Q4 2024 Amarin Corp PLC Earnings Call
Music
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Speaker Change: Welcome to Amarin Corporation's conference call to discuss its fourth quarter and full year 2024 business update and financial results. I would like to turn the conference call over to Mark Marmur, Vice President, Corporate Communications, and Investor Relations at Amarin.
Speaker Change: Good morning everyone, and thank you for joining us. Turning to slide two in our four looking statements. Please do aware that this conference hall will contain four looking statements that are intended to be covered under the safe harbor provided under federal security's law. We may not achieve our goals, carry out our plans or intentions or meet the expectations disclosed in our four looking statements.
Speaker Change: Actual results or events could differ materially, so you should not place undue reliance on these statements.
Speaker Change: We assume no obligation to update these statements as circumstances change.
Speaker Change: Our four-looking statement do not reflect the potential impact of significant transactions we may enter into, such as murders, acquisitions, dispositions, joint ventures, or any material agreements that we may enter into amend or terminate.
We encourage everyone to read these documents.
Speaker Change: An archive of this call we posted on Amarin's website in the Investor Relations section.
Speaker Change: Turning to slide three in today's agenda, Aaron Berg, Amarin's President and Chief Executive Officer, will provide an update on the state of the Amarin business.
Speaker Change: Pete Fishman, Amarin's Chief Financial Officer, will review our fourth quarter financial results. And Steve Ketchum, Amarin's Executive Vice President, President of R&D, and Chief Scientific Officer, will provide an update on recent and upcoming deceit of the Stepper Research.
Speaker Change: In the end of the presentation, Aaron Berg by closing remarks followed by a question and answer section.
Speaker Change: Thank you, Mark. Good morning, everyone, and thank you for joining us here today.
Speaker Change: Let me begin my comments by focusing on our progress and the opportunity ahead to realize the value of the CEPA globally, as well as the ADS ratio change reference to the press release of this morning, a strategic action we've taken to address a key issue for the company.
Speaker Change: Since taking on the role of CEO of the middle last year, I spent a significant part of that time working with our leadership team and a coordination with the board of directors to identify and take advantage of opportunities to rapidly accelerate momentum, strengthen the foundation for long-term growth and drive greater value now and for the future.
Speaker Change: We've made progress in this effort and the opportunity that we have ahead with the CEPA is built on a strong foundation.
Speaker Change: We have a strong foundation financially with 2024 revenues of over $200 million and a cash position of almost $300 million and no debt. This financial position helps solidify a long runway for Amarin. This financial position helps solidify a long runway for Amarin Corporation Plc Sponsored ADR
Speaker Change: The Science of the SEPA, which is underpinned by the REDUCED study and more than 500 additional publications advancing understanding of the icosapent ethyl
Speaker Change: clinical benefits and mechanism of action and its complementary position to impact the cardiovascular risk burden and unmet need around the world.
This extensive science has helped to drive regulatory progress globally.
Speaker Change: To date, we've secured approvals in 49 markets around the world, where we're in the early stages of obtaining pricing and reimbursement agreements, commercial launches, or still progressing through the regulatory approval processes, all of which set the stage for future growth.
Speaker Change: Increasingly, we've expanded access to commercial penetration with the product launched in more than 20 markets globally either directly or through our nine partnerships in place currently. There are also 16 additional countries in various stages of progress toward commercialization.
Speaker Change: This is a discreet revenue generation led by continued capture of efficient brands of revenue in the US, followed by growth in Europe and rest of the world markets.
Speaker Change: This solid and growing foundation positions to the SEPA franchise to deliver on its tremendous opportunity globally.
Speaker Change: We know we have much more work to do to capitalize on this opportunity, but overall, taking into consideration the considerable untapped potential of the franchise [inaudible]
Speaker Change: Our continued progress in its global expansion and the financial foundation and long cash run where we have in place, we believe there is a disconnect between the value potential and our current company valuation.
Speaker Change: Regarding the ADS ratio change as a publicly traded company, we seek considerable value in maintaining our NASDAQ listing.
Speaker Change: To that end, today we announce our intent to initiate a ratio change to our ADS program in order to preserve our NASDAQ listing.
Speaker Change: This step is an expression of our determination and commitment to realizing the full valued potential of amarin.
Speaker Change: Pete will cover this a greater detail later on the presentation, and I encourage everyone to review today's press release on this matter for additional information.
Turning to slide six.
Speaker Change: Let me now briefly walk you through the past 12 months plus and provide details on our progress key accomplishments, including the strategic decisions and steps we've taken that have helped us drive value.
Speaker Change: From a strategic standpoint, we successfully extended our intellectual property position in Europe , widening our IP horizon for Basketbud through 2039. This is important as it extends the runway for exclusivity and the opportunity for this brand in Europe .
Speaker Change: We've continued to execute our new commercial and pricing a reimbursement strategy in Europe , tailored to each country and focused on very high-risk patients.
Speaker Change: These are patients with established cardiovascular disease and they're currently over 5 million such patients in Europe , a significant opportunity to impact a large patient population.
Speaker Change: This strategy has accelerated our progress in the region. We've secured pricing in reverse in ten markets since adopting this new strategy, and in market demand grew in every launch market in Q4 versus Q3.
Speaker Change: We've also continued to focus our financial strategy on a fishing cash management and operating expense deployment focused only on the most value driving efforts. This has helped us extend our cash runway.
Speaker Change: Finally, as I mentioned, we announced earlier this morning that we're taking steps to maintain one of our critical corporate assets, our NASDAQ listing.
Operationally, we've made continued progress across the business.
Speaker Change: In Europe , on the commercialization front, the Schepa revenues continued to gradually increase throughout 2024, driven by growth in Spain, the UK, and central eastern Europe markets.
Speaker Change: While we've seen early demand in a number of these markets.
Speaker Change: We must find ways to accelerate growth where Veskeva has been launched.
Speaker Change: Pricing reimbursement efforts have also advanced with pricing reimbursement secured in Italy, Portugal, Greece, and most recently last month in Austria.
Speaker Change: Importantly, in Italy, we've already secured access in nine regions, which represents more than 50% of the total eligible market in that country, reflecting strong, interesting, hating access to the product in the market.
Speaker Change: In the US, throughout 2024, we've continued to officially generate cash with Viseba more than four years after the introduction of generic products.
Speaker Change: Exclusives, which now represents 74% of the total receipt of branded business, cover approximately 43 million total lives, which represents approximately 40% of the total commercial and Medicare Part D, IPE volume.
Speaker Change: Additionally, as we previously stated, we have a plan of action and are prepared to launch an authorized scenario when the time is optimal.
Speaker Change: © The Ultimate Parody Site! All Rights Reserved. © The Ultimate Parody Site!
Speaker Change: Across various regions of the rest of the world, 2024 sought continued progress in regulatory efforts, expanding access and generating demand for Visepa through existing partnerships.
Speaker Change: while early in the launch phase for a number of these markets.
Speaker Change: All partners solve growth in market demand for the product in Q4 and continue to work to expand access and further accelerate growth.
Speaker Change: Two of our partners launched in Cardiovascular Risk Reduction, ending Farming China, and CSL Securis in Australia.
Edding Pharmacy, Regulatory Approval in China Mid-Year
Speaker Change: for cardiovascular risk reduction and are now focused on promoting for at-risk patients with access to private hospitals and high-risk patients in public hospitals with inpatient acute coronary syndrome patients at the priority in this initial stage of the commercial cardiovascular risk reduction launch.
Speaker Change: Their effort is currently focused on the self-pay market in China, as they continue advancing efforts to support inclusion on the national retail drug listing, or NRDL.
Speaker Change: In Australia, our partner CSL Securist secured Australia's pharmaceutical benefits scheme, or PBS Price Listing for Veskeva, unlocking public access to the product for patients with ASCBD and elevated tribalist rides in that market.
Speaker Change: CSL officially launched at the annual scientific meeting of the cardiac Society of Australia and New Zealand in August 2024, the largest cardiology meeting in Australia and New Zealand, with more than 400 delegates attending.
While very early, they're seeing strong in-market demand in Australia.
Speaker Change: HLS received reimbursement in Alberta to round out their full public access across the country, adding opportunity for growth beyond their significant private insurance coverage for Canada.
Speaker Change: Biologics in the mean of region progressed their commercial efforts and saw increased sales in the region. They worked to continue their growth in Saudi Arabia specifically as they worked with the health authorities to further expand access to the patients with public reimbursement there.
Speaker Change: We continue to progress our regulatory efforts in Southeast Asia where our partners load us and expect first approvals to be sometimes in 2026.
Speaker Change: Amarin continues to support our partner with our medical team to attend its international scientific leader involvement at multiple medical conferences, specific scientific leader programs.
Speaker Change: Launch efforts as well as working to secure publications locally for the commercialized regions.
Speaker Change: supporting our efforts to generate worldwide growth are medical affairs, R&D, and regulatory teams who continue to expertly, tirelessly advocate for and advance the science behind
Speaker Change: For the five years from the approval of the CEPA in the US for cardiovascular risk reduction, we and others are continuing to generate meaningful data that helps the clinical community further understand the underlying science and the potential added benefit of the CEPA to further reduce the risk of cardiovascular events.
Speaker Change: in patients on standard care therapy with well-controlled LDL levels.
Speaker Change: This significant and continuously expanding body of evidence helps propel our commercial medical advocacy and regulatory progress, which Steve will review in greater detail later.
Speaker Change: And finally, from a financial perspective, we continue to make smart decisions to balance operating expenses and cash preservation with the urgent need to accelerate global revenue growth.
Speaker Change: Specifically, we closed out 2024 having generated $228.6 million in total revenue and a stable capital structure.
Speaker Change: For the year, we reduced our year-over-year operating expenses by 26% including the $50 million annual operating expense reduction we committed to in 2023.
Speaker Change: We ended the year with a strong tax position of $294 million, underscoring our prudent tax management and continued focus on strengthening our financial foundation.
Speaker Change: These financial accomplishments were accompanied by our successful efforts to renegotiate product supply agreements.
Speaker Change: These successful negotiations allow us to align our short-term supply commitments based on current demand in order to conserve important capital while ensuring we can supply the brand across markets as we build momentum with a growing global customer base.
Speaker Change: In summary, 2024 was a year of continued progress in numerous aspects of our business, driven by the execution of the entire Amarin organization.
Speaker Change: We take very seriously our obligation to drive shareholder value while we've made progress we have much more work to do to drive shareholder value primarily by urgently getting the seep into the hands of as many at risk patients around the world as possible.
Speaker Change: We know the unmet need is there, and while the last several years have been challenging, we remain steadfast in our efforts to strive, continue positive progress in realizing this product's global potential.
Speaker Change: We've remained confident we will generate further momentum in 2025, building off 2024.
Speaker Change: With that, let me turn the call over to Pete Fishman, who will take us through the financial results, as well as the specifics for regarding the ADS ratio change announced earlier this morning.
Pete Fishman: Thank you Aaron, good morning everyone. Turning to slide 8 in the fourth quarter of 2024, Amarin reported total net revenue of 62.3 million, including net product revenue of 60.1 million and 2.2 million of licensing and royalty revenue.
Pete Fishman: compared to total net revenue of 74.7 million in the fourth quarter of 2023.
Pete Fishman: US product revenue was $44.2 million compared to $64.9 million in the fourth quarter of 2023. This decline was driven by lower net selling price, the generic competition, and a decrease in volume in the second half of the year, stemming from CVS commercial, moving from exclusive to not-cutter. [inaudible]
Pete Fishman: Looking ahead, we anticipate we will continue to see the impact of this on our year-over-year comparisons through the first two quarters of 2025.
Pete Fishman: Despite the revenue decline, the U.S. business continues to deliver significant cash and a darren set earlier takes a bit of resilience with the remarkable track record for a branded product this far out from the introduction of generics.
Pete Fishman: European product revenue was formally a 2.5 million increase over the prior year period and driven primarily by growing contributions from Spain and the U.K.
Pete Fishman: Fourth Floater 2024 Product Revenue was consistent with the prior floater, which included supply shipments to our partner injuries.
Pete Fishman: Span and the UK continue to be the current drivers of revenue growth for this important and evolving
Pete Fishman: Product revenue also reflects revenue from our partnerships throughout the rest of the world, of 11.9 million, a 7.7 million increase or the prior year period.
Pete Fishman: These partnerships continue to generate meaningful cash contributions with no direct cost incurred by the company. It is important to note that in the current year product revenue with our partners includes supply shipments and preparation for market launches.
Pete Fishman: Our partnership revenue can be variable quarter to quarter and year to year based on restocking timing relative to end market demand.
Pete Fishman: Plus the good salt, excluding non-caste inventory restructuring of $36.5 million was $35.4 million in the fourth quarter compared to $29.6 million in the prior year period.
Pete Fishman: Gross Martin, excluding non-tatched inventory restructuring, was 41% compared to 58% in the prior period as a result of a decline in that selling price in the U.S.
Pete Fishman: Total operating expenses were 43 million, including 37 million in SGNA and 6 million in R&D, which is a reduction of approximately 7 million compared to the prior year period and reflects the impact of ongoing cost optimization initiatives.
Pete Fishman: We will continue to focus on deploying our capital on value-driven efforts.
Pete Fishman: Turning to the bottom line, Fourth order, 2024 Gapnet loss was $48.6 million.
Pete Fishman: Compared to a gap net loss of 5.8 million in the prior year period, primarily reflecting the impact of the U.S. generic market and the sizeable effect on plus the good sold as a result of non-cash inventory restructuring charges.
Pete Fishman: Turning to slide 9 and our efforts and results in controlling costs and effectively managing our cash.
Pete Fishman: As of December 31, 2024, we reported aggregate cash and investments of 294 million, in addition, and equally as important. We ended the year with no debt.
Pete Fishman: Over the last two years, we have made significant progress in right sizing our operations while improving our strategic focus and navigating the ongoing challenges toward U.S.
Pete Fishman: While doing this, we have also made investments to further expand the reach of the CEPA globally.
Pete Fishman: As a result of these efforts, we have successfully maintained a stable cash position over the last nine borders.
Pete Fishman: To quantify that, our cash is only declined approximately 5%, or less than 20 million since year end, 2022.
Pete Fishman: Fundamental to that track record of prudence and success has been and will continue to be commitment to balancing combination of managing costs and pursuing strategic decisions and channels to urgently expand product revenue.
Speaker Change: Now let be pivoted to this morning's announcement. As referenced by Aaron earlier in the fall, we continue to believe that our stock is undervalued given progress we've made and the global opportunity to oversee them.
Speaker Change: Amarin's NASDAQ listing is important for investors and for the company.
For Shareholders, a listing allows individuals and investment entities.
Speaker Change: to participate in the growth of Besefa through the public equity capital markets.
Speaker Change: With this in mind, and with our commitment to remain listed on the NASDAQ, this morning we announced our intent to affect a ratio change on our ADS's. From one ADS representing one ordinary share to the new ratio of one ADS representing 20 ordinary shares.
Speaker Change: The objective of the ratio change is intended to increase the first share market price of the company's ADSs to comply with NASDAQ's $1 minimum bid price per share requirement and maintain the company's listing on the NASDAQ capital market.
Speaker Change: As a result of the ratio change, each Amarin ADS holder will see the number of ADS's they hold divided by 20
For example,
Speaker Change: If an Amarin ADS folder holds 100 ADSs on the effective day, the holder will hold 5 ADSs following the ADS ratio change.
Speaker Change: This ratio change also has the same effect on the company's total outstanding shares.
Speaker Change: Importantly, the overall value of an older ADS does not change as a direct result of the ADS rates good change.
Speaker Change: The effective date of the ratio change is expected to be on or about April 11, 2025, for the benefit of shareholders with posted to the investor relations section of the company's website. A Q&A addressing key questions investors may have about the ratio change.
Speaker Change: Let me now turn the call over Steve Ketchum, who will provide a research update on our progress with advancing the CEPA science, building global support from the medical community, and furthering our regulatory progress.
Steve?
Thank you, Pete. Good morning, everyone.
Speaker Change: Before I discuss recent and upcoming research, I wanted to take a few moments to speak to critical foundational elements for Visepa and its therapeutic value for patients around the world. Namely, maintaining focused investment in research enables us to shed further light on the science behind our product and publishing the results of such research helps to drive medical advocacy for our product.
Speaker Change: As Aaron mentioned, the molecule like co sapent ethyl, the active ingredient and vasipa, is built on tremendous science
Since 2011, both Amarin and its partner investigators
Speaker Change: have supported more than 500 publications to advance our understanding around the science of ICOCIP or IPE, and to further elucidate the potential mechanisms of action for the Omega-3 ICOCIP, Penteeno Agassid, or EPA component of this Ethel Estromolecule.
Speaker Change: Research insights into both IP and EPA are fundamental to furthering our primary goal of maximizing the value and impact potential of our product globally.
Speaker Change: Looking at 2024 specifically, we supported and delivered significant additional scientific research on IPE and EPA.
Speaker Change: Amarin and Global Medical and Scientific Collaborators supported 45 publications inclusive of accepted abstracts, posters, presentations, manuscripts, review articles, and book chapters across the past year.
Speaker Change: The breadth and depth of our ongoing scientific efforts has fueled significant global medical advocacy for IPE. In total, we have secured more than 50 clinical guidelines, consensus or scientific statements on the therapeutic value of the SEPA Veskepa from global medical societies.
Speaker Change: Strong data from our Reducit Cardi Vascular Outcome Study and from our Supportive Development Program have directly driven our regulatory progress.
Speaker Change: Over the last three years, we have filed for regulatory review in 22 countries and regions and have received approval for the Reducit Clinical Indication in 15 countries and regions outside of the United States and EMA Regulatory Approval Authority.
Speaker Change: including in mainland China, Switzerland, Australia, New Zealand, and Israel. And we and our partners are advancing regulatory processes in seven additional rest of world markets.
Speaker Change: Turning to slide 12 and supportive clinical data, a post-talk analysis of reduce it was recently published in the Journal of the American Heart Association, evaluating the impact by crucifin ethyl on patients with various LDLC levels at baseline.
Speaker Change: This analysis showed consistent cardiovascular risk reduction benefit irrespective of baseline LDLC level.
Speaker Change: Even when a patient had a very low baseline LDLC level less than 55 milligrams per desk litre, or down to 40 milligrams per desk litre, patients were still at risk and derived cardiovascular benefit taking place.
Speaker Change: This data reinforces that the CEPA is a complimentary therapy to current LDLC lowering therapies.
Speaker Change: In other words, one of the primary advantages of the CPIS is that it can be added to standard of care or SOC, LDLC, lowering therapies and still further reduce the residual cardiovascular risk of a major cardiovascular event.
Speaker Change: By Voseepa being complimentary, there is no need to displace LDLC lowering drugs. This is a commercial advantage for our product as it can be a significant challenge for companies with branded LDLC lowering drugs to compete head-to-head with other LDLC products.
Speaker Change: We firmly believe that the value of a CEPA as a complement to lipid lowering therapy should be more strongly considered by clinicians globally to help address and reduce residual cardiovascular risks.
Speaker Change: It should be noted that we are focusing on secondary prevention patients. As many patients with well-controlled LDLC still have major cardiovascular events, including heart attacks and strokes.
Speaker Change: The groundbreaking results from the reduced-hit outcomes trial proved that Vesipa lowered the chance of patients experiencing a life-threatening cardiovascular event such as a heart attack or a stroke by 25% when added to a statin.
Speaker Change: This is why medical providers should be aware of the reduced outcomes data and should add Visipe on top of the LDLC lowering statin therapy for their at risk patients rather than adding another LDLC lowering drug.
Turning to Slide 13
Speaker Change: Our team will be supporting two abstracts at the upcoming American College of Cardiology Meeting in Chicago later this month. The data being presented by investigators at ACC-25 will further enhance the medical community's understanding regarding the potential mechanistic activities of EPA administered clinically in the form of a CEPA, Iqosipan Ethel, in reducing cardiovascular events in adverse patients.
Speaker Change: Specifically, the data will focus on the antioxidant effects of EPA on lipoprotein little A.
Speaker Change: LPA, Little A, Enrich Plasma, and the effects of the GLP-1 receptor agonist in combination with EPA on the expression of antioxidant proteins in the endothelial cells in vitro.
Speaker Change: High LP little A concentrations are associated with increased CV event risk and people with high levels face a two to four times greater risk of having an early event.
Speaker Change: With about 20 percent of the global population affected, research is crucial for understanding and addressing elevated L.P. Little A, and the medical community has increased its focus on L.P. Little A as a key cardiovascular risk factor.
Speaker Change: We see potential value and opportunity for a receiver and its potential impact to help address key areas driving residual cardiovascular event risk.
Speaker Change: Multiple new therapies are in development to treat CV risk beyond LTLC, lowering. However, it is our view that clinicians should not wait for new agents when a product like BCPA is already available for at risk patients.
Speaker Change: With the advancement of therapeutic approaches that address other domains of residual CV risk, our ongoing research becomes more important because there could be additional therapeutic benefits, whether overlapping protective mechanisms or additive mechanisms in combining EPA with emerging therapies like GLP1 receptor agonists that have been clearly shown to reduce CV risk on top of statin therapy.
Speaker Change: With widespread GLP1 use, there are likely an increasing number of patients with lipid abnormalities requiring statin therapy and with other comorbidities and risk factors that are in need of a
Speaker Change: At Amarin, it is important for us to continue exploring the science behind IPE and the potential mechanisms by which EPA contributes to reducing CD risk. We intend to further advance this evidence base supporting the utility and value of the CPI.
Aaron Berg: Now I'll turn the call back over to Aaron for closing remarks before we begin the Q&A. Aaron?
Thanks, Steve.
Aaron Berg: Turning to slide 15, as you've heard today, we've made operational progress while also maintaining a solid financial foundation with a long cash runway and no debt.
Aaron Berg: We have much more to do to capitalize on the untapped global potential placebo. This is what drives our priorities and informs the steps we continue to take to maximize shareholder value.
Aaron Berg: Second we will continue to focus on driving momentum in Europe, where we have patent protection out to 2039 and the rest of the world through our partnerships. We remain early in the commercialization stages in the regions outside the U S. And these are the regions that provide the greatest opportunity for long term revenue growth.
Aaron Berg: And overall value for shareholders.
Aaron Berg: Third.
Aaron Berg: We will continue to drive efficient revenue, while taking steps to maximize profitability in the U S.
Speaker Change: Fourth as Steve mentioned, there continues to be much more to learn about this unique molecule iqos <unk> ethyl and we will continue to support research drives greater understanding and awareness of the therapeutic value and impact of Vascepa for patients and payers. This is critically important as this.
Aaron Berg: Product has proven to be tremendously valuable as a complementary cost effective therapy to widely used lipid lowering drugs and reducing cardiovascular risk.
Aaron Berg: Finally, we will continue to exhibit financial and operational discipline.
Aaron Berg: While we focus on these critical strategic operational and financial priorities in 2025.
Aaron Berg: To end on a key point that brings us all back to the single biggest and most impactful opportunity before us addressing the number one killer globally cardiovascular disease.
Aaron Berg: As we sit here today right now we have a product available to clinicians that has been proven to be a valuable tool to address this global challenge in conjunction with widely used lipid lowering agents focused on LDL lowering.
Super can directly address cardiovascular risk and potentially change the curve of incidence of cardiovascular events worldwide.
Aaron Berg: LDL lowering alone is not enough.
Aaron Berg: <unk>, 30% of patients that have experienced a myocardial infarction.
Aaron Berg: Well controlled LDL C at less than 55 milligrams per deciliter.
Aaron Berg: And about 15% to 20% of those patients will experience another event in one to three years.
Aaron Berg: Providers can and need to do more for patients now to reduce cardiovascular events by addressing this risk head on.
Aaron Berg: Millions of providers globally have the power and access to a proven therapy of Vascepa, we remain committed to accelerating the pace that they have access to and use our products in the name of helping patients from the world's leading cause of death and essential priority for us here at Amarin.
Before we turn to Q&A I'd like to take a final moment to thank our AMR colleagues and partners around the world for their continued commitment and dedication. Your efforts are deeply appreciated and know that you're impacted the lives of at risk patients around the world. So thank you.
Aaron Berg: With that operator, let's begin the Q&A portion of the call.
Speaker Change: Certainly at this time, we will be conducting a question and answer session.
Speaker Change: I would like to ask a question. Please press star one on your telephone keypad, a confirmation tone will indicate your line is in the question queue. You May Press Star two if you would like to remove your question from the queue.
For participants using speaker equipment, it may be necessary to pick up your handset before pressing the star keys, one moment, please while we poll for questions.
Speaker Change: Okay.
Speaker Change: Your first question for today is from Jessica Fye with J P. Morgan.
Jessica Fye: Great. Good morning, guys. Thanks for taking my question can you talk about the factors influencing U S net price in the fourth quarter.
Speaker Change: Came in a little bit higher than our estimate looks like higher than net price over the past couple of quarters.
Speaker Change: So I'm curious kind of what the drivers were there and just how to think about U S net price.
Speaker Change: Some quarters. Thank you.
Jeff: Hi, Jeff.
Speaker Change: So first of all just overall as you know.
Speaker Change: It's <unk>.
Speaker Change: Increasingly generic market.
Speaker Change: We.
The bulk of our business is in the exclusive branded business.
Speaker Change: But there is a mix of business that changes over time, as well and that that.
Speaker Change: Can fluctuate quarter to quarter and caused some of that variability Pete here with me as well who can provide some further detail on what happened in Q4.
Speaker Change: Hi, Jess Thanks for the question.
Speaker Change: I mentioned there is some variability in terms of the business mix and that's really the driver in terms of our Q4 revenue increased compared to prior quarters. As you know in Q3, we lost Cvs going commercial going from exclusive to not covered that continued into Q.
Speaker Change: For 2024 from a volume perspective, but ultimately it's driving a shift in the business to business mix, leading to higher going from higher rebates to lower rebates.
Speaker Change: Mix in the current year when you look to two.
Aaron Berg: <unk> 2025, youre going to continue to see that volume impact and change in the first two quarters related to the Cvs exclusive covered and as Aaron noted continued pricing pressure from.
Speaker Change: The exclusive contracts.
Speaker Change: Thank you.
Speaker Change: Thank you.
Speaker Change: Your next question is from Robert Romano Ruiz with Leerink.
Speaker Change: Hi, This is amazing audit for Rwanda.
Speaker Change: Just one from US actually so as you mentioned you ended the year with $300 million cash. So curious what your outlook is on building the pipeline either internally or externally through BD and what therapeutic areas are you most excited about.
Speaker Change: Thanks for the for the questions. So.
Speaker Change: <unk>.
Speaker Change: From a BD perspective.
Speaker Change: We'll always be opportunistic.
Speaker Change: Our focus is of course on executing with Vascepa and certainly the skip in Europe, and that's our focus and the cash that we have.
Speaker Change: We invest wisely to get a return on that now that being said, we do have a strong foundation and we will look to its always better to have a second product in the bag.
Speaker Change: If that presents an opportunity for us the things that are presented to us of course, we're cardiovascular company, primarily but cardio metabolic. So there are a number of exciting things out there in development as well as commercial stage, but.
Speaker Change: Right now, we would probably focus on what our power outages.
Speaker Change: We get to that but right now we're focused on execution, we're focused on significant untapped potential.
Speaker Change: With with Vascepa globally, and we really are just getting going it's kind of a tale of two companies right. The U S. As the U S.
Speaker Change: You certainly know where we are with that and we live it every day, but everywhere else. We're just getting going in with a long runway to 2039 in Europe, we have a lot of opportunity, but a lot of work to do.
Speaker Change: Got it thank you so much.
Speaker Change: Your next question for today is from Paul Choi with Goldman Sachs.
Speaker Change: Hi, Good morning. This is Daniel on for Paul.
Speaker Change: We were wondering if you could provide more color on.
Speaker Change: What is driving the rest of the world revenue growth and if there is like better geographical breakdown of the contributions. Thank you very much.
Speaker Change: So I didn't catch the last part of that on the contributions sorry, but yes could you provide more colors on the actual geographical breakdown of the rest of the world contributions.
Speaker Change: Sure.
Speaker Change: So overall just like.
Speaker Change: Europe, we're very early and most of those regions just getting going a lot of work to be done to establish medical advocacy too.
To get access.
Speaker Change: So not only private or public every country is different every reached a different and we're fortunate that we have some good partners that are experts in those respective regions and other pretty passionate about the drug.
Speaker Change: I see that there's a lot of opportunity in their respective regions, but it takes time to get that access and then certainly public access for example, we've talked about China and.
Speaker Change: Now with Australia, just coming online.
Speaker Change: Last year, that's an opportunity for us.
Speaker Change: Both of those are decent sized markets, particularly of course, we know how big China can be.
Speaker Change: We have a number of countries.
Speaker Change: Lotus and Asian, and they are in the Asian region, and they have a number of countries where we are.
Speaker Change: Progressing through the regulatory processes and look forward to getting those done.
Speaker Change: Launch there.
Speaker Change: Have.
Speaker Change: HOS in Canada, now that they've expanded to Alberta as I mentioned in my prepared comments, hopefully, they're able to get more growth in the public sector as well.
Speaker Change: It's going but I think overall, we're seeing the fundamentals of.
Speaker Change: Launching a drug and this is a drug that.
Speaker Change: Responds well once people are educated.
As Steve mentioned, we have a lot of science to work with were well armed to promote the drug.
Speaker Change: There is clearly a unique place for this drug it takes time to educate but once you get <unk>.
Speaker Change: Providers educated payers educated the uptake is there and that's what we'll look forward to so hopefully that answers your question.
Speaker Change: Very helpful. Thank you.
Speaker Change: So that's the end of the questions that we have so first of all I just wanted to say thank you very much for your continued commitment and interest in <unk> and amarin and thanks for taking the time today. We appreciate it have a good day.
Speaker Change: This concludes today's conference and you may disconnect. Your lines at this time. Thank you for your participation.