Josh Disbrow
Analyst · Maxim Group. Naz, your line is live
Thank you, Robert, and welcome, everyone. We're excited to be speaking with you today following an exceptional year and the strongest quarter in Aytu BioPharma’s history. As you all can see from the financial results in the press release we issued after the market closed, we finished fiscal 2023 on a strong note, having achieved record annual revenues of $107.4 million, all-time high total prescriptions for our core Rx segment with over 560,000 prescriptions written for our promoted products last year, gross margins that increased to 62% for the year compared to 54% last year, positive adjusted EBITDA of $7.7 million during the fourth quarter, an improvement of $11.6 million from the year ago fourth quarter, which also translated into positive company-wide adjusted EBITDA for the full fiscal year ‘23 of $3.2 million. And while our quarterly net income was slightly negative due to several impairments taken as part of the wind down of our Consumer Health segment, we set the stage for significant improvement in fiscal 2024. And by the way, without those impairments, net income for Q4 would have been $0.6 million. This dramatic transformation of our operating results is due to the strength of our Rx segment, which is comprised of our Rx product lines of Adzenys XR-ODT and Cotempla XR-ODT and our pediatric multivitamins along with our antihistamine Karbinal ER. Our ADHD products continue to experience tailwinds from the ongoing stimulant shortages while all of our prescription products are benefiting from strong field execution and internal operating and margin improvements. This is all setting the stage for continued growth and improvement in fiscal 2024. I'll touch on this more in a moment. The transformation of our results did not happen overnight and I'm pleased to see our operating plan coming to fruition. It was a deliberate strategic plan undertaken to indefinitely pivot away from clinical development and place the company on a financial pathway to sustainability, particularly in light of the current market environment. Step one in that plan was announced last October when we indefinitely suspended our pipeline programs to minimize the research and development expenses until such time that we can fund those efforts with internally generated cash flow or through a strategic partnership. This was a difficult decision, but one we knew was in the best long-term interest of the companies and its shareholders. The second component of that plan was implemented in June of this year when we announced that we would focus our commercial efforts on our growing and profitable Rx segment while de-emphasizing our Consumer Health segment through either monetizing or discontinuing it. To put some perspective on this strategy, our Consumer Health segment had negative adjusted EBITDA during fiscal ‘23 of $3.6 million. Our clinical development program, which was really only operational for a quarter this year, had negative adjusted EBITDA of $2.6 million. So we're looking at a negative adjusted EBITDA of $6.2 million across these two segments. In contrast, our Rx segment, which I'll note supports all of our corporate overhead, had posted -- had positive adjusted EBITDA of $9.4 million for the year. Going forward, by exclusively focusing our business on the Rx segment, we've highlighted an operating company that's growing, has positive EBITDA, and is poised to achieve ongoing and consistent profitability. As we look to fiscal 2024, as our Rx segment becomes the go-forward company, we will look to carefully wind down our Consumer Health segment by selling off its remaining inventory and minimizing its expenses. We expect there to be neutral to minimal impact to our adjusted EBITDA from this segment in fiscal 2024. The strategic focus on prescription products and the de-emphasis on the Consumer Health segment should result in fiscal year 2024 company-wide adjusted EBITDA improvement and barring any unforeseen impacts, closing in on company-wide profitability. We do anticipate some residual fiscal 2024 write-downs associated with the exits of our Texas manufacturing facility and the Consumer Health segment, but these are non-cash GAAP actions that will not impact our adjusted EBITDA. Let's take a moment to dive further into what is our core business going forward, our Rx segment. As mentioned at the beginning, we operate in the ADHD category with the Adzenys XR-ODT and Cotempla XR-ODT, the first and only FDA approved amphetamine and methylphenidate extended release orally disintegrating tablets for the treatment of ADHD, respectively. These novel branded medications utilize our proprietary micro-particle modified release drug delivery technology platform and each hold multiple orange book listed patents. On the pediatric side, our portfolio includes our fluoride-based multivitamins available in various formulations for infants and children with fluoride deficiency. We also market Karbinal ER, an extended release carbinoxamine based antihistamine suspension, indicated to treat numerous allergic conditions for patients two years and older. These products serve well-established pediatric markets and offer distinct clinical features and patient benefits over the branded and generic competitive products and have strong intellectual property protection. Let's go into ADHD first. Net revenue for ADHD products was up 30% for the quarter and up 9% for the fiscal year. The long-term trends we've talked about in the last few quarters persist, including overall growth in the ADHD market. We continue to see an increase in new diagnoses of children and adults, as well as the ongoing impacts from the supply disruptions for generic Adderall XR and various methylphenidate products. These disruptions and shortages are continuing, with several stimulant products being discontinued altogether as of late. The news around these widespread stimulant shortages abounds, with articles and editorials being published almost daily at this point. We've done an exceptional job maximizing the growth opportunity presented by the ongoing ADHD market supply disruptions, while having no negative impact on our operations, i.e., we have maintained supply to meet our growing demand throughout these market events, and expect to continue to meet this ever-increasing demand. We believe the competitive supply disruptions over the past number of quarters have enabled Adzenys to gain both market and mind share, propelling new prescribers and patients to find their way to Adzenys. To illustrate this, consider that from our fiscal ‘22 to our fiscal ‘23, new Adzenys [riders] (ph) for the year grew by 28%. When looking at new rider growth over two years, we have more than doubled Adzenys riders, with new riders representing 48% of our total riders. We've increased Cotempla riders by almost 70% over that same timeframe, with new writers representing almost 40% of total Cotempla riders. As a reminder, Adzenys is approved as bioequivalent to Adderall XR, so our brand is well positioned to continue to capture additional share as the extended release amphetamine shortage remains ongoing. Also, we expect to hold onto this new share as ADHD prescriptions are sticky, as both clinicians and patients generally continue with drugs that work for them. The impact from the supply disruptions coupled with the continued strong execution of our commercial team and the leverage we are driving with our Aytu RxConnect platform drove prescriptions to record levels during the fourth fiscal quarter. All told, Adzenys and Cotempla scripts were up 15.3% for the fiscal year and up 37.5% for the fourth quarter compared to the same periods a year ago. And if we look at factory sales units year-to-date here so far in our fiscal ‘24, Adzenys shipments are up 42% over the same period last year. The momentum continues. We discussed this last quarter, but it bears reminding that in order for us to be responsive to market dynamics and to keep up with rising costs, we implemented a customary price increase for ADHD products effective April 1st. This resulted in a one-time channel adjustment last quarter, which we indicated would even itself out this quarter with script growth and net revenues being more closely aligned, and it did. It's worth reminding everyone that we do see impact for the payer changes and the resetting of the underlying patient insurance deductibles at the beginning of the calendar year, and these impact our patient savings offers and our overall gross to nets. We've seen improved margins since the March quarter and expect to see that improvement continue through the calendar year as deductibles are met and the numerous initiatives we've undertaken continue to gain traction, which they are indeed doing. Beyond the success we're seeing from the sales side, we're also implementing initiatives to improve profitability through the outsource manufacturing of both Adzenys and Cotempla. As we've discussed, this change is expected to further improve gross margins of our ADHD products. So let me update you on this process. In July, we submitted the Cotempla Prior Approval Supplement or PAS to the FDA, which once approved, enables us to transfer the production of Cotempla to our third-party manufacturer. We expect a six-month review of the PAS submission, which should enable FDA approval by late calendar ‘23 or early calendar ‘24. As you may recall, we previously received FDA approval of the Adzenys site transfer PAS and have already begun shifting Adzenys production to the company's contract manufacturer. So assuming we get the Cotempla approval, we expect to start realizing the margin improvements for the ADHD brands in calendar ‘24. This has been a tremendous team effort to advance us to this point and I applaud the entire team's hard work in advancing the site transfer of these important ADHD brands. Let's transition to our pediatric portfolio now. Net revenue in our pediatric portfolio was up 18% for the quarter and up 58% for the fiscal year, remarkable growth that we're very pleased with. The key drivers here are the ongoing commercial execution and increasing product awareness, as well as our continued Aytu RxConnect platform leverage. These improvements are providing tailwinds for the product's prescription growth trajectory. Since we added the multivitamins to the RxConnect platform, we have increased prescriptions significantly. Scripts for our pediatric products grew almost 80% over two years. Further, the number of multivitamin prescribers have grown over 250% from two years ago, which was prior to these products being added to the RxConnect platform previously developed at Neos. The number of Karbinal ER prescribers grew over 120% over that same time frame. RxConnect affords us leverage, and these numbers surely bear that out. We discussed this a bit last quarter that we are also launching a multivitamin line extension with the novel folic acid ingredient, Arcofolin. Arcofolin offers an improved profile over Metafolin as a body-ready L-methylfolate. Arcofolin's low water content and low molecular weight of the counter ion yield higher levels of acetate folate than other forms of L-methylfolate currently available on the market. It also has an improved purity profile, enhanced water solubility, and an excellent overall stability profile. The transition to Arcofolin also extends the brand's IP protection and provides further differentiation from other products. We believe the addition of Arcofolin to the multivitamin product lines will enhance those products’ profile and we look forward to continued growth and adoption of our unique pediatric portfolio. We've seen some payer changes in the multivitamin category, specifically with the big payer, a single payer rather, but we believe we can and already have begun to offset this reimbursement downdraft through growth outside of this payer and through several novel approaches we're taking to both deepen prescribing from current riders and broaden our prescriber base. These efforts are well underway and we're starting to get real traction. And I'll remind you again that the ADHD portfolio continues its tremendous growth. So we're excited about how the portfolio is performing when put all together. Overall, I'm pleased with the traction we're achieving across our Rx segment. This elevated performance has been driven by strong execution from our sales organization, the leverage we continue to achieve through our RxConnect platform, and enhanced category tailwinds with both ADHD brands. With the wind down of our Consumer Health segment, our Rx segment is the core business going forward. And it's what I would draw your attention to as you think about Aytu's financial profile as we move into fiscal ‘24 and beyond, one that is growing net revenues at double-digit rates with strong prescription growth, expanding gross margins, achieving positive adjusted EBITDA, and closing in on net income. In fact, income from operations for the fourth quarter for the Rx segment was $6.3 million, and adjusted EBITDA was $8.3 million, representing a 35% adjusted EBITDA margin for the quarter. And while we don't necessarily expect that level of EBITDA every quarter going forward in the near term, we have great confidence in this growing segment and its prospects for consistent bottom-line strength. You'll also need to keep in mind that as we wind down the Consumer Health segment, that may create some small drag on our quarterly EBITDA numbers. But once we've closed that business, the full strength of the Rx segment will be reflected in the company-wide P&L. We believe the prescription business is very attractive. And with the emphasis we're applying exclusively to this segment going forward, we believe it should enhance shareholder value. With that overview, let me turn it over to our CFO, Mark Oki, to add some additional color to the numbers. Mark?