Q1 2021 Evoke Pharma Inc Earnings Call
[music].
Good afternoon, and thank you for joining evoke pharma first quarter 2021 earnings conference call I would now like to introduce Christine Petraglia for opening remarks.
Good afternoon, and welcome to evoke pharma first.
2021.
Call and audio webcast.
Me today are Dave Barney Air evoke Chief Executive Officer and Matt.
<unk> been asked me on Chief business Officer, as well as true Quesenberry from every day.
Jim Murray Chief commercial officer.
Today evoke issued a press release announcing financial results for the first quarter ended March 31, 2021, we encourage everyone to read today's press release as well he Bulks quarterly report on form 10-Q, which is filed with the SEC. The company's 10-Q report and press release are also available.
On evokes website at Www Dot evoke pharma on Dotcom. In addition, the conference call is being webcast through the company's website and will be archived for 30 days for future reference.
Please note that certain information discussed on the call today is covered under the safe Harbor provision of the private Securities Litigation Reform Act, we caution listeners that during this call evokes management will be making forward looking statements.
Actual results could differ materially from those stated or implied by these forward looking statements due to risks and uncertainties associated with the company's business.
These forward looking statements are qualified by the cautionary statements contained any books press releases and SEC filings, including its quarterly report on form 10-Q, and subsequent filings. This conference call contains time sensitive information that is accurate.
Only as of the date of this live with this live broadcast.
Book undertakes no obligation to revise or update any forward looking statements to reflect events or circumstances. After the date on this conference call with that I would now like to turn the call over to Dave Gadhia.
Thank you Christine and thank you all for joining US. This afternoon for evoke pharma first quarter 2021 earnings conference call today, I will spend a couple of minutes upfront walking through some key points from our first full quarter since the launch of promoting albeit in the midst of the COVID-19 surge in January and February will also provide an update on our commercial.
<unk> activities and specific insight on physician and patient feedback and some important trends as we look forward and then we will review our financials.
As many of you may recall, Jim already as the first novel pharmaceutical treatment for Gastroparesis to hit the market in over 40 years and represents a robust market opportunity with 12 to 16 million adults reporting symptoms.
This market continues to grow fueled by diabetes, which is a common cause of gastroparesis.
Currently only an estimated two to 3 million patients are receiving treatment with limited therapeutic options.
<unk> is specifically designed to address the unique needs of adult patients with diabetic gastroparesis by delivering an established treatment as a nasal spray that bypasses the Gi tract.
Adult suffering from diabetic gastroparesis by definition have unpredictable stomach emptying and may or may not volume at their medications.
For these reasons oral administration may be erratic, which can be problematic since the drug absorption in the small intestine requires gastric emptying.
<unk>, which was approved by the FDA in June 2020 is the first and only treatment for diabetic gastroparesis, where absorption is unaltered in patients with delayed gastric emptying.
No. Other company is currently focused on Gastroparesis treatments in physicians offices today, and we continue to see enormous potential for gaining market share.
The only other FDA approved therapy for Gastroparesis available in todays market is medical from my typically prescribed as an oral tablet and can fail to relieve symptoms experienced by patients in this oral delivery for.
These symptoms caused by Gastroparesis include nausea, abdominal pain bloating early satiety and vomiting.
The impact of this disease on individual's quality of life can be quite detrimental and dangerous as it may lead to poor diabetes control.
And hospitalizations are also frequently occur because of dehydration and malnourishment.
The patient population, there's clearly a need of more effective treatment options. We believe promoting answers a critical unmet medical need serving as an effective alternative to the current standard of care to help those who suffer from acute and recurrent diabetic gastroparesis.
We are also acutely aware of how unique and valuable our treatment is in order to protect our intellectual property for the nasal delivery of metoclopramide.
The United States patent and trademark office recently issued a notice of allowance to evoke related to Jim Modi if granted as expected the pattern will cover methods of use for nasal delivery of metoclopramide for the treatment of Gastroparesis.
<unk> will be <unk> in the Fda's Orange book.
Over this quarter, we've made progress in providing a solution to this unmet medical need with our commercial launch of <unk>.
We lost chimbote during the pandemic and it has continued to impact both patient access and health care provider capacity to treat.
Just last month Salix a division of powers released a survey about patients with irritable bowel syndrome or ibs. During the pandemic. We believe Ibs provides a close proxy to the gastroparesis market as it is a motility disorder that is primarily treated by gastroenterologists.
The survey results offer perspective from patients with Ibs during the pandemic and insights about the symptoms and behaviors of patients over the past year.
More than one third or 37% of those surveyed acknowledged that COVID-19 pandemic has made it more challenging to manage their symptoms and reported deteriorating symptoms and most notably 35% of respondents have not discussed their symptoms with a health care provider at all since the pandemic began.
And this mirrors, the John Hopkins and CVC research that found 41% of chronic care patients have avoided care during the pandemic.
Patient volumes for Gastroparesis patients were down significantly over the past year. However, the number of patients returning to doctors' offices has begun to increase as more people feel comfortable doing so after becoming fully vaccinated.
As our strategically structured <unk> sales team throughout the U S focus their efforts in areas of high diabetic populations with heavy medical provide usage and office of the doctors across the country begin to reopen our 27 field and four in house sales representatives of dedicated evoke gastroenterology.
<unk> care specialists have been gaining increased access.
This has allowed them the ability to educate the targeted guestroom andrologist and select health care providers about the benefits of <unk>.
Our strategic message outlining the benefits of bypassing the Gi track of patients that have delayed gastric tempting straightforward and clinically meaningful.
And to date has resonated well with providers as we are encouraged by the traction we have observed over the past two months.
The Gastroenterologists and health care providers, we have had conversations with this quarter have remained very positive.
As Chris will discuss further in detail the feedback we've received from prescribing physicians and patients have been outstanding.
Over the past few months, we've heard numerous anecdotes from physicians about patients who have relieve their symptoms by switching to our starting on <unk>.
We are highly encouraged by how well received <unk> as among diabetic gastroparesis patients in search of more symptom relief, but they may not be receiving from alternative medications pace.
Patients suffering from diabetic gastroparesis, who do not receive a maximum benefit from oral treatment are pleased to find out there is now a new option available to them.
This favorable sentiment is also demonstrated by the positive trends, we're seeing within the growth of the number of prescribing physicians and refill rates.
Over this quarter and including April there were 170, <unk> prescribing physicians, which is a significant increase from the launch in the fourth quarter of last year.
This is an important indication that awareness is increasing and the medical community.
And we are confident that the word will spread as physicians discover how chimbote can provide relief and many patients compared to the other available treatments.
Additionally, refill rates for gymboree was 73%.
From launch through the end of the first quarter of 2021.
We believe these refill rates are a testament to the efficacy of the product and patient satisfaction in this difficult to treat disease.
Our management team will continue to pay special attention to these key metrics as we look to gain further market share with <unk> and as the pandemic impact starts to reverse in the months ahead and delivered different results from the second half of the year.
Expanding access to patients in need remains a high priority as we continue to execute our commercial strategy. This is why last year, we launched our program evoke assist to coordinate chimbote reimbursement and distribution through our exclusive pharmacy distribution program.
With any new product launch coverage by commercial plans and government payers is limited.
Our evoke as this program aims to make the process of determining covers seamless and minimizing patient out of pocket cost per day motive, where allowable patients with either Medicare or Medicaid account for a substantial part of the market in the first quarter, we completed the registration process to participate in Medicaid program.
Adding to the registration for Medicare part D completed December of last year.
While ensuring that patients who suffer from diabetic gastroparesis have access to our novel treatment. We are also focused on our efforts on increasing awareness.
Educating not only physicians, but also patients directly will be critical to the success of the commercial launch.
To that end in January of last year, we began our collaboration with ever signed up for the commercialization distribution and marketing of <unk> in the U S.
This has enabled us to leverage their integrated suite of commercial capabilities and they are highly experienced sales and marketing team as well as allowing us to avoid significant capital investment by utilizing the infrastructure expertise and financial resources, which were crucial ahead of our product launch and now even more importantly upon commercialization.
With that I'll now turn the call over to Chris for further details on the <unk> launch progression Chris.
Thank you Dave.
Our sales continue to ramp we're thrilled by the feedback we're receiving from prescribing physicians.
As many of you may recall, Dr. Richard Mccallum, who is professor of Medicine, and the division of Gastroenterology at Texas Tech University Health Science Center at El Paso provided us insight on Genuity at a recent key opinion leader Fireside chat on the treatment of Gastroparesis throughout this discussion Dr from accounts.
The key differences between <unk> and the traditional forum.
And then a compromise which is oral when asked how significant the difference was between oral tablets in Germany, you mentioned, Jim Modi was an advance in therapy based on absorption levels evidenced in blood levels, which remains sustained between doses of <unk>. He.
He also specifically mentioned other oral forms of metoclopramide.
Dissolving tablets and oral liquids, noting.
Noting that these formulations still needed to be absorbed by the Gi track and undergo first pass hepatic metabolism. Unlike genuity.
Additionally, he has observed no serious side effects reported from patients based on his experience and practice.
Dr. From accounts noted that eventually <unk> will be used more by specialists as they learn from peers speak about advances in gastroenterology.
We were pleased to hear Dr from account shares in our belief that <unk> will be the drug of choice to treat these patients for cash and neurologist.
The Gastroenterologists and health care providers, we've had conversations with this quarter.
Echo Dr Mccallum sentiment.
On the <unk> decided to share with you. The feedback we received from prescribing physicians and patients has been promising over the past few months, we've heard anecdotes from physicians about patients who ever leave their symptoms, but switching to or starting with genuity.
First let me start by reviewing data trends.
We're continuing to grow our prescriber base and see significant improvement in <unk> versus <unk>.
For the fourth quarter 2020, we had 45, new prescribers from 46 total prescribers.
In the first quarter of this year, we grew that unique new prescribers by 87% to 84 physicians and more than doubled the total number of physicians, who prescribed to a 113 prescribers.
In the fourth quarter, nearly all of the prescribers with Gastroenterologists.
In the first quarter prescribing expanded to include other specialties, including internal medicine family practice, and nurse practitioners and physician assistance.
Those physicians made up approximately 20% on prescribers.
We are particularly watching and tracking the uptake with <unk> and <unk>. Many of them are associated with guests or oncology group practices and provide the bulk of ongoing medical management of diabetic Gastroparesis positive momentum in this group of practitioners is an encouraging sign.
Another critical measure that we follow as refill rates.
For the fourth quarter, we shared that the number of patients have filled the first split.
The first month of therapy and are ready for the second scrip.
85% of them filled it.
That first fill rate persisted for all prescriptions in the first quarter notching up slightly to 86% refill rate for.
For patients across all refill opportunities, meaning the first second third and the fourth refill who are eligible for a refill. The overall refill rate has been 73% from launch to the end of the first quarter.
Refill rates on an important indicator of the continuing business and also a sign that the product is working for patients.
We have some patients that have received up to five sales on <unk>.
The range of refills associated with prescriptions is between one and 11 results.
Turning to reimbursement of Germany for the fourth quarter, 69% of <unk>.
<unk> were covered by a commercial payer for our savings program.
9% will cover Medicare plans with the balance coming from other payers, including Tri care.
As I mentioned on the last call, we registered Genuity with CMS to participate in both the Medicare and Medicaid programs, which occurred in December and January respectively.
In the first quarter, 57% of the expenses were covered by a commercial payor or our savings program, 32% were covered by Medicare plans, 6% by Medicaid plans and the balance being covered by other payers.
Another note is the expanding number of plants, who reimbursed chimbote in the fourth quarter, which was 10 plans tripling to 29 plans reimbursing Javadi and <unk>.
These plans provided coverage.
A contract for Debbie.
We are encouraged by these data and we will continue to monitor progress all of the noted factors are sign of patient need and the value proposition that chimbote represents.
Last quarter, we reported on our market research study ever conducted to measure awareness trial and product usage.
As a reminder, this was a quantitative survey with 104 physicians and three important cohorts targeted gastroenterologists non.
On targeting Gastroenterologists and primary care physicians.
Those data showed 20% of the respondents had reported that they had already prescribed <unk>.
The primary driver for the prescribing and switching to Giovanni was due to the lack of effectiveness with a current standard of care.
And 80% of Gastroenterologists and 50% of primary care physicians indicated that they intended to prescribe <unk>.
That study was conducted in December and the first week of January.
We launched the next wave of the <unk>. This week and we were excited to receive feedback on learn more about ACP awareness and interest.
Later this summer.
We continue to follow the patient demographics for <unk> in the fourth quarter. The typical patient had received some money was female between 50 and 64 with commercial insurance matching our general expectations.
As we grow our patient base, we see this trend continuing with some movement towards additional patients between 31% and 50 being prescribed and humidity.
77% of the genetic patients are female which is consistent with the prior experience in literature.
But besides us most of the stories were hearing from patients.
Few in particular I would like to share with you.
First a female patient who reported going from vomiting, one to two times a day net prior month.
Once or twice a week.
Another patient on your money for three months was taken off for a period of time and then the patient requested to be put back on <unk> and our reports they are symptom free.
And a third patient who is prescribed genuity, who is male says he feels just about normal again and has resumed playing basketball with his friends.
These are just a few of the many anecdotes that indicate that there is a significant need in the market for symptomatic relief of acute and recurrent symptoms pace.
Patients experienced with diabetic gastroparesis and the potential role that <unk> can play in a range where lee for those symptoms.
Lastly, I'd like to share the progress, we're making with our promotion within this market I am proud of the effort and dedication that they ever sign a sales team has demonstrated since launch in the face of unprecedented headwinds. They have remained steadfast in their commitment to patients and providers who care for them.
They are passionate advocates for these patients and are determined to ensure the hcp's learn and gain experience with genetic changes.
[laughter] habit is a difficult proposition in a normal environment.
And have it in grade over decades with no new option for these patients and a significant reduction in patients seeking care and restricted access to acp's due to COVID-19 and you have an extraordinary challenge.
This team is up to the task however.
Recently, while access to physicians due to COVID-19 remains a challenge, we see signs of relaxing restrictions, albeit uneven and slow our discussions with healthcare providers continue to be positive and reinforcing of <unk> value proposition. We are now just getting access to many hcp's that we're not seeing representatives and the.
Fourth quarter and first quarter, when we do get access and the representatives have the opportunity to educate them. We've seen the result in prescribing.
Offices are reporting an increase in patient flow likely due to increased vaccinations and a fall in cases, we encourage that patients seem to be seeking ketchup care that they were avoiding through the surge in cases in <unk> and <unk>.
From an execution standpoint, we have an increased our calls per day average from just under nine calls per day to 10 calls per day from fourth quarter to first quarter respectively.
Recently, the clip the sales team with new sales tools and are planning for samples in the near future.
Additionally, we're continuing to bolster our non personal promotion paid search and social digital campaign.
We already have an online presence and we are seeking to invest more there. Those plans include launching a branded Facebook page as well as patient support page and accompanying website or.
Our continued focus remains increasing the awareness of <unk> increase.
Increasing Chile, a demoting via prescriptions and samples and increasing access to <unk> through our <unk> program and Payors.
We remain confident that there is a substantial unmet need that providers recognize the value proposition of genuity and that there is a significant role that chimbote can play in helping patients manage their symptoms associated with diabetic gastroparesis.
I would now like to hand, the call back over to Dave Okay.
Thanks, Chris.
We're still in the beginning stages of launching demoted. However, the positive feedback we continue to receive from physicians and patients validates the need for this drug is more doctors' offices open patients will be pleased to discover new treatment option for diabetic gastroparesis drug launches have been hindered due to the pandemic, but thanks to the recent progress of the vaccine rollout roll.
Out nationwide patients feel more comfortable returning to the doctors' offices.
Additionally, our field force has experienced increased access to speak with physicians about prescribing demoting. So we're excited to capitalize on this recovery momentum and drive the progress of our commercial launch forward.
Now, let me turn to Matt Donofrio to review the financials for the first quarter of 2021.
Thanks, Dave and once again, thank you all for joining us this afternoon.
Restating the basics of the Arizona agreement ever Sino will receive reimbursement of its commercialization costs pursuant to an agreed upon budget and are only paybacks are a portion of the revenue as it is recognized and received once those costs are covered ever sign on will receive a percentage of product profit in the mid to high teens in evoke pertains over 80% net.
Net product profit or the net sales on <unk> less reimburse commercialization costs of both manufacturing and evoke administrative cost side as a fixed percentage of net sales and third party royalties.
During the term of our agreement with Arizona, They have agreed not to market promote or sell a competing product in that as states.
Now, let me review our financials for the first quarter of 2021.
For the first quarter of 2021 net sales of approximately $90000 and the net loss was approximately $2 6 million or <unk> <unk> per share compared to a net loss of approximately $1 8 million or <unk> <unk> per share in the first quarter of 2020. This increase was primarily due to costs associated with the commercialization launch of Demoting re.
<unk> and development expenses totaled approximately <unk> three.
3 million for the first quarter of 2021 compared to approximately <unk> 5 million for the first quarter of 2020.
For the first quarter of 2021, selling general and administrative expenses were approximately $2 3 million compared to approximately $1 3 million for the first quarter of 2020.
We expect that selling general administrative expenses will increase in the future as we continue to progress with the commercialization of <unk> and we reimburse ever saw on US from the net profit is obtained from the sales which ammonia.
Total operating expenses for the first quarter of 2021 were approximately $2 7 million compared to total operating expenses of approximately one 8 million from the same period of 2020.
As of March 31, 2021, the company's cash and cash equivalents were approximately $18 2 million, which includes approximately $13 1 million in net proceeds raised from our common stock offering in January of 2021, we expect sufficient runway to fund our operations into the first quarter of 2022.
Also last week a proposal was voted in on the company's annual proxy to consider an increase in the total authorized share is allowed in the company. The recommendation by evoke was to increase the shares from 50 million to $100 million.
Although the amendment to the company's amended and restated certificate of incorporation to increase the authorized number of shares of common stock received a substantial majority of votes cast. It did not receive a majority of the outstanding shares of common stock as required. So it was not approved the.
The company proposed a measured based on a few basic guiding principles.
On the.
Our fully diluted share count for the company is currently approximately $41 million based upon $32 million outstanding plus another 9 million reserve for warrant stock options and the company's employee stock purchase plan, leaving about $9 million remaining for various circumstances, such as employee hiring retention product acquisitions fund raising et cetera.
0.2, the authorized share has provided an additional financial safety net should the more funding be deemed prudent to support the ongoing activities of the company.
And three similar companies typically maintain far more shares in the $50 million authorized shares currently within evoke for such current users.
Nevertheless, the company will press forward with the current authorized shares and expect to revisit this matter in the future. Let me turn the call back over to Dave for closing remarks.
Thank you Matt.
I'd like to close the call today by saying that we have the foundation in place for growth of <unk> and we believe we are on the right track to make two Modi and an important product in the gastroparesis market.
We'll continue to implement our commercial strategy and will improve upon it every day, along with expanding reimbursement and access for <unk> to make sure Jim Modi is available for health care providers and their patients.
I'd like to thank our shareholders for their continued interest in our company and our progress throughout the rest of 2021, our team remains focused and committed to ensuring the successful commercial launch of chimbote, and we're confident and committed in our efforts to increase awareness help patients and their providers access and unlock the.
Considerable value in <unk>.
Thank you.
To open the call to questions operator.
Alright, so as a reminder to ask a question you will need to press star one on your telephone.
All your question the balance.
Again that is star one on your telephone please standby, while we compile the Q&A roster.
First question comes from the line of Rug, who Ram Silverado from <unk> right you are now live.
Hi to the team this is <unk> on for Rob Thanks for the update and congrats on the progress.
From us.
I was wondering what the gross to net discount levels trending how how they look at this point.
And how they've been trending in the last quarter.
Thanks, Bob This is Dave I'll, let Matt answer that question for you.
Sure. So we haven't put out any specific guidance on that on.
I'll just say in relationship to the WAC price, we are still receiving a substantial portion of that as it relates to the average net realized price.
If that helps provide some guidance of course with.
Early days that number can move around quite dramatically, but thus far it's remained again substantially a large portion of the original pricing itself.
Okay. Good understood I.
And I was wondering if you've made any progress on R&D activities in terms of the low dose of <unk>.
Yes, we have.
No.
Sure.
According to the FDA and when we were approved we had to put in a protocol for their review by March.
This year, we did that in early.
Early March and so we are waiting now for them to provide some feedback on that protocol. So yes. We have we've also manufacture the dose as well to have it available.
Excellent.
Finally, we wanted to get your views on credit attempt by Vanda Pharmaceuticals.
Do you think it's likely to be a competitive threat in the future.
Sure.
Where there is as we've discussed there is a huge need in this marketplace for new drugs from different drugs. My understanding they are looking for an indication for nausea as it relates to gastroparesis, we'd like to try to understand how that will differ from like zofran different products like that.
Different effects.
Then those products would have on nausea for these patients. So on understanding is that they're moving through their clinical trial, we know through experience the clinical trials in Gastroparesis gastroparesis patients are very difficult. It's tough to find these patients it's tough to do patient reported outcomes of these patients. So.
I guess, we'll have to wait and see what the data looks like Matt I don't know if you had the only other comment I would make is it's still on oral tablet, which we know from direct experience in the patient support groups that these patients pharma. It up. These these tablets <unk> don't metabolize them on a normal predictable way already so.
Given it doesn't have any pro motility action and it's not some other non oral delivery.
We still think there is.
Definitely differentiating factor between the two.
Great.
<unk> with the administration, okay. Thanks for clarifying on thanks for taking my questions. Thanks, Rob.
Next one on the line is Yale Jen from Laidlaw <unk> Company you are on our lives.
Good afternoon, and thanks for taking the questions.
Well congrats on the progress last quarter.
My first question is that in terms of the news prescribed.
New scripts versus the total amount until the scrip.
Remember.
I heard it correctly is that 86% new scripts.
Is that so.
Was the increasing.
On the high proportion of the news group.
We will be the major Gulf on.
For the marketing team over the next couple of quarters.
Yes.
The 86% number refers to the patients that have.
Completed their first month of therapy and are eligible for taking their second month of therapy and also have a refill associated with first ascription, 86% of those patients.
Filled in the first quarter compared to 85% and the.
Fourth quarter of last year, so, we're kind of maintaining that quarter to quarter.
And.
From a marketing perspective is that continuing having a high percentage of new scripts.
The major codes for the next couple of quarters.
Before getting more patient refills as well.
So we're actually seeing an increase in the total number of prescriptions and the contribution that refills are making.
So we're encouraged by that and obviously, we want to make sure that for those patients that.
That are on therapy continue on therapy. According to their physicians plans. So all refill opportunities. So that's the first the second third and fourth refill.
That rate of refill for patients again that have three of those.
Associated with the prescription is 73% and so we're encouraged by that number as well.
Okay, Great and maybe two quick ones the first of all on that.
Weighted R&D.
How should we think about the expense this fall.
Remaining of the year compared to the.
First quarter figures, we think that that may be the trial could start in the third or maybe fourth quarter all of Huntsville.
How can we help too.
Tool modeled model on that.
Yes. This is Matt so.
As you know we are a small virtual team in our burn we take pride in being extremely frugal and making sure. We're spending those dollars correctly as it relates specifically to R&D.
There's a good chance that we will not have to run a clinical trial.
So were still investigating some alternative pathways to approval for that and if that's true that would greatly diminish any potential costs.
Even if it was a clinical trial associated with that it's a straightforward PK trial with healthy volunteers that didn't have itself is usually.
A couple of million dollars or something of that nature.
But at this point were still investigating the more speedy and cost efficient route.
In vitro studies.
Okay. Maybe the last question here is that given the societies opening up a particular with the increasing back this nation.
The revenue increase.
Increasing the chances.
Face time with disposition in the Doctor's office or do you think that you still will do a lot of the online marketing efforts.
Thanks.
Yes, so I think.
On the answers, we're going to continue to leverage both routes to be able to get access to physicians in the office staff.
In the first quarter, we did see a paradoxical decline and access because of the increased patient volume and physicians and physician offices were kind of over burden with the with the load on.
Now as the first quarter ends in the second quarter starts we're seeing the acura access to offices increase.
And we're also seeing increased access to the physicians themselves, we have always been out in the field and trying to promote and gain access lives. So that's our preferred route of administration, we only use virtual and phone to supplement those efforts and to follow up so I am encouraged by the fact that we are.
Increasing our access and as I mentioned earlier, when we do have time with the physicians and especially when we have extended time.
That is resulting in a positive interaction and in many cases a prescription.
Okay, Great maybe just tack on last question one more question here you mentioned during the call about sampling.
That's something that you gained increased or start to do too.
To help the marketing effort.
Thanks.
So thanks, absolutely we're planning to do that we're hoping that we can accelerate our plans to do that.
And plan to do so over the next month or so to give access to.
Physicians to gain experience with patients on <unk>. So it's an important part of what we're trying to do but what I'll say is it's part of an overall plan to increase promotion and so as I look at it you kind of have.
Couple of positive things happening here at the same time and it's increased patient visits per that catch up care increased access to acp's.
The increase in our sales force and overall promotional effort and execution.
Help us to hit our stride.
In the upcoming quarter.
Okay, great. Thanks, and again congrats on the.
Positive progress.
Thanks.
There are no further questions at this time I will now turn the call over to back to the presenters.
Great I'd like to thank everyone for participating on the call today, and we'll look forward to be providing updates next quarter. Thank you.
This concludes today's conference call. Thank you for participating you may now disconnect.
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