John Butler
Analyst · Piper Jaffray
Yes, yes. So we talked about DaVita Rx. And then in the remarks, I talked about the CMS issue, which really was, once again, an administrative prior auth that was put on all patients who -- Medicare Part D patients who were prescribed Auryxia. 90-something percent of those prescriptions are being approved because they're mostly being written for hyperphosphatemia today, but that creates an administrative burn for the provider. So if you look at weekly scripts, you saw that right out of the beginning of the year, remember, you take all of the patients who are on Part D, January 1 comes and you need to get a prior auth. So you have this large number of patients who have to work through the PA process, and we've seen this. And you saw this drop in scripts in the first couple of weeks, but you've seen a very robust rebound in scripts to the point where, again, looking at weekly scripts, you're back right around the highest point you've had since before DaVita Rx stopped shipping. So -- really like the momentum that we're seeing. People are working through it. There are a number of tools that are available for centers to -- prescribers to use to help work through the prior auth. Prior auth is not something that providers aren't used to dealing with, right? I mean, it's something they deal with every day. But no matter how good you are at it, it doesn't take you two days to get it through. It takes some time to get it through. When you have a bowless of patients that come through, it takes a bit more time. So when I look at the prescriptions now coming out of the last week we saw in March, there's the robust -- the growth is really robust again. But to the point of giving guidance, you do want to see that sustained over time. When you look at the growth in scripts we had across '18, are we back on that? Can the sales force focus on growing the product versus kind of helping manage the experience that physicians are having today across the prior auths? That's the point that I want to see more. Very pleased with the prescription momentum but not quite ready to feel like we understand it well enough to be accurate in guidance. And just to remind you, Chris, also, this is kind of a onetime thing, right -- at least once a year. Once you get a prior auth, it's good for the year. And this hit towards the end of the year as we were closing the merger, et cetera. If we are unsuccessful in reversing or reestablishing coverage, and we certainly have an expectation that will be, will be. But we're preparing sort of this to be a very smooth process 12 months from now. And we don't go through the same upsetment in the market.