Thomas McCourt
Analyst · Morgan Stanley. Your line is open
Thank you, Peter. I'll take a few minutes and highlight the GI franchise that will form the core of new Ironwood upon separation. LINZESS is the clear brand of prescription market leader in this class and continues to demonstrate strong growth in demand in its six year. Since launch, our LINZESS commercial strategy is at three foundational elements, personal promotion, consumer marketing and pair access. We believe each of these are critical to the brand success and continue to evolve the marketing mix to focus on the highest ROI opportunities in response to market changes. For example, our most recent DTC campaign Yes LINZESS is driving all-time highs and bringing in new to brand patients, adding nearly 10,000 new patients each week with LINZESS trending nearly 10% above the pre-DTC trend. The LINZESS consumer campaigns have consistently been acknowledged among the best performing across the entire advertising industry in generating incremental business, which is fueled by the large understeer population and the expertise of our commercial team. We also continue to refine our personal promotion efforts and investment to concentrate our selling efforts on the highest prescribers. And patient access remains one of the foundational elements for the brand success. We continue to invest in market leading coverage with greater than 80% commercial patients and greater than 90% of Medicare Part D patients having unrestricted access to the brand. Our investment access has enabled us to grow LINZESS prescription volume at double-digit rates every year since launch. And we expect to continue to invest to maintain this level of payer access in 2019 and beyond. However, increase this validation and competition are making investments in this area more expensive. In addition, there has been a higher utilization in Medicare which is typically at higher rebates. As a result, we now expect a mid-single-digit decrease in LINZESS' net price in 2019 compared to 2018. We in Allegan, our investing in several innovative new strategies designed to drive brand growth and profitability. These strategies begin with expanding, strengthening and maximizing the clinical utility of one at the time. We took another important step in this area, when we initiated our Phase III trial to explore the effect of linaclotide bothers them abdominal symptoms, including pain, bloating and discomfort. Survey data suggests that as many as two thirds of adult IBS C responders frequently experienced abdominal bloating and discomfort every week. And it's the primary reason that patients seek medical treatment. This trial is successful, represents an important opportunity to enhance the effectiveness of our promotional campaigns and significantly broaden the addressable patient population. The trial is enrolling faster than we expected and we now anticipate top line data in mid-2019. If data are positive, we hope to be able to begin communicating these potential benefits to physicians and patients soon thereafter. We are also acting our many new opportunities of fuel growth through innovative consumer strategies, such as the use of increased digital and social media to further educate physicians on appropriate patients and drive patient requests. With the changing market landscape, including the withdrawal of approvals of certain large volume prescription generics for the treatment of occasional constipation that are often used for chronic constipation IBS C, we have an opportunity to reach additional patients who will be seeking alternative prescription treatments. MD-7246 previously referred to as Linaclotide delayed release, represents a new product opportunity as an intestinal non-opioid, pain-relieving agent for millions of Americans suffering from all forms of IBS. We expect to initiate a Phase II trial in the first quarter 2019. This trial is expected to enroll approximately 400 patients and is designed to evaluate the safety tolerability, treatment effect and abdominal pain and dose response of MD-7246 in patients with all forms of IBS, including IBS C, IBS M and IBS D. We plan to provide additional details on study design volume initiation. With the strong brand profile, many years of expected patent coverage ahead and multiple investments to drive growth in this market, we are enthusiastic about the growth prospects for LINZESS going forward. We continue to believe LINZESS on a growth path to more than a $1 billion in net sales. But due to the increase pricing pressure, we now believe that this target may be achieved later in 2020. In addition to our U.S. commercial efforts, we are pleased with our global footprint as it continues to expand. We expect OUS Linaclotide to remain a key part of our franchise and an important contributor to total Ironwood revenue. In late August, Astellas obtained approval of LINZESS in chronic constipation and launch shortly after. Now providing the opportunity to bring LINZESS to both IBS C and chronic constipation adult patients in Japan. In China, we and Astra Zeneca are now expecting approval early in 2019, due to the timing of the CFDA review. Turning to 3718. Our two Phase III trials for persistence GERD continue to enroll nicely. Despite advancements in PPIs, there is approximately 10 million Americans with GERD that continued to suffer from frequent and bothersome symptoms such as heartburn and regurgitation. GERD patients tend to be highly responsive to new treatments, if they believe they will feel better, they will actively seek care and demand effective treatment. We were encouraged by our Phase IIb data, which showed a meaningful improvement in both for heartburn and regurgitation, for which there are no approved therapies. We initiated our pivotal trials with 3718 in late June and look forward to sharing updates on the timing of the data as we get further along. With that, I'll turn it over to Chris to discuss our sGC franchise.