Q2 2023 Blueprint Medicines Corp Earnings Call
Good morning, Ladies and gentlemen, my name is Glenn and I'll be your conference operator today at this time I would like to welcome everyone to the blueprint medicines second quarter turn times pre <unk> financial results Conference call. All of mine have been placed on mute to prevent any background noise. After.
The speaker's remarks, there will be a question and answer session. If you'd like to ask a question. During this time simply press star worldwide number one on tap when keypad. If you would like to withdraw your question Press Star followed by two on the telephone keypad. Please plan to limit yourself to one question I will now turn it to Jennifer <unk>.
Vice President of Investor Relations to begin.
Thank you Glenn good morning, everyone and welcome to Blueprint medicines second quarter 2023 financial and operating results Conference call. This morning, we issued a press release, which outlines the topics. We plan to discuss today you can access the press release as well as the slides that we'll be reviewing today by going to the investors section of our website.
At Www Dot blueprint medicines dotcom joined.
Joining me today are Kate Haviland, Chief Executive Officer, Selena Lee Chief Commercial Officer, Swagger, Mooney, President research and development and Mike lands, It'll Chief Financial Officer Christy.
Christy Rossi, Chief operating Officer, and Becker Hughes, Chief Medical Officer will also be available for Q&A.
Before we begin I'd like to remind you that some of the statements made during the call. Today are forward looking statements is outlined on slide three and are subject to a number of risks and uncertainties. These may cause our actual results to differ materially including those described in our reports filed with the SEC you are cautioned not to place any undue reliance on these forward looking statements and blueprint disclaims any.
The obligation to update such statements I'll now hand, the call over to Kate.
And good morning, everyone.
In the second quarter, we entered a new era of blueprint medicines, which we call precision at scale.
This inflection is driven by the significant near term growth opportunity for Ava kit with the recent FDA approval and I S M.
With Eva Cat I, often patients now have the first and only medicine approved to treat their disease and importantly, a medicine that was specifically designed to stop I S. M at its source.
The launch is off to a great start and Selina will provide more color on our commercial results and key launch metrics shortly.
Importantly, everything we are seeing in these early days of launch demonstrates that the market for Ava kit is a blockbuster opportunity that we estimate to be more than $1.5 billion at peak.
Our Q2 launch momentum has continued into the second half of this year and advocate is on track to become the durable market leader across the spectrum of both advanced and indolent SM for years to come.
At Blueprint medicines, we have developed a deep knowledge of S. M that will allow us to extend and enhance our leadership in this area as we define the direction of innovation going forward.
And I asked him alone. We have studied approximately 400 patients globally at nearly 80 sites spanning 16 countries.
Through our development work, we have built a substantive and rigorous base of knowledge of SM disease biology that will allow us to continue to meet the range of clinical needs across the spectrum of patients who have S. M.
We are developing longitude longitudinal long term evidence on the treatment impact of Eva and I S. N and we look forward to sharing data from part one of our Harbor study later this year.
Beyond desktop and we are expanding our leadership and kept biology, as we build a franchise and broader mass cell driven diseases.
Today, we are very pleased to announce we have nominated a development candidate targeting wild type kit Blu 808, which has the opportunity to be the first and best in class oral wild type kit inhibitor with broad applicability across multiple diseases.
Slide will provide more details on this program as well as our other pipeline programs later on the call.
But I want to highlight this program as an example of how we are executing our strategy of precision at scale.
Our wild type kit program directly Leverages, our technical expertise and our S M commercial and medical infrastructure.
Which will allow us to work efficiently as we as we address the medical needs of patients with a wide range of basalt driven disorders.
Yeah.
Precision at scale is our strategy for driving growth through leverage.
By efficiently using our resources, we are capitalizing on our first mover advantage in S M and moving quickly into adjacent new diseases, enabling us to operate with financial discipline by leveraging true synergies across programs.
Blueprint has a strong financial foundation and Mike will cover how we have managed operating expenses, while growing revenue and advancing our pipeline.
This uniquely positions us to have true options over the coming years to drive value as we prioritize the most promising pipeline programs.
<unk> partnerships to expand our cash position.
And stay disciplined and data driven do you prioritizing programs that don't have compelling data or market opportunities.
This is our framework to build precision at scale.
Our execution, our execution across a diverse set of value drivers in the first half of this year has set us on a strong trajectory for continued success moving into the second half of 2023.
Our number one priority will continue to be driving revenue acceleration with the launch of advocate NSM. While we also progress our pipeline of programs addressing some of the most important and exciting biological targets in oncology and allergy immunology.
They have the potential to impact a large number of patients globally.
Now, let me turn it over to Phil to discuss <unk> performance in the quarter and our perspectives on the first few weeks of Biosimilars.
Thanks, Kate good morning, everyone.
Our results in the second quarter and for the first few weeks of our ISR lunch put us exactly where we want to be.
We achieved net product revenue of $39 $9 million, including $34 $3 million in the U S.
We significantly grew the number of patients on therapy exiting the quarter with approximately 585 patients on Ava kits in the U S.
The growth we saw was fuelled by S M, where we saw a significant uptick in June post approval.
While our advanced SM business continues to grow.
Lunch is the key catalyst that unlocks Ava kits blockbuster potential.
Our Q2 results are due to Ava kits strong clinical profile and I S M and exceptional execution out of the gate.
I could not be more proud of our team.
We are delivering across the three pillars of our launch strategy engaging with providers activating patients and ensuring strong access.
Let's look at each of these key strategic pillars driving the lunch.
First we're seeing strong provider engagement.
Our field teams have been educating he marks an allergist immunologist on Ava kit in I S M and the enthusiastic response, we're seeing confirms the unmet need is there.
Nearly 70% of S. M script since approval came from new prescribers, including <unk> as well as allergist immunologist.
Prescribing was evenly split between academic and community, which is great validation that providers recognize the strong benefit risk profile of Eva kit.
What we're seeing in the daily interactions of our field teams with providers across treatment settings aligns well with the overall sentiments you've seen in recent surveys by others.
Key amongst allergists are compelled by Eva kits efficacy and safety profile, they're motivated to prescribe a kit based on the broad symptom improvement.
They're identifying the first ISR patients they want to treat and linking to their upcoming appointments through the year.
We expect to see a strong and consistent cadence of new patient starts going forward as patients come in for their appointments and have the opportunity to discuss Ava kit with their providers.
Second we're beginning to see the impact of patient activation on Ava kit prescribing.
Patient activation is a critical part of driving urgency to treat before launch we drove disease awareness partnering with the advocacy community at lunch, we unveiled our branded patient campaign engaging thousands of people in our CRM database and we're just now launching our broadest multichannel direct to patient.
Efforts to grow awareness of Eva kit.
And educated patient is a catalyst for treatment.
Patients are closest to the hard decisions they've had to make to live with I S. M leading to what some have described as a sense of loss of life, while still living.
When patients see Eva kits profile, we know they're more likely to ask their provider about it.
And we're highly encouraged to hear initial examples of patients calling their providers to ask about Eva kit.
We expect this to grow as we expand our patient activation efforts.
And last access to advocate continues to be strong prescriptions are being written approved and paid for as we expected.
The majority of payer coverage policies have been updated to include Eva kit in I S N, which is highly encouraging to see this early in the launch.
These updated policies provide coverage consistent with Eva kits broad indication there.
There are no restrictions beyond the label and there are no step edits.
We have yet to face any denials and we have seen paid claims at nine of the 10 biggest payers.
Strong access is important to all providers, particularly allergists, who may have had prior negative experiences with other products.
So we're not only educating on the clinical profile of Eva kit, but we're also educating new prescribers on the access process.
And most importantly, we're hearing that when a provider has prescribed David kit they and their staff are finding the access process to be very easy.
Overall, our experience validates exactly what we expected.
Q2 reflects just the first few weeks of launch performance and while we don't typically comment past quarter close I am pleased to share. The strong initial trends we've seen have carried into July .
We have the right medicine, the right team and the right capabilities to scale, our impact and we are well on track to establish Ava kit as the standard of care in I S. M.
We are executing our plan with precision and it's a thrill to see our vision becoming reality.
With that I'll hand, it to <unk> to talk about recent accomplishments and our research and development portfolio.
Including how we continue to build on our kit franchise leadership.
Thank you for you now.
And as Kim mentioned in her introductory remarks, our blueprint medicines pipeline shows how we double precision medicine that scale with the potential to benefit a large number of patients.
We have leveraged our leadership position in mass set of diseases and knowledge of biology to further pursue large on strategy opportunities, but significantly scaled our precision discovery efforts.
I'm pleased to announce that we have nominated Blue 808, as an oral highly potent and selective normally bring Pentagon wild type kit inhibitor for development in massive disorders, including chronic urticaria.
Chronicles, etc.
It's a skin disorder characterized by heightened itching and sweating and defined by high levels of massive activation.
There are a few options for patients who are not well controlled by first line treatments and Blue 808 represents a significant opportunity to bring relief to many people.
Blueprint is uniquely advantaged to brink for Blue 808, with its very compelling preclinical profile.
As a potentially first and best in class Wild type kit inhibitor.
We expect the blue 808 to be in the clinic in 'twenty 'twenty four and look forward to updating you more on clinical development plans as they progress.
Turning now to our oncology clinical pipeline.
For which we presented promising clinical data this past quarter I'd ask you.
This includes a dose escalation data from our Egfr programs.
With late line monotherapy and combination data of Blue 94, five with automotive as well as first clinical data for Blu five one, which we are studying and exon 20 insertion and atypical egfr mutations.
Of course, both across both programs, we sold opportunity for differentiation and we continue dose escalation to determine our b to D.
One of the biggest takeaways from this year's asking what's the excitement around emerging data on CDK too.
Which exist that this new target will be the focus of medicines that can treat.
Wide range of Instructables solid tumor such as breast cancer and.
At <unk>, we presented dose escalation data from our CDK inhibitor Blu two to do that show. This molecule has both good safety profile and early clinical activity to become the best and most combinable molecule in the crash.
The additional CDK to as an important cancer target and the emerging Bluetooth <unk> clinical profile increase our optimism about the value that can be created with these investigational agents.
We are moving towards monotherapy RP, two D and the rapidly enrolling patients in the CDK four six combination cohort.
The next major inflection point for this program will come in 2024, when we expect to share the first combination data.
Bluetooth to embodies our approach to precision at scale.
Good validation potent and selective inhibition with a best in class agent developed in house and a development plan that aims to rapidly bring the benefits of precision medicine.
A large patient populations with medical needs.
Having worked with amazing medicines that transform the treatment of cancer for a large number of patients I can see Bluetooth to becoming one of these.
With this I now turn the call over to Mike to review our financial updates.
Thanks Rod earlier. This morning, we reported detailed financial results in our press release.
For today's call I'll touch on a few highlights.
In the second quarter total revenues were $57 $6 million, including $39 9 million in net product revenues from sales of Eva kit and $17 $7 million in collaboration and license revenues.
That's fully know noted we saw continued growth in <unk> demand across the S M business.
Our total costs and operating expenses were $185 $6 million for the second quarter, which includes $23 $8 million in noncash stock based compensation expense.
This marks our fourth consecutive quarter of flat or declining operating expenses and a year over year decline of approximately 5% compared to the second quarter of last year.
For the second half of this year, we expect operating expenses to remain relatively consistent with what we saw in the first half of the year.
Blueprint is at an inflection point for value creation, as we expect <unk> revenues to meaningfully ramp with the ISR launch.
As product revenue continues to ramp and we remain disciplined on our operating expenses, we expect our operating cash burn to be lower in 2023 as compared to 2022 and to continue to decline into 'twenty 'twenty four.
We remain in a strong financial position with $836 $6 million in cash on hand.
Blueprints continued diversity of fundamental revenue drivers gives us the flexibility to be strategic and thoughtful in how we manage all aspects of our business to provide the greatest value to our shareholders.
Looking forward, our highest priorities for capital allocation are investing in the continued launch of I S. M. It didnt accelerating and expanding the development of Blu 222, given the potential opportunity to drive value with our best in class CDK <unk> inhibitor throughout highlighted earlier.
And we will continue to do this while maintaining a strong financial position.
With that I'll now turn the call back over to the operator for questions operator.
Thank you, ladies and gentlemen, if you would like to ask a question. Please press star one on path on keypad now if you change your mind. Please press star followed by two to withdraw the question.
This limit to one question at a time.
We're prepared to ask your question I'm sure you'll focus on mute locally.
We have our first question comes from Brad <unk> from Stifel. Bret Your line is now open.
Great Good morning, and congrats on the initial launch results here.
If you'd like to ask for commentary around the dynamic where 70% of the new scripts were from new prescribers, because you've mentioned before you had 400 Haemonchus accounts, who are prescribing for ASM and I think they had over 400 ISN patients and I think we would've expected first adoption. There. So can you speak to what might be prevent.
<unk> the more rapid uptake there in that prescribers segment any insight into July for those and was there.
Any commentary you can have over higher off label use in that segment before the approval. Thank you.
Thanks, Brad for the question for Linda do you want to talk about how we're seeing this nice breadth of prescribing coming from both new and existing prescribers. Yeah first off Brad I think we were really pleased to see the diversity of revenue. Even this early in the launch where prescriptions are coming not only from hematology.
<unk>, where we did see the majority of scripts as expected, but also starting to see some of the first initial.
Immunology.
And so I think to your question about would we have expected more and more use from existing prescribers. Certainly we are seeing use them from some of the existing prescribers I think that skew towards hematology oncology also reflects their familiarity with that with Eva cat from advanced FM and <unk> and other settings.
But in fact, seeing this breadth and diversity of prescribing across specialties and across both the academic and the community setting we think bodes very well for a continued cadence of prescribing them for the foreseeable future.
I'll answer the second part of your question about off label use I can confirm we were not seeing appreciable off label use just a small degree, but not not significant prior to the approval.
Great helpful commentary. Thank you.
Thank you Brett.
We have our next question comes from Dane Leone from Raymond James Your.
Your line is now open.
Yeah.
When the questions and congratulations on the strong launch into I S M.
In lieu of having formal guidance. This year, obviously the street is going to be analyzing the various metrics that you've provided.
And you know the focus of the metrics that you updated today around having 585 patients are on the eve of cats.
Second quarter.
It gives us a delta of around 65 patients versus what you had stayed at around 520th onto the first quarter is it fair to think of that incremental 65 patients as predominantly or entirely coming from.
S M a N the ISR launch.
And does that also.
Hmm is that also a consistent metric for your.
So your commentary around seeing strong trends into July .
This may be carrying forward.
We're around that patient odd number into the first month of the third quarter and just generally I guess, maybe expand on how you think of the cadence of ads into the back half of the year.
As we as we think about updating our models today. Thank you.
Yeah. Thanks, Thanks, Dan I mean, I think as we have have talked about before we have not seen a bolus and we did not see that in this first these early innings of a launch and what we've seen is this kind of strong and steady growth and let me hand, it over to Selina to talk a little bit more as you think about those numbers in terms of how we expect that kind of strong and steady growth just to continue.
Throughout the rest of the year.
Yeah, Dan I think the clearest indicator isn't the timing and the fact that we saw most of that uptick occur in June post the approval.
In terms of the sort of precise what percentages I S. M that that's something that we won't ever have I think perfect visibility into them due to the fact that there's one code.
The channels that we distribute through.
We can say that early out of the gate most of the new patient starts had already converted on.
225 milligrams and we were really encouraged to see that bump in in prescribing that happened in June and based off of that we would expect strong steady and consistent growth for the foreseeable future.
Can I ask one follow up question.
Oh no.
Yeah, Yes. Please go ahead, okay great.
Going into this launch there there has been discussion around metrics.
The patients in iOS, I'm, having a potentially different skew in terms of payer coverage, whether it be commercial or Medicare or Medicaid.
They are the initial trends with the launch and the 25 milligrams scripts.
Consistent with what your expectations going into the launch and also for what we've seen so far.
The number of patients that would be going on on corn quote free drug is that also consistent with what you were expecting for the launch. Thank you.
Yeah. Thanks for the question.
Early days to really kind of see an impact in payer mix at this point, but.
Yeah, we do expect that the ISR patients will skew more to the commercial side of the business, but yeah I think based on the I S. N patient demographics stay there if they trend towards some of the younger patients. So over time, we may expect to see sort of a greater shift.
Towards commercial less Medicare I think your question around the 25 million just to clarify that that is actually a dosage strength that is used across both advanced SM with dose reduction as well as with I S. M. A.
But you know to your question about payer mix I think.
No significant changes regarding free drug we have you know, while we did see a higher proportion of patients on freedom in first quarter that has largely unwound them to what we had seen at the baseline by by second quarter.
So we'd expect the free drug percentage to stay pretty consistent at this point and you know put through this year.
Excellent. Thank you congratulations.
Thank you.
Your next question comes from Reni Benjamin from J P. M Securities Randy Your line is now open.
Great. Thanks for taking the questions and congratulations on a very quarter.
I guess just a couple of years you know how many physicians have you been able to.
Get in front of during the first month of launch and who many.
You had mentioned direct to consumer efforts are being employed I think you've mentioned in the prepared remarks multi channel can you talk a little bit about what that looks like and how long do you think it'll take to for you to know how effective those efforts.
Thanks.
Thanks for that question around and I think we've been exceptionally pleased with the access and physician engagement. We've had to date and plan on doing that kind of qualify that yeah. We're we're really excited to see the enthusiastic reception from both hematologists oncologists as well as in Allergists in fact.
Even just in the first several weeks of launch we've been able to engage the similar number of providers as the first sort of eight or nine months in the advanced S. M launched by comparison, so our field team are clearly out there working tirelessly.
As you've seen I think in some of the survey results as well as reflected in our initial prescribing. The Ava kit profile has been extremely well received by these providers.
To your question about direct to patient and so these are our multichannel efforts that will be rolling out our branded patient campaign across all of the channels, where I S. M patients are looking for information.
Including a lot of the online channels and we know that when patients are aware of Eva kit, they're much more likely to ask their providers about Eva kit and so we'll be looking primarily to that continued and increased cadence of adding new patient starts as a result.
Thanks for taking the questions.
Okay.
Yeah.
Yeah.
Thank you.
Our next question comes from Julien <unk> from Jefferies.
Your line is now open.
Thank you I have a just a quick question for Mike Mike If I heard you correctly, you said opex would be lower in 2020 is pretty comparable to 2022 does that mean your R&D will continue to decline for the remainder of the year and then one other quick question is.
Xander collaborate collaborative revenue, including royalties was about $18 million in second quarter and should we use that as a run rate for the remainder of the year. Thank you.
Great. Thanks for the question just to clarify so the comment I made with respect compared to 2023 and 2022 that was with respect to our cash burn so just breaking that out as we see revenues continue to rise with the strong <unk> launch. We are also seeing our opex maintained.
Thank you.
With our next question comes from Mack Brown T D colon Mark your life now open.
Thanks for taking my questions and Congratulant progress on lunch so far.
Maybe for just any patterns that you're seeing emerge of the patients coming on therapy in terms of.
The level of disease severity the specific symptoms that they that they're experiencing that may kind of 0.22, who are the early adopters.
Yeah. Thanks for that question Mark honestly I do want to comment on a range of patients were seen yeah. So I think as we are expected as we expected. The first patients that we're seeing coming onto therapy tend to be on the more moderate to severe end of the spectrum I think one way that we hear providers talking about it is just that.
These are patients who are not well controlled are not adequately controlled.
Spike these symptoms directed treatment so exactly as we expected and I think encouragingly, what we also see it's the recognition of medical need beyond those patients into the so-called milder patience and so we expect with first experience that adoption will expand as providers broaden valenza, if he was inappropriate patient.
Okay. That's helpful and then you <unk> very.
Very early days and cleared patients having gone through the standard quite yet, but what are you expecting in terms of potential reauthorizations and things like that.
You're not seeing a lot of <unk> and things like that for the initial prescription but in terms of your reauthorizations, maybe six months out.
Yeah, I mean, we we we don't have any <unk>.
Signs of that to date I mean, I think overall the access story is resoundingly strong and we're really encouraged him to really see all of the strong initial metro X rayed coverage to label. The majority of payer policies already updated no denials no step edits and certainly you know we don't see any signals.
Or any types of attestation or additional information that are needed to be on the label.
Thank you <unk>.
Our next question comes from the <unk> from Goldman Sachs solving your life's not open.
Good morning, Thanks for taking my question. So I think you're you're very much implying that the uptick in June is related to I S. M. But as we kind of think of this trajectory in the Ford is there anything quantitative you can give us like in terms of the proportion of 70 per cent you Prescribers center ISN versus.
Advanced S M or understanding of who's coming from.
Where these prescriptions are coming from you know, whether <unk> or non HELOC settings, and then just just remind us you'd always suggested no bullets, but also talked about the lab that that would occur from when the patient you know <unk> to request treatment and that's the kind of smog themselves into the physician office.
Can you just walk us through this as we think about at least next quarter.
Mmm.
Yeah. Thank thanks for the question Uhm Salve and so it as we've talked about before with the the single diagnosis code you will never gonna have perfect visibility on on who's in ISN patient, who was in advance S. N patient are dosage strengths are used across both and so we can certainly look at the 25 milligrams and at this point. It was mentioning you know we thought I really <unk>.
<unk> step up in June , particularly driven by patients been prescribed 25 milligrams. So that is you know like ladies are the I S. N patients who are coming out of therapy. Upon approval and I. You know I think I think you can take you know we've been giving numbers on patients at end of quarter now for this is our third quarter. So you can see some base business grow.
Coming from the end of last year into the end of Q1, and then you can see the growth now in Q2 and I think he can do some straight line and <unk>, that's probably pretty pretty straightforward and simple as you think about the rest of the year.
And then you know I as in patients are seen by both Hematologist oncologist, an allergy immunology. So there's not a way to easily split by prescriber, but I don't know if you have anything else that yeah. I mean, I think to your question about sort of the cadence and what to expect I mean, just sort of stepping back you know, we're really excited I think to just sort of confirm our expectations of the ability to find patients.
But they need is there that.
Providers are really recognizing the benefit of advocates clinical profile that they are readily identifying the first ice in patients they want to tree and so from that point forward. It's it's simply that cadence of being able to speak to those patients at their subsequent S. M appointments and so based on that we would expect.
Strong steady and continued growth for the foreseeable future.
Thank you.
With our next question comes from my <unk> My <unk> your lifestyle open.
Hey, Thanks for taking my question is I think the the Eva kit dynamics, so so pretty clear, though that you're expecting a steady flow of and you pay Smith there.
I'm located in so it sounds like from what we've seen in at the end of the second quarter, but then maybe just a quick question on the upcoming Harbor a trial for Blue 263, and N. As I think you mentioned in the policy of pre high bar for this effort to advance, but maybe help us on this reward.
Vickery of differentiation for me you have a kid you need to see in this study in order to advance. This of this as a at two o'clock the trials.
Thanks, Michael and and Yeah, we're very happy to see the strong and study study grew up an iPhone and great to get a question on the pipeline. So why would you like to take that thank you my colleagues I mean.
Absolutely you know most of it was just the best approved for the Bar Hi, Bob.
The name is given is the reception by the physician community whether in emotional allergy treatment I as in patients.
C is very strong the safety profile is very good one for a chronic therapy. So the bar is very high end it for <unk> I assume given what we are achieving with Eva put him now and as we guide and committed rebooted for the data from horrible thought one the second half of the year, but I.
<unk> again, we are very very pleased with the the profile of a record and how patients are benefiting from it.
Thank you.
With our next question comes from Amy <unk> from Needham Amy your lifestyle.
Hi, Good morning. Thank you for taking my question, perhaps another one on a pipeline can you give us in an update on through to to to say you are in the throes explanation and.
Perhaps give us a sense of when we might be able to expect data and what they're looking to achieve in terms of the <unk>. Thanks.
Thank you Amy this is Webb I think Blue 222 is probably one of the most important target that we see that actually personally I've been in drug development for some time and I see this becoming a key.
Mm potentially medicine for patients with cancer, starting with the breast cancer home above your breast cancer at.
The blueprint with our strategy of precision medicine that scalar able to America highly potent and selective molecule today. When you look at the profile of Blue 222 within its glass. It is the best in class and has efficacy data that's the worst stomach scenes and signals off within a connectivity. It has a very good safety profile that makes it very.
Compatible with other agents within CDK for six years. So we see this really I'm very I'm a very good start off of development of this measure potentially major medicine for for patients where we are in terms of involvement I think we are working towards determining the recommended phase two doors.
As for the mono therapy.
On one hand on the other hand, we are really actually the reading and the recruitment in the combination cohort of blue too too too and <unk> City K four six with breast cancer target in mind.
Plan is to generate safety data will be able to really talk about these data next year will give a much more precise guidance when when we are closer to that but I I think the idea is really to go very quickly with a good data to a development plan that in and brushed can also I think he was second wine building.
[noise] background hormone therapy C. D. K two N C D. K four six combination and the same for first line.
Cancel we do also have a branch that is in the program that is focused on a enrichment strategy would see anyone notification and we are looking at ovarian cancer in particular, some endometrial cancer too where we do mono therapy in combination with Carboplatin in that part of the development more to come next year.
But I think this is probably in the oncology pipeline one of the targets that'd be are the most <unk> most excited about.
Thank you.
With our next question comes from my cues from swollen Stannie, Mike your lifestyle open.
Good morning, everyone. Thanks for taking the question maybe just.
A quick follow up just on I assume launch impact and maybe specifically related to the.
The diagnosis right, you're seeing out there and and if the launch has had any impact yet and if not when do you think that might start to happen. Thanks.
Yeah. Thanks plan did you want to touch on the growing diagnosis.
Yeah. Thanks for the question like I think we're really encouraged in fact, just you know as we've been focused on disease awareness over the past many years I think working with advocacy community that we have seen diagnosis rates increase continually through that and we do continue to see those diagnosis rates increase through the launch.
That represents I think an important driver of you know medium to longer term growth for the opportunity.
Great. Thank you.
Thank you.
With our next question comes from Matt speaking of some Oppenheimer match your life now open.
Hi, guys. The morning. Thanks for the question, maybe a controversial one but are you hearing any evidence of clinicians earmarking. There are more advanced patients for a clinical trial over prescribing you know commercial area code. Obviously, there's at least one other large I as I'm trying all out their recruiting.
Hearing of any headwinds from that.
No I I I can't say that we're hearing of those types of headwinds I mean, I think with commercially available therapy and the urgency to treat these patients who are really not well controlled.
We have conversations with providers that as as well at these centers of excellence and you know potential investigators, but I think in total we're seeing very strong recognition of Eva kits efficacy and safety profile as well as they need to be treating these patients.
It's also you know much much easier for patients I mean, we are very robust patient assistance programs are patients do not experience significant out of pocket or kind of kind of burdens and so you know from a patient perspective to be able to access a commercial therapy rather than participate in a protocol or trial is a much more patient friendly opportunity.
Makes sense.
Thank you.
That's our next question comes from Peter <unk>, Peter your lifestyle open.
Thank you thanks for the update and.
What are you just talk about the dynamics of three drug this cruise research changed since <unk> six.
<unk> alright same patients and then kind of expectations of what you think the number of R. As in patients could get treatment by year end.
Thanks to you for the question as we said you know the <unk> the percentage of free drugs has has historically been around 30 per cent. We expect that continue through the course of this year you know it will change over time as more and more I as in patients do come on but you know through the course of this year, we expect that to be about the same we did have that free dry.
The benefit in Q1 that is completely aligned so that is you know we we knew that was a temporary benefit that's why we split that out in Q1 for you all.
And then I think your second question in terms of you know kind of guiding to the number of patients you know I think philina made some some commentary that we've seen continued does he really strong momentum in July we would not normally give any type of indication on a quarterly basis, but you'll give it or on a monthly basis. You know, we we do stick to quarterly results, but given the fact that.
The I S. M launch was really kind of one month of the last quarter. We wanted to make sure to provide some commentary to say that we've seen that really nice strong momentum continues to July which we're very excited to see them and we'll be happy to update you on patients on therapy at the end of at the end of two three.
Perfect thing do you think you'd be able to break it out.
Prescribed.
He has no name.
<unk> this is <unk>.
Yeah. So I I would say you know as we've said, we're really encouraged to see the diversity of prescribing out of the gate that as expected. The initial prescribing is weighted more towards hematology, but also highly encouraged to see the first allergist immunologist come onto the board and we expect that to grow up.
In the course of the year.
Thank you.
Our next question comes from <unk> from where I was sparkles Derek your lifestyle then.
Hey, good morning, and thanks for taking my questions. Congrats on the progress just two brief ones from US can you just help quantify the change the channel inventory for the 25 big dose for <unk> and then just a follow up to Brad's earlier question I guess, what's the biggest thing you can do to activate the current prescribers of advocate using it.
Awesome that have not yet prescribed it for I have them in the future quarters next.
So in terms of I they change the channel very easy we have not seen any meaningful change there at this point there. So I got that easy question and then so did you Wanna talk about kind of the current Eva kept prescribing cause I mean, I I think this is not a dynamic about activating them. This is really about that cadence of when they see iced.
Patients honestly, Derek but I know that clean up there yeah, I mean, I think just to be really clear our our team is targeting not only the prior prescribers who are you know.
A portion of that that market based on advanced S. M experience.
But also targeting much broader providers, including moving into allergy and immunology and using a suite of tools local market. Intel claims data patient journey data to be really thoughtful to be engaging where patients are engaging with their providers.
And so as a result of that we would expect diversity of prescribing as a strong signal and lead indicator for continued growth in the market. You know we would feel very differently out of the gate. If this prescribing were concentrated in experienced prescribers or a smaller number of centers were highly encouraged to see this breath of icke prescribing and expect that growth.
To continue and one of the things we've seen today Derek is that you know when when a physician and a patient and have a first clinical experience that really widens their aperture to accelerate the next set of patients. They get on therapy. So two flenaise point, having that increase breast with new prescribers coming on rapidly it bodes very well for a foundation for conduct continued strong and steady.
Yeah.
Thank you with our next question comes from David Leather Boots from City. David Your line is now open.
Well. Thank you very much for taking my question.
Understanding, but some patients use all doses could you give us a little perspective on how the 25 Meg dose usage might've change has there been an uptick in prescriptions.
For that particular dose in any way you can quantify that.
And one additional question on the physicians you are currently reaching out to.
Uhm, what a portion.
Of those positions have in the past prescribed advocate for a as in patients and has that number of patients.
Proportion expanded since the I as in lunch.
Yes, I do want to talk about the dynamics of the 25 milligram dose and then also I think I think your second question David at around how many experienced already advocate experience physicians are are have been prescribing. Yeah. So I think as we said at the 25 Meg now in fact comprises most of the new.
Patient start doses that were able to see through our channels I think to the second part of your question again as we fed you know, 70% are new prescribers, meaning the remaining 30% are prescribers, who had had had prior a vacate experience I think just sort of stepping back from all that we we could not be.
I think more encouraged by where we are by the breath of prescribing and what that bodes for the the continued success of the lunch.
Thank you.
Our next question comes from Joe P. P from Big Joe Your lifestyle open.
Hi, Thanks for taking a question in my prepared remarks that we can do much familiar you you have to have any denials uhm can we just discuss how long. It typically takes four appears to make that decision.
And if it's changed at all since the ice on lunch.
Yeah. So I think access has been an incredibly strong and smooth continued point of strength for a vacant and that continues to be the case throughout the lunch, whereas we're thrilled with the level of open access that we're seeing not only I think the ease of the process, but also the speed.
Of the process you know continues through the it through through item.
[noise]. Thanks.
Thank you we have no further questions on the line and I'll pass it back to Kate for closing remark.
Thank you all right operator, and thanks, everyone for taking the time to join US today, our year to date resolved provide a strong foundation for growth insignificant upside for us as as we move through the course of this year, we look forward to continuing to update you on our launch progress and and we hope everyone has a great rest of their size.
Right.
Thank you ladies and gentlemen. This concludes today's call. Thank you for joining you may know disconnect your lines.
Thank you ladies and gentlemen. This concludes today's call. Thank you for joining you may not this contact your line.