Summary of BioXcel Therapeutics (BTAI) Conference Call - August 27, 2025 Company Overview - **Company**: BioXcel Therapeutics - **Focus**: Development of BXCL501 for the treatment of agitation associated with bipolar disorders and schizophrenia in home settings Key Points Industry Context - **Agitation in Bipolar Disorders and Schizophrenia**: - A significant unmet medical need exists as there are currently no FDA-approved therapies for treating agitation in home settings [5][8] - Most agitation episodes occur at home, leading to emergency room visits and hospitalizations [5] Clinical Trial Results - **SERENITY at Home Phase III Trial**: - The trial evaluated the 120 microgram dose of BXCL501, which was well tolerated and met its primary objective [4][6] - An estimated 57 million to 77 million agitation episodes occur annually in the U.S. [6] - The trial involved 2,628 agitation events with over 2,400 treated episodes, with patients self-administering the drug successfully [10][19] - No drug-related serious adverse events were reported, and the adverse event profile was consistent with the approved label [14][19] Efficacy and Safety - **Efficacy**: - Patients experienced consistent benefits with repeat dosing throughout the study [19] - The incidence of somnolence, the most common adverse event, was 22% and did not increase with repeated dosing [15][16] - The study showed no evidence of tachyphylaxis, indicating sustained efficacy over time [70] Regulatory and Commercial Strategy - **sNDA Submission**: - The company plans to submit a supplemental New Drug Application (sNDA) in Q1 2026 for label expansion to include home use [7][20] - The FDA has provided alignment on the protocol for the sNDA submission [36][68] Market Opportunity - **Commercialization Strategy**: - The company is developing a multi-pronged commercialization strategy, potentially including partnerships and self-commercialization [39][54] - Initial estimates suggest a need for 50 to 70 sales representatives to effectively launch the drug in the U.S. market [81] Future Development - **Potential for Other Indications**: - There is a significant opportunity to explore BXCL501 for treating agitation in Alzheimer's patients, with an estimated 100 million episodes annually [43][46] - A second confirmatory Phase III trial for Alzheimer's agitation is planned, expanding the patient population to include various care settings [44][47] Financial Considerations - **Funding and Financial Strategy**: - The positive trial data opens multiple financial options for the company, including strategic partnerships and potential royalty deals [53][54] - The company is evaluating its cash position and operational expenditures to ensure sufficient runway for upcoming initiatives [52] Additional Insights - **Patient Self-Management**: - The drug allows patients to self-manage their agitation episodes, which is crucial for maintaining home stability and caregiver relationships [64][66] - **Real-World Application**: - The drug's ease of use and tolerability may encourage its adoption in real-world settings, addressing the needs of patients experiencing agitation [80] Conclusion - The results from the SERENITY at Home trial represent a significant milestone for BioXcel Therapeutics, paving the way for potential FDA approval and commercialization of BXCL501 for home use in managing agitation associated with bipolar disorders and schizophrenia. The company is well-positioned to address a large unmet need in the market while exploring future indications for the drug.

Summary of BioXcel Therapeutics Conference Call Company Overview - **Company**: BioXcel Therapeutics - **Industry**: Biotechnology - **Key Product**: EGALMI, approved for agitation in schizophrenia and bipolar disorder Key Points and Arguments Upcoming Clinical Trials and Data - BioXcel is preparing for pivotal Phase III trial data related to schizophrenia and bipolar agitation, expected in August [3][4] - The company has already proven safety and efficacy of EGALMI in care settings and is now testing it in home settings [4][6] - The primary endpoint of the home setting trial is safety, with exploratory endpoints focusing on repeat dosing efficacy [10][18] Market Opportunity - Initial estimates indicated 23 million episodes of agitation, but further research suggests a larger market opportunity [5][6] - The company has collected data from 2,200 episodes over a 12-week period, indicating a representative sample of real-world experiences [13][14] - Pricing strategy suggests a potential price of up to $1,400 per prescription, with packaging considerations for home use [26][27] FDA Interactions and Approval Process - Upcoming FDA meeting on August 20 will focus on the format and content of the supplemental new drug application (sNDA) [17][18] - The primary concern for FDA approval is demonstrating safety comparable to previous clinical settings [18][23] - The company has a robust intellectual property portfolio with 13 patents, ensuring market exclusivity until 2043 [35][36] Commercialization Strategy - BioXcel is evaluating options for commercialization, including potential partnerships to expand market reach [32][34] - The company acknowledges the need for education and promotion in the neuropsychiatric market, similar to migraine treatments [32] Alzheimer's Program - BioXcel is also developing a product for acute agitation in Alzheimer's, with plans for a second confirmatory Phase III trial [7][39] - The protocol for the Alzheimer's trial has been agreed upon with the FDA, and the company is in the process of selecting a contract research organization (CRO) [40][41] Financial Position - As of the latest update, BioXcel has $18 million in cash, with additional proceeds expected from recent financing activities [42][44] Additional Important Insights - The trial's real-world setting allows patients to self-administer the treatment, potentially leading to more accurate data on compliance and effectiveness [14][16] - The company is aware of the placebo effect in psychiatric trials but believes prior efficacy data will mitigate its impact [12][18] - The potential for prodromal use of the product is acknowledged, but it will not be part of the official label due to lack of specific study [28][29] This summary encapsulates the critical aspects of BioXcel Therapeutics' conference call, highlighting the company's strategic focus, market potential, and regulatory interactions.