Sean Brynjelsen
Analyst · B. Riley
Thank you, David, and thank you, everyone, for joining us today. The fourth quarter was an extremely important quarter for the company. And today, I'm excited to share with you an update on Biorphen as well as some of our other important milestones achieved with our pipeline products. After that, our CFO, Wilson Troutman, will then discuss our financial performance, and we'll close with a Q&A session. So starting off with Biorphen. As most of you know, Biorphen was approved in the fourth quarter and was commercially launched in December. This was a critical milestone for our company, and I'm very proud of the team's hard work to achieve our first product launch in just 2.5 years after inception. As the first and only ready-to-use formulation of injectable phenylephrine, Biorphen fulfills a critical unmet need within hospitals. Before its approval, hospitals had to manually dilute a concentrated formula in order to use it. This was both time-consuming and also introduced risk due to potential calculation and dilution errors. In order to offset this risk, some hospitals would purchase unapproved phenylephrine from compounding facilities. However, in reality, this amounted to just a transfer of risk rather than a true risk reduction in most cases. With the introduction of Biorphen, we have now provided a cost savings to hospitals, longer shelf life and, most importantly, an FDA-approved product for patients. In January, we announced a partnership with Xellia for the co-promotion of Biorphen. Xellia's existing U.S. hospital-based sales force will promote Biorphen to certain customer segments. This approach has several advantages for Eton: first, it will save us a significant amount of money in SG&A; and more importantly, it should lead to faster adoption of Biorphen due to Xellia's existing relationships with hospitals that have adopted ready-to-use products in the past. Xellia's sales force was previously focused on the promotion of Vanco Ready, a ready-to-use formulation of vancomycin injection, which has the same call point and a similar value proposition to Biorphen. Interactions with target customers have increased significantly since we brought Xellia onboard, and we strongly believe that the co-promote will be a win-win for both companies. Initial interest in Biorphen has been strong, and we have had over -- we've already had over 100 different institutions placing orders for Biorphen since launch. The onboarding process for each hospital is unique. Some hospitals and surgery centers converted to Biorphen within a week, while some others, typically the larger institutions, require a buy-in for multiple departments and committees before converting. This can lead to a 2- to 4-month, let's say, delay on conversion time line. The larger the hospital, the longer the process is, as you can imagine. We are starting to see pull-through benefit from Xellia's expanded reach, and we expect to see an even more pronounced benefit in the second and third quarter of this year. Pharmacy directors at our target hospitals have specifically been excited about the following aspects of Biorphen. First, Biorphen has a 3-year shelf life. This is unusual in the pharmaceutical industry. It also allows them to stock the product and reduce the risk of product shortage. The lack of manual dilution and calculations, this reduces risk of medication error and saves physicians critical time in using the product. And thirdly, the product's FDA-approved status. During the quarter, many of our customers continued to experience supply disruptions with unapproved phenylephrine that they had previously been purchasing from compounding facilities, some of which are known as 503B facilities. As many of you probably saw, AmerisourceBergen announced in January they were completely shutting down the PharMEDium compounding business. This is one of the largest -- or was one of the largest compounders in the United States. PharMEDium had previously been one of the leading compounders not just in this product but in other products. Supply disruption was significant. We believe that based on FDA's regulations, compounders are no longer allowed to sell compounded phenylephrine now that Biorphen has been approved. Our legal counsel sent such notifications to compounding facilities, and we are engaged with communication with the FDA regarding enforcement of their own regulations against these compounders. We expect to have an in-person meeting with the FDA in April to continue this discussion. On the GPO front, group purchasing organizations, we continue to make good progress, and I am pleased to announce that on February 1, we secured our first GPO contract with Premier, which serves over 3,500 institutions. We remain in discussions with other GPOs and expect to secure additional contracts in the coming months. Regarding market size, we continue to believe the phenylephrine addressable market is more than 20 million units a year of Biorphen. Our goal is to capture at least 4 million units long term and potentially many more if FDA regulations are enforced and lead to compounders exiting the market. We remain confident that our manufacturing partner has ample manufacturing capacity to supply the market for the ready-to-use phenylephrine. While we've been pleased with the strong initial demand for Biorphen in an ampule, after conversations with multiple customers, we believe we also have an opportunity to convert more of the market at a premium price point with the introduction of both a vial and a prefilled syringe container system. We've initiated that work on these line extensions, which we expect to file as supplements to our existing NDA, and they could potentially launch in the next 12 months. In addition to Biorphen, we have continued to make great progress advancing our late-stage pipeline candidates. A few of the major developments include, in December, we're submitting an ANDA for DS-300. We believe we are the first-to-file ANDA on this product. This would entitle us to 180 days of generic exclusivity upon successfully challenging the innovator's patent. We also estimate that the current market for DS-300 is more than $60 million annually, so we remain very excited about this opportunity. Also, in December, our partner, Bausch Health, submitted to the FDA an amendment for the EM-100 product. We believe this amendment completely addresses all the issues raised by the FDA, and we expect the product to be approved on a target action date in August of this year. On our ET-105 lamotrigine product, as we previously discussed on February 19, the FDA has requested that we make minor changes to the dosing and administration sections of the product label and run a human factors study to confirm caregivers can follow the revised instructions. We will be unable to complete the study by the current March 17 PDUFA date, so we expect to receive a CRL. We are submitting a study protocol to the FDA in the coming weeks, and we anticipate completing the study and resubmitting to the FDA during the second or third quarter of this year, which still allows for potential approval in the fourth quarter of this year. I'm happy with the progress we have made this quarter and for the full year 2019 advancing our pipeline. With the addition of the DS-300 filing in the fourth quarter, we now have 3 products under review with the FDA and additional 5 products that we expect to file ANDAs for later this year. I continue to believe we have one of the strongest 505(b)(2) pipelines in the industry, and we expect these pipeline products to provide sustainable growth for many years to come. Lastly, and perhaps most importantly, I would like to say that we are actively and continually pursuing high-value business development opportunities. We are on the hunt for late-stage development projects that fit strategically into our portfolio and can provide near-term revenue. While it's impossible to predict the timing of future deals, we are optimistic about our ability to close value-creating transactions during this year. With that, I would like to turn it over to our CFO, Wilson Troutman.