Financial Data and Key Metrics Changes - The company announced a significant increase in the number of treatment-naive patients on acoramidis, indicating positive commercial execution [47][48] - The gross-to-net ratio is expected to stabilize in the range of 30% to 40%, reflecting a more representative payer mix [56][57] Business Line Data and Key Metrics Changes - The ADH-1 program is transitioning from a single-center phase two study to a global phase three study with over 25 sites, which may lead to a more heterogeneous patient population [3][4] - In the phase two study of ADH-1, 70% of patients responded to encaleret, and the company aims to replicate this success in phase three [15][38] Market Data and Key Metrics Changes - The prevalence of ADH-1 was estimated at 1 in 25,000 based on data from multiple biobanks, indicating a consistent finding across different cohorts [18][19] - The company is learning that many patients diagnosed with hypoparathyroidism may actually have ADH-1, which highlights the need for better disease education and genetic testing [19] Company Strategy and Development Direction - The company is focused on driving disease education and increasing the utilization of genetic testing to improve diagnosis rates for ADH-1 [19] - The strategy includes leveraging compelling clinical data and new treatment guidelines to enhance awareness and diagnosis of the condition [12][13] Management's Comments on Operating Environment and Future Outlook - Management expressed confidence in the launch of acoramidis, noting that the share of treatment-naive patients has been increasing month over month [47][48] - The company believes that any treatment that stops or slows the progressive loss of function will be well-received by patients, given the lack of current options [43] Other Important Information - The company plans to present full phase two data for chronic hypoparathyroidism at an upcoming medical meeting, which may address skepticism regarding efficacy [26] - The phase three study for 418 is designed to show trends in clinical measures rather than statistically significant benefits, aligning with FDA requirements for accelerated approval [38][40] Q&A Session Summary Question: What are the risks in translating phase two findings to phase three for ADH-1? - The main difference is the number of sites and patients, with phase three being a global study involving over 25 sites [3] Question: How does the company view the use of PTH replacement therapy in ADH-1 patients? - Management indicated that PTH replacement is not ideal for these patients due to the intact parathyroid glands and the need for a more biologically appropriate treatment [9][10] Question: What factors will drive physicians to pursue genetic testing for ADH-1? - Compelling clinical data, new treatment guidelines recommending genetic testing, and the implementation of a new ICD-10 code for ADH-1 are key drivers [12][13] Question: How does the company plan to differentiate encaleret in the market? - The company aims to demonstrate urine calcium benefits and long-term safety, which are not currently addressed by other treatments [27] Question: What is the expected impact of competition on the market? - The company believes that its strategy of parity access and best-in-class hospitalization data will maintain its market position despite competition [60][61] Question: What is the company's stance on the potential for generic competition for tafamidis? - Management expressed confidence that the existing patents provide strong protection against generics entering the market [62][63]