Q2 2021 Evoke Pharma Inc Earnings Call

Good day and thank you for standing by welcome to the evoke pharma Q2, 2021 earnings conference call.

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I would now like to hand, the conference over to your speaker today, Christine Petraglia from the Ruth Group. Please go ahead.

Thank you.

Afternoon, and welcome to evoke pharma second quarter 2021 earnings conference call and audio webcast with me today are Dave Khani Air evokes Chief Executive Officer, and Matt Donofrio, Chief business Officer, as well as Chris Quesenberry, Jim Modi, Chief commercial officer from ever.

China.

Earlier today evoke issued a press release announcing financial results for the second quarter that ended June 32021, we encourage everyone to read todays press release as well as evokes quarterly report on Form 10-Q, which was filed with the SEC. The company's 10-Q report and press release are also.

Payable on evokes website at www dot evoke pharma dotcom.

In addition, this conference call is being webcast through the company's website and will be archived for 30 days for T shirt reference.

Please note that certain information discussed on the call today is covered under the Safe Harbor provisions of the private Securities Litigation Reform Act, we caution listeners that during this call evoke 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 in evokes press release and SEC filings.

Included in these court in this quarterly report on Form 10-Q and subsequent filings.

This conference call contains time sensitive information that is accurate only as the date of this live broadcast.

Evoke undertakes no obligation to revise or update any forward looking statements to reflect events or circumstances. After the date of this conference call.

With that I would like to now turn the call over to Dave Gadhia.

Thank you Christine and thank you all for joining US. This afternoon for evoke pharma second quarter 2021 earnings conference call today, I will start by walking through the commercial progress of <unk>, including the recent traction among physicians and patients.

I will then review, our new marketing and outreach programs aimed at raising awareness of <unk> before turning the call over to Chris for a more detailed discussion of our commercial and marketing efforts.

This quarter, we continued to execute our commercial strategy for <unk>. The first novel pharmaceutical treatment for Gastroparesis to hit the market in over 40 years.

<unk> provides a new and effective option for treating patients that are erratic absorption of oral medications as it's the first and only outpatient non oral treatment to treat patients suffering with diabetic gastroparesis.

<unk> addresses the unique needs of these patients by delivering an established treatment as a nasal spray that bypasses the Gi track.

In June we secured a patent from the United States patent and trademark office for Jim Modi, which covers methods of use for nasal delivery of metoclopramide for the treatment of Gastroparesis.

The issuance of this new patent entitled nasal formulation of Metoclopramide is a testament to how innovative and novel <unk> and we will strengthen our intellectual property protection for <unk>.

The new patent is listed and FDA is Orange book and carries a patent term to at least 2029.

This pattern will sustain our commercialization strategy as we continue to capitalize on our novel treatment and gain further market share.

<unk> unique approach to answering this critically unmet medical need is not only validated by the issuance of this patent but also in practice.

Since the launch of <unk> in October 2020, we have received overwhelmingly positive feedback from doctors and patients.

The testimonials, we hear from patients who had finally found long sought relief and treating their symptoms associated with diabetic gastroparesis are truly inspiring.

With respect to our product demand and interest we're pleased by how well received gymboree has been among health care providers and patients.

As a result, we continue to see positive trends within the growth of the number of prescribing physicians and refill rates.

Over this quarter, there were 132, new prescribing physicians and increase of nearly 60% compared to the last quarter.

The number of enrollments into our evoke assist program, which coordinates the reimbursement and distributions Chimbote also continued to grow each month.

Additionally, refill rates for gymboree, where 61% launch to date through the end of the second quarter.

And looking at active patients patients currently on medication the refill rate is 74%.

The high refill rates, an uptick in the number of prescribing physicians this quarter demonstrates that patients using chimbote are experiencing improved symptomatic relief.

As the pandemic was abating during the second quarter the ability of our sales team to meet face to face with physicians improved and has proven to be a tremendous advantage that we didn't have in the beginning of our commercial launch back in October and through February of this year.

These visits some of which we are seeing high value gastroenterologists for the first time since launch continued to generate positive elements and Phil.

Furthermore, we have noticed a pattern with them larger gastroenterology teams that the first physician adopting the use of <unk> has led other physicians within the same practice to begin prescribing <unk> as well.

In addition, our sales representatives have finally been able to conduct in person district meetings, which has helped to improve team dynamics.

With the easing of Covid restrictions in the second quarter and the Ryzen vaccinations. Our management team was also able to meet with sales representatives in may.

The ability to have real time conversations with physicians and hold organization wide meetings has significantly improved our communication around your motive.

We believe these sessions have been a major driving force for the increase in revenue.

Sales this quarter were approximately 237000.

And nearly 162% increase from the previous quarter.

We look forward to building on these newly established and existing relationships to further drive sales growth.

With that I'll turn it over to Chris for further details on our commercial progression of Chimbote Chris.

Thanks, Dave and good afternoon, and thank you for the opportunity to share the commercial update with you today.

Sharon days positive outlook I would like to emphasize some core leading indicators for the business are improving and we'd like to share some topline fundamentals before I speak to them in detail.

First access to physicians increased in the second quarter as Covid cases lessons, we improved our reach to Gastroenterologists and increased our details to hep's about genomic health.

Health care practitioners continue to provide positive direct feedback about promoting.

And perception of <unk> is high and stated interest to prescribe significantly increasing.

Gastroenterology meetings in Congress is starting to hold in person meetings again, and we've been able to attend these meetings in Europe.

<unk> live with key opinion leaders.

As Dave said, we were able to hold our first life sales means midway through the second quarter, which it was a boost to overall.

Communications morale.

Our online media and social digital plan is creating a significant number of impressions and engagement.

Lastly, the number of HCP prescribing Chimbote continues to increase and we are implementing programs to increase trial of <unk> further.

Our sales of <unk> continue to ramp we will closely monitor our traction among doctors and patients an important resource we have utilized to track our progress specifically among physicians.

Through timely <unk> studies.

Initially conducted in December of 2000, and the most recent study was completed in June of this year to measure awareness trial and product usage of <unk> among physicians.

This next HEU study aimed at gathering further market insights on the perception of Genuity and the Gi community.

The respondent mix included 67, Gastroenterologist currently being called on by the field sales force and an additional 50 Gi and primary care physicians.

Our objective in this study was to understand current gastroparesis treatment landscape and to evaluate physician's perception chimbote. Following recent brand marketing efforts.

Overall based on comparative analysis from the initial study we observed that awareness and adoption of <unk> is in fact, increasing.

I'd like to share a few noteworthy findings from this study.

Among 117 physicians responses, 81% of all respondents intend to prescribe <unk> in the future.

And when you look at target Gis, 90% of them intend to prescribe genuity compared to 79% in the previous study.

More than twice as many respondents 47 versus 19 reported that they have written a prescription for intermodal in the previous two months compared to the previous study.

Targeted you guys reported in person visits or increasing by sales Representatives importantly, 75% of the target <unk> said, they would prefer future interactions to be in person versus 64% in the previous study.

And lastly, HCP is rated <unk> nasal route of administration numerically higher and effectiveness at.

At $3.63 on a five point scale compared to metoclopramide delivered through oral solution or oral tablet at three 504 and 3.31, respectively.

The increased traction observed in our ATM market Research study will continue to reinforce <unk> as a viable treatment option among physicians for patients who suffer from symptoms of diabetic gastroparesis.

Gastrologist in this study confirm that what we are seeing in the market that our sales representatives are gaining increased face to face access with targeted <unk> during the second quarter as compared to what we were seeing in the fourth quarter of last year and first quarter of this year and this is a top priority.

While we have successfully gained access to 90% of our targeted offices since launch our ability to physically gain access to physicians themselves have been.

A significant hurdle.

We have improved this metric during the second quarter of this year with offices opening back up we have just been able to obtain reach of 50% to our targeted physicians with a detail.

We have put the most focus and effort on the top 1000 physicians across all of our geographies and we are seeing the best success with these physicians.

Among the top Hcp's, we have full access and have detailed over 80% of these physicians at least once.

Not surprisingly two thirds of our enrollments are coming from these gastroenterology practice.

On average we have detailed these top positions five eight times since launch or once every six weeks.

Preliminary data suggests that it takes on average four six details for HCP to write the first enrollment for <unk>, which is encouraging as we are reaching this metric with our top targets.

Additionally, within the pharma industry typically indicated that on average it takes seven to eight details to change behavior and it has historically takes about 12 to 18 months to see an HCP that many times.

I'm very pleased to see that our detailed two enrollment takes lesson that standard and indicates that our message is clear and compelling.

That said since launch access to HCP has been the challenge and we need to expand our detailed reach to our entire targeted call plan to build on this momentum.

One point remains clear and has been consistent from the first day of launch there remains a strong and just level. Among this group of physicians, who express a genuine understanding of the potential benefits of the nasal route of administration for patients with Gastroparesis and see the value of <unk> for their patients with diabetic gastroparesis.

Have it remains our biggest obstacle yet I am confident that when we can establish a reliable present with gastrologist that we can change their behavior.

To that end and in order to broaden the overall experience and utilizing Genuity, we lost a patient and physician experience program in July.

This program will provide samples agility to a significant number of targeted gastroenterologist and advanced practice practitioners. So they can provide these samples during an office visit and initiate therapy immediately.

This is an important opportunity to familiarize non prescribing physicians with Novartis and increased trial. Among patients. We are hopeful that this program will allow them to observe firsthand <unk> important therapeutic benefits and determined that <unk> may provide leads to those.

I have received excellent really from all therapies.

Our experienced program is just one of the many ways. We are raising awareness about <unk>. We're also leveraging social media to further extend our reach within the diabetic Gastroparesis community.

Especially in today's environment, we understand the importance of establishing a broader online presence.

As the unmet medical need for this disease remains so high with many patients continuing to seek alternatives even after a medical consultation many of these patients turning to the internet for their answers.

Our market research indicates one of the most common venues they use our Facebook forums with tens of thousands of people interacting on these sites.

This quarter, we launched the first wave of our social media campaigns to reach patients directly with education about diabetic gastroparesis. The initial wave of this program consists of two Facebook pages are devoting branded Facebook page in a diabetic gastroparesis community Facebook page called D. G. P <unk> diabetic gastroparesis support.

As you've already Facebook page enables us to further spread awareness of <unk> as an important nasal option for patients who are particularly for the acute and recurrent symptoms of diabetic gastroparesis, especially in cases, where oral therapies are not effective.

As a supplement to our Javadi Facebook page, we felt it was imperative and incumbent upon us as a leader in advancing medical treatments for diabetic gastroparesis to establish an online community dedicated to offering support education and a community to people living with symptoms of diabetic gastroparesis.

The launch of our two Facebook assets in mid and late July respectively. We have generated over 580000 impressions and 8000 clips to Giovanni Rx Dot com from our commodity Facebook page and over 2000 lives and reach to over 306000 users from our <unk> Facebook page.

Most notable is the engagement we're seeing on the GGP and me page engagement is a deeper interaction and constitutes reactions comments and clips.

<unk> image posts have received nearly 41000 engagements and three of our video posts have received over 45000 views.

They are up to 16 million people in the U S who suffer from the symptoms of Gastroparesis. It is an unfortunate reality that patients with diabetic gastroparesis often suffer with the Simpsons for years before receiving some firm at Torrey diagnosis.

During this time, they often resort to the internet for answers and there are no consistent readily available resources that their physician can provide them.

In a new market research study with patients with diabetic gastroparesis more than half of the respondents indicated some level of dissatisfaction with current therapies underscoring the opportunity with these patients.

To bridge the gap, we are committed to interacting with patients to help answer questions and offer much needed support.

People suffering from symptoms of Gastroparesis should not be left in the dark they deserve answers and transparency and we look forward to playing a role in helping patients access information about what it is causing their symptoms educational resources about the disease and available treatment options.

This month, we will launch a more comprehensive website to complement our <unk> Facebook page also called <unk>. This page will support patients and learning more about GGP and treatment options.

Access to HCP, and dietitians and be able to hear from patients like that.

As a reminder, these are in addition to our broader online efforts to raise awareness of DCP and Genuity since January our total media plan drove nearly seven 5 billion impressions and nearly 60000 clips to Giovanni Rx and you buy the Rx HCP Dot com, both our patient and banner ads continue.

To perform above industry standards are improving over time.

While building awareness and market share for Giovanni remains our key focus we believe there are many ways to contribute to the diabetic gastroparesis community beyond our novel treatment.

To that end in June we announced our membership into the International Foundation for gastrointestinal disorders. This is an important organization, whose mission is aligned with ours improving the lives of those affected by gastroparesis by raising awareness, improving education and promoting research into treatments and cures.

Part of the industry Council, we will participate in biannual council meetings aimed at facilitating communications that amplify the patient voice.

This is a great opportunity to gain industry insights and share valuable feedback to organizations of like minded group.

One important effort that we are collaborating with the <unk> Gd is a survey to patients to understand the care they receive during the pandemic and how that impacted their treatment and disease and the implications for future interactions with their health care providers I look forward to sharing these insights specifically for gastroparesis in the future.

Another collaboration is our support of the <unk> and patients with Gastroparesis awareness month.

Which is this month August this is an important campaign to raise awareness about the disease, the GAAP and care and the need for additional treatments for patients. We have a concentrated effort to leverage this effort via social channels and through our field force for the entire month.

We'll bring this message to HCP is directly and through our interactions that Congress meetings and peer to peer programs plane planned for late summer and through the end of the year.

Lastly, we continue to gain clarity around health insurance companies are evaluating chimbote.

Through our program, we were able to understand coverage and when there is a request for prior authorizations and what the requirements are.

To date 58 separate plans have coverage of ov.

Of our sales over 70% are covered by insurance and approximately 20% of our commercial patients who have received co pay assistance.

Through our continued commercial expansion increasing in person access to physicians and growing visibility within the Gastroparesis community. We are very excited about the progress. We made this last quarter, we're particularly encouraged by the positive trends observed within refill rates sales growth and prescribing physicians.

As we enter the second half of the year and we look forward to driving our commercial and marketing initiatives forward and further establishing <unk> as the preferred treatment option for patients suffering from diabetic gastroparesis.

Our focus continues to be on increasing awareness of <unk>, among prescribers and patients alike positioning <unk> as the best choice for patients with Gastroparesis based on our nasal route of administration, increasing trial of Genuity and improving and simplifying the access to chipotle.

Dave.

Thanks, Chris and as you've just heard we've made significant progress this quarter with building awareness of <unk> and thanks to the important insight from our market research. We are now able to better target, where our marketing and sales efforts will have the most impact.

With easing COVID-19 restrictions in the second quarter, our sales force has been able to visit doctors in person more frequently.

Because our sales continue to ramp our focus remains on broadening our network among patients and doctors to further educate and increase awareness of <unk> important benefits.

That let me turn it over to Matt to review the second quarter 2021 financials.

Thanks, Dave once again, thank you all for joining us this afternoon.

Restating the basics of the Arizona agreement <unk> will receive reimbursement of its commercialization cost pursuant to an agreed upon budget and are only paid back through a portion of the revenue as it is recognized and received once those costs recovered ever Sona will receive a percentage of product profits in the mid to high teens, while evoke retains over 80%.

Net product profit or the net sales of <unk> less reimburse commercialization costs, you, both manufacturing manufacturing and administration costs.

Set at a fixed percentage of net sales and third party royalties.

During the term of our agreement with ever Sona, They have agreed not to market promote or sell the competing product in the United States.

Now, let me review our financials for the second quarter 2021 results. The net loss for the second quarter of 2021 was approximately $2.3 million or <unk> <unk> per share.

Compared to a net loss of 7 million or <unk> 28 per share for the second quarter of 2020.

During the second quarter of 2020, we expense $5 million upon achieving a technology acquisition milestone related to FDA approval of <unk>.

For the second quarter of 2021, 2021, net product sales were approximately $237000 compared to approximately 90000 during the first quarter of 2021. The increase in net sales was due to higher number of chimbote prescriptions.

<unk> approved our <unk> NDA in June of 2020, and we began commercial sales in October of 2020. So there were no net product sales during the three months ended June 32020.

Research and development expenses totaled approximately 195000 for the second quarter of 2021 compared to approximately $5.8 million for the second quarter of 2020. The decrease in research and development expenses was due to the achievement of the commercial milestone of Genuity, receiving FDA approval in June.

2020.

And for the second quarter of 2021.

Selling and general administrative expenses were approximately $2.1 million compared to approximately $1.2 million for the second 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 reimbursed for Arizona for the net profit profits obtained from the sale of intermodal.

Total operating expenses for the second quarter of 2021.

Approximately $2.4 million compared to total operating expenses of approximately $7 million for the same period of 2020.

As of June 32021, the company's cash and cash equivalents were approximately $16.7 million and we expect our cash and cash equivalents will be sufficient to fund our operations into the third quarter of 2022.

And with that let me turn the call back over to Dave for closing remarks, great.

Great. Thanks, Matt while we're certainly excited about the momentum we've achieved in the second quarter as we continue to observe positive trends among refill rates and prescribing physicians with our sales representatives gaining increased face to face access with physicians. The positive feedback we receive inspires us to keep to put <unk> into the hands of the people who.

Who need it most.

Looking to the second half of this year, we're confident we'll be able to capitalize on this momentum as we prioritize prioritize expanding reimbursement and access for <unk> to health care professionals and patients.

I'd like to thank all our shareholders for their continued interest in our company and our progress we have the right people tools and resources in place to achieve commercial success together will continue to work tirelessly on our mission to establish <unk> as the premier product in the Gastroparesis market and help to improve the lives of those.

<unk>, who suffered from this disease.

With that I would like to open the call to questions from our covering analysts.

Operator.

And at this time, if you would like to ask any questions just press <unk> one on your telephone keypad.

Bob Ferguson moment to compile the Q&A roster.

And your first question will come from the line of Ram <unk> from H C. Wainwright. Your line is open.

Hello, guys. This is myles on for Rob Congrats on the strong.

Progress just a few from us if I may.

So you've mentioned previously that you're closely tracking the uptake with.

Jim Kelley with nurse practitioners and physician assistance.

What trends are you seeing in terms of this group.

Great. Thanks for the question I appreciate it because we wanted to turn that over to Nick excuse me too.

Chris who is we're spending a lot of time on the E&P.

MPA front it seems to be a great group for us to tackle so Chris Yeah. So we're seeing increases in prescribing and unique prescribing among both GAAP gastroenterologists as well as the <unk> and <unk> and it continues to increase.

We're working on teasing out the E&ps and Tas, who actually right under the positions of authority and seeing how we can actually capture those data a little bit more clearly, but but certainly when we engage with the physicians and the offices and the and the <unk> and <unk> that do the majority of the medical treatment and so on.

Focused on them as a key stakeholder.

And more focused also on continuing to build.

Our relationships with them. So later in September only in Las Vegas at the Gastroparesis.

Association that nurse practitioners and Tas.

And.

And we also will hold an AD board with those empties.

Mp's and pace of that meeting as well.

Alright excellent. We appreciate the detailed prescriber data that you shared.

Following on from previous discussions would you still maintain that at this point you'd probably need another quarter's worth of data to be.

Significantly confident about long term retention rate.

Well I think retention rate, we can see.

Continued prescribing physicians, who have prescribed once we're seeing some and I'll let Chris.

Talk about this as well, but we've been seeing that and then seeing the refills as we mentioned as well so.

The chance to get into finally see physicians.

Consistent level get face to face with them.

Has made a significant difference.

The impact that the sales reps are having cristina.

Chris I'm going to get any other comments.

Yes, so I think that we are seeing strong momentum with them both.

New and continued prescribing so.

The number of physicians that have written two or more prescriptions continues to increase and we're focused on increasing that depth and we have about a third of our prescriptions coming from those physicians who have written <unk>.

Five or more times, so that group continues to show promise and around the adoption.

And.

The.

The clinical value that somebody is providing those patients we have a position that for example.

<unk>.

In Alabama.

As switching his oral patients over to the nasal and it's kind of a methodical process that he is taking but thats. An example, where he sees the benefit and the route of administration had difficulties with the oral and he sees this route of administration with chimbote as a better option for patients moving forward.

The goal is to get more of those physicians to understand that and really cement that value proposition.

That's very helpful. Thank you and in terms of the plan.

<unk> are you still seeing an expansion I think you mentioned.

<unk> 29 in the first quarter do you have the current number of.

Yes, yes.

Yes.

Ft eight plans.

Through the second quarter and it continues to rise this quarter. So 58 separate plans have approved at least one prescription <unk>.

Certainly there are.

The larger plans and pbms that have approved more than one.

Si and Cvs or some of the <unk>.

Plans that have the bulk of the prescriptions coming through but we have 58 separate plans through the end of the second quarter and I think we're around 63 or 64 midway through August.

Great I'll squeeze a final one if I may regarding the lower dose of <unk> have you received any feedback from the FDA regarding the protocol we submitted in March this year.

Yes, we're still working directly with FDA on to a development plan that would be appropriate for the seven five so we are still working with FDA on that.

Okay. Thanks for taking my questions and congrats to the team.

Thank you.

And your next question will come from Yale Jen from Laidlaw <unk> Company. Your line is open.

First thanks for taking the questions and congrats on the very positive momentum.

So far.

My first question is that.

Giving this.

This momentum you have established us well both from the recent disposition.

The patients.

Do you have any sort of estimate projections in terms of the coming quarters.

In terms of either gone yourself or with Audi.

Prescribed patients.

Yeah.

We haven't made any.

Actions yet on that.

A quarter, where we feel like we have.

Got a good launch finally of demoted where we haven't had in the when we launched in October in the midst of that.

The pandemic and all the way through.

March and April it wasn't May was a very significant month and ended June where the reps got to see physicians, we got to have district meetings with our team face to face that we haven't had.

So it's very energizing time so.

We're happy to continue to capitalize on the access we hope that continues.

Getting those face to face but.

It was a good quarter from that aspect.

Great and.

Just a little bit follow up on that which is that we got a roughly a month.

<unk> off the third quarter.

Uh huh.

Have you seen this particular momentum or prescribing pattern.

These factors are still in charging in the positive direction.

Yes, yes, it's continued to improve so we're excited about that.

Like I said, if we can continue to see physicians in their respective serious face to face we have impact.

Chris mentioned that.

The work we've done when we've seen a physician prescribes is only taking four six face to face visits to get that person to write a prescription. So if we can continue getting those face to face meetings.

We will have we will have decent success with the product.

Okay great.

No go ahead.

84 <unk>.

The scripts in the first quarter and 132.

<unk>.

But your revenue seems to be much because that the differences.

The revenue seems to be much greater.

Wonder whether the revenue reflects quite a bit of refill in the second quarter.

Yes. This is Matt. Thanks, so much for the question. So the number of prescribers is I think what you were describing that we haven't we haven't disclosed any specific number of prescriptions. The number of prescribers of course is improving.

And as more information than that within our filing showing a specific numbers month by month.

That being said in many cases those persons are prescribing more than one prescription.

And then yes.

That is also attributed to refills because these patients.

Unfortunately, the disease is as intermittently chronic because the way we like to describe it once they have it in the nerve damage that's been associated with it never goes away. So some patients will be on it for.

Short amount of time, some much more extended periods of time, we now in terms of.

Oral metoclopramide, we see ranges between four prescriptions for year to upwards of 11 prescriptions per year, depending upon the severity of the patient for the oral so we suspect that physicians will also.

Have a good number of refills for those individuals of course, because the patients may be achieving.

Symptom remission at times. They May go off but we've also seen examples where patients who have been on went off of product because they are feeling better than had symptoms come back and went back to the physician requests and go back on <unk>. So it's another example, we believe of sort of both the intermittent and waxing and waning of the Senate.

And.

What patients may be feeling as the benefit of pneumonia itself.

Okay great.

Every detail.

That's very helpful and maybe the last question here.

One of the investors.

Just curious I mean, given this very positive trend you have and.

Do you anticipate possibly next year, you will be able to.

Repay all of the.

Expenses and to start to look to do it so not being able to actually move to the next stage.

Business deal.

Yes, that's a great question and as we said we haven't put out any guidance on.

Forecasted revenues and it's really because I think Dave was describing we just.

Essentially having the product launch in May and June.

Just because of that with the availability wide availability of vaccines in April and May.

One the majority of persons I think were feeling comfortable meeting with face to face and that's when most of the offices, we were trying to call on where then allowing reps in.

So it's very difficult to make any projections based upon in our eyes.

A very very near term launch we remain hopeful we continue to see positive trends, but at this point, we haven't provided any guidance around that.

Okay.

That's fine and maybe just squeezing out that's one.

What sort of.

Concerned about the Delta.

At this point.

Do you anticipate that could have any sort of negative impact or you feel that the momentum.

As bill.

The trend already left the station.

It may not necessarily be a major concern.

Thanks.

I think there's always hanging over our heads everybody's has like a cloud.

Not knowing is difficult I think with the work that the team has done from a digital standpoint, and getting awareness of <unk>.

Line is a big help we didn't have that through the first part of the pandemic. So I think that piece of it helps tremendously.

But.

I think Chris will tell you some areas of has seen physicians closed down a little bit in terms of.

Access, but it hasn't been widespread.

So wait and see but we're pushing more on the digital trying to keep active that way.

With patients with physicians physicians.

And move forward and we'll see what happens with the Delta.

Okay, great. Thanks, a lot and again congrats on a very good quarter.

Thanks, Joe.

And that concludes our question and answer session I will now turn the call over to back to Dave Gonyer for closing remarks.

Great. Thank you I just say, thank you again to our shareholders for your participation and look forward to reporting the next quarter. Thank you.

And this concludes today's conference call. Thank you for participating you may now disconnect your lines.

Okay.

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