Chris Lento
Analyst · Oppenheimer your line is open
Thank you, Gavin. Today we'll walk you through the 2014 successes we have had with our flagship product Abstral. I'll also take a moment to discuss the status of the launch of our second commercial product Zuplenz, as well as our plans for continued growth of the Galena commercial franchise. As noted in our press release and as Ryan will review in greater detail, our Abstral net revenue was $9.3 million in 2014. We achieved this number with the focused sales effort and we’re excited for continued growth of Abstral in 2015. As a reminder, Abstral is indicated for the treatment of breakthrough cancer pain and there is a TIRF or a Transmucosal Immediate Release Fentanyl product. As Mark mentioned, Galena is an oncology company and we're steadfastly focused on building Galena's commercial business within the oncology space. Our goal is to develop long-lasting relationships with medical oncologists, radiation oncologists, and palliative care specialists, as well as the pain specialists who are treating a large number of cancer patients. As we shared last quarter, we believe the oncology market represents the most long-term potential and we understand that this market is slower to evolve and has a greater need for provider education. For the focus and targeted approach, our commercial team has four goals that will help Galena drive revenue for the company. Our primary goal is to make each of our commercial products profitable on a standalone basis. This will lend to profitability of the entire commercial franchise and ultimately generate funding for Galena's clinical development programs. Secondly, we continue to build and grow our relationships in the oncology space. These relationships exist with healthcare providers, wholesalers, distributors, specialty pharmacies, and managed care organizations. Third, we're focused on building the commercial organization in anticipation of the launch of NeuVax. As Gavin discussed, Galena has a very strong cancer immunotherapy pipeline with multiple shots on goal with NeuVax and GALE-301. A key goal of our commercial team is to establish our oncology footprint now, so we’re ready to market the drugs from our own internal pipeline when the opportunity presents itself. Finally, we now have the ability to add additional products to our commercial portfolio, while our commercial programs are currently focused on oncology supportive care; the in-house expertise we have built allows us to expand and to market oncology therapeutics as well. With that background I would like to walk you through the metrics we used to evaluate our business. We acquired the U.S. marketing rights for Abstral from Orexo and relaunched the product in the fourth quarter of 2013. We relaunched Abstral that had previously sold approximately $1 million over its previous 12-month period and we were able to grow the grant to $9.3 million in net revenue in 2014. We believe that we can continue to grow Abstral and our successful commercialization will carry over to the relaunch of the Zuplenz in Q2. At the time of the actual product launch, we had two key goals. Reestablish the brand identity for Abstral and provide access to the greatest number of patients. In order to do this, we introduced our Patient Assistance Program or PAP. I want to take a step back and remind everyone of the evolution of our Patient Assistance Program which includes both voucher and copay programs. This is relative to my upcoming discussion around the profitability of our Abstral business. In an effort to reestablish Abstral’s brand identity, a launch we implemented rules for the Patient Assistance Program that would encourage physicians to prescribe Abstral through a generous voucher program in which all eligible and appropriate patients could receive a one month supply of Abstral at no cost. As a result, a large percentage of our Q1, 2014 sales were fueled by this voucher use. This program gave providers the ability to allow their patients to trial Abstral while also giving the provider the time and flexibility to appropriately titrate their patients. Initially providers were able to write a prescription for their patients to receive up to 96 tablets of Abstral via the voucher. Each of these vouchers when regained at the retail pharmacy level was recorded by data sources as one prescription. For that reason the number of prescription was much larger earlier in the year. In April of 2014, we made small modifications and rule changes to the program. All patients were still able to receive a one month supply of Abstral but no longer were they able to redeem all three prescriptions for 32 tablets each at one time. And time limits between refills were refined. At the same time, we scaled up our Galena Patient Services or GPS program which was implemented to provide support to providers and their patients in the form of prior authorization, support and reimbursement coverage. With the combination of our PAP rule changes and the success of our GPS program, we have been able to greatly reduce the number of voucher transactions while at the same time almost doubling our average transaction price. On my first Slide number 20, you can see how this breaks down on our overall calculation of our gross to net revenue dollars and how we have improved this over time with the changes to our PAP. Over the course of 2014, we’ve increased our gross to net ratio from 25% in Q4, 2013 to 63% in Q4, 2014. In addition on Slide number 21, you can see the dramatic impact of our patient assistance rule changes and our GPS services have had on increasing the average number of Abstral unit dispensed per pay transaction. In December 2013, the average units of Abstral per pay transaction was roughly 42 tablets – forward to December 2014 and the average number increased roughly 60% to 69 tablets per transaction. In addition to GPS and the program rule changes, providers have become comfortable prescribing Abstral for their breakthrough cancer pain patients. Our current market share on the branded TIRF market remained steady at about 5% of total prescriptions on a monthly basis according to Wolters Kluwer. On increasing our prescriptions and our market share is obviously a goal of our team, our critical metric is increasing profitability. One of the most important metrics, we have used over the past year is the actual revenue derived from each filled prescription or pay transaction. While our prescription numbers may fluctuate, there are significant nuances in the strength of which Abstral can be prescribed and the dollar amounts we received from each pay transaction. Given that Abstral has six different strengths that can be prescribed in a variety of quantities, this metric is more valuable than most. For example, a provider can prescribe Abstral for a patient in a one week supply of 32 tablets of 100 microgram strength. This prescription would generate roughly $1000 in retail sales. According to all data sources, this would count as one prescription. Conversely, a provider could also prescribe the patient of one month supply of the 800 microgram Abstral. This prescription would generate roughly $12,000 in retail sales. This prescription would also count as one prescription according to data resources. Therefore one does not always equal one, and one prescription could have a vastly different impact on our bottom line. As you can see on Slide number 22, over the course of 2014, we doubled the average price per transaction of Abstral. Therefore each transaction we generate is becoming more valuable and leading Galena and Abstral towards greater profitability. The strength has continue to grow into 2015 as more and more providers become comfortable with Abstral and are taking advantage of our Patient Assistance Program and GPS service offerings. I mentioned our overall market share in the branded TIRF market and I am proud to report that we’ve materially grown our business in the Oncology segment over the past year as shown on Slide number 23. While pain physicians represent the majority of our business, in Q4 we generated 20% of our business from Oncology focused specialists. It’s important to point out that upon launch of Abstral, less than 1% of the prescriptions came from this segment. We will continue to grow this business organically and expect that adding Zuplenz will further increase our penetration into the Oncology space. We gained a great deal of knowledge during our Abstral launch and during the scale up of our commercial team. I’m incredibly proud of the team we have on board and the opportunity to expand our product offering with Zuplenz which we expect to launch in Q2. As a reminder, Zuplenz is approved by the FDA for the treatment of patients suffering from Chemotherapy, radiation and postoperative induced nausea and vomiting, otherwise known as CINV, RINV or PONV. Primary ingredient in Zuplenz is Ondansetron, which is the goal standard and the most widely prescribed anti-emetic worldwide, giving Zuplenz an extremely strong clinical profile and provide our acceptance. Zuplenz also has several patient benefits including its ease of use via the oral soluble film delivery method. It dissolves on the tongue in less than 30 seconds. It doesn’t require water to administer. Has an soothing peppermint flavor with no gritty after taste associated with other valuable versions of Ondansetron. Because of our strong relationships on the product distribution side, we have partnered with our key distributors to successfully manage this significant product inventory which will become outdated later this year. As Mark mentioned, the new batches of Galena labeled Zuplenz are in the final manufacturing stages and we will begin distribution of our new product to coincide with our commercial launch. As I mentioned last quarter, we also face significant hurdles regarding the managed care coverage for Zuplenz and we launched an initiative to improve both Zuplenz commercial and Medicare part D formulary coverage. It’s important to note that negotiations with Medicare organizations can occur at least year in advance. So we are currently taking the necessary steps to expand coverage for the brand. We have already achieved several significant wins that will increase our Medicare part D coverage from 1% upon acquisition to roughly 40% in 2015. In addition, we continue to work on achieving improved formulary status with commercial payers. And we expect to be at or near parity with the competition in 2016. Upon launch, we will also be implementing physician sampling program and robust patient assistance program and our current GPS program will also be available to Zuplenz providers and patients. 2014 was an incredibly busy and productive year for our commercial team. Not only do we meet our guidance range but we also acquired a second product making us a true portfolio company. I’m extremely encouraged about our opportunities in 2015 as we grow our Abstral sales and as we launched Zuplenz into the market. With that, I will turn the call over to Ryan Dunlap to discuss our current financial status.