Earnings Labs

PTC Therapeutics, Inc. (PTCT)

Q1 2020 Earnings Call· Fri, May 1, 2020

$69.88

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Transcript

Operator

Operator

Ladies and gentlemen, thank you for standing by, and welcome to the PTC Therapeutics First Quarter 2020 Financial Results and Corporate Update Conference Call. At this time, all participants are in a listen only mode. After the speakers' presentation, there will be a question-and-answer session. [Operator Instructions] Please be advised that today’s conference is being recorded. [Operator Instructions] I'd now like to hand the conference over to your speaker today, Alex Kane, Head of Investor Relations of PTC Therapeutics. Thank you. Please go ahead, sir.

Alex Kane

Analyst

Good afternoon and thank you for joining us to discuss the PTC Therapeutics first quarter 2020 corporate updates and financial results. I hope that everyone is doing well and staying safe. Joining me on today's call is our Chief Executive Officer, Stuart Peltz; our Chief Financial Officer, Emily Hill; as well as Matt Klein and Eric Pauwels, who are recently appointed Chief Development Officer and Chief Business Officer, respectively. Before we start, let me remind you that today's call will include forward-looking statements based on current expectations. Please take a moment to review the slides posted on our Investor Relations website in conjunction with the call, which contains our forward-looking statements. Our actual results could materially differ from these forward-looking statements, as any and such risks can materially and adversely affect our business and results of operation. For a detailed description of applicable risks and uncertainties, we encourage you to review the company's most recent quarterly report Form 10-Q and Annual Report Form 10-K filed with the Securities and Exchange Commission, as well as the company's other SEC filings. We will disclose certain non-GAAP information during this call. Information regarding our use of GAAP and non-GAAP financial measures and a reconciliation of GAAP to non-GAAP is available in today's earnings release. With that, let me pass the call over to our CEO, Stuart Peltz.

Stuart Peltz

Analyst

Thanks, Alex and thank you for joining us today, as we provide an update on the first quarter. I hope that everybody is staying safe and healthy amid these challenging time. I’m incredibly proud of how the PTC team has responded to the COVID-19 crisis, recognizing the seriousness of COVID-19 and acting early. In late February, we understood the threat and set up a COVID-19 task force that included individuals from all areas of expertise of PTC, including physicians, public health experts, and epidemiologists that understood the implications of the viral pandemic. This team immediately implemented a plan to safeguard the health and safety of our employees and ensure that they have the necessary equipment to work effectively from home. This task force continues to meet and refine processes that allow us to remain productive and safe. We have a second task force that focuses on critical aspects of our business to ensure access to our therapies. This task force is continually assessing issues that could arise with our clinical programs, manufacturing, supply chain, research, as well as the commercial business. We have revised strategies to mitigate potential issues in our businesses and continuously assessing how well they are functioning. Patient services and engagement teams are now working together to ensure that patients have the necessary access to treatment. We have also created a third COVID-19 task force whose mission is to look at what is next and think through the strategies we should employ as the world begins to open from being locked down. Their job is to strategize multiple scenarios of what will be needed to be successful in different places around the globe. As a result of these efforts, our teams have adapted and have continued to execute. Field teams are engaging with the physicians, identifying patients…

Matthew Klein

Analyst

Thanks, Stu. I'm thrilled to join the executive management team at PTC, and I look forward to the continued progress at our clinical programs. It's an exciting time to step into this role with our multiple upcoming clinical catalysts, even in light of the current environment. In terms of timing updates for our clinical programs, I will start with the Study 045, the U.S. Translarna dystrophin study. Due to COVID-19, the 045 study site is closed to elective procedures, which has delayed the study completion has a few patients still require final study muscle biopsy. Based on the site's current timelines, we now anticipate reporting top line data in the third quarter. We expect that in combination with our existing clinical data, statistically significant results in 045 would be sufficient for accelerated approval in the U.S. As a reminder, this is a single site, 40-week study that enrolled 20 boys aged two to seven years with nonsense mutation. The primary endpoint is percentage dystrophin change from baseline as measured by electrochemiluminescence or ECL. In close collaboration with the FDA, we developed and validated an ECL liquid based assay that is highly sensitive, highly linear and particularly well suited to identify large proteins, such as [indiscernible] dystrophin. Turning now to our splicing platform, Stu detailed the exciting results for risdiplam, our first small molecule from this platform. Our next splicing program in Huntington's disease remains on track with initiation of clinical studies in healthy volunteers to start prior to the end of the year. These Phase 1 studies will include both single and multiple ascending dose regimens in order to inform safety and pharmacokinetic parameters. We expect these studies will be relatively straightforward and support those selection to achieve target Huntington RNA reduction levels in the range of 50%. Shifting to…

Eric Pauwels

Analyst

Thanks. [Technical difficulty] Matt's comments, I am delighted to join the executive management team at PTC. With a strong first quarter behind us, an important upcoming milestone this year, we will continue to build on our existing portfolio of revenue generating products, prepare for future launches and remain selective with business development opportunities. Currently, on the commercial side of the business, our top priority is ensuring that patients on treatments have the necessary drug supply. And we have not seen significant disruptions to date. With personal promotion from our sales team worldwide limited by COVID-19, we continue to engage with health care providers, patient advocacy groups and payers by driving DMD, disease awareness activities through virtual calls, DMD master class webinars and educational podcasts, as well as leveraging virtual platforms to host local advisory boards. Additionally, social media is playing an even important role in the current environment, especially for DMD patients seeking information about our products. We had a solid first quarter with Translarna and Emflaza, both in terms of maintaining our existing patients and in new patient growth. New patient growth was driven in part by diagnostic and educational efforts over the last several months. And we continue to see these efforts positively impacting the business into the second quarter. For Translarna, we saw continued growth in Q1 and positive trends both in diagnosis and prescriptions globally. In the EMEA region, we have successfully maintained adherence in compliance with patients on Translarna and have seen minimal disruption. In the LatAm region, we continue to have ongoing discussions with the Ministry of Health in Brazil to secure future purchase orders. And we have seen the number of positive injunctions that will allow patient access to increase. Importantly, we continue to highlight comparison of the impressive real world results from…

Emily Hill

Analyst

Thanks, Eric, and congratulations to Eric and Matt for their promotion. We are happy to have you on the management team. We're also happy to have reported such a strong first quarter with our DMD franchise growing 28% year-over-year and with the positive tailwinds from the first quarter continuing into April. We feel well prepared to handle the current environment, as we have highlighted this afternoon. But due to lingering uncertainty regarding the duration and the degree of the impact of COVID, we are withdrawing financial guidance for 2020. As you have heard reflected throughout today's call, we have given a great deal of thought to cost, timelines and prioritization throughout the COVID-19 pandemic. We're fortunate to have a portfolio of home administered commercial products, diverse assets across multiple platforms and the ability to shift resources as needed. Strategically, we've identified trade-offs where we can push forward certain programs and be more conservative with capital intensive programs, such as deferring some capital expenditures for our Hopewell biologics manufacturing facility for future commercial products. It doesn't impact our production of near-term commercial in the clinical programs such as AADC deficiency and Friedreich ataxia gene therapy that allows us to conserve some cash as we move through this uncertain time. Now I want to take a few minutes to highlight the first quarter 2020 financial results. The press release issued earlier this afternoon summarizes the details of our first quarter 2020 financial results and I will review these details now. Starting with our top line results. We reported $68.3 million in total revenues in the first quarter of 2020 compared to total revenues of $53.6 million for the first quarter of 2019. Translarna net products revenues were $40.5 million for the quarter. This compares to $35.3 million for the first quarter of…

Operator

Operator

[Operator Instructions] Our first question comes from the line of Brian Abraham from RBC Capital Markets. Your line is now open.

Unidentified Analyst

Analyst

Hi. This is [indiscernible] for Brian tonight. Congrats on all the progress in your handling of the COVID situation. I just wonder if you could talk a little bit about how much progress you've been able to make on the additional study of the AADC gene therapy and gathered a combination prior to the pandemic? And then I guess what types of data from that study do you need to complete the following?

Stuart Peltz

Analyst

Yes. Hey, thanks for that question. So yes, so we were making progress with the AADC clinical trial. Matt, why don’t you actually talk through what you would do -- what we were doing and next step.

Matthew Klein

Analyst

Yes. Thanks, Stu and thank you for the question. As you mentioned, towards the end of 2019, we had received feedback from the FDA on additional data around the use of the intended commercial cannula in young patients. As a reminder, the clinical efficacy in our AADC deficiency program is quite strong. We've demonstrated durable impact with 5 years of continued effect as well as evidence of continued benefit to 10 years, and we of course have a strong safety profile. Manufacturing also remains on track and we were able to submit the MAA to the EMA in January. And so the key gating item for the BLA was the treatment of young children with the commercial cannula. We had identified two patients that we were prepared to treat before the end of the first quarter and due to the hospital closure for elective surgeries, those procedures have been pushed back, likely to be done sometimes towards the end of Q2, possibly early Q3. And so once we have those surgeries and the data from that, we will be able to continue preparations for BLA submission.

Unidentified Analyst

Analyst

So we made [indiscernible] just the pandemic [indiscernible] so that -- it just take a little time to move forward on.

Stuart Peltz

Analyst

Great. Thank you so much.

Operator

Operator

Our next question comes from the line of Alethia Young from Cantor. Your line is now open.

Eileen Maysek

Analyst

Hi there. This is Eileen for Alethia. Thanks for taking our questions. I guess the first one is on COVID-19. Just wondering, are you seeing any changes in buying patterns for Translarna? And then how do you manage to keep the access for patients? And then second, for the FIREFISH data, how do you think a risdiplam matches up to SPINRAZA and Zolgensma in type 1 patient? And then for SUNFISH data, is there any plan to present subgroup analysis, particularly around age, from the data set? Thanks.

Stuart Peltz

Analyst

Okay, great. Well, thank you. So the -- maybe we'll start with the first one, which is on Translarna, for that matter as well. So I think you could see from the numbers we have actually a good first quarter. And I think as both Eric and Emily talked, we are in -- we saw the numbers continually known. So the distribution remains ongoing. And I think we feel patients have been able to be in order. Eric, maybe you want to talk a little bit about how you see what's coming up in for the next quarter or two?

Eric Pauwels

Analyst

Yes. Sure, Stu, and thanks for the question. We're seeing continued growth in the number of patients on both products with DMD, Translarna and Emflaza. And we haven't seen any actually decline in orders. But actually what happens is, is we've actually been able to establish even deeper relationships with our health care providers and in some cases payers and advocacy groups during the pandemic. I think our main focus right now is really to provide that current base of patients we have on Emflaza and Translarna a continuity of supply. And we haven't seen any sort of major upticks. If the question is centered around are people asking for multiple months, there have been a few patients that have asked for 90-day supplies of Emflaza. But generally, the vast majority of patients have been getting monthly supplies in the quarter. That may tick-up a little bit, but it's not very significant. But most importantly, we've been able to really establish our case management team in the U.S., been able to establish a strong sort of connection with many of the DMD patients to ensure that they have all the resources they need. And we currently have adequate -- and we assure them that we have adequate supply both in Emflaza and Translarna.

Stuart Peltz

Analyst

Yes. And so the second question relates to risdiplam and in a sense that contextualize how we feel the risdiplam will do relative to the other products that are out there. And it's really our contention that risdiplam is the best-in-class molecule with efficacy potential. And I think, what you could see from the recent FIREFISH data is both Part 2, but as well, Part 1, that this was compelling efficacy that was seen in that. And that occurred even despite the older age, when you do comparisons of that. And that we saw -- we not only did we see that, but we're able also to show durable increases in the SMN proteins and changes in the RNA, both in the CNS as well as the periphery. So that's actually really critical. I think we're the only ones who've been able to show that. We're not only we showed that, but it was in the periphery. And we -- not as much has been talked about of how SMA, but it's becoming clearer and clearer is a whole body disease. Well, the CNS is critical, it also affects other tissues as well. And then we take another advantage is that it's really the risdiplam itself. That is the treatment, you don’t need an intrathecal [ph] injection for that, nor do you need to take a immunosuppression as a consequence of taking the drug. So we think that's really a major advantage. And then we also think that so far what we've seen to date was that there was no drug related safety findings and that we're very proud that we've had the broadest clinical trial program thus far in treating patients in SMA one, two and three patients from 2 to 25 years old, where we've had placebo controlled…

Eileen Maysek

Analyst

Okay, great.

Stuart Peltz

Analyst

Then I think you had one other question which is the SUNFISH?

Eileen Maysek

Analyst

Yes, the SUNFISH subgroup, yes.

Stuart Peltz

Analyst

Yes. That, you know, I'm sure we'll be having addition of posters over time on the data as it accumulates.

Eileen Maysek

Analyst

Okay, great. Thanks.

Operator

Operator

Thank you. Our next question comes from the line of Tazeen Ahmad from Bank of America. Your line is now open.

Tazeen Ahmad

Analyst

Hi, good afternoon, guys. Thanks so much for taking my questions. Maybe one on AADC, and then I have a couple more on a couple of other programs. Stu, in the past, you had been starting to give us updates on a number of patients that you've been able to identify. Can you give us a refresh number on how many patients you have as of today? And also whether you're thinking still is that they're around, let's say, 6,000 patients worldwide that you hope to find over the course of the next several years.

Stuart Peltz

Analyst

Yes. Great, thanks for that. Yes. So I'd say that, yes, as we said in January, we had about 200 -- greater than 200 patients identified in the J.P. Morgan meeting. We continued to search. We obviously have some issues as a consequence of COVID and I'll have Eric talk a bit about that. But we're still comfortable with the numbers that we said that we think is there. And now it's really a matter of patient identification. And to do so in the -- right now in the COVID environment is obviously more difficult than previous. And so we're still working hard at that. Eric, maybe why don’t you talk a little bit about how we're doing this in the current environment.

Eric Pauwels

Analyst

Sure. So, hi, Tazeen. I think right now it's pretty safe to say that, the COVID environment has had a direct impact on patient identification efforts, but we're doing a lot of activities right now and adapting to this new environment. As Stu said, we've identified more than 200 patients at this point. And our goal is to actually get 300 patients identified by the first country launch, whether that's in the U.S. or Europe. We have had a number of different initiatives, particularly in Q1. And when things started to slow down a little bit, we shifted and we increased our web presence in online efforts substantially. We had a master class that had about 200 health care provider physicians in 20 countries. We rolled out this program that was very, very well received, called "The Road Less Traveled" and it really helped sort of health care providers to understand how to diagnose AADC deficiency patients earlier, as well as recognize various symptoms, particularly in areas where we're trying to target right now to cerebral palsy clinics on epilepsy clinics. In addition to that, we've actually had -- we’ve rolled out quite a few of the European AADC Steering Committee meetings. And we executed quite a number of those and had surprisingly really good reception from key opinion leaders in the virtual education classes to help with patient identification. Now, with all that said, it's clear that COVID-19, have had an impact given that patient -- fewer patients are seeing physicians and tests are being done. But we're still doing quite a bit of activity virtually to keep up the educational noise level.

Tazeen Ahmad

Analyst

Okay. Thanks for that. And then maybe, Stu, a question on Translarna. For the study that you're doing to measure dystrophin, can you give us an idea of what percent of patients have not yet received that biopsy? And does it make any meaningful difference if, let's say, a patient was scheduled to get a biopsy in March or April, but they don't end up getting it until May or June?

Stuart Peltz

Analyst

Yes, that's a good question. So we -- probably we've gotten, I'd say we're waiting to get the last biopsy on approximately 40% of the patients somewhere around there. They were all scheduled to come in and this is sort of interrupted there. We don't think there's a real issue in terms of getting -- and took the biopsy for treating them longer. We don't think that will be a real problem, right? So we should be able to be able to -- once the sites are back and running and open, be able to -- to be able to get this accomplished. So we don't think that that’s -- think that will be a big deal.

Tazeen Ahmad

Analyst

Okay. And is there something that you've discussed with FDA, this delay?

Stuart Peltz

Analyst

I think in general, they know that sites are having issues. And so I don't know if we've actually talked to them directly, but they put out things already about -- because they know some sites are just closed down, especially in metropolitan areas. So -- and in this particular case, I mean, you might recall from the Sarepta case that they actually had a 9 month and 18 month. So we don't look at this as a real issue.

Tazeen Ahmad

Analyst

Okay. Thank you.

Operator

Operator

Thank you. [Operator Instructions] Our next question comes from the line of Joel Beatty from Citi. Your line is now open.

Joel Beatty

Analyst

Hi. Thanks for the question. So risdiplam launches, should we anticipate that payers will only cover as a monotherapy, or could there also be situations that payers could be open to paying for it as combo therapy, like Zolgensma or SPINRAZA?

Stuart Peltz

Analyst

So maybe a couple of points to think about. When -- you’ve got to remember that, let's start with Translarna -- I mean, risdiplam with SPINRAZA. We don't understand actually why that was occurred necessarily, because they both sort of promote this alternative splicing into the SMA transcript. And I think what -- I think -- and we've shown pretty clearly that you can actually make all of the SMA to our nation, to the appropriate RNA to make the protein. So risdiplam does a very good job in terms of being able to make the appropriate RNA and therefore proteins. In the case of Zolgensma, our guess is that we'll be competing with them in order of getting type -- order to get type 1 patients in that. My guess is that as patients feel a need to get additional treatment, they want -- and we know from our trial that we currently have that there are patients who -- from Zolgensma who are now on open-label trial, who are now getting risdiplam as well. So we would anticipate that there'll be patients who probably would want to get risdiplam as well especially in light of, we don’t know how durable or the variability of how patients do when they get this.

Joel Beatty

Analyst

Makes sense. And then I have one more question on risdiplam. Are there certain regions that you anticipate have a little bit more favorable dynamics for more rapid launch than other regions? And what type of factors would help the region have a rapid launch of risdiplam?

Stuart Peltz

Analyst

Well, we say -- I mean, I think that Roche will -- obviously Roche is in charge of -- in charge of commercialization, but they're certainly going to want to get moving rapidly in the U.S. and then really throughout the world, will want to be done. But the U.S. is the first, the first country that they will go for. The other point actually I wanted to make on the previous question also was that when I think about it, there were precedents and where SPINRAZA was covered after Zolgensma. So I think, certainly that also goes along with the notion of we anticipate that risdiplam would probably be given [indiscernible].

Joel Beatty

Analyst

Great. Thank you.

Operator

Operator

Thank you. Our next question comes from the line of Joseph Thome from Cowen and Company. Your line is now open.

Joseph Thome

Analyst

Hi, there. Thank you for taking my questions. Just the first one on the GMP manufacturing in early 2021. Can you just articulate how this maybe slight delay would impact any sort of initiation of gene therapy studies as those are tied together. And then my second question is, it looks like there is a study on clinicaltrials.gov for Translarna in DMD patients aged 6 months to 2 years. Just wondering, what you're hoping to show here and is this related to a potential U.S. submission or the ex-U.S label? Thank you.

Stuart Peltz

Analyst

Sure. Yes, thanks. So the GMP manufacturing in terms of Hopewell site was really just so when we're thinking about COVID, we've already -- we already started making toxicology level material in the Bridgewater site. So we -- based on being able to do that, and we don’t anticipate really it would be slowing it down in any way. So a lot of this is just for the opening the plant and we get 2021 in the current environment we have so that it will -- there'll be no delays as a consequence of pushing it forward by four months. So we didn't think it was a real issue and it concerned a considerable amount of cash, so we thought we might well do that because we already created the tucked up access in our Bridgewater site. In terms of the 6 months to 2 years, they just really just to get the extension and to be able to bring -- we've done the work to get the -- and we did that and we've gotten that actually approval in the U.S. That was -- I mean, in Europe, sorry -- to expand the label so that people with [indiscernible] mutations can get it earlier and so that's what we’ve report towards. So that's just to continue to get earlier and earlier patients.

Joseph Thome

Analyst

Great. And then, if I could just do one more on AADC. I see you're having some data presentation at ASGCT, outline changes of the body scale and aims and kind of functional endpoint. In terms of the regulatory review and maybe what physicians are interested in, how are they each going to look at these different efficacy endpoint? Is the one that's most important, or they look at them kind of holistically.

Stuart Peltz

Analyst

Sure. So, Matt, do you want to take that?

Matthew Klein

Analyst

Yes, sure. Thank you, Joseph, for the question. I think what we -- when we think about the AADC data package, first, it's very important is the fact that we're able to show on PET scan that there is a significant increase in dopamine production in all the patients. So that's the first very important sign that we're addressing the critical underlying biochemical defect. That's very compelling evidence that we're really targeting the fundamental pathology of the disease. Then as you look at the data package in its whole, including the primary endpoint of head control, we're able to show that there's benefit in every patient treated. And what we're now seeing with the long-term data as shown in some of the abstracts you mentioned is that we're seeing durability of effect out past five years, even close to 10 years in some patients. That's a very strong, compelling data. So what we believe is that physicians will appreciate the totality of the data that one we're addressing, the fundamental biochemical defect in all patients; and two, across the board we're seeing correction and evidence of correction of the key motor function defects in the disease, and that those effects, those favorable effects are sustained.

Joseph Thome

Analyst

Great. Thank you so much.

Operator

Operator

Thank you. Our next question comes from the line of Vincent Chen from Bernstein. Your line is now open.

Vincent Chen

Analyst

Congratulations on all progress and thanks for taking the questions. A couple for me. The first one is just on, I guess, revisiting the COVID-19 impact. I was wondering if you could elaborate a little bit further on what impact you’ve seen so far or a slowdown related to COVID. It sounds like the franchises have been pretty resilient so far and have to imagine the [indiscernible] largely been in April. It was basically made to withdraw guidance given potential COVID related impacts. Just want to get a better sense for whether you're indeed seeing any slowdown in demand for return to market products over the course of the last couple of months, whether end of Q1 or in April to date? Or is pulling guidance just in case things were to get worse going forward. And then the second one is -- I will pause there. Yes.

Stuart Peltz

Analyst

Okay. So -- yes, that’s a good question, because it goes to the pulling of guidance was more on -- or withdrawing it at the moment, really on the uncertainty of the -- of where things are going. In the long-term, you just don't know. I would say in the short-term, we feel pretty good where in the first quarter and even after how they slow in terms of maintaining the patients already on drug and using new prescriptions. So it wasn't like we saw a slowdown. And maybe, Eric, maybe you want to put a little bit of -- around this a bit?

Eric Pauwels

Analyst

Yes. Sure, Stu. Yes, Vincent, thanks for the question. I mean, in terms of the top line, I mean, we've seen the trends right now, both in Europe with Emflaza that are very encouraging still. As I mentioned, we haven't had any kind of increases at all, patients asking for more product. We've been shipping mostly -- most the patients on a month-to-month basis. And we continue to see those positive trends in Q2. The existing patient base and new patient growth is still there, although new patient diagnosis and new prescriptions have decreased a little bit now, as we've seen, because patients are not seeing physicians as frequently, but we have protected the base, which is very good and the trends are good there. We have gone back to make sure that everybody realizes we have an adequate amount of supply. And there have been some requests in addition to the uptake. There have been a few patients and we're seeing more and more requests for potentially 90 days of supply for Emflaza, but it's still a small percentage. I think what we were concerned more about is the unknown. And I think as Stu highlighted, there's -- if the pandemic continues and there is a shift of unemployment and payer mix or potentially disruption to some of our Translarna shipments that might be in various markets. Keep in mind, we have patients in close to 50 countries with partners as well as direct business. If some of that is disrupted because of the pandemic, at this point in time, we're just trying to be cautious. But there's no indication now that based on our strong results in the first quarter and what we're seeing so far right now, that we're losing patients or that growth would go down. And I will give it back to Stu.

Vincent Chen

Analyst

Right. And maybe one quick follow-up on that point. If you think about the price for Emflaza in the U.S., how does the price paid on Emflaza differ between patients on commercial insurance and patients who are on government insurance? Take another way, if more patients were -- if you were to see a meaningful shift in payer mix, how might that impact the net price paid on average?

Stuart Peltz

Analyst

Yes. Well, the simple answer is, it's basically the statutory rebate from CMS, which is more -- which is higher right now. Our current payer mix is about sort of 60-40 with commercial payer thing the majority. If obviously that shifted our gross to net would shift because there would be more patients moving onto Medicaid. So far, we haven't seen that. And that seems to be that DMD families in general have pretty good insurance and have covered. And then in addition to that, if patients do go from private payers to Medicaid programs, a number of the states actually have disability programs for children and they can move very quickly. So, again, I think the only effect there, Vincent, would be the statutory rebates that we would have to pay to CMS, if the payer mix shifted.

Vincent Chen

Analyst

I see. And let me ask another one, just on Translarna and the ongoing study. I was just wondering if you could give us a sense for how the powering calculations were done in terms of using the number of patients in the ongoing U.S. dystrophin study. What data did you have sort of draw upon in terms of estimating the likely effect size, like are there -- is there data you collected from other patients treated with Translarna to see just how much of an increase you see in dystrophin, whether from your studies or from clinical experience, I guess, in territories where Translarna is used?

Stuart Peltz

Analyst

Yes. Yes, thanks for that. That's a good question. We did look at other studies as well, and it was based on data that we saw from Sarepta and some just making some assumptions based on that and what the assays like that we got there. Matt, do you want to sort of -- is there anything else you want to answer that?

Matthew Klein

Analyst

Yes, just that we believe with the 20 subjects in the trial that we would be able to achieve -- we have 90% power, which we thought would be sufficient to show the Translarna effect. And, of course, we expect a baseline to be very, very low levels of dystrophin expression.

Vincent Chen

Analyst

When you say 90% power, do you -- can I just ask, what was the effect size and the variability?

Matthew Klein

Analyst

Correct. As Stuart said, base we'd be looking at other trial data and running simulations.

Vincent Chen

Analyst

Okay. Thanks for taking all the questions.

Operator

Operator

Thank you. Our next question comes from the line of Gena Wang from Barclays. Your line is now open.

Peter Kim

Analyst

Hi. This is Peter for Gena Wang. Thank you very much for taking the questions. I guess, my first question -- my question is on risdiplam. I guess, do you expect to -- do you expect risdiplam to generate meaningful revenue this year, or do you anticipate some patient initiation impact to COVID? And my second question on the related note is could you remind us when the EAP was opened and how many patients have been sort of enrolled in U.S. and OUS? And whether pre-COVID and post-COVID EAP enrollment rate has sort of changed? Thank you.

Stuart Peltz

Analyst

Sure. So maybe the big picture on COVID and revenues. So I think on the big picture, COVID, I think in some ways I think people will start thinking about how do I make sure I get -- have drug supply to patients. So I think in some ways that might be helpful from a commercial launch perspective. I think in terms of revenues that would be royalty, maybe Emily, you want to talk a little bit about that?

Emily Hill

Analyst

Sure. I mean, we have the potential for up to $42 million in milestone this year on our collaboration with Roche on the risdiplam programs. Obviously, we have tiered royalties up to the mid teens and with the MAA having them submitted earlier this year and PDUFA in the U.S. now in August 24, I'd expect this to ramp up more significantly next year. I think as far as COVID impacts the rate and ramp of those revenues, there's really some advantages and potentially being the only SMA therapy that can be delivered at home.

Stuart Peltz

Analyst

And then the patient numbers. Well, I don't think Roche has discussed that. But I think what they did say on the call previously, and what they have chosen is a lot of interest. And so they are bringing patients in, already -- that are already on the EAP and they're continually do that both in the U.S as well as then to set it up also in Europe as well. So it'll be a global, in a sense EAP program. It was certainly in the U.S. all over and then in countries that allow you in Europe to have these EAP programs.

Peter Kim

Analyst

Got it. Thank you very much.

Operator

Operator

Thank you. Our next question comes from the line of Raju Prasad from William Blair. Your line is now open.

Raju Prasad

Analyst

Thanks for taking the questions. On risdiplam, when do you anticipate presenting additional JEWELFISH and RAINBOWFISH data? And do you have any general -- aside from what you’ve already mentioned, do you have any general commentary on how many patients are Roche is bringing in on the expansion of the Early Access Program, or any details around how -- what types of scenarios that they’re expanding it too, just if patients are off spin rather, don’t want to go in, they apply, or is there more stringent criteria? And then I have one on Translarna.

Stuart Peltz

Analyst

Sure. Yes, so that’s an important point too, is that they’re now planning presentations for that probably be an update on the [indiscernible] SMA. And then, yes, they have changed the EAP program to allow patients to who are in other therapies to get into the EAP program as well. And they’ve also added type 2 as well to the program. So, yes, so patients who can't get, say, intrathecal injections or naive patients, that they certainly can. It's really based on the physician discretion based on what they think the need is. So COVID is obviously making limited access. So this is really a nice way which they can get it at home and take it. So that's also adding to the number of patients who are hopefully transitioning to risdiplam. Very strong interest in this though.

Raju Prasad

Analyst

Yes. Do you have any idea of how many in the U.S. versus EU are getting on the early access program, just kind of a general percentage wise?

Stuart Peltz

Analyst

No. Yes, that hasn't been disclosed yet.

Raju Prasad

Analyst

Okay. And then one on Translarna. I know obviously, you pulled guidance and you've commented on it enough on this call. But just wondering, usually, you have a Q2, Q4 bolus from Latin American orders, is the general pattern of revenue recognition going to be similar?

Stuart Peltz

Analyst

Yes. I think -- so I think maybe Eric could comment on that.

Eric Pauwels

Analyst

Yes, sure. We are -- with regards to Latin America, for Translarna, as you can recall, we had approval from ANVISA last year, and we've been building a very nice base of patients. And we saw new patients coming in the first quarter, not only diagnosing these patients, new prescriptions. But the base of patients that received positive injunctions for therapy continues to increase. So we've seen growth on all those parameters. With regards to that base, we have ongoing negotiations with the Minister of Health and with ANVISA to require that we get those group purchase orders. We're working towards securing a new purchase order in the second quarter. We've shifted a lot of our virtual communications right now with the Minister of Health because of COVID-19 to virtual-type meetings, and we continue to have a very strong working relationship with the payers in Brazil. So our goal is, as we've seen continuous number of increases in patients right now, our goal is to get and secure an order for Q2, barring any kind of exceptional acceleration of the pandemic or some kind of government diversion of resources. You got to keep in mind though that the rare disease bucket for cost centers at Minister of Health is relatively small in comparison to the overall health care budget. So we think we can work through some of these things and negotiate and hopefully obtain an order in Q2 and ensure that patients continuity is there. But we are -- again, we are very encouraged with the continued growth, and it's going to continue to put pressure on the Minister of Health to secure those orders.

Operator

Operator

At this time, I'm showing no further questions. I would like to turn the call back over to Stu for closing remarks.

Stuart Peltz

Analyst

Okay. Well, look, I want to thank all of you for joining the call today. I want to remind you that at the end of March was our 22nd anniversary at PTC. And so I look back upon now our long history, I'm very proud of how the company has evolved. It's gratifying to see the progress that we've all made and continue to make in discovering, developing and commercializing treatments with -- for patients living with rare disorders. And I think really a consequence of the hard work and dedication of the team. We're well positioned to be able to push forward and even thrive, even under this uncertain environment. So again, thank you for joining the call. I look forward -- I hope to see you all soon.

Operator

Operator

Ladies and gentlemen, this concludes today's conference call. Thank you for participating. You may now disconnect.