NASDAQ:MDWD MediWound Q4 2024 Earnings Report $16.29 -0.06 (-0.37%) As of 04:00 PM Eastern Earnings HistoryForecast MediWound EPS ResultsActual EPS-$0.36Consensus EPS -$0.59Beat/MissBeat by +$0.23One Year Ago EPS-$0.19MediWound Revenue ResultsActual Revenue$5.84 millionExpected Revenue$5.79 millionBeat/MissBeat by +$48.00 thousandYoY Revenue GrowthN/AMediWound Announcement DetailsQuarterQ4 2024Date3/19/2025TimeBefore Market OpensConference Call DateWednesday, March 19, 2025Conference Call Time8:30AM ETUpcoming EarningsMediWound's Q1 2025 earnings is scheduled for Tuesday, May 27, 2025, with a conference call scheduled on Monday, June 2, 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 TranscriptPress Release (8-K)Annual Report (20-F)Earnings HistoryCompany ProfilePowered by MediWound Q4 2024 Earnings Call TranscriptProvided by QuartrMarch 19, 2025 ShareLink copied to clipboard.There are 10 speakers on the call. Operator00:00:00Good day, and welcome to MediWarm's Fourth Quarter and Full Year twenty twenty four Earnings Conference Call. All participants will be in listen only mode. After today's presentation, there will be an opportunity to ask questions. Please note today's event is being recorded. I would now like to turn the conference over to Dan Ferry of LifeSci Advisors. Operator00:00:32Please go ahead. Speaker 100:00:34Thank you, operator, and welcome, everyone. Earlier today, pre market open, MediWound issued a press release announcing financial results for the fourth quarter and full year ended 12/31/2024. You may access this press release on the company's website under the Investors tab. I would ask you to review the full text of our forward looking statements within this morning's press release. Before we begin, I would like to remind everyone that statements made during this call, including the Q and A session, relating to MediWound's expected future performance, future business prospects or future events or plans are forward looking statements as defined under the Private Securities Litigation Reform Act of 1995. Speaker 100:01:19These statements may involve risks and uncertainties that could cause actual results to differ materially from expectations and are described more fully in our filings with the SEC. In addition, all forward looking statements represent our views only as of today, and MediWound assumes no obligation to update or supplement any forward looking statements, whether as a result of new information, future events or otherwise. This conference call is the property of MediWound and any recording or rebroadcast is expressly prohibited without the written consent of MediWound. With us today are Ofer Goenen, Chief Executive Officer of MediWound Hany Luxemburg, Chief Financial Officer and Barry Wolfenson, Executive Vice President of Strategy and Corporate Development. Following our prepared remarks, we will open the call for Q and A. Speaker 100:02:09Now, I would like to turn the call over to Ofer Gonin, Chief Executive Officer of MediWound. Ofer? Speaker 200:02:18Thank you, Dan, and good morning, everyone. 2024 was a pivotal year for Meriwound, marked by strong execution, significant progress in clinical development, commercial expansion and strategic partnerships. These achievements have strengthened our position, enabling us to drive continued growth and innovation in 2025 and beyond. I'll begin with EscharEx, our next generation asthmatic debridement therapy for chronic wounds. In early twenty twenty four, we reported compelling results from our head to head analysis against SANTYL. Speaker 200:02:58Currently the only FDA approved in thematic debridement product in The United States generating approximately $370,000,000 annually. The data demonstrated Escorex's superiority over SANTYL across key clinical endpoints, including higher incidence of complete debridement, faster time to complete debridement, more rapid and effective wound bed preparation and faster time to wound closure. Clinicians surveyed across diverse cursings recognize these superior clinical benefits and the substantial value they provide. In fact, recently conducted market research estimates Escorex peak sales potential at approximately $725,000,000 for its primary indications in the Sled ulcers and diabetic foot ulcers. These clinical benefits also make Escorex well positioned for upcoming changes in wound care reimbursement. Speaker 200:04:03Starting next month, Medicares new LCD policy will require full wound debridement and granulation tissue formation before covering cellular and tissue based products. This shift strengthened EscharEx's opportunity as a major commercial opportunity for our company. EscharEx now is in Phase three. We recently launched the Valu global Phase three trial to evaluate Escorex for venous leg ulcers, involving two sixteen patients across 40 sites in The United States and Europe. The co primary endpoints of the trial are the incidence of complete bright and the incidence of wound closure. Speaker 200:04:46This program is strategically derisked, building on the strong results of our Phase two studies with key modifications to maximize the likelihood of success. Modification that includes a larger patient sample size to strengthen statistical power and interim analysis at sixty five percent enrollment, allowing for adaptive adjustment and standardized treatment protocols to minimize variability and ensure consistency. It is also important to note that EscharEx shares the same active pharmaceutical ingredient as NexoBrid, which is FDA approved for a nearly identical indication, Eschar removal. The interim assessment, a significant milestone is anticipated in mid-twenty twenty six with full trial completion expected by year end 2026. To further strengthen our BLA submission and enhance commercial readiness, we are planning a 45 patients randomized prospective Phase two head to head comparison of EscharEx versus collagenase scheduled to begin in 2025. Speaker 200:05:58This study will include both Santill and the European collagenase product EvuXol generating critical comparative data that will be instrumental in our market access and pricing strategies. The VLU program is supported by strategic research collaborations with leading wound care companies, Solventum, Molneke and NEMEDIX. These partners will provide advanced wound care products for our trials, ensuring optimized patient outcomes and standardized wound management across all sites. Additionally, earlier in 2024, we secured EUR 16,500,000.0 in funding from the European Innovation Council to accelerate the development of EscharEx for the diabetic foot ulcers. The Phase twothree DFU clinical trial is planned for 2026 and we are pleased to announce a new strategic research collaboration agreement with Kerasys, a subsidiary of Coloplast to support this effort. Speaker 200:07:07Kerasys, which is a global leader in wound care solutions will be supplying its fish skin graft for active closure in this trial. Additionally, we anticipate securing another collaboration with a major industry leader to supply their market leading advanced wound care dressings. With these partnerships, MediWound will be working alongside all the relevant key players in Advanced Wound Care, reinforcing our strong industry positioning. Now let's move to NexoBrid, our innovating enzymatic therapy for severe burns. Before we discuss our progress with NexoBrid, I want to take a moment to highlight its critical real world impact. Speaker 200:07:56This past weekend, a devastated night club fire in North Macedonia claimed fifty nine lives and injured at least one hundred and fifty five people. A medical delegation from Israel equipped with NexoBrid immediately flew in to provide support and treatment. We are grateful that NexoBrid could play such a vital role in this strategy. With that said, in 2024, we achieved significant progress in expanding NexoBrid's commercial reach, generating annual revenue of $20,200,000 driven by robust global demand. Moving forward, we anticipate continued strong growth with projected revenue of $24,000,000 in 2025, capped only by our manufacturing capabilities. Speaker 200:08:51This growth will be driven by expanding sales in key markets. Europe, where NexoBrid is now available in more than 90 burn centers. Japan, where our partner, Kaken Pharmaceutical, has achieved a remarkable adoption with 400 plus medical facilities using NexoBrid and The United States, where very strong commercialization efforts yielded a 42% increase in hospital orders in Q4 twenty twenty four. ExoBrid market's potential was further expanded with FDA approval for pediatric patients newborn to 18 years old. The pivotal Phase three pediatric study data supporting the approval were recently published in Burns, the peer reviewed journal of the International Society for Burns Injuries. Speaker 200:09:46Another potential indication expansion emerged during the Israeli Hamas war, where dozens of patients with vast injuries were treated with NexoBrid. The outcomes were remarkable and the data from these cases will be presented at the upcoming American Burn Association Conference. Additionally, we reported positive results from the expanded access protocol, NEXT, which evaluated two thirty nine patients across 29 U. S. Burn centers. Speaker 200:10:17The study confirms NexoBrid's safety and efficacy in eschar removal as well as its significant reduction in the need for surgical procedures for burn patients. Operationally, we successfully completed the construction of our state of the art GMP manufacturing facility, which remains on track to reach full operational capacity by late twenty twenty five. Commercial availability will depend on regulatory approvals from FDA EMA, which are expected in 2026. This facility will significantly expand our production capabilities, allowing us to meet the growing demand the growing global demand and sustain long term revenue growth. This year, we also strengthened our balance sheet with a strategic $25,000,000 pipe financing round led by Molnicki. Speaker 200:11:13This reflects industry confidence in our strategy and provides additional resources to execute our clinical and commercial growth plans. With a robust cash runway of approximately $44,000,000 MediOne is well positioned to deliver on its critical clinical operational and commercial objectives. Now I'd like to turn the call over to Hany to review our financial performance in greater detail. Speaker 300:11:43Thank you, Ofer, and good morning, everyone. I'll now take you through our financial results for the first quarter and full year of 2024. Starting with the fourth quarter, we reported revenue of $5,800,000 compared to $5,300,000 in the same period last year. Gross profit came in at $900,000 with gross margin of 15.5%, up from $700,000 and a 13.5% margin in Q4 twenty twenty three. R and D expenses were $3,000,000 compared to $1,800,000 in the prior year quarter, primarily due to cost related to the Escorex Value Phase III trial. Speaker 300:12:34SG and A expenses totaled $4,000,000 compared to $2,800,000 in Q4 twenty twenty three, mainly reflecting higher share based compensation expenses. This resulted in an operating loss of $6,100,000 compared to 3,900,000 last year. Net loss for the quarter was $3,900,000 or $0.36 per share compared to $1,700,000 or $0.19 per share in Q4 twenty twenty three. On a non GAAP basis, adjusted EBITDA loss was $4,900,000 compared to $3,200,000 in the same period last year. Now moving to full year, we reported total revenue of $20,200,000 compared to $18,700,000 in 2023. Speaker 300:13:33The increase was primarily driven by higher revenue from Vericel, a new contract with the U. S. Department of Defense. Gross profit for the year was $2,600,000 with a gross margin of 13% compared to $3,600,000 and a 19.1% margin in the prior year. The decline was mainly due to changes in revenue mix and higher fixed costs associated with scaling our production. Speaker 300:14:08R and D expenses came in at $8,900,000 compared to $7,500,000 in 2023, primarily due to costs related to Esperance Value Phase three trial. SG and A expenses were $13,100,000 compared to $11,600,000 in 2023, mainly reflecting higher share based compensation costs. Our operating loss for the year was $19,400,000 compared to $15,300,000 in 2023. Net loss for the year was $30,200,000 or $3.03 per share compared to $6,700,000 or $0.75 per share in the prior year. The $23,500,000 increase was primarily due to financial expenses, mainly from the revaluation of warrants following a 75% increase in our share price in 2024. Speaker 300:15:18Non GAAP adjusted EBITDA loss for the year was $40,800,000 compared to $12,300,000 in 2023. Turning to balance sheet, we ended the year with $43,600,000 in cash, cash equivalent and deposit compared to $42,100,000 at the end of 2023. During the year, we successfully raised $25,000,000 through pipe offering, received $1,200,000 from the exercise of Series A warrant and secured $1,200,000 grant from the European Commission. We also fully settled our liability with Teva. In total, we used $22,900,000 to fund operation, including $6,800,000 allocated to capital expenditure, primarily for scale of our manufacturing facility. Speaker 300:16:22That concludes my financial review offer. Back to you. Speaker 200:16:28Thank you, Hany. So in summary, 2024 was a transformative year for Meriwound defined by significant clinical, commercial and strategic achievements. Our strong execution, expanding pipeline and key partnerships position us for sustained growth and long term value creation. As we continue to advance our programs, expand market adoption and drive innovation, our focus remains on delivering meaningful improvements in patient care. We look forward to providing further updates in our progress in the coming quarters. Speaker 200:17:06And with that, I will now turn the call back to the operator to open the line for questions. Operator? Operator00:17:12Thank you. Yes, sir. We will now begin the question and answer session. You. Today's first question comes from Josh Jennings at Cowen. Operator00:17:29Please go ahead. Speaker 400:17:31Hi, good morning. Good afternoon. Thanks for taking the questions and congratulations on the initiation of the value study. Appreciate all the review of the trial design and the path forward. One follow-up was you have some powerful wound care collaborators in this study, so that's the molecule, MiMedix. Speaker 400:17:54And I was just wondering, what is outside of supplying their wound care products for the study, what else are they doing in terms of enhancing study execution? Just wanted to get that under our belt. Speaker 200:18:10So hi, Josh, and thank you for the question. Barry, do you want to address it? Speaker 500:18:15Yes. Thanks, Josh, for the question. Generally speaking, having standardized products across these three key categories, the moist wound dressings, the compression bandaging and the tissue substitute will help just to make sure that all variability is minimized throughout the study, which of course will optimize the outcomes. As far as the companies themselves are concerned, aside from the products that they'll be supplying, they'll also be supplying training. So in fact, this weekend in Philadelphia, we have our investigators meeting and there'll be training of all the sites. Speaker 500:18:54Those companies will be involved and on an ongoing basis, if there are any questions related specifically to their products, they'll provide that education and training. Speaker 400:19:06Excellent. Thanks for that. And wanted to ask about the DFU study expected beginning 2026, maybe funding is Operator00:19:16in Speaker 400:19:16place. There's two part question. I mean, one, should we expect it to be a global trial with the EU funding similar to the VLU study, the value study? And then two, maybe just outline what's required in just a similar pathway that you took for VLU in terms of getting trial design approved by the FDA and EMA. Love to just hear you walk us through that again, sorry to make you review it. Speaker 200:19:50So the Phase three study with DFU patients will be as close as we can to this Phase III study of the VLU patients. The only difference is that we have less data that we have for VLU patients. So in order for the agencies to agree to that structure of the study, we need to get their sign off. Our plan is to approach both FDA and EMA in the second half of this year with a protocol that is based on the data that we have to date. We have a few dozens of patients that we treated with DFU patients and the data looks basically similar to what we have with BVU, but we need to have it approved. Speaker 200:20:41This is why when we guide about the study, we say a Phase II, III study because maybe we need a kind of an interim assessment and shift into a Phase III down the road. Having said that, we need to get clearance from the agencies before we can give a lot of details. Our thoughts about how the study will look like is currently posted on our website, and it looks quite similar to the VFU trial. With this trial, we will also have strategic collaborations, the same as we have with the VLU trial, but it will be with different partners. Speaker 400:21:21Excellent. And just one last one on NexoBrid. As I've made great progress in terms of doing the RTMP manufacturing facility in place and ramping up capacity this year. I understand that regulatory approvals are necessary for product to be commercially available, which is when is the earliest that regulators can get in to, I guess, do the inspection and move forward with clearance? I know you you don't have any control over the timing, but when is the earliest that they could start that process? Speaker 400:21:56And it sounds like you're expecting approvals in 2026. Speaker 200:22:03So currently, our guidance for the revenue are reflecting the fact that we will get in the beginning of twenty twenty six approval in Europe. And by mid-twenty twenty six, we'll get FDA approval. The thing that we need to have in place in order for those approval to take place is that we need to make sure that we are able to manufacture product with the same quality and the same characteristic of the current manufacturing facility that we have, which is quite smaller. After we finish proving that we can do the same, we need to manufacture a few batches of both MexoBrid for The United States and for Europe. Europe demands three months of stability after that, that they can come for an inspection. Speaker 200:22:56This is why we expect the European approval to be earlier. And the U. S. FDA, the guidelines is that we need to wait six months of stability. So these are the timelines and this is why we guided in the beginning and in the middle of 2026 both approvals. Speaker 400:23:16Thanks, Sophie. Thanks, Barry. Appreciate it. Speaker 200:23:20Thank you. Operator00:23:22And our next question today comes from Francois Brisebois with Oppenheimer. Please go ahead. Speaker 600:23:28Hi. Thanks for the questions and congrats on the progress this year in 2024. I was just wondering if you can touch base, you started your call talking about the Medicare update. Can you just remind us when that came in place and how just a little more color on how do you think that is a positive for MediWound? And then the second question is more on the interim analysis. Speaker 600:23:50Just a reminder, I think you mentioned it on the timing of that for the trial, the Phase three and what are the different kind of outcomes that can come out of this interim analysis? Thank you. Speaker 200:24:03Okay. Thanks for your question. Barry, can you step in to address the first question and I will answer the interim assessment one? Speaker 500:24:11Sure, of course. So with regard to the Medicare question, recently as you're likely aware, the seven local MACs, the Medicare administrator contractors posted final changes to what's called an LCD, a local coverage determination policy related to the usage of cellular and or tissue based products, CTPs. This category has exploded in the last several years to as high as $3,000,000,000 in The U. S. And while several dramatic changes were written into the draft policy, as it turns out, the final policy ended up not really too different than the current one. Speaker 500:24:51This new policy becomes active in less than a month on 04/13/2025. One key change is the slight limitation on the number of applications of tissue that could be put in place on a patient during one complete episode. That number has gone down from 10 previously to four, but it does have the ability to do an additional four if the wound situation warrants additional applications. And for these additional four, the sites must complete some additional paperwork, but that extra work is not deemed to be too time consuming to keep them from doing so. That's the bigger change that the industry will focus on. Speaker 500:25:31From a MediWound perspective and how it relates to EscharEx, another meaningful change from this new LCD is the increased attention to documentation required showing that the wound is completely debrided and covered in granulation tissue prior to application of any tissue substitute to the wound. And given that this is what EscharEx does so well, it debrides and it gets wound bed the wounds prepared, this will position our drug as the optimal product of choice when surgery or sharp debridement is not deemed to be the best option. Speaker 200:26:10Okay. Barry, I have nothing to add to that. Thank you for answering. As for the interim assessment, as I said in my prepared remarks, this program is strategically derisked. Many of them succeeded in 14 out of 14 clinical studies, and we have no plans to fail in the most significant study that we are conducting. Speaker 200:26:35So we plan an interim assessment after sixty five percent of the patient in the study, which is one hundred and forty patients, are treated. And there are two outcomes to this assessment. One, ninety percent there is a ninety percent probability of success. The ninety percent power for success is maintained. And in this case, we are stopping the enrollment of the study. Speaker 200:27:02By then, more than 200 patients will be already included in the study. And then we just are waiting for the follow-up and the study is done. If we see that the likelihood of success is less than ninety percent, let's say, seventy seven percent, we have some flexibility in the protocol to include additional few dozens of patients in order to maintain the ninety percent probability of success. If everything goes as we planned, the interim assessment should be by mid-twenty twenty six and the study completion, assuming that ninety percent probability of success is maintained, the study completion is by the end of twenty twenty six. I hope I answered the question. Speaker 600:27:52Yes. Thank you. Speaker 100:27:55And Operator00:27:57our next question today comes from RK from H. C. Wainwright. Please go ahead. Speaker 700:28:02Thank you. Good afternoon, Ofer and Hany and good morning, Barry. A couple of questions. Barry, thanks for explaining the LCD, the new LCDs that was it's going to become official in a month. So based on what you're saying regarding the granulation of the tissue, is there a way you at least if you can compare for us how SANTINEL performs versus what we should expect from EscharEx? Speaker 700:28:44And based on that, does EscharEx has potential to be better than what Sartanel does right now? Speaker 200:28:56So Barry, do you want to address it? Speaker 500:28:59Sure. Well, a couple of things. Firstly, and thank you, RK for the question. As you know, we announced the results from this head to head Phase two study earlier this year and EscharEx was shown above Santel in all the key endpoints, whether that was time to complete debridement, incidence of clip to complete debridement and also time to wound closure. With regard to the so right there off the bat, if you're a treating physician and you have a wound that comes in and you want to get towards a CTP for active closure, you're going to know that the data suggests that, EscharEx can get to that CTP within only a couple of weeks, that the average is going to be five to six applications within a couple of weeks and the published data, even outside of for Santo, even outside of our Phase II analysis suggests that it's more along the lines of six to eight, if not even more weeks. Speaker 500:30:17So there's going to be an incentive to use EscharEx because it will get to that CTP application much, much more quickly than would Santel. Speaker 700:30:30Thank you for that. And then, Ofer, a quick question on the VLU, the ongoing VLU study. Is there any possibility for this study to enroll quicker than expected so that we can expect data earlier, whether it's the interim or the final complete data set later next year? Speaker 200:31:02Yes. So hi, Alke, and thank you for this question. It's a great question because I was asked about it again and again by my board yesterday. I wouldn't expect a quicker enrollment. That many patients, we are in the largest centers in The United States and Europe, there are a lot of patients that are available, but we are making sure that we are recruiting the right patients. Speaker 200:31:26I want patients with real chronic wounds. I don't want patients with a wound which is not that severe, and even a placebo will do something. So we're spending a lot of time and a lot of effort in screening and making sure that no patient is getting into the study unless he has a real chronic wound, a real heart rate wound because our intention is that placebo will do nothing to it. I don't mind waiting another month, another two months. I'm not incentivizing centers to recruit as many patients as they can as quickly as they can. Speaker 200:32:06On the contrary, I'm just making sure it's a very lucrative study. Everyone wants to get to be treated with ancillaries that we are getting, the most expensive dressings, the most effective pressure garments. We know that we will have there is a lot of demand to participate in this trial. Our motivation is to make sure that it is done adequately, and I would not expect quicker enrollments. Speaker 700:32:38Okay. Thanks for that. And then on the collaboration with BARDA, in terms of identifying a new S facility and trying to plan and design a facility in The United States. What is the status there? And also can you give us any color as to how you're going to manage these big projects like you just got done with the Israeli facility? Speaker 700:33:13And what's the timeline if you so decide and identify a specific site in The United States and how does it play into the expansion of NexoBrid from what you're yet to accomplish that's already been signed up for? Speaker 200:33:41So the facility in Israel that is going to be in full capacity scale by the end of this year and getting the approval by mid next year, we will have there the capacity to support the foreseeable market of NexoBrid both in The United States and globally. Having said that, the U. S. Government recognized the need to having a backup facility in The United States. So we are now in a pool, so we got some funding to identify a location, an ID location for such a facility. Speaker 200:34:20We are planning such a facility. We are having additional indications such as the temperature stable formulation and additional indications that we are working on that this facility will need to support. So we have the funding for that. Hopefully, by the end of this year, we will know exactly what is required in order to finalize building such a facility. I would expect a three year effect. Speaker 200:34:53It will not have any impact on our revenue guidance because we are speaking now on twenty twenty seven, twenty twenty eight. But we will have a Speaker 400:35:04lot Speaker 200:35:04of additional capacity either to manufacture more Escorex or to manufacture the military use indication, etcetera. So it's a project which is very important for us, but it won't have any impact on the next four years other than getting funding from the U. S. Government. Speaker 700:35:25Perfect. Thank you very much. Thanks for taking my questions. Speaker 200:35:28Thanks, RK. Operator00:35:30And our next question today comes from Chase Knickerbocker with Craig Hallum. Please go ahead. Speaker 800:35:37Good morning. Thanks for taking my questions. Just a couple on the VOU study around enrollment. So can you just kind of queue us in on what you're hearing from prospective centers as far as what they think enrollment rates that are feasible are? And then how are the early site activation activities going? Speaker 800:35:56Everything is planned so far? And then along those lines and with the LCD, there's a number of skin sub trials going on as a result of the clinical evidence requirements in that LCD we were referencing. Are you watching out for any competition for patients or kind of what are you hearing from these centers? Sorry for the multi parter. Thanks. Speaker 200:36:19So hi, Jaysh, and I hope I remember all the part of the question. Let's start with the end because this is how my memory works. We when we did the feasibility study, feasibility testing about which sites to pick, we chose sites that do not have competing trials. Having said that, we might have one trial or two competing in specific sites, but none of them can compete financially in our trial. We are much complicated trial. Speaker 200:36:52We are paying much more money for each patient per center, around $100,000 per patient, which is at least three or four times more than they are getting from simpler CTP trials. So we do not identify it as an issue. This is the last part of your question. As for the rates, we are aiming for the same rates that we had in the previous Phase two chronic study, which is half a patient per center per month. Very feasible. Speaker 200:37:25It is also based on the experience of the CRO that we are working on in this Phase III study. And it looks something that all our calculations are based on these numbers. It can be a little bit quicker, but as I said as I answered to, I think, RK, I don't we are not pushing to we are not we are focusing on the quality of the trial and not in trying to record as many patients as possible quicker because the patients are there. Did I miss any part of the patient case? Got it. Speaker 800:38:02Yes, yes. And then just kind of on the site activation side, that was all very helpful. And just on the site activation side, has everything kind of happened to plan, anything that's going better or anything that's taken a little bit longer? I know it's early days. Speaker 200:38:21Currently, we were well prepared to start the study. So we have the agreements in place and the sites are very enthusiastic and we don't see any delays. On the contrary, we are again, we started we are we just started in The United States. So at least something like 50% of the site will open only in the next couple of months. But we are in a very good place. Speaker 200:38:48And in The United States, there is a lot of enthusiasm on this specific trial. Speaker 800:38:55Good. And then just maybe one for Hany. If we think about R and D spend this year as the VLU trial ramps up, is that kind of per patient as they're enrolled the right kind of way for us to think about it and model R and D? Or are there other kind of startup expenses we should be thinking about? Maybe just kind of any way you can help us think about R and D spend in 2025? Speaker 800:39:16Thank you. Speaker 300:39:18Yes. I think that in 2025, our R and also said, per patient, the cost will be around USD100. So as we are aiming to enroll around 100 patients this year, you can do the calculation and the result is that we will the R and D cost will increase substantially compared to 2024. Speaker 800:39:55Very helpful. Thanks for the questions. Speaker 200:39:58Thank you, Chase. Operator00:39:59Thank you. And our next question comes from Michael Uphinowicz with Maxim Group. Please go ahead. Speaker 900:40:05Hey guys, thank you so much for taking my questions today. Congrats on all the good progress. Speaker 500:40:11Thank you. I guess first off, Speaker 800:40:14I'd just like to ask Speaker 900:40:15a little bit about, on the DFU study, could you talk about the rationale for partnering with CARESYS and does this replace the MIMET IX grafts or is it a different type of graft? Speaker 200:40:30So the rationale is that we want to work with the best products and we don't want to be associated with a specific advanced wound care company. So if you look at the CTP, the best data as far as we know in Venus leg Alters are mimeticses, and this is why we signed with them. And the best result that we see in diabetic foot ulcers are of kerasys coloplast. This is why we picked them. As you can imagine and based on the environment and the CPP and the LCD and the reimbursement, all of them are interested to participating in such trial to generate more data and to be used by as many sites as possible. Speaker 200:41:16So we have the ability to choose and we are happy with those specific two partners that we picked. Speaker 900:41:25Okay. And then when we look here 2025 revenue guidance, could you help us understand where that $4,000,000 in incremental growth comes from if we are expecting the EMA approval on the facility to come in early twenty twenty six? Speaker 200:41:43Yes. So as I'm saying, we do not expect to sell more NexoBrid units not substantial more NexoBrid units in 2025. There are a couple of two or three weeks more that we can manufacture due to all kinds of activation effort that we had last year. So we have a few more weeks of manufacturing. And also, we increased the price a little bit where we could, and we are shifting territories. Speaker 200:42:16There are more profitable territories. So the numbers according to the current plan, the math shows that the revenue will increase quite substantially. But again, it is still based on the same capacity, maybe another two or three weeks more and higher prices. Speaker 900:42:38Okay. Thank you very much for the additional color. Speaker 200:42:42Thank you. Operator00:42:44Thank you. This concludes our question and answer session. I'd like to turn the conference back over to management for closing remarks. Speaker 200:42:52So thank you everyone for joining us today. We enjoyed it. We look forward to continuing our dialogue and updating you on our progress during the next quarterly call. Bye bye.Read moreRemove AdsPowered by Conference Call Audio Live Call not available Earnings Conference CallMediWound Q4 202400:00 / 00:00Speed:1x1.25x1.5x2xRemove Ads Earnings DocumentsPress Release(8-K)Annual report(20-F) MediWound Earnings HeadlinesMediWound (NASDAQ:MDWD) Share Price Passes Below 200-Day Moving Average - Should You Sell?April 9, 2025 | americanbankingnews.comMediWound reports Q4 EPS (36c), consensus (61c)March 20, 2025 | markets.businessinsider.comNow I look stupid. Real stupid... I thought what happened 25 years ago was a once- in-a-lifetime event… but how wrong I was. Because here we are, a quarter of a century later, almost to the exact day, and it’s happening again. April 16, 2025 | Porter & Company (Ad)MediWound files $125M mixed securities shelfMarch 20, 2025 | markets.businessinsider.comLoss-Making MediWound Ltd. (NASDAQ:MDWD) Expected To Breakeven In The Medium-TermMarch 20, 2025 | finance.yahoo.comMediWound Ltd. (MDWD) Q4 2024 Earnings Call TranscriptMarch 20, 2025 | seekingalpha.comSee More MediWound Headlines Get Earnings Announcements in your inboxWant to stay updated on the latest earnings announcements and upcoming reports for companies like MediWound? Sign up for Earnings360's daily newsletter to receive timely earnings updates on MediWound and other key companies, straight to your email. Email Address About MediWoundMediWound (NASDAQ:MDWD), a biopharmaceutical company, develops, manufactures, and commercializes novel, bio-therapeutic, and non-surgical solutions for tissue repair and regeneration in United States, Europe, and internationally. It markets NexoBrid, a biopharmaceutical product for the removal of eschar, a dead or damaged tissue in adults with deep partial- and full-thickness thermal burns to burn centers and hospitals burn units. The company also develops EscharEx, which has completed Phase II clinical trials for the debridement of chronic and other hard-to-heal wounds; and MW005, which is in phase I/II for the treatment of low-risk basal cell carcinoma. MediWound Ltd. was incorporated in 2000 and is headquartered in Yavne, Israel.View MediWound 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 Tesla Stock Eyes Breakout With Earnings on DeckJohnson & Johnson Earnings Were More Good Than Bad—Time to Buy? 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There are 10 speakers on the call. Operator00:00:00Good day, and welcome to MediWarm's Fourth Quarter and Full Year twenty twenty four Earnings Conference Call. All participants will be in listen only mode. After today's presentation, there will be an opportunity to ask questions. Please note today's event is being recorded. I would now like to turn the conference over to Dan Ferry of LifeSci Advisors. Operator00:00:32Please go ahead. Speaker 100:00:34Thank you, operator, and welcome, everyone. Earlier today, pre market open, MediWound issued a press release announcing financial results for the fourth quarter and full year ended 12/31/2024. You may access this press release on the company's website under the Investors tab. I would ask you to review the full text of our forward looking statements within this morning's press release. Before we begin, I would like to remind everyone that statements made during this call, including the Q and A session, relating to MediWound's expected future performance, future business prospects or future events or plans are forward looking statements as defined under the Private Securities Litigation Reform Act of 1995. Speaker 100:01:19These statements may involve risks and uncertainties that could cause actual results to differ materially from expectations and are described more fully in our filings with the SEC. In addition, all forward looking statements represent our views only as of today, and MediWound assumes no obligation to update or supplement any forward looking statements, whether as a result of new information, future events or otherwise. This conference call is the property of MediWound and any recording or rebroadcast is expressly prohibited without the written consent of MediWound. With us today are Ofer Goenen, Chief Executive Officer of MediWound Hany Luxemburg, Chief Financial Officer and Barry Wolfenson, Executive Vice President of Strategy and Corporate Development. Following our prepared remarks, we will open the call for Q and A. Speaker 100:02:09Now, I would like to turn the call over to Ofer Gonin, Chief Executive Officer of MediWound. Ofer? Speaker 200:02:18Thank you, Dan, and good morning, everyone. 2024 was a pivotal year for Meriwound, marked by strong execution, significant progress in clinical development, commercial expansion and strategic partnerships. These achievements have strengthened our position, enabling us to drive continued growth and innovation in 2025 and beyond. I'll begin with EscharEx, our next generation asthmatic debridement therapy for chronic wounds. In early twenty twenty four, we reported compelling results from our head to head analysis against SANTYL. Speaker 200:02:58Currently the only FDA approved in thematic debridement product in The United States generating approximately $370,000,000 annually. The data demonstrated Escorex's superiority over SANTYL across key clinical endpoints, including higher incidence of complete debridement, faster time to complete debridement, more rapid and effective wound bed preparation and faster time to wound closure. Clinicians surveyed across diverse cursings recognize these superior clinical benefits and the substantial value they provide. In fact, recently conducted market research estimates Escorex peak sales potential at approximately $725,000,000 for its primary indications in the Sled ulcers and diabetic foot ulcers. These clinical benefits also make Escorex well positioned for upcoming changes in wound care reimbursement. Speaker 200:04:03Starting next month, Medicares new LCD policy will require full wound debridement and granulation tissue formation before covering cellular and tissue based products. This shift strengthened EscharEx's opportunity as a major commercial opportunity for our company. EscharEx now is in Phase three. We recently launched the Valu global Phase three trial to evaluate Escorex for venous leg ulcers, involving two sixteen patients across 40 sites in The United States and Europe. The co primary endpoints of the trial are the incidence of complete bright and the incidence of wound closure. Speaker 200:04:46This program is strategically derisked, building on the strong results of our Phase two studies with key modifications to maximize the likelihood of success. Modification that includes a larger patient sample size to strengthen statistical power and interim analysis at sixty five percent enrollment, allowing for adaptive adjustment and standardized treatment protocols to minimize variability and ensure consistency. It is also important to note that EscharEx shares the same active pharmaceutical ingredient as NexoBrid, which is FDA approved for a nearly identical indication, Eschar removal. The interim assessment, a significant milestone is anticipated in mid-twenty twenty six with full trial completion expected by year end 2026. To further strengthen our BLA submission and enhance commercial readiness, we are planning a 45 patients randomized prospective Phase two head to head comparison of EscharEx versus collagenase scheduled to begin in 2025. Speaker 200:05:58This study will include both Santill and the European collagenase product EvuXol generating critical comparative data that will be instrumental in our market access and pricing strategies. The VLU program is supported by strategic research collaborations with leading wound care companies, Solventum, Molneke and NEMEDIX. These partners will provide advanced wound care products for our trials, ensuring optimized patient outcomes and standardized wound management across all sites. Additionally, earlier in 2024, we secured EUR 16,500,000.0 in funding from the European Innovation Council to accelerate the development of EscharEx for the diabetic foot ulcers. The Phase twothree DFU clinical trial is planned for 2026 and we are pleased to announce a new strategic research collaboration agreement with Kerasys, a subsidiary of Coloplast to support this effort. Speaker 200:07:07Kerasys, which is a global leader in wound care solutions will be supplying its fish skin graft for active closure in this trial. Additionally, we anticipate securing another collaboration with a major industry leader to supply their market leading advanced wound care dressings. With these partnerships, MediWound will be working alongside all the relevant key players in Advanced Wound Care, reinforcing our strong industry positioning. Now let's move to NexoBrid, our innovating enzymatic therapy for severe burns. Before we discuss our progress with NexoBrid, I want to take a moment to highlight its critical real world impact. Speaker 200:07:56This past weekend, a devastated night club fire in North Macedonia claimed fifty nine lives and injured at least one hundred and fifty five people. A medical delegation from Israel equipped with NexoBrid immediately flew in to provide support and treatment. We are grateful that NexoBrid could play such a vital role in this strategy. With that said, in 2024, we achieved significant progress in expanding NexoBrid's commercial reach, generating annual revenue of $20,200,000 driven by robust global demand. Moving forward, we anticipate continued strong growth with projected revenue of $24,000,000 in 2025, capped only by our manufacturing capabilities. Speaker 200:08:51This growth will be driven by expanding sales in key markets. Europe, where NexoBrid is now available in more than 90 burn centers. Japan, where our partner, Kaken Pharmaceutical, has achieved a remarkable adoption with 400 plus medical facilities using NexoBrid and The United States, where very strong commercialization efforts yielded a 42% increase in hospital orders in Q4 twenty twenty four. ExoBrid market's potential was further expanded with FDA approval for pediatric patients newborn to 18 years old. The pivotal Phase three pediatric study data supporting the approval were recently published in Burns, the peer reviewed journal of the International Society for Burns Injuries. Speaker 200:09:46Another potential indication expansion emerged during the Israeli Hamas war, where dozens of patients with vast injuries were treated with NexoBrid. The outcomes were remarkable and the data from these cases will be presented at the upcoming American Burn Association Conference. Additionally, we reported positive results from the expanded access protocol, NEXT, which evaluated two thirty nine patients across 29 U. S. Burn centers. Speaker 200:10:17The study confirms NexoBrid's safety and efficacy in eschar removal as well as its significant reduction in the need for surgical procedures for burn patients. Operationally, we successfully completed the construction of our state of the art GMP manufacturing facility, which remains on track to reach full operational capacity by late twenty twenty five. Commercial availability will depend on regulatory approvals from FDA EMA, which are expected in 2026. This facility will significantly expand our production capabilities, allowing us to meet the growing demand the growing global demand and sustain long term revenue growth. This year, we also strengthened our balance sheet with a strategic $25,000,000 pipe financing round led by Molnicki. Speaker 200:11:13This reflects industry confidence in our strategy and provides additional resources to execute our clinical and commercial growth plans. With a robust cash runway of approximately $44,000,000 MediOne is well positioned to deliver on its critical clinical operational and commercial objectives. Now I'd like to turn the call over to Hany to review our financial performance in greater detail. Speaker 300:11:43Thank you, Ofer, and good morning, everyone. I'll now take you through our financial results for the first quarter and full year of 2024. Starting with the fourth quarter, we reported revenue of $5,800,000 compared to $5,300,000 in the same period last year. Gross profit came in at $900,000 with gross margin of 15.5%, up from $700,000 and a 13.5% margin in Q4 twenty twenty three. R and D expenses were $3,000,000 compared to $1,800,000 in the prior year quarter, primarily due to cost related to the Escorex Value Phase III trial. Speaker 300:12:34SG and A expenses totaled $4,000,000 compared to $2,800,000 in Q4 twenty twenty three, mainly reflecting higher share based compensation expenses. This resulted in an operating loss of $6,100,000 compared to 3,900,000 last year. Net loss for the quarter was $3,900,000 or $0.36 per share compared to $1,700,000 or $0.19 per share in Q4 twenty twenty three. On a non GAAP basis, adjusted EBITDA loss was $4,900,000 compared to $3,200,000 in the same period last year. Now moving to full year, we reported total revenue of $20,200,000 compared to $18,700,000 in 2023. Speaker 300:13:33The increase was primarily driven by higher revenue from Vericel, a new contract with the U. S. Department of Defense. Gross profit for the year was $2,600,000 with a gross margin of 13% compared to $3,600,000 and a 19.1% margin in the prior year. The decline was mainly due to changes in revenue mix and higher fixed costs associated with scaling our production. Speaker 300:14:08R and D expenses came in at $8,900,000 compared to $7,500,000 in 2023, primarily due to costs related to Esperance Value Phase three trial. SG and A expenses were $13,100,000 compared to $11,600,000 in 2023, mainly reflecting higher share based compensation costs. Our operating loss for the year was $19,400,000 compared to $15,300,000 in 2023. Net loss for the year was $30,200,000 or $3.03 per share compared to $6,700,000 or $0.75 per share in the prior year. The $23,500,000 increase was primarily due to financial expenses, mainly from the revaluation of warrants following a 75% increase in our share price in 2024. Speaker 300:15:18Non GAAP adjusted EBITDA loss for the year was $40,800,000 compared to $12,300,000 in 2023. Turning to balance sheet, we ended the year with $43,600,000 in cash, cash equivalent and deposit compared to $42,100,000 at the end of 2023. During the year, we successfully raised $25,000,000 through pipe offering, received $1,200,000 from the exercise of Series A warrant and secured $1,200,000 grant from the European Commission. We also fully settled our liability with Teva. In total, we used $22,900,000 to fund operation, including $6,800,000 allocated to capital expenditure, primarily for scale of our manufacturing facility. Speaker 300:16:22That concludes my financial review offer. Back to you. Speaker 200:16:28Thank you, Hany. So in summary, 2024 was a transformative year for Meriwound defined by significant clinical, commercial and strategic achievements. Our strong execution, expanding pipeline and key partnerships position us for sustained growth and long term value creation. As we continue to advance our programs, expand market adoption and drive innovation, our focus remains on delivering meaningful improvements in patient care. We look forward to providing further updates in our progress in the coming quarters. Speaker 200:17:06And with that, I will now turn the call back to the operator to open the line for questions. Operator? Operator00:17:12Thank you. Yes, sir. We will now begin the question and answer session. You. Today's first question comes from Josh Jennings at Cowen. Operator00:17:29Please go ahead. Speaker 400:17:31Hi, good morning. Good afternoon. Thanks for taking the questions and congratulations on the initiation of the value study. Appreciate all the review of the trial design and the path forward. One follow-up was you have some powerful wound care collaborators in this study, so that's the molecule, MiMedix. Speaker 400:17:54And I was just wondering, what is outside of supplying their wound care products for the study, what else are they doing in terms of enhancing study execution? Just wanted to get that under our belt. Speaker 200:18:10So hi, Josh, and thank you for the question. Barry, do you want to address it? Speaker 500:18:15Yes. Thanks, Josh, for the question. Generally speaking, having standardized products across these three key categories, the moist wound dressings, the compression bandaging and the tissue substitute will help just to make sure that all variability is minimized throughout the study, which of course will optimize the outcomes. As far as the companies themselves are concerned, aside from the products that they'll be supplying, they'll also be supplying training. So in fact, this weekend in Philadelphia, we have our investigators meeting and there'll be training of all the sites. Speaker 500:18:54Those companies will be involved and on an ongoing basis, if there are any questions related specifically to their products, they'll provide that education and training. Speaker 400:19:06Excellent. Thanks for that. And wanted to ask about the DFU study expected beginning 2026, maybe funding is Operator00:19:16in Speaker 400:19:16place. There's two part question. I mean, one, should we expect it to be a global trial with the EU funding similar to the VLU study, the value study? And then two, maybe just outline what's required in just a similar pathway that you took for VLU in terms of getting trial design approved by the FDA and EMA. Love to just hear you walk us through that again, sorry to make you review it. Speaker 200:19:50So the Phase three study with DFU patients will be as close as we can to this Phase III study of the VLU patients. The only difference is that we have less data that we have for VLU patients. So in order for the agencies to agree to that structure of the study, we need to get their sign off. Our plan is to approach both FDA and EMA in the second half of this year with a protocol that is based on the data that we have to date. We have a few dozens of patients that we treated with DFU patients and the data looks basically similar to what we have with BVU, but we need to have it approved. Speaker 200:20:41This is why when we guide about the study, we say a Phase II, III study because maybe we need a kind of an interim assessment and shift into a Phase III down the road. Having said that, we need to get clearance from the agencies before we can give a lot of details. Our thoughts about how the study will look like is currently posted on our website, and it looks quite similar to the VFU trial. With this trial, we will also have strategic collaborations, the same as we have with the VLU trial, but it will be with different partners. Speaker 400:21:21Excellent. And just one last one on NexoBrid. As I've made great progress in terms of doing the RTMP manufacturing facility in place and ramping up capacity this year. I understand that regulatory approvals are necessary for product to be commercially available, which is when is the earliest that regulators can get in to, I guess, do the inspection and move forward with clearance? I know you you don't have any control over the timing, but when is the earliest that they could start that process? Speaker 400:21:56And it sounds like you're expecting approvals in 2026. Speaker 200:22:03So currently, our guidance for the revenue are reflecting the fact that we will get in the beginning of twenty twenty six approval in Europe. And by mid-twenty twenty six, we'll get FDA approval. The thing that we need to have in place in order for those approval to take place is that we need to make sure that we are able to manufacture product with the same quality and the same characteristic of the current manufacturing facility that we have, which is quite smaller. After we finish proving that we can do the same, we need to manufacture a few batches of both MexoBrid for The United States and for Europe. Europe demands three months of stability after that, that they can come for an inspection. Speaker 200:22:56This is why we expect the European approval to be earlier. And the U. S. FDA, the guidelines is that we need to wait six months of stability. So these are the timelines and this is why we guided in the beginning and in the middle of 2026 both approvals. Speaker 400:23:16Thanks, Sophie. Thanks, Barry. Appreciate it. Speaker 200:23:20Thank you. Operator00:23:22And our next question today comes from Francois Brisebois with Oppenheimer. Please go ahead. Speaker 600:23:28Hi. Thanks for the questions and congrats on the progress this year in 2024. I was just wondering if you can touch base, you started your call talking about the Medicare update. Can you just remind us when that came in place and how just a little more color on how do you think that is a positive for MediWound? And then the second question is more on the interim analysis. Speaker 600:23:50Just a reminder, I think you mentioned it on the timing of that for the trial, the Phase three and what are the different kind of outcomes that can come out of this interim analysis? Thank you. Speaker 200:24:03Okay. Thanks for your question. Barry, can you step in to address the first question and I will answer the interim assessment one? Speaker 500:24:11Sure, of course. So with regard to the Medicare question, recently as you're likely aware, the seven local MACs, the Medicare administrator contractors posted final changes to what's called an LCD, a local coverage determination policy related to the usage of cellular and or tissue based products, CTPs. This category has exploded in the last several years to as high as $3,000,000,000 in The U. S. And while several dramatic changes were written into the draft policy, as it turns out, the final policy ended up not really too different than the current one. Speaker 500:24:51This new policy becomes active in less than a month on 04/13/2025. One key change is the slight limitation on the number of applications of tissue that could be put in place on a patient during one complete episode. That number has gone down from 10 previously to four, but it does have the ability to do an additional four if the wound situation warrants additional applications. And for these additional four, the sites must complete some additional paperwork, but that extra work is not deemed to be too time consuming to keep them from doing so. That's the bigger change that the industry will focus on. Speaker 500:25:31From a MediWound perspective and how it relates to EscharEx, another meaningful change from this new LCD is the increased attention to documentation required showing that the wound is completely debrided and covered in granulation tissue prior to application of any tissue substitute to the wound. And given that this is what EscharEx does so well, it debrides and it gets wound bed the wounds prepared, this will position our drug as the optimal product of choice when surgery or sharp debridement is not deemed to be the best option. Speaker 200:26:10Okay. Barry, I have nothing to add to that. Thank you for answering. As for the interim assessment, as I said in my prepared remarks, this program is strategically derisked. Many of them succeeded in 14 out of 14 clinical studies, and we have no plans to fail in the most significant study that we are conducting. Speaker 200:26:35So we plan an interim assessment after sixty five percent of the patient in the study, which is one hundred and forty patients, are treated. And there are two outcomes to this assessment. One, ninety percent there is a ninety percent probability of success. The ninety percent power for success is maintained. And in this case, we are stopping the enrollment of the study. Speaker 200:27:02By then, more than 200 patients will be already included in the study. And then we just are waiting for the follow-up and the study is done. If we see that the likelihood of success is less than ninety percent, let's say, seventy seven percent, we have some flexibility in the protocol to include additional few dozens of patients in order to maintain the ninety percent probability of success. If everything goes as we planned, the interim assessment should be by mid-twenty twenty six and the study completion, assuming that ninety percent probability of success is maintained, the study completion is by the end of twenty twenty six. I hope I answered the question. Speaker 600:27:52Yes. Thank you. Speaker 100:27:55And Operator00:27:57our next question today comes from RK from H. C. Wainwright. Please go ahead. Speaker 700:28:02Thank you. Good afternoon, Ofer and Hany and good morning, Barry. A couple of questions. Barry, thanks for explaining the LCD, the new LCDs that was it's going to become official in a month. So based on what you're saying regarding the granulation of the tissue, is there a way you at least if you can compare for us how SANTINEL performs versus what we should expect from EscharEx? Speaker 700:28:44And based on that, does EscharEx has potential to be better than what Sartanel does right now? Speaker 200:28:56So Barry, do you want to address it? Speaker 500:28:59Sure. Well, a couple of things. Firstly, and thank you, RK for the question. As you know, we announced the results from this head to head Phase two study earlier this year and EscharEx was shown above Santel in all the key endpoints, whether that was time to complete debridement, incidence of clip to complete debridement and also time to wound closure. With regard to the so right there off the bat, if you're a treating physician and you have a wound that comes in and you want to get towards a CTP for active closure, you're going to know that the data suggests that, EscharEx can get to that CTP within only a couple of weeks, that the average is going to be five to six applications within a couple of weeks and the published data, even outside of for Santo, even outside of our Phase II analysis suggests that it's more along the lines of six to eight, if not even more weeks. Speaker 500:30:17So there's going to be an incentive to use EscharEx because it will get to that CTP application much, much more quickly than would Santel. Speaker 700:30:30Thank you for that. And then, Ofer, a quick question on the VLU, the ongoing VLU study. Is there any possibility for this study to enroll quicker than expected so that we can expect data earlier, whether it's the interim or the final complete data set later next year? Speaker 200:31:02Yes. So hi, Alke, and thank you for this question. It's a great question because I was asked about it again and again by my board yesterday. I wouldn't expect a quicker enrollment. That many patients, we are in the largest centers in The United States and Europe, there are a lot of patients that are available, but we are making sure that we are recruiting the right patients. Speaker 200:31:26I want patients with real chronic wounds. I don't want patients with a wound which is not that severe, and even a placebo will do something. So we're spending a lot of time and a lot of effort in screening and making sure that no patient is getting into the study unless he has a real chronic wound, a real heart rate wound because our intention is that placebo will do nothing to it. I don't mind waiting another month, another two months. I'm not incentivizing centers to recruit as many patients as they can as quickly as they can. Speaker 200:32:06On the contrary, I'm just making sure it's a very lucrative study. Everyone wants to get to be treated with ancillaries that we are getting, the most expensive dressings, the most effective pressure garments. We know that we will have there is a lot of demand to participate in this trial. Our motivation is to make sure that it is done adequately, and I would not expect quicker enrollments. Speaker 700:32:38Okay. Thanks for that. And then on the collaboration with BARDA, in terms of identifying a new S facility and trying to plan and design a facility in The United States. What is the status there? And also can you give us any color as to how you're going to manage these big projects like you just got done with the Israeli facility? Speaker 700:33:13And what's the timeline if you so decide and identify a specific site in The United States and how does it play into the expansion of NexoBrid from what you're yet to accomplish that's already been signed up for? Speaker 200:33:41So the facility in Israel that is going to be in full capacity scale by the end of this year and getting the approval by mid next year, we will have there the capacity to support the foreseeable market of NexoBrid both in The United States and globally. Having said that, the U. S. Government recognized the need to having a backup facility in The United States. So we are now in a pool, so we got some funding to identify a location, an ID location for such a facility. Speaker 200:34:20We are planning such a facility. We are having additional indications such as the temperature stable formulation and additional indications that we are working on that this facility will need to support. So we have the funding for that. Hopefully, by the end of this year, we will know exactly what is required in order to finalize building such a facility. I would expect a three year effect. Speaker 200:34:53It will not have any impact on our revenue guidance because we are speaking now on twenty twenty seven, twenty twenty eight. But we will have a Speaker 400:35:04lot Speaker 200:35:04of additional capacity either to manufacture more Escorex or to manufacture the military use indication, etcetera. So it's a project which is very important for us, but it won't have any impact on the next four years other than getting funding from the U. S. Government. Speaker 700:35:25Perfect. Thank you very much. Thanks for taking my questions. Speaker 200:35:28Thanks, RK. Operator00:35:30And our next question today comes from Chase Knickerbocker with Craig Hallum. Please go ahead. Speaker 800:35:37Good morning. Thanks for taking my questions. Just a couple on the VOU study around enrollment. So can you just kind of queue us in on what you're hearing from prospective centers as far as what they think enrollment rates that are feasible are? And then how are the early site activation activities going? Speaker 800:35:56Everything is planned so far? And then along those lines and with the LCD, there's a number of skin sub trials going on as a result of the clinical evidence requirements in that LCD we were referencing. Are you watching out for any competition for patients or kind of what are you hearing from these centers? Sorry for the multi parter. Thanks. Speaker 200:36:19So hi, Jaysh, and I hope I remember all the part of the question. Let's start with the end because this is how my memory works. We when we did the feasibility study, feasibility testing about which sites to pick, we chose sites that do not have competing trials. Having said that, we might have one trial or two competing in specific sites, but none of them can compete financially in our trial. We are much complicated trial. Speaker 200:36:52We are paying much more money for each patient per center, around $100,000 per patient, which is at least three or four times more than they are getting from simpler CTP trials. So we do not identify it as an issue. This is the last part of your question. As for the rates, we are aiming for the same rates that we had in the previous Phase two chronic study, which is half a patient per center per month. Very feasible. Speaker 200:37:25It is also based on the experience of the CRO that we are working on in this Phase III study. And it looks something that all our calculations are based on these numbers. It can be a little bit quicker, but as I said as I answered to, I think, RK, I don't we are not pushing to we are not we are focusing on the quality of the trial and not in trying to record as many patients as possible quicker because the patients are there. Did I miss any part of the patient case? Got it. Speaker 800:38:02Yes, yes. And then just kind of on the site activation side, that was all very helpful. And just on the site activation side, has everything kind of happened to plan, anything that's going better or anything that's taken a little bit longer? I know it's early days. Speaker 200:38:21Currently, we were well prepared to start the study. So we have the agreements in place and the sites are very enthusiastic and we don't see any delays. On the contrary, we are again, we started we are we just started in The United States. So at least something like 50% of the site will open only in the next couple of months. But we are in a very good place. Speaker 200:38:48And in The United States, there is a lot of enthusiasm on this specific trial. Speaker 800:38:55Good. And then just maybe one for Hany. If we think about R and D spend this year as the VLU trial ramps up, is that kind of per patient as they're enrolled the right kind of way for us to think about it and model R and D? Or are there other kind of startup expenses we should be thinking about? Maybe just kind of any way you can help us think about R and D spend in 2025? Speaker 800:39:16Thank you. Speaker 300:39:18Yes. I think that in 2025, our R and also said, per patient, the cost will be around USD100. So as we are aiming to enroll around 100 patients this year, you can do the calculation and the result is that we will the R and D cost will increase substantially compared to 2024. Speaker 800:39:55Very helpful. Thanks for the questions. Speaker 200:39:58Thank you, Chase. Operator00:39:59Thank you. And our next question comes from Michael Uphinowicz with Maxim Group. Please go ahead. Speaker 900:40:05Hey guys, thank you so much for taking my questions today. Congrats on all the good progress. Speaker 500:40:11Thank you. I guess first off, Speaker 800:40:14I'd just like to ask Speaker 900:40:15a little bit about, on the DFU study, could you talk about the rationale for partnering with CARESYS and does this replace the MIMET IX grafts or is it a different type of graft? Speaker 200:40:30So the rationale is that we want to work with the best products and we don't want to be associated with a specific advanced wound care company. So if you look at the CTP, the best data as far as we know in Venus leg Alters are mimeticses, and this is why we signed with them. And the best result that we see in diabetic foot ulcers are of kerasys coloplast. This is why we picked them. As you can imagine and based on the environment and the CPP and the LCD and the reimbursement, all of them are interested to participating in such trial to generate more data and to be used by as many sites as possible. Speaker 200:41:16So we have the ability to choose and we are happy with those specific two partners that we picked. Speaker 900:41:25Okay. And then when we look here 2025 revenue guidance, could you help us understand where that $4,000,000 in incremental growth comes from if we are expecting the EMA approval on the facility to come in early twenty twenty six? Speaker 200:41:43Yes. So as I'm saying, we do not expect to sell more NexoBrid units not substantial more NexoBrid units in 2025. There are a couple of two or three weeks more that we can manufacture due to all kinds of activation effort that we had last year. So we have a few more weeks of manufacturing. And also, we increased the price a little bit where we could, and we are shifting territories. Speaker 200:42:16There are more profitable territories. So the numbers according to the current plan, the math shows that the revenue will increase quite substantially. But again, it is still based on the same capacity, maybe another two or three weeks more and higher prices. Speaker 900:42:38Okay. Thank you very much for the additional color. Speaker 200:42:42Thank you. Operator00:42:44Thank you. This concludes our question and answer session. I'd like to turn the conference back over to management for closing remarks. Speaker 200:42:52So thank you everyone for joining us today. We enjoyed it. We look forward to continuing our dialogue and updating you on our progress during the next quarterly call. Bye bye.Read moreRemove AdsPowered by