Michael Castagna
Analyst · SVB Leerink. Please go ahead
Thank you. Hello, everyone, and welcome to our second quarter earnings call today. As you can imagine, we're very excited here at MannKind, as today's call is important, given the caps off, the recapitalization journey we started two years ago when I became CEO. Since then we've raised over $160 million, paid off our senior secured lender, signed multiple partnerships, including a $105 million deal with royalties from United Therapeutics, as well as laid the foundation for our future. This journey has been a bumpy ride for our shareholders, our debt holders and our employees and I want to say thank you to everyone involved in getting us to this point. I believe we are now in a solid position to deliver on shareholder value going forward. Over the past 24 months we transformed MannKind into a growth engine for years to come, when you look at these four pillars: First, we have announced five key partnerships since 2017. UT is progressing very nicely as we just completed the build up of our high potency area within our factory and the teams are now in the process of preparing commercial batches. This program should move very quickly to the next stage of development where we expect to bring in $37.5 million in milestone payments in the next 15 months. Additionally, we received approval for Brazil in Q2 and we expect to ship our first commercial supply in Q3 for an October launch. We are very excited about our partnership there as well as India as we get ready to start the Phase 3 trial. And finally, AMSL is working on preparing our file for submission in Australia. In addition, our recent announcements with OneDrop, is our first partnership to move Blue Hill forward as we think about ways to make it easier for people to manage their disease. Our second pillar is around our UT partnership, as they have exclusivity on our platform for pulmonary hypertension and we anticipate we identify other opportunities to work with them over the coming years, in addition to our own internal pipeline progress. We will provide some greater detail on how we view this move forward based on our recently completed landscape assessment. The good news is, our large scale dry powder manufacturing and formulation capabilities continue to be unique in the industry and give us a competitive advantage. The third pillar is our FDA-approved product Afrezza, which is protected by our best time before that now exceeds 975 patents. We have made strategic investments to help close the clinical gaps Afrezza such as new time and range data with CGM dosing and hypoglycaemia. For the last 24 months, we have updated our packaging, pricing structure, dosing recommendations, our FDA label as well as our move on REMS program. As we go forward, you can now see ADA standards-of-care been updated to include a Afrezza’s unique attributes. Our pediatric cohort 2 is almost complete and three opened up last week with top tier centers. We also expect numerous new publications to continue to help build out the scientific story in addition to our new data showing how well we can improve time and range, which we expect to become the next standard-of-care. The good news is Afrezza is here to stay and help transform the standard-of-care for diabetes. Our fourth and final pillar is our financial position. Let me go to the next slide to talk about this. As many of you have seen by now, we have a summary of over seven transactions we've been working on over the last month or two. The first thing is the recapitalization creates a solid financial foundation going forward. We've restructured over $200 million in liabilities to improve cash flow and capital structure. We've reduced our legacy debt by approximate $28 million. And the majority of our near-term maturities, which were almost $100 million were due in 2021 are now due in five years. We just put a new current financing vehicle in place that provides almost $100 million in non-dilutive capital, when you add up the $75 million loan with midcap plus the United Therapeutics milestones. This mid-cap loan is broken into three segments: $40 million upfront has been just taken with an option for $10 million but no later than April 15, 2020 and then additional option for $25 million no later than 2021, assuming we meet the covenants in the agreement. Additionally, we've reduced our cash burn. When you look at our insulin purchase commitment that existed historically, these were aligned within our current demand. We've now been able to work with Amphastar to get a more reasonable forecast and purchase commitment over the next four years, reducing our expense by $45 million dollars. We've also driven efficiencies and reduced spending throughout our business, as you look year-over-year continued expense reductions and as you look into 2020. All of these choices that we've made are expected to fund the cash -- the company to cash flow breakeven. My goal has always been to put this company on a path of cash flow breakeven. Now that we've completed this transaction when combined with the continued reduction in our expense base, as well as stretching moving forward, I believe we now have the flexibility and opportunity to make this happen, unless, of course, we find investment opportunities that create greater value for shareholders. The team at MidCap have done extensive due diligence on the management team, Afrezza and the prospects for the company as we go forward. MidCap manages the large dept portfolio with extensive health care experience backed by the Apollo Group and we're excited to be partnering with them. As you can see on this slide, they have a vast experience in biopharmaceuticals, health care and they really understand our business and our strategy and I've followed the company for a long time. They have broad access to funding through the partnership with Apollo Group and currently are managing over $20 billion in commitments. Now let me turn our focus to Q2: First is international partnerships, we just discussed and the second is Australia, which I also mentioned. United Therapeutics is going very nicely. We expect to start the Phase 3 trial very shortly. The high potency manufacturing area is complete and built out. We anticipate achieving our second milestone with $12.5 million in the second half of 2019. The research agreement for the undisclosed PH compound is substantially complete. We expected decision with United Therapeutics in Q3. On insulin and MannKind awareness, many of you've seen our Indianapolis 500 Sponsorship with Conor Daly as well as our Friends for Life as we go into the pediatric space. We also are trying to change the conversation with print ad that you'll see in a second in one aspect as well as inhalemyinsulin, website, social media, billboards that we just launched this past week. And finally, we've increased our analyst coverage to four with BTIG initiating in May. The first thing I want to share with you is the excitement that's going on in Brazil. Since the day of announcement of approval, it's been very exciting down there. We've appeared on the front page of the two big newspapers. And there has been lots of write-ups by the physician community down there, over 60 appearances have happened and there's just a lot of buildup there and so we're looking forward to working with them and make this a very, very successful launch where we can take the learnings from the U.S. and launch successfully in Brazil the first time. The second big thing many of you may have seen in the past week is two targeting messages that we're working on in Texas around spread the word, say goodbye to mealtime insulin, say goodbye to needles for your mealtime insulin, visit inhalemyinsulin.com. And everybody knows somebody with diabetes, tell them about inhalemyinsulin.com. This is targeted in a couple of cities right now including airports in the Midwest. So, we're excited to see how this works and so far the early days of website traffic and video shares, et cetera have been going above expected. The next agreement that we signed was One Drop which was announced on Monday. The important part of this aspect is it really starts to connect Afrezza into the Connected Care community when we think about providing seamless integration of patients managing their disease on third-party platforms. We expect One Drop to be the first of other -- many platforms we go forward with in the coming years. This will make it a seamless experience for when a patient takes their Afrezza, the dosing will show up in the One Drop app. And when you look at your glucose data, they are able to integrate Dexcom as well as their own BGM data. Patients will able to see an overlay of their glucose response curves and with that data, ultimately will be able to start to do predictive analytics. The next slide here talks about the scientific communication. These are decisions that were made over one to two years ago when David Kendall joined 18 months ago where we started a couple of these trials. We submitted the data from 2017 and 2018 and now you can see it just takes a while to get the scientific data moving, but as we go forward, we see numerous publications coming to support Afrezza at the various conferences already in 2019, but as we go forward in the publications in the second half and new data generated in 2020. For those you may have missed one of the important datasets that ADA, I want to share with you here is around our new fixed dose titration schedule in Type 2 patients. This very easy to follow protocol resulted in a 1.6% reduction in A1C in the first 12 weeks. Additionally, we measured time in range where we saw an improvement by 76% from baseline, almost 93% of people achieved A1C less than 180, and the time spent greater than 180 was reduced almost by 50%. These types of results are unheard of and very excited about continue to make Afrezza part of the standard-of-care. Now, I'm going to bridge to the pipeline. We completed an external third-party landscape assessment to give us some feedback on how our platform stack-up against other inhaled products including nasal technologies. When we completed this assessment we were convinced that amongst our peers out there, we have a platform that does differentiate itself and that these compounds are the right ones to continue to focus on. When we look at the real way to create value, it's really licensing these products when they get to Phase I. A lot of questions I get are around when will these products get to Phase I? And how long does it take? And so the next slide really gives you some descriptions of what this typically looks like for typical program. So, this is a sample development plan to show you year one and year two and our various compounds are in the various phases between year one in year two as we get to pre-IND. But you can see the decisions that we made back in December to move the pipeline forward take six to 12 months before you start to get to pre-IND filing, for example, EpiHale has already done in year one of this project and we have to go back to the FDA to find a feasible population that we feel this product can work in. But we are very excited to now fund the pipeline and this is in our cash flow plan to get each of these molecules to at least Phase I where we think we can create significant shareholder value. Now I'm going to turn it over to Steve to walk us through our financials.