Randy Milby
Analyst · Roth Capital Partners. Please proceed with your question
Good morning and welcome to the CorMedix, fourth quarter 2014 conference call. I will begin by providing you with an update on our commercial strategy and operational progress. Then Harry O'Grady our CFO, who is here with me today in New Jersey, will provide a more detailed summary of our financial results. First, I want to remind you that this conference call may contain certain forward-looking statements within the meaning of the Private Securities Litigation Reform Act of 1995 that are subject to risks and uncertainties. All statements other than statements of historical facts regarding management's expectations, beliefs, goals, plans or the Company's prospects, future financial position, future revenues and projected cost should be considered forward-looking. Our actual results may differ materially from these projections or estimates due to a variety of important factors including uncertainties related to clinical development, regulatory approvals and commercialization. These risks are described in greater detail in CorMedix filing with the SEC, copies of which are available free-of-charge at the SEC's Web site or upon a request from CorMedix. CorMedix may not actually achieve the goals or plans described in these forward-looking statements and investors should not place undue reliance on these statements. Please note that CorMedix does not intend to update these forward-looking statements except as required by law. CorMedix is a specialty pharmaceutical and biomedical device company focused on developing and commercializing therapeutic products for the treatment of infectious disease in both acute and chronic care settings. Our first commercial product being marketed outside of United States is Neutrolin, which is used to prevent central venous catheter or central line-associated bloodstream infections and thrombosis or clotting. Neutrolin is novel formulation of Taurolidine, citrate and heparin at 1000 units per mil that provides a combination preventative solution, decreases of triple threat of infection, thrombosis and biofilm to keep catheter's operating safely and efficiently by optimizing catheter blood flow while minimizing infections and biofilm formation for oncology, hemodialysis and intensive care patients. Today I will update you on the key near and longer-term catalyst for CorMedix growth. First, plans for the U.S. clinical trial and commercial development. Second, our effort to identify and engage strategic partners to accelerate the clinical development and commercialization of Neutrolin. Third, commercialization of Neutrolin in the European Union and expanding the product label to include new indications. And fourth, expansion beyond the EU through marketing and distribution partners in the Middle-East, Asia and Latin America. As you know Neutrolin is a Class III medical drug device in the European Union. But the FDA regards it as a drug for purposes of regulatory approval in the United States. As we discussed during the third quarter call, the FDA's division of anti-infective products in Cedar has said that we can initiate a pivotal clinical study in United States. This IND includes a pivotal Phase III protocol for Neutrolin in hemodialysis patients with a central venous catheter. Just to give you an idea of the market potential here, it is estimated that there are approximately a 127 million catheter days in hemodialysis in the United States per year. The Phase III clinical trial will be a multi-centered, randomized, controlled study conducted in the United States. The study will include about 600 patients moderated for catheter related bloodstream infections and the relevant comparison will be Neutrolin versus heparin as a control arm. We intend to propose a second study with about 500 patients for a new indication in oncology patients undergoing total parenteral nutrition. We are developing a smaller Phase II 2b study to elucidate the use of Neutrolin in critical care and intensive care patients as part of our overall submission package. As a testament to the value of Neutrolin, we are pleased to announce that the receipt of the fast track designation from the FDA to prevent catheter related bloodstream infections in patients receiving hemodialysis. Fast track designation is intended to facilitate the development and expedite the review of drugs to treat serious conditions and fill unmet medical needs. As a result, we expect to have more frequent interactions with the FDA during the drug development process. Importantly, products designated as fast track can obtain rolling review of the marketing application that can lead to an expedited approval. In addition, in December we were thrilled to learn that the Neutrolin has been designated a qualified infectious disease product or QIDP under the federal GAIN Act which provides incentives for the development of new antimicrobials. This provides for extension market exclusivity beyond the drug approval by five years above and beyond the standard five years for new chemical entity. When combined with the possible additional extension for pediatric use this means that Neutrolin could enjoy an aggregate period of post market approval exclusivity in the United States of as long as 10.5 years from the date of launch. The value of Neutrolin is being recognized by the FDA with the fast track and QIDP designation. We have completed internal health economics market research which gives us a clear commercial path and will help us in our strategic partner discussions. I want to offer a few observations as to how best realize this vision for the commercialization of Neutrolin. We have been working to identify a strategic partner to complete the phase III clinical study, as it would be challenging for us to execute a trial of that scope and magnitude on our own. We have had interest and continue to discussions and I believe that the fast track and QIDP designation has increased this interest. As noted in our recent press release we have retained Evercore as our advisor in this matter as we believe it is the best way for us to accelerate the process and importantly to ensure that we explore all possible options to maximize Neutrolin’s value and underlying value to our shareholders. These options might include product development collaboration, a merger or sale of assets. We are in the preparation phase and they will launch the process in the coming weeks. We are working closely with the Evercore professionals as they identify and evaluate various strategic alternatives. I want to reiterate what we have disclosed publicly, which is that, we do not know if we will succeed in this effort but we are convinced that we need to assure ourselves and our shareholders that we’ve explored all viable options. As you can appreciate given the sensitive nature we are not providing updates until the outcome is completed. As you know we launched Neutrolin in European Union beginning in Germany last year as a class III medical device. Knowing that the value proposition of the medical device is different compared to the reimbursed drug, we initiated a Neutrolin usage monitoring program. This is a registry study in selective dialysis center and hospitals. To-date we have 175 patients enrolled and have reported one infection and one thrombosis during 9,935 catheter days. As a comparison you would ordinarily expect per 1,000 catheter days between 2.5 and five infections and between 0.5 and three thrombosis, to-date this is over a 95% reduction in inflections. Although this study is not designed to show statistical significance we believe this provides compelling evidence demonstrating the anti-infective anti-clotting value of Neutrolin and de-risk the U.S. phase III study. We are presenting these interim results in two international conferences, [Dr. Hollenbeck] a member of our European Union Scientific Advisory Board will present a poster session at the vascular access society conference in Barcelona on April 18th and Dr. [indiscernible], the Chairman of our European Union Scientific Advisory Board will give a late [pancreal] oral presentation at the National Kidney Foundation Annual Meeting in Dallas on March the 28. We are encouraged about what we believe are excellent Neutrolin usage monitoring programs results and we have been working to better understand the German physician’s perspectives so that we can translate these positive data into meaningful medical communications with our nephrologists, oncologist, intensive care units with patients on central venous catheter. Although we’re not satisfied with our sales revenue and commercial progress in Germany; we have restructured teams to account for the label’s expansion and we are gathering the valuable data in the Neutrolin usage monitoring program. We need to make clear the value of our product for the patient and to do that we must better develop and articulate the medical and scientific data to present to physicians to determine the optimal share voice and capability in Germany. To that end, we have conducted additional market research and prepared new marketing materials for the expanded product label to address those patients with the central venous catheter are being treated for cancer or in hospital intensive care units or receiving total parenteral nutrition. This label now includes new indications for use of our product in oncology patients receiving chemo, IV hydration, IV medication via a central venous catheter as well as patients receiving medication and IV fluids via central venous catheters and intensive care or critical care of units. Let me make one other comment that relates to our commercial position in Europe. As we discussed last quarter we filed a patent infringement actions in Germany against our primary competitor TauroPharm, claiming infringement of our European patent which is granted by the European patent office on January 8, 2014. Our patent covers low heparin catheter lock solutions for maintaining patency and preventing infection in the hemodialysis catheter. There was a hearing of this matter on January 30 before a three judge panel; the court date for rendering judgment is currently scheduled for March 27th. On January 15, 2015, we filed a second complain in Germany against TauroPharm claiming unfair competition based upon their usurpation of our product knowhow and our proprietary information. This oral hearing is scheduled for June 18, 2015. Of course I cannot tell you how these will play out these kinds of cases are complicated; in any case I cannot comment on specific aspects of an ongoing legal matter. But I can tell you that we continue to believe we have a strong case and we are confident that we have the freedom to operate and commercialize our product in a manner that we’re doing now. As I have said to you previously we seek to market Neutrolin on a global basis in those territories where there is evident medical need and adequate reimbursement. We're very active in identifying pursing commercial partnerships in the EU, Asia, Latin America and the Middle East. In general, we're seeking partners with a regulatory and marketing strength that have historically focused on hemo-dialysis and in the hospital marketing including oncology, critical care, ICU and total parenteral nutrition. I strongly believe that this is the best commercial strategy for CorMedix, in that it would allow us to prudently introduce Neutrolin to a larger number of central venous catheter patients throughout the world while minimizing our expenses and fixed capital commitments that would be substantial if we were to establish in country operations. As you can surmise, it maybe that in working with Evercore on a broader strategic efforts we will further enhance our international expansion as well. In summary, Neutrolin was designated a qualified infectious disease product, we were branded Fast Track status by the FDA and we're pursuing our clinical development strategy. We continue to focus on execution, we're in the early phases of commercialization of Neutrolin outside the United States with our expanded label and we're accelerating our efforts to collaborate with a global partner and expand to additional countries. We have completed several market research studies which articulate the value of Neutrolin and we have a publication plan in place to publish these results in peer-reviewed journals. The positive Neutrolin usage monitoring program data highlights the value proposition of Neutrolin and de-risks the Phase III studies in United States. We have accomplished much this quarter and while there is more to do to accelerate our commercial progress in the EU we're encouraged by the progress evident in these recent successes. I look forward to your questions. With that I would like to turn the call over to Harry O'Grady to provide detail on our financial updates.