Bob Apple
Analyst · H.C. Wainwright
Thanks, Fred. Let's turn now to Slide 8. With our PDUFA date for XYOSTED of October 20, 2017 fast approaching, we're extremely busy with more preparation. I now like to take you through a very high level overview of our XYOSTED launch plan. Let's turn to Slide number 9, we have a number of critical decisions to make in the coming weeks, including finalizing price, third-party payer access strategy, final marketing activities, our distribution strategy, trade negotiation and most importantly account representative recruitment, which will begin and be at a little closer to the October PDUFA date. Moving now to Slide 10, important to our commercial launch plan is the identification of the right physician population for XYOSTED. We will be targeting neurologists, primary care physicians and endocrinologists who are currently high prescribers of testosterone products. We have completed the physician targeting and we have mapped all the territories for the 60-specialty account representatives, which we expect to hire. And as I mentioned earlier, we have already hired 7 outstanding regional sales managers to assist in the screening, recruitment and selection of qualified account representatives as well as the development of all the sales training tools needed for launch. The hiring process will commence shortly and the account representatives will be brought on board contingent upon XYOSTED's approval targeting a late fourth quarter 2017 or early first quarter 2018 launch. On Slide 11, we'll see that we have concluded - conducted a larger amount of third-party payer market research in advance of the potential launch. At the Academy of Managed Care Pharmacy meeting held in April, we organized an advisory board which consisted of members of the XYOSTED's sales and marketing team, as well as representatives from various health plans and pharmacy benefit managers. The goal of the meeting was to increase our understanding of the insurance coverage of the various existing testosterone therapies while each payer is willing to choose structure of each plan. We shared our thoughts on XYOSTED pricing with the advisory board and obtained their feedback on potential coverage rebates formally positioned and any restrictions to coverage based on price. Antares' National Account Directors in partnership with a retained service team of strategic account managers will target and engage formulary placement discussions with approximately 40 of the top PBM national, regional and government payers during the fourth quarter of 2017. These target payers represent 75% of the overall brand commercial utilization and 70% of the generic commercial utilization for the testosterone replacement market basket of products. We also plan to engage in discussions regarding Medicare opportunities with the payers. Medicare Part D represents 14% of the overall testosterone market annual utilization. And finally when asked about initial formulary actions for XYOSTED, over 50% of the target commercial accounts responded what they would entertain access during the first six months of launch provided the company offers an access rebate. Turning now to Slide 12, in addition to conducting market research on third-party payer coverage, Antares had conducted both qualitative and quantitative physician prescriber research over the past year. In conjunction with the American Urology Association's annual meeting and the annual meeting of the Sexual Medicine Society of North America, we convene an advisory group of 15 nationally recognized clinical experts in the treatment of testosterone deficiency. During these events, academic conditions represented data from the Phase III clinical trial of XYOSTED as well as aspirational product messages and target plan to meet the experts at pharmacokinetics, clinically meaningful testosterone levels even used and commercial access are most important prescribers and their patients. We believe the PK profile of XYOSTED including both the average T levels after does as well as the average C trough data depicts the product that produces clinically meaningful and viable total testosterone levels. In our Phase III trial, 98.5% of study completers were within the physiologically normal range of between 300 and 1,100 nanograms per deciliter, six weeks after the start of therapy. Further, by week 12, patients achieved an average P level of 553 nanograms per deciliter or approximately 330 points above their total testosterone levels prior to treatment. Over the course of one year, the average C trough level for patients in our study was 435 nanograms per deciliter, still well above the cutoff levels considered normal and importantly no patients in our study exceeded total P levels of 1,500. Regarding the introduction of pain associated with self-administration, of 1,519 total injections observed in our Phase III study, 1,510 or 99.4% were reported by patients to be completely painless. And lastly, our critical experts noted that commercial insurance patient access is widely important to our product success. To that end, Antares has designed and expects to implement a comprehensive patient support program that will offer co-pay systems in most commercially insurance patients as well as the benefits of investigation and prior authorizations for service for physician offices. Antares had recently conducted a double-blinded online electronic survey of 150 community based urologists, endocrinologists and primary care physicians to help validate the insight of our clinical expert advisors. Moving now to Slide 13 for an update on sumatriptan, sumatriptan continues to be a great story for Antares. In the past 12 months since we launched the product with our distribution partner, Teva, market share growth has been impressive. To date, we recorded $15 million in revenue over four quarters. According to Symphony Health Solutions, the second quarter market share for sumatriptan injection was 26%, up from 21% in the first quarter of this year. Recent weekly prescription data for the weekend in July 21, as our sumatriptan auto injector had a 29% market share, very impressive indeed. We remain pleased with the market acceptance of our product. On Slide 14, we see a record of prescriptions for OTREXUP. Prescriptions grew 14% in the second quarter of '17 versus the same quarter one year ago. We've seen the gap between gross sales and net sales grow as we had to renegotiate some of our third-party payer agreements in order to get better formulary coverage for OTREXUP. We have not been able to avoid the industry trend of larger rebates and major PBMs and plans in order to maintain coverage, which only gives us a lower net selling price of our product. With that said, net revenue of OTREXUP increased 3% versus the second quarter of 2016 and 19% versus the first six months of 2016. Let's wrap up by turning to Slide number 15, I'll provide an update on the progress we made this quarter in our Alliance business. On our last quarterly call, we outlined a potential approval timelines for all four of our Alliance business projects, beginning with exenatide, we begun to execute our purchase order for commercial devices with Teva. You'll recall while Teva's ANDA for exenatide is still under active review of the FDA. Litigation with AstraZeneca has been settled and Teva had negotiated settlement launch date of October 15 of this year with 180 days of exclusivity pending approval. Until then we will continue to manufacture pre-launch products and devices in anticipation of approval. Turning now to epinephrine, we continue to ship pre-launch devices to Teva in the second quarter bringing the total dollar amount shipped to-date of approximately$20 million worth of devices. Teva's ANDA for this product is still under active review in the FDA. And Teva recently changed its guidance from approval in late 2017 or early 2018 due to potential for an early 2018 launch again pending FDA approval. With respect to teriparatide, TEVA's ANDA is still under active review in the US. Although the paragraph for 30-month stake ends in the US in August of 2018, teriparatide was approved with marketing authorizations grant in 17 countries within the EU last December. We believe Teva is anticipating a 2018 launch in certain countries in Europe. But the exact timing of those launches could be impacted by the overall US patent litigation currently ongoing and existing European pat. And finally, AMAG reported the second quarter that the FDA had set their sNDA review period 10 months, which resulted in a target action date of February 14, 2018. We are currently executing on a purchase order for commercial devices for use in our Makena subcutaneous auto injector product as AMAG await FDA action on their sNDA. Overall, I'm very pleased with the progress we made during the past quarter and excited about our current commercial business and our near-term opportunities. We continue to grow our marketing products and we anticipate an approval on October 20 of this year for our most exciting active development, XYOSTED. And we're extremely active in pre-commercial activities as well as positioning our partners and gaining approval of four high valued partnered products. I look forward to providing you an update on our progress during the next quarterly call. That concludes the prepared remarks for today. Operator, could you now open the lines for the questions and answers session.