Q1 2021 Esperion Therapeutics Inc Earnings Call
Ladies and gentlemen, thank you for standing by and welcome.
At this time all participants are in listen only mode. Following the presentation, there will be a question and answer session.
Please be advised that today's conference call maybe recorded.
I would now like to hand, the conference over to Dan Church, Investor Relations and corporate Communications at Experian. Please go ahead Sir.
Thank you operator, good afternoon, and welcome to experience first quarter 2021 financial results and company update conference call and then church and I'm responsible for Investor Relations and corporate communications here on experience with me on today's call are Tim <unk>, President and Chief Executive Officer, Sheldon Koenig, Chief operating officer and.
Rick Bartram, Chief Financial Officer, I want to remind callers that the information discussed on the call today is covered under the safe Harbor provisions of the private Securities Litigation Reform Act I caution listeners that management will be making forward looking statements actual results could differ materially from those stated or implied by our forward looking statements due to risks and <unk>.
Certainties associated with the business. These forward looking statements are qualified in their entirety by the cautionary statements contained in today's press release and SEC filings. The content of this conference call contains time sensitive information that is accurate only as of the date of this live broadcast may four 2021, we undertake no obligation to revise.
Or update any forward looking statements to reflect events or circumstances. After the date of this conference call and webcast. As a reminder, this conference call and webcast are being recorded and archived we issued a press release. This afternoon detailing the content of today's call a copy can be found at www dot experian dot com within the investors and media section we.
We'll begin with prepared comments and then open the call for your questions. Following today's call. The team will be available for follow up questions. Please email investor relations at Experian Dot com to reschedule 20 minutes to speak with the team.
I'd now like to turn the call over to our President and CEO, Tim Maly bin Tim.
Thank you Ben.
Good afternoon, everyone. Thank you for joining us today as we review the progress made across our global business during the first quarter on.
I'll start today's call with a brief overview.
I guess touching on the highlights from the quarter.
Sheldon will review, our recent U S commercial initiatives in greater detail and finally, Rick will provide additional color on our financial performance.
For this stage of our U S launch our priority is to ensure that as many patients as possible have a positive experience with our medicines from the start we are purposely positioned our medicines to minimize barriers around price and access to enable that experience. We have been on wavering in this commitment to patients.
Following our mission of lipid management for everyone.
We entered the year with new commercial leadership, who quickly identified and implemented a refined strategy to position our medicines for both near term and longer term success today.
Today, we will highlight the great things happening across the business, but will also provide you insights into the U S. Net revenue results for the quarter.
As you saw in our press release, our commercial team continued to drive strong prescription demand growth for next little on next list that in the U S. During the first quarter in fact, almost 50% demand growth, but net U S revenue was negatively impacted by first quarter net pricing.
Rick will provide more detail on the factors influencing this result, and their impact on this quarter's U S net revenue.
And Sheldon will also provide you insights into the moderating impact of these factors on future quarters.
We continue to be optimistic that there is any easing commercial environment as we see stat in new to brand prescriptions recovering and patients taking their first steps to prioritize cardiovascular health by returning to their physicians offices.
This re prioritization combined with our newly implemented refined commercial strategy.
<unk> us increasing confidence for a shift in demand growth in the second half of the year.
I want to turn now to a couple of announcements, we recently made to advance our global strategic priorities to expand the reach of our medicines through a strong and experienced ex U S partners, while simultaneously strengthening our balance sheet.
Last week, we announced an expanded partnership with Daiichi Sankyo granting daiichi exclusive rights to commercialize our medicines in select territories across the Africa region.
Which includes countries across Asia, the Middle East and Latin America.
The agreement builds upon an already highly productive relationship and reinforces both companies' commitment to bringing novel cardiovascular medicines to patients globally.
The $30 million upfront tied to the expansion of the Daiichi relationship came simultaneously with the announcement of our Sperry on securing the remaining $50 million from Oberland capital under our existing revenue base funding agreement.
As a result, our pro forma cash at the end of the first quarter is around $300 million.
Turning now to Europe, the depth of Daiichi is global cardiovascular expertise as evidenced by the success of their ongoing launch of our medicines in Germany, which will be followed which is in other European countries. Later this year and into next year.
The number of patients treated with our medicines in Germany. During the first quarter increased significantly already reaching near 14000 patients by the end of the first quarter.
Great progress continues on Japan as well.
I am pleased to report that a sukkah, what's owns rights to the <unk> acid franchise in Japan continues to advance the clinical development of our medicines.
Otsuka initiated phase II development in April enrolling their first patient in a clinical study.
More to come on this in future quarters.
Finally, I want to highlight that it's very on still retains full rights to China. Among many other ex U S territories and of course, 100% commercial rights in the U S.
Now that the expanded partnership with Daiichi is in place.
Call that we've already recognized approximately $400 million from our ex U S. Partnerships, we will be exploring all avenues to accelerate the speed and reach of our medicines to patients physicians and payers in the U S Inc.
Importantly.
We will do this in ways that are in the best interest of our long term shareholders.
I'd like to end with this.
Our spirit. Unlike most companies launching new medicines in the U S. During the pandemic has experienced both expected and unexpected commercial challenges since FDA approval of our medicines in the U S last February.
More broadly.
<unk> has also experienced a number of important successes during this time, both in the U S and abroad.
In our industry there has been too little focus on the plight of people suffering from cardiovascular disease still the number one killer worldwide.
And as the lipid management company, we will continue pursuing our mission to provide these people with convenient oral LDL cholesterol lowering medicines.
I am confident that our new commercial team is advancing a spring in the right direction here on the U S. As a team we are absolutely committed to taking the necessary steps to elevate the U S commercialization of <unk> and as I said, a few moments ago to do so in ways that are in the <unk>.
The interest of our shareholders and with that.
I will turn the call over to Sheldon Sheldon thank.
Thank you Tim and good afternoon, everyone last quarter I outlined several operational and commercial initiatives related to our Medicare part D market access approach enhanced product positioning and health economics and outcomes research and scientific platform that would result in a more competitive go to market strategy I'm happy.
To say that as of today. The majority of those initiatives are in place or in the final stages of implementation.
Our new market access strategy has driven improved on boarding and pull through of payer contracts.
And the opportunity to present, our refined clinical profile to Payors combined with our new strategy to improve the formulary status of our medicines with a top Medicare part D providers that account for approximately 80% of lives.
Just this past quarter two of our biggest commercial plans elevated next low tall and next was at to preferred tiers, we anticipate a full reengagement with these top providers by the end of this year with potential adds throughout 2022 and possibly sooner.
In addition, I'd like to highlight that as of May 1st both next with Paul and <unk> will be included on one of the largest U S payer formularies, adding roughly $8 5 million Medicare part D lives and bringing our part D coverage to near 60% a great success for our spirit on and these patients.
Turning next to our enhanced product positioning throughout the first quarter the team revitalized with great precision and simplicity the market positioning and messaging of next low Tal index was at to ensure physicians are provided a clear guide on the appropriate patient population that will benefit from our therapies. This new package was.
It rolled out to physicians mid April.
We also spoke about driving awareness of next little index was at to bring physician attention back to the unmet need in cardiovascular disease and the benefits of art non statin oral medicines within a few short months, our newly added health economics and outcomes research team paired with our World class development and medical Affairs teams.
<unk> launched a real world evidence study in partnership with UT Southwestern Medical Center, and Cerner real World data to complement our clinical work and strengthen our scientific platform. We expect this study to conclude in the first half of 2022 ahead of our CV okay.
I am very proud that the headway made during the first quarter and putting the pieces in place to improve our commercial strategy, which we expect will demonstrate increased traction in the months ahead.
In terms of our first quarter results next total index was at average weekly growth of 3% outperforming that or is that am I statin and pcf's canine on a unit volume basis during the period.
Overall prescriptions grew 46% quarter over quarter in spite of seasonal headwinds adverse weather in select regions and the apex of COVID-19 cases in the first two months of the quarter.
Some metrics that are encouraging from a broader market perspective, our new to brand statin prescriptions, which are now down approximately 4% year to date compared to last year's pre COVID-19 levels or January to early March 2020.
By comparison during most of last year, new to brand statin prescriptions were down 30%.
Similarly in office patient visits to cardiologists and general practitioners have improved modestly relative to the late March to early may trough in 2020.
We continue to hear in our conversations with leaders in the cardiovascular space such as Dr. Peter Toth. The current president of the American Society for preventative cardiology.
Patients who have returned to physician offices have lipid panel, suggesting a time very soon where patients will be forced to address long term cardiovascular health. While it is clear our GAAP in cardiology and general practitioner office visits and diagnosis still remain we are encouraged that patients are beginning to take the first steps to re price.
<unk> their cardiovascular health.
Next I'll talk index was that needed to brand prescriptions grew 8% for the quarter driven by 24% month over month growth in March alone.
This is a very important metric for the launch as these prescriptions compound over the life of the product. This has been more challenging during the pandemic, hence our generous $10 per prescription copay card.
Studies have shown nearly 25% of all new to brand prescriptions are abandoned when patients were asked to pay more than $20.
This quarter, we saw an increased reliance on that co pay program more than expected rely on actually the majority of this is due to the fact, our co pay card supported patients during a time of increased economic hardship along with seasonal first quarter insurance deductible resets and other insurance dynamics.
As the economy continues to improve we've adjusted and we will continue to adjust the copay card program to align with more traditional measures.
At this early stage of the launch the importance of patients having positive experiences at every step of the process and remaining on therapy is key to establishing patient goodwill and building momentum.
Having a co pay assistance program was deeply valued by physicians and patients, especially during these difficult times.
And while adversely impacted net revenue for the first quarter the underlying prescription demand growth of almost 50% was very strong and it is a good indication for patients on therapy and future script volumes.
I'd remind you that while patients have begun to return to physician offices, there's a natural lag from an office visit to a written next little next was that prescription dependent on step throughs prior authorizations and a number of other factors such as a number of necessary lipid panels patient history and so forth.
But it typically requires a few months from initial office visit two of filled prescription.
However, as we progress into the second half of this year based on current trends, we have an opportunity to make an accelerated impact with our strategic commercial initiatives as we all emerge from this pandemic here in the U S.
With that I'll now turn the call over to Rick for remarks on our financial performance.
Thanks, Sheldon I'll now provide some commentary on our first quarter financial results were highlighted in our press release from earlier today.
As Tim and Sheldon touched upon our U S. Net product revenue during the quarter were adversely impacted by lower net price driven by higher copay card utilization and increases in managed care rebates co.
Copay card usage was a contributing factor as a high number of patients remained on therapy and utilize the copay card.
Insurance deductibles reset last year, we designed our copay card program to prioritize patient access and affordability. During the pandemic. In addition, there was also an impact from additional formulary coverage that came into effect during the first quarter.
Based on the timing of the various payer contracts start date experience kept the original launch strategy bite on design of the copay cards in place as a bridge to ensure that patients under these plans could get on treatment with ease and stay on therapy, reinforcing our commitment to ensuring patients have a positive.
Experienced in accessing our medicines.
Managed care rebates also increased during the quarter based on the timing of the various <unk>.
Date of the payer contracts and again as Sheldon noted two of our biggest commercial plans elevated an excellent call on next with debt to preferred tiers we.
We do not provide our gross to net discount rates for competitive reasons, but as I've stated previously gross to net for our medicines will fluctuate due to seasonality as additional Medicare part D contracts are implemented coverage expands and prescription volumes increase over time as we complete our contract.
<unk> plans to fully implement coverage and volume scales up we anticipate our gross to net for our medicines will normalize and net price will improve.
Accordingly in the first quarter U S. Net product revenue was $6 4 million in total revenue amounted to approximately $8 million.
This includes approximately $600000 of royalty revenue from our collaboration.
On expenses R&D expense for the first quarter totaled approximately $28 million down.
Down, 33% sequentially and 19% year over year.
SG&A expense was approximately $61 million for the first quarter, which included a one time charge of $13 $3 million related to the settlement of a 2016 lawsuit.
Adjusting for the onetime settlement costs SG&A expense was approximately $48 million for the first quarter up 15% year over year due to the commercialization of an excellent call on excellence that is down 22% from the fourth quarter of 2020.
We continue to expect full year 2021, R&D expense to fall between $120 million to $130 million and SG&A expenses to be between $200 million to $210 million.
Note that these amounts are inclusive of approximately $30 million in non cash expense for the full year associated with stock based compensation.
Our pro forma cash balance as of March 31 is approximately $300 million.
Including the funds to be received from the expanded Daiichi Sankyo partnership and the third tranche of our agreement with Oberland capital.
With the additional milestones associated with the expanded guidance. Thank you.
Our relationship experience now has over $1 $2 billion in future milestone payments from our collaboration that we expect will feed our balance sheet with continued execution by our partners.
We remain committed to prudently managing expenses and ensuring the organization is adequately funded to advance the business.
In the second quarter, we once again demonstrated our ability to fund our company in an advantageous manner going forward you should expect us to continue to balance cash spend against growth potential and the cash needs to ensure the business is adequately resource for future growth.
With that I will turn it back over to Tim for closing remarks.
Thank you Rick.
The first quarter was one of implementation and execution by our new commercial leadership team, we remain optimistic for a shifting tide in the U S. As these new initiatives gain traction and the conditions for improved uptake of our medicines continues to improve.
I want to thank our colleagues and partners for their unwavering dedication and hard work weekend on week out and especially to our shareholders for their continued support and fortitude, especially over the past year.
With that operator, please poll for questions.
Thank you, ladies and gentlemen, if you like to ask a question. Please press Star then one on your Touchstone telephone again, if you would like to ask a question. Please press Star then one.
One moment please for our first question.
Our first question comes from Michael Yee of Jefferies. Your line is open.
Hi, guys. Thanks for the question and congrats on the recent capital additions that's great I had two questions one was.
Can you better explain the difference of net price change on the impact of call revenue in other words, if you take your script growth and look at the consensus numbers I think you would've been around 11 or $12 million.
Reported $6 four is the difference there essentially all rebating and I should think about net price going forward as 30 40, 50% lower can you just talk about that.
And if we're thinking about right question. Two is for Tim You mentioned many times you would love to do everything that are on the best ways of long term shareholders can you just shed some light on what that means are there scenarios. Your options are things youre thinking about and help help point us in the right direction. Thank you.
Sure. Thanks, Thanks, Mike I will answer your second question first and then.
Provide some commentary so on your on.
First question I think.
With the with the recent expansion of the relationship with Dai Ichi.
That is.
Other ex U S deal debt as you noted has us fortify the balance sheet.
Also expanded this partnership with Daiichi Sankyo, who has <unk>.
Leasing strength in <unk> and.
And commercializing cardiovascular therapies, we've already seen that in Europe, and we will see it in the <unk> region is as they get traction there.
I think as I think I emphasized when you certainly caught as well our focus now is on this improving U S environment. It's we see it I think we all see it with the vaccination rates and other things that are developing here patients as Sheldon said returning to their physicians.
So.
Need to accelerate the speed and reach of our medicines to patients physicians and payors.
But again, we have to do that in ways that are in the best interest of our shareholders. So I don't think we can be more specific than that.
But.
We absolutely have has an interest in expanding the reach and speed of our medicines, but again balancing that with doing what's best for our long term shareholders.
With respect to the comment about net pricing, maybe I'll just highlight again something that both I said and Sheldon said as well, which is the very best indicator of.
The health of our franchise here in the U S is that prescription demand growth.
Best indicator of our progress and the health of the franchise.
Are going to as you.
<unk> highlighted we are going to see some variation in there.
Net pricing.
But it will normalize so I don't think you should think of this as what we saw here in the first quarter as continuing but I'll.
Pivot to Sheldon and Rick for a bit more detail on that Mike.
Yeah. Thanks, Thanks, Tim Thanks, Mike.
I'll start.
As we highlighted in the prepared remarks.
The impact on net price was really two fold increases in rebates and utilization of the co pay card. So again first on rebates and again, specifically going back to to comparisons of prior quarter.
Okay.
Not necessarily apples to apples, there's a seasonality impact but.
There is additional coverage coming on line naturally increased rebate expense and that's a good thing it it's indicating pull through on the payer contracts and as Sheldon mentioned.
Two of our biggest plans just elevate our medicines too.
Tiers, so that had a increase in rebate expense as well.
On copay, I'll start, but I'll ask Sheldon to provide a little bit of commentary there.
But during the quarter, we did see some seasonality in the first quarter.
Increased benefits on the copay card really reinforcing our commitment to making sure that patients remain on therapy.
And have a have a good experience with our medicines, so with that backdrop as Tim mentioned as we complete all of our contracting.
We have fully implemented coverage.
Net prices for our medicines will will normalize and improve.
But there is there is a variability aspect given some seasonality Sheldon anything you'd add on the copay card, yes, great. Thanks, Rick and Hi, Michael. Thank you for the question first of all again I think one thing that we're very encouraged by was as Tim mentioned, the 46% growth that we saw quarter over quarter.
And that was even keeping in mind that both January and February were two months, where COVID-19 was spiking. So we are pleased to see that the copay card program was designed from the start of the launch it was to ensure that day.
Net pricing in access we're not deterrent in patients taking their medicines, nor physicians prescribing <unk>.
Due to COVID-19, we actually extended the program. It included additional benefits to support patients during what we thought were generally economic hardship. So it was extended for months beyond what normally would be typically plant.
And as Rick mentioned, even with commercial coverage in place as we know first quarter is always a checker tricky quarter on.
On the Copay card was a priority we know that with managed care programs their adjudicating theyre going through prior author it prior authorizations et cetera, and we didn't want patients to wait for their medication. So it was a way to bridge patients over to the medication, while waiting for insurance coverage to be pulled through so they'll although it negative.
Impacted revenues for the first quarter.
A good indication of future prescription volume moving forward, we are adjusting our co pay card to better align with industry standards now that the market and the economy are improving just yesterday, we heard over a $100 million.
People in the United States are now vaccinated and as we've said in the past, we always felt that we'd be moving more to normalcy as we got to the second half of the year.
So let me just.
On the rise.
We gave you a lot of information, but highlighting that prescription demand growth, which was almost 50% best indicator of the health of the franchise.
We expect net pricing to normalize.
And what that means is that we're going to see some of these effects moderate going forward.
The better economy.
Q1 seasonality behind US and then as you just heard Sheldon say.
Lower utilization on the co pay card.
Yeah.
Got it thank you guys very much.
Thanks, Mike.
Thank you. Our next question comes from Jason Butler of JMP Securities. Your line is open.
Thanks for taking the questions I had two also.
Sheldon you talked about the enhanced product positioning can you give us any more.
On granularity there about what your your message now is and was this a case of a lack of awareness or do you think there was any confusion with prescribers with potential prescribers that needed to be.
And then second question.
It looks like that the.
Prescription growth in the last few weeks of the first quarter first couple of weeks of the second quarter has come down somewhat any color there and is it in any way tied to the rollout of the new commercial strategies.
For example at that as that works through you you'd hope to see a return to the growth rate you saw earlier in the first quarter. Thanks.
Great, Yes, hi, Jason and thank you for the question. Let me start first with your first question regarding positioning.
I won't go on to all the specifics of positioning but the two areas that you mentioned, one being awareness to being confusion.
And in light of the company actually launching in a COVID-19 environment amplified both of those as issues. What we've done now is we truly have simplified our message.
And we are really have the ability now to tell physicians and what the appropriate patient is where both net flows that are next to talk can be used.
As many patients out there that are taking a statin and they're taking is that them up and they are still not at LDL goal. There's a significant opportunity there for <unk> and next was at to play a role and with our favorable commercial coverage and also now with our improving Medicare part D coverage with over 60% of Medicare.
Patients covered we feel that we have significant.
<unk>.
As it relates to prescription volume in the first quarter. So what we have seen is that in the first few weeks of April when you looked across the market. All products were relatively flat, we are actually exhibiting approximately a 3% week over week growth.
And our hypothesis there was that it was flat due to Easter and many vacations et cetera that were that were taking place that was actually the hypothesis was actually proven via some IQ via data, we receive which essentially showed that I would say in the later weeks of April.
We've actually seen momentum continue as it relates to growth of <unk> as a matter of fact in the week ending April 23rd we actually we're surpassing most other products that you would compare us in the lipid market and actually some products even in the diabetes market as well.
<unk>.
So we have seen momentum starting to pick up and we.
We will continue to monitor as the months go by.
Okay, that's great. Thanks.
Thanks for the color thanks for the questions.
Sure.
Thank you. Our next question comes from Geoff Meacham of Bank of America. Your line is open.
Okay.
Hey, guys. Thanks for taking the question.
Just had a couple so when you think about the pricing environment.
What would give you more leverage with payers aside from from higher volume would the outcomes data next year. For example have an impact I'm just trying to think about the price you picture in the next year or two.
And then just from a competitive standpoint, just wanted to note on <unk> is there any kind of warehousing effect or any sort of pause you think ahead of that launch.
And maybe just help us with kind of how that you would expect that the shake up competitively. Thank you very much.
Yeah. Thanks, Thanks, Jeff I'll answer the second question first on and closer and then ask Sheldon to comment on pricing.
So I think like many of you were following development in the <unk>.
Space.
I guess like most folks don't know when.
The other injectable PCF canine will launch I think.
Longest time, we bid.
Suggesting that.
That will be a competitive factor in the injectable PCF canine space, but as we've talked about previously the positioning of our medicines is as <unk>.
Oral once daily therapy that are far more affordable than the injectable therapies more convenient more traditional therapies. If you think about the LDL cholesterol lowering space.
And again thinking about how other medications and not only in our therapeutic category in diabetes category.
On the philosophy is exhaust all oral options before going to Injectables. So we think that is a could be a potentially wonderful medicine for.
For patients. It's another win there, but we think it is in that category of injectable PCF canines, and our medicines are clearly positioned as efficacious tolerable medicines that are oral convenient and.
Used before injectable therapies.
Thank you, Tim and Jeff, Let me speak to a payer perspective and messaging to payers and also your question relate to cbot.
All of this related to pricing. So the first thing I would say is from a pricing perspective in all my years in commercializing products. This is the first time that nobody has ever come to us to say your price too high.
For us we have a impeccable market access team combined with Hcl, our team, where we have been able successor successfully positioned next was that next was that an excellent call.
Not only based upon the price, but the value that.
That that product brings to not only the payers and the patients. This is really also the last oral therapy before you'd have to go to an injectable PCF canine and there's advantages to that as well.
Of course, cbot will be an additional benefit in the future.
But something that we've actually have done we've gone back to payers and the strategy that I talked about in the last question and then I talked about also when we did our announcement that strategy is a clear strategy that payers understand and they now have a better appreciation of the fit of where it <unk>.
And next let Tal falls, so that in combination with as I mentioned, our health economics outcomes Research story really helps solidify the positioning of this product. It's the reason why humana added it to their formulary.
As well as we mentioned that increases our Medicare lives too.
By 9 million almost 60% so that message has really resonated.
Okay, great. Thanks, guys I appreciate it.
Thank you Tim.
Thank you.
Our next question comes from Joe on <unk>.
Cowen and company your line is open.
Hi, there. Thank you for taking my questions first one.
Just on any additional ex U S partnership deals how big of a priority is getting a partnership deal for China in reference to kind of balancing out the U S. Landscape first how are you prioritizing that.
And then second one was just on sort of the cadence of the copay card.
If you can give us any additional details in terms of how many patients are using the co pay card and you did mentioned that $20 co pay amount that 25% of new to brand prescriptions were abandoned.
In patients that do have full insurance coverage is there still going to be some sticker shock here if the co pay card program is removed.
Should we be thinking about that cadence. Thank you.
Thanks, Thanks, Joe I'll take your first question.
Okay.
Again, I think the expanded partnership with Daiichi.
Outside the U S with so called Eschar reason.
Rather provides us periodically.
The other ex U S geographies as you highlighted.
And that gives.
Eating.
<unk> in those geographies, but I think as we've highlighted.
It's really an emphasis here on this improving U S market.
And.
Our real focus is is going to be on.
Of our medicines to patients healthcare providers and payers.
Yes.
I think that's a focus but I think as you highlighted there is certainly.
Yeah.
Focus has to be now on on the U S. Sheldon okay. Thanks.
So the copay card and where those adjustments have any effect on on page.
Simply saying no we do not believe so the copay card what were going.
In the past it included additional months of benefit and what we want to do now.
To normalize the copay card put less reliance on the copay cards.
Contracts again, we have over 90% coverage, we're past that aspect of it.
And you have to go through prior authorizations and they are delayed so we see minimal.
And on the co pay card will still be available and to the question of how many patients are using it.
And again it was mostly due to the fact of.
These patients not half.
Great. Thank you.
Thank you Joe.
Thank you. Our next question comes from Eric Artz, You lost people. Your line is open.
Hey, guys.
Good evening, thanks for taking the questions and congrats on the progress here. So just a couple of questions from US maybe the first one for Sheldon as you think about kind of the easing of COVID-19 restrictions and more people kind of going into the offices do you have any specific commercial initiatives planned as you kind of move into.
That timeframe and certainly into the second half and the second question is probably for Rick you talked about the milestones that you have piled up here through some of these transactions and deals that you've done any color on when we could see another milestone it would it be more commercially.
Driven or would it be something regulatory driven around.
On the outcomes data.
Great Yes so.
So what will we be doing as we emerge from COVID-19 obviously the.
And it is on pulling through our new strategy and also going to position.
<unk> redefined our targeting list based upon our new positioning.
Yeah.
It was effective on May the first a few days ago, so really making that a price.
Since our I really within our demographic we're also amplifying.
Our medical Science liaisons are rolling out a new scientific platform.
Education at two major meetings, both ACC and AAD.
So is that an extra tall, so really creating that surround sound and AD awareness debt.
It was launched and we're excited about these programs I mentioned the real world.
Southwest.
With Dr. Eric Peterson, formerly of <unk>.
Physicians will be involved in the study touching the product et cetera. So that's.
And Derrick.
Cover off the question on the collaboration milestone.
With the completion of this expanded relationship with Daiichi.
Over $1 2 billion.
Do you expect in the future in terms of context, there there's a mix between.
I'll Stone base, but then there's also a healthy portion related to sales based milestones.
We will continue to come in and feed our balance sheet as well.
One.
Completion finalization of the cardiovascular outcomes trial.
Execute commercially in their respective territories.
And so on the timing of Windows.
These will be are expected to be received but obviously.
Everyone as we report quarterly.
Yes.
Got it thank you.
Yeah.
Yeah.
Thank you. Our next question comes from Jeff Hung of Morgan Stanley. Your line is open.
Thanks for taking the questions sorry, if part of this is a repeat part of that was breaking out so I'm not sure. If it was just my line you mentioned plans to adjust the copay card going forward would that decision point be triggered by some metrics like time on market or a number of scripts or is it something else and then I have a follow up.
Yeah sure Yeah, we just heard I got the message as well that way.
Apologize for that I'm, just going to check to see if you can hear me clearly for just a second can you.
Yeah, it faded out a little bit, but I can hear you.
Okay, Great maybe I'll comment on.
Moving to switch positions, yes, sorry.
Okay.
Okay.
The room here and really my bosses glasses, okay. So.
For your question as it relates to the co pay card program the program.
Okay.
It's really to provide access to patients.
We kept it going.
There is economic pressures hardship et cetera, typically the copay card.
This extended months beyond that.
Once beyond what was typically plan I think.
With the commercial coverage that we have in place.
We can rely more on.
You receiving the coverage through their insurance companies.
Well fight if you will as we went into the first quarter.
I'd say the first quarter.
And prior authorizations to get their prescription so we wanted to make sure they had a bridge to get.
Now we feel that based upon our coverage as it relates to <unk>.
On that we're going to be focusing more on utilizing our contracts.
And hence we better adjusted our co pay card to align with essentially industry standard.
Improving as well, we will not have to rely on that benefit as much.
Okay.
I think I got that.
And then can you talk about how the DTC campaign has gone relative to your expectations and what kind of decision factors remain to determine if you might run a traditional consumer TV campaign, if that's even something you are considering.
Sure Yes.
And I think there is a time and a place for DTC, but.
Now.
Active DTC campaign currently ongoing or planned we're really just focusing on Iraq.
And thought leaders to pull through our products.
Thank you. Thank you.
Yeah.
Thank you one moment, please check to see if we could get that takes free diligently one on it. Thank you.
Okay.
Okay.
Yeah.
Yeah.
Okay.
It looks like our next question comes from Paul Choi with Goldman Sachs. Your line is open.
Okay.
Yeah.
Okay.
Yeah.
Paul are you there.
Yes, I'm here can you hear me.
Yes.
Okay, great. Thanks.
So first question is just on the prescription side can you.
Update us on what the current refill rate is just how it's been trending over the prior quarters and then I had a follow up.
Yes, hi, Paul our refill rate actually looks.
<unk> to other products, we benchmark debt products, such as Entresto, <unk> et cetera, and it's in the high Fifty's.
Of course, Youre never going to get 100% from a refill perspective, but we're encouraged by our refill rates.
Okay.
Thanks for that detail than assets.
A follow up on the on the co pay program.
Given the sort of payer framework, you've laid out with 90% commercial on the.
60% on growing Medicare just in terms of the timeframe for that for sort of a fading or transition of the co pay program is that over the course of 'twenty. One really the right timeframe that you were trying to guide the street to or will this continue to be still a factor or a driver in the 'twenty two timeframe as well. Thank you very much.
Sure. Let me just speak to the copay card itself and I'll ask risk. If he has any additional questions, but as it relates to the co pay card and what we're doing to essentially better alignment with industry standards Thats happening immediately we're doing that right now we're working on that and that's something that we should have completed.
We will be completed in the next few weeks or so.
Yes, Paul this is Rick just to follow up on the question on the.
The co pay card gross to nets.
Again, just kind of coming back we don't provide.
Gross to net.
Estimates or rates, obviously for competitive purposes.
Those will continue to vary.
So we're not providing guidance on that topic and then obviously as it relates to revenue no revenue guidance. This year, but you should expect it you should expect that next year.
Okay.
Okay. Thank you.
Thank you.
Ladies and gentlemen, this does conclude today's conference. Thank you all for participating and have a great day you may all disconnect.
Yeah.
Thanks Hillary.
You're welcome have a great day.
Yes.
Okay.
[music].
Okay.
Okay.