Q1 2021 STRATA Skin Sciences Inc Earnings Call
Greetings and welcome to strata skin Sciences first quarter 2021 earnings conference call.
At this time all participants are in a listen only mode.
A question and answer session will follow the formal presentation.
If anyone should require operator assistance during the conference. Please press star zero on your telephone keypad.
As a reminder, this conference is being recorded it.
It is now my pleasure to introduce your host Leigh Salvo Investor Relations first strata skin sciences. Thank you you may begin. Thank you and good afternoon, everyone. Joining me today are Bob Moshe Chief Executive Officer, and Matt Hill, Chief Financial Officer.
Earlier today strata released financial results for the quarter ended March 31, 2021 copy of the press release is available on the company's website.
Before we begin I'd like to remind you that management will make statements. During this call that include forward looking statements within the meaning of federal Securities laws, which are made pursuant to the safe Harbor provisions on the private Securities Litigation Reform Act of 1995.
Any statements contained in this call, but do not relate to matters of historical fact are relate to expectations or predictions of future events results or performance are forward looking statements.
All forward looking statements, including without limitation.
That was relating to our operating trends and future financial performance the impact of COVID-19 on our business ex the recovery, including the distribution and the effectiveness of the COVID-19 vaccine expense management expectations for hiring growth in our organization market opportunity guidance for revenue gross margin and operate.
<unk> expenses commercial expansion and product pipeline development expected future product launches and milestone unexpected result, and performance of our partnerships and commercial products, including patient outcomes are based upon our current estimates and various assumptions. These.
These statements involve material risks and uncertainties that could cause actual results or events to materially differ from those anticipated or implied by these forward looking statements.
Accordingly, you should not place undue reliance on these statements are on.
A list and description on the rest of the uncertainties associated with our business. Please refer to the risk factors section of our public filings with the SEC, including our annual report on form 10-K for the year ended December 31 2020.
This conference call contains time sensitive information is accurate only as of July broadcast today May 12 2021.
Strata skin sciences disclaims any intention or obligation, except as required by law to update or revise any financial projections or forward looking statements, whether because of new information future events or otherwise.
Also during this presentation, we refer to domestic gross billing, which is a non-GAAP financial measure.
A reconciliation of this non-GAAP financial measure to the most directly comparable GAAP financial measure is available on the company's earnings release.
First fiscal quarter ended March 31, 2021, which is accessible on the SEC's website and posted on the Investor Relations page of Stratus website at jumped up the strata skin sciences dot com and with that I'll turn the call over to Bob.
Thanks, Lee good afternoon, everyone and thank you for joining us for our first quarter 2021 earnings call.
We got a disappointing first quarter of 2021 and that we reported total revenue of $5 8 million of which recurring revenue was $4 7 million a 17, 9% decrease over the first quarter in 2020.
There were several contributing factors to this decline the first of which was the continued impact of the pandemic.
Especially early in the quarter as dermatology options remain understaffed in many regions restrictions remain in place and patients were reluctant to seek treatment.
In addition, we experienced an unfavorable swing of 800000 and deferred revenues in Q1, 2021 as compared to the first quarter of 2020.
Our international business was impacted due to a deliberate strategic transition from capital equipment sales.
Revenue model that is a combination of capital equipment sales and recurring revenue.
We exited the first quarter with installed base of 871 recurring revenue extract devices, including 837 in the U S and 34 international placements 30 of which have been placed in South Korea and four in Japan. This is up from 860 units at the end of December but lower than our inner.
Shall expectations.
In addition.
Six China placement shipped at the end of Q1 field to make the deadline in time to be counted in the first quarter numbers, but will be recognized in the second quarter.
Despite a slow start to the first quarter improve patient visits in March that continued into the second quarter combined with pent up demand from new patients, resulting in dermatology offices ramping up to more normal staffing levels is encouraging rd.
Rd ex charge, which indicate patients seeking reimbursement for extract treatments largely driven by our direct to consumer advertising, which we started in Q4 2020 are reaching pre COVID-19 levels.
We perceive this as a good indicator that new and returning patients are once again shaking out treatment from their dermatologists.
Since our last update in March I've spent considerable time in the field to meet with our customers our territory managers and key opinion leaders. Additionally, we conducted our first advisory meeting with key customers to best assess our current market position potential to grow our business and devise a path to improve stakeholder.
<unk>.
These meetings have been very enlightening and I've left left me even more excited about the opportunities ahead.
Extract remains an invaluable asset and dermatologists treatment of psoriasis, atopic dermatitis and vitiligo.
Patients should take comfort in the fact that this therapy is drug free steroid free painless and reimbursed by insurance.
Dermatologists prescribe it because the effective efficient treatments provide their patients with quick visible improvement relief from painful persistent edge as a safe alternative from la with lower risk of side effects and biologic and topical treatments.
Driving commercial execution will be our highest priority.
I have identified several areas upon which to focus.
First we plan to prudently increase our investment in direct to consumer advertising.
Historically DTC spend has been the lifeblood of the commercial organization, which was evident in 2016 through early 2018.
On the spend would you do cause reduced the company sorry, a subsequent reduction in patient flow and recurring revenue.
Then in the back half of 2018, when DTC investment resumed we saw subsequent double digit growth in 2019.
In 2020, DTC spend was once again reduced conserve cash during the pandemic with similar results in the fourth quarter ruse resumed funding to consumer advertising and the early results are encouraging.
Second re engaging with our high volume accounts is a priority here.
These customers represent about 15% of our total accounts and almost 40% of our recurring revenues. They are they have adopted extract and I believe hold the best opportunity for growth and improved utilization.
We plan to increase our frequency of calls on these accounts and stepping up the efforts to provide these practices with added support they need to grow.
Third we will target previous customers that have not yet started producing revenues, whether or not due to COVID-19 related issues in the first quarter, we had approximately 20% extract non revenue generating partners. Typically we found that these accounts were more severely impacted by the pandemic.
Our sales force is focused on helping these accounts returned to more consistent production levels by employing dedicated support services and DTC campaigns.
Fourth we will be pursuing opportunities to support our sales organization marketing campaigns that can best drive awareness. Among dermatologists. This starts with additional market research too hard on marketing strategy going forward and present, a consistent compelling message to providers.
As a key marketing tool, we plan to reintroduce clinical data that supports all three indications and reinforces the messages of safety efficacy and cost benefit to the patient and clinic.
It is our goal to raise our profile and presence in the industry. We have already begun to ramp up investments in this area in order to execute as quickly as possible.
Internationally, we currently have direct distribution contracts in Korea, Japan, and China that provide for a hybrid capital equipment and recurring revenue model.
We will continue to execute this strategy to drive recurring revenue when and where we can.
This model is new to our distributors and will likely take time to implement processes and procedures at origin successfully drive this model.
As a result, it is possible that our equipment sales may be impacted in the short term as our distributors distributors navigate this transition.
I have met with our worldwide distributor and we are developing a plan for growth and our current international markets with expansion potential for future markets.
On the development front, we have plans to target the vitiligo indication as we believe there is a significant untapped market opportunity that our extract laser can specifically address.
We are developing our relaunch plan and are working with an outside adviser to strengthen our managed care coverage with more wins similar to Cigna, which this past October issued a new medical coverage policy for excimer laser therapy therapy, or dermatologic conditions, including bit of libel.
Additionally, in March we announced the publication of an independent study in the journal.
European Academy of Dermatology and burn Ology.
In brief this study was conducted by a team of dermatologists in Japan and it was approved by the Ethics Committee of cancer and Medical University Pori Hospital. The study results demonstrate that patients with refractory bit of libel achieved satisfactory re pigmentation in five treatments, including those who were previously.
Unresponsive interventional treatments. This study attribute attributed better patient outcomes to extracts hi, irradiation rate as compared to other available UBB photo therapies.
We are also delighted to welcome Bill Humphries to our board of directors, who brings more than 30 years of leadership in the pharmaceutical industry and particularly in dermatology. We look forward to the many contributions he can make to our leadership team.
Turning to our outlook for 2021, I have now been which dropped to approximately 75 days I have been working closely with the team on a planned through the balance of 2021 and be on that will position us for a return to consistent double digit growth that we experienced from 2018 to 2019.
As I outlined we plan to focus on initiatives to drive worldwide recurring revenue with an emphasis on sales and marketing it to migrate international capital equipment customers to a reoccurring recurring model as we have done in South Korea, Japan and now China.
Additionally, we plan on prudently increasing our spending on directed dermatologist marketing, thereby creating further awareness of the extract product line and the value it adds to partner clinics and patients.
In addition to all the services, we provide to our partner clinics, including direct to consumer advertising clinical support and reimbursement support among others. We will expect to add more educational programs and customer focus support such as increased presence at dermatology meetings speakers to the podium and customer fee.
Back opportunities to better serve their practices. In addition to supporting top line growth I am confident that these initiatives will help improve our margin profile and generate meaningful cash flow from operations.
In short commercial execution and our back to basics approach will be key we have a strong DTC machine and a great opportunity to make targeted investments in sales and marketing in order to drive growth.
Well based on our experience we believe the impact of sales may lag the investment with the initiatives Ive. Just described we believe we will be approaching pre COVID-19 levels of revenue by the end of the year.
My goal is to improve top line growth and my experience in commercial organizations in dermatology a show me that initiatives such as marketing directly to our potential partners.
Banning our sales force in order to build stronger relationships with the providers.
<unk> to partner with the clinics through our support services and delivering a clear and consistent message on the benefits of extract eczema laser lead to greater awareness for extracts.
In summary, strata skin sciences has long been at the forefront of dermatology on.
Our best in class extract exit Malaysia has been shown in more than a 150 peer reviewed clinical studies to be the safest and most effective treatment for psoriasis vitiligo and atopic dermatitis diseases that impact 31 million people a year.
Strata offers a safe effective treatment for patients a stable increase base revenue base for clinics and the least expensive treatment available for payers.
With a reoccurring model our growing installed base further investment in sales and marketing and the desire to grow our product pipeline, we have some exciting opportunities ahead.
With that I'll turn the call over to our CFO, Matt Hill, Matt.
Thank you Bob.
As mentioned revenues for the first quarter of 2021 were $5 $8 million a $13 four per cent decrease as compared to revenues of $6 $7 million for the first quarter of 2020, reflecting the continued impact of the pandemic, especially early in the quarter, particularly in the north east as dermatology offices remain.
Understaffed restrictions remain in place and patients were reluctant to seek treatment as well as the unfavorable impact of $800000 on deferred revenue as compared to the first quarter of 2020, and the timing of certain orders and placements as we transition our international business from capital sales to combined equipment and re.
<unk> revenue model.
First quarter revenue also reflects the step down in revenue from the fourth quarter of 2020 as patient insurances reset at the beginning of each year.
Recurring revenues were $4 $7 million to $17 nine per cent decrease as compared to $5 $7 million for the first quarter of 2020.
In addition to the above noted impacts on the revenue recurring revenue was also impacted by lower DTC spend in 2020 included in COVID-19 related cost reductions.
<unk> revenues were $1 $1 million, an increase of $10 four per cent as compared to $1 million from the first quarter of 2020.
As we discussed last quarter included in our press release issued this afternoon, we provided information on a non-GAAP measurement described as gross domestic recurring billings, which represents the amount invoiced partner clinics when treatment codes are sold to the position.
It does not include any normal GAAP adjustments, which are deferred revenue from prior quarters recorded as revenue in the current quarter. The deferral of revenue from the current quarter recorded as revenue in future quarters and adjustments for co pay and other discounts.
We felt this is an important disclosures in light of COVID-19 pandemic to assist in the understanding of our business to more effectively view the trends that we're seeing with our business. We also want to provide transparency with respect to deferred revenue since we defer a portion of our got recurring revenue into future quarters decrease in deferred revenue impact each subsequent quarter.
Non-GAAP gross domestic recurring billings was $4 $6 million as compared to $5 million in the first quarter of 2020, the impact of deferred revenue. The reconciliation from non-GAAP gross domestic recurring billings to record revenue was an unfavorable $800000 in the first quarter of 2021.
To the first quarter of 2020.
Overall gross profit was $3 $7 million or 63, 7% of revenue as compared to $4.4 million or 65.4 of revenues for the first quarter of 2020.
Gross profit from recurring revenues was $3 $2 million were 67, 9% of revenues as compared to $3 $9 million or $68 four per cent of revenues in the first quarter of 2020.
The primary reason for the decrease in overall gross profit was lower sales the unfavorable impact of deferred revenue as compared to the force of 'twenty, 'twenty, which were partially offset by lower depreciation expense.
Engineering and product development costs were $384000 as compared to $292000 for the first quarter of 2020 as a result of certain engineering projects.
Selling and marketing expenses were $2 $9 million as compared to $3.0 million in the first quarter of 2020.
Sales and marketing expenses were slightly lower primarily.
Due to lower trade show costs, and travel spend partially offset by compensation and consulting costs.
General and administrative expenses were $2 $8 million as compared to $2 $1 million in the first quarter of 2020.
General and administrative expenses were higher due to the CEO transition in the first quarter of 'twenty, 'twenty, one, including accruals for severance recruiting fees and stock compensation for the acceleration of vesting of certain option grants net.
Net loss for the first quarter of 2021 was $2 $4 million or loss of seven cents per basic and diluted common share as compared to the net loss from the first quarter of 2000 $21 million $1 million or loss of three cents per basic and diluted common share.
At March 31, 2021 cash cash equivalents and restricted cash was $17 $5 million as compared to $18 $1 million at December 31, 2020.
After cutting discretionary spending in 2000, twenty's due to the pandemic and the fourth quarter of 2020, we began our investment back into DTC advertising in Q1, 2021 reached pre COVID-19 level levels.
We believe the recent improvement you've seen in key performance indicators is reflective of the increase in advertising spend.
<unk> to make investments in sales and marketing we believe it will generate a return and increased placements and utilization and our partner clinics and now I.
I would like to open the call for questions.
Yeah.
Thank you, ladies and gentlemen, we will now be conducting a question and answer session. If.
If you'd like to ask a question you May press star one on your telephone keypad confirmation tone will indicate your line is on the question to you May Press Star two if he would like to remove your question from the Q4 participants using speaker equipment. It may be necessary to pick up your handset before pressing the star key our first question comes from the line of Joe <unk>.
N genius with H C. Wainwright. Please proceed with your question.
Hey, guys. Good afternoon. Thanks for taking the question a couple of questions. Obviously, a lot of things are out of your controls because of COVID-19 and some of the things you've talked about with regard to deferred revenue. So I'm going to ask something a little differently. Obviously, you've talked about the northeast you know being a little choppy and there are some territories that still remain choppy.
Because of the pandemic have any territories outperformed your expectations.
That's a good question Joe This is Bob.
The west and the Midwest have seem to be recovering a little bit quicker.
In the northeast.
In the South East is also a little bit slow but.
We were out and we are seeing improvement, especially on the west coast and in the heart of the of the country. At this point I think with the northeast is a combination of a couple of things based on the input I got from dermatologists that I spoke to.
Whether there was a lot of bad weather as you probably remember the northeast are in February.
And secondly, just elderly patients in particular, not wanting to go out into terms offices and two times a week for several weeks based on based on the fact that COVID-19 was.
Pretty rapid back then and there was still restrictions in place. So that's why we think the northeast a little slower coming back, but you know we're encouraged by what's happening with our rdx charts and seeing more improvement.
That's fair. Thanks, and then when you guys talk about the pent up demand because obviously you know there are patients that would certainly want to get back to the clinic to get an extract treatments.
So I guess when you talk about your you know what you would like from a projection standpoint that you said to get to pre COVID-19 levels by year end, how do you see some of this pent up demand or backlog are being able to work through it like how quickly do you think you could work through it.
Yeah, I think it's really a function of of the derm offices themselves and you know again, we're encouraged that they're opening up and seeing more patients again, the feedback that I got from dermatologists that I spoke to is that staffing was an issue earlier in the year, but they are having a lot better success in getting staffing back up to <unk>.
So once that's in place on you know I would expect that the patients will start to flow in.
That's why we really want to focus on increasing our direct to consumer advertising, we want to drive more patients into the <unk> offices are high volume customers are of course, a critical yeah. They dropped off just like everybody else, but clearly if we can get them back are functioning at a high level, they can produce or or treated.
Number of patients very quickly and then we had about 20% of our accounts that just generated no revenue force in the first quarter. So if we can get them up and running that creates also capacity. So I think the capacity is there it's a matter of getting the patients feeling comfortable going into the derm offices, and that's helping drive them to them.
For treatment.
That's great. Thanks, a lot guys. It's nice to see all the background activities prepping for the the new markets. If you will thanks, a lot great. Thanks, Joe I have a great day.
Our next question comes from the line of Jeffrey Cohen with Ladenburg Thalmann. Please proceed with your question.
Hi, Bob how are you.
Hey, Jeff how are you doing.
Just fine so person could you give us a breakdown of our U S and international just a on the topline.
Yeah, absolutely domestic revenues for the three months ended March 31, 2021 were $4 $7 million I'm, sorry, we're a $4 $7 million and internationally with $1 $1 million.
Okay I got it so that was the getting the five.
Five eight.
Yeah, similar breakdown to a recurring and equipment.
Absolutely.
Hope you have a 4.7 and a $4 seven and recurring and 1.1 in paint.
And equipment.
Okay got it can you we control some of your comments on us from six units.
Her Charlie.
So arguably sounds like they will hit in the second quarter on that kind of correlate that with the deferred revenue number which I'm, assuming is mostly or all U S. So what amount of debt gets pulled through into the second quarter or it gets pulled off in the second quarter as well that's a great. Great question. When we look at the <unk>.
Bird revenue, Jeff It really comes around with what comes in from last quarter into this quarter. So the difference coming into Q1 of 2021 as compared to 20 was half a million dollars.
So day, one we started Q1 'twenty one half a million dollars behind last quarters.
And now leaving Q.
Q1 into Q2, we have an additional $300000 coming out of Q1 into Q2 'twenty. One so that sets us up better from Q2, especially as compared to Q2 last year, when we only had $1 $5 million coming in.
Now as it as it did that cover your question.
Yeah. So it's on about 300 does that include or exclude the the six units for China and I'm, assuming they are a combination of our capital and recurring through your own distribution model.
Yeah, absolutely so to be specific we had four units to Japan, which was about $400000 that shipped.
Too late for Q1, and then we had six placements and we refer to placements.
What we're talking about is the recurring revenue model.
That will show up in our installed base come next quarter.
So it was a combination of Japan, and China, China was placements and.
Japan was actual equipment sales.
Okay. So the 400 from Japan in the 300.
The deferred revenue to bump Q2 bars are those two amounts potentially.
As compared to.
Last year and based on the timing of the orders, we do we expect to see a bump in equipment sales.
In.
In Q2, but you know equipment sales can be which is why we're trying to move away from it as they can be choppy.
Got it and could you talk about the commercial organization now into gear, how many ftes and where does that stand now what would you expect for the balance of 'twenty one.
Sure. So we have 28 territories currently Jeff I would anticipate that we will add some additional people to the sales force and I'll tell you why we have as you can imagine very big territories.
Lot of windshield time, and I'm, a big fan of frequency in other words getting into the accounts under our regular basis every other week if possible. So I'd like to cut down on those large territories and what I plan on doing is a realignment exercise, where we will make sure that we have coverage in the best possible.
Places on a geographic basis and that will determine how many people that we you know we may need to add on so I don't see it being dramatic but there could be some additional bodies in the sales force, which I think will improve our our opportunities for growth and then from a marketing standpoint.
May look to bring on a.
On a marketer who has some derm experience in direct marketing to dermatologist, you've heard me say before I think the company has done an outstanding job with their direct to consumer advertising program, but one thing I think where we can improve as marketing directly to the dermatologists on the provider and I think that is.
The place I'd like to show us up a little bit.
Okay, and then any commentary on our product development. She made a couple of references to that in both your on your script as well as the documents you filed so could you talk about product developments for the quarter each day.
New products.
New devices, new recurring models et cetera, yeah. So a couple of things. So I think there's opportunities for four indications I think the vitiligo indication is under your under capitalized by asset you know at this point and I think there's an opportunity there I'd like to see us relaunch in vitiligo, we have good clinical data behind it as you.
No there are some new topical treatments coming from is it a lago here in the second half of the year from some big pharma organizations now those treatments will get a lot of noise, they're very expensive.
Maybe.
Amazed to be seen how effective they are but they have side effects. So I think that we certainly remain a good alternative to any topical or oral treatment for vitiligo and I want to make sure the germs or aware of that there are other indications that the the eczema lasers used for that we can't talk about it gets used off label and we want to explore.
If those indications are things that we could add to our five 10-K. So that those are some of the development areas that we're looking at as well as improvements to the current extract we the company has done a good job in improving the technology and I think there's some opportunities there as well as we move into the latter part of the year.
Got it the lesson for me net any commentary on margins from where they were about 220 basis points ahead of what we estimated but secondly be affected by mix or is that a current level that you're you're feeling good about maintaining going forward.
Overall margins are.
Worried about.
Coming to this company and seeing the recurring revenue model executed well pre COVID-19 and now looking to re engage and drive the recurring revenue utilization through our partner clinics.
The fact that the margins.
Accelerate.
Once you get above the breakeven on the placements so that we get up into the low ninety's per.
<unk> margin so it will it will greatly be.
Be affected by the growing recurring revenue, particularly specifically domestically.
Okay got it thanks for the reader I appreciate the commentary.
My pleasure good talking to Jeff Day Steph.
Yeah.
Our next question comes from the line of Suraj.
Calia with Oppenheimer. Please proceed with your question.
Hey, Bob Matt can you hear me all right.
Yep. Thank you perfect.
So Bob first and foremost.
Got some numbers from the on the call.
215% of the accounts.
Do about 40 per cent of the revenue was Bob.
I was wondering if you could tell US you know are these revenues from <unk>.
Higher.
Sessions per patient or are they from the higher overall patients I guess, what is the secret to their success based on what you've seen and how translatable.
Yes.
Yeah, No. That's a good question Suraj. It really is a factor of volume on our highest producing accounts.
Move more patients through their offices.
And then probably my.
My estimation, there probably more successful in making sure the patients complete a complete course of therapy. So by that alone they've done they're gonna give more treatment. So you know 120 is where we were in the first quarter and just for comparison in 2019 were at $2 20 of top accounts. So.
You know we've got a we got some work ahead of us to get our numbers back up to where they were in 2019 with these high volume customers and they are an absolute priority for us. The sales force is getting has got.
Marching orders to increase their frequency there and to do anything they can to drive patients in and improve their are there efficiencies. So they're very important to us and we think we can turn that around with just some good back the basic blocking and tackling.
Got it.
Bob D. D. C has been repeatedly thought he did.
You know as one of the drivers for growth.
With I'm not sure if it is a one to one correlation but a pretty strong R squared to topline growth.
On long term, Bob how do you look at leverage ability in this model that is one part of the question on the second part Bob.
To piggyback on the Vitiligo comments, you made it will be on.
With the JAK inhibitors are coming shortly right an.
Implicitly referenced them on vitiligo would that be.
Introducing a new product to go head to head with I should say had to it but you know it.
There'll be some level of crowding in right.
Would this be the best spend of money at this time in your view would love to get your expertise and thoughts behind that.
Sure. So I think you know the direct to consumer model that the company has run for the last several years. Obviously, it's been very very successful on and if you just look at the history and Matt has more insight on it than I do but just from what I've been able to gather I mean, when the spend was increased by the company and direct to consumer App.
Advertising the number of visits.
Visits or appointments made for the treatment for by extract increase.
Increase so I mean, I certainly think that that's something that we want to continue and invest in as I said I think the company has done a great job I think where we can improve as our marketing directly to dermatologists because ultimately the dermatologists the one who's making a decision and if we want to expand usage, which is one of the goals that we have in 2002.
On one and beyond then we need to make sure that extract is top of mind when a psoriasis patient comes in to that office not just because we sent them and from direct to consumer advertising, but the halo effect that we generate by sending.
Patients and who asked for extracts who come back to the dermatology and dermatologists and praised the treatment and how much they liked it and you know in the interactions that I've had in the last couple of months with terms. The feedback has been that it's effective treatment that patients like it you know as we mentioned painless drug free it treats.
It's very quickly all of these things are very positive and reinforcing for their usage of extracts. So from that perspective, I think the direct to consumer advertising is important and we'll continue to do that with regards to vitiligo. You know my experience Suraj has been whenever a new drug comes into the market in an indication.
Such has been a long ago that does not have a lot of choices for treatment.
Right now there really aren't many choices any dermatologists will tell you that in laser is one of the few things that it was actually approved for it the noise level is going to go up dramatically and what will happen is as you know patients who haven't sought treatment a long time I'm going to come in to the dermatologist to get treatment and not everyone is going to be a candidate for a Jack for.
A number of reasons the cost they're gonna have maybe some difficulty with reimbursement the effectiveness is suspect in some ways.
With certain patients and it's it's an immunosuppressant and right now a lot of patients don't want to take Immunosuppressants because of COVID-19. So I think that we're in a really good opportunity to be there as an alternative to these topical or oral JAKKS as a treatment thats proven it's safe, it's effective and it's cost effective for the patient and it's a revenue.
Generated for the Doctor. So I do think it's an opportunity for US did I do want to focus on and capitalize on we know who the kols are in vitiligo, we'll get them to the podium talking about our treatment and I think we can capitalize on that opportunity.
Got it finally, Bob.
Could you give us the status on M D and the field has there been a shift in total number of sessions per patient with use of M. D.
Any color there would be greatly appreciated gentlemen, thank you for taking my questions.
Thank you.
Not a real shift, though we haven't seen I think partially because of COVID-19 are maybe that the NMB has not got the attention. It might've debt if we weren't in a COVID-19 situation. So we have not seen a shift in the number of treatments to this point because of that and you know it is potentially.
An opportunity for those patients who don't want to go through the full course of.
But certainly there are a number of patients and providers for that matter, who do like to treat the full courses extract therapy. So.
Hard to say, if that's going to change going forward, but we'll keep an eye on that.
Thank you.
There are no further questions in the queue I'd like to hand, the call back to Bob Marshall for closing remarks.
Thank you operator, I'd just like to thank everyone for joining us today, and hope everyone stays safe and healthy going forward and I look forward to speaking you on the next call. Thank you.
Ladies and gentlemen, this does conclude today's teleconference. Thank you for your participation you may disconnect. Your lines at this time and have a wonderful day.