Neurocrine(NBIX)2022-05-04 16:30Financial Data and Key Metrics Changes - Neurocrine Biosciences reported strong Q1 performance with INGREZZA sales totaling $303 million, marking a significant achievement in a typically challenging quarter [11] - The company exited Q1 with a record number of new patients, reflecting an improving external environment and benefits from commercial initiatives [12] - The gross to net guidance for Q1 was around $5,300 per script, with an expectation of $5,400 per TRx for the full year, indicating a 2% headwind in Q1 [30] Business Line Data and Key Metrics Changes - The INGREZZA franchise experienced over 30% year-over-year growth in Q1, driven by improved healthcare professional access and effective execution by field teams [14] - The company expanded its sales force by 140 representatives, which is expected to benefit growth in the latter half of the year [14][15] - The management noted that while Q2 is expected to show sequential growth, the percentage increase may be lower than in previous years due to the strong performance in Q1 [12][15] Market Data and Key Metrics Changes - The company highlighted that approximately 85% of the estimated 600,000 people living with tardive dyskinesia (TD) remain undiagnosed or untreated, indicating a significant market opportunity [17] - The external environment has improved, but challenges remain, particularly in adapting to remote healthcare delivery [7] Company Strategy and Development Direction - Neurocrine is focused on expanding the INGREZZA franchise and advancing its clinical pipeline, including filing a supplemental NDA for INGREZZA in Huntington's disease [8][20] - The company is committed to increasing awareness and treatment of TD through significant commercial investments and an expanded sales force [17] - The management emphasized the importance of adapting to the evolving healthcare landscape, including the integration of telemedicine [56] Management's Comments on Operating Environment and Future Outlook - Management expressed optimism about the trajectory of INGREZZA and the ability to treat more TD patients, despite the challenges posed by the conflict in Ukraine [110] - The company is looking forward to a wealth of data readouts in 2023, indicating a strong pipeline and growth potential [111] Other Important Information - The company received regulatory approval for valbenazine in Japan for the treatment of tardive dyskinesia, which is expected to support its launch plans [20] - The humanitarian crisis in Ukraine has impacted some clinical programs, but the company is implementing contingency plans to mitigate these effects [24][110] Q&A Session Summary Question: Can you provide context around compliance improvement this quarter? - Management noted a less significant decline in refill rates from Q4 to Q1, attributed to improved management of the reauthorization process and a better access environment [30] Question: Was there any impact from inventory during the quarter? - Management reported no significant swings in inventory and described the quarter as clean from that regard [32] Question: How is the split between psychiatrists and neurologists in terms of scripts? - Historically, the split has been about 80% psychiatry and 20% neurology, with efforts to better penetrate the neurology segment through an expanded sales team [35] Question: What are the plans for ONGENTYS given its commercial performance? - Management acknowledged lower-than-expected sales for ONGENTYS but emphasized positive feedback from prescribers and plans to continue focusing on neurologists [41][44] Question: What are the key drivers for new patient starts? - The company identified increased awareness, improved healthcare professional access, and direct-to-consumer campaigns as key drivers for new patient starts [71] Question: How does the company differentiate its M4 program from competitors? - The M4 program is a highly selective orthosteric agonist, with potential advantages over competitors, and the company is considering a range of other indications [107]