I just finished listening to Acadia present at the Guggenheim Securities 5th Annual Inflammation and Immunology Conference and here are my takeaways:
▪️Acadia presented last and was represented by Mark Schneyer (CFO) and Dr Doug Williamson (Head of R&D). Steve Davis was not in attendance.
▪️Interestingly, Acadia is now talking about Daybue first in their introductory spiel and analysts devoted more time to Daybue than anything else. Could be the excitement of the launch but perhaps Daybue is going to eclipse their other asset Pimavanserin.
▪️MS stated that the Daybue launch continues to go exactly as planned and is meeting or exceeding expectations on every metric. Very pleased with launch performance and benefits to patients. Mentioned ROW deal for Daybue and looking forward to taking Daybue to patients around the world.
▪️Asked for qualitative data on Q4 Daybue revenue. MS stated that the adoption curve would enter a more linear phase now. There was an initial surge in patients early in the launch due to the knowledgeable patient community combined with payer coverage coming faster than expected (both formal plans + letters of medical necessity). Now the company is seeing the number of new patients more in line with early expectations and expect more of a linear growth curve from hereon in.
▪️Asked about guidance on persistence. MS explained that a lot of modelling is done by the company on discontinuation focussing on the following variables: revenue from patient conversions; new patients; dose and titration. Acadia doesn’t recognise revenue on scripts but bottles of Daybue delivered.
▪️Asked about breakdown of patients: Centres of Excellence (20-25% of patients); Large Academic Institutions (60%); and Community Practices (15%). Early penetration has been in COE’s. Interesting tidbit: Large Academic Institutions are virtually the same as COE’s but don’t have the designation.
▪️Compliance Rate of 75-80% in real world although Acadia can’t track patients’ exact dose. In the Phase 3 trial, patients started on the highest dose. In the real world, doctors are more likely starting patients on a 50% dose and titrating up to an 80% dose over a couple of months.Tolerability has been better in real life due to guidance, product label and diarrhoea protocols.
▪️Asked about Q4 guidance in relation to seasonality in rare diseases and impact of upcoming US holiday period (Thanksgiving & Christmas) on Daybue sales. MS acknowledged that the end of the year holiday period can have an impact on sales (sounds as though they experience this with Pimavanserin, but noted completely different drug and patient population) but it is too early to tell. In future years, Acadia will be able to compare and analyse this. MS reiterated very high interest in Daybue but moving to a more consistent level of weekly scripts.
▪️Asked about guidance Acadia will continue to give one quarter forward guidance until 2024 when they will switch to annual guidance. Less committal to which quarter they will switch to annual guidance than in previous presentations.
▪️Asked about pipeline. ACP101 trial in Prader-Willi Syndrome kicks off this month. Asked about competition in this space and I thought DW was coy in his response (given Neuren’s current Phase 2) and didn’t give much away - as you’d expect.
▪️Asked about cashflow/management over the next year and MS stated that Acadia would have been cashflow positive if not for the US$100 million payment made to Neuren ROW rights to Daybue.
Most of the above information was already known to us through previous presentations. Most interesting points for me where in relation to the large academic hospitals being virtually the same as COE’s except that don’t have the designation. Does this mean there is more low hanging launch fruit for Acadia to pick in these institutions? Also the discussion on seasonality was interesting but I can’t see how families would let the holidays get in the way of a life changing drug. On the other hand Daybue is delivered to their doors so how does the holiday surge of mail + public holidays affect postal/delivery times? Apologies in advance if the formatting is terrible - the HC popup ad is blocking my typing…
NEU Price at posting:
$12.75 Sentiment: Buy Disclosure: Held
(20min delay)