Q4 2019 Earnings Call
Excuse me everyone and thank you for your patience and holding today's conference call will be getting that materially. Please remain on the line.
Thank you for your patience in holding today's conference call will be getting momentarily. Please remain on the line.
[music].
Good day and welcome to the Stemline Earnings Conference call. Today's conference is being recorded at this time I would like to turn the conference over to can't Hoberman. Sir. Please go ahead.
[laughter]. Good morning, Thank you for joining us trying to try and shift [laughter] todays has is called [laughter] with me on todays call.
[laughter] I didn't work, you're not Chief Executive Officer, David You know, our Chief Accounting Officer, [laughter] remarks, well open the call to take your question.
I'm wondering maybe [laughter] missionary certainty.
Actual results could differ materially [laughter] detailed description of these recently started in the forward looking statements from these factors friction.
For a form 10-K sort of your ended December 31st where that gene.
Yes. Thank you [laughter] now I'll turn it over the call to ours. It works you don't see no Ivan the floor is yours.
Thank you Ken and good morning, everyone.
I Hope and trust everyone is doing they're up most to keep yourself you family friends and colleagues they community base it's possible.
Uncertainty.
These big issues facing the saw it almost seems trivial to have this call.
But as Pete T. Barnum was famous for saying the show must go on.
With that.
Let me distract us for a brief moment.
Serious macro issues. It can throw a mine you that 2000 Tonight. He was a tremendous year stem line as we launch celadon was the first PD ones, where I see targeted agent Evercore.
Got it was on the market and generating revenue coupled with our strong balance sheet you built a strong foundation from which to grow as a company.
This includes aggressively pursuing growth opportunities federal dollars, both within and beyond yen, including expanding the potential utility of those honestly, an additional CD one slightly positive indications.
And we look forward to trial updates in data read out some indications, including G.M.L. chronic myelogenous leukemia, and last myelofibrosis and email acute myeloid leukemia, including in CD 123 enriched population.
Later, this year and honestly next year.
Ultimately, we see all donerson potentially global product.
Has the multiple approved indications, including a possible target label and in parallel we continue to advance our pipeline of additional agent, namely our novel and differentiated XP. One inhibitor. So you know one currently in phase one trials of advanced solid tumors Asian, and Latin handler.
Panel one currently slot of to answer Phase one trial next year.
Overall, we believe that with this multi pronged approach and solid balance sheet, we are setting ourselves up for the potential for significant growth and success, which that I will now turn the call over Robert Saccomano, Our Chief commercial officer.
I detailed on the launch and overall commercial by Robert.
Thank you I've been.
In the fourth quarter net sales of Elds honors totaled $11.8 million contributing to the full year 2019, net revenue of 43.2 million.
We're pleased with a solid uptake seen in the first year old El Sonorous commercial launch what are set squarely focused on continuing to successfully create grow and penetrate this new P.D.C.N.U.S. market.
Building upon the launch initiatives, we enacted last year, we have instituted the number of new strategies and tactics that focus our efforts in two key areas.
First we are laser focused on increasing brand uptake among the correctly diagnosed the P.D.C. and patient.
And second to substantially improved disease diagnosis skill sets in the market, while reducing misdiagnosis rights together, we expect to further expand the BDC and market.
Going into more detail on the first bucket further penetrating the correctly diagnosed patients segment, we are implementing three new initiatives.
First is the enhancement of patient targeting an identification efforts [laughter] de leveraging of the most recent claims data we expect to identify patients earlier in their journey, which will lead to improved efficiency and deployment of our field force and resource.
Second is to expand prescriber base to be a targeted a precise customer engagement.
But the utilization of new data, we can judiciously engage not only the most influential targets face to face, but expand or reach into new market segments. This will lead to an increased efficacy of our field force.
Third and one that we are very excited about it.
So expand treatment rates withheld on unrest in the community setting.
New partnerships with oncology networks and group purchasing organizations, we believe the community market segment will be receptive to further diagnosing and treating baby do you see a patients that in the past may have been refer it elsewhere.
An attractive byproduct of this expansion will be the reduction of our 340 be discount exposure, which should enhance net revenue.
Shifting to the second growth bucket substantially improving disease diagnosis skill sets in the market, while reducing misdiagnosis rights.
We will first implements a new focused on diagnostic labs to increase diagnostic proclivity in diagnosis rate.
It should yield reduce misdiagnosis, while keeping BB D.C.N. and see do you want to 23 top of mind.
Our efforts will further enhance the being perhaps what being acting up lab alerts pathologists clinical limitations and Taylor disease State education.
Second in starting within the next few weeks, we will roll out they diagnostic sales team this new and highly experienced team will mainly target diagnostic labs across the U.S. and allow us to more broadly interact with a very important health care practitioner.
We firmly expect there's two advanced see do you want 23 testing and B B D C N awareness.
Lastly for this bucket as to more deeply study the baby D.C. and patient journey be a new claims data analysis.
The latest claims data will allow us to better characterize market and patient demographics and the misdiagnosis segment. As you would expect this will also aid and further penetrating the BDC an observer population.
We expect us to lead to improved early diagnosis and transition more BBCN diagnosed patients to BELSOMRA starts of course within label.
We fully expect that these new strategies and tactics will start to benefit the growth trajectory later, this year and into the foreseeable future.
Shifting to other key data points that we disclosed earlier this month acutely a recently conducted analysis of the 2018 medical claims data that was very supportive of our previously reported estimates of the U.S. market size based on disease incidents.
And it I can be found 534 unique patients that had at least one medical claim consisting of the plastic NK cell lymphoma diagnosis.
Specifically, referring to the I see take I C. D 10 diagnostic hold of see 86.4 as many of you know plastic NK cell lymphoma is the former name up BBD. So yeah.
There are few important takeaways from this data.
First this number could represent an annual minimum incidents given the data capture rate is only about 30% to 50% of all medical claims.
Additionally, this number does not include the inpatient setting misdiagnosed store on diagnosed patients.
We believe this dataset paves the way for deeper understanding of this burgeoning market.
Quoting patient journey presentation manner, geography, diagnosis and treatment patterns.
All of these combined initiatives, which I just touched on are likely to help inform my market approach tomorrow optimally penetrate the BDC and market.
Beyond the U.S., we're looking forward to potential commercialization in Europe, where we continue to build the appropriate corporate infrastructure in preparation of a possible approval in the second half of 2020.
Our March 5th we met with the European Medicines Agency Scientific Advisory group to discuss the track so fast clinical data in patients with BBCN.
Aspects of benefit risk, such a safety and efficacy as well as other elements pertaining to the marketing authorization application procedure where discussed.
After the meeting and look forward to receiving the final beating minutes.
Overall, we're pleased with L. dahmer stopped taking 2019, but not that much work remains to be done.
Our commercial medical affairs teams are well positioned and prepare to execute on all of these new initiatives.
This approach reflects our commitment to helping BP DCM patients receive a rapidly correct diagnosis and ultimately.
Okay. The best treatment for their disease again, we see ourselves in a marathon, but one that we believe we are well equipped to win.
At this time I'd like to turn the call over to stem lives Chief Accounting Officer, David You Alco David.
Thank you Robert our fourth quarter results can be found in the press release that we issued on Friday evening, which I will summarize.
Stemline ended the fourth quarter with $164.4 million in cash cash equivalents and short term investments, reflecting net cash expenditures of $10.1 billion during the quarter.
Research and development expenses were $10.5 million for the fourth quarter up 29 team.
Which reflects a decrease of $1.6 million compared with $12.1 million for the fourth quarter up 28 T.
The lower expenses are primarily attributable to higher costs incurred during the fourth quarter 118 related to the Elds onwards, BLE filing and manufacturing abeles on merus prior to the F.D.A. approval.
Selling general and administrative expenses were $16.5 million for the fourth quarter up 29, tea, which reflects an increase of $1.6 million compared with $14.9 million for the fourth quarter up 2080.
The increase in costs were primarily attributable to ongoing U.S. launch expenses for Eletrobras and prelaunch Els on related costs in support of a potential regulatory approval and launch in the European you.
The company ended the fourth quarter 2019, with 50.3 million shares outstanding.
I will now turn the call back to Ivan Bernstein, our CEO for concluding remarks Ivan.
Thank you David again, we remain very pleased with the continued progress that mine is making both in the market.
Selling efforts that span honestly its potential utility both within and beyond BBCN as well as with the progress we've made with the overall pipeline and we're looking forward to building upon the strong foundation moving forward.
Here at stem line really driven by a mission.
Improved lives and patients with cancer I would like to take this opportunity. Thank all patient physician health care professionals and all the outstanding employing some line their dedication and passion and making a difference in patient lives and again recognizing the unprecedented macro events. We are now all see corona buyer.
Yes, and uncertain market.
It's their money, which you all know from Keith.
We're all in this together.
Let me, let me remind that we have wont chosen health care is off the fashion not by accident.
Of course, we all share the common goal a battery in time.
And it is our industry, which all of US playing into the world, which will lead the way to count going to school and Dan.
With that I'd like to open the call for questions.
Thank you Sir.
I would like to ask a question. Please signaled by pressing star one on your telephone keypad.
If you're using its speakerphone. Please make sure your mute function is turned off to a blocker signaled to reach our equipment.
Again, Please press star one to ask a question.
Well pause for just a moment to allow everyone the opportunity to signal for questions.
Our first question will come from Jessica Fye with JP Morgan.
Hi, good morning, and thanks for taking my question just a couple and thanks for the third quarter, you provided a quarter over quarter growth in new patient starts can you provide that for the fourth quarter and second one is with the diagnostic sales teams central roll out in the uniques I'm individuals without him.
And should we anticipate any disruptions of planned rollout in light of eat outbreak mitigation efforts things.
Robert you want to take those.
Yes, certainly a good morning, just the.
Indeed, where you saw for the fourth quarter based.
Think about what we did in third quarter based on then what we saw in the fourth quarter. There was roughly about a 30 or 33% decrease in new patient starts.
So that should answer that question.
As far as the the diagnostic sales liaisons rollout I think it's safe to say that what what is going to happen in the foreseeable future I couldn't indeed have some sort of impact.
With the starting up a of this new liaison team and going through training and targeting a lot of that work in the beginning is is a is busy work and studying and preparing a no <unk> strategies and plans so.
Depending on how long this the cold it'll corona virus situation entails it could potentially affect that rolled up but but we do have in places are complete strategies for advancing business needs to the best of our abilities, while minimizing face to face interactions.
The approach that we are taking is 100% the inline and consistent with a with industry norms.
Great. Thank you.
You're welcome.
Thank you. Our next question comes from Boris Peaker with Cowen.
Oh, good morning, I, just want a probe a little bit further on the new patient starts you mentioned in Fourq two versus Threeq. You can you comment exactly what was driving that those dynamics.
What what as far as the 30% or 33% reduction in patient starts or other dynamics force. That's what I meant in any decline in patient starts yeah.
Yeah, I think it's it's it's pretty much of the consistent story that we we relate in the past that what we see it is in this this disease state certainly, but the small land that were finding is that.
The patients are presenting or getting diagnose and transitioning tell bombers starts with really no rhyme or reason that traditional choppiness that we've been characterized quite well over the past. Many many months. So I think it's just a byproduct of that so we we firmly believe then and continually the data we we.
Receive supports the premise that the patients are going to present per per our our wishes. If you will or that basis on the number of they'd be incident population, but oh, we look back and see their presentation rate on a on a yearly on a yearly basis, rather than a quarter on quarter. So when I I assume back and looked at 29 team.
Oh, we are very happy with the number of patients we.
We were able to transition to an l. dawn Russ start or less concerned honestly with with quite a quarter to quarter to quarter dynamics.
Gotcha I just another question on my last question from term in terms of patient treatment, what fraction of actual BBCN patients into being treated.
Their diagnosing positions on what fraction.
The physician actually send it to somebody else and essentially lose the patient.
Yeah.
I don't have all of the answers, but I can give you some some thoughts on what we we are.
Our assuming based on data first and foremost I had mentioned in the prepared comments that we are a in the process of conducting a patient journey.
Research piece that will look at the claims data and give us more precise insights into that question. So what I I. My my standard answer there was that will be oh kind of wait for us to report on that when we see those results honestly, we don't know how many years just if you look at the history of the disease. It makes.
A very.
Strong argument that many of these patients which are coming through the the derm to the term path channel arc AAT Misdiagnose first and foremost and then if they are lucky enough to get a correct diagnosis, they're being there being seen buying hey, Mark and then and then diagnosed and treated.
That probably is the lions share of the patient. So I can't give you an exact number on on how that happens, but that's there's still a significant amount of miss diagnosis and an under diagnosed as we've done a great job improving that over the last year with a with the efforts of stem line and then even prior to that without disease awareness.
The B actually a data if you compare that versus the.
Persons the sphere database from a couple of years ago. It you can clearly see a growth and the diagnosis up this disease, we certainly feel that that's at the handlebar work since nobody else is really focusing on this disease state. The way we are up but at this point until we get some further clarity on these other analyses of the recent claims Dave I can't tell you precise.
Numbers force.
Great. Thank you very much for taking my questions.
Thank you.
Thank you. Our next question will come from Matt Kaplan with Ladenburg Thalmann.
Hi, Good morning, guys I'm, just wanted to dig in a little bit more to the acuvue data or I guess in terms of you indicated really the Tigers 34 patients with the code and see 86 got for and at that diagnosis.
But could represent a an annual minimum or what's your thinking now in terms of what the kind of more accurate number is now in the U.S. and potentially in Europe from from this and looks like study that excuse me a complete.
Yeah, Matt I think I think we're going to stick with the same you know the same numbers that we've been saying consistently that we feel that the U.S. market as a minimum of 500, but could certainly be north of bad what we really need to do is installed so we're going to stick with that number right now, which I think as everybody knows that is.
It's certainly a barry.
Good opportunity for Stemline barrels on risk.
Certainly given the price points.
As we look at the actually will be a date and once again I'll read I'll refer back to the greater analysis that we're undertaking.
We would expect that that if you look at the capture rates of the data and and and misdiagnosis and the patient journey that we seek to understand further is that.
It.
This really could only be that the tip of the iceberg what were more likely to understand them is is the really the presentation and the diagnosis of the disease, where are we seeing these patients I'm most likely get misdiagnosis, where are they misdiagnosis what are they getting misdiagnosis Miss diagnosed with and then ultimately the ones that arc.
Correctly diagnosed with BBCN, where are they presenting and hopefully where are they getting treated and all of these insights art art I believe are gonna be pretty close at hand once this up what's these latest analyses.
Bear fruit, but we'll have a pretty decent projection and and understanding of that in short term, but not quite.
Quite yet ready to to give any answers there.
Okay Fair enough. Thank you and then just on the diagnostics team, we're well your initial focus the government or impact on the hemo false area, where do you think that the largest amount of misdiagnosis is occurring at this point.
The current data and that shows that the they the the largest amounts of work that needs to be done would be on a dramatic pathologist of course that is not in an indictment on on their good work just a byproduct of of of the work flow. If you will so we would expect bad.
The the targeting which will of course use metrics and data that we have will focus on both the dramatic pathologists the amount of pathologist and as mesas Ariad the general pathologists, but we'll focus on those pathologists, mostly in those and those labs that or are you seeing the bulk of these both.
Because these tissue samples.
The diagnostic sales leaders on can then I'm, probably the bread crumbs, if you will and go to outside.
Sources or other laboratories them based on the needs of the business, but but in short answer yes, I would assume that most of the time is going to collect the the the misdiagnosis are helping increase the skill set with the dramatic pathologists, but there still is an opportunity for the him I'm thinking path as well.
Great.
And then last question I guess, maybe providing can you give us an update in terms of how the CNN now and programs are progressing and when we should expect some initial read out maybe from the three a and and when can we see a transition to the three b and C N O <unk>.
Yeah. So both of them a recently opened so they're they're open for enrollment. So it's still early days in terms of with the next stages of these studies.
<unk> said for a while that create the combined stage three you expect to be at two to three year endeavor that obviously can shift upwards things pick up and he said was a one but we think of two to three years. So [laughter] may have some initial uptake.
Later, this year, but probably more likely early next year on bolt.
And then and then lastly in terms of perhaps the program with respect to getting an overall, it's easy 123 or classes.
Uh Huh diagnostic.
For the cross need these weren't where are you in terms of interaction yeah yeah.
Yeah, So [laughter] no formal interaction on that yet, we'll we're gonna we're going to pick the appropriate time to do that but we were laying the groundwork what well with what we hope will be about the doctor They actually all the groundwork feeling.
Well in that they see monthly normal he's on all of those studies.
Including the long enough.
And though so within each study will be looking at expression levels as well as we're working on putting together all kotler study back in the drafting stage that will also contribute to this body of knowledge and.
But.
The story together nicely and expecting yeah, yeah, Yeah, probably sometime later next year.
Yes, So we think there's there's a strong.
Basis for proceeding here as we've said before it seems like the design, that's yet to be thinking out of the box.
Yeah.
Yeah.
Great. Thanks luck and taking the question huh.
Thank you once again, if you like to ask a question. Please press star one.
Our next question will come from I think a young with Cantor Fitzgerald.
Hey, guys. Thanks, taking my question one.
Timelines the maintenance if it is in trial and.
Can we.
Couple of it more about kind of what you think that happened in the community I guess, if it does that factor or finding these positions or is it just really you know the fact that there's some other dynamic that if it were not appreciating that isn't out kind of them more important dynamic to consider once you've gotten probably think lot of the came out and in the third question have you guys I find recently.
The diagnosis rate is and BBCN.
Thanks, Robert I'll take the first one.
The maintenance study is open for enrollment.
It is slated to be a several years study. However, it's our intention to given its open label nature to provide incremental updates.
Steady at appropriate times at various conferences over the next year, So say that would be kind of rolling will hold up data that study proceeds.
Yeah.
[noise] Ah, yes, a b.
Sure the looking at what we saw on 29 paying them and trying to understand some of the the latest medical claims data.
It's hard to give an exact diagnosis rate, but I would tell you a quite familiar it's it's my position our position that the diagnose the diagnosis rate is still quite low.
Compared to what's out there Oh the success, we saw in 29 pain, but the patients that we were able to get transition fails andras I'll remind you that the launch a the go to market strategy and the launch Oh. The brand was to focus of course on the NCCN.
See I cancer centers as well as an additional 30 or 35 other tie targeted cancer centers, where a lot of the a the patients would be treated and typically diagnosed at them of course, that's what we're going to continue to do but as we move into that and so the community, but that's going to do is is get us into the area.
Theres, probably a lot of misdiagnosis, an under diagnosis and and the need for even greater CD went 23 testing to get to those diagnoses. So.
<unk>.
We we feel really firmly that but a lot of the patient starts last year, where we're really due to the the efforts of our field force and going out and really finding these patients and that's what the market seems to to respond to quite heavily is.
There is following the Brett hubs and trying to put the pieces together and and find potential patients that maybe otherwise headed down a path of a a for different diagnosis and getting them to a BDC BBCN diagnosis and we were successful at that with our existing structure. If we move into the community setting if you look at lab alerts.
Precision <unk> analytics to get us to pockets of business in the community, we can get to the community in a very precise fashion I'm not only with the analytics and the level or alerts and and analysis of data, but then also with the the partnering with group purchasing organizations. It allows us to get into a very tight.
Hi, good portion of that business to then starts to build the the that segment and that revenue stream for US and then a then then take it further along but the the path. There. So we feel that the the path forward as it was quite clear on how to get them, but but it until we see the market.
Perform in a different way.
We feel that we have to be very very assertive in going and helping find the patience and that's what were prepared to do to support the revenue growth for 2020.
Great.
<unk>.
What did I Miss sorry did I Miss any other.
It was just a diagnosis rate I, I think probably kind of touched on it.
Yeah, I think at scale, we I I don't have a a perfect number but we have a lot of work to do that aren't prove that.
Got it thank you.
You're welcome.
Thank you. Our next question comes from Joe Kennedy Sorrow with Piper Sandler.
Hey, guys that thank for taking the questions. Just two quick ones for me. So Robert you mentioned that you know of the Choppiness in new patient starts that you observed over the last couple of quarters is that something we should expect to continue into 2020, and then I just wanted to follow up on the Miss diagnosed patients and it sounds like you're doing work to better understand the but what is your current understanding.
The Miss diagnosed patients and their treatment journey, where are they being diagnosed with how are they being treated and you know how do you get them onto elds on this thanks.
Sure the.
Copy notes that we saw and and 2019, we Ah we forecast the same type of Choppiness in 2020, as well does that mean, you'll see that the same pattern of Choppiness and in 2020 as we did in 2019, no I think what we we learn every every day of of our lives and this in this market is that the market.
Just does not have any type of a formal consistency as of yet as we build a number of diagnosed cases and els on restarts, we believe that Choppiness of course will attenuate so.
So the answer there is yes, we should I would expect the choppiness in 2020.
As far as they the Miss diagnosis and the journey.
Okay I'm sorry can you just give me that question what that aspect of the question one more times to like and make sure I give it a a proper answer.
Yeah sure. So I guess I I got it sounds like you guys are doing work to better understand this but I guess as of now what is your understanding of missed diagnosed patients and their treatment journey what are they being diagnosed with how are they being treated.
Et cetera, Okay, Yeah beat the data that we haven't had it not only on and our research analyses, but also talking with with key opinion leaders leaders and then also being in the mark enough for the past years.
It's still the same type of entities that we disclosed in the past. So I'm you know A.M.L. forms of A.M.L., not otherwise specified perhaps leukemia, Acuitas Oh cutaneous lymphoma, and then the list can go on now, but it's it's typically those types of disease entities.
And essentially what is happening is that of course, and those and those situations and I'll I'll speak in general terms. Those those patients are typically then going to be treated with either a a standard of care for whatever disease, they are being treated for or sometimes depending on how how.
How I guess far they are in there in there and their treatment, where they're not responding they make sometimes even be transition to two to other other treatments. So.
Essentially.
That's the answer if somebody has a a diagnosis that might be even more like an A.O.L. They might go and get may allow treatment as well or if it's if there's a disease that has a lot of characteristics of a lymphoma. It might go to what shop and things of that nature. So I think it's pretty consistent with how the the market and the physician coal typically treats the disease that they're getting mistake.
No Swift of course, if they can lead to a missed or to a correct diagnosis, which does happen.
We saw a lot of these misdiagnosed patients in the past I'm speaking and anecdotally, we've seen a lot of patients in the past that were previously missed diagnosed and not responding to the treatment at hand go back because of our work Oh patients would would get get another sample taken as tissue sample tests for Cds.
123, which would lead to among other things to Ah BBCN other things, meaning other biomarkers like CD foreign 56.
And of course in those situations <unk> the best chance at a a good response for treatments to get them to wells honors until we have seen that happened as well.
Okay, Great. That's helpful. Thanks for taking my questions.
Thank you.
Thank you. Our next question comes from he Chen with H.C. Wainwright.
Thank you for taking my question.
Could you called them.
Oh, how many of those 574 patients identified in acuvue or Steve receiving treatment and.
Whether the patients who received zones in 29 paying overlap with any of those patients.
Thank you the so I'll provide a just a couple of more points of context around that at QB data yet keeping in mind. It was it was 20.
It was 2018 full year data those 534 patients of course, none of them would have received dell's honest because oh soundless was not approved at that point in time, our analysis stop there it for that portion of the analysis. The patient journey research that I referenced a few times this morning.
Well give us more precise answers to that so I would expect with the data lateness of the disease with a with treatment rates that many of those patients logically.
If they were either not on.
Not correctly diagnosed in the beginning likely had severe disease and may not I've ever been treated for Bbds and BDC and with at that point in time, just as you know standard treatments like hyper see better or <unk> or the like.
So what no way of knowing if any of those patients ever came onto came onto Alzheimer's. It would stand to reason, Matt. If you looked at the the approval which came at the end of 2018 or we loaded the the distribution channel at the end of January there could quite possibly unlikely could have been a handful of patients that.
Spans 2018 to 2019, and then likely would have come onto an l. genre start possibly in the relapsed refractory setting a that's that's speculative though at this point.
Thanks, and the second question news of those patients who received those Olson 2019 could you comment on what proportion of patients who started induced continued in 2019 and what proportion started and continue treatment into 20 tone.
Hello.
[laughter], Oh, I'm, sorry, I got to pick myself off hoping it.
Well.
Once again, what we've stated in the past. This is why we do have a level of of understanding of.
Patients.
Patient flow and journey on on L. sonorous, it's imprecise, because our distribution channel and methodologies of of getting product to patients doesn't allow us to fully understand.
The full picture of how patients are treated went in and wind and and whatnot. So there's there's there's a lot that.
It is unknown to us, but what I would likely tell you is that you know these are hard deadly diseases and a lot of these patients are certainly the successful ones that are getting it to stem cell transplant are saying, maybe three four or five or six cycles of.
Bells andras getting into a CR and then if they're stem cell transplant eligible they're going into and they're going into that and then that patient comes off therapy. So.
At this point, there's not a you know we're dealing traditionally with an incident population rather than a prevalent population until we get the like raised the level of above of proclivity, what the product and we start to increase the the survival rates its they'll generally would be.
A certain percentage of patients for instance that started treatment and 29 team that will both remain on treatment and twentytwenty. So there will be a there will be a uh huh.
Bridging of those two years the exact number it's hard to say.
It all depends on <unk> on how they're going.
Okay last question is a well at least when we talk about potential negative impact from the Culotta virus outbreak.
Do you think the the impact is going to be primarily on the identification you patients or Oh, maybe a uncle treatment of existing patients.
Well I wouldn't expect to.
You know why it's hard to say, how this well will impact the business anytime.
Any time in organization, like ours, which which drives on on face to face interactions as as is the industry Oh, there's gonna be some shift.
So it's hard for me to say at this early stage, what will happen I would tell you that with the deadliness up this disease. If a patient as is is diagnosed with B B D. C. N. A this is no less of a serious caused them than say the corona virus. So I would expect that all patients that are diagnosed with BP D.C.N. that none of their treatments would be.
Would be happy what I find that hard to believe although that's an opinion as far as the the idea of patients I think we're gonna be to be a very a very creative and and diligent in doing that because I do believe we have a strong role if we look at the big side of misdiagnosis and.
What we can do to affected change on that a lot of that can happen in the virtual manner.
With with the Teleconferences with web access with virtual programs. In fact, this past weekend, we had a speaker program that was to take place in Dallas.
With that same path.
With Oh, Hey, Mark Dermatologist, and we shifted that program from a a burke from a live event in Dallas to a virtual program, which was quite successful. So we believe in our capability of transitioning these face to face interactions to other virtual methods and we're gonna go very very aggressively towards that to make sure that to the best the bar.
Ability, we keep the we keep the diagnosis rate climbing and patient starts with Alzheimer's increasing.
Thank you.
Well.
Thank you at this time, we have no further questions I'd now like turn the call back over time and Bernstein for closing remarks.
Thank you operator, and thank you all for joining us on the call. This morning, everybody Stacy.
Thank you ladies and gentlemen. This concludes today's teleconference. You may now disconnect.
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