NASDAQ:TARS Tarsus Pharmaceuticals Q2 2024 Earnings Report $47.36 -2.94 (-5.84%) Closing price 05/2/2025 04:00 PM EasternExtended Trading$49.86 +2.50 (+5.27%) As of 05/2/2025 04:38 PM Eastern Extended trading is trading that happens on electronic markets outside of regular trading hours. This is a fair market value extended hours price provided by Polygon.io. Learn more. Earnings HistoryForecast Tarsus Pharmaceuticals EPS ResultsActual EPS-$0.88Consensus EPS -$0.98Beat/MissBeat by +$0.10One Year Ago EPS-$1.17Tarsus Pharmaceuticals Revenue ResultsActual Revenue$40.81 millionExpected Revenue$31.30 millionBeat/MissBeat by +$9.51 millionYoY Revenue GrowthN/ATarsus Pharmaceuticals Announcement DetailsQuarterQ2 2024Date8/8/2024TimeAfter Market ClosesConference Call DateThursday, August 8, 2024Conference Call Time4:30PM ETUpcoming EarningsTarsus Pharmaceuticals' Q2 2025 earnings is scheduled for Tuesday, May 6, 2025Conference Call ResourcesConference Call AudioConference Call TranscriptPress Release (8-K)Quarterly Report (10-Q)Earnings HistoryCompany ProfilePowered by Tarsus Pharmaceuticals Q2 2024 Earnings Call TranscriptProvided by QuartrAugust 8, 2024 ShareLink copied to clipboard.There are 13 speakers on the call. Operator00:00:00Good afternoon, and welcome to the Tarsus Second Quarter 2024 Financial Results Conference Call. As a reminder, this call is being recorded. At this time, I would like to turn the call over to David Nakasone, Head of Investor Relations to lead off the call. David, you may begin. Speaker 100:00:19Thank you. Before we begin, I encourage everyone to go to the Investors section Speaker 200:00:24of the Tarsus Speaker 100:00:25website to view the earnings release and related materials we will be discussing today. Joining me on the call this afternoon are Bobby Azamian, our Chief Executive Officer and Chairman Aziz Motiwala, our Chief Commercial Officer Jeff Farrow, our Chief Financial Officer and Chief Strategy Officer and joining us for the question and answer session, Seshavarvanan, our Chief Operating Officer. I'd like to draw your attention to slide 3, which contains our forward looking statements. During this call, we will be making forward looking statements that are based on our current expectations and beliefs. These statements are subject to certain risks and uncertainties, and our actual results may differ materially. Speaker 100:01:07I encourage you to consult the risk factors contained in our SEC filings for additional detail. With that, I will turn the call over to Bobby. Speaker 300:01:17Good afternoon, everyone, and thank you for joining us. I'm excited to share yet another quarter of impressive results as we continue to exceed launch expectations for XtEMBI, including our own. This call is particularly special as we have just surpassed the 1 year mark of XtEMBI being the 1st and only FDA approved therapy for the treatment of deminectalephritis or DB for short. It was an important opportunity to reflect on one of the most transformative moments in Tarsus history, while also looking forward to redoubling our efforts in this next phase of the Xtendv launch. With just 3 full launch quarters under our belt, we are well on our way to creating what we believe will be one of the largest categories in eye care based on 3 key metrics: the number of patients we are serving, the speed with which eye care providers or ECPs have adopted Xtember and the exceptional high quality payer coverage we have secured to date. Speaker 300:02:21To further accelerate our success, we are investing in an expanded sales force that we expect will be fully deployed by the end of this quarter and the planned launch of our first ever consumer television campaign later this year. You'll hear more about these plans from Aziz in a moment. But first, let's turn to our outstanding Q2 results, which include generating more than $40,000,000 in sales. That's a 65% increase over Q1 2024, delivering more than 37,000 bottles to patients, increasing traction among our target base of 15,000 ECPs. Currently, approximately 11,000 of these ECPs are prescribing XtendBI with more than 60% prescribing XtendBI to multiple patients. Speaker 300:03:15And finally, recognizing an exceptional gross to net discount of approximately 44% that reflects the unique value of Xtendv and the dedicated efforts of our market access team. As a result, we are now recording a net price of more than $1,000 per bottle. That's an impressive standard by any measure and one that is rarely seen with other front of the eye therapeutic launches. Importantly, we expect to maintain this high value throughout the remainder of 2024 with even more improvement anticipated in early 2025 when broad Medicare coverage comes online. Our mission since our founding has been to pioneer new medicines for diseases with significant unmet need. Speaker 300:04:02And while creating a new category is not easy or fast, Tarsus is doing just that. Thanks to years of research, strong clinical trial results, months of pre launch educational efforts and the relentless work of the entire team, we are delivering on the promise of a potential blockbuster. Perhaps the most exciting element is our strong belief that we are just scratching the surface of the potential of XtEMBI. We have made significant traction in reaching the roughly one point 5,000,000 patients already diagnosed with and seeking treatment for DB. This initial addressable segment alone represents a potential $1,000,000,000 market opportunity. Speaker 300:04:47Beyond that, we are already expanding into the additional segments we believe make up the remaining 5,500,000 patients who visit ECPs with complementary eye conditions, such as dry eye disease, cataracts and patients who struggle to stay in their contact lenses. Not to mention, the additional 18,000,000 patients with DB visiting ECP offices who can ultimately be served with Xtendy. Together, they represent a multibillion dollar potential opportunity. Any way you look at it, the enormous market potential of Xtendvii is clear. Millions of patients are actively seeking solutions. Speaker 300:05:33ECPs are excited by increasing adoption and utilization in the additional DB patient segments of dry eye, cataracts and contact lens users. And with the support of our field teams, more and more ECPs are moving along the continuum from trialing Xtendi to championing it as a consistent prescriber. As a physician, I really enjoy being in the field, listening and learning from our ECPs who consistently tell me about the positive impact of XtendBI on their patients. I recently met with a father daughter team in Denver whose practice has been around for 30 years. During my visit, the father couldn't wait to pull me aside to say that Xtendvii has delivered the best outcomes he's seen in his entire career. Speaker 300:06:32And the good news is, I'm hearing that same sentiment everywhere I go. Regardless of whether the ECP is an early user or an established champion, I am uniformly hearing how well XtendBI is working for their patients and every day they're finding more and more people to treat. And now with an expanded sales force entering the field and planning for our consumer television campaign underway, I am even more convinced of our ability to further accelerate the number of patients served and deliver on the promise of this novel medicine. Before I pass the call to Aziz, I want to remind you that we are simultaneously advancing a robust pipeline based on Lotelanor, the same promising antiparasitic molecule used in Xtember. We remain on track to bring our 3 programs focused on meibomian gland disease, Lyme disease prevention and rosacea to the FDA by the end of this year and look to continue creating and leading in eye diseases that have not yet been effectively served. Speaker 300:07:37With that, I'll turn the call over to our Chief Commercial Officer, Aziz Motiwala for more details on our commercial progress. Speaker 400:07:46While echoing everything Bobby just said, what a phenomenal quarter. We're obviously very pleased with the launch to date and our ability to continue delivering XtendBI to more patients in need. We're also delighted with the significant improvement in gross net discounts this quarter, which as Bobby said, reflects payer recognition of the significant value of XtendBI. This exciting development is primarily a result of contracts we secured with 2 of the 3 big commercial payers and 1 of the largest Medicare payers, which is now covering XtendBI without a prior authorization. The quality of coverage we've secured in such a brief period of time is truly remarkable and rarely seen in eye care. Speaker 400:08:24As a result, we expect the gross to net discount rate to remain relatively stable within the mid-40s through the end of the year. Another incredible outcome is the rapid level of adoption among our target ECPs that is happening much more quickly than we anticipated. As of August 7, approximately 11,000 ECPs have started patients on XtendBI with more than 60% prescribing XtendBI to multiple patients. What those numbers mean is that on average each sales rep has changed the behavior of more than 100 ECPs, all of whom are now prescribing Xtendy. This is a remarkable metric, but also a stark reminder of the importance of frequent and quality ECP interactions. Speaker 400:09:05I'm incredibly proud of the strides we've made so far with our current target of 15,000 physicians, but we know it can take an average of 5 to 10 visits to move an ECP from trialist to champion. Our current sales team is already maximizing both their time and their actions with ECPs at a level of intensity and intentionality I've never seen before. But time is a finite resource, so we need more people in the field calling on our ECPs more often. This is going to allow us to realize the full potential of Xtandi. As you know, we had always planned on a sales force expansion and the timing for executing on that plan was very well considered. Speaker 400:09:43We wanted to have a couple of strong revenue quarters under our feet, which we've now done, and we wanted to begin the expansion during a time that would be least disruptive to the business. We knew it would be a heavy lift for the sales team because we needed to take them out of the field to interview, hire, train and onboard approximately 50 new employees, all while continuing to call on their target list ECPs. I've been there before and it's really no easy feat. That's why we made the very deliberate decision to begin hiring process in the summer when ECPs, their staff and their patients typically take vacations and things generally slow down. To be clear, there's never a good time to pull your sales team out of the field, particularly with such a promotionally sensitive product. Speaker 400:10:24And you'll see some of those lost days reflected in the Q3 numbers alongside the general ECP office slowdown you see each summer. But I'm confident that once the expanded sales force is fully deployed, our strong upward trajectory will continue alongside the increasing ECP adoption of Xtendi. And with our plans to turn up the dial on our marketing efforts in Q4, we are truly pouring fuel on the fire. DV patients are highly motivated by and responsive to the visual aspects of this disease. So we're planning a hard hitting action oriented DTC TV campaign that will be key to driving in more patients to their doctors to get screened for DV. Speaker 400:11:03In closing, our tremendous results this quarter speak to the compelling value proposition of XtendBI and the power of category creation. With our expanded sales force preparing to enter the field, our anticipated consumer advertising campaign and ongoing strong payer coverage, we expect a rapid acceleration of our current momentum, a strong close to the year and continued opportunities for growth for years to come. As always, thank you so much for Speaker 500:11:29your time and interest. I will now turn the call over to Jeff Ferro, our Chief Financial Officer and Chief Strategy Officer to discuss our Q2 financial results and outlook for the Q3. Thanks, Aziz. As highlighted by the team, Q2 marked yet another exceptional quarter of strong commercial execution that generated $40,800,000 in Xtendv net product sales, driven by more than 37,000 bottles dispensed to patients. Several new and impactful payer contracts, the results of which we expect to be reflected in the gross to net discount beginning next quarter and a substantial improvement in gross to net discount of 44% compared with 55% in Q1, demonstrating a strong understanding of the disease burden by payers and their recognition of XtEMVI as the only FDA approved therapeutic for disease with high unmet need. Speaker 500:12:25The improved gross to net discount, which evolved much more quickly than we anticipated, primarily reflects the significant commercial coverage we gained during the Q2 as well as a lower estimated impact for the Medicare donut hole in this quarter. Given the general characteristics of our patient population, most of whom appear not to have as many comorbid diseases, we now expect to see more of an impact related to the donut hole in the second half of the year. Accordingly, with further commercial and Medicare coverage to come, we now anticipate our gross to net discount to range from approximately 42% to 46%, exiting 2025 at the lower end of the range. Due to the Medicare donut hole dynamic I mentioned earlier, we expect to see the potential for a 1 to 2 point increase in the gross to net discount from Q2 in the second half of this year. In other words, at the higher end of the range provided. Speaker 500:13:29Turning to our P and L. Our total operating expenses were approximately $74,800,000 for the Q2 of 2024. The sequential increase in operating expenses of approximately $9,500,000 was primarily driven by increases in the cost of sales of Xtendi due to the growing number of bottles sold and increases in selling, general and administrative expenses due to sales and marketing costs, the expanded sales force to further support the launch of Xtemv and other corporate expenses. Gross margins for the Q2 remained flat at approximately 93%, which includes the royalty and the amortization of any milestones we pay to Elanco. Finally, we ended the quarter with approximately $323,600,000 in cash and marketable securities inclusive of the approximately $40,000,000 net drawdown from the Pharmakon credit facility signed in April 2024. Speaker 500:14:36Looking ahead to the Q3, we do anticipate inventory levels will be similar to what we saw in the 2nd quarter and we expect operating expenses to increase incrementally due to the sales force expansion and other Xtendvii related marketing efforts. Additionally, and as Aziz mentioned, there are some specific dynamics in play that will likely impact our bottles dispensed, namely the very deliberate and strategic decision we made to begin the sales force expansion process during the summer. We understood that there would be some disruption as we trained and prepared these new sales representatives and leaders, And we did this to ensure we were on the ground and ready to go during some of the most productive months of the year. This resulted in us pulling some team members from the field to interview, hire and onboard the new sales force. We also anticipate the following factors could further impact our expectations for bottles dispensed. Speaker 500:15:411st, the traditional summer slowdown that occurs at ECP offices. Over the last several years, we have seen this result in a decrease in new patient bottles dispensed for eye care products in general during the Q3. 2nd, summer vacations and holidays such as the 4th July and Labor Day. With that in mind, we expect the number of bottles dispensed to patients in the Q3 to grow at a relatively modest rate of approximately 10% over Q2, meaning we expect approximately 41,000 bottles to be delivered to patients in the Q3. The vast majority of these bottles will be to new patients as we are not yet seeing the benefits of meaningful retreatment volumes. Speaker 500:16:30Now looking ahead to the Q4, we expect to see a much stronger growth trajectory in bottles dispense, resulting from our fully expanded sales team out in the field and patients making multiple ECP visits to maximize their insurance plan benefits before they reset in 2025. And finally, with the planned launch of our 1st direct to consumer television campaign, we expect our momentum to continue accelerating into 2025, when we will see the first fruits of those marketing efforts realized. In summary, we are pleased with both our ongoing launch performance and financial metrics and look forward to sharing more updates with you next quarter as we embark on the next phase of launch. I will now turn the call back to Bobby for final remarks. Speaker 300:17:22Thank you, Jeff. A couple of key messages about our launch. First, I am more confident than ever in Xtandi's growth because I hear from doctors every week, including this week where I met with several who stress how they've never seen a medicine this effective and also describe their own prescribing journey and how they see no limit on patients to diagnose and treat in their clinics. 2nd, I'm excited about the near term acceleration in serving DB patients. Starting incept to building through Q1 of 2019. Speaker 300:18:15In terms of our TB campaign, campaign, celebrating our next generation and our next generation gaming experience. I know we are just scratching the surface with Operator00:19:06first question comes from Tim Lugo with William Blair. Tim, go ahead. Your line is open. Speaker 200:19:12Thanks for taking the question and congratulations on a great quarter. Given the strong performance in the quarter and all the clarity around GTA and bottle suspense expected in Q3. I just love to hear your thoughts around what I see as consensus of about $38,800,000 or $39,000,000 for Q3. You don't need to give exact guidance obviously, but I'd love to hear your thoughts around consensus in Q3 and maybe even how it looks for Q4 as well? Speaker 500:19:52Yes, we can't explicitly provide guidance on that because we would be providing guidance on that if we did do that. If you do the math, that we see can start sometime in Q4. Speaker 200:20:20That's fine. I understand. Maybe also can you just broadly talk about when Medicare kicks in in 2025 given all the granularity on GTN in 2024, directionally is it probably going GTN maybe take the hit due to Medicare, but obviously the volumes should be at a much higher level. Can you just directionally speak to that? Speaker 400:20:47Sure, Tim. It's Ziv. Thanks for that question. Great coverage and we're really pleased with that. That's been one of the levers that's gotten us to where we are today. Speaker 400:20:59We also mentioned on the call earlier that we signed 1 large Medicare payer and that will go into effect later this year. So we're going to start to see some of that Medicare coverage this year. The remaining ones we do expect to kick in, in 2025. Speaker 600:21:13I think Speaker 400:21:13what you can expect based on that is essentially stable gross to net between now and the end of the year Speaker 200:21:28All right. Thank you so much. Operator00:21:34Thank you. Stand by for our next question. Next question comes from Bhavan Patel with BofA. Please go ahead. Your line is open. Speaker 700:21:47Hey, guys. This is Bhavan on for Jason Gerberry. Two questions from us. Firstly, appreciate the commentary for full year 2024 gross to net discounts. I was wondering if the longer term gross to net discounts, you expect to be in a steady state here at the low 40s Or is it likely to evolve as payer mix changes and you gain further coverage in 2025 and beyond? Speaker 700:22:13And then my second question is regarding your DTC efforts. So when do you kick those off and how soon would you expect to see benefit from that inpatient uptake? Thank you. Speaker 500:22:28Happy to take the first part of the question over to Aziz to talk about the DTC. So what we anticipate is a slight increase in the gross to net discount as I had mentioned given the doughnut hole issue where we're seeing essentially more patients coming in Q3 and we anticipate that to be in Q4. Of course, in Q1 of every year, you get co pays reset and so frequently there's a larger gross to net discount in that Q1 period. And then subsequent to that, in 2025, we expect that to improve sequentially to be sort of at say 42% -ish the low end of the range we provided and that should be pretty consistent with our long term gross to net discount beyond Speaker 400:23:162025. Great. And then in terms of the DTC question, so anticipate that launching sometime in Q4. You'll see some impact of that this year. But as you can imagine, it takes a few repetitions for the patients to be out a couple of times. Speaker 400:23:31And we think you'll start to see some impact this year, but you really start to see that really take hold as we scale that effort into next year. Operator00:23:45Thank you. Stand by for our next question. The next question comes from Corey Jubanville with Life Science Capital. Go ahead. Your line is open. Speaker 800:23:57Hey, this is Dennis on for Corey. Congrats on the quarter and thank you for taking our question. As we near 2025 and we start to think about kind of the retreatment dynamics here, Do you have any indication as to which patient profile is more likely to experience a reinfestation that calls for retreatment? And in your view, kind of what percent of DV patients will ultimately require 1 or more courses of Xtend B long term? Speaker 400:24:29Yes. Thanks for that question. So, as you can imagine, it's still relatively early in terms of the retreatment volumes. I think if you look at the IQVIA data, low dose digit rate of early 2025. A little bit more color into which the patients get treated again sooner and which types of patients may have more durability with the drug. Speaker 400:24:56In terms of what we expect to see long term, if you go back to our Phase 3 studies in the follow-up we did, about 40% of the patients recur at month 12. So you can expect some proportion of those patients will get retreated over time. And again, that's something that will scale over time. I don't think about it as a step up, but essentially something that scales over time as patients get more and more sorry, as physicians get more and more experience with the drug, the patients come back and then doctors will get their groove of how they want to retreat. So I think the short answer is it's still very early. Speaker 400:25:28We expect to see retreatment volumes start to be more meaningful in 2025. And once we start to see that we'll be able to dig in and really understand the dynamics there. Operator00:25:46Next question comes from the line of Andrea Tan with Goldman Sachs. Go ahead. Your line is open. Speaker 900:25:53Hi, all. This is Tawani on for Andrea. Congrats on the quarter and thanks for taking our questions. A couple from us here. The first, characterize a little bit more about the quarterly growth and the number of ECPs to date, especially in the context of penetrating the more, the eager doctors and the new DB segments? Speaker 900:26:08And could you share the feedback that you've been getting on the disease education efforts from those providers? Speaker 400:26:16Sure. Thanks, Talani for that question. And when you look at the performance to date, I think one of the highlights has really been the performance of Xtandi. It's very unique in terms of the wow effect it has for patients. And I think that's something that's really gotten the physician community very excited. Speaker 400:26:30I think that's one of the reasons we've seen a continuing scaling in our ECP adoption with over approximately 11,000 doctors writing prescriptions at this point. So really speaks to the broad appeal of the drug and the utility it has in practice. In terms of getting beyond from early treaters to those different segments, I think there's 2 factors that really drive this. 1 is physicians getting their experience, right. As they continue to get experience seeing that while affecting their practice, they start to think about using the product more broadly. Speaker 400:27:00So they typically start with a typical diabetic blepharitis patient, they see a handful of cases, they see the results and then they start to think about other patient segments that really expand the utilization in the practice. So you can think about per se a recalcitrant dry patient or proactively screening their cataract patients. So that's a level of experience that the doctor gets that really potentiates further use. The other factor that is repeat visits from the sales force. Hearing that message again and again and to your point, the feedback on the education has been very positive and the physicians are very receptive. Speaker 400:27:34And we have so many of them that want to hear it and our sales force can only get to them so many times. And that's why we're really excited about the sales force expansion. This is really going to create some capacity for our team to see these doctors more often, repeat that message, be that constant reminder and provide that staff support to really facilitate that broadening utilization in the practice. So the two factors I think that are key here are getting those doctors multiple shots on goal and seeing that consistent response in the patient and then hearing that message in disease education on the last the last piece I'll add is the role of DTC here, empowering the patient and having the patient sort of raise their hand, if you will, and proactively bring this up will further enhance this dynamic as well. Operator00:28:29One moment for our next question. Next question comes from Frank Brevoie with Oppenheimer. Please go ahead. Your line is open. Speaker 600:28:40Thanks for the question and congrats on the quarter. I was just wondering in terms of practices, is it a question of I'm sure at first there's some practices where physicians were a little more skeptical at first and then so maybe they try one patient or 2 patients and see how it works. Is it one of those situations where all of a sudden they are convinced that this is working and they just switch the entire practice to say, hey, make sure you look for these in the foot lamp on every patient? Or is it more of a progressive, let's wait and see on the patient feedback and it's more the patient starting the conversation? Just what are the dynamics there? Speaker 600:29:22Thank you. Speaker 400:29:24Hey, Frank, it's Aziz. Yes, it's a great question. 1, we see a lot of when we're in the field and when we dig into a lot as well. And I think what you see is that physicians are very curious that the drug is obviously getting a lot of attention in the space. So you do get doctors that want to write those first few cases. Speaker 400:29:40I think the it varies by doctors. So you have some doctors that get those first few cases, they see the results, they see the consistency and predictability and they implement it in their practice. I would say even with those doctors in many cases we're just scratching the surface because they're looking for it in certain areas, but they could be looking for it in other areas. And that's where our sales team plays a key role. You do have some doctors that take a little bit more time as you can imagine. Speaker 400:30:03And in those cases, they want to see a handful more cases and typically it's about 10 cases or so where they really hit that tipping point. And then what I think happens is they start to look by segment. So I think the average physician doesn't just say, okay, I'm going to wholesale change the practice over. They say, okay, I'm having great results with these patients. Who's the next patient? Speaker 400:30:22Okay, recalcitrant dry patient, I've got dry patients that are in the practice that are cycling through meds. Let me look at their lids. Okay, I've got great success there. All right. Now let me look at my cataract patients and maybe start with premium cataracts and then broaden it. Speaker 400:30:36So there's definitely a stepwise approach in which physicians adopt. And as we mentioned earlier, how can we facilitate that happening more quickly and that's really getting in front of the doctor more have some observations here as well. Yes. Just to echo, what I hear time as some observations Speaker 200:30:55here as well. Speaker 1000:30:55Yes. Just to echo, what I hear time and again is doctors to your point, Frank, they get experience with the medicine and then they're just amazed. I have not heard a doctor say, it didn't work on this 1 or 2 patients. And that's just wind in our sails. And obviously, when a doctor is able to deliver that to one of their patients, that gives them even more confidence. Speaker 1000:31:19And then the other thing I hear time and again is the diagnosis becomes easier, the conversation becomes easier, doctors start looking for other patients with different reasons to treat than perhaps the first few. And that's those additional segments that as you described. So I think we're in this very positive loop of doctors getting great experience and then looking for more and more of their patients and very notably not finding that they have reached a limit in finding patients in their own clinics they can serve. And that's high volume practices that are early adopters, but also more rural single practices that are not typically the early adopters. And to get 11,000 to 15,000 at this point means that we've had a very meaningful impact on educating a broad swath of this community. Speaker 600:32:09Are you getting any doctors that are admitting that maybe they weren't looking correctly in the past? Or is that not coming up Speaker 500:32:20with the physicians? Speaker 400:32:22We hear that all the time. It's actually one of the most fun parts of the job, right, as doctors. And I think it's this value of category creation, right, as you hear that we're solving a problem that was being missed. And I think that's a really compelling piece of it. I think it's obviously very rewarding for us to hear that we're able to change how things are being practiced and change the outcomes for these patients. Speaker 400:32:42But I think it's also very compelling when doctors hear that from their colleagues at the conferences and on the podium. And that's one of the most compelling parts of the story is, hey, did you know we were missing this and now we have a very clear and impactful solution that gets consistent and predictable results. And I always say that's sort of the invisible hand on this launch is the physician testimonial. The doctors getting up on podium and talking about their positive experience to Bobby's point, this drug doesn't disappoint. The results are almost always consistent and patients come back with clear healthy lids and becomes a very compelling story for us to hear, but more importantly it becomes a compelling story for other doctors to hear from their colleagues. Speaker 400:33:23So that's a really exciting part of the launch that does underpin the rapid adoption we've seen. Speaker 1000:33:28And we're doing that right as these across so many of our efforts, whether it's marketing or medical affairs. The peer to peer engagement here is another powerful amplifier of spreading the word. Speaker 600:33:44That's it for me. Thank you very much and congrats on a great quarter. Operator00:33:48One moment for our next question. The next question comes from the line of Balaji Prasad with Barclays. Go ahead. Your line is open. Speaker 1100:33:57Hi. This is Mikaela on for Balaji. Thanks for taking our questions. Just wondering of the 11,000 prescribers you called out, are you able to actually quantify the portion that fall into the 3 buckets you called out? So how looking to understand how many are early adopters versus newer to DV at this point? Speaker 1100:34:15Thanks. Speaker 400:34:17Yes. Thanks for the question, Mikaela. So obviously, we cut the data lots of ways. As you can imagine, it's very dynamic. So we don't go into that level of detail in this forum. Speaker 400:34:28But I think our focus is to say, okay, for each of these doctors, we've gotten to 11,000 of the 15,000. So we've gotten to the vast majority. Our focus is really going to be now how do we start to pull those doctors from folks that are just getting that early experience. What we talked about earlier, which is becoming routine writers, routine prescribers and how do we increase our frequency with our sales force expansion to facilitate that. So I think the way we think about this going forward is we've got a great prescriber base established and now the focus is going to be on that depth of prescribing that enhanced utilization within the practice in that prescriber base. Speaker 400:35:03So the segmentation of the doctor becomes a little less important in terms of where they came from, but more important on where we think they're going to go in the future and how we can continue to move the needle there. Operator00:35:23The next question comes from Eddie Hickman with Guggenheim Securities. Go ahead. Your line is open. Speaker 1200:35:29Hey, good afternoon and congrats on the great quarter. Thanks for taking my question. So I appreciate the added color on the 3rd and 4th quarter dynamics in terms of bottle growth. But I'm wondering if you could help us think about 2025 and what the bottle growth should look like with the fully deployed sales force and DTC. It sounds like 4Q is going to be pretty strong. Speaker 1200:35:45So I'm wondering like how many quarters beyond that do you expect that level of growth before it studies out? And then on the summer holiday slowdown, like is that unique to this early part of the launch or do you think that to be an annual pattern? Thanks. Speaker 500:35:59Hi, Eddie. It's Jeff. Maybe I'll answer your first question or second question first. It's a little early for us to know if it's specific to us annually, but we did note in general for eye care products that there was a slump in new RXs during the Q3. So it's probably likely we'll see a similar effect in the Q3. Speaker 500:36:18But again, we don't have a whole lot of history for Xtandi at this point. In terms of your question in 2025, I think there's a couple dynamics that we will continue to see impressive growth beyond the 4th quarter. One will be the full deployment and we'll see some of the impact of the direct to consumer campaign, meaning streaming TV, potentially network TV should continue and should help drive patients in to go see their docs. And then secondly, as the sales force incremental sales force begins to continue to get online and continue to have those frequency of visits, we expect that growth to continue as a result of that. So we continue to see quarter over quarter growth throughout 2025. Operator00:37:11I'm showing no further questions at this time. Thank you for your participation in today's conference. This does conclude the program. You may now disconnect.Read morePowered by Conference Call Audio Live Call not available Earnings Conference CallTarsus Pharmaceuticals Q2 202400:00 / 00:00Speed:1x1.25x1.5x2x Earnings DocumentsPress Release(8-K)Quarterly report(10-Q) Tarsus Pharmaceuticals Earnings HeadlinesTarsus Pharmaceuticals’ Earnings Call Highlights Robust GrowthMay 2 at 9:48 PM | tipranks.comTarsus Pharmaceuticals anticipates 85,000-90,000 XDEMVY bottles dispensed in Q2 2025 amid expanded DTC campaignMay 2 at 10:55 AM | msn.comBuffett’s favorite chart just hit 209% – here’s what that means for goldA Historic Gold Announcement Is About to Rock Wall Street For months, sharp-eyed analysts have watched the quiet buildup behind the scenes. Now, in just days, the floodgates are set to open. The greatest investor of all time is about to validate what Garrett Goggin has been saying for months: Gold is entering a once-in-a-generation mania. Front-running Buffett has never been more urgent — and four tiny miners could be your ticket to 100X gains.May 3, 2025 | Golden Portfolio (Ad)Tarsus Pharmaceuticals, Inc. (TARS) Q1 2025 Earnings Call TranscriptMay 1 at 10:06 PM | seekingalpha.comTarsus Pharmaceuticals, Inc. 2025 Q1 - Results - Earnings Call PresentationMay 1 at 6:24 PM | seekingalpha.comTarsus Reports First Quarter 2025 Financial Results and Recent Business AchievementsMay 1 at 4:17 PM | globenewswire.comSee More Tarsus Pharmaceuticals Headlines Get Earnings Announcements in your inboxWant to stay updated on the latest earnings announcements and upcoming reports for companies like Tarsus Pharmaceuticals? Sign up for Earnings360's daily newsletter to receive timely earnings updates on Tarsus Pharmaceuticals and other key companies, straight to your email. Email Address About Tarsus PharmaceuticalsTarsus Pharmaceuticals (NASDAQ:TARS), a commercial stage biopharmaceutical company, focuses on the development and commercialization of novel therapeutic candidates for eye care in the United States. The company's lead product candidate is XDEMVY, a novel therapeutic for the treatment of blepharitis caused by the infestation of Demodex mites, as well as to treat meibomian gland disease. It is developing TP-04 for the treatment of rosacea; and TP-05 for Lyme prophylaxis and community malaria reduction. In addition, the company develops lotilaner to address diseases across therapeutic categories in human medicine, including eye care, dermatology, and other infectious disease prevention. 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There are 13 speakers on the call. Operator00:00:00Good afternoon, and welcome to the Tarsus Second Quarter 2024 Financial Results Conference Call. As a reminder, this call is being recorded. At this time, I would like to turn the call over to David Nakasone, Head of Investor Relations to lead off the call. David, you may begin. Speaker 100:00:19Thank you. Before we begin, I encourage everyone to go to the Investors section Speaker 200:00:24of the Tarsus Speaker 100:00:25website to view the earnings release and related materials we will be discussing today. Joining me on the call this afternoon are Bobby Azamian, our Chief Executive Officer and Chairman Aziz Motiwala, our Chief Commercial Officer Jeff Farrow, our Chief Financial Officer and Chief Strategy Officer and joining us for the question and answer session, Seshavarvanan, our Chief Operating Officer. I'd like to draw your attention to slide 3, which contains our forward looking statements. During this call, we will be making forward looking statements that are based on our current expectations and beliefs. These statements are subject to certain risks and uncertainties, and our actual results may differ materially. Speaker 100:01:07I encourage you to consult the risk factors contained in our SEC filings for additional detail. With that, I will turn the call over to Bobby. Speaker 300:01:17Good afternoon, everyone, and thank you for joining us. I'm excited to share yet another quarter of impressive results as we continue to exceed launch expectations for XtEMBI, including our own. This call is particularly special as we have just surpassed the 1 year mark of XtEMBI being the 1st and only FDA approved therapy for the treatment of deminectalephritis or DB for short. It was an important opportunity to reflect on one of the most transformative moments in Tarsus history, while also looking forward to redoubling our efforts in this next phase of the Xtendv launch. With just 3 full launch quarters under our belt, we are well on our way to creating what we believe will be one of the largest categories in eye care based on 3 key metrics: the number of patients we are serving, the speed with which eye care providers or ECPs have adopted Xtember and the exceptional high quality payer coverage we have secured to date. Speaker 300:02:21To further accelerate our success, we are investing in an expanded sales force that we expect will be fully deployed by the end of this quarter and the planned launch of our first ever consumer television campaign later this year. You'll hear more about these plans from Aziz in a moment. But first, let's turn to our outstanding Q2 results, which include generating more than $40,000,000 in sales. That's a 65% increase over Q1 2024, delivering more than 37,000 bottles to patients, increasing traction among our target base of 15,000 ECPs. Currently, approximately 11,000 of these ECPs are prescribing XtendBI with more than 60% prescribing XtendBI to multiple patients. Speaker 300:03:15And finally, recognizing an exceptional gross to net discount of approximately 44% that reflects the unique value of Xtendv and the dedicated efforts of our market access team. As a result, we are now recording a net price of more than $1,000 per bottle. That's an impressive standard by any measure and one that is rarely seen with other front of the eye therapeutic launches. Importantly, we expect to maintain this high value throughout the remainder of 2024 with even more improvement anticipated in early 2025 when broad Medicare coverage comes online. Our mission since our founding has been to pioneer new medicines for diseases with significant unmet need. Speaker 300:04:02And while creating a new category is not easy or fast, Tarsus is doing just that. Thanks to years of research, strong clinical trial results, months of pre launch educational efforts and the relentless work of the entire team, we are delivering on the promise of a potential blockbuster. Perhaps the most exciting element is our strong belief that we are just scratching the surface of the potential of XtEMBI. We have made significant traction in reaching the roughly one point 5,000,000 patients already diagnosed with and seeking treatment for DB. This initial addressable segment alone represents a potential $1,000,000,000 market opportunity. Speaker 300:04:47Beyond that, we are already expanding into the additional segments we believe make up the remaining 5,500,000 patients who visit ECPs with complementary eye conditions, such as dry eye disease, cataracts and patients who struggle to stay in their contact lenses. Not to mention, the additional 18,000,000 patients with DB visiting ECP offices who can ultimately be served with Xtendy. Together, they represent a multibillion dollar potential opportunity. Any way you look at it, the enormous market potential of Xtendvii is clear. Millions of patients are actively seeking solutions. Speaker 300:05:33ECPs are excited by increasing adoption and utilization in the additional DB patient segments of dry eye, cataracts and contact lens users. And with the support of our field teams, more and more ECPs are moving along the continuum from trialing Xtendi to championing it as a consistent prescriber. As a physician, I really enjoy being in the field, listening and learning from our ECPs who consistently tell me about the positive impact of XtendBI on their patients. I recently met with a father daughter team in Denver whose practice has been around for 30 years. During my visit, the father couldn't wait to pull me aside to say that Xtendvii has delivered the best outcomes he's seen in his entire career. Speaker 300:06:32And the good news is, I'm hearing that same sentiment everywhere I go. Regardless of whether the ECP is an early user or an established champion, I am uniformly hearing how well XtendBI is working for their patients and every day they're finding more and more people to treat. And now with an expanded sales force entering the field and planning for our consumer television campaign underway, I am even more convinced of our ability to further accelerate the number of patients served and deliver on the promise of this novel medicine. Before I pass the call to Aziz, I want to remind you that we are simultaneously advancing a robust pipeline based on Lotelanor, the same promising antiparasitic molecule used in Xtember. We remain on track to bring our 3 programs focused on meibomian gland disease, Lyme disease prevention and rosacea to the FDA by the end of this year and look to continue creating and leading in eye diseases that have not yet been effectively served. Speaker 300:07:37With that, I'll turn the call over to our Chief Commercial Officer, Aziz Motiwala for more details on our commercial progress. Speaker 400:07:46While echoing everything Bobby just said, what a phenomenal quarter. We're obviously very pleased with the launch to date and our ability to continue delivering XtendBI to more patients in need. We're also delighted with the significant improvement in gross net discounts this quarter, which as Bobby said, reflects payer recognition of the significant value of XtendBI. This exciting development is primarily a result of contracts we secured with 2 of the 3 big commercial payers and 1 of the largest Medicare payers, which is now covering XtendBI without a prior authorization. The quality of coverage we've secured in such a brief period of time is truly remarkable and rarely seen in eye care. Speaker 400:08:24As a result, we expect the gross to net discount rate to remain relatively stable within the mid-40s through the end of the year. Another incredible outcome is the rapid level of adoption among our target ECPs that is happening much more quickly than we anticipated. As of August 7, approximately 11,000 ECPs have started patients on XtendBI with more than 60% prescribing XtendBI to multiple patients. What those numbers mean is that on average each sales rep has changed the behavior of more than 100 ECPs, all of whom are now prescribing Xtendy. This is a remarkable metric, but also a stark reminder of the importance of frequent and quality ECP interactions. Speaker 400:09:05I'm incredibly proud of the strides we've made so far with our current target of 15,000 physicians, but we know it can take an average of 5 to 10 visits to move an ECP from trialist to champion. Our current sales team is already maximizing both their time and their actions with ECPs at a level of intensity and intentionality I've never seen before. But time is a finite resource, so we need more people in the field calling on our ECPs more often. This is going to allow us to realize the full potential of Xtandi. As you know, we had always planned on a sales force expansion and the timing for executing on that plan was very well considered. Speaker 400:09:43We wanted to have a couple of strong revenue quarters under our feet, which we've now done, and we wanted to begin the expansion during a time that would be least disruptive to the business. We knew it would be a heavy lift for the sales team because we needed to take them out of the field to interview, hire, train and onboard approximately 50 new employees, all while continuing to call on their target list ECPs. I've been there before and it's really no easy feat. That's why we made the very deliberate decision to begin hiring process in the summer when ECPs, their staff and their patients typically take vacations and things generally slow down. To be clear, there's never a good time to pull your sales team out of the field, particularly with such a promotionally sensitive product. Speaker 400:10:24And you'll see some of those lost days reflected in the Q3 numbers alongside the general ECP office slowdown you see each summer. But I'm confident that once the expanded sales force is fully deployed, our strong upward trajectory will continue alongside the increasing ECP adoption of Xtendi. And with our plans to turn up the dial on our marketing efforts in Q4, we are truly pouring fuel on the fire. DV patients are highly motivated by and responsive to the visual aspects of this disease. So we're planning a hard hitting action oriented DTC TV campaign that will be key to driving in more patients to their doctors to get screened for DV. Speaker 400:11:03In closing, our tremendous results this quarter speak to the compelling value proposition of XtendBI and the power of category creation. With our expanded sales force preparing to enter the field, our anticipated consumer advertising campaign and ongoing strong payer coverage, we expect a rapid acceleration of our current momentum, a strong close to the year and continued opportunities for growth for years to come. As always, thank you so much for Speaker 500:11:29your time and interest. I will now turn the call over to Jeff Ferro, our Chief Financial Officer and Chief Strategy Officer to discuss our Q2 financial results and outlook for the Q3. Thanks, Aziz. As highlighted by the team, Q2 marked yet another exceptional quarter of strong commercial execution that generated $40,800,000 in Xtendv net product sales, driven by more than 37,000 bottles dispensed to patients. Several new and impactful payer contracts, the results of which we expect to be reflected in the gross to net discount beginning next quarter and a substantial improvement in gross to net discount of 44% compared with 55% in Q1, demonstrating a strong understanding of the disease burden by payers and their recognition of XtEMVI as the only FDA approved therapeutic for disease with high unmet need. Speaker 500:12:25The improved gross to net discount, which evolved much more quickly than we anticipated, primarily reflects the significant commercial coverage we gained during the Q2 as well as a lower estimated impact for the Medicare donut hole in this quarter. Given the general characteristics of our patient population, most of whom appear not to have as many comorbid diseases, we now expect to see more of an impact related to the donut hole in the second half of the year. Accordingly, with further commercial and Medicare coverage to come, we now anticipate our gross to net discount to range from approximately 42% to 46%, exiting 2025 at the lower end of the range. Due to the Medicare donut hole dynamic I mentioned earlier, we expect to see the potential for a 1 to 2 point increase in the gross to net discount from Q2 in the second half of this year. In other words, at the higher end of the range provided. Speaker 500:13:29Turning to our P and L. Our total operating expenses were approximately $74,800,000 for the Q2 of 2024. The sequential increase in operating expenses of approximately $9,500,000 was primarily driven by increases in the cost of sales of Xtendi due to the growing number of bottles sold and increases in selling, general and administrative expenses due to sales and marketing costs, the expanded sales force to further support the launch of Xtemv and other corporate expenses. Gross margins for the Q2 remained flat at approximately 93%, which includes the royalty and the amortization of any milestones we pay to Elanco. Finally, we ended the quarter with approximately $323,600,000 in cash and marketable securities inclusive of the approximately $40,000,000 net drawdown from the Pharmakon credit facility signed in April 2024. Speaker 500:14:36Looking ahead to the Q3, we do anticipate inventory levels will be similar to what we saw in the 2nd quarter and we expect operating expenses to increase incrementally due to the sales force expansion and other Xtendvii related marketing efforts. Additionally, and as Aziz mentioned, there are some specific dynamics in play that will likely impact our bottles dispensed, namely the very deliberate and strategic decision we made to begin the sales force expansion process during the summer. We understood that there would be some disruption as we trained and prepared these new sales representatives and leaders, And we did this to ensure we were on the ground and ready to go during some of the most productive months of the year. This resulted in us pulling some team members from the field to interview, hire and onboard the new sales force. We also anticipate the following factors could further impact our expectations for bottles dispensed. Speaker 500:15:411st, the traditional summer slowdown that occurs at ECP offices. Over the last several years, we have seen this result in a decrease in new patient bottles dispensed for eye care products in general during the Q3. 2nd, summer vacations and holidays such as the 4th July and Labor Day. With that in mind, we expect the number of bottles dispensed to patients in the Q3 to grow at a relatively modest rate of approximately 10% over Q2, meaning we expect approximately 41,000 bottles to be delivered to patients in the Q3. The vast majority of these bottles will be to new patients as we are not yet seeing the benefits of meaningful retreatment volumes. Speaker 500:16:30Now looking ahead to the Q4, we expect to see a much stronger growth trajectory in bottles dispense, resulting from our fully expanded sales team out in the field and patients making multiple ECP visits to maximize their insurance plan benefits before they reset in 2025. And finally, with the planned launch of our 1st direct to consumer television campaign, we expect our momentum to continue accelerating into 2025, when we will see the first fruits of those marketing efforts realized. In summary, we are pleased with both our ongoing launch performance and financial metrics and look forward to sharing more updates with you next quarter as we embark on the next phase of launch. I will now turn the call back to Bobby for final remarks. Speaker 300:17:22Thank you, Jeff. A couple of key messages about our launch. First, I am more confident than ever in Xtandi's growth because I hear from doctors every week, including this week where I met with several who stress how they've never seen a medicine this effective and also describe their own prescribing journey and how they see no limit on patients to diagnose and treat in their clinics. 2nd, I'm excited about the near term acceleration in serving DB patients. Starting incept to building through Q1 of 2019. Speaker 300:18:15In terms of our TB campaign, campaign, celebrating our next generation and our next generation gaming experience. I know we are just scratching the surface with Operator00:19:06first question comes from Tim Lugo with William Blair. Tim, go ahead. Your line is open. Speaker 200:19:12Thanks for taking the question and congratulations on a great quarter. Given the strong performance in the quarter and all the clarity around GTA and bottle suspense expected in Q3. I just love to hear your thoughts around what I see as consensus of about $38,800,000 or $39,000,000 for Q3. You don't need to give exact guidance obviously, but I'd love to hear your thoughts around consensus in Q3 and maybe even how it looks for Q4 as well? Speaker 500:19:52Yes, we can't explicitly provide guidance on that because we would be providing guidance on that if we did do that. If you do the math, that we see can start sometime in Q4. Speaker 200:20:20That's fine. I understand. Maybe also can you just broadly talk about when Medicare kicks in in 2025 given all the granularity on GTN in 2024, directionally is it probably going GTN maybe take the hit due to Medicare, but obviously the volumes should be at a much higher level. Can you just directionally speak to that? Speaker 400:20:47Sure, Tim. It's Ziv. Thanks for that question. Great coverage and we're really pleased with that. That's been one of the levers that's gotten us to where we are today. Speaker 400:20:59We also mentioned on the call earlier that we signed 1 large Medicare payer and that will go into effect later this year. So we're going to start to see some of that Medicare coverage this year. The remaining ones we do expect to kick in, in 2025. Speaker 600:21:13I think Speaker 400:21:13what you can expect based on that is essentially stable gross to net between now and the end of the year Speaker 200:21:28All right. Thank you so much. Operator00:21:34Thank you. Stand by for our next question. Next question comes from Bhavan Patel with BofA. Please go ahead. Your line is open. Speaker 700:21:47Hey, guys. This is Bhavan on for Jason Gerberry. Two questions from us. Firstly, appreciate the commentary for full year 2024 gross to net discounts. I was wondering if the longer term gross to net discounts, you expect to be in a steady state here at the low 40s Or is it likely to evolve as payer mix changes and you gain further coverage in 2025 and beyond? Speaker 700:22:13And then my second question is regarding your DTC efforts. So when do you kick those off and how soon would you expect to see benefit from that inpatient uptake? Thank you. Speaker 500:22:28Happy to take the first part of the question over to Aziz to talk about the DTC. So what we anticipate is a slight increase in the gross to net discount as I had mentioned given the doughnut hole issue where we're seeing essentially more patients coming in Q3 and we anticipate that to be in Q4. Of course, in Q1 of every year, you get co pays reset and so frequently there's a larger gross to net discount in that Q1 period. And then subsequent to that, in 2025, we expect that to improve sequentially to be sort of at say 42% -ish the low end of the range we provided and that should be pretty consistent with our long term gross to net discount beyond Speaker 400:23:162025. Great. And then in terms of the DTC question, so anticipate that launching sometime in Q4. You'll see some impact of that this year. But as you can imagine, it takes a few repetitions for the patients to be out a couple of times. Speaker 400:23:31And we think you'll start to see some impact this year, but you really start to see that really take hold as we scale that effort into next year. Operator00:23:45Thank you. Stand by for our next question. The next question comes from Corey Jubanville with Life Science Capital. Go ahead. Your line is open. Speaker 800:23:57Hey, this is Dennis on for Corey. Congrats on the quarter and thank you for taking our question. As we near 2025 and we start to think about kind of the retreatment dynamics here, Do you have any indication as to which patient profile is more likely to experience a reinfestation that calls for retreatment? And in your view, kind of what percent of DV patients will ultimately require 1 or more courses of Xtend B long term? Speaker 400:24:29Yes. Thanks for that question. So, as you can imagine, it's still relatively early in terms of the retreatment volumes. I think if you look at the IQVIA data, low dose digit rate of early 2025. A little bit more color into which the patients get treated again sooner and which types of patients may have more durability with the drug. Speaker 400:24:56In terms of what we expect to see long term, if you go back to our Phase 3 studies in the follow-up we did, about 40% of the patients recur at month 12. So you can expect some proportion of those patients will get retreated over time. And again, that's something that will scale over time. I don't think about it as a step up, but essentially something that scales over time as patients get more and more sorry, as physicians get more and more experience with the drug, the patients come back and then doctors will get their groove of how they want to retreat. So I think the short answer is it's still very early. Speaker 400:25:28We expect to see retreatment volumes start to be more meaningful in 2025. And once we start to see that we'll be able to dig in and really understand the dynamics there. Operator00:25:46Next question comes from the line of Andrea Tan with Goldman Sachs. Go ahead. Your line is open. Speaker 900:25:53Hi, all. This is Tawani on for Andrea. Congrats on the quarter and thanks for taking our questions. A couple from us here. The first, characterize a little bit more about the quarterly growth and the number of ECPs to date, especially in the context of penetrating the more, the eager doctors and the new DB segments? Speaker 900:26:08And could you share the feedback that you've been getting on the disease education efforts from those providers? Speaker 400:26:16Sure. Thanks, Talani for that question. And when you look at the performance to date, I think one of the highlights has really been the performance of Xtandi. It's very unique in terms of the wow effect it has for patients. And I think that's something that's really gotten the physician community very excited. Speaker 400:26:30I think that's one of the reasons we've seen a continuing scaling in our ECP adoption with over approximately 11,000 doctors writing prescriptions at this point. So really speaks to the broad appeal of the drug and the utility it has in practice. In terms of getting beyond from early treaters to those different segments, I think there's 2 factors that really drive this. 1 is physicians getting their experience, right. As they continue to get experience seeing that while affecting their practice, they start to think about using the product more broadly. Speaker 400:27:00So they typically start with a typical diabetic blepharitis patient, they see a handful of cases, they see the results and then they start to think about other patient segments that really expand the utilization in the practice. So you can think about per se a recalcitrant dry patient or proactively screening their cataract patients. So that's a level of experience that the doctor gets that really potentiates further use. The other factor that is repeat visits from the sales force. Hearing that message again and again and to your point, the feedback on the education has been very positive and the physicians are very receptive. Speaker 400:27:34And we have so many of them that want to hear it and our sales force can only get to them so many times. And that's why we're really excited about the sales force expansion. This is really going to create some capacity for our team to see these doctors more often, repeat that message, be that constant reminder and provide that staff support to really facilitate that broadening utilization in the practice. So the two factors I think that are key here are getting those doctors multiple shots on goal and seeing that consistent response in the patient and then hearing that message in disease education on the last the last piece I'll add is the role of DTC here, empowering the patient and having the patient sort of raise their hand, if you will, and proactively bring this up will further enhance this dynamic as well. Operator00:28:29One moment for our next question. Next question comes from Frank Brevoie with Oppenheimer. Please go ahead. Your line is open. Speaker 600:28:40Thanks for the question and congrats on the quarter. I was just wondering in terms of practices, is it a question of I'm sure at first there's some practices where physicians were a little more skeptical at first and then so maybe they try one patient or 2 patients and see how it works. Is it one of those situations where all of a sudden they are convinced that this is working and they just switch the entire practice to say, hey, make sure you look for these in the foot lamp on every patient? Or is it more of a progressive, let's wait and see on the patient feedback and it's more the patient starting the conversation? Just what are the dynamics there? Speaker 600:29:22Thank you. Speaker 400:29:24Hey, Frank, it's Aziz. Yes, it's a great question. 1, we see a lot of when we're in the field and when we dig into a lot as well. And I think what you see is that physicians are very curious that the drug is obviously getting a lot of attention in the space. So you do get doctors that want to write those first few cases. Speaker 400:29:40I think the it varies by doctors. So you have some doctors that get those first few cases, they see the results, they see the consistency and predictability and they implement it in their practice. I would say even with those doctors in many cases we're just scratching the surface because they're looking for it in certain areas, but they could be looking for it in other areas. And that's where our sales team plays a key role. You do have some doctors that take a little bit more time as you can imagine. Speaker 400:30:03And in those cases, they want to see a handful more cases and typically it's about 10 cases or so where they really hit that tipping point. And then what I think happens is they start to look by segment. So I think the average physician doesn't just say, okay, I'm going to wholesale change the practice over. They say, okay, I'm having great results with these patients. Who's the next patient? Speaker 400:30:22Okay, recalcitrant dry patient, I've got dry patients that are in the practice that are cycling through meds. Let me look at their lids. Okay, I've got great success there. All right. Now let me look at my cataract patients and maybe start with premium cataracts and then broaden it. Speaker 400:30:36So there's definitely a stepwise approach in which physicians adopt. And as we mentioned earlier, how can we facilitate that happening more quickly and that's really getting in front of the doctor more have some observations here as well. Yes. Just to echo, what I hear time as some observations Speaker 200:30:55here as well. Speaker 1000:30:55Yes. Just to echo, what I hear time and again is doctors to your point, Frank, they get experience with the medicine and then they're just amazed. I have not heard a doctor say, it didn't work on this 1 or 2 patients. And that's just wind in our sails. And obviously, when a doctor is able to deliver that to one of their patients, that gives them even more confidence. Speaker 1000:31:19And then the other thing I hear time and again is the diagnosis becomes easier, the conversation becomes easier, doctors start looking for other patients with different reasons to treat than perhaps the first few. And that's those additional segments that as you described. So I think we're in this very positive loop of doctors getting great experience and then looking for more and more of their patients and very notably not finding that they have reached a limit in finding patients in their own clinics they can serve. And that's high volume practices that are early adopters, but also more rural single practices that are not typically the early adopters. And to get 11,000 to 15,000 at this point means that we've had a very meaningful impact on educating a broad swath of this community. Speaker 600:32:09Are you getting any doctors that are admitting that maybe they weren't looking correctly in the past? Or is that not coming up Speaker 500:32:20with the physicians? Speaker 400:32:22We hear that all the time. It's actually one of the most fun parts of the job, right, as doctors. And I think it's this value of category creation, right, as you hear that we're solving a problem that was being missed. And I think that's a really compelling piece of it. I think it's obviously very rewarding for us to hear that we're able to change how things are being practiced and change the outcomes for these patients. Speaker 400:32:42But I think it's also very compelling when doctors hear that from their colleagues at the conferences and on the podium. And that's one of the most compelling parts of the story is, hey, did you know we were missing this and now we have a very clear and impactful solution that gets consistent and predictable results. And I always say that's sort of the invisible hand on this launch is the physician testimonial. The doctors getting up on podium and talking about their positive experience to Bobby's point, this drug doesn't disappoint. The results are almost always consistent and patients come back with clear healthy lids and becomes a very compelling story for us to hear, but more importantly it becomes a compelling story for other doctors to hear from their colleagues. Speaker 400:33:23So that's a really exciting part of the launch that does underpin the rapid adoption we've seen. Speaker 1000:33:28And we're doing that right as these across so many of our efforts, whether it's marketing or medical affairs. The peer to peer engagement here is another powerful amplifier of spreading the word. Speaker 600:33:44That's it for me. Thank you very much and congrats on a great quarter. Operator00:33:48One moment for our next question. The next question comes from the line of Balaji Prasad with Barclays. Go ahead. Your line is open. Speaker 1100:33:57Hi. This is Mikaela on for Balaji. Thanks for taking our questions. Just wondering of the 11,000 prescribers you called out, are you able to actually quantify the portion that fall into the 3 buckets you called out? So how looking to understand how many are early adopters versus newer to DV at this point? Speaker 1100:34:15Thanks. Speaker 400:34:17Yes. Thanks for the question, Mikaela. So obviously, we cut the data lots of ways. As you can imagine, it's very dynamic. So we don't go into that level of detail in this forum. Speaker 400:34:28But I think our focus is to say, okay, for each of these doctors, we've gotten to 11,000 of the 15,000. So we've gotten to the vast majority. Our focus is really going to be now how do we start to pull those doctors from folks that are just getting that early experience. What we talked about earlier, which is becoming routine writers, routine prescribers and how do we increase our frequency with our sales force expansion to facilitate that. So I think the way we think about this going forward is we've got a great prescriber base established and now the focus is going to be on that depth of prescribing that enhanced utilization within the practice in that prescriber base. Speaker 400:35:03So the segmentation of the doctor becomes a little less important in terms of where they came from, but more important on where we think they're going to go in the future and how we can continue to move the needle there. Operator00:35:23The next question comes from Eddie Hickman with Guggenheim Securities. Go ahead. Your line is open. Speaker 1200:35:29Hey, good afternoon and congrats on the great quarter. Thanks for taking my question. So I appreciate the added color on the 3rd and 4th quarter dynamics in terms of bottle growth. But I'm wondering if you could help us think about 2025 and what the bottle growth should look like with the fully deployed sales force and DTC. It sounds like 4Q is going to be pretty strong. Speaker 1200:35:45So I'm wondering like how many quarters beyond that do you expect that level of growth before it studies out? And then on the summer holiday slowdown, like is that unique to this early part of the launch or do you think that to be an annual pattern? Thanks. Speaker 500:35:59Hi, Eddie. It's Jeff. Maybe I'll answer your first question or second question first. It's a little early for us to know if it's specific to us annually, but we did note in general for eye care products that there was a slump in new RXs during the Q3. So it's probably likely we'll see a similar effect in the Q3. Speaker 500:36:18But again, we don't have a whole lot of history for Xtandi at this point. In terms of your question in 2025, I think there's a couple dynamics that we will continue to see impressive growth beyond the 4th quarter. One will be the full deployment and we'll see some of the impact of the direct to consumer campaign, meaning streaming TV, potentially network TV should continue and should help drive patients in to go see their docs. And then secondly, as the sales force incremental sales force begins to continue to get online and continue to have those frequency of visits, we expect that growth to continue as a result of that. So we continue to see quarter over quarter growth throughout 2025. Operator00:37:11I'm showing no further questions at this time. Thank you for your participation in today's conference. This does conclude the program. You may now disconnect.Read morePowered by