Earnings Sentiment

Sentiment Analysis of the earnings transcript to help figure out if there are any bullish or bearish sentiments that could be gathered from it. We're doing ML and AI based analysis on the earnings call to get some more insights.

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Sentiment Distribution

   

Earnings Call Transcript Word Cloud

     

Bullish Statements during Earnings call

Statement
So we are confident of that guidance raise that we've given and that confidence is based on not only first quarter, but very importantly, the momentum that we saw strongly in March and as we moved through April and into May
Now in 2023 with established payer policies, we are taking steps to tighten the business rules associated with our free goods program and have seen the percent of prescriptions reimbursed jump from 60% in the fourth quarter of 2022 to 72% in the first quarter of 2023 with continued momentum and improvement to 75% in April
Not only are we continuing to increase the breadth and depth of prescribing within our existing super targets and targets within the target universe, but also I think the productivity increases that we are seeing in the additional target population are also starting to see significant benefits as we've roll out over the course of time
So we're very pleased with the evolution that we are seeing, but in this marketplace, which is seeing significant growth, there is a lot more growth for us to build on as we are doing at this point in time
Our journey with Trudhesa continues to make consistent progress, and we are pleased to announce first quarter 2023 revenue of $4.4 million, driven by strong in-market demand of over 18,000 normalized prescriptions, over 70% of which were reimbursed
So we are very pleased that we've rolled out the count on it program
This momentum added to our stable prescription size of six PODS per prescription, a solid and high refill rate in the low 60% range, and an expanding prescriber base
These achievements to date form a solid foundation for continued growth as we move through 2023
As mentioned on the left hand side of this slide, we are delighted to show continued robust growth in new patient starts reaching over 3,600 in the first quarter, an 18% increase versus the fourth quarter of 2022
As we articulated on our last call, I think the impact of increasing our sales force from 60 to 90 in the kind of July, August period of last year, we have seen significant kind of productivity and efficiency benefits of that broadening of the sales force and clearly some of the parameters and lead indicators that we've covered today, particularly amongst new patient stats and obviously prescription evolution and manifestations of that broad efficiency that we've seen
These lead indicator growth catalysts are providing excellent momentum as we journey through this in the second quarter of 2023
To date, we have generated just over 25,000 prescriptions, more than 100% increase versus the same time last year, and that's a significantly higher net price
So that thought gives us the confidence
After a solid first full year of commercialization for Trudhesa in 2022, we remain pleased with the continued performance of Trudhesa in the first quarter of 2023, and in particular with the strong growth in new patients, and importantly, net price evolution
And that's going to lead to a very good evolution of the net price
You will know, significant share gains amongst our top prescribers who now have Trudhesa accounting for 7.6% of the few branded prescriptions, a clear sign that with continued investments and focus, we believe that Trudhesa can achieve a 12% share predicted by neurologists in independent surveys
This enabled consistent improvement in the percent of prescriptions reimbursed over the course of 2022, peaking at 60% in the fourth quarter
And very importantly, I think not only is building our prescriber base continues to be important, and that gets the essence of our broadened target physician population, which is going very, very nicely in terms of consistent increases in new prescribers
Importantly, our refill rates have remained consistent and solid in the lower 60% range
This increasing reimbursement, together with high refill rates, provide a solid foundation for meaningful revenue growth in 2023
But very importantly, the fuel of prescription growth in new patient starts, and seeing the very significant increases in new patient start that we are seeing, that's going to be the key driver together with the consistently high refill rates that we are building up over the course of time
It is this latest search in new patients that provide us with additional compass in Trudhesa's momentum as we move through the second quarter of this year
And it's that momentum that, that has created the confidence that we have
Not losing sight of the base and foundation of our super targets, but building depth and broadening the kind of the utility prescriptions in our increased target physician population
So, as you saw on the slides we've been able to increase the percent of prescriptions approved from 60% at the end of Q4
Regarding Impel's ongoing priorities in 2023 our execution focus remains on the following key buckets of potential value growth; accelerating prescriptions and share gains with Trudhesa among our target positions, continued evolution of the Trudhesa net price and the resultant positive impact on net revenue growth, securing additional financing to fuel our ongoing commercialization activities and as previously mentioned, we do have ongoing discussions regarding additional capital and our optimistic assuring progress in the near-term and continued interest in aggressive and opportunistic business development
Therefore, we are delighted to see continued market share evolution already reaching 4.7% share among prescribers of Trudhesa in the first quarter of 2023, just 18 months into the launch of Trudhesa
Driving depth of prescribing among our high value prescribers, a larger proportion of whom are neurologists is a critical success factor for continued growth in 2023
So we still feel very confident about that $400 to $500 range that you mentioned
So we are delighted on being able to roll out this DTC campaign
       

Bearish Statements during earnings call

Statement
Given the tolerability of these products, it is our contention that the primary reason for this continued churn over with gepants is that prescribers and indeed patients are not finding the rapid sustained and consistent efficacy they are looking for in the acute migraine treatments
For the first quarter of 2023, Impel reported a net loss of $30.1 million or $1.27 per common share compared to a net loss of $27 million or $1.17 per common share for the same period in 2022
In the first quarter of 2023 we did see a small pullback in normalized nTRx, however, this was not surprising given normal first quarter dynamics seen with all products like deductible resets and reauthorizations
Moreover, we added to this unit pressure by proactively making targeted adjustments to our QuickStart free goods program
I do recall when we first launched Trudhesa, we had a lot of questions around DTC and when we were going to take steps to invest in that
In concert with that, as in the first quarter, there's often the highest amount of pressure on your traditional co-pay, which is the buy down from a $75 or a $50 co-pay down to the $0 that we offer to reimburse patients
   

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