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Aytu BioPharma, Inc. (AYTU)

Q2 2018 Earnings Call· Thu, Feb 8, 2018

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Transcript

Operator

Operator

Good afternoon, everyone, and thank you for joining us for the Aytu BioScience Fiscal 2018 Second Quarter Business Update Call for the Quarter Ended December 31, 2017. With me this afternoon are Aytu's Chief Executive Officer, Josh Disbrow; Chief Operating Officer, Jarrett Disbrow; and Chief Financial Officer, Dave Green. Aytu BioScience issued a press release earlier this afternoon with details of the company's operational and financial results. A copy of the press release is available on the news page of the company's website at aytubio.com. I'd like to remind everyone that today's call is being recorded. A replay of today's call will be available by using the telephone numbers and conference ID provided in the earnings press release. In addition, an archived webcast replay will be available on the company's investor page, under Corporate Presentations and Media, at aytubio.com, following the conclusion of this conference call. Finally, I'd like to call your attention to the customary safe harbor disclosure regarding forward-looking information. The conference call today will contain certain forward-looking statements, including statements regarding the goals, strategies, beliefs, expectations, and future potential operating results at Aytu BioScience. Although management believes these statements are reasonable, based on estimates, assumptions and projections as of today, February 8, 2018, these statements are not guarantees of future performance. Time-sensitive information may no longer be accurate at the time of any telephone or webcast replay. Actual results may differ materially as a result of risks, uncertainties and other factors including, but not limited to, the factors set forth in the company's filings with the SEC. Aytu undertakes no obligation to update or revise any of these forward-looking statements. I'd now like to turn the call over to Aytu's CEO, Josh Disbrow.

Joshua Disbrow

Management

Good afternoon, and thanks for joining us for today's quarterly update call. As Rocco just said, I'm joined this afternoon by our COO, Jarrett Disbrow; and Dave Green, Aytu's recently appointed Chief Financial Officer. Aytu's second fiscal quarter ending December 31, 2017, was an important time for the company, during which we demonstrated continued traction in the marketplace with Natesto, the company's FDA-approved treatment for hypogonadism, while also significantly improving the company's capital markets presence by up-listing to NASDAQ. Additionally, in Q2, we continued to grow our business outside the U.S. for our MiOXSYS male infertility device, having now sold that platform into 36 countries around the world. Finally and very importantly this quarter, we recruited and appointed Dave Green as our new CFO, and we're pleased to have attracted such a high-caliber individual with strong credentials in finance, accounting, strategic transactions, valuation and operations across his 25-year career as an investment banker, adviser and as a public company CFO. I'll ask Dave to introduce himself formally when he covers the key financials for this quarter. First, though, some operational highlights on the company's performance on what was another solid quarter for the company. This quarter, we achieved all-time high prescription rates for Natesto and have more physicians prescribing than in any quarter since the product's launch. For the quarter, we generated 2,501 total prescriptions, which represents 23% growth over the previous quarter and 317% over the same quarter last year. Also, in the second quarter we had 1,178 prescribers writing Natesto, which is up 19% from the previous quarter and up 174% from the same quarter last year. Additionally, pull-through from our field force drove wholesale demand to its highest level to date. For the 3-month period ending December 31, we sold 7,163 Natesto units through our wholesale channel…

David Green

Management

All right. Thanks, Josh, and thank you to everyone who's joined us today. We appreciate your interest and investment in Aytu. By way of background, I've been focused in life sciences my entire professional career. I started out in clinical research in biotech labs after finishing an undergraduate degree in chemistry. Then after a chanced introduction to the business school of the University of Rochester, where I was busy characterizing in-film receptor activity, I changed directions and enrolled in the MBA program to pursue finance. From Rochester, I went on to advise a broad range of life science and tech companies at Duff & Phelps, and E&Y Capital Advisers that were engaged in M&A, financings and other strategic transactions. Then, after 13 years as a banker, I joined a public medtech company in Salt Lake City as CFO, which we quickly built into the leader of our space and then sold to C.R. Bard. Since then, I served as CFO of both public and private medical device and pharma companies, typically, earlier-stage enterprises with substantial growth opportunities, much like Aytu. For this chapter, I'm extremely pleased to team up with Josh and Jarrett and the rest of the team to build Aytu into a leading urology company. We have a fantastic group, punctuated by a highly capable commercial infrastructure and sales rep coverage across the U.S. As I looked at Aytu, I came to realize that there are really few earlier-stage life science companies with the commercial experience, capabilities and leadership that Josh and Jarrett have assembled here at Aytu. And with this commercial capability and the right product portfolio, we can create substantial enterprise value. I'm truly excited about this team and the company's bright prospects. Now turning to the quarterly financials. For the second quarter ended December 31,…

Joshua Disbrow

Management

Thank you, Dave. So as Dave just indicated, sales were again over that $1 million mark, with Natesto accounting for proportionally more sales than in recent quarters, and burn has come down this quarter to a manageable level that we do indeed expect to continue to decrease. However, and despite the significant prescription growth we are seeing with Natesto, we know we can drive revenues higher. We can do this by continuing to increase prescriptions, but with lower patient and pharmacy discounting and higher refill rates. We're confident that via an increased investment through a highly strategic approach, Natesto will be positioned for more growth than we've seen in the past. I'll remind you all that we're still in the very early innings here and the business is being built from the bottom up, and the results continue to be encouraging. The hard part for Natesto, I remind you, has been done. It has already been FDA-approved, which, by the way, has proven to be very difficult for prospective competitors. We've also successfully now laid the foundation of early prescribers and initial patient starts. Now is the time to invest in further growth and make Natesto into a leading branded product in the TRT category that we believe can capture meaningful market share and become a standard of care in low T treatment. Before going into our strategic growth plans for Natesto, let me speak to a relevant market event that we believe sets the stage for Natesto being in a protected market position, potentially for years to come and potentially more than we have previously estimated. I described this in a shareholder letter that I sent a few weeks ago, so for those of you who didn't receive that, I'll revisit what I said. On January 10 of this…

Operator

Operator

[Operator Instructions] Today's first question comes from Monish Bahl of MHB Capital.

Monish Bahl

Analyst · MHB Capital

Just a couple quick questions. Maybe I have 4 -- 4, 5 questions really quickly. One is, can you tell me what your gross to net is today? I know your goal is to get to 50%, but can you give me some short-term objectives over the next several quarters, for example? And two, with regard to the Natesto Support Program, I know that's only been launched, I think you said 1 or 2 weeks ago, can you give me an idea of where this has been implemented to show that it works with regard to a new product launch? And then, third, with regard to the competitive landscape, can you quantify or give me some sort of indication of the success you're seeing with regard to the lack of competition because of the 2 competitors getting FDA rejection? That will be great for right now.

Joshua Disbrow

Management

Thank you, Monish. Appreciate you dialing in, and thanks for your questions. So we can share, generally, on where we are with respect to gross to net. So as a company, we've published this, obviously, in our Qs and Ks, we've got over a 50% gross to net across our product portfolio. Now we don't enjoy that gross to net with Natesto, it is less than the industry standard or the market standard in testosterone replacement of around 50%. While we haven't specifically said what that is, it's a reasonable step below that, and we do think it's going to take a few quarters to start creeping back up to really what is more a nominal level of closer to 50%. Axiron sort of in its twilight was in the 50% range. That product, of course, has been discontinued from the U.S. market. So we realistically expect that the discounting that will be required, the rebating, the couponing and ultimately the all-in cost to essentially sell the product will be hovering in the 50% range. Again, we haven't disclosed specifically what it is, we're below that. We think this program, the Natesto Support Program, will go a very long way in helping support that. Because what's happening right now is men are going to the pharmacy and we're giving them essentially free goods, initially. We're giving them a voucher to start and get their first prescription or first month free. And that's great, and everyone feels good. But ultimately, that voucher, if they have -- if that physician office has not implemented the prior authorization, which is a requirement across the board in this category, those men are coming back to get their refill and they're experiencing essentially a cash, an out-of-pocket price for our prescription product. That's often a…

Monish Bahl

Analyst · MHB Capital

Yes, the current revenue is key, obviously. And I just have 2 more follow-ups, based on what you said today, that would be helpful. One is with regard to the -- from the P&L's perspective, is there going to be a significant ramp-up in expenses with this new program? And two, if I look at what you did in Q1 with regard to your sales, what percentage of those customers came back in Q2? Would that be fair to ask?

Joshua Disbrow

Management

Yes, that would be fair, it's a little bit tough to look at it that way, Monish, but let me just give you a general sense. And first of all, will we expect to ramp up expenses, this will cost money, this program is not free, there is obviously an expense associated with it and I want to be straightforward with our investors to that effect. Will it be millions and millions and millions of dollars to start up? No, it will not be, but there will be an expense associated with it. But we look at this as a very, very prudent way to invest in growing the brand, which is still in its very early stage. So I'll leave it at that. But in terms of patients that come back, if you will, repeat users, if you will, we don't have -- we don't have -- unlike a medical device where you can very easily track one patient to the next, we obviously don't have patient names. What we do have are new prescriptions and then we get data on total prescriptions. Total prescriptions, obviously, encompass new prescriptions and on top of that any refill that come on top of that. What I will say is we are seeing refills, but we're seeing them at a lower-than-expected rate, primarily due to reimbursement, almost exclusively due to reimbursement. So where that for example, an AndroGel patient, on average, we're seeing a 2:1 ratio of TRxs to new Rxs across the category. We're seeing more like 1.6, maybe 1.7. That has grown from 1.3 or 1.4. But it's still almost a multiple behind. It's a significant percentage behind the market standard. So with that, we expect -- and that's almost entirely due to the fact that they come back -- they go in Q1, they come back Q2 and they get presented with a very high cash out-of-pocket payment and they walk away from the prescription and neither get switched back to AndroGel or just stop their T therapy. That's what we're going to stop. That's what we expect this program will stop. And with that, we begin to get the multiplier effect and an install base, if you will, of patients that starts to be reflective of some of these long-term go-forward patient, who may not just get one prescription and then a refill and walk away. He may get 3, 4, 5 or 6 or even more. And we do have patients currently with that much reimbursement in place that are getting refills consistently. It's not enough, we need to get more, this program will drive towards that.

Operator

Operator

[Operator Instructions] Today's next question comes from Joshua Horowitz of Palm Global.

Joshua Horowitz

Analyst · Palm Global

Question for you. Obviously, I'm sure you won't be able to put specific numbers to it, but it looks like you've reduced OpEx from quarter-to-quarter. Any color you could give on the cadence of level of spend going forward? I know, obviously, there is some new programs that have high ROIs, but what should we expect?

David Green

Management

Generally, we do expect to hold OpEx roughly where it is. And kind of the one element you should look for as you dig into the financials is there are quite a few noncash expenses that GAAP require that run through our operating expenses. So some of those can, on the face of the financials, look like the operating expenses are moving around quarter-to-quarter. But overall, the important ones that are, say, very much cash-driven, we do expect to keep roughly in check. There will be some uptick with, say, as we grow the business and, obviously, cost of goods sold will grow with revenue. And -- but as far as staffing goes and the team that we fielded at the time, that is roughly set for where we need to be to reach the growth milestones that we're shooting for. So we don't expect a lot of change.

Joshua Horowitz

Analyst · Palm Global

Great. I guess, as a follow-up to that, would you say that your existing infrastructure is set up for a much larger business and there's no real additional projects from a capital allocation standpoint that you need to put resources to?

David Green

Management

That's definitely true. And one of the beauties of this business is it's very-low capital. From a capital perspective, it's very low-level intensity. So we don't have much CapEx at all planned. And really, we do have capacity in the field and in our commercial infrastructure, which is really we've built that group and that capacity to do more than it's doing today. But until we find the right, say, complementary product to put in the bags, we are running with this, but we do have capacity.

Joshua Disbrow

Management

Yes. And further to that, I'll piggyback on what Dave said is we obviously have an infrastructure it's our, obviously -- it's our most costly piece of the business is our sales force. We view that very much as an asset, as David said. They do have capacity to pick up additional assets. And I will say that, right now, they call on, on average, 100 to 150 physicians really actively. They got 200 plus in their target database, but they're really actively accessing 100 or so physicians. In the course of a given week or 2-week period, it's relatively straightforward to get to that number of people. So with the infrastructure we have in place and with what we expect to be really a beginnings of a multiplier effect with the introduction of this program, we can drive sales to a much higher level with the infrastructure we have, so we don't need a bolt-on.

Joshua Horowitz

Analyst · Palm Global

Terrific. If I look at your business as, let's say, a subscription business, and there's a cost of customer acquisition and a monthly or a bimonthly subscription, how do you assess the cost of customer acquisition and the lifetime value of that customer as you roll out things like the support program?

Joshua Disbrow

Management

That's a good question. We don't necessarily look at it that way, Josh, but there is -- there certainly is a fixed cost that we know. In pharmaceuticals, it's obviously there's not a capital equipment buy, so there is not a, hey, it's 6 months to get them to a purchase. What we do look at is sort of routine prescriptions over the course of, say, a 12-month period, and that is costly. Obviously, our sales force is expensive. It's $150,000 to $180,000 per FTE, depending on sort of the month and the quarter. That's going to be a cost whether they get one customer, 2 customers or 1,000 customers. So obviously, the objective is very simple: to get to as many high-prescribing targeted potential prescribers as we can, to get as many of those physicians routinely writing and to get as many of that physician's patients getting prescriptions refilled on a regular basis. Frankly, it's both of those things that we need to improve. We're still at an early stage, and so we're excited about the implementation of this program, whereby we can do both of those things. We can get more doctors writing more broadly, because right now, it's sporadic in some cases, it's consistent in others. We want to get it across the board where the majority of our prescribers are writing this on a routine basis, at least daily. And those prescriptions that are going out the door, we want to increase that from 1.7 to 3.5 or 4 or even higher prescriptions per year on average. And frankly, that starts to pop the top. And that's all within reach with what we have in structure today.

Joshua Horowitz

Analyst · Palm Global

What are some pushbacks you're hearing out there from physicians on the product? Is it just lack of awareness or misinformation or no information or their tendency to stick to what they know? How do you educate and what are people pushing back and saying?

Joshua Disbrow

Management

Yes, very good question. And it's 2 things that are consistently heard and it's nothing new and there's nothing inherently negative about Natesto, which is a good thing. We don't get pushed back in terms of, well, that's not a product that I would use, that's not something that I would value for my patient. We get, very simply, I've used what I've used for the last 20 years, and that's often an unspoken objection, but it's the most common. It's simple habit and it's simple routine. Physicians have written AndroGel or done injectables for the better part of the generation. In the case of injectables, they've done it for 2 generations, so these are very entrenched long-standing competitors. And injectables are dirt cheap and AndroGel is covered by 99.9% of the payers on this land -- in the country, rather. So -- and in fact you could probably extrapolate it to the planet because it's covered very, very well across the globe. Those are the 2 encumbrances we face, those aren't insurmountable, and frankly, it's good and it's encouraging. Those aren't reflective of anything inherently negative about our product. Our product is a good product, and it's well received. And when you lay it side-by-side with the competitive set, it is resoundingly accepted as a better profile. When you introduce reimbursement as a challenge, to say, well, roughly 50% of the time, it may get rejected, that changes the tune. That's why we're excited about this program and why it is going to require further investment to take it to the next level, but we're comfortable because the case studies in similar circumstances, in similar markets with similar sort of inertia or lethargy have shown that when you can remove reimbursement as a barrier or at least manage it effectively, we can get on equal footing and we can get to, in a physician's mind, a preferred status because now they can get back to prescribing the better product, better for their patients, because we're helping with some of the headaches associated with prior authorizations. So I don't know if that answered the question, but there is nothing inherently negative about the product that pushes back, it's just they've done what they've done and they don't like to get pushback from payers, and so we're working to solve that, obviously, in earnest now.

Joshua Horowitz

Analyst · Palm Global

I have to imagine there are organization -- there are third-party organizations that help smaller drug companies manage that process. You are going to try and do this in-house? Have you looked at outsourcing this function?

Joshua Disbrow

Management

This is a function that we'll outsource at least initially and, potentially, for the long term, very simply because this is a group that's done it before. They do this with specialty brands all over the country. They have a very, very good track record. And so sometimes you buy, sometimes you build, we're going to buy this service because we know they can do it well. Over time, as we learn, perhaps it's something we can internalize. Right now it makes sense for us to invest with this third-party provider because we know that they can do it and teach us a lot along the way.

Joshua Horowitz

Analyst · Palm Global

And the way they're paid is mostly success-based?

Joshua Disbrow

Management

It is -- primarily, there's a success element in that they get paid on the refill piece. There is an upfront cost that is ultimately, until we get a sense for which plans are going be more amenable to this type of calling and sort of hand-holding. So we will pay irrespective of success at that point, but we'll begin to predict success very, very well and know which plans does it make sense to pursue appeals and pursue prior authorization and step edits, which ones frankly will it not make sense because 99 times out of 100 they're saying don't waste your time, we won't cover this product. In that case, by the way, we'll simply put the patients to what we call the cash option, whereby the patient will pay no more than $150 per prescription, which is in this day and age frankly, it's not that expensive for a branded pharmaceutical. So we'll always have an escape hatch. Generally speaking, when you get covered, the patient will pay $25 per prescription and they'll get that every time, every month, every refill. In the event that it's not covered, again, we slip them to this cash option, they pay no more than $150.

Joshua Horowitz

Analyst · Palm Global

Got it. Okay. I've taken up a lot of your time. I guess, any just quick thoughts on U.S. commercialization of MiOXSYS and when we could see that?

Joshua Disbrow

Management

Yes, thanks for that. We've talked about that. And obviously, MiOXSYS continues to be a product we're very excited about. I'll, as an aside, mention the fact that recently, ESHRE, the European Society of Reproductive -- Human Reproduction and Embryology, put out guidelines back in November, specifically for the first time calling out oxidative stress is something that should be tested in any couples, specifically in men, that are having recurrent pregnancy loss. And so that's a huge sort of watershed market event. So we expect that to be helpful as we get outside the U.S. In the U.S., realistically, we're a year to 18 months away from, I would say, a meaningful inflection point from the FDA. We're currently engaged in a pilot study with a group of very prolific researchers in neurology here in the U.S. We -- I don't want to go too far other than to say we've got some very interesting preliminary data. And we believe we have a path with the -- pathway with the FDA, that's distinct from what we're doing outside the U.S. So we think we're 1.5 years from probably having that product commercially ready. And that will be a very nice hand in glove because this study will specifically be a urology play. It will be a urological procedure that is done in the context of correcting men with infertility. It's an anatomical issue. So more to follow on that, but there is a path, we believe, to get this thing FDA-cleared and into the bag of our sales force.

Operator

Operator

And our next question comes today from [ Raymond Smeazy ], a private investor.

Unknown Attendee

Analyst

Yes, Josh, Ray Smeazy. How are you going to fund the new program, which you're talking about for reimbursement and stuff, when you only have $1 million -- approximately $1 million of revenue, operating expenses of $5 million, cash use of over $3 million and only $4 million cash left. Now I know you don't have many shares out, but what's your plan in the next quarter? You're going to have to raise money because, if you don't, people are going to start shorten this thing because they're going to know you got to go out and raise money.

Joshua Disbrow

Management

Yes. Good question, Ray. I mean, obviously, you're asking an important question and one that's on the minds of...

Unknown Attendee

Analyst

Because I look at the old stock because I own the old. I mean it's valued at like $0.14 a share right now. So when you divide 20 into the [ 2 75 ]. So how are you going to -- even if your cash goes to [ 1 3, 1 4 ] revenue in the next quarter, you said there's going to be some new added expenses for this new program, even if it's only a couple, I'm not guessing, only a couple of hundred thousand dollars. So what is your plan to raise?

Joshua Disbrow

Management

Yes, let me first take a step back, Ray, and I thank for your question again. It's one that is likely on the minds of several. And I'll remind people, we are, obviously, in the very early stages here. We, obviously, are in a circumstance where the company continues to be in growth mode and want to continue and need to be able to fuel that growth. We cannot preclude the fact that we could have access to capital markets in the relative near term. That having been said, we can, we believe, scale this very efficiently, because what we don't have today is something sort of akin to an install base, where patients are getting more routine repeat. And that is something that we believe will enable us to catch up and potentially supersede even our internal forecast. We don't have a firm number and certainly not guiding to where we think this new program will go. But what I'll say very simply is, yes, we're a young company, access to capital remains something obviously that we need to continue to have available to us. And ultimately, we believe that what we have in place will more than make up for any potential dilutive financing or any financing period that we do because the upside here is substantial. I'll remind people again, this is essentially a $2 [ million ] market. This is a product that is protected with patents -- public patents today that go through 2024. And frankly, the opportunity with pending patents to go beyond that, this can be a product that lives for many, many years. And when you look at this thing in the out years, there's a very, very substantial prospect for growth. And we continue to be enthusiastic by everything we're seeing. So I'm not answering your question other than to say, we can't preclude the chance that we'll raise capital, and that would be prudent for us to maintain our strength, to maintain, obviously, the momentum that we're gaining in the market every single day.

Operator

Operator

And our next question comes from Rich Beaven of Signia Capital.

Richard Beaven

Analyst · Signia Capital

Our question -- our first question was answered for the most part by the last caller. But curious AndroGel, can you give us a little bit of an update as to what's happening on their side of the business as it relates to growth and pricing and so forth? I mean, obviously, as you just mentioned, that's the big competitor out there and we just want to -- we're just curious as to how they're progressing and what the market landscape looks like from their perspective.

Joshua Disbrow

Management

Yes. Thank you, Rich, good to hear your voice, appreciate the call. We -- let met first take a step back. And if you look at the TRT category, broadly, if you look at last year's total prescriptions versus 2017, so moving annual total December of '16, there were 6.4 million prescriptions generated in the class. Moving annual total same time then the year after, so December of '17, there was 6.88 million, almost 6.9 million prescriptions, so substantial growth. And my math shows that's thereabout -- it's about 12% up from 2 years prior and about 6% up from 1 year prior, so the market continues to grow. AndroGel has actually maintained its share. If you look at December of '16 versus '17, only down about 100,000 prescriptions, 1.4 million to 1.3 million prescriptions generated in the year, so we continue to hold on. Prices slipped because there are some, obviously, some generics. And there is, obviously, a -- there's some growth in what I would call sort of a separate segment, the injectables, those have grown disproportionately more than the gel market. AndroGel is very well positioned, they have been -- they have made a strategy consciously to lock up the market through payers. They've opted to dial down their promotional spend from a professional standpoint, that is reps calling on doctors. And they've opted to put their resources into locking up payers to get preferential status. So they've rebated the product significantly to the major payers and the [ CBMs ] in order to attempt to block out future competitors. One thing we know from various things, inclusive of the fact that they're almost entirely footing the bill for the TRT consortium study that the FDA has mandated, we expect that they expect to be in the market long term, which is good for us because that tells us it's a long-term viable market that -- where growth is expected. So they're about flat. The market has grown from a prescription standpoint. There has been some migration to generics and injectables. And ultimately, they maintained the top spot. Our objective becomes, with physicians that are open to writing branded prescription TRTs, our target is AndroGel and our target is those physicians because, obviously, they don't mind, obviously, the prior authorizations. They'll, obviously, work through some of those things. And so we'll continue to target those physicians that are the highest AndroGel prescribers.

Richard Beaven

Analyst · Signia Capital

Great. Okay. And so if I'm putting all the pieces together here just from some of the commentary, I think when we had talked earlier about you proceeding to cash flow breakeven or cash flow positive position, it was going to be in the calendar latter part of 2018, mid to latter part. So that pushes from your -- from some of this commentary that pushes that back maybe a quarter or 2. Can you just touch on that?

Joshua Disbrow

Management

Potentially, and I don't want to guide specifically because it does, obviously, become dependent upon sales trajectory and improvement on the gross to net. We still think we've got a relative near-term view to profitability. And what exactly that is by the quarter, we won't guide to. But what we'll say is we're significantly further along than we were this time last quarter. And we are significantly better positioned than really any other companies in the space, particularly when you consider our relative use. So if we take a look at the trajectory we were on, and we make some assumptions in terms of additional refills and an improved gross to net and realized revenue sort of per patient, again taking it out over the life of that patient's prescriptions, we think we can inflect that line significantly, but more to follow. We remain confident in the trajectory and, in fact, we fully expect to inflect our sales growth over the next quarter or so.

Operator

Operator

And our next question comes from Eric Anderson of Hartford Financial.

Eric Anderson

Analyst · Hartford Financial

Josh, I was just interested in the demographics of the typical user for the hormone replacement therapy. Is it -- are you talking for a period of month? Is it sort of a product that someone would be on for the rest of their lives? What's the typical use here?

Joshua Disbrow

Management

Yes. So firstly, the demographic. I mean, the average patient is sort of mid- to late-40s, realistically, so it's not just "old man's disease" as has I think commonly been presumed. And in terms of length of therapy, it's all over the board, it's an exceedingly wide standard deviation. But generally speaking, yes, it's a product that you would stay on for some extended period of time, certainly through your active years, potentially for the rest of your life. No different than blood pressure medicine or anything that you would take long term. This is something that is for health maintenance. It's -- while it is, to some degree, considered a lifestyle condition, it's very serious and one that results in all kinds of negative things. So men should be on it long term, which is why it works better about building the base of business to really reflect men that are going on it long term, that are going to stay on it long term and those are patients, frankly, right now that we're not capturing. And so...

Eric Anderson

Analyst · Hartford Financial

But you'd hope to have refills then that go on for years, not just months?

Joshua Disbrow

Management

AndroGel sees that, and AndroGel sees that routinely. A, it's been around for a long period of time. When it first started off, it was obviously in the hundreds of prescriptions and then thousands. And when it goes to the hundreds, to the thousands, tens of thousands, those tens of thousands are very often repeat prescriptions, not first-time buyers. These are people that have been on it for 6, 7, 10 years, and those refills just keep turning through. And in fact, if you were to ask a physician to identify his AndroGel patients, he has a hard time doing it because they've been on it for so long, he doesn't think of them as active patients. He's seeing them now for other things, like heart disease or he got him on a lipid-lowering agent, and he just refills, he just -- does a refill prescription on his AndroGel, which, of course, is commonplace. That's what we think we can build to long term. But this is -- we're playing long ball here, this is not a short -- this is not one for those who don't have a longer appetite. Again, this is one that ultimately, as it builds out, we think can build a substantial trajectory with respect to the patients that continue to flow through on the product.

Operator

Operator

[Operator Instructions] Seeing no further questions, I would like to turn the conference back over to Mr. Disbrow for closing remarks.

Joshua Disbrow

Management

Thank you, Rocco, and thanks, everyone, for participating in today's call. Thanks for your questions. Thanks for your investment. We continue to be pleased with our progress. And of course, we've got a lot in front of us. And as we roll out these several key initiatives and take advantage of these market events in both the testosterone and, frankly, in the male infertility arenas, we'll continue to keep our shareholders informed as we make additional progress, and we thank you for your continuing support. So thanks again for your time. Thanks for your support, and have a good evening.

Operator

Operator

Thank you, sir. This concludes today's conference, and we thank you all for attending today's presentation. You may now disconnect your lines, and have a wonderful day.