYFYVI net product revenue of $152,000,000 were more than double the same period last year. Speaker 200:02:08However, we recognize that revenue fell short of expectations declining by 1.7% relative to the last quarter. This was partially due to higher gross to net adjustments which Adam and Tim will speak to shortly. Importantly, we expect gross to net to be stable going forward with more modest quarterly adjustments typical of a buy and build model. Also affecting our performance this quarter was an overall slowing within the GA market. Total tile demand did grow quarter over quarter, but at a slower pace than in previous quarters. Speaker 200:02:46Market growth is now being driven by the next group of retina specialists who often need more time to appreciate the benefit risk profile of complement treatments and therefore take longer to decide to treat their GA patients. To support meaningful growth going forward, we need to continue building awareness of SYF-four forty's strong clinical profile. We have launched several key initiatives aimed at increasing our share of new patient starts, strengthening our market leadership and accelerating growth in the overall GA markets. Early science suggests that these efforts are delivering positive results, but their impact on the GA market and Xiphobri demand will take time. Considering this, we remain conservative in our near term expectations for growth anticipating low single digit percentage value growth for the remainder of 2024 with flat to modest net revenue growth in the Q4. Speaker 200:03:46We plan to provide further insight into the GA market dynamics and our growth expectations for 2025 in the coming months as we gain visibility into the impact of our new commercial initiatives. It is important to remember that we are still in the early stages of the launch. We estimate that only about half of OGA patients are diagnosed and seen by an eye care professional and of those an estimated 15% are currently being treated. GA patients are on an irreversible path to blindness and TYPHORI has a significant impact on slowing disease progression and potentially preserving patients vision for longer. We see tremendous opportunity over the long term, but expect the sales ramp to be more gradual going forward. Speaker 200:04:36Importantly, we continue to believe CIFOVRI remains on track to become a blockbuster drug. Quickly touching on Europe, we were disappointed with the negative CHMP opinion despite multiple analyses showing that treatment with Cyfobri preserve visual function. We do not have plans to pursue EU approval further at this time. And then moving to Empavily, we were extremely pleased to share the full results from the Phase 3 VALION study in C3 gs and primary ICMPGN at Kidney Week last month. I will let Caroline discuss these results further, but we believe EMPOWITY has the potential to become a best in class treatment for these rare kidney diseases, redefining the current treatment paradigm for patients with C3G and ICMP Gen. Speaker 200:05:28At Apenis, we have spent the last 2 decades investigating C3 as a therapeutic target because we believe in the significant benefit of targeting C3 as compared to other targets within complement. These positive valued results suggest once again that Avelis' C3 targeted therapies are particularly effective across multiple therapeutic areas now including PNH, geographic atrophy and C3 gs and ICMPGN. We received feedback from the FDA last week that our submission proposal has been accepted which means that we remain on track to file our supplemental NDA early next year in both C3G and ICMPGN based on our positive 6 month data. Importantly, the FDA did not require us to file with the full 52 week data. Our ex U. Speaker 200:06:22S. Partner Sobe expects to file a regulatory submission in the EU in early 2025 followed by a submission with the Japanese health authorities later in 2025. The Valyant data also unlocked additional opportunities within nephrology that we are evaluating and plans to provide detail on soon. On the commercial front, Embavetti generated $24,600,000 in U. S. Speaker 200:06:49Product revenue in PNH in the 3rd quarter, up 3% as compared to the same period last year. The 97% compliance rate supports the substantial benefit that these patients are receiving. In closing, our strong fundamentals position us well for the future. Aperis has 2 commercial products, each with blockbuster potential which are already making a meaningful difference in patients' lives. Our emerging pipeline holds exciting products and we look forward to sharing more on this soon. Speaker 200:07:25We are on a clear path to profitability and continue to believe we can independently fund our core business. And with that, I will now turn it over to Adam to discuss our commercial activities. Thanks, Speaker 300:07:39Cedric, and good morning, everyone. I will begin with Cyfobri. In the Q3, we delivered approximately 84,500 commercial doses, a 7% increase compared to Q2 and approximately 4,000 samples of SYFOVRI. The growth in demand seen during the quarter reaffirms SYFOVRI's leadership in the market. SYFOVRI closed the 3rd quarter with approximately 65% market share as defined by injections and approaching half of new patient starts. Speaker 300:08:13As of September, more than 2,200 sites of care have ordered Cyphobury. As Cedric mentioned, the increase in demand was offset by adjustments to our gross to net, including contracting that affected overall net revenue. As a reminder, contracting with physician practices is common within the buy and bill space. At the end of 2023, we made strategic contracting decisions to remain competitive that impacted Xiphovery's average sales price or ASP reimbursement in the Q3 of 2024. We also recorded higher rebates this quarter due to some incremental contracting decisions that took effect on July 1. Speaker 300:09:00While this quarter was particularly impacted, to be clear, we have not chased large rebates or deep discounts nor do we intend to in the future. Our strategy has always been to maximize access to Cyfovir for patients while preserving long term economics. We recognize the importance of staying competitive and have balanced these economics with the efficacy that Xiphobri offers. Turning back to demand, we are encouraged by the continued demand growth for SYFOVRI, but we know there's more work to do to sustain this growth moving forward. To that end, we've launched several initiatives as part of Phase 2 of our commercial strategy to help shift the dialogue with ECPs towards Xiphobri's robust efficacy profile, including its increasing effects over time up to 42% in non subfovial patients, multiple analyses demonstrating preservation of visual function and well documented safety. Speaker 300:10:08Key initiatives include leveraging medical congresses and other key forums to reinforce Xiphobry's unique benefits, actively engaging with younger retina specialists who tend to treat a higher share of new patients, Expanding our engagement with non injecting ECPs such as optometrists and general ophthalmologists so that patients with GA seek treatment with a specialist. Generating new clinical data and real world evidence to further reinforce Xiphobry's clinical profile. We introduced the new injection needle making the user experience even easier by reducing injection force. And we continue to educate payers on the strong value proposition for XIFAVERY. We are pleased to already see some early indications of positive momentum. Speaker 300:11:03For example, after seeing a slight decline in new patient share at the start of Q3, SYFOVRI rebounded in the last half of the quarter, closing the quarter approaching 50%. Additionally, market research shows the efficacy messages are resonating. Surveyed ECPs recall Xiphovi's efficacy as the leading discussion topic from their last Apellis interaction, up from 46% in April to 73% in September. And lastly, a large Medicare Advantage plan recently made Xiphobry the only preferred product on their formulary, effective January 1, 2025. This adds to the 2 large national PBMs that place Xiphofri as the only preferred product on their commercial plans in July. Speaker 300:11:56Looking ahead, we plan to launch Phase 2 of our branded DTC campaign soon, which brings back Henry Winkler. This campaign is intended to educate patients on Xiphofri's profile, increasing patient awareness and driving Xiphori conversations with ECPs. Xiphori's market share has been stable at roughly 65% since September. This combined with the uptick in new patient share in recent weeks suggests that our initiatives are starting to have an impact. While we are encouraged by the positive momentum, it will still take time for these to gain traction, which is why we must be prudent in our guidance for the remainder of 2024. Speaker 300:12:43Market research shows that questions about safety continue to delay more meaningful discussions about the benefits of cyphovary and those benefits that are offered to patients. It can take at least 6 conversations with an ECP before the efficacy messages truly resonate. That said, our long term outlook for Xiphobry remains strong. We have only scratched the surface of SYFOVRI's market potential and there is a significant opportunity for further growth. We anticipate growth moving forward will be gradual, but with only 2 available therapies in a large category and no new competition expected for at least the next 4 years, we are confident SYFOVRI will remain the leading GA product in the U. Speaker 300:13:33S. For many years to come. Beyond cyfovary, I'm excited about the opportunity for Empervelate to expand into C3g and ICMPGN. We believe the commercial opportunity for these indications is significant. We estimate approximately 5,000 patients in the U. Speaker 300:13:54S. But also believe that these diseases are likely under diagnosed because there are no treatments currently available. Feedback from physicians has been resoundingly positive that the severity of these diseases warrants use of the most efficacious treatment option available. Across the board, nephrologists' feedback is that Emper Valley data are significantly differentiated from other compounds in development with the enthusiasm amongst physicians exceeding even our highest expectations. If approved, we believe we are in a strong position to capture a significant proportion of this market and generate meaningful growth for Emperveli. Speaker 300:14:37Now, let me shift to Emperveli and PNH. In the Q3, Empervali generated approximately $24,600,000 in U. S. Net product revenues. Compliance rates remain high at 97% and the safety profile remains consistent with our previous updates. Speaker 300:14:56With that, I will now turn the call over to Caroline. Caroline? Speaker 100:15:01Thanks, Adam, and good morning, everyone. As Adam mentioned, we are starting to see multiple instances of meaningful real world presentations, reaffirming Xiphofri's robust efficacy and we expect the first paper from a third party on Xiphofri to be published soon. These real world data reinforce Xiphobry's unprecedented effects, adding to the largest body of evidence supporting Xiphobry treatment and allowing us to further strengthen our message around efficacy. Moving to Empivelli, the feedback on the full Valyant data set that was presented at Kidney Week last month was remarkable. In these diseases, physicians are focused on 3 key markers of disease activity when evaluating a potential treatment. Speaker 100:15:55These are proteinuria, EGFR and C3C staining. As detailed in our full data set, pegzetacopalan showed positive effects on all three in just 6 months. This included a statistically significant 68% reduction in proteinuria with reductions observed as early as week 4 and effects that were consistent across all subgroups of patients regardless of disease type, age and transplant status. A stabilization of eGFR, a key measure of disease function and a substantial reduction in C3C staining with over 70% of pegzetacoplin treated patients having achieved 0 C3C staining intensity indicating complete clearance of C3C deposits. There are no approved treatments for C3G or ICMPGN and the unmet need given the severity of these diseases is extremely high. Speaker 100:17:09The totality of the efficacy data from Valyant shows that pegcetacopalan rapidly, significantly and consistently improved key outcomes for patients with C3G and ICMPGN. We are ecstatic about what the results mean for the patients, physicians, caregivers and everyone else within the C3G and ICMPGN communities. Finally, we are continuing to advance our earlier stage pipeline, such as our C3 siRNA that is currently in Phase 1 development and our BEAM collaboration. We are excited to share more details about our pipeline programs with you in the future. I will now turn the call over to Tim for a review of the financials. Speaker 100:18:02Tim? Speaker 400:18:03Thank you, Caroline. I will now provide an overview of our financials. Additional details are available in the press release that we issued earlier this morning. Total revenue for the Q3 of 2024 was approximately $197,000,000 including $152,000,000 in SIFO REIT and $24,600,000 in Emba Valley U. S. Speaker 400:18:24Net product revenue. This compares with $110,000,000 in total revenue in the Q3 of 2023. Turning to the rest of the P and L. For the Q3, cost of sales was $33,600,000 R and D expenses were $88,600,000 SG and A expenses were $122,000,000 and we reported a net loss of 57,400,000 dollars Cash operating expenses, which excludes stock based compensation and depreciation and amortization were approximately $180,000,000 for the Q3. We continue to expect total cash operating expenses in 2024 inclusive of R and D and SG and A expenses to be less than our total cash expenses in 2023. Speaker 400:19:14As Adam mentioned, there was an increase in our in Xiphobry's gross to net percentage this quarter as compared to previous quarters. This is a result of 2 factors. The first was due to contract decisions resulting in higher discounts to physicians. The second was related to a true up of certain fees from prior quarters included in gross to net in Q3. Looking ahead, we expect gross to net to continue to be impacted by ASP erosion and required contracting, but we expect that erosion to be modest and not at the rate we saw in the Q3. Speaker 400:19:49We now expect gross to net through 2025 to be in the low to mid-twenty percent range. With $397,000,000 in cash and cash equivalents as of September 30, we remain confident in our strong financial position. We expect our existing cash combined with our future product sales to be sufficient to fund our core business to positive cash flow. I will now hand the call back over to Cedric for closing remarks. Speaker 200:20:15Cedric? Thank you, Tim. We are focused on building out the GA market and realizing the opportunity in front of us in C3G and ICMPGM. With 2 potentially blockbuster commercial products, a pipeline of innovative programs in development and a strong financial position to support the business, we are confident in our ability to continue to create significant value for our patients and our shareholders. With that, we will now go over to the Q and A session. Operator00:20:49Certainly. Our first question will be coming from John Miller of Evercore. Your line is open. Speaker 500:21:12Hi, guys. Thanks so much for taking the question. I would love to spend my one question talking about the evolution of market share in 3Q and beyond. Obviously, we all heard your competitor talking about increased market share in 3Q and their expectations for, well, in their mind, continuing dominance from here. So what are Speaker 600:21:37the pushes and Speaker 500:21:38pulls, you versus them on who's going to end up with the dominant market share? And to what extent do you think that the actions you're taking to drive patients into the retina physician practice out of those ophthalmology offices? To what extent are those going to deliver patients to you as opposed to the competitor? Speaker 200:22:00Thank you, Soren. Great hearing you. So look, as we've always said, the benefit of SYFYVI lies in its differentiated efficacy profile, right. It is also the only drug that has shown increasing effects over time that has shown efficacy with every other month dosing both in foveal and sub foveal patients. That differentiated efficacy profile is really what stands out and what we will be building the market on now. Speaker 200:22:30So Adam, I'll hand it over to you to clearly add Speaker 400:22:32a couple of thoughts. Speaker 300:22:33Yes. Thanks, John. So obviously, as we're heading into year 3 of the launch, we're now calculating market share based on injections versus based on patients. We actually believe this is similar to the way our competitor calculates market share. We think it's a really important metric and we believe that we are a market share of 65%. Speaker 300:22:57Now, if we were still to use a market share based on patients as we have previously reported, that market share would be approximately 70%. Injection share incorporates factors such as dosing frequency, bilateral usage compliance and active patients. That's why we think it's a really valuable metric. Now, as per new patient starts, after seeing a slight decline in new patient starts at the start of Q3, XIFAVU rebounded in the last half of the quarter, closing the quarter, approaching 50%. The reason we believe is that this is an efficacy driven market and we have the strongest efficacy profile and we're executing our plan to bring new prescribers and young prescribers into the market. Speaker 200:23:52Does that answer your question? Speaker 500:23:57Yes, that helps. Thanks very much. Speaker 200:23:59I'll hop back in the queue. Queue. Operator00:24:02And one moment for our next question. Our next question will be coming from Tazeen Ahmad of Bank of America. Your line is open. Speaker 700:24:14Hi, guys. Good morning and thanks for taking my question. I maybe wanted to stay on topic with SYFOPRI. Your competitor has been wanting, it seems to provide a lot of detail about the cadence of their launch, providing a first stab at guidance and then revising it at their last call upward. I know a question that investors had is when Appellus would feel comfortable providing guidance on sales. Speaker 700:24:41And I think that's also tied to how people think you think the rate of growth of the market is going to be. I think there's some questions about the size of GA with the 2 products currently approved. So what are you feeling that you need comfort on in order to provide, let's say, full year sales guide on a go forward basis? And how are you thinking that's going to be reflected about how you're thinking about the size of the overall opportunity? Thanks. Speaker 400:25:09Thank you, Tazeen. Look, we're considering providing guidance for next year and we haven't made a decision on that yet. A couple of things, we have these initiatives we've discussed and there are certain market dynamics that we think will settle out over time. We'd like to see how those evolve. And for the moment right now, we're focused on fortifying our position as the market leader and then growing the GA market overall. Speaker 400:25:30But once I think we feel we have a little better understanding of that, I think we would feel comfortable doing some sort of guidance. But at this point, it's under consideration. Operator00:25:44And one moment for our next question. Our next question will be coming from Anupam Rama of JPMorgan. Your line is open. Speaker 600:25:55Hey, guys. Thanks so much for taking the question. Do you think your sales team is sort of right sized to get to that next tier of docs that you're talking about in terms of prescribing Cyfovary and a complement inhibitor? And any trends we should think about in terms of sampling for that next tier of physicians relative to what you kind of disclosed in 3Q? Thanks so much. Speaker 300:26:19Hey, Adam, Pam, it's Adam. Thanks for your question. So we analyze our sales team and our infrastructure on a regular basis based on our target audience. And at the moment, we believe that we have the right feel force structure to execute and grow a depth and a breadth strategy across the market. We have made a couple of new initiatives to drive more patients and patient referrals. Speaker 300:26:45So we are in the process of putting an ophthalmology field team in place to educate on geographic atrophy for non injecting ophthalmologists to help refer patients to Xiphobia users. And we also have a digital, virtual optometry team to also fuel more and more referrals to injecting retina physicians. As it comes to sampling, obviously with our commercial vial demand growing at 7% and given that this is a buy and bill commercial model, we now have a J code, we have well established payer coverage and over 2,200 sites of care. We believe that sampling has less significant role at the moment. But we still believe that samples will make up approximately 5% of Xiphobri's total vial demand moving forward. Speaker 300:27:41You would expect that new prescribers will use samples as part of this market as they get more and more experience of SIFOFRIN. Operator00:27:52And one moment for our next question. Our next question will be coming from Salveen Richter of Goldman Sachs. Your line is Speaker 800:28:02open. Thank you. Good morning. You noted that market growth is now being driven by the next group of retinal specialists. Could you just elaborate on who these specialists are and how large that group is? Speaker 800:28:16And if I could just also just go back to this flat to modest revenue growth in 4Q, can you just help us understand what this accounts for in terms of gross to net? Speaker 200:28:29Thank you so much, David. I will answer the first part of the question and then hand it over to Tim. So I think the retina community and I think this is not just typical to the retina community, but any type of launch. You have the initial wave where you have patients that have been waiting on the sidelines for something to be approved with retina doctors that are enthusiastic to be first movers. So then you have a whole swatch of the next wave of physicians as well as patients in a disease that is slowly progressing. Speaker 200:29:03That kind of wait for the dust to settle of that first wave to then engage and slow down this devastating disease. So that's really where we currently are and what we are seeing in the marketplace. Carolyn, I don't know if you want to add something to this. Speaker 100:29:18Sure. Thank you. Hi, Salveen. I think that many trainees and younger retina doctors also have only been in practice for a limited time, so have maybe not seen the full effects of geographic atrophy on their patients. But they're very, very motivated to learn about geographic atrophy and how to treat these patients. Speaker 100:29:40So we really would like to make sure that we don't forget any of these new young trainees and with more and more physicians training in retina that they have available to SYFOVRI. Speaker 400:29:54Thank you, Selene. In terms of the guidance that incorporates our gross to net that I mentioned in the prepared remarks, which was going forward through 2025, we believe that gross to net will be in the low to mid-20s. Obviously, this quarter, we had a relatively large gross to net jump. That's a function of certain launch dynamics that all came together in this Q3. So we don't expect anything remotely like this going forward and gross to net to evolve in a more modest sense as ASP sort of steadily erodes as we discussed. Operator00:30:28And one moment for our next question. Our next question will come from Yigal Nochomovitz of Citigroup. Your line is open. Speaker 500:30:38Yes. Hi, guys. Thank you. So for my one question, I guess I'll ask a 2 part question. Just could you just provide a little more clarity on this impact to the ASP? Speaker 500:30:48Sounds like there was something related to maybe a discount trigger in the contract related to order volume that may have just all lined up in Speaker 600:30:57the Q3, if you could clarify that. And then regarding the duration and persistence of therapy, I'm curious Speaker 500:31:02if you've collected any data, Adam, in terms of the percent of patients that are staying on the therapy and then the percent that may be taking a break or don't return on schedule? Thank you. Speaker 400:31:16So sure. Thanks, Yigal. I will start with the gross to net part of Speaker 900:31:20the question. So the impact in Speaker 400:31:22the Q3 was really a result of 3 things. I know we mentioned 2 in the prepared remarks, but I'll dig in and divide this first one into 2 parts. And this ultimately sort of created the perfect storm for just this quarter. The first one, which is again these two parts, is the strategic contracting decisions that we actually made in late 2023, and that resulted in a lower ASP starting in Q3, okay? Beyond that, we had certain rebates provided as a result of incremental contracts within the Q3. Speaker 400:31:52And then the final piece, which was not insignificant was a true up of certain fees and expenses from prior quarters. So as I said, we now expect gross to net through 2025 to be in the low to mid-twenty percent range. Speaker 300:32:06Hey, Gal, it's Adam. You also asked a question on discounts. So obviously, at the moment, we're happy with the feedback from physicians on patient adherence. We're seeing persistence and discontinuation rates similar to what is seen with the anti VEGFs in wet AMD. A key driver of compliance is patient motivation. Speaker 300:32:29These patients are really committed to staying on drug to preserve their vision. Every other month dosing provides meaningful flexibility to those patients and we believe that also drives strong compliance with the efficacy you also see with every other month dosing. Speaker 500:32:47Thank you. Operator00:32:48And one moment for our next question. Our next question will be coming from Steve Seedhouse of Raymond James. Your line is open. Speaker 400:32:58Hi, thank you. This is Nick on for Steve. Just a quick one for us. Are you able to comment on which renal indications you like for testing at the Velonex? Or do you have a timeline set for when you'd articulate further clinical development in kidney? Speaker 400:33:12Thank you. Speaker 200:33:14Thank you so much for that question. So not yet, just a short answer. But we're working hard in the next couple of months, we will provide more clarity. Speaker 400:33:27Great. Thank you. Operator00:33:28And one moment for our next question. Our next question will be coming from Phil Nadeau of TD Cowen. Your line is open. Speaker 1000:33:37Cowen. Speaker 1100:33:40One follow-up and then one extra question on us from us. Tim, you've been very clear where gross net is going. I'm still not entirely clear where gross net actually was in Q3. Could you quantify what the gross net was in Q3? And then in terms of going forward, there's been some reports of Vasculitis for IZURVEY in the adverse event database at the FDA. Speaker 1100:33:59Has that had any impact on prescribing the market from what you've seen? Curious to get your feedback from your feet on the street on those reports. Thanks. Speaker 400:34:10Yes. Thank you, Phil. So, we previously had guided from the beginning of the launch of gross to net in the 10% to 20% range. And we had sort of earlier on been kind of in the middle ish of that range. And in this quarter because of what we described as the perfect storm, we were at the high end of that. Speaker 400:34:29And that's about all probably going to give in terms of accuracy there. Speaker 1100:34:34Got it. Thank you. Speaker 200:34:34Thank you. And then sorry. Bill, you had a follow-up to that? Speaker 1100:34:40No, no, I was just saying thank you. That's very helpful. Speaker 200:34:44As it relates to Vasculitis, so we're not going to comment on our competitor safety. But again, as we mentioned earlier, we believe that the only and real difference between the two products is on the efficacy profile, where St. Forgery stands out head and shoulders. We are the only product with increasing effects over time with every other month dosing and with both 4th year and SIT4VIA patients included in our data set. Speaker 1100:35:12Great. That's helpful. Thank you. Speaker 400:35:14Thank you. Operator00:35:17And our next question will be coming from Akash Tewari of Jefferies. Your line is open. Speaker 700:35:23Hi. This is Cathy on for Akash. It seems like your competitor is spending on promotional efforts for IZURVEY with an increase in SG and A spend associated with IZURVEY of $127,000,000 for 6 months of sales of $185,000,000 So during a similar time period for SysoVry's launch, like around 1 year of approval, what was your return on investments? And then in the long term, what are the ROI levels you're targeting? And more specifically for your DTC spend in 2025, do you think it will be much different from the spend this year since you're investing in BDC this year already? Speaker 700:36:01Thank you. Speaker 400:36:02Yes. So thank you. I'll quickly start out, and I'll turn it over to Adam. So we don't actually break out exactly what we're spending specifically on commercial for SYFOVRI. Obviously, we work hand in hand with Adam on those amounts and we really haven't as a finance group haven't really constrained those efforts. Speaker 400:36:23We've just tried to be as efficient as possible based on things like metrics like ROI. And for that answer, I'll turn it Speaker 300:36:29over to Adam. Yes. Thanks, Kathy. So we look at every initiative from an ROI perspective. So we analyze it internally on a regular monthly cadence and take a big initiative like disease state education pivoting to DTC with Henry Winkler. Speaker 300:36:46We do a robust ROI analysis on that. We actually believe that that's a really, really sound sophisticated business approach for us and it drives many, many more patients in. So it's a very positive ROI for DTC. So that's the type of analysis we do. This is a really, really big market and we've only just started to scratch the surface. Speaker 300:37:11So the more effective we are in executing our plan and balancing what that looks like from an ROI perspective, the better the results will be. Speaker 700:37:22Okay, great. Thank you so much. Operator00:37:25And one moment for our next question. Our next question will be coming from Ellie Merle of UBS. Your line is open. Speaker 1200:37:33Hey, guys. Thanks for taking the question. I want to talk a little bit more about the volume trends that you're seeing. So specifically, you said that you expect the sales ramp to be more gradual going forward. Just in terms of vials shift, does that mean we should expect similar vial growth in 4Q as in 3Q? Speaker 1200:37:51And just any more details you can give us on the volume trends you're seeing so far in October? Thanks. Speaker 900:38:00So I think that we did Speaker 400:38:03give some guidance in the prepared remarks on the vial growth and we sort of said mid percentages roughly is what to expect, low to mid percentage vial growth, right? So beyond that, I don't think we're planning on guidance for the quarter. Speaker 100:38:19Okay. Thanks. Operator00:38:28And our next question will come from Annabel Samimy of Stifel. Your line is open. Speaker 1000:38:34Hi. Thanks for taking my question. So, I guess from the initial launch, it looks like you got a lot of low hanging fruit. Now it's a bigger push to get more. What are you seeing in terms of dynamic referrals? Speaker 1000:38:48Like when a patient comes into the retinal specialist, from the ophthalmologist to the optometrist, are they coming in for monitoring now or treatment? Are they typically severe enough to treat or are they still in a watchful waiting mode? And then you mentioned 6 conversations to convert a retinal specialist who wasn't an early adopter. Does this get worse as these patients from the optometrists and the ophthalmologists come in because there may be less severe? I just wanted to understand the dynamic there of what types of patients you're starting to see from those specialists from those from that group? Speaker 200:39:28Thank you, Neville. So that's a really important and good question, right. So I think what was actually really great in the last few months is that kind of the uncertainties, people not knowing how to think about efficacy, how to think about safety, etcetera, that is slowly dissipating, right? So we're going to end up next year in a situation where kind of from a with a lot of data available to us, both from our trials but now also as Caroline alluded to from the real world and that data looks very good, the states where physicians and patients can make an educated decision on treatment and that's something that we really look forward to. Carolyn, I don't know if you want to add something to that? Speaker 100:40:13Sure. I can add from what my colleagues are telling me and from what I'm seeing myself. This is a novel mechanism of action and we have a new treatment paradigm. And there's still many patients who are coming into the office. We're always having patients referred with macular degeneration, of all types, whether it's early or they're patients who have later stages of the disease. Speaker 100:40:40And, so we're still seeing a whole host of different types of patients. I think that physicians are having conversations with their patients and they really center around efficacy. Now of course, whenever we have a treatment, safety also plays a role, but patients, are really driven by efficacy and the flexibility of dosing with 6 injections a year. And then I think the other thing that moves the needle for physicians is we have a lot of long term robust data. In addition to GALE, where patients have already had 5 years of full treatment, we have a real world Garland study. Speaker 100:41:17And then there are 4, real world studies done unrelated to a pellet. And that really in many ways speaks more to physicians. One of those studies has over 12,000 patients and those studies have shown robust reductions in GA lesion growth, photoreceptor preservation and all of the things that we have found. So just confirming our data. Go ahead, Alex. Speaker 300:41:41Hey, Annabel, it's Adam. Just on the final part of your question. So we are educating optometrists and ophthalmologists so that the patient also is aware as they progress to a retina physician about their disease and what treatment could possibly look like. We are actually hearing a lot from the field that patients go in saying, I want the Henry Winkler drug and that type of activity. So these patients are educated and are learning about the disease. Speaker 300:42:09We find it takes between 6 to 9 conversations to get a new physician on board with the efficacy and the benefit risk for Xiphofri. So we have the capability of getting time with these physicians, access is not a problem and we'll continue to execute as flawlessly as we can. Speaker 100:42:30Thank you. Operator00:42:32One moment for our next question. Our next question will be coming from Francois Brisebois of Oppenheimer. Your line is Speaker 400:42:42Hi, this is Dan on for Frank. Thanks for taking our questions. Just a quick one from us. I'm sorry if you touched on this, but the uptick in new patients in the recent weeks. Could you give us any color in terms of what factors may have contributed to that, anything around that recent uptick? Speaker 400:43:01Thanks. Speaker 300:43:04Thank you, Austin. Yes. Thanks, Sam. Yes, so we continue we did dip below and we're below 50 and we're back and stable at approximately 50%. And that uptick has been stable. Speaker 300:43:16I think it's down to us executing our plan on the benefits that the efficacy that SYFY can bring, increasing effects over time, flexible dosing, well documented safety and the significant real world experience. And I think that's starting to resonate with our current prescriber base, but also all of these new physicians that we're targeting. So we will continue to execute as flawlessly as we can. Operator00:43:45And one moment for our next question. Our next question will be coming from Douglas Tayo of H. A. Wainwright. Your line is open Douglas. Speaker 1300:43:55Hi, good morning. Thanks for taking the questions. Maybe Adam, just as a follow-up on that. I'm just curious in terms if you could provide some color in terms of the messaging and what resonated with physicians to drive the rebound in share? Was it really that physicians had simply weren't aware of some of these efficacy differentiation points? Speaker 1300:44:18Had they lost focus on it? Perhaps were they sort of under a mistaken impression on the rate of vasculitis events? Speaker 300:44:29Yes, great question, Doug. We did see a lot of what you've described. So we have simplified our efficacy messages so that we can hit them across field based interactions and digital interactions around the strong efficacy up to 42% in non subfovial patients, flexible dosing and well documented safety. We have been very transparent on our safety and we have communicated that to physicians to make sure that people understand the fact base behind our efficacy as well as our safety. And that's what we will continue to hit and that's I think part of the plan of what's leading to the stability that we're seeing in the market. Speaker 300:45:11Caroline, I don't know if you want to add anything from a physician perspective. Speaker 100:45:15Thank you, Adam. I think another important thing is that we're very aligned with the rest committee and the ASRS. And that is an organization that's retina physicians run by retina physicians, it's their organization. And physicians really take confidence in that we're working with them, the rate hasn't changed and they've seen no unsuspected events. So that based and the real world data that's come into play has really increased confidence amongst retina doctors. Speaker 100:45:47And I guess this Speaker 1300:45:48is a follow-up. I mean between all those factors that you mentioned and Caroline, I mean was there one in particular that you thought was perhaps where you've gotten feedback was misunderstood in the marketplace and as your reps have gone out sort of has been corrected? Speaker 300:46:05Yes, Doug. We've been consistent that we believe that Speaker 200:46:08this is a market that's going Speaker 300:46:10to be driven on efficacy. And we get some incredibly positive recall data and knowledge from physicians on the efficacy messages once we've hit them. And it does take a little bit of time for them to resonate. So we think efficacy is changing the curve. Speaker 1300:46:28Okay, great. Thank you so much. Operator00:46:31And one moment for our next question. Our next question will be coming from Lachlan Hanbury Brown of William Blair. Your line is open. Speaker 1400:46:41Hey, thanks for taking the question. We've already had a few questions this morning around the October trends for Xiphobri. It sounds like you've recovered new petroidshare and you're seeing decent growth, but you're also guiding to sort of lowtomidsingledigit volume growth in the Q4. So can you just sort of reconcile some of those October trends that you've talked about with the full quarter commentary? Speaker 400:47:06Sure. Listen, I'll just start out and then I'll turn Speaker 900:47:08it over to Adam. Adam said is what Speaker 400:47:10we can obviously what we've seen. We've seen new patient share approaching 50%. We've also seen, as you can see, the market is still growing, but it was growing at a little bit of a slower rate in the last quarter. So I think our confidence over the long term is quite strong that the efficacy profile of SYFOPRI will dominate over time, but in the short term these dynamics take some time to take effect, right. We have certain initiatives we're putting in place like DTC and others that we've described as Adam talked about, those don't have an immediate impact. Speaker 400:47:40So from the perspective of what we can see this quarter, I think it was for you to take that approach and to say, look, low to mid single digit growth in the bio basis and flat to moderate growth on a revenue basis. I don't know if you want to comment more on this. Speaker 300:47:55No, I think you said it really well. Thanks. Operator00:47:59And one moment for our next question. Our next question will be coming from Derek Archila of Wells Fargo. Your line is open. Speaker 1500:48:10Hey guys, thanks for taking the question. So just I wanted some help reconciling your comments on reaching profitability with current cash while anticipating flat to modest sales growth. I guess, what type of growth does that imply for SYFOVRI in 2025 beyond? And I guess maybe on the flip side, what levels of OpEx? And then another just to squeeze in, I guess should we assume the sale of receivables is part of that funding strategy to profitability? Speaker 1500:48:37Thanks. Speaker 400:48:38Sure. Thank you. That's a great question. So look, we ended the quarter with about $400,000,000 in cash. That included a sale of roughly $57,000,000 in receivables. Speaker 400:48:48So that was obviously you've read the Q. So congratulations, Megan. Look, when you look at our operating expenses on a cash basis, if you exclude one time items of about $15,000,000 Speaker 900:49:02on the COGS line, and Speaker 400:49:04then our cash OpEx of roughly $180,000,000 on the SG and A and R and D lines, You get to the fact that we're basically neutral on a net revenue to cash operating expenses basis. And beyond that, we had net interest of around $10,000,000 So you're looking at kind of $10,000,000 in operating Speaker 900:49:23burn and Speaker 400:49:23the rest of this sort of cash usage relates to working capital. And for that, we put in place this ability to monetize our receivables a little bit earlier because we extend these receivables quite significantly as much as 5 months, 4 to 5 months. So from our perspective, that's really just bringing in cash that's ours a little bit early. And but you can see from an operating level, we are pretty much nearing, if not around breakeven. So our perspective is it doesn't take much growth to make us cash flow positive. Speaker 400:49:56And obviously, we have a lot of faith in the long term of this product as we've talked about. We also have C3G coming on. So we don't see any immediate feed or risk from a capital perspective. Speaker 1500:50:09Got it. Thank you. Operator00:50:11And one moment for our next question. Our next question will be coming from Biren Amin of Piper Sandler. Your line is open. Speaker 1600:50:21Yes. Hi, guys. Thanks for taking my questions. Can you maybe talk about how many switches you're seeing from IsoVe as part of the new patient share growth that you're experiencing in the last half of Q3? And for 2025, what's the SG and A increase that we should expect for C3 MPGN? Speaker 1600:50:39I think Novartis mentioned that they have about 100 plus person sales force dedicated to nephrology. Thank you. Speaker 300:50:48Hey, Barrett. Yes, it's Adam. So switching first on cyfovirate. So obviously, our data analysis suggests that switching does occur, but we actually think it doesn't happen that frequently. So hence we're executing our plan to grow depth and breadth in accounts and bring on new young prescribers to our business. Speaker 300:51:08We think that's what's really going to move the needle forward. When it comes to infrastructure for the nephrology indications, so we're doing that homework now. We obviously have a really small but mighty PNH infrastructure, which we will leverage to move into the kidney. So we're doing our homework there to look at the target population and what field force structure that we would need to compete to get those patients with the great profile that Emphyrately is showing. Thank you. Speaker 300:51:40And maybe adding one thing to that or Speaker 200:51:42two things to that. On the switches, there are switches occurring in both directions, right? I mean, as again this field will settle and there's a couple of things still that we need to see materialize in the next couple of months and go in both directions. The other aspect is as it relates to C3GNIC and PGN, again reiterating the fact that we were not asked to submit the 12 month data, but the 6 month data was sufficient. We had a pre NDA meeting that was scheduled with our team in Washington. Speaker 200:52:15Meeting got canceled because all questions were answered. So again, very exciting program for us that we think will add meaningfully to what we are doing. Speaker 1600:52:26Great. Thank you. Operator00:52:28And one moment for our next question. Our next question will be coming from Lisa Walter of RBC. Your line is open. Speaker 1000:52:38Great. Thanks so much for taking my questions. Maybe just one on CIFOVRI and given the recent negative CHMP opinion and also your competitor withdrawing from filing in the EU, how are you thinking about the possibility of potential approval in other ex U. S. Geographies, particularly the UK, Australia, Canada, Switzerland? Speaker 1000:53:00And also beyond those four countries, are there any other large foreign markets that are also on your radar? Thanks for taking the question. Speaker 300:53:10Hey, Lisa, it's Adam. Yes, thanks for your question. So, obviously, we still progress with the UK, Switzerland, Canada and Australia. Those are countries that are outside of EMIS guidance. They used to be within something called the Access Consortium. Speaker 300:53:27So we continue to have positive and robust conversations with those geographies. We also will move forward in areas where the U. S. File is required. So we've started to build a lean infrastructure in Brazil to get ready for those regulatory interactions. Speaker 300:53:45And we have distributors who will help partner with us to get to other smaller markets where the U. S. Filing is accepted. So we still see a really large unmet need outside of the U. S. Speaker 300:53:58When it comes to geographic atrophy and we're executing country by country. Speaker 1000:54:04Got it. Thanks so much. Operator00:54:07And one moment for our next question. Our next question will be coming from Greg Harrison of Scotiabank. Your line is open. Speaker 500:54:16Hey, good morning. Thanks for taking the question. Looking at the feedback from ASN, everything was very positive there. Are you able to provide any additional color on physician feedback now that they've had some time to digest the data from the conference? And how are you thinking about your competitive positioning in those indications in the shorter and longer term? Speaker 500:54:40Thanks. Speaker 200:54:42Thank you so much, Greg. Thank you for asking a question about the kidney, something we're really excited about. And to your point, Essent it was a very pleasant conference for us to attend. The reality here is that if you are a teenager with C3G or iCMP Gen and with the data that we have, we believe that you have an opportunity to never have to worry about being on hemodialysis or requiring a transplant. Think about that, right. Speaker 200:55:10I mean that is what these data really represent. So really excited about that competitively. As I mentioned before, we are we have very different profile on 3 important endpoints on proteinuria reduction of course, but also on EGFR stabilization and importantly on C3C staining where we saw these dramatic effects. And Carolyn, maybe you want to add something to that? Speaker 100:55:33Sure. Thank you. Well, it was my first nephrology meeting. And I can say across the board, the clinicians were so excited about these findings. I mean, to see this sort of effect is really remarkable. Speaker 100:55:49And I think one thing that was really important for them was that the effects started as early as 4 weeks in these patients. And as a physician, why wait for kidney disease to get worse? It might get worse to the point that it's irreversible, right? And these patients are often young. In our studies, the mean age were patients in their 20s. Speaker 100:56:14So they were really excited to give them something that worked and worked quickly and could prevent them from having a negative outcome. So, across the board, everyone was very excited for this. Operator00:56:30And one moment for next question. And our next question will be coming from John Miller of Evercore. Your line is open. Again, John Miller of Evercore, your line is open. Moving forward to our next question. Operator00:57:01Our next question will be coming from Greg Savino of Mizuho Securities. Your line is open. Speaker 1700:57:10Good morning. Thanks for taking my question. My question is, on your longer term and perhaps aspirational view around potential peak penetration of the complement inhibitor class, You've been great about providing granularity on current penetration, which I believe you said earlier might be at about 15%, but longer term, where do you think 15% can go and how long do you think it might take to get there? Thanks. Speaker 200:57:36Thank you, Greg. Caroline? Speaker 100:57:38Well, I think that no one should be deprived of this treatment. And our patients are only getting older. These patients come in whether it's for AMD, for cataract, we have so much education that we can do not just with optometrists, but across the eye care, provider market, which is more than just optometrists and retina. So I think that hopefully we will continue. So chronic disease will continue to have the penetration go up. Speaker 100:58:07We're just really at the start. Operator00:58:18And one moment for our next question. Our next question will be coming from Laura Chico of Wedbush Securities. Your line is open. Speaker 1000:58:32Good morning. Thanks very much. Two clarifications for me. Just following up on the cash runway guidance, just wanted to clarify, does that incorporate a C3 gs launch and revenue contribution? And then second, I think I might have missed it, but the average number of injections per patient, how has that changed over the course of the launch here? Speaker 1000:58:49Thanks very much. Speaker 400:58:53Thank you very much, Laura. I'll take obviously the first question. It absolutely does. The incremental cost for a C3 gs launch would not be massive in terms of expenditure relative to where we are. And so that absolutely does. Speaker 300:59:08Hey, Laura, it's Adam. To your second part of the question, so every other month dosing or that flexibility to push to every other month dosing has been really stable at 80% to 90% of all of Xiphobry's prescriptions. Physicians and patients believe in the efficacy and the flexibility of every other month's dosing. So we expect that to stay the same as we move forward. Operator00:59:37One moment for our next question. Our next question will be coming from John Miller. Your line is open. Speaker 500:59:45Hi, guys. Thanks for taking my follow-up here. I'd love to ask more on the kidney indications. How do you expect obviously, it's a little early to discuss eventual label, but given you've got data in C3gIC MPGN, both pre and post transplant, how do you expect your potential label to look relative to Novartis' considering the differences in trial design? And do you expect that proteinuria efficacy differences aside, is the patient population going to be materially broader for you guys? Speaker 201:00:25Thank you, John. So that is we're not going to comment on what we expect in the label. But to your point, we studied pediatric adults, pre transplant, post transplant, C3G and ICMPGN and all levels of C3 concentration in the blood, right. I mean our competitor studied only patients with C3G only in adults, only pretransplant and only in patients that had C3 depletion. So it's really a very narrow population compared to what we studied in Valyant where across the board we saw the same efficacy profile. Speaker 201:00:58And again the benefit of being able to file with the 6 month data is reflection of the robustness and the quality of what we were able to establish. So again, we believe that this is a treatment that may offer the possibility to an adolescent to never have to worry about hemodialysis or a transplant. And there are at least 5,000 patients we believe in the U. S. With this condition of which already 1,000 to 1500 are transplanted and at risk of relapsing. Speaker 201:01:26So really important indication and we believe a tremendous first line and all encompassing solution for these patients. Operator01:01:39And I would now like to turn the call back to Cedric for closing remarks. Speaker 201:01:44Thank you so much and thank you everyone for joining us this morning. If you have any follow-up questions, feel free to contact Meredith and we look forward to speaking with many of you today. Thank you so much. Operator01:01:54And this concludes today's conference. Thank you for your participation. You may now disconnect.Read morePowered by