Earnings Labs

MediWound Ltd. (MDWD)

Q1 2017 Earnings Call· Mon, May 8, 2017

$16.59

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Transcript

Operator

Operator

Good day ladies and gentlemen, and welcome to the MediWound 2017 First Quarter Financials Health Conference Call. At this time, all participants are in a listen-only mode. Later, we will conduct a question-and-answer session and instructions will be given at that time. [Operator Instructions] As a reminder, this call is being recorded. I would now like to turn the call over to Anne Marie Fields. You may begin.

Anne Marie Fields

Analyst

Thank you, Michelle. Good morning, this is Anne Marie Fields with LHA. Thank you all for participating in today’s call. Joining me from MediWound are Gal Cohen, Chief Executive Officer; and Sharon Malka, the company’s Chief Financial Officer. Before we begin, I would like to caution that comments made during this conference call by management will contain forward-looking statements that involve risks and uncertainties regarding the operations and future results of MediWound. I encourage you to review the company’s filings with the Securities and Exchange Commission including without limitation, the company’s Forms 20-F and 6-K, which identify specific factors that may cause actual results or events to differ materially from those described in the forward-looking statements. Furthermore, the content of this conference call contains time-sensitive information that is accurate only as of the date of the live broadcast, May 8, 2017. MediWound undertakes no obligation to revise or update any statements to reflect events or circumstances after the date of this conference call, if that does required by law. With that said, I’d like to turn the call over to Gal Cohen. Gal?

Gal Cohen

Analyst

Thank you, Anne Marie, and thank you all for your interest in MediWound and for participating in today’s call. 2017 is off to a great start highlighted by meaningful progress across both clinical and our commercial programs. Let me start with a discussion of EscharEx, our product in development for the debridement of chronic and hard-to-heal wounds. In February, we reported the final results from our second Phase 2 clinical study with EscharEx, which affirmed the positive top line data and showed the incidence of complete debridement with up to 10 daily applications of EscharEx was significantly higher and was achieved earlier year compared with the control board. Safety data was comparable to the control board for both top line and final results. In addition to safety and efficacy, one of the key objectives of the study was to further analyze these effects in different theologies to guide a design of our future pivotal studies. The final data confirmed that the results were even more outstanding in the prospective sub-group analysis of diabetic foot ulcers and venous leg ulcers. As a result, we are moving forward with our development plans in these two important indications of DFU and VLU. Convenience and compliance are also very important considerations in the development of a successful wound-care product that can be used in both the outpatient and the in-home care settings. Consequently, we have a second cohort of this study underway in which 32 DFU and VLU patients are being treated to demonstrate safety over extended period of application of 24 hours to 72 hours. We believe that offering a wider range of choice for caregivers and patients to change dressings from as often as everyday to every two or three days, will feel better into the routine and lifestyle and thus enhance…

Sharon Malka

Analyst

Thank you Gal and good morning everyone. We are pleased to report our quarterly revenue during the first quarter of 2017 as it demonstrates how usage and awareness turn into product sales and eventually the new standard of care in severe burn care. We enter 2017 well positioned financially with a continued support of our U.S. clinical program from BARDA and our ongoing financial discipline, which is expected to support our ongoing clinical trials for NexoBrid and EscharEx and our commercial efforts. Turning now to our first quarter financial results, we reported that revenues in the first quarter of 2017 increased about 113% to $540,000, up from $254,000 in the prior year first quarter. Operating loss for the first quarter of 2017 was $3.7 million, down 9% from $4 million in the first quarter of 2016. The decrease was due to gross profit that was generated in 2017 of $0.2 million compared with a gross loss of $0.2 million in the first quarter of 2016. While our operating expenses remained at the same level as it was in the first quarter of 2016 above $3.9 million. More specifically, research and development expenses, net of participation, for the first quarter of 2017 were $1.8 million, which was in line with our budget and compared with $1 million for the first quarter of 2016. The higher expense was primarily due to an increase of $0.2 million related to NexoBrid and EscharEx clinical trials and a decrease of about $0.5 million of participation from the Israel Innovation Authority, which resulted from the revaluation of with respected contingent liability in 2016. Selling, general and administrative expenses in the first quarter of 2017 decreased $0.8 million to $2.1 million from $2.9 million in the first quarter of 2016. Net loss for the first quarter of…

Gal Cohen

Analyst

Thank you, Sharon. We expect to build on the progress we’ve made to-date in 2017, as we continue to execute our growth strategy to increase NexoBrid sales and to advance our clinical development programs in burns and wound-care. During the balance of the year, we expect to achieve a number of important milestones. We plan to report top line data from the second cohort of our Phase 2 clinical trial of EscharEx in chronic wounds, we expect to initiate the U.S. EscharEx 2 clinical program, we anticipate further global expansion of NexoBrid and certain of our international distributors may gain regulatory approval and launch, and we look forward to the continued publication and presentation of data, highlighting the clinical merits and cost effectiveness of NexoBrid of debridement of severe burns. We believe that executing our plan and achieving those milestones, supports our goal to build MediWound into a leading burn and wound-care company and would create significant value for our shareholders. And now operator, please open the call for questions.

Operator

Operator

[Operator Instructions] Our first question comes from Bruce Nudell of SunTrust Robinson Humphrey. Your line is open.

Bruce Nudell

Analyst

Good morning, gentlemen. Just a question; now that you’ve talked to the FDA, could you give us any feeling for the likely duration of treatment, the number of patients follow-up period until you get the efficacy data in EscharEx trail? And then I have a follow-up.

Gal Cohen

Analyst

Thank you, Bruce, for the question. We were very happy to receive FDA feedback that we are able now to have the primary end point as instance of complete debridement and our teams now are looking into the optimal ways to design the U.S. Phase 3 program and the pivotal program. One we have completed this work, we will be able to communicate exactly what would be the design of the study, their duration, the number of patients and all the consequences. We’re playing to initialize – However, we are planning to finish this work – sorry, it’s my error; we’re planning to finish this work and initiate the studies hopefully already this year.

Bruce Nudell

Analyst

Perfect. And my second question is, with regards to cash, I mean clearly sometimes in 2018, there’s going to need to be some sort of capital event. I’m’ just wondering how are you thinking about either a public or a private raise and/or a commercial partner for EscharEx contributing to the finances of the company?

Gal Cohen

Analyst

Thank you. Currently we have cash sufficient for the coming six quarters. I believe that once we finalize our plans for EscharEx we will see what are the cash requirements to fund this program. And as you mentioned, they are several options to that. One, we are expecting revenues from New York to increase, we are expecting procurement of BARDA, we are expecting all those from our international partners. So one possibility would be to fund part of it from our own resources and our possibility would be to ask for capital to fund this very exciting program, and the third possibility would be to partner or to walk with their partner in order to fund the same program. All venues are open, we are actively looking at all three of them and we will do whatever will be best to maximize the value for our shareholders.

Bruce Nudell

Analyst

Thanks so much.

Operator

Operator

Our next question comes from Raj Denhoy of Jefferies. Your line is open.

Raj Denhoy

Analyst

Hi, good morning.

Gal Cohen

Analyst

Good morning.

Raj Denhoy

Analyst

I wonder if I could maybe ask about the positive gross margin in the quarter. So the first time you’ve actually shown some gross profit implication being that you’re actually probably selling more now than you’re actually placing free of charge. And so maybe you could dive into that dynamic a little bit?

Sharon Malka

Analyst

Hi, Raj. So basically the key reasons for this gross margin I have two; first of all, it’s the increase of revenue such as the first quarter of 2016. And I mentioned in the past, the revenues will increase, the gross margin will increase and eventually we’ll have a gross margin of about 80% when we will stabilize. The second reason is a effectiveness all our resources of the plants, while the plant currently part of it allocated to the cogs and the other one is supporting R&D activities and allotment are allotted to R&D activities. So those are mainly the two main reason reasons for this gross margin and we anticipate that as I’ve said before, these margins going forward will increase and eventually we’ll stabilize on about 80%.

Raj Denhoy

Analyst

So we see expectation and we should assume from this point forward that you generate a positive gross margin and as the revenue continues to ramp where NexoBrid, ultimately EscharEx that, we should see it sort of move off of this 37% gross margin continue to build from here?

Sharon Malka

Analyst

Yes.

Raj Denhoy

Analyst

Okay, fair enough. Maybe just on the progress of NexoBrid in Europe, has there been any change on the reimbursement side, any notable wins in any countries or any anything you want to call out in terms of the progress there?

Sharon Malka

Analyst

Thank you. I think the two main things that we can see is one, I would say even three; again depending on the country, as you remember, reimbursement in Europe is very fragmented and it’s different from country to country. So it’s difficult to give an answer on a P&L level, maybe I’ll go to a – to some of the highlights of the countries. In Italy we are making progress by implementing the national level reimbursement region by region. We recently got FIT Sicilia [ph] which is a region that usually takes a very, very long time, we’re able to get these approval within about six months. And the more regions adopt the national decision, the more we can generate sales from that region. We have not yet finished all the regions in Italy, but we’ve made a big progress forward. And I hope that by end of this quarter maximum the next all Italy will be in a position that they can actually purchase the product. The second country is England, again in England deposit is going center by center into the formulary process, into the formulary hospital process. We have already several customers in England that are able to purchase the product, we know several customers that in this quarter should have the meeting – the internal meeting of the hospital to allow them to start purchasing the product. I just came back few days ago from the British Burn Association Conference, a lot of enthusiasm, a lot of customers approaching us and wanting to start using and buying the product. So I hope that this backwind would also support us in these formulary discussions. The third country I would say is Germany. In Germany, this year we were able to convince the German Burn Association or perhaps NexoBrid was able to convince the German Burn Association, that they now should submit on their behalf to the government for what is called an OPS code, which is similar to a CPT code let’s say in the U.S. Then if they are successful, they will be able take charge or get refund or reimbursed for the specific use of NexoBrid in patients. Their efforts in all the local countries, in addition to that, we are also seeing physicians on their independent initiative starting to do local studies to show that NexoBrid is cost effective, because they need to show it to their administration. So as I mentioned in the call, in Italy a peer reviewed paper just showed that we save €5,000 per patient and we know that such efforts are being made in other countries like England, Spain, Italy, Germany and the more we see of that independent data showing that we are cost effective. The more difficult, it will be to the reimbursement body to in all that.

Raj Denhoy

Analyst

No, that’s helpful. And maybe just a follow-up but I know you guys, you typically don’t like to give guidance but given all the progress on the reimbursement front and general progress at the company broadly is there anything you want to offer in terms of revenue level, you’re comfortable with this year and maybe as you move into 2018 as well.

Gal Cohen

Analyst

As you rightly mentioned, we don’t give guidance on revenues because at this stage, when the reimbursement is still changing from country to country and there’s no consistency it would not be the right thing to do. We do give guidance on expenses and we never missed the guidance on expenses. And as Sharon mentioned we reiterate our guidance that in this year 2017, we will spend between $15 million to $17 million.

Raj Denhoy

Analyst

Okay, that’s helpful. Thank you.

Operator

Operator

Our next question comes from David Maris of Wells Fargo. Your line is open.

Katie Brennan

Analyst

Hi. This is Katie Brennan on for David Maris. It’d be great to just get a little more clarity from you guys. In the press release, you noted that the complete debridement will be the primary endpoint of the studies. So I am wondering if the FDA gave you any indication if you need to more than one additional study. And if what you heard from the FDA was like – significantly different than what you were expecting to implement. So if the time you need to kind of finalize that the design of the pivotal program if this was expected or if the agency is asking for more changes than you anticipated.

Gal Cohen

Analyst

Thank you, Katie. I don’t think that we got more feedback from the FDA that we – than we anticipated, usually as – FDA usually, when you ask FDA what you need to do? FDA answer would be, it’s sort of a view issue, because FDA doesn’t want to commit – it depends what will be the results of the study, what will be the p-value, what will be the safety signals and so on. So usually they do not commit to something unless you go to an FDA process something like that. We are aware of the regulations that – or calling to the regulations, there is a need to do two adequately control studies to get an approval pair indication in the U.S. We are aware of the regulations that require a certain amount of exposure to patients. We are aware of the regulations that in the U.S. or internationally to be honest going to IgG4 [ph], one needs to do what is called a build wrench finding study. Having said that, we are also aware that we have enough experience with NexoBrid and NexoBrid is already in Phase 3 within Europe, there is a lot of exposure there, it went to Phase 3 and Phase 4 and so on. What we are doing now, we are – the easiest thing is just to follow the guidelines, do whatever is in the book. We are walking with FDA and with the other consultants to see how we can do something different, something better for the company and for the shareholders. We believe that we will be able to come up with this plan. And if you’d asked me, what is mobility that FDA after 40 years, will agree that we’ll do a study with a primary endpoint of interest of complete debridement. Every consultant would tell you zero, it’s impossible, FDA consistently said wound closure is the primary endpoint and we saw that all the products that went before us will not able to achieve that in a Phase 3 program. So we have argued with FDA, we’ll provided with rational and scientific rational to justify why we believe that with NexoBrid as well as with EscharEx interests complete debridement would be the primary endpoint and by choosing a consent from the FDA that this would be the primary endpoint and that wound closure would be a safety measurement. That we just need to show no deleterious effect exactly like what we did with the Phase 2 in Europe, and exactly like we’re trying to do with a Phase 3 study with NexoBrid. I think this is a great achievement because without it, as you know the program will be much more complex. So we’re taking all these elements into account in order to bid an optimal, I would say plan to get the product to the market as soon as we can.

Katie Brennan

Analyst

Okay, great. Thank you. And just finally on NexoBrid revenues, would you expect that the contributions you’re gaining in Europe as well as ex-Europe should lead to sequential increases going forward quarter-over-quarter for NexoBrid revenue.

Gal Cohen

Analyst

In general, this is our anticipation, we always like to show sequential growth sometimes because of the magnitude – one places in all there three days after the end of the quarter and sometimes we have just two weeks and sometimes you saw that our significant like for example in this quarter, we had something like that in England when the – all those came just after the end of the quarter. But if you look at it over time as a trend, the trend is always growth since launch. We are walking and striving to maintain this growth going forward.

Katie Brennan

Analyst

Great, thank you.

Gal Cohen

Analyst

Thank you.

Operator

Operator

There are no further questions. I’d like to turn the call back over to Gal Cohen for any closing remarks.

Gal Cohen

Analyst

Thank you all for your questions and for your continued interest in MediWound. We look forward to updating you again, when we report our second quarter 2017 financial results in August. Have a good day.

Operator

Operator

Ladies and gentlemen, thank you for participating in today’s conference. This does conclude the program and you may all disconnect. Everyone have a great day.