Bruce C. Cozadd - Jazz Pharmaceuticals Plc
Analyst · Leerink Partners. Your line is now open
Thanks, Kathy. Good afternoon, everyone, and thank you for joining us. 2017 was a pivotal year in the continuing evolution of Jazz as a fully integrated biopharmaceutical company, with significant advancements on many fronts. We received two marketing approvals, Vyxeos in the U.S. and Defitelio in Canada, and completed key regulatory submissions, including our NDA for solriamfetol in the U.S. and our MAA for Vyxeos in the EU. We continued to make substantial progress in multiple late-stage clinical programs in both sleep and hematology/oncology, and announced positive results in three Phase 3 studies of solriamfetol for the treatment of excessive sleepiness, or ES, in narcolepsy and obstructive sleep apnea or OSA, and the Phase 2/3 study of Xyrem in the pediatric narcolepsy population. We also announced multiple corporate development transactions, including our collaboration with ImmunoGen on three innovative antibody drug conjugate programs and with Nippon Shinyaku to develop and market Defitelio and Vyxeos in Japan. We enhanced our debt structure to provide significant capacity to move quickly on opportunities to expand our business. We are excited to carry our momentum into 2018, advancing pre-clinical and clinical development activities, moving forward with multiple regulatory submissions, further investing in the commercialization of our products, and evaluating corporate development opportunities to expand our portfolio. We are also pleased with the expected benefits of the U.S. Tax Cuts and Jobs Act, should allow us to increase our investment in new innovative therapeutic options for patients. After providing more detailed updates on key commercial, legal, regulatory, and development activities and highlighting key events expected before year-end, I'll turn the call over to Matt to review financial results and provide 2018 financial guidance. Before moving on, I want to take the time to thank Russ Cox for the strong leadership that he brought to Jazz for seven years, initially leading the U.S. Commercial organization and most recently as our Chief Operating Officer. We wish Russ all the best. I also want to welcome Dan Swisher, our President and Chief Operating Officer, who many of you had the chance to meet at the JPMorgan conference earlier this year. Dan is working with other members of our strong leadership team to drive an efficient and effective global organization that is positioned to support our continued growth. So let me start with our heme/onc therapeutic area. 2018 should be a great year for our global heme/onc business, with revenues of approximately $500 million and expected advances in our pipeline. Let me start with Vyxeos. We were pleased to see demand accelerate in the fourth quarter, driven by continued growth in key academic institutions as well as higher than expected early adoption in select community hospitals. During the initial four and a half months of launch, 50 of the top 75 accounts ordered product. Through the fourth quarter, academic centers represented the highest number of ordering accounts by type as well as the highest volume of orders. To ensure the continued coverage of all key academic accounts while we expand our reach to high-potential community accounts, we are positioning our AML sales force to focus solely on Vyxeos by adding a dedicated transplant team for Defitelio. On the formulary front, we continue to observe positive outcomes in P&T committee reviews, and majority of our top decile accounts now have Vyxeos on formulary. We were very pleased with the NCCN Guideline recommendation for the treatment of AML. We believe the Guidelines are supportive of our label and provide a strong level of evidence for the use of Vyxeos in the induction and consolidation phases. For treatment induction, the NCCN Guidelines now include a Category 1 recommendation for use of Vyxeos for patients 60 years of age or greater with newly diagnosed therapy-related AML or AML MRC, and a Level 2a for consolidation and groups of patients beyond our labeled indication. Given the importance of these Guidelines, we believe these recommendations provide further validation of our data and the benefits of Vyxeos. The Vyxeos MAA was submitted in November under an accelerated pathway. We are working with the EU regulators to maintain our accelerated timing. And if successful, we anticipate a mid-year approval, which would enable us to begin our EU rolling launch and our pricing and reimbursement efforts in select countries in the EU during the second half of this year. Our R&D efforts are focused on positioning Vyxeos as the new backbone of AML therapy. We plan to support multiple investigator-sponsored trials and oncology cooperative group studies in 2018 to evaluate Vyxeos both alone and in combination with targeted therapies in a variety of AML patient populations. As one example, we intend to support a cooperative group Phase 2 study in MDS in high-risk patients, with planned initiation in the second half of the year. Now I'll turn to Defitelio. We continue to make progress in our commercialization efforts, with additional new accounts ordering Defitelio. In the U.S., awareness and use of pediatric centers is high. However, we are underpenetrated in adult centers. Our global efforts are focused on disease awareness and medical education to expand healthcare providers' knowledge and recognition of veno-occlusive disease, or VOD, and the urgency to treat patients, including adults, experiencing this life-threatening complication of stem cell transplant. As mentioned earlier, we plan to modestly expand our U.S. hematology/oncology sales force with a dedicated and specialized transplant team for Defitelio. We expect this team to be in place at the beginning of the second quarter. The introduction of new hepatotoxic agents for the treatment of leukemia has increased awareness of VOD, providing us an opportunity to reinforce the value and importance of Defitelio. Defitelio remains an important growth opportunity for us globally. In 2017, Defitelio became available in Canada, and we submitted for marketing approval in Brazil. Our global team continues to identify further geographic regions for expansion. At the 2018 BMT Tandem meetings in Salt Lake City last week, we had a strong presence, with six defibrotide-related poster presentations building on the scientific evidence for defibrotide, including the final data cut from the treatment IND in adult and pediatric patients post-HSCT as well as important data on outcomes based on severity of multi-organ dysfunction, supporting our medical education initiatives to expand healthcare providers' knowledge and recognition of VOD, and reinforcing the urgency to treat patients upon diagnosis. On the development side, our programs are focused on identifying rare life-threatening conditions related to endothelial cell damage where defibrotide may have benefit. Our Phase 3 study for the prevention of VOD continues to enroll well. We activated sites in January for our Phase 2 proof-of-concept study for the prevention of acute graft-versus-host disease and enrolled the first patient earlier this month. We also announced our plans to evaluate defibrotide for the treatment of transplant-associated thrombotic microangiopathy, which is another rare disease associated with endothelial cell damage following stem cell transplant. These patients have a very high mortality rate and can have significant morbidity as a result of renal damage. We are working toward finalizing the clinical study protocol by mid-year and anticipate beginning to activate study sites during the fourth quarter. Now on to Erwinaze. Throughout 2017, including in the fourth quarter, we continued to experience global supply challenges for Erwinaze. We are currently experiencing temporary supply disruptions in numerous markets, and there may be further temporary disruptions for the balance of the year. We continue to work with the manufacturer of Erwinaze to increase the predictability and timeliness of product releases, with the ultimate goal of increasing capacity and ensuring consistent supply for patients in need of Erwinaze. During 2017, we added 40 new Erwinaze accounts in the U.S., and all but one of these accounts treated adult patients. In 2018, our global sales force will continue to educate healthcare providers on the importance of recognizing hypersensitivity reactions and appropriately switching to Erwinaze in both pediatric or adolescent and young adult populations. Because asparaginase is an important part of the treatment regimen for patients with acute lymphoblastic leukemia, we are also progressing our R&D programs aimed at identifying a new and improved crisantaspase or asparaginase product candidate to advance into clinical development. We are working with multiple companies toward the goal of improving the target profile and reliability of supply. Also in the heme/onc space, our partner, ImmunoGen, is currently enrolling a Phase 1 study of IMGN779 in AML patients and recently began enrollment in a Phase 1 study of IMGN632 in patients with CD 123-positive hematologic malignancies, including AML and blastic plasmacytoid dendritic cell neoplasms. Now on to our sleep therapeutic area, starting with Xyrem; Xyrem delivered 7% sales growth during the fourth quarter and full-year 2017 compared to the same periods in 2016. Xyrem bottle volume growth in the fourth quarter was flat compared to the fourth quarter of last year and grew less than 1% in 2017 compared to 2016. Volume growth in 2017 was impacted by the loss of some government-pay patients throughout the year and an operational issue with the central pharmacy in the second half of 2017 caused by implementation of a new automated phone system that delayed some prescription fulfillment. The central pharmacy operational issue was resolved in the fourth quarter. We expect that bottle volume growth will normalize in 2018, and expect low to mid-single-digit volume growth for the year. The average number of active Xyrem patients increased to 13,525 in the fourth quarter of 2017, up 5% compared to the same period in 2016. During the fourth quarter, we experienced consistent high payer reimbursement approval rates and stable patient enrollment levels. We believe that our unbranded narcolepsy disease awareness efforts are helping patients, as evidenced by the increase in newly diagnosed narcolepsy patients during the investment period. Following the success of our 2017 unbranded disease awareness program, a 2018 program is underway and planned for the full year. The increase in the number of newly diagnosed narcolepsy patients and the positive trend we observed in new patient enrollments during 2017 give us confidence that we will continue to generate positive volume growth. Finally, our field reimbursement team continues to positively impact the trends and approval rates for prior authorizations and targeted accounts across the country. Let me give a brief legal and intellectual property update on Xyrem. In January 2018, we entered into a settlement with a fifth ANDA filer, resolving our patent infringement litigation and related proceedings against Par Pharmaceutical, Inc. In connection with the settlement, Par was granted the right to sell a limited volume of an authorized generic, or AG, version of Xyrem in the U.S. for a term beginning July 1, 2023 and ending December 31, 2025. Par's AG volume will be limited to an annual amount equal to a low single-digit percentage of Xyrem sales volume during the year preceding the AG entry date, and we will be entitled to receive meaningful royalties on net sales by Par over the AG sales period. We also granted Par a non-exclusive patent license to launch its generic sodium oxybate product as of December 31, 2025. These entry dates could be accelerated under certain circumstances. Patent litigation is ongoing against the remaining four of the nine companies that have filed ANDAs for a generic version of Xyrem. Three of the remaining filers, Amneal, Watson, and Lupin, are in a consolidated case. Although no trial date has been set in that case, trial could be scheduled for as early as the third quarter of this year. Next, I'll give you a brief progress report on our oxybate-related development programs. We are on track to submit the planned sNDA for Xyrem in pediatric narcolepsy patients with cataplexy and excessive daytime sleepiness in mid-2018, including our response to FDA's pediatric written requests. We continue to advance both JZP-258 and JZP-507, and believe that our reduce-sodium oxybate product candidates could provide potential improvements in patient safety. In addition to the well-accepted relationship between dietary sodium and high blood pressure, the recently published 2017 hypertension guidelines stress that excessive consumption of sodium is independently associated with an increased risk of stroke, cardiovascular disease, and other adverse outcomes. The development of a reduced-sodium oxybate product is a priority for us, part of our commitment to provide narcolepsy patients with new and improved therapeutic options for this highly debilitating disease. Our lead candidate, JZP-258, has 90% less sodium than Xyrem. We expect to complete enrollment of our Phase 3 study of JZP-258 in the fourth quarter and anticipate an NDA submission in 2019, assuming positive safety and efficacy data. JZP-507 has 50% less sodium than Xyrem while demonstrating bioequivalence, and we can be ready to submit an NDA as early as midyear. We are continuing development of both of these product candidates and look forward to identifying the best reduce-sodium option for patients with narcolepsy. Our efforts to develop an oxybate product with once-nightly dosing also continue. Finally, we plan to initiate a Phase 3 study of JZP-258 in idiopathic hypersomnia in the second half of 2018. Idiopathic hypersomnia is an area of significant unmet medical need with no approved therapies. We will provide more details as we finalize the study protocol. Our significant progress with solriamfetol, previously referred to as JZP-110, during 2017 was highlighted by our December submission of an NDA for the treatment of excessive sleepiness in narcolepsy and OSA. We continue to anticipate FDA approval in late 2018 and expect to be ready for U.S. launch as soon as DEA schedules the product, which typically occurs a few months after approval. In preparation for launch, we have begun pre-commercialization activities. We have worldwide rights to solriamfetol other than in certain Asian jurisdictions, and we are preparing for an EU regulatory submission late this year. We remain enthusiastic about the potential of solriamfetol to offer patients an important new therapeutic option as the first new potential medication for the treatment of excessive sleepiness in narcolepsy and OSA in the U.S. since 2009. We continue to enroll patients in our Phase 2 proof-of-concept study of solriamfetol in excessive sleepiness and Parkinson's disease, and our objective is to complete enrollment by year end. We believe there is a large market opportunity for solriamfetol in excessive sleepiness, in narcolepsy, OSA, and Parkinson's disease. Because solriamfetol is a highly differentiated product candidate with a unique mechanism of action, we are evaluating multiple opportunities in other debilitating diseases where there is significant unmet medical need. In 2018, we plan to invest aggressively in driving strong performance of our key products, continuing the evolution and expansion of our global commercial organization, advancing our promising R&D pipeline, and bringing additional innovation to our R&D portfolio. Our strong cash position, low leverage, and anticipated cash generation from our current and near-term products of approximately $2.5 billion over the next three years enable us to pursue significant opportunities to broaden our portfolio through corporate development activities, with a continued focus on long-lived, medically differentiated products aimed at a targeted prescriber base. At the same time, we believe that the oxybate portfolio, including the Xyrem and our low-sodium oxybate product candidates, will remain a significant contributor to our business for many years. As we move into 2018, we look forward to continuing this significant progress made last year toward bringing innovative new products to patients and driving sustainable long-term growth. Matt, let me now turn the call over to you.