Rhonda Farnum
Analyst · J.P. Morgan. Your line is open
Thanks, Rick. I am pleased to have the opportunity to share our latest performance update on YUPELRI, which is the first and only once-daily, nebulized, long-acting muscarinic antagonist that provides a full 24 hours of control for patients and is indicated for the maintenance treatment of patients with COPD. Despite the continued headwinds created because of the global pandemic, we are encouraged by the growth of YUPELRI’s performance in 2021. As a reminder, Theravance Biopharma and Viatris co-promote in the U.S. with our combined sales infrastructure, targeting healthcare professionals who treat COPD patients suitable for YUPELRI. Theravance Biopharma’s commercial and medical teams cover the hospital segment and Viatris covers outpatient-based community healthcare professionals. From a financial perspective, we share profits on YUPELRI in the U.S. 65% going to Viatris and 35% to Theravance Biopharma. Slide 8 shows Theravance Biopharma’s implied 35% share of net sales for YUPELRI during the fourth quarter 2021 of $15.3 million, which is the brand's strongest quarter-to-date. YUPELRI’s year-over-year net sales are up 13% Q4, 2021 versus Q4 2020. The implied 35% share of YUPELRI net sales for the full year 2021 was $56.7 million, which represents a 13% increase from 2020. Demand doses for YUPELRI increased 8% in the fourth quarter of over third quarter 2021 and 17% year-over-year. Total product demand for the full year 2021 was up 25% versus 2020. It was the case last quarter while institutions in some parts of the country are allowing more in-person access. In-person engagements remained below pre-pandemic levels for our team. It is also important to note that although total prescription volumes continue to demonstrate growth across most therapeutic specialties with volumes heading towards parity with 2020. Prescription volumes within the pulmonology specialty remain below pre-pandemic levels. This lag in growth is associated with the challenges the pulmonary community has experienced throughout the respiratory pandemic when treating COPD patients, which include competing time demands of COVID patients, a decrease in inpatient COPD patient visit volume and a limited ability for HCPs to diagnose and reassess their patients without pulmonary function test or spirometry, which cannot be performed via telemedicine. These factors contributing to a reduction in prescriber confidence and ultimately fewer prescriptions. Despite these challenges we have been encouraged with growth in total scripts for YUPELRI, which were up Q4 versus the prior quarter, Q3 by 7%, an increase by 32% year-over-year. New-to-brand prescriptions also increased 11% in Q4 of 2021 versus Q3 and 31% year-over-year Q4 2021 versus Q4 2020. As a reminder, these script data represent the retail setting and they serve as a proxy for overall growth but are not inclusive of the DME or durable medical equipment fulfillment channel, which represents a major of the volume of YUPELRI sales. Turning to Slide 9, you can see that YUPELRI’s share continues to grow in both the hospital and the community settings. YUPELRI’s share of the long-acting nebulized COPD market increased to 23.2% through October 2021, which is our latest data point and up from 18.2% in October of 2020. As we have noted previously many patients with COPD experience an acute respiratory episode, serious enough to require a trip to the hospital. And therefore, the hospital becomes a key point to assess a person with COPD and convert or switch them from their current medicine to YUPELRI. Data shows that many patients who receive YUPELRI in the hospital are discharged with a prescription to continue treatment, allowing for continuity of YUPELRI therapy post discharge. The Viatris and Theravance Biopharma teams continue to work effective and collaboratively using multiple tools and tactics in coordination to convert appropriate patients to YUPELRI during their hospital visits, supporting them through their discharge and enabling them to be maintained on YUPELRI after their return home. Looking specifically at the Theravance field sales deployment efforts in Q4 of 2021. Doses sold exclusively in the hospital setting represented an 18.5% increase from the previous quarter demonstrating the highest quarter volume launch to date. Slide 10 visually illustrates YUPELRI's growth trajectory in the hospital segment since launch. You can see how the unprecedented demands on pulmonologists in 2020 due to the pandemic changed the growth trajectory. Today, the YUPELRI hospital volume has returned to growth and during the fourth quarter of 2021 we achieved new key hospital account formulary placements and new purchasing accounts are being added regularly. We believe these wins will yield significant growth in 2022, as YUPELRI will be the first LAMA of choice in many hospital systems. Moving to Slide 11, the outlook for 2022 and beyond for YUPELRI is favorable. Our medical liaisons have surveyed healthcare professionals who have shared their observations on the role and use of nebulization and even with the COVID surges we saw in the fourth quarter, nebulization was reinstated. YUPELRI's once daily dosing is proving critically important to alleviate systems overwhelmed by COVID-19 in cases and healthcare provider shortages. It is important to understand that according to the evidence-based gold guidelines for COPD management, LAMA or long-acting muscarinic antagonist is foundational to COPD maintenance care. The execution of our tactical plan will continue to let these guidelines in the important role or once a day nebulized therapy like YUPELRI can offer inappropriate patient types. Looking beyond 2022 as we announced in early January Theravance Biopharma enrolled the first patient and PIFR-2 study, a Phase 4 trial evaluating the performance of YUPELRI compared to SPIRIVA in patients with low-peak inspiratory flow. If successful the PIFR-2 study will allow us to capture more of YUPELRI's addressable market and further strengthen its competitive advantage. Lastly, Viatris continues to develop YUPELRI for registration in China and if YUPELRI is marketed in China, Theravance Biopharma will receive double-digit royalties and milestones from sales in the China market. I will now turn the call over to Rick Graham.