NASDAQ:AQST Aquestive Therapeutics Q4 2023 Earnings Report $2.86 +0.01 (+0.18%) As of 11:19 AM Eastern This is a fair market value price provided by Polygon.io. Learn more. Earnings HistoryForecast Aquestive Therapeutics EPS ResultsActual EPS-$0.12Consensus EPS -$0.08Beat/MissMissed by -$0.04One Year Ago EPSN/AAquestive Therapeutics Revenue ResultsActual Revenue$13.21 millionExpected Revenue$11.79 millionBeat/MissBeat by +$1.42 millionYoY Revenue GrowthN/AAquestive Therapeutics Announcement DetailsQuarterQ4 2023Date3/5/2024TimeN/AConference Call DateWednesday, March 6, 2024Conference Call Time8:00AM ETUpcoming EarningsAquestive Therapeutics' Q1 2025 earnings is scheduled for Tuesday, May 6, 2025, with a conference call scheduled on Wednesday, May 7, 2025 at 8:00 AM ET. Check back for transcripts, audio, and key financial metrics as they become available.Conference Call ResourcesConference Call AudioConference Call TranscriptSlide DeckPress Release (8-K)Annual Report (10-K)Earnings HistoryCompany ProfileSlide DeckFull Screen Slide DeckPowered by Aquestive Therapeutics Q4 2023 Earnings Call TranscriptProvided by QuartrMarch 6, 2024 ShareLink copied to clipboard.There are 12 speakers on the call. Operator00:00:00Good morning, and welcome to Aquestive Therapeutics 4th Quarter and Full Year 2023 Conference Call. At this time, all participants are in a listen only mode. After the speakers' presentation, there will be a question and answer As a reminder, this call will be recorded. I would now like to introduce your host for today's conference call, Bennett Watson of ICR Westwicke Investor Relations. Please go ahead. Speaker 100:00:45Thank you, operator. Good morning, and welcome to today's call. On today's call, I'm joined by Dan Barber, Chief Executive Officer and Ernie Toth, Chief Financial Officer, who are going to provide an overview of recent business developments and performance for the Q4 year end 2023, followed by a Q and A session. During the Q and A session, the team will be joined by Doctor. Carl Krause, Chief Medical Officer and Doctor. Speaker 100:01:13Stephen Worgacki, Senior Vice President, Research and Development. As a reminder, the company's remarks today correspond with the earnings release that was issued after market close yesterday. In addition, a recording of today's call will be made available on Aquestive's website within the Investors section shortly following the conclusion of this call. To remind you, the Aquestive team will be discussing some non GAAP financial measures this morning as part of its review of Q4 year end 2023 results. A description of these measures along with a reconciliation to GAAP can be found in the earnings release issued yesterday, which is posted on the Investors section of Aquestive's website. Speaker 100:01:57During the call, the company will be making forward looking statements. We remind you of the company's Safe Harbor language as outlined in yesterday's earnings release as well as the risks and uncertainties affecting the company as described in the Risk Factors section and in other sections included in the company's annual report on Form 10 ks filed with the Securities and Exchange Commission on March 5, 2024. As with any pharmaceutical company with product candidates under development and products being commercialized, there are significant risks and uncertainties with respect to the company's business and the development, regulatory approval and commercialization of its products and other matters related to operations. Given these uncertainties, you should not place undue reliance on these forward looking statements, which speak only as of the date made. Actual results may differ materially from these statements. Speaker 100:02:51All forward looking statements attributable to Aquestive or any person acting on its behalf are expressly qualified in their entirety by this cautionary statement and the cautionary statements contained in the earnings release issued yesterday. The company assumes no obligation to update its forward looking statements after the date of this conference call, whether as a result of new information, future events or otherwise, except as required under applicable law. With that, I will now turn the line over to Dan. Speaker 200:03:21Thank you, Bennett. We have once again made tremendous progress since our last earnings call. We finished 2023 on a high note with solid revenue growth, improvements in non GAAP adjusted EBITDA, a healthy cash balance and significant progress in the product development part of our business. While these are significant achievements, our focus is firmly on the future and on building a solid foundation for long term growth. Our strategy for accomplishing this remains simple and straightforward. Speaker 200:03:59Over the next 2 to 3 years, we expect to bring not 1, but 2 oral rescue products to patients for conditions for which they are currently dependent on rescue medical devices. In the allergy space, ANNOFOM Epinephrine Sublingual Film is a transformational product for patients and for the company if approved by the FDA. We believe annual peak sales of ANIFILM on a global basis could surpass $1,000,000,000 In the epilepsy space, Libervant diazepam buccal film could begin launching in markets around the world, including here in the U. S. As early as this year, if approved by the FDA. Speaker 200:04:48We believe worldwide annual peak sales of Libervant could be between $1,000,000 $200,000,000 We continue to advance in house technology to replenish our pipeline once Anasalone and Libervant graduate to the commercial product phase. We are currently conducting initial human studies using our ADRENNAVIRSE technology and expect that our initial indication targets will also represent multi $100,000,000 peak sales opportunities. Finally, as you know, we continue to have a profitable base business with partnerships on multiple continents that grew in 2023 and we are focused on continuing this growth in 2024. These four pillars of growth position us well to expand the company in the years to come. Regarding ANAFILM, we have completed dosing in our pivotal study and we should receive data shortly. Speaker 200:05:53We expect to publicly announce our top line data within the next 2 weeks. We are more excited than ever by the opportunity to transform patient care in the treatment of severe allergic reactions including anaphylaxis. As I've talked about in the past, the number one problem in this patient population is having a rescue product with you when you need it. Patients as a whole simply don't carry the product with them. While this has many reasons, we firmly believe that ANIFILM will bend the carrying curve and potentially decrease bad outcomes associated with anaphylaxis. Speaker 200:06:37For the past several months, I have been testing how carriable ANIFILM truly is. I've carried ANIFILM in my pocket with my ID and credit cards and I've also carried ANIFILM inside the case on the back of my phone. For me, this means that literally 20 fourseven without exception, I can access ANIFILM in a matter of seconds. This also means I don't have to remember a carrying case or to bring a rescue product with me or to do anything other than live my life. In the world of psychology, this is referred to as habit stacking. Speaker 200:07:15I always carry my phone with me and therefore by putting the film on the back of my phone, I've aligned carrying my rescue product with my existing habits. Habit stacking is a powerful tool and one that potentially aligns well with ANNO Film. 2 weeks ago, I attended the American Academy of Allergy, Asthma and Immunology Conference or AAAAI in Washington DC. I was able to spend time with some of the most important leaders in the allergy space, both advocacy leaders and clinical leaders who spend their days focused on better serving patients at risk for anaphylaxis. Without exception, they agreed and resonated towards bending the carrying curve by fitting our product within the daily lives of patients. Speaker 200:08:08I asked one clinician, but how do you know that people may carry ANIFILM more than the existing medical devices? She held up the sample film in front of her and said, all you need to do is look at this. It's just too obvious. We will continue to share more of our findings from interactions such as this over the months to come. We have also begun planning for a commercial launch for as early as the second half of twenty twenty five. Speaker 200:08:40Given the analogs in the market, we believe the commercialization path for this indication is well understood. We are currently working on our marketing and market access approach and we'll continue to share our strategy as it evolves. On a separate note, we are rapidly approaching our FDA action date for Libervant. Every month, thousands of adults fill a prescription for a diazepam rectal gel with the specific intent of using it to rescue their 2 to 5 year old child when seizure clusters occur. We believe there is a better way and that is Libervant. Speaker 200:09:23As previously disclosed, we have tested Libervant in an epilepsy monitoring unit in children within this age group and found the product to be comparable to the rectal gel. We are hopeful that on our action date of April 28, the FDA will also see the benefits of treatment for this patient population. We continue to believe that distribution of Libervant is better in the hands of a company that is focused on CNS and epilepsy. We are in active discussions with potential distribution collaborators now. As I've said in the past, we will maintain value discipline and if a reasonable distribution arrangement is not realized, we will launch the product ourselves. Speaker 200:10:14Beyond Libervant in the U. S, we remain active with business development discussions. Our focus in 2024 will be on expanding our ex U. S. Licensing opportunities for our lead assets and on monetizing any of our non core assets. Speaker 200:10:34Regarding our future pipeline, we continue to move forward with AQST-one hundred and eight, which comes out of our adreniverse platform. This is a topical cream formulation that we believe has potential application among dermatology indications. We are currently in the clinic with our first in focused on characterizing the absorption profile of AQST-one hundred and eight at different dose levels. We will have more to say on this program later in the year. In conclusion, 2023 was a phenomenal year for the company and we are now focused on building the foundation for long term growth. Speaker 200:11:18Our upcoming milestones remain on track with ANNOFELM data expected in the next 2 weeks and an FDA action date on Libervant in late April. We continue to guide towards an ANAFILM NDA filing in 2024. Our collaboration activities remain robust and ongoing. With that, I will turn the call over to Ernie. Speaker 300:11:42Thank you, Dan, and good morning, everyone. By now, you will have seen our financial results in our earnings release that was issued last evening. As we typically do, we will address most of the discussion related to the Q4 and full year 2023 results in the Q and A. We continue to evolve as a company with a solid base business generating revenue, a validated platform having produced over 2,600,000,000 strips and 2 key pipeline assets, ANAFILM and Libervant. During the Q4, we continue to execute on our strategy to strengthen our financial position by refinancing our expanding debt as well as managing expenses to extend our cash runway to support the continued development of our lead product, ANIFILM, the 1st and only non device based orally delivered epinephrine product. Speaker 300:12:45As a reminder, during the Q4, we refinanced the 12.5% senior secured notes that had a maturity date of June 30, 2025. The new financing of $45,000,000 by a large leading institutional investor was used to repay all outstanding obligations under the prior credit facility and for general corporate purposes. The notes are senior secured obligations of Aquestive and will mature on November 1, 2028. The notes bear interest at a fixed rate of 13.5% per year payable quarterly. Principal will be repaid starting on June 30, 2026. Speaker 300:13:35In connection with the financing transaction, the company entered into royalty agreements granting the note holders a tiered royalty between 1% 2% of annual worldwide net sales of ANAFILM for a period of 8 years from the first sale of ANIFILM on a global basis. The note holders are also entitled to a tiered royalty between 1% to 2% of annual worldwide net sales of Libervant until the earlier of the first sale of ANNO Film and 8 years from the first sale of Libervant. Importantly, the notes contain no revenue or cash covenants and no warrants for purchase of the company's stock. The structure of this non dilutive refinancing transaction maximizes our flexibility in the short term and reduces our cash requirements by approximately $28,000,000 through June 30, 2025, the due date of the original credit facility. Despite very difficult market conditions, the investors' willingness to invest in our future represents an important step forward in the continued growth of Aquestive. Speaker 300:14:52Now let's turn to the recap of our quarterly and full year financial results. Excluding the impact of prior year proprietary sales of SYMPAZAN, total revenues increased $10,100,000 in the Q4 2022 to $13,200,000 in the Q4 of 2023. This 31% increase was primarily due to a one time milestone royalty payment of $1,000,000 for Astarus from Zevra Therapeutics and higher revenue from the company's 5 out licensed products. Total reported revenues were $13,200,000 in the Q4 of 2023 compared to $10,700,000 in the Q4 2022, an increase of 24%. For the Q4 2023 compared to the prior period, we saw a 104% increase in license and royalty revenue, mostly due to the milestone licensing revenue for Astarus from Zevra, a 23% increase in manufacturing and supply revenue due to increased manufacturing revenues of $3,200,000 for Suboxone, offset by decreased revenues of $800,000 for SYMPAZAN and $300,000 for ONDIEF for HIPERE in Brazil and a 33% increase in co development and research fees revenue. Speaker 300:16:29For the full year 2023, excluding the impact of prior year proprietary sales of SYMPAZAN, total revenues increased from $40,000,000 for the year ended December 31, 2022 to $50,600,000 for the year ended December 31, 2023, an increase of 26%. Total reported revenues were $50,600,000 for the full year of 2023 compared to $47,700,000 for the full year 2022, an increase of 6%. The change was due to increase in manufacturer and supply revenue and license and royalty revenue, offset by the discontinuance of proprietary product sales of SYPPAZAN subsequent to the out licensing agreement with Assertio in October 2022. Manufacture and supply revenue increased 20% or $7,400,000 for the year ended December 31, 2023 compared to the same period in 2022. This change was due to increased revenues of $4,400,000 for Suboxone, dollars 2,100,000 for Ondif and $600,000 for SYMPAZAN. Speaker 300:17:51License and royalty revenue increased 129% or $3,000,000 for the year ended December 31, 2023 compared to the same period in 2022. This change was due to $1,500,000 in milestone licensing revenues for Astarus from Zevra, increased licensing revenue of $600,000 and royalty revenues of $700,000 for SYMPAZAN and increased royalty revenue of $300,000 for Astartis. Co development and research fees increased 8% or $100,000 for the year ended December 31, 2023 compared to the same period in 2022. Proprietary product sales decreased $7,700,000 for the year ended December 31, 2023 compared to the same period in 2022. This decrease was due to the discontinuation of SYMPAZAN proprietary product sales revenue in the Q4 of 2022. Speaker 300:18:59Our net loss for the Q4 of 2023 was $8,100,000 or $0.12 loss per share. The net loss for the Q4 2022 was $12,400,000 or $0.23 loss per share. This reduction in net loss was driven by increases in revenue described above, decreases in selling, general and administrative expense, including severance costs, lower administrative costs in our commercial organization subsequent to the out licensing of SYMPAZAN, a decrease in research and development costs and expenses, partially offset by one time loss on extinguishment of debt of $1,000,000 and higher non cash interest expense related to the amortization of debt discount on the refinancing of the 12.5% debt. Our net loss for the full year 2023 was $7,900,000 or $0.13 loss per share. The net loss for the full year 2022 was $54,400,000 or $1.12 loss per share. Speaker 300:20:12The reduction in net loss was driven by other income of $14,500,000 which consisted of $6,000,000 from the amendment to the Indivior commercial exploitation agreement, dollars 8,500,000 from the patent litigation settlement with BioDelivery Science International, an increase in revenue as previously described, a decrease in selling, general and administrative expense, including severance costs and significantly lower administrative costs in our commercial organization a decrease in research and development costs and expenses and lower non cash interest expense related to the Camobi monetization transaction, partially offset by one time loss and extinguishment of debt of $1,400,000 and higher non cash interest expense related to the amortization of debt discount on the refinancing of the 12.5 percent debt. Non GAAP adjusted EBITDA loss was $2,800,000 in the Q4 of 2023 compared to $9,600,000 loss in the Q4 of 2022. Non GAAP adjusted EBITDA loss excluding adjusted R and D expenses was $100,000 in the Q4 2023 compared to a non GAAP adjusted EBITDA loss excluding adjusted R and D expenses of $5,600,000 in the Q4 of 2022. Non GAAP adjusted EBITDA loss was $11,600,000 for the full year 2023 compared to a loss of $35,300,000 in the full year 2022. The year over year change in non GAAP adjusted EBITDA loss was driven by the items previously described. Speaker 300:22:12Non GAAP adjusted EBITDA income excluding adjusted R and D expenses was $1,000,000 for the full year 2023 compared to a non GAAP adjusted EBITDA loss excluding adjusted R and D expenses of $18,700,000 for the full year 2022. Cash and cash equivalents were $23,900,000 as of December 31, 2023. Under the ATSA market or ATM facility, we access net proceeds of $3,700,000 during the Q4 of 2023 $9,000,000 for the full year of 2023. The ATM facility has approximately $24,000,000 available at December 31, 2023. In addition, during the year ended December 31, 2023, approximately 8,700,000 common stock warrants were exercised with proceeds of approximately $8,300,000 Our focus in 2024 will continue to be reporting top line data from our pivotal trial, advancement of our ANNOFILM program and following our NDA with the FDA by the end of the year. Speaker 300:23:34As outlined in the press release issued last night after market close, our full year 2024 financial guidance is as follows: total revenues of approximately $48,000,000 to $51,000,000 and non GAAP adjusted EBITDA loss of approximately $22,000,000 $26,000,000 Please note revenue guidance does not include any revenue for Libervant. In addition, our guidance for 2024 includes increased R and D investments related to the continued development and planned NDA filing of ANAFILM, the first orally administered epinephrine product. I will now turn the line back to the operator to Speaker 200:24:20open the line for questions. Thank Operator00:24:44The first question comes from Francois Brisebois with Oppenheimer. Your line is open. Speaker 400:24:52Hi. Thanks for taking the questions and congrats on the progress here. So just a couple from me here. Can you just help us we're 2 weeks away. Can you just help us set maybe expectations around data? Speaker 400:25:03What should we be waiting for here in terms of PKPD, single and repeat dose here? Speaker 500:25:11Sure. Good morning, Frank. Well, I'll outline for you what we will be releasing from a package perspective. And then I'll turn it over to Carl, who can tell you about what we from our side think success looks like. From a package perspective, as we've shared over the last few months, we'll have all of the data from our pivotal study. Speaker 500:25:37So, as you recall, there's a Part A, which is a repeat dose part and a Part B, which is single dose. We'll have all of that data. And we'll also have our findings from meeting with the FDA under a Type C meeting event. But let me pass it over to Carl, who can tell you about from our perspective what we think success looks like. Speaker 600:26:01Sure. Thanks Dan and thanks for the question, Frank. The data we're expecting related to successful outcomes here would be one demonstration of sustainability of our pharmacokinetic and pharmacodynamic curves over the period of observation as well as bio comparability demonstrating that we are able to achieve levels that are north of our RLB, our reference listed products. So those two items in conjunction with characterization of the safety of our product within our mind demonstrate success. Speaker 400:26:42Okay. Thank you very much. And in terms of the commercial potential here of Anafilm, can you help us understand how big did maybe EpiPen get? And just maybe a breakdown, if you talk about peak sales over 1,000,000,000 dollars I believe that was worldwide. So maybe a breakdown of the market and the market potential U. Speaker 400:27:03S. Versus ex U. S? Thank you. Speaker 500:27:06Yes. So in terms of EpiPen peak sales at its height, I don't have that number. But the way we are looking at it is there is a couple of dynamics at play. 1, you have a market that is growing, right, not just here in the U. S, but globally as the need for as unfortunately severe allergic reactions and anaphylaxis growth, so does the need and the prevalence. Speaker 500:27:36And 2, as you look at the different healthcare systems around the world, there's more and more people who are gaining access to rescue medications for anaphylaxis. So, in the work we've done, we do think on a global basis that the $1,000,000,000 mark is a reasonable one. In terms of how much of that is in the U. S. Versus the rest of the world, I think we stay true to most of the industry that the U. Speaker 500:28:08S. Is typically by far the larger part of the opportunity. Speaker 400:28:15And then when you just spend time at Quadai and we're talking about just having the product on you and the willingness to use the product versus obviously versus an auto injector, Is it that patients are just kind of waiting and waiting until kind of last minute to use the auto injector or do a lot of patients not even use it? And I guess what I'm getting to is, would it be fair to say that the market might be bigger? If people take it earlier, they're probably more likely reload and refill a prescription versus not taking it at all or waiting too long to take it. Is that fair? Speaker 500:28:56Yes. No. And Frank, and that kind of ties into your previous question, right? What I didn't say is I outlined the global opportunity is that the prevalence rate by far is larger than the use rate, meaning that as we know and as we've talked about, people are simply not carrying rescue devices. So we do think as alternative delivery technologies like ours come into the market, that people will be more willing to use and carry the product. Speaker 500:29:31And it's funny you should mention QuadAI. I spent a lot of time at AAAAI talking with physicians and making sure that we truly understood not just their perspective, but the patient perspective. And it was reaffirming to hear back that our beliefs seem to hold true from a physician perspective and that is by getting rid of the needle, by creating an easier product to carry, physicians do believe as I put in my remarks before, they do believe that there is the opportunity for more people to carry the product and have it with them when they need it. Speaker 400:30:14Okay, great. Yes, that's we're clearly hearing that there's an unmet need and it seems like a lot of people even the ones carrying seems like the products expired anyway. So, okay, that's it for me. Thank you for the questions. Speaker 500:30:27Thanks, Craig. Operator00:30:28One moment for the next question. The next question comes from Jason Butler with Citizens JMP Securities. Your line is open. Speaker 700:30:40Hi, thanks for taking the question. And then you talked about the commercial prep work you're going to be doing, getting ready for launch at the back end of 2025. Can you maybe just talk about the work you can do between data and throughout the regulatory submission? And obviously, you're going to be gating your spend, but what's the kind of work that you can do in terms of physician targeting, building awareness, etcetera to get ready for a launch? Thanks. Speaker 500:31:11Yes. And Jason, the way you asked the question actually, you put in 2 important elements, right, which is for us in 2024 and even the first part of 2025, the commercial spend will not be a large onerous amount that we can't handle. We do believe that given our cash position and the levers that we have in our business that is a very manageable set of activities. In terms of what those activities are, as you alluded to, awareness is by far an important factor prior to launch. And one of the things that helps us in the dynamics that exist right now is not only is the market already growing, but some of our competitors in the marketplace are also focused on awareness. Speaker 500:32:07So, by nature, just making people aware of the alternate products that will be available to them and of the necessity of having a rescue product with them at all times helps as we look to come to the market. In terms of the other activities that we will focus on, we will of course make sure we have the base infrastructure in our company. So think of people who are dealing with the payers, people who are on the medical affairs side. And we will, of course, make sure that our messaging is ready and clear as we get closer to launch. Speaker 700:32:49Got it. And then just briefly on 108, Speaker 500:32:54can you maybe just give us an Speaker 700:32:55idea at a high level what the target PK profile or absorption profile looks like for when we look ahead to data later this year? Sure. Speaker 500:33:07So for that one, I'll pass it over to Carl. Speaker 600:33:10Yes. The PK profile would be consistent with what we've been targeting all along, which is demonstration of a PK curve that is north of a reference listed drug for the duration of observation and remains within the bracketing that has been discussed at last year's advisory committee where we are north of at least the references to drug as well as staying within a reasonable bound on the bracket between ourselves and the auto injectors. Speaker 500:33:43And Jason, I think Carl gave a really important point that we talk a lot about here in the way he said that at E North. The one place you don't want to be, we believe is lower in that first 10 minutes in particular, lower than the manual I'm So that's a spot that everyone can look for in terms of where we're able to be above that mark. Speaker 700:34:11Okay, great. Thanks for taking the questions. Operator00:34:15One moment for the next question. The next question comes from Andreas Arguerats with Wedbush. Your line is open. Speaker 800:34:27Good morning and thanks for taking our questions. It's a couple from us here. So looking ahead to the commercial opportunity for AnnoSom, how are you thinking about penetrating the various segments of the market outside EpiPen and generics, which is currently less than $1,000,000,000 The immediate goal to target patients who should carry and don't, those who are given a script and don't fill it? And what does the market look beyond that, those two segments? And then lastly, how are you thinking about positioning ANNOYSM against competitors on the market? Speaker 800:34:53Thank you. Speaker 500:34:55Sure. Good morning, Andreas. Nice to hear your voice. So, I think the way to think about launching our products, I think is very similar to the way other products have been launched in this space. Of all of the pieces and parts that all of us have to go through to bring a product to market, the launch is actually fairly simple. Speaker 500:35:20It's obviously all of the packaging to make sure the FDA is comfortable in getting through that work that we believe is the more difficult task. In terms of penetrating, our launch process will be very straightforward. You first go after the people who are already using or carrying an EpiPen who have a script and then you work your way into the segments where people have either gotten a script and didn't fill it to your point or used to carry a product and don't anymore or should be carrying a product that never had. So it is a sequence process that I would be surprised if our competitors didn't follow the same process. In terms of positioning, I think we've been clear, but I'll make sure we say it the right way. Speaker 500:36:13When we look at our product, we think the single biggest advantage we have in the marketplace is that people we believe people are likely to carry it with them where they are not carrying a product today. And that's why in my remarks before I focused on this idea of not having to think about carrying our product, you just have it with you. But clearly, there are other benefits. We do believe there is the potential for people to use the product faster or earlier in the disease state because it is an oral product. And we also believe that our scientific data, which shows a very rapid uptake of epinephrine as you know, it has a very rapid median Tmax is an important set of data that particularly for the healthcare providers will be an advantage compared to some of the other or could be an advantage compared to some of the other products that may be in the market. Speaker 200:37:15Okay, great. And looking forward to the upcoming data. Congrats on the progress. Speaker 500:37:19Thanks, Andreas. Operator00:37:21One moment for the next question. Next question comes from Thomas Flaten with Lake Street Capital Markets. Your line is open. Speaker 900:37:33Hey, good morning and congrats on all the progress as well. Dan, we talked a lot about ANNO Film commercialization, but you did leave open the possibility of you guys perhaps launching Libervant later this year. Any commentary on what you've done or need to do and what timeframe we might think about if you go it alone with that? Speaker 500:37:54Sure. Good morning, Thomas. And I'm glad you brought Libervant off. There's a lot of excitement around ANIFILM both outside and inside of our company as there should be. But Libervant is an important product. Speaker 500:38:06And from a FDA perspective right now, all of the questions the FDA has asked, we've answered and we're awaiting the decision date. I do have to remind people that there is an orphan drug challenge that could occur with this product. So we obviously want to get past the next couple of months and see how that unfolds. Having said that, I do believe that there are appropriate epilepsy focused companies who not only could do a good job with launching Libervant, but would be interested in launching Libervant. If those were to not unfold or we were not able to get the fair deal that we've talked about, we would launch the product and I would point to the second half of twenty twenty four as where we would look to do that. Speaker 900:39:06Great. Appreciate that. And a quick one for Ernie. Gross margins were kind of all over the place this past year. And I'm guessing Q4 was a little bit of an uptick for some one time royalty payments. Speaker 900:39:19Anything you can help us there? Anything you can help us there with respect to gross margins, Ernie? Speaker 500:39:26Hi, Tom. It's good to talk to you. Certainly, the biggest item is the recognition of the milestone payment from Zevra for Astarus. So that $1,000,000 in the Q4, there was no cost associated with that. So that would have an impact on gross margin. Speaker 400:39:48Appreciate it guys. Thank you. Operator00:39:52One moment for the next question. The next question comes from Ram Selvaraju with H. C. Wainwright. Your line is open. Speaker 1000:40:06Thanks very much for taking my questions and congrats on all the progress. Can you hear me? Speaker 500:40:11Yes, Rob. Speaker 1000:40:13So just very quickly with respect to ANAFILM, I was just wondering if you had any updated thoughts regarding the regulatory outlook for these kinds of alternative delivery epinephrine products, particularly given recent developments with nephi and if you see any additional perspectives there for ANASOEM as you gear up to the submission of the NDA? Speaker 500:40:36Yes. Nice to hear your voice, Ram. From our perspective, in our experience with the FDA from the first time we spoke with them about, products for anaphylaxis through to today, we believe the FDA has been very consistent. And we actually think the FDA is doing their job. They want to make sure if we're we or anyone else are creating a product that is a rescue product that has the potential to save lives that we do all the work we're supposed to do to make sure that it works the way it's supposed to work under all conditions of use. Speaker 500:41:17So, we understand that's a big responsibility for us and our competitors and we understand that, which is why our package is robust and we are confident that the FDA will continue to be consistent in how they look at the market and how they think about approval. In terms of our competitor, obviously, we just see what is public just like you and our read through is that it appears from a distance like the FDA is being consistent with them as well at least when we think about the comments given to us and then what we hear coming through the public domain from competitors. Speaker 1000:42:04Okay, great. Just also with respect to kind of optimizing the value of ANA Film as a franchise, do you have any sort of broader strategic thoughts regarding that, particularly if this pertains to any potential opportunities for ANAFILM as a product that may exist outside of the United States and how you might be able to access those? Speaker 500:42:28Yes. No, that's a really good point, Ram. From given where we are in our company evolution and this goes back to the idea of long term growth, right? We do not have designs at this point in time to launch on our own the product outside of the U. S. Speaker 500:42:50At all. So we like we have done with Libervant, we will be and actively are talking with potential partners in different markets around the world. For us, the nice thing about where we are right now is we don't have to find a partner tomorrow or this quarter or anything like that. We can make sure we find the right partner to get through the regulatory process in different markets and also support the product once it has been launched. But yes, an important part of the Aquestive story for both Libervant and ANAFILM is the ex U. Speaker 500:43:32S. Potential. Speaker 1000:43:35Okay. And lastly, and I'm just asking this as a housekeeping item. I'm sure all of you are very well aware of the change healthcare cyber attack that occurred last month. Just wanted to ask whether your guidance for 2024 includes any potential impact that you may see. I don't even know whether that's really relevant in your case from the Change Healthcare cyber attack and the disruptions to processing of prescriptions? Speaker 500:44:04Yes. No, that for 2024, I don't see any impact to Aquestive. The only comment I would give you for our IT is just even as a company, we do all of the things you would expect a public company to do to protect from cyber attacks that could affect our business. Speaker 1000:44:26Thank you. Operator00:44:29One moment for the next question. Next question comes from James Molloy with Alliance Global Partners. Your line is open. Speaker 1100:44:41Hey, good morning guys. Thank you for taking my questions. I had a question on the couple of questions. The Antifilm Human Factors Program, can you walk us through what that encompasses? And then, can you talk a little bit about outreach to advocacy or allergy networking groups in advance of launch and how that sort of how that has played out? Speaker 500:45:01Yes. Good morning, James. I'll or Jim. I'll take the second question first and then I'll hand it over to Carl who can talk to you about the human factors program. From an advocacy perspective, as you probably know, in this space, there are roughly 4 advocacy groups that are at a national level and all of them do great work. Speaker 500:45:26I mean just phenomenal work where they're looking to make sure patients rights are protected and access to drug is protected and all of the things you would want. So we do think that having a good relationship and supporting the various advocacy groups in this space is important. We have done that. We actually if you look at even last year, we did that even more than most of our competitors. So that shows you how seriously we take it. Speaker 500:46:00We met with all of them at QuadAI just a few weeks ago and we'll continue to support them as best we can as they do the good work that they do. But with that, I'll turn it over to Carl on the human factors. Speaker 600:46:12Sure. Thanks, Dan, and thanks for the question, Jim. As far as our human factors program goes, as you're probably aware, these programs are an iterative process and ours is no different. We are evaluating how adults, pediatrics and their caregiver patients might engage our technology in a pathway where we better understand interactions between our technology and the patients. So that's a process that goes through a typical formative and then validated protocol, which we have gone to great lengths to support and we are in the midst of completing and progressing those efforts between ourselves and the FDA with ongoing dialogue. Speaker 600:46:54So that's an ongoing iterative process that is on schedule. Operator00:47:00All right. Speaker 1100:47:01Great. Maybe one quick follow-up. I know that certainly then you get plenty on your plate to keep you busy coming up, but looking beyond the horizon, what do you see as potential Are you seeing any potential acquisition candidates or things to bring on board to bolster the pipeline? Speaker 200:47:15Sure. Well, Speaker 500:47:18I would first look at where our pipeline is. If you look beyond ANIFILM, we are definitely excited about the opportunity with AQST-one hundred and eight as a topical cream. I know we haven't spent a lot of time with you or the public on what we see in that space, but we are actively doing work and in the second half of the year we'd love to talk about it more. We're actually in the clinic right now with that program and we're looking forward to having more to say. In terms of the acquisition world, I think we have a lot on our plate right now to focus on and we want to deliver ANIFILM on time, on schedule with the right results and the right package. Speaker 500:48:07So obviously we'll be opportunistic like any public company, but there that is not our focus right now. Speaker 1100:48:16Great. Thank you for taking the questions. Operator00:48:18I show no further questions at this time. I would now like to turn the call back to Dan Barber for closing remarks. Speaker 500:48:28Thank you, Michelle. Thank you for joining us today. This is an exciting time for Aquestive and we're looking forward to speaking with you again in the next couple of weeks. And with that, I hope all of you have a good day.Read morePowered by Conference Call Audio Live Call not available Earnings Conference CallAquestive Therapeutics Q4 202300:00 / 00:00Speed:1x1.25x1.5x2x Earnings DocumentsSlide DeckPress Release(8-K)Annual report(10-K) Aquestive Therapeutics Earnings HeadlinesAquestive Therapeutics to Participate in Piper Sandler Spring Biopharma SymposiumApril 9, 2025 | globenewswire.comAquestive Therapeutics Announces Positive Topline PK Results from its Pediatric Study and Completes the NDA Submission for Anaphylm™ (epinephrine) Sublingual FilmApril 3, 2025 | seekingalpha.comCrypto’s crashing…but we’re still profitingMost traders are panicking right now. Bitcoin’s dropping. Altcoins are bleeding. The stock market’s a mess. The news is screaming fear. But while most traders watch their portfolios tank…April 25, 2025 | Crypto Swap Profits (Ad)Aquestive Therapeutics (AQST) Gets a Buy from Lake StreetApril 2, 2025 | markets.businessinsider.comAquestive announces positive results from pediatric study for AnaphylmApril 2, 2025 | markets.businessinsider.comAquestive completes marketing application for Anaphylm in U.S.April 1, 2025 | msn.comSee More Aquestive Therapeutics Headlines Get Earnings Announcements in your inboxWant to stay updated on the latest earnings announcements and upcoming reports for companies like Aquestive Therapeutics? Sign up for Earnings360's daily newsletter to receive timely earnings updates on Aquestive Therapeutics and other key companies, straight to your email. Email Address About Aquestive TherapeuticsAquestive Therapeutics (NASDAQ:AQST) operates as a pharmaceutical company in the United States and internationally. The company markets Sympazan, an oral soluble film formulation of clobazam for the treatment of lennox-gastaut syndrome; Suboxone, a sublingual film formulation of buprenorphine and naloxone for the treatment of opioid dependence; Zuplenz, an oral soluble film formulation of ondansetron for the treatment of nausea and vomiting associated with chemotherapy and post-operative recovery; and Azstarys, a once-daily product for the treatment of attention deficit hyperactivity disorder. Its proprietary product candidates comprise Libervant, a buccal soluble film formulation of diazepam for the treatment of seizures; KYNMOBI, a sublingual film formulation of apomorphine for the treatment of episodic off-periods in Parkinson's disease; and Exservan, an oral soluble film formulation of riluzole for the treatment of amyotrophic lateral sclerosis. The company's proprietary pipeline of complex molecule product includes AQST-108, a sublingual film formulation delivering systemic epinephrine for the treatment of conditions other than anaphylaxis; and Anaphylm, an epinephrine sublingual film for the emergency treatment of allergic reactions, including anaphylaxis. In addition, it develops Adrenaverse, an epinephrine prodrug platform. The company was incorporated in 2004 and is headquartered in Warren, New Jersey.View Aquestive Therapeutics ProfileRead more More Earnings Resources from MarketBeat Earnings Tools Today's Earnings Tomorrow's Earnings Next Week's Earnings Upcoming Earnings Calls Earnings Newsletter Earnings Call Transcripts Earnings Beats & Misses Corporate Guidance Earnings Screener Earnings By Country U.S. Earnings Reports Canadian Earnings Reports U.K. Earnings Reports Latest Articles Market Anticipation Builds: Joby Stock Climbs Ahead of EarningsIs Intuitive Surgical a Buy After Volatile Reaction to Earnings?Seismic Shift at Intel: Massive Layoffs Precede Crucial EarningsRocket Lab Lands New Contract, Builds Momentum Ahead of EarningsAmazon's Earnings Could Fuel a Rapid Breakout Tesla Earnings Miss, But Musk Refocuses and Bulls ReactQualcomm’s Range Narrows Ahead of Earnings as Bulls Step In Upcoming Earnings Cadence Design Systems (4/28/2025)Welltower (4/28/2025)Waste Management (4/28/2025)AstraZeneca (4/29/2025)Booking (4/29/2025)DoorDash (4/29/2025)Honeywell International (4/29/2025)Mondelez International (4/29/2025)PayPal (4/29/2025)Regeneron Pharmaceuticals (4/29/2025) Get 30 Days of MarketBeat All Access for Free Sign up for MarketBeat All Access to gain access to MarketBeat's full suite of research tools. 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There are 12 speakers on the call. Operator00:00:00Good morning, and welcome to Aquestive Therapeutics 4th Quarter and Full Year 2023 Conference Call. At this time, all participants are in a listen only mode. After the speakers' presentation, there will be a question and answer As a reminder, this call will be recorded. I would now like to introduce your host for today's conference call, Bennett Watson of ICR Westwicke Investor Relations. Please go ahead. Speaker 100:00:45Thank you, operator. Good morning, and welcome to today's call. On today's call, I'm joined by Dan Barber, Chief Executive Officer and Ernie Toth, Chief Financial Officer, who are going to provide an overview of recent business developments and performance for the Q4 year end 2023, followed by a Q and A session. During the Q and A session, the team will be joined by Doctor. Carl Krause, Chief Medical Officer and Doctor. Speaker 100:01:13Stephen Worgacki, Senior Vice President, Research and Development. As a reminder, the company's remarks today correspond with the earnings release that was issued after market close yesterday. In addition, a recording of today's call will be made available on Aquestive's website within the Investors section shortly following the conclusion of this call. To remind you, the Aquestive team will be discussing some non GAAP financial measures this morning as part of its review of Q4 year end 2023 results. A description of these measures along with a reconciliation to GAAP can be found in the earnings release issued yesterday, which is posted on the Investors section of Aquestive's website. Speaker 100:01:57During the call, the company will be making forward looking statements. We remind you of the company's Safe Harbor language as outlined in yesterday's earnings release as well as the risks and uncertainties affecting the company as described in the Risk Factors section and in other sections included in the company's annual report on Form 10 ks filed with the Securities and Exchange Commission on March 5, 2024. As with any pharmaceutical company with product candidates under development and products being commercialized, there are significant risks and uncertainties with respect to the company's business and the development, regulatory approval and commercialization of its products and other matters related to operations. Given these uncertainties, you should not place undue reliance on these forward looking statements, which speak only as of the date made. Actual results may differ materially from these statements. Speaker 100:02:51All forward looking statements attributable to Aquestive or any person acting on its behalf are expressly qualified in their entirety by this cautionary statement and the cautionary statements contained in the earnings release issued yesterday. The company assumes no obligation to update its forward looking statements after the date of this conference call, whether as a result of new information, future events or otherwise, except as required under applicable law. With that, I will now turn the line over to Dan. Speaker 200:03:21Thank you, Bennett. We have once again made tremendous progress since our last earnings call. We finished 2023 on a high note with solid revenue growth, improvements in non GAAP adjusted EBITDA, a healthy cash balance and significant progress in the product development part of our business. While these are significant achievements, our focus is firmly on the future and on building a solid foundation for long term growth. Our strategy for accomplishing this remains simple and straightforward. Speaker 200:03:59Over the next 2 to 3 years, we expect to bring not 1, but 2 oral rescue products to patients for conditions for which they are currently dependent on rescue medical devices. In the allergy space, ANNOFOM Epinephrine Sublingual Film is a transformational product for patients and for the company if approved by the FDA. We believe annual peak sales of ANIFILM on a global basis could surpass $1,000,000,000 In the epilepsy space, Libervant diazepam buccal film could begin launching in markets around the world, including here in the U. S. As early as this year, if approved by the FDA. Speaker 200:04:48We believe worldwide annual peak sales of Libervant could be between $1,000,000 $200,000,000 We continue to advance in house technology to replenish our pipeline once Anasalone and Libervant graduate to the commercial product phase. We are currently conducting initial human studies using our ADRENNAVIRSE technology and expect that our initial indication targets will also represent multi $100,000,000 peak sales opportunities. Finally, as you know, we continue to have a profitable base business with partnerships on multiple continents that grew in 2023 and we are focused on continuing this growth in 2024. These four pillars of growth position us well to expand the company in the years to come. Regarding ANAFILM, we have completed dosing in our pivotal study and we should receive data shortly. Speaker 200:05:53We expect to publicly announce our top line data within the next 2 weeks. We are more excited than ever by the opportunity to transform patient care in the treatment of severe allergic reactions including anaphylaxis. As I've talked about in the past, the number one problem in this patient population is having a rescue product with you when you need it. Patients as a whole simply don't carry the product with them. While this has many reasons, we firmly believe that ANIFILM will bend the carrying curve and potentially decrease bad outcomes associated with anaphylaxis. Speaker 200:06:37For the past several months, I have been testing how carriable ANIFILM truly is. I've carried ANIFILM in my pocket with my ID and credit cards and I've also carried ANIFILM inside the case on the back of my phone. For me, this means that literally 20 fourseven without exception, I can access ANIFILM in a matter of seconds. This also means I don't have to remember a carrying case or to bring a rescue product with me or to do anything other than live my life. In the world of psychology, this is referred to as habit stacking. Speaker 200:07:15I always carry my phone with me and therefore by putting the film on the back of my phone, I've aligned carrying my rescue product with my existing habits. Habit stacking is a powerful tool and one that potentially aligns well with ANNO Film. 2 weeks ago, I attended the American Academy of Allergy, Asthma and Immunology Conference or AAAAI in Washington DC. I was able to spend time with some of the most important leaders in the allergy space, both advocacy leaders and clinical leaders who spend their days focused on better serving patients at risk for anaphylaxis. Without exception, they agreed and resonated towards bending the carrying curve by fitting our product within the daily lives of patients. Speaker 200:08:08I asked one clinician, but how do you know that people may carry ANIFILM more than the existing medical devices? She held up the sample film in front of her and said, all you need to do is look at this. It's just too obvious. We will continue to share more of our findings from interactions such as this over the months to come. We have also begun planning for a commercial launch for as early as the second half of twenty twenty five. Speaker 200:08:40Given the analogs in the market, we believe the commercialization path for this indication is well understood. We are currently working on our marketing and market access approach and we'll continue to share our strategy as it evolves. On a separate note, we are rapidly approaching our FDA action date for Libervant. Every month, thousands of adults fill a prescription for a diazepam rectal gel with the specific intent of using it to rescue their 2 to 5 year old child when seizure clusters occur. We believe there is a better way and that is Libervant. Speaker 200:09:23As previously disclosed, we have tested Libervant in an epilepsy monitoring unit in children within this age group and found the product to be comparable to the rectal gel. We are hopeful that on our action date of April 28, the FDA will also see the benefits of treatment for this patient population. We continue to believe that distribution of Libervant is better in the hands of a company that is focused on CNS and epilepsy. We are in active discussions with potential distribution collaborators now. As I've said in the past, we will maintain value discipline and if a reasonable distribution arrangement is not realized, we will launch the product ourselves. Speaker 200:10:14Beyond Libervant in the U. S, we remain active with business development discussions. Our focus in 2024 will be on expanding our ex U. S. Licensing opportunities for our lead assets and on monetizing any of our non core assets. Speaker 200:10:34Regarding our future pipeline, we continue to move forward with AQST-one hundred and eight, which comes out of our adreniverse platform. This is a topical cream formulation that we believe has potential application among dermatology indications. We are currently in the clinic with our first in focused on characterizing the absorption profile of AQST-one hundred and eight at different dose levels. We will have more to say on this program later in the year. In conclusion, 2023 was a phenomenal year for the company and we are now focused on building the foundation for long term growth. Speaker 200:11:18Our upcoming milestones remain on track with ANNOFELM data expected in the next 2 weeks and an FDA action date on Libervant in late April. We continue to guide towards an ANAFILM NDA filing in 2024. Our collaboration activities remain robust and ongoing. With that, I will turn the call over to Ernie. Speaker 300:11:42Thank you, Dan, and good morning, everyone. By now, you will have seen our financial results in our earnings release that was issued last evening. As we typically do, we will address most of the discussion related to the Q4 and full year 2023 results in the Q and A. We continue to evolve as a company with a solid base business generating revenue, a validated platform having produced over 2,600,000,000 strips and 2 key pipeline assets, ANAFILM and Libervant. During the Q4, we continue to execute on our strategy to strengthen our financial position by refinancing our expanding debt as well as managing expenses to extend our cash runway to support the continued development of our lead product, ANIFILM, the 1st and only non device based orally delivered epinephrine product. Speaker 300:12:45As a reminder, during the Q4, we refinanced the 12.5% senior secured notes that had a maturity date of June 30, 2025. The new financing of $45,000,000 by a large leading institutional investor was used to repay all outstanding obligations under the prior credit facility and for general corporate purposes. The notes are senior secured obligations of Aquestive and will mature on November 1, 2028. The notes bear interest at a fixed rate of 13.5% per year payable quarterly. Principal will be repaid starting on June 30, 2026. Speaker 300:13:35In connection with the financing transaction, the company entered into royalty agreements granting the note holders a tiered royalty between 1% 2% of annual worldwide net sales of ANAFILM for a period of 8 years from the first sale of ANIFILM on a global basis. The note holders are also entitled to a tiered royalty between 1% to 2% of annual worldwide net sales of Libervant until the earlier of the first sale of ANNO Film and 8 years from the first sale of Libervant. Importantly, the notes contain no revenue or cash covenants and no warrants for purchase of the company's stock. The structure of this non dilutive refinancing transaction maximizes our flexibility in the short term and reduces our cash requirements by approximately $28,000,000 through June 30, 2025, the due date of the original credit facility. Despite very difficult market conditions, the investors' willingness to invest in our future represents an important step forward in the continued growth of Aquestive. Speaker 300:14:52Now let's turn to the recap of our quarterly and full year financial results. Excluding the impact of prior year proprietary sales of SYMPAZAN, total revenues increased $10,100,000 in the Q4 2022 to $13,200,000 in the Q4 of 2023. This 31% increase was primarily due to a one time milestone royalty payment of $1,000,000 for Astarus from Zevra Therapeutics and higher revenue from the company's 5 out licensed products. Total reported revenues were $13,200,000 in the Q4 of 2023 compared to $10,700,000 in the Q4 2022, an increase of 24%. For the Q4 2023 compared to the prior period, we saw a 104% increase in license and royalty revenue, mostly due to the milestone licensing revenue for Astarus from Zevra, a 23% increase in manufacturing and supply revenue due to increased manufacturing revenues of $3,200,000 for Suboxone, offset by decreased revenues of $800,000 for SYMPAZAN and $300,000 for ONDIEF for HIPERE in Brazil and a 33% increase in co development and research fees revenue. Speaker 300:16:29For the full year 2023, excluding the impact of prior year proprietary sales of SYMPAZAN, total revenues increased from $40,000,000 for the year ended December 31, 2022 to $50,600,000 for the year ended December 31, 2023, an increase of 26%. Total reported revenues were $50,600,000 for the full year of 2023 compared to $47,700,000 for the full year 2022, an increase of 6%. The change was due to increase in manufacturer and supply revenue and license and royalty revenue, offset by the discontinuance of proprietary product sales of SYPPAZAN subsequent to the out licensing agreement with Assertio in October 2022. Manufacture and supply revenue increased 20% or $7,400,000 for the year ended December 31, 2023 compared to the same period in 2022. This change was due to increased revenues of $4,400,000 for Suboxone, dollars 2,100,000 for Ondif and $600,000 for SYMPAZAN. Speaker 300:17:51License and royalty revenue increased 129% or $3,000,000 for the year ended December 31, 2023 compared to the same period in 2022. This change was due to $1,500,000 in milestone licensing revenues for Astarus from Zevra, increased licensing revenue of $600,000 and royalty revenues of $700,000 for SYMPAZAN and increased royalty revenue of $300,000 for Astartis. Co development and research fees increased 8% or $100,000 for the year ended December 31, 2023 compared to the same period in 2022. Proprietary product sales decreased $7,700,000 for the year ended December 31, 2023 compared to the same period in 2022. This decrease was due to the discontinuation of SYMPAZAN proprietary product sales revenue in the Q4 of 2022. Speaker 300:18:59Our net loss for the Q4 of 2023 was $8,100,000 or $0.12 loss per share. The net loss for the Q4 2022 was $12,400,000 or $0.23 loss per share. This reduction in net loss was driven by increases in revenue described above, decreases in selling, general and administrative expense, including severance costs, lower administrative costs in our commercial organization subsequent to the out licensing of SYMPAZAN, a decrease in research and development costs and expenses, partially offset by one time loss on extinguishment of debt of $1,000,000 and higher non cash interest expense related to the amortization of debt discount on the refinancing of the 12.5% debt. Our net loss for the full year 2023 was $7,900,000 or $0.13 loss per share. The net loss for the full year 2022 was $54,400,000 or $1.12 loss per share. Speaker 300:20:12The reduction in net loss was driven by other income of $14,500,000 which consisted of $6,000,000 from the amendment to the Indivior commercial exploitation agreement, dollars 8,500,000 from the patent litigation settlement with BioDelivery Science International, an increase in revenue as previously described, a decrease in selling, general and administrative expense, including severance costs and significantly lower administrative costs in our commercial organization a decrease in research and development costs and expenses and lower non cash interest expense related to the Camobi monetization transaction, partially offset by one time loss and extinguishment of debt of $1,400,000 and higher non cash interest expense related to the amortization of debt discount on the refinancing of the 12.5 percent debt. Non GAAP adjusted EBITDA loss was $2,800,000 in the Q4 of 2023 compared to $9,600,000 loss in the Q4 of 2022. Non GAAP adjusted EBITDA loss excluding adjusted R and D expenses was $100,000 in the Q4 2023 compared to a non GAAP adjusted EBITDA loss excluding adjusted R and D expenses of $5,600,000 in the Q4 of 2022. Non GAAP adjusted EBITDA loss was $11,600,000 for the full year 2023 compared to a loss of $35,300,000 in the full year 2022. The year over year change in non GAAP adjusted EBITDA loss was driven by the items previously described. Speaker 300:22:12Non GAAP adjusted EBITDA income excluding adjusted R and D expenses was $1,000,000 for the full year 2023 compared to a non GAAP adjusted EBITDA loss excluding adjusted R and D expenses of $18,700,000 for the full year 2022. Cash and cash equivalents were $23,900,000 as of December 31, 2023. Under the ATSA market or ATM facility, we access net proceeds of $3,700,000 during the Q4 of 2023 $9,000,000 for the full year of 2023. The ATM facility has approximately $24,000,000 available at December 31, 2023. In addition, during the year ended December 31, 2023, approximately 8,700,000 common stock warrants were exercised with proceeds of approximately $8,300,000 Our focus in 2024 will continue to be reporting top line data from our pivotal trial, advancement of our ANNOFILM program and following our NDA with the FDA by the end of the year. Speaker 300:23:34As outlined in the press release issued last night after market close, our full year 2024 financial guidance is as follows: total revenues of approximately $48,000,000 to $51,000,000 and non GAAP adjusted EBITDA loss of approximately $22,000,000 $26,000,000 Please note revenue guidance does not include any revenue for Libervant. In addition, our guidance for 2024 includes increased R and D investments related to the continued development and planned NDA filing of ANAFILM, the first orally administered epinephrine product. I will now turn the line back to the operator to Speaker 200:24:20open the line for questions. Thank Operator00:24:44The first question comes from Francois Brisebois with Oppenheimer. Your line is open. Speaker 400:24:52Hi. Thanks for taking the questions and congrats on the progress here. So just a couple from me here. Can you just help us we're 2 weeks away. Can you just help us set maybe expectations around data? Speaker 400:25:03What should we be waiting for here in terms of PKPD, single and repeat dose here? Speaker 500:25:11Sure. Good morning, Frank. Well, I'll outline for you what we will be releasing from a package perspective. And then I'll turn it over to Carl, who can tell you about what we from our side think success looks like. From a package perspective, as we've shared over the last few months, we'll have all of the data from our pivotal study. Speaker 500:25:37So, as you recall, there's a Part A, which is a repeat dose part and a Part B, which is single dose. We'll have all of that data. And we'll also have our findings from meeting with the FDA under a Type C meeting event. But let me pass it over to Carl, who can tell you about from our perspective what we think success looks like. Speaker 600:26:01Sure. Thanks Dan and thanks for the question, Frank. The data we're expecting related to successful outcomes here would be one demonstration of sustainability of our pharmacokinetic and pharmacodynamic curves over the period of observation as well as bio comparability demonstrating that we are able to achieve levels that are north of our RLB, our reference listed products. So those two items in conjunction with characterization of the safety of our product within our mind demonstrate success. Speaker 400:26:42Okay. Thank you very much. And in terms of the commercial potential here of Anafilm, can you help us understand how big did maybe EpiPen get? And just maybe a breakdown, if you talk about peak sales over 1,000,000,000 dollars I believe that was worldwide. So maybe a breakdown of the market and the market potential U. Speaker 400:27:03S. Versus ex U. S? Thank you. Speaker 500:27:06Yes. So in terms of EpiPen peak sales at its height, I don't have that number. But the way we are looking at it is there is a couple of dynamics at play. 1, you have a market that is growing, right, not just here in the U. S, but globally as the need for as unfortunately severe allergic reactions and anaphylaxis growth, so does the need and the prevalence. Speaker 500:27:36And 2, as you look at the different healthcare systems around the world, there's more and more people who are gaining access to rescue medications for anaphylaxis. So, in the work we've done, we do think on a global basis that the $1,000,000,000 mark is a reasonable one. In terms of how much of that is in the U. S. Versus the rest of the world, I think we stay true to most of the industry that the U. Speaker 500:28:08S. Is typically by far the larger part of the opportunity. Speaker 400:28:15And then when you just spend time at Quadai and we're talking about just having the product on you and the willingness to use the product versus obviously versus an auto injector, Is it that patients are just kind of waiting and waiting until kind of last minute to use the auto injector or do a lot of patients not even use it? And I guess what I'm getting to is, would it be fair to say that the market might be bigger? If people take it earlier, they're probably more likely reload and refill a prescription versus not taking it at all or waiting too long to take it. Is that fair? Speaker 500:28:56Yes. No. And Frank, and that kind of ties into your previous question, right? What I didn't say is I outlined the global opportunity is that the prevalence rate by far is larger than the use rate, meaning that as we know and as we've talked about, people are simply not carrying rescue devices. So we do think as alternative delivery technologies like ours come into the market, that people will be more willing to use and carry the product. Speaker 500:29:31And it's funny you should mention QuadAI. I spent a lot of time at AAAAI talking with physicians and making sure that we truly understood not just their perspective, but the patient perspective. And it was reaffirming to hear back that our beliefs seem to hold true from a physician perspective and that is by getting rid of the needle, by creating an easier product to carry, physicians do believe as I put in my remarks before, they do believe that there is the opportunity for more people to carry the product and have it with them when they need it. Speaker 400:30:14Okay, great. Yes, that's we're clearly hearing that there's an unmet need and it seems like a lot of people even the ones carrying seems like the products expired anyway. So, okay, that's it for me. Thank you for the questions. Speaker 500:30:27Thanks, Craig. Operator00:30:28One moment for the next question. The next question comes from Jason Butler with Citizens JMP Securities. Your line is open. Speaker 700:30:40Hi, thanks for taking the question. And then you talked about the commercial prep work you're going to be doing, getting ready for launch at the back end of 2025. Can you maybe just talk about the work you can do between data and throughout the regulatory submission? And obviously, you're going to be gating your spend, but what's the kind of work that you can do in terms of physician targeting, building awareness, etcetera to get ready for a launch? Thanks. Speaker 500:31:11Yes. And Jason, the way you asked the question actually, you put in 2 important elements, right, which is for us in 2024 and even the first part of 2025, the commercial spend will not be a large onerous amount that we can't handle. We do believe that given our cash position and the levers that we have in our business that is a very manageable set of activities. In terms of what those activities are, as you alluded to, awareness is by far an important factor prior to launch. And one of the things that helps us in the dynamics that exist right now is not only is the market already growing, but some of our competitors in the marketplace are also focused on awareness. Speaker 500:32:07So, by nature, just making people aware of the alternate products that will be available to them and of the necessity of having a rescue product with them at all times helps as we look to come to the market. In terms of the other activities that we will focus on, we will of course make sure we have the base infrastructure in our company. So think of people who are dealing with the payers, people who are on the medical affairs side. And we will, of course, make sure that our messaging is ready and clear as we get closer to launch. Speaker 700:32:49Got it. And then just briefly on 108, Speaker 500:32:54can you maybe just give us an Speaker 700:32:55idea at a high level what the target PK profile or absorption profile looks like for when we look ahead to data later this year? Sure. Speaker 500:33:07So for that one, I'll pass it over to Carl. Speaker 600:33:10Yes. The PK profile would be consistent with what we've been targeting all along, which is demonstration of a PK curve that is north of a reference listed drug for the duration of observation and remains within the bracketing that has been discussed at last year's advisory committee where we are north of at least the references to drug as well as staying within a reasonable bound on the bracket between ourselves and the auto injectors. Speaker 500:33:43And Jason, I think Carl gave a really important point that we talk a lot about here in the way he said that at E North. The one place you don't want to be, we believe is lower in that first 10 minutes in particular, lower than the manual I'm So that's a spot that everyone can look for in terms of where we're able to be above that mark. Speaker 700:34:11Okay, great. Thanks for taking the questions. Operator00:34:15One moment for the next question. The next question comes from Andreas Arguerats with Wedbush. Your line is open. Speaker 800:34:27Good morning and thanks for taking our questions. It's a couple from us here. So looking ahead to the commercial opportunity for AnnoSom, how are you thinking about penetrating the various segments of the market outside EpiPen and generics, which is currently less than $1,000,000,000 The immediate goal to target patients who should carry and don't, those who are given a script and don't fill it? And what does the market look beyond that, those two segments? And then lastly, how are you thinking about positioning ANNOYSM against competitors on the market? Speaker 800:34:53Thank you. Speaker 500:34:55Sure. Good morning, Andreas. Nice to hear your voice. So, I think the way to think about launching our products, I think is very similar to the way other products have been launched in this space. Of all of the pieces and parts that all of us have to go through to bring a product to market, the launch is actually fairly simple. Speaker 500:35:20It's obviously all of the packaging to make sure the FDA is comfortable in getting through that work that we believe is the more difficult task. In terms of penetrating, our launch process will be very straightforward. You first go after the people who are already using or carrying an EpiPen who have a script and then you work your way into the segments where people have either gotten a script and didn't fill it to your point or used to carry a product and don't anymore or should be carrying a product that never had. So it is a sequence process that I would be surprised if our competitors didn't follow the same process. In terms of positioning, I think we've been clear, but I'll make sure we say it the right way. Speaker 500:36:13When we look at our product, we think the single biggest advantage we have in the marketplace is that people we believe people are likely to carry it with them where they are not carrying a product today. And that's why in my remarks before I focused on this idea of not having to think about carrying our product, you just have it with you. But clearly, there are other benefits. We do believe there is the potential for people to use the product faster or earlier in the disease state because it is an oral product. And we also believe that our scientific data, which shows a very rapid uptake of epinephrine as you know, it has a very rapid median Tmax is an important set of data that particularly for the healthcare providers will be an advantage compared to some of the other or could be an advantage compared to some of the other products that may be in the market. Speaker 200:37:15Okay, great. And looking forward to the upcoming data. Congrats on the progress. Speaker 500:37:19Thanks, Andreas. Operator00:37:21One moment for the next question. Next question comes from Thomas Flaten with Lake Street Capital Markets. Your line is open. Speaker 900:37:33Hey, good morning and congrats on all the progress as well. Dan, we talked a lot about ANNO Film commercialization, but you did leave open the possibility of you guys perhaps launching Libervant later this year. Any commentary on what you've done or need to do and what timeframe we might think about if you go it alone with that? Speaker 500:37:54Sure. Good morning, Thomas. And I'm glad you brought Libervant off. There's a lot of excitement around ANIFILM both outside and inside of our company as there should be. But Libervant is an important product. Speaker 500:38:06And from a FDA perspective right now, all of the questions the FDA has asked, we've answered and we're awaiting the decision date. I do have to remind people that there is an orphan drug challenge that could occur with this product. So we obviously want to get past the next couple of months and see how that unfolds. Having said that, I do believe that there are appropriate epilepsy focused companies who not only could do a good job with launching Libervant, but would be interested in launching Libervant. If those were to not unfold or we were not able to get the fair deal that we've talked about, we would launch the product and I would point to the second half of twenty twenty four as where we would look to do that. Speaker 900:39:06Great. Appreciate that. And a quick one for Ernie. Gross margins were kind of all over the place this past year. And I'm guessing Q4 was a little bit of an uptick for some one time royalty payments. Speaker 900:39:19Anything you can help us there? Anything you can help us there with respect to gross margins, Ernie? Speaker 500:39:26Hi, Tom. It's good to talk to you. Certainly, the biggest item is the recognition of the milestone payment from Zevra for Astarus. So that $1,000,000 in the Q4, there was no cost associated with that. So that would have an impact on gross margin. Speaker 400:39:48Appreciate it guys. Thank you. Operator00:39:52One moment for the next question. The next question comes from Ram Selvaraju with H. C. Wainwright. Your line is open. Speaker 1000:40:06Thanks very much for taking my questions and congrats on all the progress. Can you hear me? Speaker 500:40:11Yes, Rob. Speaker 1000:40:13So just very quickly with respect to ANAFILM, I was just wondering if you had any updated thoughts regarding the regulatory outlook for these kinds of alternative delivery epinephrine products, particularly given recent developments with nephi and if you see any additional perspectives there for ANASOEM as you gear up to the submission of the NDA? Speaker 500:40:36Yes. Nice to hear your voice, Ram. From our perspective, in our experience with the FDA from the first time we spoke with them about, products for anaphylaxis through to today, we believe the FDA has been very consistent. And we actually think the FDA is doing their job. They want to make sure if we're we or anyone else are creating a product that is a rescue product that has the potential to save lives that we do all the work we're supposed to do to make sure that it works the way it's supposed to work under all conditions of use. Speaker 500:41:17So, we understand that's a big responsibility for us and our competitors and we understand that, which is why our package is robust and we are confident that the FDA will continue to be consistent in how they look at the market and how they think about approval. In terms of our competitor, obviously, we just see what is public just like you and our read through is that it appears from a distance like the FDA is being consistent with them as well at least when we think about the comments given to us and then what we hear coming through the public domain from competitors. Speaker 1000:42:04Okay, great. Just also with respect to kind of optimizing the value of ANA Film as a franchise, do you have any sort of broader strategic thoughts regarding that, particularly if this pertains to any potential opportunities for ANAFILM as a product that may exist outside of the United States and how you might be able to access those? Speaker 500:42:28Yes. No, that's a really good point, Ram. From given where we are in our company evolution and this goes back to the idea of long term growth, right? We do not have designs at this point in time to launch on our own the product outside of the U. S. Speaker 500:42:50At all. So we like we have done with Libervant, we will be and actively are talking with potential partners in different markets around the world. For us, the nice thing about where we are right now is we don't have to find a partner tomorrow or this quarter or anything like that. We can make sure we find the right partner to get through the regulatory process in different markets and also support the product once it has been launched. But yes, an important part of the Aquestive story for both Libervant and ANAFILM is the ex U. Speaker 500:43:32S. Potential. Speaker 1000:43:35Okay. And lastly, and I'm just asking this as a housekeeping item. I'm sure all of you are very well aware of the change healthcare cyber attack that occurred last month. Just wanted to ask whether your guidance for 2024 includes any potential impact that you may see. I don't even know whether that's really relevant in your case from the Change Healthcare cyber attack and the disruptions to processing of prescriptions? Speaker 500:44:04Yes. No, that for 2024, I don't see any impact to Aquestive. The only comment I would give you for our IT is just even as a company, we do all of the things you would expect a public company to do to protect from cyber attacks that could affect our business. Speaker 1000:44:26Thank you. Operator00:44:29One moment for the next question. Next question comes from James Molloy with Alliance Global Partners. Your line is open. Speaker 1100:44:41Hey, good morning guys. Thank you for taking my questions. I had a question on the couple of questions. The Antifilm Human Factors Program, can you walk us through what that encompasses? And then, can you talk a little bit about outreach to advocacy or allergy networking groups in advance of launch and how that sort of how that has played out? Speaker 500:45:01Yes. Good morning, James. I'll or Jim. I'll take the second question first and then I'll hand it over to Carl who can talk to you about the human factors program. From an advocacy perspective, as you probably know, in this space, there are roughly 4 advocacy groups that are at a national level and all of them do great work. Speaker 500:45:26I mean just phenomenal work where they're looking to make sure patients rights are protected and access to drug is protected and all of the things you would want. So we do think that having a good relationship and supporting the various advocacy groups in this space is important. We have done that. We actually if you look at even last year, we did that even more than most of our competitors. So that shows you how seriously we take it. Speaker 500:46:00We met with all of them at QuadAI just a few weeks ago and we'll continue to support them as best we can as they do the good work that they do. But with that, I'll turn it over to Carl on the human factors. Speaker 600:46:12Sure. Thanks, Dan, and thanks for the question, Jim. As far as our human factors program goes, as you're probably aware, these programs are an iterative process and ours is no different. We are evaluating how adults, pediatrics and their caregiver patients might engage our technology in a pathway where we better understand interactions between our technology and the patients. So that's a process that goes through a typical formative and then validated protocol, which we have gone to great lengths to support and we are in the midst of completing and progressing those efforts between ourselves and the FDA with ongoing dialogue. Speaker 600:46:54So that's an ongoing iterative process that is on schedule. Operator00:47:00All right. Speaker 1100:47:01Great. Maybe one quick follow-up. I know that certainly then you get plenty on your plate to keep you busy coming up, but looking beyond the horizon, what do you see as potential Are you seeing any potential acquisition candidates or things to bring on board to bolster the pipeline? Speaker 200:47:15Sure. Well, Speaker 500:47:18I would first look at where our pipeline is. If you look beyond ANIFILM, we are definitely excited about the opportunity with AQST-one hundred and eight as a topical cream. I know we haven't spent a lot of time with you or the public on what we see in that space, but we are actively doing work and in the second half of the year we'd love to talk about it more. We're actually in the clinic right now with that program and we're looking forward to having more to say. In terms of the acquisition world, I think we have a lot on our plate right now to focus on and we want to deliver ANIFILM on time, on schedule with the right results and the right package. Speaker 500:48:07So obviously we'll be opportunistic like any public company, but there that is not our focus right now. Speaker 1100:48:16Great. Thank you for taking the questions. Operator00:48:18I show no further questions at this time. I would now like to turn the call back to Dan Barber for closing remarks. Speaker 500:48:28Thank you, Michelle. Thank you for joining us today. This is an exciting time for Aquestive and we're looking forward to speaking with you again in the next couple of weeks. And with that, I hope all of you have a good day.Read morePowered by