Ladies and gentlemen. Thank you for standing by. Welcome to Esperion’s Second Quarter 2024 Earnings Conference Call. At this time, all participants are in a listen-only mode. Following the presentation there will be a question-and-answer session. Please be advised that today's conference call may be recorded. I would now like to hand the conference over to Alina Venezia, Director of Investor Relations. Please go ahead.

Thank you, Operator. Good morning and welcome to Esperion’s second quarter 2024 earnings conference call. With us today are Sheldon Koenig, President and CEO, and Ben Halladay, CFO. Other members of the executive team will be available for Q&A following our prepared remarks. We issued a press release earlier this morning detailing the content of today's call. A copy can be found on our investor page of our website together with a copy of the presentation that we will also be referencing. I wanted to remind callers that information discussed on the call today is covered under the Safe Harbor provision of the Private Securities Litigation Reform Act. I caution listeners that management will be making forward-looking statements. Actual results could differ materially from those stated or implied by our forward-looking statement due to the risks and uncertainties associated with the business. These forward-looking statements are qualified in their entirety by the cautionary statements contained in today's press release and in our SEC filings. The content of this conference call contains time-sensitive information that is accurate only as of the date of this live broadcast, August 12, 2024. We undertake no obligation to revise or update any forward-looking statements to reflect events or circumstances after the date of this conference call and webcast. As a reminder, this conference call and webcast are being recorded and archived. We will begin the call with prepared remarks and then open the line for your questions. I'll now turn the call over to Sheldon.

Thank you, Alina, and good morning, everyone. Thank you for joining us today to review the meaningful progress we have made during the second quarter and to review our plans moving forward to continue to cement NEXLETOL and NEXLIZET as cornerstone therapies in reducing cardiovascular risk. The second quarter was an undeniably watershed period as we successfully executed our strategic initiatives across all areas of the business, key to building Esperion into a leading biopharmaceutical company improving outcomes for patients with or at risk for cardiovascular and cardiometabolic diseases. The second quarter was highlighted by double-digit increases U.S. product revenue, significant progress by our partners in expanding international access to NILEMDO and NUSTENDI, and importantly, the monetization of our European royalties from our partner, Daiichi Sankyo Europe, or DSE. And the early discounted payoff and termination of our existing revenue interest purchase agreement, or RIPA with Oberland. This strategic transaction significantly enhances our balance sheet and better positions us to focus on optimizing our U.S. commercialization efforts. Ben will discuss this transformational transaction in greater detail later. Now let me turn to our progress with our U.S. commercialization efforts, which are gaining momentum as validated by U.S. product revenue growth in the second quarter of 2024 of 14% sequential and 39% year-over-year growth. This growth was driven by the expanded new labels we received in late March. Our prior labels for NEXLIZET and NEXLETOL were limited to LDL-cholesterol reduction in a population of patients that already had a CD event and were on statin therapy. Our expanded labels have three significant differences; one, includes CV risk reduction benefits; two, expands the patient population by including primary prevention; and three, enables use in patients that are unable to tolerate or maximize statin therapy. NEXLETOL and NEXLIZET are now the first oral…

Thank you, Sheldon. Before I get into the details of the quarterly results, I want to highlight the transformational transaction we completed at the end of the quarter. We were excited to monetize our European royalty stream from DSE for a variety of reasons, not the least of which is it allows us more control to leverage our balance sheet and capital structure. As we reported, proceeds from the royalty purchase agreement facilitated early payout and termination of the Oberland RIPA, removing all leans and covenants associated with the agreement, avoiding a significant headwind of payment step-ups in 2025 and dramatically improving the liquidity outlook of the company. While we have made significant progress over the past two years in extending our cash runway, this is the single most important action we have taken to build our financial foundation for future growth. With that, let me now turn to our solid financial performance for the second quarter of 2024. I will provide a brief overview of the results, noting that additional information can be found in our press release issued early this morning and 10-Q that will be filed shortly. Please note that unless otherwise specified, my comments reflect results for the second quarter ended June 30, 2024. Total revenue for the second quarter of 2024 was $73.8 million, compared to $25.8 million for the comparable period in 2023. U.S. net product revenue was $28.3 million, compared to $20.3 million for the comparable period in 2023, an increase of approximately 39%. Sequential quarterly net revenue growth was 14%. We believe this revenue growth, along with the total retail prescription equivalents growth in June that Sheldon just discussed, are an early indicator of our progress with the launch and the potential for these drugs. Collaboration revenue was $45.5 million, compared to…

Thank you, Ben. In closing, we are proud of the tremendous progress we have made throughout the first-half of 2024, and we are looking forward to an exciting second-half of the year as we continue to grow our U.S. product sales, expand internationally and strive to reach our goals to create and deliver innovative options to reduce the risk of cardiovascular disease for patients around the globe. Our accomplishments to-date are a culmination of the hard work of our talented and dedicated Esperion team, who are passionately committed to reaching goals and making a difference in patients' lives. Importantly, we could not have made these achievements without the ongoing support from our stakeholders. We are on an exciting journey together, and I look forward to sharing more successes with you in the future. Again, we thank you for your ongoing trust and support. Operator, we are now ready for Q&A. Question-and-Answer Session Operator [Operator Instructions] Our first question coming from the line of Dennis Ding with Jefferies. Your line is open.

Hi, good morning. Thanks for taking our questions. Two for me. Maybe can you just share a little bit about the feedback from doctors who are on the ground around setting PAs approved and there's been any directional improvements recently? And has that been going to your expectations? And then, number two, just curious on your thoughts on the momentum after June 1 and what more work you need to do for scripts to pick up? Thank you.

Eric, do you want to take that?

I sure do. Got it. Good morning, Dennis. Good to hear your voice. So with regards to physicians on the ground, so clearly, over the past four years prior to the label change, it wasn't always easy to get our products, especially for some of the patients that they wanted to use it in specifically in the statin intolerant or in those primary prevention patients. But as a result of the label change in the work that BJ and her team have done progressively improving, and, as you noted, a pretty significant improvement in June 1. Takes a little time for clinicians to kind of regain that confidence, if you will, but they are progressively improving in their confidence. And I did see your primary care survey, I thought that was accurate. And that shows that there is still opportunity for us to reach these physicians, not only with the clinical message to get them excited about the brands, but also to get them over the edge from a prescribing and an access perspective. With regards to the momentum in June, so yes, as you saw a great pickup in June, directly related to sales force execution, but also the improvements that we had from a prior authorization from a UM perspective. I expect our growth to continue. I'm happy with that what we saw in June. I'm happy with the overall 14% that we delivered from Q2 -- Q1 to Q2, and I continue to expect progressive improvement in growth.

Thank you.

Thanks, Dennis.

Thank you. And our next question coming from the line of Serge Belanger with Needham. Your line is open.

Hi, good morning. Congrats on the progress. A couple of questions for us. I guess, first on the coverage with that you've done some great work on the commercial side and are expanding on the Medicare side. Remind us what is the breakdown between those two segments for this market opportunity? And how much of a focus is it for the company to standing on the Medicare coverage side? And then secondly, can you remind us how many scripts are currently going through your specialty pharmacy, trying to figure out what we're missing out when we're looking at the good data set. Thank you.

So maybe I can start this, and I'll turn it over to BJ. First of all, surge, as you mentioned, our coverage is continuing to increase. Just from a commercial perspective, we have over 90% of the plans covered, from a Medicare perspective, we have over 50% covered. And we're pretty much there as far as maximizing all of our coverage. There is one Medicare account that we're still working with that we feel good about, so stay tuned there. But just from an overall coverage perspective, we're in a great place. And just to reiterate what Eric said earlier, as you know, one of our greatest headwinds, previous to our new label, were the utilization management criteria. That has gotten a lot easier. In some areas, there are -- for some accounts, there are no prior authorizations. As it relates to Aspen, what I would say is, remember, that was a bridge that we set up so that until we have this coverage, patients could get their medications until maybe their PA was approved, et cetera. So that was really a great stop gap measure from the team. And maybe I'll turn it over to BJ, if he wants to add any more color as it relates to prescriptions going through Aspen, et cetera.

Yes. Thank you, Sheldon. I would say, Serge, that Medicare is the most important channel to the agile lower -- lipid-lowering treatment. And so we are laser-focused to garner more coverage there and stay tuned. Positive negotiations continue there. So we were at 50% now. We continue to have that as a key focus going forward. Sheldon captured Aspen correctly. We used that. That was a great tactic for us to bridge patients, while payers were updating their UM criteria, but we were so pleased that payers really accelerated those reviews and so less and less patients went in there because of the payers now updating and we're getting patients on payer-paid prescriptions. So hopefully, that answers your question, Serge.

Thank you.

Thank you. And our next question coming from the line Jason Zemansky with Bank of America. Your line is open.

Hey, good morning. This is Cameron on for Jason. Congrats on the quarter. So with regards to BA, when you think about launches in the cardiovascular space, they often require sometimes longer to ramp relative to other indications like oncology. So I'm curious what you expect dynamics to look like here for uptake we do you expect growth to continue to be more steady? Or are there factors that could potentially support a more near-term inflection? Thank you.

I'm happy to...

Sorry, Eric. I was going to just leave this off and then turn overview, I was on mute here. First of all, thanks for your question. I would refer you to slide nine of our corporate deck, which is available, which aligns to our prepared remarks. And again, what you'll see is this 14% growth. And we've shown double-digit growth quarter-over-quarter. So we're seeing that ramp up now. And just taking a look at the launch angle that we have, we're going to continue to see that momentum and you're going to continue to see prescriptions go higher. And Eric, I'll turn it over to you because I know you've done some analysis.

Yes, yes. Thanks, and thanks for your question. So absolutely, it takes a little bit more time than oncology to reach peak in this market. But we're confident in our ability to deliver continuous growth quarter-over-quarter, year-over-year. I did look at some other cardiovascular analog products that had significant CVOT trials that resulted in a label change and looked at their growth over the course of 3 years, also looked at their 1-year growth. And we're tracking right on if not ahead of where these competitive analogs are. Also remind you, from a PCSK9 perspective in Repatha, they're nine years into this mission, and they're still not peaked yet. So really confident in our ability to deliver a progressive continuous growth and realize the full potential of these molecules.

Thank you. And our next question coming from the line of Thomas Shrader with BTIG. Your line is open.

Hi, good morning. This is Sam on for Tom. Thanks for taking our questions. So two questions for us. So first, could you just provide any additional color on gross to net and any potential remaining headwind. And for the second question, just wanted to ask about what the market dynamics in Japan is and what the unmined related to that and tolerance?

So I'll go first with Japan, and then we'll hand it over to Ben Benjamin as it relates to GTN. The opportunity in Japan, Japan is, as we've said in our prepared remarks, one of the largest markets that is out there. As a matter of fact, with Zetia, Vytorin when I ran that brand, that was really kind of the number three market in the world. As it relates to statin intolerance, what we do know globally, and there's a little bit of debate around the percentages is that statin intolerance is anywhere between 15% to 20% of the population that could need a statin. And you've heard us talk about the millions of people out there that need LDL lowering. So just thinking about 15% to 20% of them, it's very big. But Japan is a great opportunity. Fortunate to have Otsuka as a partner and looking forward to their next steps and filing. Ben, do you want to speak to GTN?

Yes. Thanks, Sheldon. So as far as gross to net goes, we've had a good year, things have remained largely consistent with last year when we saw some significant [Technical Difficulty]

Did we lose Ben? I think we have lost, Ben.

Yes, I think we have, Sheldon.

Yes. So maybe I'll speak to GTN. Sorry, I wasn't sure if the whole site has gone down, and we're texting each other. We don't disclose our gross to net, but I would say is that we are in a steady state. We're comfortable where we are now, not only from what we do from a contracting perspective, what we do with wholesalers, et cetera. So we've been managing that appropriately. I think we can go on to the next question.

Thank you. I am showing no further questions in the queue at this time. Ladies and gentlemen, this does conclude today's conference call. Thank you all for participating, and you may now disconnect.