Really starting to get some really cool data on the number of repeat patients we're having. So if you keep in mind, every one of our scripts is a new prescription. We don't have TRXs, b ut we can track. Obviously, we don't know patients' names, but we can look at an identifier on a patient, and seeing these patients getting a second, third prescription, and that's really increased. Now, I think that might go hand in hand with seeing the doctors, the repeat doctors, but we're also seeing repeat patients. So, we really, from what we've heard from our doctors, from all the tracking we do, the product's doing phenomenal in the field, which is the single most important thing. It's working. I mean, if you look at our complaint rates, AEs, any way you want to look at it, it's under 1%. I don't know another drug that's 99% effective. It, it's working, and it's working fast. So those metrics we're really, you know, we're really impressed by. We're expanding the sales force, as you know. Right now, we're in the middle of it, and that'll allow us to continue to grow the new doctors, continue to increase the frequency on current doctors, to drive the business forward. I guess, you know, you did touch on or you mentioned, you know, expansion of the sales force, and maybe just help us understand what that really will let you operationally accomplish, and maybe just to help review people where you started in terms of reps, where you are now, and ultimately, where you expect to go? So we started when we launched with forty reps. You know, we look back on it, did we have enough reps when we launched? You could probably give us some criticism that, boy, but we took a very conservative approach to it. You know, we're creating a market. It's not like you're walking into a doctor's office, and you know he writes 100 prescriptions a year of XYZ pill. You're going to replace XYZ pill with your XYR pill, a nd this isn't it. This is creating a market. It's moving patient care from an inpatient setting, being in an IV clinic, in a doc's office, or in a hospital, and moving it to the patient's home. So it's really a paradigm shift in how docs would treat worsening heart failure. So I thought we took a conservative approach to that. Let's go out, let's learn, and then let's grow as we learn, so we did take the sales force up to 68 last year, and we're taking it to 90 right here, right now. It should be pretty much complete by the end of this quarter, and then hitting the field beginning of next quarter. Eventually, we have a kidney indication coming up in March. We'll do another expansion because we'll be calling on nephrologists to probably 125 - 130 reps. If you look at kind of just a regular cardiology sales force, you usually see it between 110 - 150 reps. So we think 125 understand what the kidney opportunity from a heavy lifting standpoint is for the reps, but we could see one more expansion after that. But I think the 125 gets us to about where we need to be. You know, one of the things I wanted to touch on in terms of what we've seen is the number of units that are being filled with each script is considerably higher than what you originally anticipated. You know, what has been the driver behind that, and how do you expect that to change over time as maybe your mix shift changes a little? Yeah, and this is, again, learnings you have when you're out in the field. We had anticipated four units per script. That's kind of the guidance we gave. That's how we were modeling it internally, and it was really based on how many days they were in the hospital just receiving furosemide, was about four days. So, when we... and we did think there'd be more of a 50/50 mix between a post-discharge patient, which is in how we're defining a post-discharge patient is any patient that's been admitted into the hospital. After that admission, they're a post-discharge patient. Now, post-discharge patients can be a couple different types. They can be what I spoke about before, the patient who's gone in the hospital, been stabilized, had one or two days of IV diuretics, and they're ready to go, except you got to finish the diuretic management, so they're getting two or three days. We thought we'd see more of that early than we did. Now, what we've learned is that's harder to do if you're just calling on a cardiologist and then hoping that the cardiology consult, that the hospitalist will call the cardiologist, "Hey, I'm letting Mrs. Jones out." Cardiologist: "What are you talking about?" So that really is more of an IDN approach. The other post-discharge patient, where we thought we'd have 50% of our use early, was the patient that's been discharged after four or five days in the hospital, comes back for a post-discharge visit, day three, post-discharge, and, oh, boy, they're residually congested. What am I gonna do? I need to be aggressive with this patient. I'm gonna get penalized if they bounce back into the hospital. I'm going hard for Furoscix right there. We thought that mix between that pre-admission and that post-discharge patient would be 50/50. We know the post-discharge patient's probably only receiving three days of therapy because they've just received five days of IV, or they wouldn't be a post-discharge patient. We always thought the pre-admission patient would be closer to five or six units. What we learned is that post-discharge patient, the doctor wanted to know that the product was going to work and work consistently before they'd try it there. They in their minds think that that patient's more severe. Really, what they're thinking about is, "I'm going to get penalized if that patient bounces back. I better be sure that this product works before I do that," so they got- It's the same doctor, and it's the same patient. It's just where they are on the journey. What we've seen is now that doctors have gotten more and more comfortable using Furoscix, it's very predictable, it's working really quickly, we're starting to see that shift in the mix, so that's a long answer to the story. We thought it'd be four, it's closer to six. It's because of the mix. We also thought plans would put quantity limits of four on us. They have not done that. Now, I'm going to throw on top of that, we received approval for Class IV heart failure about three weeks ago. We launched about two weeks ago in Class IV. Class IV are the sickest patients. Now, half of them are waiting for heart transplants, VADs, whatever. Not really our patient. It's the patients that have congestive heart failure, that are kind of palliative care, and they either use the hospital as an IV clinic, so they're getting admitted six times a year, or they use the doctor, an IV clinic, and they go in two or three times a week, excuse me, just to get the fluid on. So what Furoscix does is it gives the doctor and the patient the ability to do that at home. So the scripts we've seen, the early scripts for Class IV, some of them are 12 units, a nd what they're doing, and we thought they'd do this, is they're prescribing a month's worth of Furoscix for their patient to use. I hate to use the word prophylactically, but in a way, it is prophylactically, that they're telling Mrs. Jones, "Take your Furoscix Monday, take it Wednesday, take it Friday or, you know, Saturday," whatever. S o they're writing a month's worth, and the patients are taking it, you know, 3× a week to stay out of the hospital, checking in with the doctor's office or the clinic. So I think you have two factors driving the script count moving forward. One will be the continued use and the expanded use in the post-discharge patient, offset by the prophylactic scripts we're seeing in Class IV. All of that saying, you know, we still think it's going to be in the five to six range as those two things kind of interact. Do you have concerns that with those Class IVs and that you start to see some very intense use for individual patients, that you might start to have payers implement quantity limits bec ause you know, you sort of benefit that not happening, and... We're always concerned about it. Now, how plans and how we work with the plans on this is, okay, let's look across all of your patients and what the average usage is. It's not 12, right? It's eight, maybe, for a patient. Some patients are one course of therapy and done. The Class IV patients represent about 10% of the total market. They'll have a big impact on us, but from a plan standpoint, if they're looking at the average number of units across the patients, I mean, across all of their heart failure patients, not just those Class IV, we don't think we'll see much. It doesn't make... and we're out there making this argument. It's been pretty well-received. It doesn't really make clinical sense to give a patient 2 units. So a quantity limit, like, of two would be bad for business, but it'd be really bad for patients, 'cause it's just not enough. Do I think with the redesign that we're going to see more quantity limits? I do, b ut it wouldn't make sense for them to be, like, under four, but we could see that, and I wouldn't be surprised to see a little bit more of that next year. You know, you mentioned the sort of recent addition of Class IVs. You filed, and we expect to get approval for chronic kidney disease for Furoscix in March of next year. March, yes. So maybe just walk us through a little bit on that opportunity and how that might differ from what you're seeing with heart failure patients, and I know there's some overlap between patients. Yeah. We're incredibly excited about this. I don't think we're getting any credit for it, which frustrates us a little bit, but that's fine. It's about a million patients that have chronic kidney disease, are diuretic resistance, and do not have heart failure. So it's when you look at our TAM, you're going to add about a million patients to it. Now, a lot of patients have heart failure and chronic kidney disease. We're already indicated for that because we have the heart failure indication. It's funny, nephrologists manage fluid. It's what they really do. So we're already seeing uptake in nephrologists on the heart failure part of that indication. So I think it gives us a little. I won't call it a foothold, but I'll call it a toehold in nephrology when we launch early next year. But the value prop is really similar, and they use a little different terminology than cardiologists. Cardiologists, heart failure specialists, talk about worsening heart failure. You know, in nephrology, they talk about diuretic resistance. It's kind of the same thing. Diuretic resistance really refers to oral resistance. It's the same argument with oral not being absorbed in the GI tract or, and so they have reduced bioavailability, so the value prop is really the same. Call what you want, resistant to oral diuretics, what are your choices? Oh, boy, we're going to have to go to the hospital. One of the reasons why we think the uptake in nephrology at the end of the day will be higher is they don't own the IV heart failure clinics like the heart failure. So a heart failure specialist could say, "Hey, just go in the clinic, get, use the IV." It's still, it sucks for patients to do that. They're going to sit there and diurese for five hours, but they have access to an IV clinic. A nephrologist is actually going to have to refer them over. So we think our share is much higher in nephrology, and at the end of the day, we think as much as 40%-45% of the total opportunity at our peak is going to be in nephrology as opposed to in heart failure. So we're excited. We have a March 6th PDUFA date. Good interactions with the FDA on this. We'll again expand the sales force. We've already started to put our toe in nephrology around with the heart failure indication. So we think the value prop is even cleaner there. As a reminder, right, similar to heart failure, you didn't need to run sort of patient studies to get approval, and so that's, you know the label expansion is sort of relatively straightforward. Yeah, I think so. You know, I knew the Class IV was a slam dunk. I'm not calling this one a slam dunk. It's a different patient, but if you look at our regulatory strategy, and our pathway was always a 505(b)(2). If you look at the label of the IV, it has chronic kidney disease already in the label. All we're trying to do is match the label in the IV. With the five-hour product, we showed similar PK, similar PD, to the IV, so our argument is we can match that label. The FDA's agreed. We had a pre-NDA meeting with them around CKD, and there was really just this documentation. You have a different risk analysis, but it was really a documentation exercise, not a clinical exercise. One of the other sort of product development sort of milestones is the launch of an auto-injector, which is different than the infusor that you currently have on the market, and I know you've highlighted some financial benefits of that. From a patient standpoint, you know, the infusor seems to be very elegant and so w hat's the need that you meet clinically with an auto-injector? Yeah, so we've been working on this for four years. You know, we love our current product. You know, the choice the patient has is to lay in a hospital bed or go into an IV clinic three times a week, or wear an auto infusor around, you know, around their home, take the pets for a walk, go to the mall, whatever you want to do. But we do know there are some patients that, "Boy, I'm, you know, I might not want to wear that." The doc might think, "Hey, maybe Mrs. Jones isn't capable of using it." This auto-injector, it's a two-stage auto-injector. It's not a three, it's two. They just take the cap off, and they press it against their skin, and they're getting 8 mg of furosemide in five seconds. So the same dose they're getting now in five hours. We announced the results of our study, our PK study. We couldn't have drawn the curves being any better. It's not going to have the peak of the IV. We didn't want that. We thought that would be probably too extreme. But the peak is quicker than our infusor. So I do think there's... We're just talking, Ed, about this. I do think there's patients that doctors might want to see a quicker onset, and I think there's patients that, "Oh, I don't want to wear something for a couple of hours. It's going to interfere with my ADLs, activities of daily living," even though we showed that our infusor doesn't. Patients might still have that perception. Boy, the auto-injector, put it there, five seconds later, you're done. We measured pain scores, really no difference in pain from putting an IV in. You're going to have to put the IV in, or you're going to use the auto-injector, and this gives them all the flexibility. So we do think the use case will be different. The TAM doesn't change necessarily. It's heart failure patients. But I think the use case, I think you'll see it more of a convenience. I think you'll see more, even more prophylactic use. I think you'll see more patients with it on the shelf that had a high sodium meal, go to the scale, they're two pounds over. Hey, hey, Doc, I'm going to take this auto-injector because I have it. Are you okay with that?" So... Okay. I know we're almost out of time, so you have to be really quick on this one. I'm very quick. Because I did want to touch on this, but you did recently note that you think you're funded through to profitability. You know, just a quick update and sort of that roadmap for that. Yeah. So we did a financing a couple of weeks ago, and really the goal of the financing was to finance to profitability, to be able to invest in the business, to invest in the CKD launch, to invest in the auto-injector launch, but to take us to profitability, and this does it. You know, we've talked about, everyone says, "When is that?" Well, it's more what is it? You know, we need probably $23 million-$25 million in net revenue in a quarter for profitability, based on our current operating plan. I think if you look at where analysts' estimates are, that's probably sometime in the second half of next year. We don't want to eke into profitability and then eke out a profitability the next quarter, right? We really think, and how the timing is going to work is, that net revenue will hit that with the infusor, and then we'll explode through it with the auto-injector. The auto-injector takes our costs down 70%. It will just flow right to our bottom line. So we're going to get to profitability probably with just the infusor, and then really explode through it with the auto-injector as that flows to the bottom line. Okay, I think we're over time, so, we got to wrap it there. Great. Thank you. Thank you, Dan.
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