Keith Kendall
Analyst · BMO Capital Markets. Your line is now open
Thank you, Stephanie and thank you everyone for joining us this morning. In our remarks, John and I will be discussing a number of important developments in our business during the fourth quarter and over the first 2.5 months of 2020. We will be joined by additional members of the Aquestive leadership team during the Q&A session afterward. As we committed through 2019, we delivered or achieved a number of important milestones related to the key drivers of value for our business. First, we held a very constructive pre-IND meeting with the FDA related to AQST-108, an oral sublingual film delivering systemic epinephrine that is in development for the treatment of anaphylaxis. Perhaps most importantly in that meeting, we received confirmation that our candidate would be reviewed under the 505(b)(2) regulatory pathway. Next, we received FDA acceptance of our NDA for Libervant, a diazepam based buckle film for the management of seizure clusters. We received a PDUFA goal date of September 27, 2020 from the FDA. We continue next to grow SYMPAZAN, which now has an 18% penetration of the target prescriber base and has grown monthly shipments by over 24% between the end of September and the end of 2019. We raised additional capital in December and we were preparing for the monetization of our apomorphine rights, if approval is received on its PDUFA date on May 21. Equally importantly, we are continuing to manage our costs and focusing spend to extend our capital horizon. Let's discuss in a little more detail each of these key areas of focus for the company. First, as I said, we had a very constructive pre-IND meeting with the FDA in early February regarding epinephrine. At this meeting, the FDA confirmed two key points. First, the clinical development for epinephrine will be reviewed under the 505(b)(2) pathway as proposed by Aquestive; and second that no additional studies would be necessary prior to opening the proposed IND application. They also gave us clear guidance about what they were looking for from our development programs. The outcome of the meeting means that this will be a less complex, less costly and potentially faster path to filing, than originally anticipated. The FDA also confirmed that it understands that there is a significant unmet medical need among patients, who resist the standard of care use of subcutaneous and intramuscular injections in the treatment of anaphylaxis and that AQST-108 may potentially address some of those unmet needs. We're now planning to open an IND in the second quarter of 2020. We're on target to initiate PK clinical trials before the end of the year. We anticipate providing additional updates to the market in coming months, as we gain greater clarity on the expected clinical development program. Next, as we committed, we filed our NDA for Libervant in late November. That filing was accepted as we anticipated in January and assigned a PDUFA goal date of September 27, 2020. We believe that Libervant if approved by the FDA will represent a major contribution to patient care, as compared to the available treatment options and will further expand patient choice as the first orally administered product available for its proposed indication. The FDA has recently indicated that when evaluating clinical superiority for drugs demonstrating a major contribution to patient care that it may consider such factors, as convenience of treatment location, duration of treatment, patient comfort, reduce treatment burden, advances in ease and comfort of drug administration, longer periods between doses, and the potential for self-administration. We believe that we can demonstrate why Libervant as an orally delivered product for this indication has one or more of the attributes required by the FDA to be considered a major contribution to patient care relative to the currently approved and device-driven rectal and nasal products. We believe the Libervant will potentially contribute up to $300 million in peak net revenues within three to four years post launch. Over one million patients in the U.S. have active uncontrolled epilepsy and a need for rescue medication. Less than 10% of these patients are successfully treating their seizures with the current standard of care, a rectal gel application of diazepam. A medicine is only as good as its ability to be used by patients where they need it, when they need it and in a form they accept. And we strongly feel that Libervant represents this type of improvement to patient care as compared to device-driven alternatives. That said, we cannot ignore the potential risk to the timing of a Libervant launch based on the FDA's actions in January. We have an accepted filing for a product with a very strong value proposition, and we believe that we can demonstrate to the FDA that Libervant is clinically superior to the currently approved alternatives. There are multiple paths to approval and market access for Libervant, and we do not believe Libervant will be blocked from the epilepsy market for seven years, and we are working to accomplish that. However, we will be thoughtful and prudent about our choices recognizing the additional risk and appropriately manage our pre-launch spend on Libervant and SYMPAZAN prior to having greater clarity on the timing of approval. Next we remain focused on building our CNS franchise. We launched SYMPAZAN at the very end of 2018. SYMPAZAN is a product we believe will ultimately generate $65 million of peak annual net sales. SYMPAZAN has a meaningful value proposition for caregivers of patients suffering from Lennox-Gastaut syndrome or LGS. We launched SYMPAZAN whose prescribers substantially overlapped with potential prescribers of Libervant with the aim of raising the profile of our PharmFilm technology. SYMPAZAN was developed and launched as a commercial precursor, an eventual complementary product in support of the Libervant opportunity. SYMPAZAN gave us the opportunity to build out and pressure-test our commercialization capabilities and processes prior to the commercial launch of Libervant. All of our commercialization efforts relating to SYMPAZAN provide an opportunity for direct conversations with health care practitioners, patients, caregivers, advocacy groups and others about the value of our PharmFilm technology that will be the basis for Libervant. On a sequential quarterly basis, we continue to be focused on the growth and further market penetration of SYMPAZAN. Since the beginning of the year, shipment volume on a monthly basis has grown over five times and at the end of the year had grown over 24% since the end of the previous quarter. The prescribing base also continues to grow over 44% since the end of the third quarter, with over 78% of those prescribers writing multiple scripts. We now have a penetration rate of 18% for the core target group of prescribers we are focused on. Additionally, we surpassed our goal of having over 70% of lives covered by the end of the year of 2019. SYMPAZAN is strategically accomplishing what was intended when we developed and launched the product last year. The work we do to continue to build the revenue stream and market penetration of SYMPAZAN will be an important foundation for the successful launch of Libervant. Finally, with respect to capital as you know, we raised over $40 million in December and we began the year with cash of just over $49 million. We have a great opportunity with Libervant and epinephrine. And we want to focus all of our energy and available resources on ensuring, we move as quickly and as decisively as we can on those opportunities. Additionally, we need to recognize and react to the declining revenue from our Suboxone business. As such, we'll continue to manage our costs and target our spending in 2020. Those plans are reflected in our updated guidance. We have the capital required through early 2021. We continue to expect to monetize our rights to Sunovion's licensed apomorphine product once approved. That monetization would further extend our capital horizon. To summarize going forward in 2020, we're focused on advancing our proprietary products. First, we're planning to open an IND for AQST-108 epinephrine during the second quarter of the year and anticipate commencing PK clinical trials by year-end. We are preparing for the anticipated launch of Libervant in the fourth quarter of 2020 assuming approval in late September in line with the PDUFA date. We will continue to efficiently grow SYMPAZAN shipments and revenue, while establishing strategic relationships for us in the epilepsy market in advance of an anticipated Libervant launch. And finally, we'll continue to prudently manage expenses and capital and look to efficiently monetize our apomorphine rights on Sunovion's product. As I said before, this product has a PDUFA date in May of 2020. We look forward to continuing to update you as we advance all of these initiatives throughout 2020. With that, I'd like to turn the floor over to John Maxwell, who'll provide specifics on our financial performance and outlook. John?