Summary of Zebra Therapeutics Conference Call Company Overview - **Company**: Zebra Therapeutics - **Focus**: Rare diseases, specifically ultra-rare diseases - **Products**: - MyPlifa (adimoclomol) for Niemann Pick type C - Alpruva for certain urea cycle disorders - Pipeline includes a program for vascular Ehlers Danlos syndrome (in phase three) and KP1077 for idiopathic hypersomnia (phase two) [1][7][6] Key Points on MyPlifa - **Patient Enrollment**: - 129 patient enrollment forms submitted, with 7 added in the latest quarter - Represents approximately 40% of the diagnosed patient population in the U.S. (300-350 diagnosed out of 900 total prevalence) [10][11][12] - **Market Share Growth**: - Achieved a 2% market share growth with the addition of 7 patients in a quarter [12] - Revenue growth of 26% quarter-over-quarter from Q1 to Q2 [13][15] - **Treatment Efficacy**: - MyPlifa is the only drug shown to halt disease progression for up to five years [14] - **Reimbursement Trends**: - 52% of covered lives have MyPlifa on formulary, with expectations for this number to increase [30][32] - High success rate in securing coverage for patients despite initial denials [30][15] Competitive Landscape - **Miglustat**: - Off-label standard of care for Niemann Pick type C, with 80-90% of diagnosed patients having been on it [19][20][21] - Combination therapy with MyPlifa shows synergistic effects [41] - **Alpruva**: - Launched in a mature market with competition from Revicti and an upcoming authorized generic [58] - Recognized an impairment charge due to enrollment trends and market dynamics [60] Pipeline and Future Prospects - **Vascular Ehlers Danlos Syndrome**: - Ongoing phase three trial with an interim analysis planned [63][64] - **Cash Position**: - Cash balance of $2.17 billion after selling a priority review voucher, with neutral cash burn during the quarter [66] Additional Insights - **Market Awareness**: - Increased awareness of MyPlifa among community physicians, leading to more undiagnosed patients being identified [34] - **Regulatory Strategy**: - Filed for MAA in Europe ahead of schedule, with a robust data package to support approval [48][49] - **Intellectual Property**: - Orphan drug exclusivity and ongoing efforts to extend patent life [43] This summary encapsulates the key discussions and insights from the Zebra Therapeutics conference call, highlighting the company's strategic focus, product performance, and market dynamics.

Financial Data and Key Metrics Changes - The company reported a strong cash position with $217 million in the bank, allowing it to operate independently of capital markets [47] - The enrollment forms for MyPlifa have reached 122 since its launch, indicating a successful initial uptake [8][12] Business Line Data and Key Metrics Changes - MyPlifa, the recently launched product for Niemann Pick disease type C, is in its launch phase and has shown promising enrollment numbers in the U.S. market [5][8] - Olpruva, the other commercial product, is targeting specific urea cycle disorders and has seen five enrollments in line with its revised strategy [42] Market Data and Key Metrics Changes - In the U.S., there are approximately 900 patients diagnosed with Niemann Pick disease type C, with 300 to 350 diagnosed patients currently identified [7][8] - In Europe, the market is more mature with about 1,100 patients, but many are already on treatment, presenting a challenge for new product uptake [9] Company Strategy and Development Direction - The company is focused on executing the launch of MyPlifa and expanding its European filing for the product in the second half of the year [37][40] - There is an emphasis on increasing disease state awareness and product awareness to drive patient diagnosis and treatment [18][36] Management's Comments on Operating Environment and Future Outlook - Management expressed optimism about the future, citing the successful launch of MyPlifa and the potential for increased patient identification through awareness efforts [18][36] - The company is committed to supporting patients through the reimbursement landscape and ensuring access to therapies [27][32] Other Important Information - The company is exploring various avenues for its go-to-market strategy in Europe, considering both direct and partnership approaches [40] - The enrollment in the saliprolol program for vascular Ehlers Danlos syndrome has reached 32 patients, with ongoing efforts to increase participation [44] Q&A Session Summary Question: Can you provide an overview of Zebra and its products? - The company is a commercial stage rare disease company with two products in the U.S. market and a pipeline in various stages of development [4] Question: How is the launch of MyPlifa progressing? - The launch is exceeding expectations, with significant patient enrollment already achieved [8][12] Question: What are the challenges in diagnosing Niemann Pick disease type C? - The heterogeneous nature of the disease complicates diagnosis, leading to many undiagnosed patients [14][15] Question: How does the company plan to penetrate the market further? - The company is leveraging successful strategies from Europe to increase awareness and diagnosis in the U.S. [18][33] Question: What is the current status of reimbursement levels? - The company is pleased with the current reimbursement efforts and the willingness of physicians and patients to navigate the process [26][28] Question: How does the company support patients transitioning from EAP to commercial therapy? - The company has a robust support system in place to assist patients through the transition [29][32] Question: What is the strategy for the European market? - The company is focused on the MAA filing and is exploring various market entry strategies [37][40]

Financial Data and Key Metrics Changes - The company reported net revenue of $20.4 million for Q1 2025, with $17.1 million from MyPlifa, $0.1 million from Olpruva, and $2.3 million in net reimbursements from the French EAP for Aramcholamol [29] - Operating expenses decreased to $22.8 million, down $0.6 million compared to the same quarter last year [30] - The net loss for Q1 2025 was $3.1 million, or $0.06 per share, compared to a net loss of $16.6 million, or $0.40 per share, for the same quarter a year ago [30] Business Line Data and Key Metrics Changes - MyPlifa's launch has exceeded expectations, with 122 prescription enrollment forms received since launch, indicating that approximately one-third of diagnosed NPC patients in the U.S. have been enrolled [19][20] - Olpruva received a total of 28 prescription enrollment forms since its initial availability, with five forms in Q1 2025 [12][26] Market Data and Key Metrics Changes - The company achieved 38% of covered lives for MyPlifa by the end of Q1 2025, which aligns with expectations for this stage of the launch [20][64] - The European market for MyPlifa is being targeted, with an estimated 1,100 people living with NPC, and regulatory submissions are planned for the second half of the year [11] Company Strategy and Development Direction - The company is focused on commercial excellence, pipeline innovation, talent and culture, and corporate foundation as its four strategic pillars [5][6] - The recent monetization of the Pediatric Rare Disease Priority Review Voucher added $148.3 million of non-dilutive capital to the balance sheet, enhancing financial strength [8][30] - The company aims to establish MyPlifa as a cornerstone treatment for NPC globally and maximize commercial opportunities with Olpruva [16][32] Management's Comments on Operating Environment and Future Outlook - Management expressed optimism about the early success of MyPlifa and the refined marketing strategy for Olpruva, indicating a strong position for future growth [33] - The company is well-positioned to support strategic priorities independent from capital markets, with ample resources for execution [32] Other Important Information - The company has made a strategic decision to withdraw the NDA for Apodas, reducing regulatory costs [16] - The ongoing Phase III trial for saliprolol is being actively managed to drive enrollment, with 32 patients currently enrolled [14][72] Q&A Session Summary Question: Details on the number of patients on MyPlifa and reimbursement status - Management indicated that the majority of the 122 enrollments are on the drug, with some undergoing benefits investigation [36] Question: Top reasons for reimbursement denials for MyPlifa - Initial denials are common, primarily due to prior authorization requirements, but the company has successfully secured coverage for most patients [39] Question: Visibility on patient sources and enrollment cadence - Approximately 600 undiagnosed patients exist, and efforts are ongoing to raise awareness and enroll both diagnosed and undiagnosed patients [48] Question: Inventory levels at the end of the quarter - The company is managing inventory closely and maintaining target levels as they support patient needs [51] Question: Qualitative metrics on refill rates and patient retention - Most patients receiving active drug have continued with refills, reflecting the clinical benefit of MyPlifa [55] Question: Coverage details and impact on patient access - 38% of covered lives means that many plans have reviewed MyPlifa, with successful reimbursement through medical exception pathways [64][66]

Financial Data and Key Metrics Changes - In Q1 2025, the company reported net revenue of $20.4 million, with $17.1 million from MyPlifa, $0.1 million from Olpruva, and $2.3 million in net reimbursements from the French EAP for Aramcholamol [29][30] - Operating expenses for Q1 were $22.8 million, a decrease of $0.6 million compared to the same quarter last year [30] - The net loss for Q1 2025 was $3.1 million, compared to a net loss of $16.6 million in the same quarter a year ago [30][31] - Total cash, cash equivalents, and investments as of March 31, 2025, were $68.7 million, a decrease of $6.8 million from December 31, 2024 [30][31] Business Line Data and Key Metrics Changes - MyPlifa's launch has exceeded expectations, with 122 prescription enrollment forms received since launch, indicating that approximately one-third of diagnosed NPC patients in the U.S. have been enrolled [20][21] - Olpruva received a total of 28 prescription enrollment forms since its initial availability, with five forms received in Q1 2025 [12][27] - The company has achieved 38% of covered lives for MyPlifa, which is in line with expectations at this stage of the launch [21][22] Market Data and Key Metrics Changes - The company is focusing on expanding MyPlifa's availability outside the U.S., with plans for a marketing authorization application in Europe in the second half of the year [11] - The European market for NPC is well established, with approximately 1,100 people estimated to be living with the disease [11] Company Strategy and Development Direction - The company is executing on four strategic pillars: commercial excellence, pipeline and innovation, talent and culture, and corporate foundation [5][8] - The focus is on bringing innovative therapies to patients with rare diseases, with a strong emphasis on MyPlifa as a cornerstone treatment for NPC [17][33] - The company is also assessing strategic alternatives for its Phase III ready asset KP1077 for rare sleep disorders [6] Management's Comments on Operating Environment and Future Outlook - Management expressed optimism about the early success of MyPlifa and the refined marketing strategy for Olpruva, indicating a strong position for future growth [33] - The company believes it is well positioned to support its strategic priorities and execute on its long-term vision, independent from capital markets [31][32] Other Important Information - The company has successfully monetized its Pediatric Rare Disease Priority Review Voucher, adding $148.3 million of non-dilutive capital to its balance sheet [8][31] - The company is committed to patient access and comprehensive patient services through its in-house program, Amplify Assist [27] Q&A Session Summary Question: Details on the number of patients on MyPlifa and reimbursement status - The company received 122 enrollments since launch, with the majority of patients actively on the drug, while some are in the benefits investigation process [36] Question: Reasons for reimbursement denials for MyPlifa - Initial denials are common for rare disease products, primarily due to prior authorization requirements, but the company has been successful in securing coverage through medical exception processes [39][40] Question: Visibility on patient cohorts and enrollment cadence - The company estimates around 600 undiagnosed patients and 300 diagnosed patients, with ongoing efforts to raise awareness and facilitate treatment [47][59] Question: Inventory levels at the end of the quarter - The company is managing inventory closely and maintaining target levels as it supports patient needs during the early launch phase [50] Question: Qualitative metrics on refill rates and patient retention - The majority of patients receiving active drug have continued to refill, reflecting the clinical benefit and durability of MyPlifa [54] Question: Coverage details and impact on patient access - 38% of covered lives have access to MyPlifa, with ongoing efforts to increase this percentage as more plans evaluate the product [63][64]