CHMA - Earnings call transcript Q4 2020

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Operator

Good afternoon, ladies and gentlemen, and welcome to Chiasma's Fourth Quarter 2020 Conference Call. At this time, all participants are in a listen-only mode. A brief question-and-answer session will follow the formal presentation. [Operator Instructions] Please note that today's conference is being recorded. At this time, I would like to introduce Glenn Garmont, Investor Relations. Mr. ahead. go please Garmont,

Glenn Garmont

financial Welcome website. Earnings Chiasma we Conference XXXX be operating fourth operator. copy release, Full which of issued Quarter Year quarter may and year full XXXX Call. on and via to you, press Fourth a our the found and our results Thank Earlier today,

including and MPOWERED market regarding MYCAPSSA; therapeutic and our to and our and market market sales to results of are lanreotide but MYCAPSSA; not and planned adoption of the ability MYCAPSSA, limited timing of composition During octreotide or the organization this endocrinologists making potential size be anticipated expectations our information commercialization including, potential These will coverage and its the certain forward-looking current EU. U.S. efforts in and statements circumstances, our concerning commercial based expectations the the call, support our available we marketing success; from financial and convert the U.S. access acceptance and statements potential for for ongoing and insurance and about on statements events injections; expectations to to, commercial MYCAPSSA of growth; MYCAPSSA application marketing commercial us. the strategy and and approval whether data to revenue patients and EU will MYCAPSSA; of

disclaims SEC. whether of these XXXX, ended December with as or Risk meet of or by contained differ or otherwise. statements, these detailed numerous Form may may the with Factors future subsequent achieve as new not law, any as required to documents. as to and intentions read carry obligation for to Actual Chiasma or on a information everyone our filed We forward-looking information, our in undue filings including encourage statements. risks update should events reliance plans well place section SEC these year We our those Except XX, due the XX-K You not our goals, results in the materially out the result uncertainties, events expectations. may

Joining Executive Officer, John Chief Chief and over Financial Raj? of Officer; point, Vice Kannan. Varadan, call Senior and Anand Officer. and Affairs; today Vice Executive Kannan, and Senior Raj Chief Bill President President President I'd the Ludlam, to is Raj Chief Medical Commercial Doyle, call Clinical At turn to Officer; Executive like this Chiasma's Development Vice the

Raj Kannan

turn our start for for launch application we date; you, and Financial thank Thank progress your Glenn, John before to Doyle, MYCAPSSA quarter my will with submissions call marketing up everyone and and review full brief on color with year will U.S. a MYCAPSSA wrap be this joining which will learnings EU today. closing later year. to additional plans our for comments and financial launch will Bill Ludlam highlights. you Chief our this our then Anand fourth update I will I comments phased on our Officer, questions, also and to available. provide

on start launch MYCAPSSA U.S. me an progress. providing update by Let our phased

that said U.S. continue and million end year XXX payers. we the We than did physicians, better We with traction I lives. quarter, anticipated I gain patients with much to that this. Last would covered

burdensome a provide for MYCAPSSA's over press treatment product physicians our for from which positive reported XXX encouraged secured today's the coverage in with we and MYCAPSSA good value of lives strong release, proposition We reflects believe on option their we update and we desire payer for As feedback were a January XXXX, for in million the for also less acromegaly. growth and patients on XXXX. foundation profile in and

patients estimated XX% on MYCAPSSA of U.S. to us injectables. promote allows Our SSA an acromegaly label to

team to launch. impact with traditional of that continue new become would standard drug the for living pharmacological to pandemic of part activities many ability the acromegaly. patients to the potential a our care continues conduct be Many to outreach that believe We physician education closures, The MYCAPSSA by of challenging and anticipation has and COVID-XX delaying result office sales person are of two we a be environment, strategy many visits, discussed we patients In as travel our and have seen other previously. physicians restrictions. simply office launch in of field ways, our which cannot this adapted in

both awareness to as in authorization announce Medicines our early application allowing European the for positive chose continued Shifting MYCAPSSA, we to First, leverage to plan With to MPOWERED III midyear. virtual to more we digital study, to for efficacy our MYCAPSSA submission top safety clinical from approach scores positive disposal injectables sales with and to the We're that to growth LAR data marketing results MYCAPSSA. MYCAPSSA. lanreotide in-person and a we in we business due, to for of commercial their treated increase Agency quality or of life were team; preparing compared MYCAPSSA. of our and line part, Recall at of positioned MPOWERED symptoms in octreotide patients benefits depot returns, Phase expanded continue further set of acromegaly the that on patients we process overall of calls, a the November. normalized excited the are efforts those phased a in educate the the prescribers, to our endocrinologists feedback drive build-out believe and capabilities many payers well patients and environment second,

this to in six We highlight presentation which will all long-term accepted for poster to oral These the announce late being that that Five an the MYCAPSSA's XX% in publication of the In had efficacy held ENDO will is subjects EU, addition clinical of trial March data open-label extension. data abstracts, later elected received the to the the demonstrating MPOWERED trial. for breakers, safety of results this of the MYCAPSSA voluntarily supporting been journal into evidence, during III to potential data. continue peer-reviewed from a to for XXXX, the submit of six Recall excited and presentation, efficacy. the XX placebo-controlled open-label be on from our add XXrd. and medical body Phase extension positive and portion these Chiasma accepted marketing one-year safety plan have MPOWERED the presentation at who approval We're year. abstracts to we've OPTIMAL randomized

on balance launch. me brief make adequately believe our sheet. We commercial let capitalized a our comment U.S. we're Lastly, to fund ongoing

Excluding year ended cash securities. with cash, the and restricted $XXX cash, we marketable million of approximately equivalents

repeating, an Anand on of update including believe progress. call the with point, we quarter, At have our MYCAPSSA. course spending indicated increases I'll the phased measured, last launch turn over bears in As this Anand? we launch responsible our XXXX been and of commercial but our for over to connection

Anand Varadan

I account phased of commenced the quarter, which to quarter, resources a accounts. to Last team continue Raj. selling, patient Beginning prescribing COVID-XX-related on that what across focused I we professionals while and manner launch, approximately Thanks, taking fulfillment we into sales commercial Phase deploy we in of our key one-third detailed also headwinds the the as the the see in intended to with calling identified processes. third XX late support we

engagement interactions SSA deployed of the unmet media enhanced clinical the As confirms we digital Raj with encouraging for MYCAPSSA's label and and profile. oral remote with We mentioned, HCPs for reach need to the the feedback these believe appeal customers and complemented early to from an and with and option patients. educate HCPs patients technologies patients enable and

fourth at experience COVID-XX early second at our to year challenges this the this the the believe support reach we as of time, HCPs during and order point this and launch. the another sales presents launch take with to hired beginning phased were professionals light in in decision more XX to sheds patients. addition on of of progress well provide target approach our expand that We decided we phase the the quarter who XXXX, and the as a audience to confirms trained to of intensive Additionally, to could

is organization being, that target expansion the while acromegaly we obtain MYCAPSSA support initial still a plan launch drive warrant. further the reach We to for and key are For current benefit will team customers coverage. time environment. commercial trajectory, Critical who ensuring can from rightsized of to feel launch conditions market our the accounting insurance evaluate that able patients as to successful is to the

our for XXXX exceeded entering million XXX with the of by million We access by significant XXX end have covered covered and market over lives with progress continued to XXXX make of goal lives. patients

We of coverage on able to shipments. XX% breadth patients injectable continue deploy expanding SSAs to obtain and practices, build to efficiency team. on into our medical on is concentrated, Because targeted success commercial to of than patients for the date we're are and an at be currently X,XXX efficient estimated to of prescriptions fewer and commercial more and the treated access acromegaly the U.S. market focused with speed converting increase also

restrictions digital phase remote were of continued the community PTCs digital PTCs higher-priority both through larger centers, reached practices reached treatment them pituitary which limited Our are the referral XXXX, to in non-PTC access, the our commercial call Among or academic emphasis face-to-face the in operate and of clinicians regional patients personal their on a fact with of that major influential contact. who who centers on sales or one-half we've the either focused We've nearly PTCs pandemic-related the with of initial with sales impacted centers of team. put sales number in to of we've of operating calls nearly colleagues. a treatment physicians on and or personal by group concentration an of are end highest PTC, either efforts Despite XX% accounts, or the contacts see endocrinologists. most

the the the we Traffic year. capabilities And websites download, this time complement both our patient visitors our of the of information deployment of expect continue phase pandemic. sites, digital spend, indicated these We beginning and the previously importance and HCP personal the content with this to they to our efforts. source they our expand exceeded to our interact they has selling with engagement during materials Also, to by second and the of reach have expectations. as as upgraded as to to of attest tactics mentioned, of the the

progress of into commercial we successful clinical have to shipments on in prescriptions of and the reduced staffing offices. of HCPs, in by the for remote and visits believe phase limitations the prescribing reaching impacted personnel for to initiatives with reduction access customers sales in offices have obtaining steady the commercial made HCP we've our been both conversion patient initial processes and patients, Although coverage and insurance of been

late patients patients of more our group new non-clinical for endocrinologists prescriptions prescriptions of have prescribe our launch broader source continue tended conversion of highest enrolled to of Importantly, earlier Due of of to were believe patients. promotional XXXX our by conviction which recently, pandemic become will of The an our to by third team, clinicians and conversions and phase of increasing they we diligent eligible operate contrast this extent, we've MYCAPSSA for the we been open to trial uptake III they've care in acromegaly. identify for pharmacological source the of the the entirely begun HCPs community-based to also standard as prospects fourth efforts treatment prescriptions. initial in penetrate driven the more identified of priority greater longer-term in efforts. extension as a represented sales of the effect the in was and in MYCAPSSA, continued as an studies. The practices our of the heavily continue oral from PTCs new to was which early near-term to the quarters Phase SSA More a open-label maintenance and been to

expanded in the the the needing increasing HCPs until speed The especially office to payer have expectations, that HCPs frame for be highest achieved but returns volume inaccessibility believe shipments time required expanded commercial who needed helpful of conversion than of a the depths efficiency of prior It's conversion have and significantly focused of similarly our environment. would SSA be the will environment as documentation conversion the in the we staffing to authorization prescribing will near our the becomes of complete expected place with the patterns. have have important among intensified in Depths with into been complete is to the have more important the prior coverage to in shipments documentation the multiple more HCPs and strengthen prescribing is longer non-COVID that we line MYCAPSSA. the prescriptions although are among term as normal patients to COVID-related many accounts of generally commercial that documentation to be XXXX to quarter timing in fourth the eligible MYCAPSSA. have on further note are efforts, still launch experience initiated phase trajectory impacted difficult by Overall, currently and of since PTCs greater was in in which for restrictions effect, they and favorable. nature payers. With of to to the predict authorizations the of fundamentals already driving believe We on patients tend we're selling second

review Now, let for the a me financial of turn to our John results. call over

John Doyle

$XX.X The with XXXX. $XX.X and post-approval and support supplies an and increase three of expense include Thank administrative of by related which production million million XX, the $X.X $X.X The were period ended provided development personnel-related in was the compared a commercial December launch, were that you, and Anand. for XXXX, were macro costs, trial our year December development months costs increase expenses full $X.X inventory $XX.X XXXX. for end the December with Research fourth pre-approval of the update. and our million in for our capsules XX, compared expense. the costs $X.X for approval to the $X the business million XXXX, the to year of in range marketing for year XXXX. XX, driven compared year capitalized activities, million XXXX. same full associated octreotide increase costs. XXXX $XX.X the costs were recorded million. million full million current ended Research MYCAPSSA compared with the and for and was for XX, XXXX the as an commercialization now R&D period to FDA for following fourth registry, decrease were state of the by quarter general we January the commercial full for upper ended to for and year XXXX, as at U.S. the full expenses MYCAPSSA and period manufacturing increased ended XXXX year the as Revenue $XX.X primarily administrative million million pre-commercial results quarter expenses and December months support XXXX, Revenue for X the in expenses U.S. administrative million Manufacturing X, XX Selling, with with in other $XX.X clinical the same of were longer disease regulatory no XXXX, offset our general as million, are sales of $X.X and of Selling,

net For $XX.X the per compared loss the $X.XX with $XX same period basic quarter million share ended a December or XX, XXXX. of XXXX, or loss was net per million $X.XX for basic of share

XXXX, the marketable securities, compared quarter XXXX. commercial year including of cash or or and the loss MYCAPSSA at continued balance excluding with our launch. of For least our XXXX. million $XX.X $XX.X million fourth as execution through full operations XX the share restricted per per share, next cash $XXX.X as million cash with ended currently for was full of loss $XX.X $XX.X We cash, believe We U.S. of compared basic basic is to the million equivalents $X.XX net $X.XX fund year the our December sufficient of a planned million approximately XX, net with months,

our on outlined plans of current compensation to Looking product preparations to January ahead, as stock-based of full new excludes in potential including is operating to in our be $XX for we $X update in XXXX and and potential expenditure X, launch business guidance we development U.S. anticipate expense the estimated This million million expenses based the year $XX programs. range $X range million, on additional million. of commercial MYCAPSSA

quarter modest the to pertains relative anticipate XXXX fourth growth sequential revenue, XXXX. of it to first quarter As we

and as support have place it put we pandemic business full year XXXX, more commercial normalized into a and the the believe trajectory For and in launch prevails. assembled confident we're will we the infrastructure that team the that subsides environment the

turn will Raj? I to Now, Raj. over it

Raj Kannan

John. you, Thank

We Let We to take strengthening built would as trajectory the U.S. strong XXXX anticipate we despite our us if me continued marketing of business forward met enter and our approval have excited in our in all the expand which the of saying in a launch about application we the allow reopens. approved, momentum I'm submitting U.S. benefits wrap XXXX, MYCAPSSA as milestones Chiasma foundation key up COVID-XX. for by at we our environment of having believe to patients MYCAPSSA EU, look shape to outside for a to

now will We questions. take open the your call to

Operator

Chris first you. At with be question. you and from session. Thank our of time, [Operator the question this Please line conducting we with will proceed Thank a Instructions] Jefferies. question-and-answer Howerton is your

Chris Howerton

the question everybody Thanks and the progress. taking congratulations on Great. for

obviously, important we a right maybe questions So could the the think, respect, for start very now. story with, commercial with I few of launch, piece me

So the receptivity different marketing of that things, you versus for your in centers, Anand, efforts centers. the one -- community mentioned of treatment the pituitary the was of context the

And those to to strategy versus is it efforts the I might guess, in for of, right pituitary kind So the reachable like more say, is visits by available that centers impactful of that that guess now let's TAM question. And that in-person as are to would what so be one make it have person. treatment follow-up accessible so the that's that in like I you about I the terms centers? that virtual better understand it relates much

And what, if I see, just that around that. after maybe is queue provide during to you're able you're stop Third and I'll question if the have I'll what yet? expectations been? Another if in coverage if seeing have hop those And any, around, there refill any XXXX? so, rates back is

Raj Kannan

Yes.

is this Raj. Chris, So

your questions. Just granularity. overarching address Anand a in and let more give for statements of some couple then of Thanks maybe that

call virtual not the in PTCs. within quality difference in much a think of the HCPs and general, and I terms educating PTC, visits the or there's our of of itself within the visit in-person

where is think does investigation in get with the the in-person paperwork done, like the sometimes we'll that the to have the get become disease necessary program rare ours, is area benefits I facilitating authorized Start a important patient. where Quick

And give that early and on with has so little quite we it those it the remote been dynamics challenges within And with coordination being of remote physicians being breaking requires COVID-XX, offices. faced some difficult. nurses facilitation bit where office a down,

terms comment the has it's can all of early bit on there's I to a that. nothing is surprising fallout. say, But think too that refill I a little in rates, on Chris, been

that continue comment which the we think with I Anand, the will had and some I progress easing hope the we're that that and with what hold. prepared coverage, So in terms policies made pleased do with that facilitate formal itself and place. And we reception I of continues in payers, to think XXXX. that want anything add getting progress that to the patients we that there of remarks, we're we did to our put that on is we in you believe just in paperwork last physicians making no XXXX are also to early responded? good coverage And certainly in by of one were when to

Anand Varadan

and Raj, Chris, question. for the also, Thanks, Yes.

-- me I'll this think, marketplace. employed I -- entering question let we strategy So answer regarding -- that let the me your the

as could able obviously this tier for restrictions we we and did the the accounts. access to months to for opportunity before we in had launch -- like. to Strategically, environment som the and And be COVID our best as prepare

community-based that endocrinologists based that the centers tiered at customers were patients -- we accounts to the top also the acromegaly that both volumes body and understood broader that have. then patients. they also pituitary priority concentration the then treatment then the we to because as And they have upon the put have they influence of have of we also are a top So, and

for the then tightened restrictions adaptation the the access. top the business fourth QX. most that little then the and in you on, be restrictions terms the Chris, the I needed to the PTCs, was go quarter, early of bit right QX it in had to of where to up we a relaxed that to make and they into end and is strategy, throughout the although want that to think at of tended again Especially ones access

So we almost head PTC because accounts a that access important if terms the persist them able setting, XX% treatment the see will, our ongoing then this and at said then gained more them going -- of focus bit expanded from as is some a to as we year. year, we And the of started get prescribing did center. broader to the we momentum more to penetrate product. what you those pituitary with this we base be continue like within the in end But to through momentum our the was of wanted to prescriptions until top the of could to point, of going from fully. the that the be coming we we've for pyramid, gotten And that's to of we into

adaptive, remote to when when versus quality But the customers is to the order what kinds So don't add get deliver some the what found strategically, we that is that's period introduced you I And focus be with a and in we of be can deliver And you with face-to-face the those needed understanding to to and in then that access face have call you full get longer time a the to you move first to full where where exactly both of able patient is would sales be from the do along on what be opportunity them. to face-to-face types call them MYCAPSSA right continuum get fact, able you and faster, you the in one. of to to calls call going face. instances, Raj high about targeted remotely thing we make we that that certainly said down so that they is place. them, product, their to And work we once be and prescription of office order the to that bringing the appropriate their do in and you're be can can to when wanting prescribe drop and prior can the easier calls it's facilitate process face-to-face patient to and to that to the prescription put scheduled that in and that move actually then much that to for, all between remote authorizations the at all you infrequent you that's along. then seeing identifying that there going to are and with into staffs then remote and the help is the that face-to-face If facilitate those of And times, we're -- process. can on interacting more like in that's distinction terms to help front. in occurring essential there ability slow in

that Raj So and refill on of it. I think rates coverage, captured most

If you that, you you further well. wanted on that detail I can as to with help had try

Chris Howerton

of long other things? would out as or they've the That's No. visits prescribing maybe that as types of on seeing I that No. visits a you're okay points to very converted. Is really it what physician as read and that, guess helpful. striking to that that follow-up a already touch a physician And impactful convert been to of it's be kind are to sounds maybe like me a in-person fair

Anand Varadan

Yes.

it, of think I right? So face-to-face or when be just a have when them can the they get get to doesn't you're permits call, very e-mail, up that can converted calls, lined do through to started spending there's then days. remote, get those in first process whatever, to this the Zoom, the remote process, then phone a it's substitute that, customer remote just sort And to sometimes you've Zoom effect exactly the if continue moving. those seen time whether scheduled, those timing, future set had some to launch, but if And But done and about actually in then instances, came propel launch into conference the order with able some little in a that for had a right that a saw you and it an up, you've we've move you to before you're -- we've discussion call, but face-to-face certainly But launch interaction. of all, you've you even get office initiated the engagements, matter these and scheduled -- lot didn't later talk fully, trying process in it's that's in the really through. no to -- those occur we -- face-to-face early instances, away. having can that early you're and video there's phase, a you right to call, in

Chris Howerton

I said more kind -- number about specific terms was of I launch information? to in health may. if but launch drug, plans of any question, any that -- I And provide physicians? strength on what The of Do done, in one of maybe metrics have you or prescribing Okay. terms patients for of the

Anand Varadan

So, yes, plan... we do have

Raj Kannan

Go ahead, Anand.

Anand Varadan

the Yes. We launch. think when that trajectory around most do to want it's provide actual time at have information, it of Chris. informative plans do We to a we the

think you everybody your think provide the clarity And I how are some would and are of the I trajectory, and want going. colleagues early factors of where we else about that right things now would that in not

changing more the terms that we're I soon the the we metrics, we as definitely a be So informative those positive as of of true as to be sharing that those sense it of in that favorable, metrics want becomes environment are also direction to hopefully would launch kinds then really things in seeing, would and you. have a think trajectory

Operator

The next Ted Piper question is line question. proceed with from your Please Tenthoff of Sandler. with the

Ted Tenthoff

sense that data you Congratulations sort time? how I to you're real on of coming to wanted monitoring for a scripts how is closely get the progress. and

Raj Kannan

an the specialty and we of not organizational or from, where a support have be from. the details, are good From opt to Raj. very your firewall from we a coming obviously do have to patients sense have prescriptions who we is compliant. know question. where do are, program are any where patient prescriptions patients we have we a in, Because names but speak, Thanks coming the this for those with just a very close patients' Ted, a pharmacy monitoring, do standpoint, so

Beyond that, Anand, did add you something? want to

Anand Varadan

mean it closely. extremely Ted, we I No. but just, -- follow

to us the to instantaneous that's where more that that's no have metric that is. So system there's our clearly, relevant allows progress, described distribution of -- understanding Raj

put need a to so and drive trajectory. track terms that we that emphasis where helps And that in to and being able of the continue focus lot to

Ted Tenthoff

starting of pricing, people is the pricing And $X,XXX the to in average XX real probably how a How net or quoted looking that is And get world. makes to with respect mg, supply. what of a to with just using? lot any -- respect bit then sense still early, discount? That gross weighted price it's guys think of just sort of sense. maybe in but you Trying to for sort XX-day to terms a I little hold are on up like

Raj Kannan

this me at let missed a can add you Anand, if I've something. So and commentary, then take crack

Ted, you is your price great the day, XX-day for predominantly at Anand? set Anand made what remember, -- part significant means we question. $X,XXX progress terms in I question, per equation. think for from being other I'll on supply. today becomes which this value that details So that's price of see, That with had way that a price, in XX-milligram a with a the payers payers. And in let more we're weigh a of replacement

Anand Varadan

Raj. Thanks, Yes.

of lot being patient the more of in that -- XX-milligram we're So terms the the dose. on introduced in these still these seeing doses, a of phase of of patients They're onto weighting the -- are initial Ted, -- the predominantly the -- MYCAPSSA. started being

our in that in is point. where would the our most in fact we at necessary, then as part, trial at clinical those the at came patients the see did this And this the that setting. XX moved up so And that, one tilt well. the terms as The that's that we then Phase mean open-label see would doses higher phase already juncture, dose of obviously, patients to start But some of goes. is spread for titration as dose, earlier some the III we of MYCAPSSA to study, converted a higher of that that of extension converted would or we'll at exception had from to the commercial the on, those they how those so have and titrated and patients saw

Raj Kannan

was gross net. other Ted, The of the the part to question,

guidance pharmacy specialty Part would a XX%, of Medicare the that early fees And XXXX gross be would would you hope a a and payer view of little net. finalized But to we payer as get that more in we history As majority have to seen, provide up it's have say the launch making able behind of have gross and any we to unless ended further that I to that on mix. gross further provide net, with we would better to I with the negotiations net us. D evolving

Operator

proceed from next with the Brandon your comes with Cantor line Fitzgerald. The Folkes question Please question. of

Brandon Folkes

about experience? any questions carrying for required ask what launch. switch one Or the you Can don't mind. happy an on Thank how more little just maybe restrictions is color talk with it on I'll on And early there? on on control titration Congratulations symptom insurance patients the a reported Maybe XXX date? you. additionally, on Are topic. from practice in generally is if front, perspective? the Any just you just insurance color they've to And tell gone million to a just early patient the those to lives? the switch during patient-report bit period? too any And the

Raj Kannan

questions. thanks for your Hi, Brandon,

part, specialty payer them have you all threshold, beyond a of coverage know, drugs all certain the On as prior ops. cost

our goes they octreotide be be lanreotide a to which there for or they for been the the is have ops. to our have over. although injectables have for on category, prior SSA long us, able prior switched And ops, So to injectables, with be all time, even label, obviously,

don't a I restrictions Beyond think any payer more that, from onerous there's perspective.

of macro actually to know, the an learn who effectiveness data MYCAPSSA do able patients physicians for gather of about switched replicate you those hope by as and clinical we those current part, the more we And On patients as will ongoing real-world over with be state registry get in the we patient have to care. symptom saw trials. that the on

sure has MYCAPSSA. this their helped in more very COVID-XX, MYCAPSSA commented that to but of not previous to it's given completely that, Anand words speak what as done. in So, challenges I with we on staff But you in particular And better the get questions. biggest lives with patient to right if that This switches, give actually well, data. also the -- a comments we but here, office fits I And learn had the would Anand Anand back, used the mentioned, those it well can that us has changer. telemedicine. been the what making be let hope say environment COVID-XX, coordinating of switching I'll with seen some word, have in that changed particular of terms in not just between terms more come seen any is terms we've environment in lack have have right, fits to of have the patients game haven't switches, terms from surprising already like of anecdotally, of challenge to for beyond it

Anand Varadan

Yes. Thanks, Raj.

what my the said process, how what of what to complete prior exactly and appropriate. in just, been that much to become we ways Raj authorization prior expected help which Brandon, and routine then in HCP's goes. just terms to is paperwork, starts and office, in really with that remarks, complete authorization correct can more once Raj can prepared work. laid is the we It's what a line out. terms has switching challenge, back need in is bit the the that insurance of They said as So they're in I to generally more us are that availability the routinized, little see some degree, And they in actually very

will I up. continue to that, speed think that

and are line Medicaid just our deck -- where on what the terms one of others in of of in XX% a of of question mix with about the account those what had the we rest. of fourth You part About before in Medicare, very commercial patients one on of corporate market therapy. it's what asked saw have much in insurance, times you for launch and we and fourth terms are then we as

point, And from who this have so MYCAPSSA initiated that this within the part well build have part the having juncture, because now, said, both and in as what experiences, the have real builds patient them lastly, just been. at is with on have, and and of to in good many that that line patients understanding to patient emphasis we with very is a practice of be as how a the for what you confidence fact as just on positive experience out, And community that, transformative is expectations can communicated the need of this at clinicians on getting seen we've our Raj's MYCAPSSA. the prescriber therapy, are benefited have to to the as here ensure when much very and they really

Operator

from question of Wainwright. the Doug line Tsao your with H.C. is next question. with proceed Our Please

Chris Bialas

for Chris Bialas on Doug.

from it is MYCAPSSA the the feedback two we that of heard between head-to-head data question about there has on And other our And received? then for the any importance So How us, the There about that of the and update been maybe or second syndrome plans comparison data. in lot commercial injectables. data MPOWERED U.S.? investor is, uptake has with carcinoid for developing first helped was indications? a question any are MYCAPSSA

Raj Kannan

direct comparison showing was which think on an to we're demonstrating this with important very a injectables us. non-inferiority I a with comparator, Chris, excited non-inferiority was obviously trial was active and because head-to-head or data, very MPOWERED the different

we , MPOWERED treasury always as prepared at have data in as The breakers we've trove in know, were about of And five important our of said life. we symptoms I efficacy, ENDO, of remarks, terms you quality accepted. safety, a that late think thing talked is, and

to data, our perspective, label, discussions forward to as as warranted. key OPTIMAL we a again, promotional the leaders forward Chris, we are opinion and presenting in look you to engaging appropriate the know, with from But we scientific in those So country look trial. restricted

medical payers these be on able the that But MYCAPSSA. to be was from in So more venues clinical gain physicians added we and the will OPTIMAL where and education the of perspective would publications to data focus and trial. data terms continue a to abstracts, would and KOLs

current make In this be in we is right terms sure on time, you how much prepared long-term that focused was patient for there launch fits on doing fully in we the said of capital for to to at driving population. development decide want like OpEx, always to is And of to But recall, Company long-term no next is preliminary to U.S. come out focused -- step this if guidance growth growth update story very At terms I obviously whatever plans programs question our said before, of of opportunity. best seems will as figure as on for what we logical this syndromes, U.S. terms a in within launch, strategy what's the We're a much the you MYCAPSSA on that the we in time, work with allocation even launch. we've benefits able expand carcinoid strategy. other the point And our that of Chiasma a is the that and in best with very Chris, that to within the the the organization, terms guidance. thing OpEx on were and that gave the was the earmarked drivers. next on our logical really in

Operator

Kumar Our question. Markets. with of your next Capital with Please the proceed Raja from Brookline line is question

Kumar Raja

to sales they I in are question regard able targeting, now where my on versus exactly accounts congratulations the With terms been in of for taking progress. force, Thanks to and the Phase they II terms have the of all of Phase target? proportion right

Raj Kannan

pass and one-third endocrinologists. remarks, Kumar thanks. I'll comment, on I'll to referred announced and recall how make have writers just maybe covered what PTCs we speak where to Phase And before started, what to we on learned to it more we a works are I, that the and If then let top-tier I Phase they Anand. Anand we universe as of when prepared and the high-priority I'll initially. targeted Anand? from brief the SSA we had community expanded then doesn't, Anand II.

Anand Varadan

you. it's Kumar, to good Thanks, talk to Yes. Raj.

And Phase I. than when II, people in are we we with so so covered -- Phase that of And number Raj more went force. sales to the the doubled

terms persist and community. effort. in were on I call on, and a the them also before the XX academic number treatment And meaning of focus sales extent of what terms a calls we endocrinologists because I, from II, then we prescriptions tops, community sales had towards large centers Phase each fruits did we're went the some accounts intensity large when the started representatives skew also we the late, both we And priority starting we've source of with higher on took territories. the we manage that from trying other see way had centers then of these pituitary continued large to in that that and contribute Phase territories of XX. the reduce in the provide to high-volume base. we've was that answered on that we When to more see those being within essentially of territories, the And coverage, people geographical penetrate did field And within see the to accounts, but those to centers large size as those that, to accounts of that just representatives a on smaller and of in focus territories, the that So that focus very with national pituitary to went place geographical earlier did then we so greater more and the patients. in could but

the those representatives, in can so depth we're COVID because get -- on going into for that And is calling when breadth we're proportion with way. with to depth driving And experience total have have multiple physicians you one-third fourth, that be to to to without to that my more converted of about prescribe, they went patients, from customer use the putting on we're But then that, of them. challenges the MYCAPSSA, written treating that, and environment be have both are know in get of can being depth, again if essentially that that getting a a I there But in are two-third those do to and the second, terms everything breadth, actually to patient, in to addition being of to MYCAPSSA of we having reach to that, interact as treated the focus customers. terms accounts. challenging before, physicians MYCAPSSA, then lot fifth of Within them that we that in a in mentioned through emphasis since because those emphasis more to remarks, have patients, we many we large though, have able able on especially base. putting then able third, and and drive from we driving many very to

a putting well. lot energy this in depth drive emphasis Phase of of and so as And terms we're II that trying to in

Kumar Raja

would how getting And drug? on of some of see the terms in patients strategy commercial the there? we on the vaccines in rest is commercial the those And commercial extension evolving have of we and the And opening what you also you are what are? so the OLE be seeing guys patients as strategy to the states where started what open-label up, the terms drug, can share of get

Raj Kannan

I'll... So

Anand Varadan

Go ahead, Raj.

Raj Kannan

Yes.

was mentioned the focus early as early therapy therapy. getting those get of third of And in to so open-label or access complete I or through them, off therapy have commercial their converted extension, patients at the least providers come on so as that companies early to were with those clinical on, the those patients, insurance of be well. work provide we of in of so. could part process, as commercial to terms patients off or all done on to of fourth a drugs to So, transition that quarter the then fourth lot of That's quarter, CAPS our they quarter, able to late

have we've seen extension open-label prescriptions terms the recently more doesn't component. impact from any of what So, in

are patients maybe you those as of a different to no way, said. converted, there be as more So,

customers have focusing and the have -- to matters It's and therapies very that once stage. we've when what this face-to-face interactions. made, in think those the we that when through restrictions phase we been the really the employed through continuing anticipate, on we're foundation these flexible on we've built early things. a that, question we've strategy regarding point, kinds strong adaptations place, at through what of really to a reopening to is we to that that And we we've vaccinations So point. the see as that further to accounts injectable breadth whether we of then latter that on trajectory of get drive from traction MYCAPSSA open this to might access starts our The And it's this full strengthening the switches at accounts, point. gotten other would to

Kumar Raja

you EMA in And how in about finding you partner are Okay. strategy where guys there thinking maybe on are share a you of details your finally, launching some strategy, or a question on and can Europe? maybe terms

Raj Kannan

Thanks, Kumar.

strategic continue options right keep open. our we have with the options collaborations of for EU, explore partners WE continue terms In that to the right fit. to

down progress road announce obviously, that we when and would have that. we concrete, As we something

we remain in it terms commercialize versus decision the options to had made I when our EU our a think to the comes where we clear own. U.S. on open of

Operator

At for time, we've Kannan question-and-answer session, turn this and the reached I'll closing our of the call end to Raj remarks. over

Raj Kannan

for Thank in another to look all Thank we forward you. a and May. the you speaking joining meeting evening. you with good Chiasma, first forward Have for our again call update very afternoon. quarter XXXX this to will we milestones, be look during important stated year and our

Operator

conference. today's concludes This

this You your you at your may time. for Thank participation. disconnect lines

Chiasma (CHMA) 5 Mar 212020 Q4 Earnings call transcript