Bruce C. Cozadd - Jazz Pharmaceuticals Plc
Analyst · Piper Jaffray
Good afternoon, everyone, and thank you for joining us. We had a strong start to 2018 with continued progress in our pre-clinical and clinical programs and the successful accomplishment of multiple regulatory milestones. Our focus on driving performance of our key products resulted in robust Xyrem net sales and continued growth in demand for Vyxeos in the first quarter of 2018. In March, FDA accepted our NDA submission for solriamfetol for the treatment of patients with excessive sleepiness in narcolepsy and OSA. And last month, we submitted our supplemental NDA for Xyrem for pediatric narcolepsy patients with cataplexy and excessive daytime sleepiness. In late April, we entered an agreement with Spark Therapeutics to purchase for $110 million a rare pediatric disease priority review voucher that will allow Jazz to accelerate the review process by FDA for one of our future regulatory submissions. Finally, we remain on track with an accelerated assessment for Vyxeos in the EU leading to a potential approval this summer and with our planned submission of an MAA for solriamfetol in the EU by year-end. We're very excited about the opportunities ahead for multiple upcoming product launches. Now, I'll provide updates on some of our key commercial, legal, regulatory and R&D activities and then turn the call over to Matt to update you on our financials. In the first quarter, we observed growing Vyxeos demand from key academic institutions and expanding use among community hospitals. Since launch, 236 accounts have ordered Vyxeos with academic centers representing the largest segment in volume. Three-quarters of the top 75 target accounts have ordered product and we are pleased with the formulary placement in these important teaching centers. This is a promising time for AML patients with the recent introduction of multiple new therapeutic agents into the market. KOLs and many AML treaters strongly support the use of Vyxeos in its studied population, and pharmacy directors are working to integrate these new agents into their AML protocols and pharmacy budgets. Guided by our recent market research, our newly dedicated AML sales force is focused on effectively delivering the most critical message for physicians, the overall survival benefit of newly diagnosed high-risk AML patients who receive Vyxeos compared to 7 + 3 in our Phase 3 study, and has extended its coverage within key academic accounts and to high-potential community accounts and outpatient clinics. Our field teams are also concentrating on ensuring that the clinical superiority of Vyxeos in high-risk AML patients and value proposition are well understood by pharmacy directors and other stakeholders in each institution. We believe that there is significant upside opportunity for Vyxeos growth as we increase demand in our top academic accounts and further prioritize community hospitals. We're also excited to begin our promotional activities to increase physician awareness of the recently published NCCN AML guidelines. With respect to the EU, our Vyxeos team is preparing for potential approval. We've hired key account managers and reimbursement experts and filled medical roles to support a rolling launch of Vyxeos in the EU. This launch will be an ongoing process rather than a onetime event as we first need to obtain pricing and reimbursement in each country. We are well along in our P&R (06:44) work with individualized plans ready for focused implementation in every major market country. We expect that our EU launch of Vyxeos will occur in waves, beginning in countries with the opportunity for favorable early market access, such as the UK, Germany, Austria, the Netherlands and the Nordic countries. We continue to make progress on our Vyxeos R&D strategy. Our plan includes generating data through multiple avenues to support the use of Vyxeos as the new therapeutic foundation in high-risk AML. We are also implementing initiatives to evaluate Vyxeos in other AML patient segments, such as pediatric patients and adults with standard or intermediate risk AML, relapsed/refractory settings and in combination with other targeted AML agents. We also expect to expand research into other hematological malignancies such as MDS. We look forward to sharing more details on our progress later this year when we anticipate the protocols and contracts will be finalized to support a broad clinical data generation plan through support of ISTs, cooperative group studies and Jazz-sponsored studies. Turning to Defitelio. Our new and dedicated adult transplant team in the U.S. began to reach out to transplant centers beginning in early April. The team continues to focus on VOD-related educational efforts. We believe we are making progress on this front as our recent market research indicates that physicians are beginning to recognize, diagnose and treat VOD earlier. We also believe that the introduction of newer anti-cancer agents that can increase a patient's risk of developing VOD is further heightening physician awareness and recognition of VOD. On the development side, our Phase 3 study in prevention of VOD and our Phase 2 study in prevention of acute graft-versus-host disease are enrolling patients. The protocol for our planned pivotal study for the treatment of TA-TMA will be finalized following feedback from FDA and scientific advice from the EMA with site activation expected in the fourth quarter. Now onto our sleep therapeutic area starting with Xyrem and the low sodium oxybate programs. We were pleased with the strong growth of Xyrem in the first quarter of 2018 including bottle volume growth of 9% compared to the same period last year. We believe that the underlying early indicators observed in late 2017 translated into strong volume growth in early 2018. The average number of active Xyrem patients increased to 13,800 in the first quarter of 2018, up 7% compared to the same period last year. During the first quarter, the Xyrem central pharmacy successfully navigated the typical heavy payer churn and we observed consistent high payer reimbursement approval rates. The educational efforts of our field reimbursement team continued to impact the approval rates for prior authorizations in key accounts across the country. Our disease awareness education efforts in 2017 are leading to increased diagnosis of new narcolepsy patients. The narcolepsy diagnosis rate for full-year 2017 reversed a downward trend with an uptick in diagnosis rates once again. As a reminder, in 2017, our disease awareness program ran for six months. Our 2018 program is underway and will run the full year. The observed positive trends in newly diagnosed narcolepsy rates and commercial metrics, such as patient enrollments and first-time prescription fills, support our belief that we can continue to generate volume growth in 2018 and beyond. Turning to a brief legal and intellectual property update on Xyrem and an update on progress around the U.S. Department of Justice subpoenas. We recently entered into a settlement with a sixth ANDA filer resolving our patent infringement litigation and related proceedings against Teva, formerly Watson. In connection with the settlement, we granted Teva a non-exclusive patent license to launch its generic sodium oxybate product, as of December 31, 2025, subject to customary acceleration events. Patent litigation is ongoing against the three remaining generic Xyrem ANDA filers. Two of the remaining filers, Amneal and Lupin, are in a consolidated case. Although no trial date has been set in that case, trial could be scheduled as early as the fourth quarter. A brief update related to the subpoenas we received in 2016 and 2017 from the U.S. Attorney's Office for the District of Massachusetts regarding our support of 501(c)(3) organizations that provide financial assistance to Medicare patients. We have been engaged in discussions with the U.S. Department of Justice about a possible resolution, and last month we reached an agreement in principle on a proposal for a civil settlement of potential claims by the DOJ subject to the negotiation of a definitive settlement agreement and other contingencies. We recorded an accrual of $57 million in the first quarter related to this matter. On the development front, we remain focused on completing enrollment in our JZP-258 clinical trial in adult narcolepsy patients with cataplexy and excessive sleepiness. JZP-258 provides a 90% reduction in sodium load compared to the current Xyrem formulation. We believe this sodium reduction would be a meaningful improvement in patient safety for a product that treats patients with a chronic, persistent, debilitating disease like narcolepsy, where lifelong therapy is clinically indicated. 2017 hypertension guidelines linked excessive consumption of sodium with an increased risk of stroke, cardiovascular disease, and other adverse outcomes. The FDA Commissioner recently communicated the need to reduce sodium intake in the American diet and identified this as an FDA priority. Throughout 2017 and the early part of 2018, we have been actively progressing both of our reduced sodium oxybate product candidates, JZP-258 and JZP-507. Recently we made the decision to focus our efforts on JZP-258, our product candidate with a 90% reduction in sodium load compared to Xyrem. As a result, we have decided to suspend our NDA submission efforts for JZP-507, our product candidate with a 50% reduction in sodium compared to Xyrem, although we could rapidly move towards a submission if our priorities change. We expect to complete enrollment in the JZP-258 Phase 3 study in adult narcolepsy patients in the fourth quarter to support an NDA submission next year assuming positive safety and efficacy data. Now onto solriamfetol. We announced the FDA acceptance of our NDA submission for solriamfetol in March and have a PDUFA date of December 20. We are planning for a U.S. launch in the first quarter of 2019 following the DEA scheduling decision for the product. We are making significant progress with our U.S. launch readiness initiatives including brand management staffing, disease awareness programs, health economic outcomes research to support the value proposition of solriamfetol, sales force sizing analyses, OSA and narcolepsy market assessments, and payer and patient access plans, among many other initiatives. In late April, solriamfetol Phase 3 results in narcolepsy were presented during the main plenary at the American Academy of Neurology Annual Meeting, and we expect to have a strong presence at the SLEEP APSS 2018 Meeting next month with multiple accepted abstracts and oral presentations. Our team is also progressing toward a planned regulatory submission in the EU late this year for solriamfetol. On the development side, we're pleased with the rate of enrollment in our Phase 2 proof-of-concept study of solriamfetol in excessive sleepiness and Parkinson's disease, and we expect to complete enrollment by year-end. Before we turn to other matters, I'd like to take a moment to thank Karen Smith, our outgoing Chief Medical Officer, for her leadership and contributions to Jazz over the last three years. We've appointed Allen Yang, our VP, Hematology and Oncology and Therapeutic Area Head, to serve as acting Chief Medical Officer. Allen and other members of our strong R&D leadership team will ensure the continued progress of activities across our R&D portfolio during this transition. We believe that management transitions provide valuable opportunities for us to strengthen organizational leadership by advancing high-performing internal leaders, as well as attracting seasoned and highly capable external candidates as we continue our transformation of Jazz into a leading integrated biopharmaceutical company. We're encouraged by the progress we made in our highly productive first quarter which was marked by strong financial results, significant progress with our ongoing regulatory reviews, and a continued advancement of our broadening R&D pipeline. We're excited to continue this momentum as we ramp up for multiple near-term product launches, prepare for additional regulatory filings, and continue to pursue further expansion of our product portfolio through the execution of our corporate development and internal R&D initiatives. Matt, now I'll turn the call over to you.