Jeff Leiden
Analyst · Bank of America-Merrill Lynch
Thank you, Michael. Good evening, everyone. 2012 has been a very dynamic and productive year for our business. During the last seven months we have delivered a series of important advancements. For cystic fibrosis, the approval and successful launch of Kalydeco in the US, m more recent approval of Kalydeco in Europe, and positive Phase II data for the VX-809 plus Kalydeco combination in delta 508 homozygous patients that supports progressing to a pivotal program; and now in hepatitis C, very impressive seven-day viral kinetic data for ALS-2200, our nucleotide analogue. With these advancements, all made since the start of this year, we are demonstrating our consistent ability to discover, develop and commercialize multiple transformative medicines, which in turn represents a strong foundation for the sustainable long-term growth that we expect to create with our business. During the last few months I've been working closely with the cystic fibrosis and hepatitis C franchise teams at Vertex. I'll provide a perspective on how we are positioned in these markets and also strategically how we are planning on extending and enhancing our presence in the treatment of these diseases. I'll also highlight for you what I think are the tangible markers for our progress as a business that we will ask you to focus on in the months and years ahead. After that, Ian will review our financial performance, our 2012 guidance and discuss how we're prioritizing investment in our business. Then Peter is going to provide you with a more detailed update on data and recent developments in our pipeline. Beginning with cystic fibrosis, Vertex is seeking to fundamentally change the outlook for people with this disease, and we have made excellent progress toward the goal this year. Kalydeco, which was approved earlier in the year in the US for G551D CF patients age six years and older, has been rapidly adopted in the US as a groundbreaking new medicine that addresses the underlying cause of the disease in these patients. The launch of Kalydeco has exceeded our expectations. We are currently treating a significant number of G551D patients, and we expect additional G551D patients to begin treatment in 2012, including patients who are rolling off the PERSIST Phase III extension study. Our field teams have done an excellent job with the launch, working to educate physicians and caregivers about Kalydeco and helping eligible patients and their families get the medicine. Last week we received approval in the EU for Kalydeco for G551D patients, and our team there is working to make Kalydeco available as soon as possible in multiple countries. We also believe that we can significantly expand the CF population that is addressable with Kalydeco alone. And towards that end, we have initiated additional monotherapy studies that Peter will discuss in his remarks. If our strategy is successful, these studies could increase the addressable population from the current 4% to 8% to 10% of the CF population, and potentially more as we consider the applicability of Kalydeco to certain other people with CF. During this quarter we also produced clinical data that provided convincing insights into how we may be able to treat a much greater number of people with CF, the homozygous delta 508 population. Specifically, we reported Phase II combination data for VX-809 and Kalydeco, which support moving into pivotal development, targeting delta508 homozygous patients early next year. If successful with these development efforts, we could potentially address 60% or more of the cystic fibrosis population with our different medicines. CF is a serious genetic disease, and I'm very proud that our team is at the forefront in developing potentially life-changing medicines for patients and their families. We're committed to being a leader in cystic fibrosis and continuing to work closely with the CF Foundation, patient groups, physicians and patients and their families around the world to develop additional breakthrough medicines and to provide hope. Let me now turn to hepatitis C. We are leaders today in the treatment of this disease, and with the portfolio of novel medicines we have in development, we think we are well-positioned to continue to deliver new regimens to the treatment of hepatitis C. I'll make comments on Incivek's recent performance and near-term outlook. We've learned about this evolving market in recent months and I want to share our thinking in terms of how we're approaching our commercial efforts. I'll also talk about our ongoing plans to develop all oral treatment regimens for the future, which I think is very promising based on today's announcement about our new program. Let me start with Incivek and two things that have not changed in the first half of this year, Incivek market share and persistence rates. First, market positions. Incivek has been and remains the leading direct-acting antiviral or DAA. Seventy to 75% of Genotype 1 patients who initiate therapy with a DAA in the Unites States continue to initiate treatment with Incivek. This position, which we have maintained since the launch of the drug, and which we expect to maintain, speaks to strong execution by our commercial team as well as to the benefit that this treatment provides to those with hepatitis C. Second, persistence rates, that is the number of patients completing 12 weeks of treatment with Incivek. Persistence rates for Incivek remained strong, and this has been consistent since launch, which once again speaks to the benefit of Incivek and the execution of our commercial team. What has changed in this market is the number of hepatitis C patients initiating treatment, which I'll refer to as the treatment rate. This treatment rate is changing faster than we expected compared to earlier this year, and this is the reason for our revised guidance that Ian will talk about during his remarks. I'd like to describe the pattern that we've observed to provide some perspective for you on the 13 months since Incivek was approved. Soon after launch in the fall of 2011, the annualized treatment rate for all Genotype 1 patients had increased to approximately 90,000 to 105,000 patients per year, due in large part to the influx of warehouse patients seeking treatment with the newly approved DAAs. During the first four months of 2012, this treatment rate stabilized at approximately 70,000 to 75,000 Genotype 1 patients per year. The guidance range that we set in February and reiterated in April was based upon this relatively stable treatment rate, adjusted downward for anticipated seasonality and potential for fewer patients to start treatment as the year progressed as well as on our stable share of this market and our persistence rates. However, in May and June, the number of people with hepatitis C initiating any type of therapy substantially decreased by 20% to 25% when compared to the first four months of this year. We attribute this decrease in the overall hepatitis market to two main factors. First, physicians deferring treatment of patients, especially those with less advanced liver disease, following the presentation of multiple sets of mid-stage results for oral combination therapies at this year's EASL conference in April. And second, an increase in the number of ongoing and planned clinical trials in hepatitis C, which has drawn in increasing numbers of patients. The timing and impact of these factors has been difficult to predict and forecast, especially the deferral of treatment in some patients. Based on this change in treatment pattern, we are adapting our marketing efforts for Incivek and we have also revised our 2012 Incivek revenue guidance. As I mentioned, we believe that expectations of future all-oral regimens are an important factor in the decreased treatment rates we are seeing over the last few months. Therefore, I would also like to provide some perspective on Vertex's potential to participate in the evolution of these all-oral therapies. Based on the Alios data we reported today, we are moving quickly to develop all-oral regimens for hepatitis C that we believe could make a major difference for patients and be highly competitive as hepatitis C treatment continues to evolve. We're very encouraged by the clinical potency of ALS-2200. The compound has shown excellent tolerability to date. Therefore, we believe ALS-2200 could be a central component for future all-oral combination regimens. Our guiding principle in the development of all-oral regimens is that we want to do what's best for patients. Our new Alios data, coupled with the evolving regulatory pathways, opens the field for us to pursue multiple options. Our key imperatives with our all-oral development program are, first, evaluate combination regimens with our own DAAs and consider combination regimens with other companies' DAAs. And second, gather as much Phase II data as quickly as possible and in parallel to enable us to pick the best regimen or regimens to take forward into a pivotal program next year. Most specifically, our approach will be to initiate smaller Phase II studies of ALS-2200 plus multiple other therapies this year to design -- to guide the design of a pivotal trial. Given the many unknowns concerning different all-oral combinations, we believe it will be important to design our pivotal program based upon efficacy and safety data from these Phase II studies. With these Phase II data in hand in the first half of next year, we will then target the initiation of a pivotal program starting in late 2013, which we believe represents the best and shortest duration regimen or regimens for people with hepatitis C. Peter will talk more about our data and our plans in a moment. In summary, during the last year, we have seen a significant evolution in our business at Vertex. Our teams have produced a series of major clinical and commercial achievements that have markedly enhanced the foundation of the business going forward. These achievements which speak to Vertex's ability to consistently discover, develop and commercialize multiple breakthrough medicines are the foundation upon which we will build a sustainable, growing global business over the years to come. I look forward to updating you as we go. I'll now turn it over to Ian.