Coherus BioSciences Q1 2024 Earnings Call Transcript

Quartr
Provided by Quartr
May 9, 2024

There are 13 speakers on the call.

Operator

Ladies and gentlemen, thank you for standing by. At this time, I would like to welcome everyone to Coherus Biosciences Inc. 1st Quarter 2024 Earnings Conference Call. All lines have been placed on mute to prevent any background noise. After the speakers' remarks, there will be a question and answer session.

Operator

Thank you. I would now like to turn the conference over to Jamie Taylor, Head of Investor Relations. Please go ahead.

Speaker 1

Thank you, operator. Good afternoon, and welcome to Coherus Biosciences' Q1 2024 Earnings Conference Call. Joining me today to discuss our results are Denny Lan Fehr, Chief Executive Officer of Coherus Brian McMichael, our Interim Chief Financial Officer Paul Reeder, our Chief Commercial Officer Rosh Dias, Chief Medical Officer and Teresa Lavalley, our Chief Development Officer. Before we get started, I'd like to remind you that today's call includes forward looking statements regarding Coherus' current expectations about future events. These statements include, but are not limited to, the following: our ability to advance our pipeline, projections of future growth, revenue expenses and counted debt levels.

Speaker 1

All of these forward looking statements involve substantial risks and uncertainties that are beyond our control and could cause actual results, performance or achievements to differ from those implied by the forward looking statements. These statements are not guarantees of future performance and are subject to substantial risks and uncertainties, including risks and uncertainties inherent in the clinical drug development process that

Speaker 2

are discussed in our press release that we issued today as well as in

Speaker 1

the documents that we file with the SEC. Forward looking statements provided on the call today are made as of this date, and we undertake no duty to update or revise any forward looking statement. And now, I'll turn the call over to Denny.

Speaker 3

Thank you, Jamie. Good afternoon, everyone, and thank you for joining us on our call today. As we open the call, let me emphasize 2 things. First, the strength of our Q1 results and secondly, the strategic initiatives we are successfully executing to position our company for long term success. As you are aware, in the Q4 of 2023, we received 2 U.

Speaker 3

S. FDA approvals for products vital to our commercial portfolio. First, Lactorsi for nasopharyngeocarcinoma, a rare and devastating cancer for which it is the only FDA approved therapy and UDENYCA On Body Injector, an innovative drug delivery mechanism with novel features that opens up large portions of the pegfilgrastim market that we previously could not access. In the last 3 months, we launched both products, leveraging synergies derived from our company's focus on oncology. Our Chief Commercial Officer, Paul Reeder will describe these launches in more detail in just a moment and share with you the enthusiasm with which both products have been received in the market and the revenue growth each has experienced this quarter.

Speaker 3

Recently launched innovative products are fully aligned to our company's mission of extending the survival of cancer patients. On the development side, in just a moment, Doctor. Teresa Lovale and Doctor. Raj Dias will describe how our R and D pipeline is advancing to plan with impressive data consistently presented at major medical conferences and more to come. Across every key dimension, company is executing well and to plan.

Speaker 3

Regarding strategic initiatives, we have focused on exercising our strategic optionality to strengthen the company's balance sheet and enhance long term value for our shareholders consistent with our mission. This is particularly relevant

Speaker 4

to the

Speaker 3

commitment we have demonstrated strengthening Coherus' capital structure, where strong progress has

Speaker 5

been made. I'll

Speaker 3

highlight just 2 of the recent steps and developments. Early in the Q1, we announced the divestiture of Simile, a non core, non oncology asset for $170,000,000 upfront cash payment, plus an additional $17,800,000 in cash for inventory. This divestiture has allowed us to pay down a large portion of our $250,000,000 term loan debt, while reducing interest costs, reducing headcount and overhead costs and significantly improving our gross margins. Today, we announced a new non dilutive debt and royalty financing, which fully repays the remaining $75,000,000 which was otherwise due in October of 2025. With this transaction completed, we have now reduced our structured term loan debt by 85% over the recent 3 month period, while the remaining $37,500,000 and moving the due date out 5 years to 2029 with no spring in maturity.

Speaker 3

Timeline for debt maturity under this agreement extends beyond that the development horizon of our products. And with that, let me turn the call over to Paul Reeder. Paul?

Speaker 5

Thank you, Denny, and good afternoon, everyone. With the ophthalmology divestiture, we are now an oncology centered commercial organization, which supports our overarching business objectives. The ongoing oncology launches, Wontorzi, UDENYCA OnBody, UDENYCA Auto Injector enable singular focus on driving top line revenue. We are executing the plan. We are pleased with our progress.

Speaker 5

Regarding the quarter's performance, total net product revenue was 76,700,000 a 137% increase over Q1 2023. For our core oncology brands, Q1 UDENYCA net revenue was $42,700,000 an 18% increase quarter over quarter and a 63% increase over Q1 2023. Leptorzi net revenue was $2,000,000 in the quarter, still early in launch and in line with our expectations and with new patient accrual momentum building. For our non core products, Q1 net revenue for USIMRI was $3,900,000 77% growth quarter over quarter. And finally, similarly, given the deal closed on March 1, net revenue for the quarter was $28,200,000 dollars and only reflects sales for January February.

Speaker 5

I'll now speak in more detail about our core oncology assets starting with Lactorsi. The commercial launch of LOCKTORZI now establishes Coherus in the immuno oncology therapeutic area, serves as the foundation upon which we will commercialize our exciting pipeline of IO products. Bactorsi has a broad label and is approved in combination with Cisgem for first line treatment of adults with metastatic or with recurrent locally advanced NPC and as a single agent for adults with recurrent unresectable or metastatic MPC, the disease progression on or after a platinum containing chemotherapy. Today, standard of care is chemotherapy. So our ambition is to establish lactorsi plus chemo as the new standard of care and offer NPC patients the hope for greater survival based on the final overall survival results from the JUPITER-two trial in which LOCTORZY plus chemo resulted in a 37% reduction in the risk of death versus chemotherapy alone.

Speaker 5

Educating NPC treating oncologists on these clinical data remain a top priority and it's being amplified by the advocacy of the nation's leading NPC opinion leaders who have affirmed the strength of the LOCKTROZY clinical data and its position as the new standard of care. Since launch, we've achieved a series of milestones necessary to enable broad prescribing over the course of 2024 and beyond. I'll highlight 4 examples. 1st, lectoriz was included in NCCN, ASCO and CLINpath guidelines. In NCCN, Lactorsy is the only PD-one with Category 1 designation for first line use and the only preferred regimen in second line plus.

Speaker 5

2nd, payer coverage has been confirmed now on greater than 85% of medical benefit lives and health plans, including Medicare fee for service, Medicare Advantage and national and regional commercial plans. 3rd, among the top academic research hospitals, Montoursey was added to the formulary on 55% of the 33 NCCN Institutions with the remaining institutional reviews scheduled. Formulary position is highly expected to be achieved with all NCCN institutions by the end Q2, 2024. Finally, product specific permanent J code has been granted by CMS, will take effect July 1, 2024. This will enable more efficient billing processes and speed the time to reimbursement for providers.

Speaker 5

Based on Lactorsi's labeled indication, we estimate approximately 2,000 patients will fall within the addressable market opportunity for Lactorsi. With the hospital formulary conversion process underway, the enthusiasm with which the community is bracing the product, we're building momentum as the launch continues. In Q1, approximately 80 patients received LOCKTORZI treatment across all lines of therapy, combination with chemo or as monotherapy, which was in line with our expectations. We're pleased that the launch is progressing to plan. Now turning to UDENYCA.

Speaker 5

UDENYCA delivered another quarter of revenue growth driven by continued strong execution. Strength of our execution is fueled by 3 drivers. 1st, the commercial launch of UDENYCA On Body, a novel and proprietary state of the art delivery system for pegfilgrast, enabling UDENYCA to now compete across the entire pegfilgrastim market. 2nd, UDENYCA is the only pegfilgrastim brand with 3 device options to meet the unique needs of providers and patients. This strengthens our competitive position and allows us to compete on factors other than price.

Speaker 5

3rd, we come into 2024 with payer coverage nearly 2 times that of 2023, opening up access significantly more patient lives. As for key performance indicators for the quarter, UDENYCA franchise demand grew 36% quarter over quarter, driven primarily by the prefilled syringe and auto injector presentations. In addition, franchise market share was 25%, an increase of 10 market share points quarter over quarter. Regarding the launch of UDENYCA OnBody, customer receptivity has been very positive. Specifically, providers are pointing to UDENYCA OnBody's 5 minute injection time, which is approximately 90% faster medication delivery than Neulasta Onpro.

Speaker 5

This is noted as a key differentiator and this differentiation is translating into strong customer adoption. In summary, UDENYCA franchise now offers providers and patients the total solution and we expect continued unit and revenue growth with a focus on improving margins over the course of 2024. I'll now turn the call to Doctor. Rosh Dias, our Chief Medical Officer. Rosh?

Speaker 5

Thanks very

Speaker 6

much, Paul, and good afternoon, everyone. ORTORZY or toripanumab with a profound survival advantage demonstrated in nasopharyngeal carcinoma together with additional positive efficacy data sets published across a variety of tumor types continues to form the foundational element of our immune oncology portfolio. As an IO company with an approved and highly efficacious PD-one, it affords us the opportunity to prosecute 3 distinct strategies for further development across a wider variety of tumor types. Firstly, combinations with our own internal pipeline, which consists of 3 competitively well positioned assets, tightly focused development plans, all of which are progressing according to plan. As docetok, our IL-twenty seven targeting antibody, CHS-one hundred and fourteen, our CCRA targeting antibody and our anti ILT4.

Speaker 6

Secondly, development opportunities where toripalumab is studied in combination with novel compounds with near term registration opportunities fully funded by partner companies in Phase 3 registration enabling studies such as the Inovio vaccine combination study in head and neck squamous cell carcinoma sponsored by Inovio, where we're providing toripalumab for supply and the ongoing Junshi BTLA toripalumab combination study in limited stage small cell lung cancer. And thirdly, development opportunities for toripalumab with partner companies that have earlier phase novel compounds for which they are looking for a PD-one partner. With respect to our internal pipeline, let me first start with Cazdozo. We remain excited about the potential of COSDOZO in both non small cell lung cancer, where we've demonstrated monotherapy activity in PD L1 refractory subjects in the advanced setting and also in hepatocellular carcinoma, where we have demonstrated encouraging overall response rates in the first line advanced setting. We're taking forward the non small cell lung cancer data with our Phase 2 study that is currently ongoing and is active in the U.

Speaker 6

S. And where we remain on track to report out data towards the end of this year or early next year. Our second development program with CatDoza in advanced HCC also remains on track to start in the second half of this year, building upon the promising data presented earlier this year at ASCO GI. Turning to CHS-one hundred and fourteen, our CCR8, mitolytic antibody. We've continued to make good progress through dose escalation and are now moving on to the next stage of the study with expansion into head and neck squamous cell carcinoma where the disease leakage is particularly strong.

Speaker 6

We're excited that an abstract has been accepted for presentation at ASCO in a few weeks' time, which will further detail data from the dose escalation portion of the trial. Theresa will speak more about the status of our ILT4 program and will highlight data presented at the recent AACR meeting. Next, with respect to our pivotal partnered programs with nearer term registration opportunities, our partnership with Innovia continues with the Phase 3 registration enabling study in HPV positive locally advanced head and neck squamous cell carcinoma currently actively in development. In addition, the tauriparumab BTLA Phase 3 combination study in limited stage small cell lung cancer led by our partners, Junshi, continues to progress in the U. S.

Speaker 6

And also other multi regional sites. And this serves as a further example, the potential of toripalumab to act as a foundational element of novel combinations. Finally, with respect to earlier stage novel combinations, we were delighted to announce yesterday that toripalumab was selected by Cancer Research Institute as the PD-one backbone for exploration with ENB Therapeutics Endothelin B inhibitor within a platform ovarian cancer study exploring novel combinations in this patient population that historically has been underserved by immunotherapy. Selection of toripalumab by CRI provides further validation of our strategic trials approach for utilizing toripalumab as an investigational PD-one backbone in these areas outside NTC. I'll now turn the the call over to Doctor.

Speaker 6

Livalli, our Chief Development Officer. Theresa?

Speaker 2

Thank you, Raj, and good afternoon, everyone. I'm pleased to update you on additional progress and our efforts to pursue development of our Tumor Microenvironment or TME focused pipeline, we have 2 approaches, combinations broadly with immune activators with partners and the internal development plans focused on combination with Lactorsy. The casdosing keytag clinical data in non small cell lung cancer in HCC that were presented in December 2023 and January 2024 have demonstrated clinical efficacy in early clinical studies. Importantly, the studies show a favorable safety profile, lending causdoso to combination treatments. And of equal importance immune activation in cancer patients.

Speaker 2

In the CaZdoso Phase 1 study, the biomarker data show at Cazdoso doses of 10 mgs per kg or higher, but not at 3 mgs per kg or lower that IL-twenty seven signaling is inhibited and further NK and T cells are activated. While rebalancing the immune system with anti cytokine antibodies is well established in inflammatory diseases, such as rheumatoid arthritis, inflammatory bowel disease and psoriasis, this approach has not yet been successfully demonstrated for the treatment of cancer. Custoza keto is an antagonist and 1st in class. It blocks IL-twenty seven, which is in the IL-twenty three, IL-twelve, IL-six family of cytokines, a family that has multiple approved antibody drugs and inflammatory diseases. Our scientific advisor, Doctor.

Speaker 2

Christopher Hunter from University of Pennsylvania was honored for his research on IL-twenty seven with the distinguished lecture at the American Association of Immunologists Congress in Chicago on May 4th. In Doctor. Hunter's lecture, he described the basic research in mouse models to understand the immune regulatory role of IL-twenty seven and how the absence of IL-twenty seven results in immune pathology due to an overactive immune system, specifically dysregulated and activated T cells and NK cells. Interestingly, these effects are most notable in liver, lung and brain tissue. The translation of this work to cancer and treatment of patients with Kastuzaketuk showing antitumor activity in lung and liver cancer is very exciting.

Speaker 2

The strong line of sight for tumor indications where IL-twenty seven biology is critical for regulating immune response allows Coherus to have a focused development plan. I'm also proud to say that at the recent ACR meeting, our team presented IND enabling studies for ILT4 antibody CHS-one thousand. CHS-one thousand is our first internally discovered and developed IO drug candidate. We remain on track for FDA feedback on the IND in Q2 2024. I'll now turn the call to Brian McMichael.

Speaker 7

Thank you, Theresa, and good afternoon, everyone. Since Denny covered the updates to our capital structure and Paul covered revenues, I will focus on the rest of the P and L and cash. Cost of goods sold during Q1 2024 was $34,600,000 Excluding the impact of the inventory write down in Q4, COGS would have decreased $3,000,000 or 8% from Q4 2023. R and D decreased $5,700,000 17% from Q1 a year ago, primarily reflecting savings from reduced headcount and reduced development costs on biosimilars, partially offset by investments in our IO pipeline. SG and A increased to $7,400,000 15% driven by a net 6 point $8,000,000 charge in Q1, 2024 associated with the non cash write off of NZV-nine thirty, which is now license obtained in the Surface Oncology acquisition that was terminated by Novartis.

Speaker 7

For the Q1 of 2024, we reported net income of 100 and $2,900,000 or $0.83 per diluted share compared to a net loss of $75,700,000 or $0.96 per share diluted share for the same period in 2023. Non GAAP net loss per share, which excludes the gain on divestiture and the net charge associated with the termination from Novartis mentioned earlier, was $35,800,000 or $0.32 per diluted share in Q1 2024 compared to $59,500,000 or $0.75 per diluted share for the same period in 2023. Cash and cash equivalents and investments in marketable securities were $259,800,000 as of March 31, 2023 compared to $117,700,000 at year end. As noted earlier, we used the cash on hand to pay $175,000,000 in principles after the quarter ended. Today, we are reiterating our expected range of combined 2024 R and D and SG and A expenses of $250,000,000 to $265,000,000 This guidance includes approximately $40,000,000 of stock based compensation and excludes business development activities and other unforeseen activities.

Speaker 7

With that, I will turn the call back over to Denny for closing remarks.

Speaker 3

Thank you, Brian. As we have emphasized throughout our remarks today, we are executing well in our 4 part plan to deliver shareholder value. 1st, driving the top line of our revenues and secondarily, controlling

Speaker 5

our operating expenses. We're

Speaker 3

making great progress advancing our pipeline of tumor microenvironment focused assets. And lastly, as I disclosed, improving our capital structure. I'm fully confident in both the progress we are making and of course we have charted as an innovative oncology company. Operator, we're now happy to open the line for questions.

Operator

Thank you. The floor is now open for questions. Your first question comes from the line of Yigal Nochomovitz with Citi. Your line is open.

Speaker 4

Hi, guys. This is Ashan Gabbard on for Yigal. Thanks for taking my questions and congrats on the quarter. I joined a little bit late, so I apologize if I missed this. But how are you thinking about the contribution of each presentation of UDENYCA to the revenue mix for the quarter?

Speaker 4

And more importantly, how is that going to look like moving forward? I kind of assume that weighting will increase towards the new presentations, but I'm wondering how you're thinking about it.

Speaker 3

Hi, thank you very much for your question. Paul Reeder will be happy to further describe the contribution revenues for the 3 presentations that we now have on the market. Paul?

Speaker 5

Paul? So the in the Q1, the prefilled syringe still represented the largest share of our SKU mix. It was around 90%. The auto injector is around 8% and the odd body came in around 2%, recalling that we launched mid quarter. So, we only had about half of the quarter of the On Body.

Speaker 5

So that's the breakdown of the SKU mix. It varies a little bit by segments. So, clinics and hospitals tend to customize the SKU that works best for them, which is exactly how we are now competitively positioning the franchise. And we're the only franchise that can offer providers and patients 3 different options to meet the unique needs of each individual patient or how they deliver pegfilgrastim. So you could see how that differentiation is translated into market share growth, 10% points quarter over quarter to 25%.

Speaker 5

And so we're going to continue to drive that differentiation as the remainder of

Speaker 3

the year unfolds. Paul, how do we see the market share of each of the presentations evolving through the rest of the year? Do you have any line of sight on that?

Speaker 5

Yes. I think it's still early in the OnBody launch. So we are gaining feedback from customers as where it's fitting in. I can tell you right now that it's moving primarily in the clinic segment and also different segments of the hospitals. But I think we're still going to see throughout this year at least the prefilled syringe still holding a good percentage of the SKU mix with the remainder being auto injector and the on body.

Speaker 5

But the on body growth has largely been in the clinic segment. We would expect that to continue throughout the year.

Speaker 3

Thank you for your question.

Speaker 4

Got it. That's super helpful.

Operator

Next question comes from the line of Kripa Devarackonda with Truist Securities. Your line is open.

Speaker 8

Hi, guys. Thank you so much for taking my question. For on LOXTERZY, you mentioned that the launch is going well. Can you maybe provide some color on whether the drug has been used more in frontline or second line setting? And also, I think it's a new launch and it's relatively rare disease.

Speaker 8

So you mentioned it can take time to get on the formularies. You talked about 55% being on 55% of the 33 NCCN hospitals, is this in line with your expectations?

Speaker 2

Thank you.

Speaker 3

Kripa, thank you for your question. Paul, I'll be happy to comment a little bit about frontline versus second line utilization and the 55% NCCN of conversion. Paul?

Speaker 5

Yes. Thanks for your question. So, going back to the labeled indication or LOCKTORZI, it's indicated in the earlier stage of the recurrent locally advanced patients. And that we are seeing Lactorsa use in those patients. It's typically in that case combined with chemotherapy.

Speaker 5

What we also saw as expected was contribution of Lactorsi in both the metastatic setting in both the frontline and the second line plus. And in those cases, if it's frontline, it was being combined with chemotherapy, consistent with the JUPITER-two trial and our labeled indication and more as monotherapy when it's second line plus. So as expected, it's being positioned all throughout the indicated uses. The only thing and I think you mentioned this was like when in the second line and the later lines of therapy, these patients' duration is likely going to be less. And if when we have eligible patients though that are already on and off label PD-one, those will be difficult for LOCKTORC to capture.

Speaker 5

So value of the franchise will occur over the next 3 years as we build up the large majority of the new standard of care the frontline setting. As for the formularies, yes, that's very much in line with our expectations. Academic medical centers have processes. It takes time to go through those formularies. And as I mentioned, we would expect all the remaining NCCN institutions to be completed by the end of the year.

Speaker 8

Great. Thank you.

Speaker 3

Thank you, Kripa.

Operator

Next question comes from the line of Mike Medelkiewicz with TD Cowen. Your line is open.

Speaker 9

Thank you for the questions. I have 2. The first is also on Lactorsi. Your progress in gaining from the way we access is impressive. Is that basically the lever that's needed to be pulled in order to displace any residual off label prescription of other checkpoint inhibitors?

Speaker 9

Or is there additional work that needs to be done from a marketing or physician education perspective? So that's one question. And then my second question is on USIMRI. I think in the past you've suggested that 2025 could be an inflection year for a biosimilar like eosimetry based on some of the IRA provisions. Are you still thinking about it that way?

Speaker 9

Does eosimetry have a bright future ahead? Or what is your latest thinking on UCIIMRI's outlook? Thanks.

Speaker 3

Great. Thank you for the question. I'll let Doctor. Raj Diamis firstly address the issue of the therapy selection decision that physicians now have with the launch of like towards the end, then Paul can secondarily talk about your summary of Rush.

Speaker 6

Yes. Thanks very much for the questions. I would say doctors tend to be pretty evidence driven and we have 3 things that no other PD-one has. First of all, we have an indication. Secondly, we have a profound survival advantage in the first line setting, 37% risk reduction of death.

Speaker 6

And again, that's in the context of negative trials with other PD-1s in nasopharyngeal carcinoma. And then the third thing we have is also a preeminent positioning on the NCCN. So first line, we are the only category 1 designated IO therapy. And in second line and beyond, we have the we are the only preferred regimen actually. So I think as we start seeing patients, I think these three things are key and all the team is continuing to message on those three things.

Speaker 6

Thank you. Paul, you want

Speaker 3

to comment a little bit about our expectations for you saying

Speaker 5

we're going to 2025 with IRA? Sure, Denny. Thanks for your question, Mike. Yes, the 2025 formulary negotiations are ongoing. And, Usimare and Coherus are actively engaged in that process.

Speaker 5

So, we continue to believe that, that will be the I think the point where we see even greater inflection of biosimilars in the adalimumab space. So I think we're well positioned there based on our price point and the value that this product brings to the healthcare systems and patients. Thank you.

Speaker 3

Thank you for your question.

Operator

Your last question comes from the line of Balaji Prasad with Barclays. Your line is open.

Speaker 10

Good afternoon. This is Shao on for Balaji. Thanks for taking our question. Just a quick follow on question on the UDENYCA franchise. Amgeny recently announced that the licensing peg filgrastim onboarding injector and prefilled auto injector and they expect to submit the BRA in Q1 of 2025.

Speaker 10

And there are a few other players that are trying to get into this landscape. So what is your expectation for the Pacfir GRAS teams onboard the injector landscape and the entire market for the next 2 to 3 years? And do you have any plans or mechanism to build and defend your market shares against those potential new entrants? Thank you.

Speaker 7

I'm sorry, I want to understand we're

Speaker 3

having a difficult time hearing you. I want to understand your question. Is your question with respect to future entrants in the on body space with the filgrastim market or with auto injectors?

Speaker 10

Filgrastim market, like especially the onboarding injector and the auto fill prefilled auto injector as Amneal recently announced that they have something in plan and they plan to sell a BLA in Q1 of 2025.

Speaker 3

Paul, would you like to address how we view the competition in the for future auto injectors?

Speaker 5

Yes. Well, first of all, we've been operating in this pegfilgrastimarket now. We're in our 6th year and maintain one of the leadership positions here. So, what we're going to continue to do is focus on our business and the positioning of UDENYCA, which is to be the total solution for providers and patients. And we're doing this, as I mentioned, because today we've got all three presentations.

Speaker 5

It's tried and true and well established in the market. Secondly, we've got strong payer coverage. And so that's being recognized by payers that UDENYCA brand is a go to brand because of all of these benefits that we bring to not only the consistency in the marketplace, the predictability, but also the high quality and reliability of this brand. So, we'll be prepared for any competition if anybody else comes, but we believe we'll continue to be well positioned to compete and win whenever that landscape unfolds.

Speaker 3

Thank you, Paul. The other point that I would make is consistent with Paul's remarks. Our on body injector represents an innovative de novo highly sophisticated device with a 5 minute injection time. And the enthusiasm with which it has been received by the market, the physicians and the patients is due to that. We believe there are significant technical hurdles to such an approach and we investigated a number of approaches before settling on this one.

Speaker 3

So we think this is a very important, we think we got it right. But lastly, as Paul said, we are first competitors in the tight fill grassland market and our track record over the last six years demonstrates that. We are the only team with all three presentations each filling a particular need in the market. So I believe that we're very confident in our ability to compete and remain successful and grow share in this market.

Speaker 5

Thank you.

Operator

Another question comes from the line of Douglas Tsao with H. C. Wainwright. Your line is open.

Speaker 11

Hi, good afternoon and thanks for taking the questions and congrats on the progress. Obviously, there are a number of sort of dates that you need to clear in terms of the ramp up for La Torzi in particular, getting on to formulary. How quickly do you think you can get through those and sort of have access at sort of the most of the majority of the market? And what other steps do you think we might need to you might need to clear before we really start to see an acceleration in the revenue trajectory?

Speaker 3

Thanks for your question, Doug. Paul, would you like to comment a little bit on the gating of the adoption of Lactorsi and how we do that?

Speaker 5

Yes. Thanks for your question, Doug. Yes. So obviously, the payer coverage is the first one and that's well established. And I don't really foresee any further hurdles on the payer side.

Speaker 5

The second gate is now that we've got the NCCN guidelines, what we have to ensure now is in each of the accounts that the guidelines that are translated into the order sets. So again, this enables the doctor at the time of prescribing that when they click through the order set that Lactorsi chemo combination is there. That's ongoing, but that will typically settle in here over this next quarter. Then Doug, I really think the next gate is just sort of washing out all of the current patients that are on current off label PD-1s and establishing the new patients with Lactorsi as the new start and getting anybody that's on chemo today or not on a PD-one treated with Lactorsi. And that's just going to take a continued effort in terms of promotion, both through our sales team, from the KOLs, from the podium and through the referral networks, but also through our digital efforts.

Speaker 5

And we're going to continue to invest and deploy those so that at the time of decision, the oncologist knows that Lactorsi and chemo is the regimen of choice for those patients. But again, it's a rare disease. It's going to ramp up, which is why we think peak is going to occur around year or 3 of this. But we feel very confident we're going to achieve that. Doug, for

Speaker 3

all the reasons that Paul just elucidated, we see the growth of this market as a steady ramp up to peak market share and penetration probably out around year 3. So this isn't a market and such as a replacement enzyme market or something where you can get out to these patients and just find them, merely convert them. These patients are in various stages of therapy. They may have been exposed to another PD-one. We're going to catch the patients that are on chemotherapy.

Speaker 3

Those are all eligible. They will all benefit. Some patients, we will have to wait for them to progress to second line. But the key issue is, as Raj Pai has pointed out, we are the only first line therapy from the FDA. We've gotten position on all of the formularies.

Speaker 3

We're doing very, very well with the NCCM. But I would say with the building blocks are in place for the market, we see a steady ramp forward over the future.

Speaker 11

Okay, great. And maybe a follow-up question on the UDENYCA franchise. I'm just curious, we're starting to see uptake of both the of your on box device as well as the auto injector. I'm just curious if you have any insight in terms of how physicians are using the 2 those 2 dosage forms or product types. Are there sort of themes in terms of the types of patients that are getting the OnBody versus the auto injector and vice versa?

Speaker 11

Thank you.

Speaker 3

Paul, I guess the next question is, what sort of patient settings, would they go for the auto injector with patient settings for the Opati and so on?

Speaker 5

Yes, Doug. So, let me frame this in a couple of different ways. First, let's take the clinics. So the clinic segments are going to gear more towards all three of the presentations, because they have patients who like to come back to the office the next day. They like the high touch connectivity with their nurse and with their doctor.

Speaker 5

So therefore, the prefilled syringe or the auto injector are positioned for those patients. But some patients in the clinic, they want their injection experience at home. Therefore, we give them the option of the on body device with a well designed 5 minute injection. But if the patient wants to self inject and not wear the device, they can choose the auto injector and under 10 seconds inject themselves at the time and place that they like. So that's really how we're positioning by the patients and by the provider.

Speaker 5

The hospitals, they tend to go a little bit more with the on body device or the prefilled syringe. So, we've had good uptake with auto injector in the hospital, but not nearly as much in the clinic because they prefer either the prefilled syringe or the on body is the at home preference. So that's kind of how we're seeing it. And again, being the only franchise with all three options really sets us apart from a competitive differentiation. And I think you see that in our market share growth.

Operator

Question comes from the line of Colleen Kussi with Baird. Your line is open. Thanks.

Speaker 12

Good afternoon and thanks for taking our questions. So for realizing you're not providing guidance at

Speaker 2

this point, but just how to

Speaker 12

think about what the growth drivers for UDENYCA

Speaker 2

will be in 2024? Is it growing the OnBody? Is it just focusing on

Speaker 12

the prefilled syringe and the auto injector? Just kind of thoughts around growth for UDENYCA this year. And then sorry if I missed this in the prepared remarks, but if you

Speaker 2

could just speak towards the potential of

Speaker 12

reaching cash flow positivity and if that goal is still set for 2024? Thank you.

Speaker 3

Thank you, Colleen. I'll let Paul handle the growth drivers for UDENYCA first and then I'll handle your secondary question with respect to 2024. Paul? Yes. Thanks for

Speaker 5

your question. Yes, I think we fully expect the On Body to be the predominant driver of our growth in 2024. As Denny mentioned that the approval of that product now opens up segments of the market that had been difficult to penetrate with our prefilled syringe and auto injector. So, we're really looking for that SKU, that presentation to drive market share growth for the remainder of the year. It will be buoyed and facilitated by our payer coverage, which I mentioned was doubled this year versus last year.

Speaker 5

And that payer coverage extends to all three product presentations. So really not inhibited by payer coverage by each of those presentations. So where we've got it, we've got all 3 and we will leverage that as we continue to execute. Thanks, Paul. With respect to your secondary question,

Speaker 3

I would first say, 2024 is shaping up to be a more predictable year than 2023. And so far as in 2023, we had to focus a lot on getting approvals. We focused on getting the antibody approval. We did that successfully. We went and got like Lactorsi approved in the FDA.

Speaker 3

That was that took a little time. We got that done.

Speaker 5

And then we rolled into

Speaker 3

the launches, particularly the launch of the On Body launch of the auto injector and now launch like Torzi. So the trajectory over 2024 is continued revenue growth. We'll see more like Torzi as we go on the year quarter to quarter and we believe that we'll also see continued growth with respect to UDENYCA for the reasons that Paul just laid out. Issue is like how steep will that growth curve be, how much growth. And what we are constrained by is the rearward looking experience looking backwards, right?

Speaker 3

We're very early in these launches. We've just gotten out there. With respect to Lactorsi, we're making very good progress on the formularies, but it's a rare disease. Now we have to acquire the patients and so on. But I think we're off to a very good start.

Speaker 3

So we don't want to forecast with respect to our forward looking, although clearly, as I indicated, growth will continue. So it's a question of when and how that will go up, but that remains very clearly in our sights is to move forward in that direction. But the growth is something that we're happy with.

Speaker 12

Great. Thanks for taking our questions.

Speaker 3

Thank you, Colleen.

Operator

There are no further questions at this time. Mr. Denny Lanfer, I turn the call back over to you.

Speaker 3

Thank you, operator. Thank you all for joining us on our call today.

Speaker 5

And thank you for

Speaker 3

the opportunity to enumerate for you the progress we've made across all of our key overtures, particularly with respect to driving our sales and advancing our tumor microenvironment focused pipeline. And we look forward to pricing you of our progress at our next call. Thank you.

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Earnings Conference Call
Coherus BioSciences Q1 2024
00:00 / 00:00