Q3 2024 Theravance Biopharma Inc Earnings Call
Okay.
Speaker Change: Ladies and gentlemen, good afternoon, I'd like to welcome everyone to the <unk> Biopharma third quarter 2024 conference call.
Speaker Change: During the presentation, all participants will be in a listen only mode. A question and answer session will follow the Companys formal remarks to ask a question Press Star Press. The Star key followed by the digit one digit one on your phone again that starwood and want to ask the question if you're listening via webcast. Please mute your audio on your webcast the box for asking a question.
Speaker Change: The phone I'll repeat the instructions after management completes their prepared remarks also today's conference call is being recorded and now I'd like to turn the conference over to Rick Winningham, Chief Executive Officer. Please go ahead Sir.
Rick Winningham: Good afternoon, and welcome to <unk> third quarter 2024 earnings results Conference call.
Rick Winningham: I encourage you to review our forward looking statements disclaimer on slide two which covers certain risk factors, which could cause actual results could differ materially from any forward looking statements that we might make in today's call and which are described further in our filings with the SEC.
Rick Winningham: You will find today's agenda on slide three you'll all with members of the thorough advance leadership team, who will join me on the call today.
Rick Winningham: These are Rhonda, Florida, Chief business Officer, Z swath, Chief Financial Officer, and Andre Miller head of development.
Now if you turn to slide four I'd like to cover our most recent operational and financial results.
Rick Winningham: On the left we're pleased to have delivered sequentially improved repel rate quarterly net sales performance in partnership with Beatrice, having driven 7% growth year on year, and 14% quarter on quarter to $62 2 billion and a new launch today.
Rick Winningham: Third quarter your power demand increased 14% to the hospital doses increased 40% versus the same period a year ago.
Rick Winningham: Second we made solid progress on our pivotal <unk> study for <unk> and remain on target to achieve our updated timelines.
Lastly, GSK delivered another good troubled years old, reaching $789 million for the quarter and putting us in a position to achieve the higher 50 million in 2024 sales milestone should fourth quarter sales exceed.
Rick Winningham: Approximately $610 million, which is well below consensus estimate.
Speaker Change: If achieved their events, we would expect to receive this milestone in the first half of 2025.
Speaker Change: Turning to slide five I'd like to cover two initiatives. Our board has approved related to our ongoing efforts to unlock value of their events Biopharma.
Speaker Change: These reflect our willingness to proactively implement measures aligned with the interest of our shareholders, while sharpening our operational focus in pursuit of delivering innovation to medicines to patients with the highest unmet medical need.
Speaker Change: First in keeping with our regular review and updating of governance practices, we announced that the board of directors is separate and the role of CEO and chair and Thats Susanna Gray has been elected chair of the board of <unk> Biopharma.
Speaker Change: Continuing my focus.
Speaker Change: My efforts on <unk> mission, as a director and CEO.
Speaker Change: Suzanne is unique experiences and skill set maker a natural choice to lead the board moving forward as she brings over 30 years of experience in the biopharmaceutical industry specializing in capital markets and corporate finance.
Speaker Change: Second we announced today that the board of Directors has formed a strategic review committee consisting of independent directors was the purpose of comprehensively exploring alternatives available to the company involving all of its key assets and putting the power rate.
Speaker Change: <unk> trilogy, and its tax attributes.
Speaker Change: Lazard will be acting as a financial advisor to assist in this review process. As we've stated consistently <unk> board regularly considers options to enhance the company's strategic positioning and we believe that forming a strategic review committee highlights our focus on unlocking value and aligns with our shareholders best interest.
Speaker Change: Lastly, as we've previously communicated we remain committed to returning excess capital to shareholders.
Speaker Change: Now I'd like to turn the presentation over to Roger to cover your <unk> performance in the quarter Rhonda.
Roger: Thanks, Rick.
Speaker Change: I will begin with slide seven where we present <unk> quarterly net sales progression.
Speaker Change: Beatrice reported 7% year over year growth in net sales, reaching approximately $62 million, which is an all time high.
Speaker Change: This growth was driven by a 14% increase in demand exceeding expectations.
Speaker Change: Additionally, this quarter showed sequential improvement in pricing and channel mix relative to Q2.
Speaker Change: And we have also seen a more recent increase to average selling price or ASP.
Speaker Change: When we reported second quarter performance, we highlighted net pricing headwinds due to channel mix, specifically increased demand and two lower margin channels.
Speaker Change: And one time charges charges that impacted quarterly pricing.
Speaker Change: In collaboration with Beatrice, we are executing on strategies to deliver demand in higher margin non retail channels and we are confident these initiatives will continue to enhance net pricing and overall brand performance.
Speaker Change: And as a reminder, we are limited in our ability to discuss certain elements of pricing and giving.
Speaker Change: Vinci Aldi considerations.
Speaker Change: Turning to slide eight we continue to experience considerable momentum in the hospital setting during.
Speaker Change: During the quarter, we shipped approximately 227000, you tolerate doses.
Speaker Change: Up 40% compared with Q3 of 2023 and equivalent to our performance in Q2, which was particularly strong.
Speaker Change: Notably this pattern is typical of the seasonality, we see in our hospital business.
Speaker Change: Q3 does not show as much sequential growth as in other quarters.
Speaker Change: As a reminder, this strategic objective for our focus on the hospital setting.
Speaker Change: The catalyst to drive post discharge outpatient maintenance use of your tolerance.
Speaker Change: Supporting that objective, we continued to broaden our base of formulary wins and implementation of therapeutic interchange protocol to position patients to continue their treatment after leaving the hospital.
Speaker Change: Based on our historical experience and a better than expected greater formulary and new account wins in the quarter, we expect a strong finish to the year and continued momentum into 2025.
Speaker Change: On slide nine you can see how our hospital performance has contributed to share gains within the hospital long acting neb market on the left hand side.
Speaker Change: Based on data through the end of the quarter, we're up to nearly 19% share.
Speaker Change: Which is a new all time high.
Speaker Change: As it relates to our concomitant use messaging and the goal of driving to a two to one ratio of Napa harbour power used over time.
Speaker Change: Continue to make good progress and ended the quarter at a three to one ratio.
Speaker Change: We see further opportunity for improvement in coming quarters, which should help us continue to contribute significantly to <unk> overall growth.
Speaker Change: On the right hand side of the slide you can see your calories share development in the community setting.
Speaker Change: As a reminder, we do not have a full data view by the time. We report so the 32% share we are presenting here only represents our performance through August <unk>.
Speaker Change: Given the demand generation, we are seeing compared with trends, we see for Nab realized losses in the community setting. We are optimistic this trend will continue to develop favorably moving forward.
Speaker Change: Moving on to Slide 10. In addition to the substantial opportunity that still remains in the U S. We also see significant potential to realize value in China, where Beatrice filed an NDA in June.
Speaker Change: The median time to review an NDA in China is approximately 15 months and we stand to realize seven 5 million milestone on approval.
Speaker Change: Additionally, we have the opportunity to earn up to $37 5 million of sales milestones and upwardly tiered royalties of between 14 and 20%.
Speaker Change: Finally, I will wrap up my comments on slide 11.
Speaker Change: First <unk> is a unique medicine.
Speaker Change: Offering a substantial and highly differentiated value proposition.
Speaker Change: It is the only Nebulize Lama for COPD maintenance treatment in the U S and we believe it is underutilized within the patient population to which it is best suited.
We see long term growth potential for the product driving considerable value to <unk> shareholders.
Speaker Change: Second in addition to our co promotion economics in the U S. We potentially stand to achieve milestones and royalties as outlined here, which include those I referenced in the previous slides associated with the potential new opportunity in China.
Speaker Change: At this point I'll turn things over to <unk> for an update on trilogy.
Speaker Change: Thanks, Rhonda I'll start on slide 13, where I'll discuss our potential third milestones for trilogy as reported by GSK trilogy sales increased 17% in the quarter to $789 million.
Speaker Change: Year to date this spring sales to $2 6 billion up 30%.
Speaker Change: Based on year to date results in Q4, we estimate that GSK needs approximately $260 million in sales.
Speaker Change: To achieve the $25 million milestone and approximately $610 million in sales to achieve the $50 million milestone.
Speaker Change: To put the $610 million requirement into perspective, this is $240 million or approximately 30% less than the consensus estimate of $850 million.
Speaker Change: We believe the recent performance for trilogy bodes well not just for the 2024 milestone, but also for the $150 million of additional milestones we could achieve in 2025 and 2026, where consensus consensus estimates are significantly higher than the sales required to achieve the full 150.
Speaker Change: A milestone.
Speaker Change: Given we are in a position to earn a milestone in 2024 I'd like to remind investors that achieving these milestones is tied to royalty pharma is the receipt of trilogy royalties from GSK.
Speaker Change: In order to make it easier for investors to track we've provided an estimate of what net sales would need to be in order for these royalty threshold to be met for.
Speaker Change: For example, should 2024 net sales exceeded $3 2 billion, we estimate that GSK would pay royalty pharma at $275 million in royalties, which would trigger the $50 million milestone milestone with their events.
Speaker Change: Turning to slide 14, a reminder, that in 2029 high single digit royalties oncology will revert back to therapy.
Speaker Change: We believe it's often overlooked as a component of long term value to shareholders.
Speaker Change: Now I'll hand, it back behind it too on yet.
Speaker Change: Now I'll hand, it to <unk> to provide a brief update on <unk> the team on yet.
Aviv: Thanks Aviv.
Speaker Change: Again on slide 16.
Speaker Change: We discussed on our last earnings call, we've been working with important academic institutions and affiliated MSA centers of excellence in order to deliver high quality results.
Speaker Change: Our phase III pivotal study Cyprus and.
The level of expertise at these sites ensures that the trial experience with these patients is well managed and enables us to both recruit and retain the appropriate number of patients we required to report out the Cypress study.
Speaker Change: During quarter, three we were able to progress.
Speaker Change: Additional sites are planned.
Speaker Change: We have enrolled patients over the quarter on a month over month Royce, but keeps us on track to achieve our objective of enrolling the final patients in the open label portion of fiber by the middle of next year on disclosing topline results of the study approximately six months later.
Speaker Change: Turning to the bottom of the slide we continue to engage the scientific community with presentations at both the international Parkinson's disease and movement disorder Conference also referred to as the Mds meeting, which took place in September and the American Autonomic Society meeting held earlier this month.
Our Mds presentation focused on safety and Tolerability data observed in the long term extension of 31 17.
Speaker Change: And <unk> was generally well tolerated by patients, but I know H, but only 10% of patients experiencing treatment emergent adverse events considered related <unk> and no patient reporting supine hypertension.
Speaker Change: So 6% of the 110 patients evaluated in the study have dropped out of our median duration of exposure to unblock the thing.
Approximately nine months.
Speaker Change: A second analysis, just presented at AAN evaluated data from our <unk> study and highlighted the impact of NIH on symptom burden and daily functioning in patients, but I know age.
Speaker Change: This analysis demonstrated greater baseline <unk> symptoms and MSA as compare to other than you can in applebee's translating into higher symptom burden reduced functioning and lower quality of life. Despite treatment with available preparations are.
Speaker Change: A clear need for improved treatment alternatives remains in symptomatic moh and MSA that we home and productivity will help address.
Speaker Change: On slide 17, I'll briefly remind you of where we found with <unk>.
Speaker Change: We've substantiation of the significant unmet need which we believe can be addressed with a targeted commercial commercial efforts approximately <unk> of patients where MSA in the United States suffer from symptoms of NIH and available therapies have significant efficacy and safety limitations.
Speaker Change: We validated <unk> target profile, which has clear differentiation from available alternative used to treat NIH and MSA patients.
Speaker Change: Our work to date on ample liquidity to support the safety and Tolerability profile.
Speaker Change: <unk> cloud plasma norepinephrine and prevent system worsening.
Speaker Change: We are aligned with FDA on requirements for a full approval simplify first study would be positive and we have obtained orphan drug designation in the United States.
Speaker Change: We believe we are positioned to complete our regulatory filing quickly given we have already given the work we've already completed.
Speaker Change: Now I will turn the presentation back to you for our financial results and guidance.
Speaker Change: Thanks, Tanya starting off with the results for the quarter Slide 19, and 20 to cover the detailed financials I'll review the highlights on slide 21, where we had a solid quarter with slightly better than expected results across all key financial metrics.
Speaker Change: Starting with collaboration revenue, we reported $16 9 million above expectations, representing an 8% increase compared with last year.
Speaker Change: This quarter also marked an all time high end product level of profitability.
Speaker Change: Total operating expenses, excluding share based comp so modest year over year increase due to the progression of the Cypress study, but were slightly better than expectation.
Speaker Change: And while our R&D expenses increased thanks to cost savings initiatives G&A expenses decreased by 7% in the quarter and 21% year to date compared with last year positioning us to achieve achieve our goal of a 20% reduction for the year.
Speaker Change: We reported $5 million and share based comp for the quarter, another 21% reduction when compared with last year.
Speaker Change: Again puts us on track with both our G&A and share based comp production targets for the year.
Speaker Change: During the quarter, we incurred a $1 6 million noncash impairment charge due to the write down in the value of our operating lease assets related to our access lab space.
Speaker Change: Given current market conditions, we took a conservative approach and wrote down the full remaining value of the lease.
Speaker Change: Related to our excess lab space.
We closed the period with $91 million of cash and 49 million shares outstanding.
Speaker Change: On slide 22, I'll comment on our expected financial performance in the fourth quarter and full year 2024.
Speaker Change: We are reaffirming guidance made at the beginning of the year and expect our R&D expenses in Q4 to be slightly higher than Q3 due to the continued progression of the Cypress study and for SG&A expenses to be similar to Q3 for.
Speaker Change: For the full year this would put us near the midpoint midpoint of guidance for both R&D and SG&A.
Speaker Change: Furthermore, we expect our non-GAAP results in cash burn in Q4 can be consistent with Q3.
Speaker Change: Finally as was the case last year, we expect to incur a higher noncash tax charge sequentially in Q4, primarily due to better than expected results and other noncash charges from one of our operating entities.
Speaker Change: Looking ahead to 2025 are minimal cash burn enables us to progress the Cypress study to a major value inflection point without relying on the capital markets are.
Our focus remains on driving growth through disciplined investment in delivering long term value to shareholders.
Rick Winningham: With that I'll pass it back to Rick to conclude Rick.
Rick Winningham: Thanks disease I'll conclude on slide 23 by covering the main strategic elements of our plan to maximize the value of their events biopharma, while delivering all of our core mission of delivering medicines that make a difference to patients.
Rick Winningham: First our top priority is always to maximize the number of appropriate patients on <unk>, who could benefit from a significant lung function improvement delivered via nebulous nation over a full 24 hours based on our market research, we continue to see considerable opportunity.
Rick Winningham: To expand your calories utilization in the United States and we're optimistic about its growth moving forward.
Rick Winningham: We're progressing well with both cypress enrollment and our.
Rick Winningham: Our regulatory and early commercialization preparations for <unk> and in a way it's an MSA.
Looking forward to delivering important milestones in 2025.
Rick Winningham: Third we are dedicated to maximizing value for shareholders. We're excited with the trends that we've seen in <unk> and the potential milestones that could accrue to the company, we're managing our expenses carefully and expect to limit cash utilization moving forward.
Rick Winningham: Board has formed a strategic review committee to evaluate all alternatives available with their events to unlock the significant value of their events with assets given our view that most of the intrinsic value is not currently reflected in our share price.
Rick Winningham: Finally, we remain committed to returning excess capital to shareholders. We.
Rick Winningham: We thank you for your continued support and at this time, we're ready to open the line questions.
Speaker Change: Thank you Sir once again, if you would like to ask a question you may do so by pressing the star key followed by the digit one dessert one on your Touchtone phone.
Speaker Change: Listening via webcast. Please mute the audio on your webcast suffice for asking your questions over the phone if you're using a speaker phone for todays call. Please make sure. Your mute function is turned off to allow your signal to reach our equipment again that starwood, one if you'd like to ask the question and we will pause for a moment, while we assemble our roster.
Speaker Change: Yes.
Speaker Change: Our first question comes from Julian Harrison with <unk>. Your line is open.
Speaker Change: Hi, congrats on the quarter and thank you for taking my questions.
Speaker Change: First im curious if youre seeing any changes in <unk> prescribing patterns post and suspension launch either headwinds or tailwind. There and then second can you remind us where you stand on site activation Activations for the Cypress study are you at target now.
Speaker Change: If not how far away are you from that.
Speaker Change: Yeah sure Julien. Thank you Roger you want to take the <unk> question and then on yes, we will.
Speaker Change: Hello, Greg.
Thanks for the question Julien.
Speaker Change: As I've mentioned before.
Speaker Change: Very excited to have.
Speaker Change: Sure.
Effort and share of voice in the marketplace, highlighting the importance of mobilization as an offering for patients and I think it's a little too early to see kind of the full gamut of what exact patients are getting what relative to answer pentron, but I will say in.
Speaker Change: Have anecdotal feedback that we're hearing from the field we are hearing that.
<unk> is being added on to tolerate and specifically <unk>.
Speaker Change: <unk> are examples of concomitant use so LABA plus Lama and then <unk> added on.
Speaker Change: I think as we get closer maybe another quarter and we will have full visibility into the med D prescribing and can be able to comment on that more readily.
Speaker Change: Yes.
Speaker Change: Hi, Julien.
Very pleased to say that we're in.
Speaker Change: Now in a position where we have the vast majority of our sites now activated you'll remember last quarter, we talked about the remaining number of key sites that we wanted to show progress.
Speaker Change: And in a position to progress them.
Over the last quarter and almost all pipe over the line at this point.
Speaker Change: Excellent. Thank you and congrats again.
Speaker Change: One moment for our next question.
Speaker Change: Our next question comes from Ernie Rodriguez with TD Cowen Your line is open.
Ernie Rodriguez: Hi, Tim Congratulations on your record quarter.
Speaker Change: Thanks for taking our questions.
Speaker Change: I'll start with it.
Paul you apparently.
Speaker Change: You mentioned the hospital doesn't sold increased by 40% year to year.
Speaker Change: You also are increasing your market share could you give us some more color on what's driving that.
Speaker Change: What the expectations are going forward.
Speaker Change: The year to year.
Speaker Change: Doug a harder comp.
Speaker Change: Okay.
Speaker Change: Rhonda.
Speaker Change: Yes, Thanks Ernie.
Speaker Change: What continues to drive that growth, which we are very pleased with is continuing to build upon the number of formulary approvals, we have in the U S. As well as when we are able to achieve a formulary that that formulary also includes a therapeutic interchange, which I think you already appreciate that that.
Speaker Change: Basically puts in place in the EMR system.
Speaker Change: The substitution for went along as prescribed that you power is the choice. So seen this last quarter that of our focused accounts. We have now moved up to 50% of those accounts have a therapeutic interchange so where we have therapeutic interchange we have significantly higher.
Speaker Change: Market share. So I commented that we're roughly at 19% for total market share, where we have therapeutic interchanged. We are at 36% market share. So it's getting those wins that are continuing to drive that effort in the hospital channel.
Speaker Change: Got it. Thank you that's very useful and then.
Speaker Change: Another quick question on the on the committee.
Uniform committed to assessing strategic alternatives.
Speaker Change: From the initiatives I guess, why now and what would be the ideal outcome.
Speaker Change: Of of options that you have to consider.
Speaker Change: Yes, great Great question, while the board is always evaluating the company strategy against.
Speaker Change: Both short term and long term goals. If you look at where the company is today and we've covered.
Speaker Change: Number of the number of the key elements of value in the company, namely the continued strength of trilogy.
Speaker Change: Not only the $50 million milestone coming into for for 2024 sales coming into frame and what we shouldnt be able to earn but the other milestones and 25 and 26 as <unk> highlighted so you put trilogy, and those milestones and longer term the royalty is coming back to us.
Speaker Change: Your Perl rate growing in the United States continuing to grow and we've worked.
Mostly as Rhonda said with Beatrice over the last quarter sharpening up our execution sort of across the board.
Speaker Change: And then the <unk>.
Speaker Change: Approval, and then slightly around 12 months or so from from data from a very important phase III study with an philosophy and a rare neurological condition.
Speaker Change: Cypress and then you kind of disclose what the tax attributes.
Speaker Change: The board determined that mail is just an appropriate time to undertake a formal review with Lazard help of the options that are available to the company to unlock the value.
Speaker Change: Those of those assets and Kevin.
Speaker Change: We want to take a proactive approach that allows us to make informed decisions that will benefit our benefit our shareholders. So.
Speaker Change: Thanks.
Speaker Change: Some substance of the action is we believe that our our assets are appropriately valued.
Speaker Change: <unk> got a strategic review committee in place now to work with Lazard.
Speaker Change: To map out a play out of the actions to get better valuation out of those assets the benefit of our shareholders and the underlying business of <unk> is very strong and we're optimistic about it so we need to pull that value through to our shareholders.
Speaker Change: Does that help.
Speaker Change: Yes, no. That's very helpful. Thank you for that and congrats again on the quarter.
Speaker Change: Yes.
Speaker Change: Thank you again, ladies and gentlemen, if you have a question or a comment at this time. Please press star one on your telephone.
Okay.
Speaker Change: It appears we have no further questions on the phone I'd like to turn the conference back over to Mr. Winningham. Please go ahead Sir.
Rick Winningham: Thank you operator, thanks, everyone for participating and joining us at our third quarter update call and look forward to seeing all of you soon and have a good day.
Speaker Change: Pardon me Mr. Winningham, we did have one person just queue up did you want to go ahead and take that question.
Rick Winningham: Yes, sure one moment.
Our next question comes from Douglas Tsao with H C. Wainwright Your line is open.
Rick Winningham: Hi.
Speaker Change: Good afternoon, and thanks for taking the questions.
So apologies in advance if this question has already been asked but just curious.
Speaker Change: Look like we sort of started to have a nice rebound with <unk> this quarter certainly coming in.
Speaker Change: Ahead of our expectations just curious.
Speaker Change: The extent that you were able to make progress in terms of impacting the ESP.
Speaker Change: And what that might mean for <unk>.
Speaker Change: Expectations heading into 2025, thank you.
Speaker Change: Robert you want to take that.
Robert: Yes, Thanks, Doug.
Speaker Change: I think relative to progress as we've highlighted in the past typically to ASP, that's a two quarter lag.
Speaker Change: Of impact once there are any implications or initiatives that are put in place. So I think more of what was able to drive the success in Q3 was really looking at that.
Speaker Change: Further supplier diversification and.
Speaker Change: The output of the channel deployment and execution of various specifically across all channels that being community hospital in long term care et cetera.
Speaker Change: What I would say relative to the improvement in price relative to Q2, and the expectation that overall price will continue to improve that's more relative to early 2025. So you combine that with the strong demand growth. We have been seeing now for two quarters straight we're just remaining.
Speaker Change: Very optimistic about net sales progression for the brand and to 2025 and certainly beyond.
Speaker Change: And I think coming out of the second quarter, the collaboration really with via tourists.
Speaker Change: On.
Speaker Change: On pricing on.
Speaker Change: Marketing and driving the business forward.
<unk> has been has been excellent so.
Speaker Change: I interrupted you go ahead.
Speaker Change: And I can say, Rick I mean, it's so obviously Ryan as you noted there is a lag in terms of reported asps and that obviously effects.
Speaker Change: <unk>.
Speaker Change: What youre able to command.
In certain channels, but I'm just curious in terms of the sort of receptivity or impact on the customer base as you sort of try to pursue these initiatives and in what you had experienced any resistance.
Speaker Change: Or were you able to sort of implement them without any kind of disruption from a volume standpoint for.
Speaker Change: Ruffling feathers, perhaps have a better way to put it.
Speaker Change: Yes, well, it's always the goal to not ruffled feathers. So I would say I would answer to the latter.
Speaker Change: The situation.
Speaker Change: You might just talk broadly briefly for Doug about the overall value.
Speaker Change: The value prop really for <unk>.
Speaker Change: In the patients.
Speaker Change: That were treated in the hospital community.
Speaker Change: Yes, well I think.
Speaker Change: <unk> certainly highlighted in the past of where there continues to be what we feel is.
Speaker Change: Under realized opportunity within three different patient segments, and certainly borrowing off of what I commented on relative to the comp the concomitant use strategy, ensuring that where there is LABA youth that we want to ensure that along with.
Speaker Change: Mirroring gold guidelines that adding that Lama or <unk> is certainly in that consideration so executing on that improving that ratio. The goal is to get to two to one and continuing to see improvements in both the hospital and the community efforts there.
Speaker Change: And then for those patients to already prefer nebulizer therapy.
Speaker Change: <unk>.
Speaker Change: Recognize that.
Speaker Change: <unk> is certainly an option there are still those patients that are relying on short acting therapy to support what they feel is there maintenance care, but they are using annualized are four to six times, a day and still experiencing symptoms. So the goal is to continue to switch those patients from short <unk>.
Speaker Change: <unk> get those patients control and ensure that.
Speaker Change: They are recognizing the value of a long acting medication.
Speaker Change: And then lastly.
Speaker Change: For those patients that are receiving triple therapy.
Speaker Change: Handheld often most often I should say as a dry powder inhaler, we want to ensure that this patient patient population recognizing that dexterity cognition difficulties.
Speaker Change: Are limiting their ability to use the device properly. So this rep represents a primary reason of why we feel that there is an opportunity to educate on the value of changing device, which is easy to administer and offers a once day daily option for these patients we feel like.
Speaker Change: Recognizing the value and the number of roughly one 5 million patients that could stand to benefit from <unk>. In addition to the 400000 that represents the first two segments I just highlighted there is significant room to grow this brand.
Speaker Change: Okay, great. Thank you.
Speaker Change: And that was our last question I'm not sure. If you are finished your concluding comments Mr. Winningham.
Speaker Change: Operator, thank you very much. Thank you for joining US you are welcome.
Speaker Change: This concludes today's conference call. We thank you all for your participation you may now disconnect.
Speaker Change: Okay.
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