Earnings call transcript Q3 2022

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Jonathan Neely

[Starts Abruptly]

Third quarter 2022 performance and our plans for the remainder of the year. I'm joined today by our CEO, Peter Miller; our President and Chief Operating Officer, Dr. Ramy Mahmoud; and our Chief Commercial Officer, Victor Clavelli.

The slides that will be presented on this call can be viewed on our website, optinose.com in the Investors section.

would conference remind statements. call I discussions that start, this during will we like you to our Before include forward-looking statements historical forward-looking not that hereby All as identified facts statements. are are

risks Forward-looking statements results differ from materially uncertainties statements. could indicated such cause to by and those are actual that to subject

section issued forward-looking the regarding statements on earnings the SEC our section website and discussed elsewhere website, today well their the under statements and we as as information optinose.com. sec.gov, Factors most available and that Additional XX-K factors cautionary OptiNose's under Risk of Form release is and at and the these are recent note forward-looking of that on with filed Form at XX-Q

The as this call we to any statement, You revise are cautioned undertake the not of earlier to such obligation place this statements statements. date speak conference forward-looking call only undue and no date forward-looking any statements. original of reliance in or of these or indicated during update on

will turn move session. will to I then With to that, make a now we will prepared We call Miller. Peter? question-and-answer over Peter remarks, the and now

Peter Miller

detail I'd Slide takeaways Thanks, morning. today. a on you into presentation. We X. today's from like but in more We'll joining Jonathan, Starting moment, to highlight go key us appreciate good and X

for as treatment in in a the consistent remarks discuss with a First, further the sinusitis. our for expectations during last cover call, September this to FDA XHANCE prepared NDA set met with Ramy our moment. we his in supplemental will submission chronic

was it a believe meeting. positive we summary, In

our we with that is early XXXX. Our now for following second today in takeaway expect submit to NDA discussion FDA, supplemental the key

significantly the CS us XXx addition new enthusiastic chronic current indication allow about increasingly health indication to where diagnosed will audiences use a payers, environment in nasal physician is the believe constrained to more and drive approximately we larger patient is an off-label we polyps, treat of access and growth. by the than remain care Third, potential to frequently sinusitis.

of cash we CS launch launch to tremendous Fourth, for company. can XHANCE position Indication, plan for our ever first to continuing for believe we success while XXXX enable reduce openly that in use future our successful a materially the

for Fifth, note in milestone the made for millionth the the reached was next. I'd quarter OptiNose it with that population importantly, possible And kind would larger to thank scale that at this XHANCE significantly given it for as achieve chronic approved nasal filled. like to a my diagnosed an come of X what third the may I like to us excited prescription sinusitis, colleagues treatment makes efforts when polyps.

results I'll to Ramy the now discuss the turn and call over next program of to steps. the ReOpen

Ramy Mahmoud

you, Thank Peter.

our earnings included of the to prepare that pre-NDA with call, as which Turning us will FDA planned, roadmap September. meeting guide Slide meeting last On XXXX, with we was That development the remainder our for conducted feedback received we our we help planned was and submission. the for you X. of shared as a end

received submission. expected now Previously, additional anticipate has occur content expectations of time enabled sNDA to scope the end the we feedback XXXX. submission of early include our for current on The us of XXXX. in the that the Based the the submission, of September we the incorporate in by to into preparation we to in

treat of of meeting pleased the with the were chronic disease for the to drug and would continue first this months, fall to be anticipate XXXX. type and quarter being in the to look we expect outcome of date Overall, sinusitis. we the of standard XX possibility forward therefore, to application FDA that to the the of pre-NDA fourth XHANCE approved common action FDA continue We the period review

of filing efficacy our database our support reinforced the supplemental novel that this meeting and safety clinical sufficient for belief NDA The the is indication. to

the trials with that you patients statistically both placebo comparator. positive, we to previously have those to significant a showing moment. reported XHANCE ReOpen trials compared the that for remind co-primary Turning were treated endpoints receiving to like improvement I'd for on both

measures of to of continue importance clinical of that can stakeholders, to pleased significantly are believe Therefore, number and interest nasal acute show of program We patients. the that prescribers to that that III to first reduce of therapy outcome the chronic are all we're rhinosinusitis. particular report is ReOpen a exacerbations we including aware Phase ever

are ambulatory source CRS XX% for care are for driver of that visit of major an in approximately adult there antibiotic making annually, Data of all doctor exacerbations suggests disability that the patients United a States. for who receive CRS this a use antibiotic, and physician XX context, visits a For approximately office patients. million CRS top

you're both to with produced to of It's only importance society, that easy to the risks to antibiotic-resistant as convey As XX% ReOpen CRS mediate of loss and such in quality gut for changes life XHANCE antibiotic reduction such finding not data treatment of individuals use emergence exacerbations of comparatively clinical trials aware, frequent or to CRS. but to pooled stakeholders the patients the nasal microbiome can the the pose acute organisms. from up of in all exacerbations as acute

is reduction of stakeholders of ENT disease. for specialists use podium for audience. presentation Annual from presented ReOpen XXXX. engage the October, that infectious section. major in Phase presented compelling The chronic larger III targets Society X first at successful specialty meetings. scientific the results abstract creating we Turning Rhinologic and a ReOpenX on and the is was the program Meeting Slide Rhinology range an and allergy to at IDWeek at new abstract during important our begin with Clinical beyond our associated physicians, presentation of multiple In a late-breaking exacerbations data for top-rated IDWeek information rhinosinusitis antibiotic current American is to significant opportunity and a of to X. XHANCE this trials September, In and The opportunities in acute conference in were

of trials, ReOpenX III Annual Phase Finally, we XX our on the look at X Immunology results November Allergy Asthma, of American forward College from to presenting the Scientific second the and Meeting.

ReOpenX publishing literature. our manuscript primary to We're sharing forward scientific forward, report of results look in to a look published. findings we an distinguished with and scientific and ReOpenX the of course, when update steering actively working is committee peer-reviewed addition, of the In

now I'll to turn discuss our third the call over performance. Peter commercial quarter to

Peter Miller

Ramy. Thanks,

Turning to Slide X.

everybody like Before to reviewing and to continue are full of year we the support quarter believe of there for take that moment XXXX, multiple XXXX XHANCE. performance revised a for to factors third remind a growth to future guidance I'd

chronic XHANCE tenfold the opportunity and create for should and polyps patients nasal number that, diagnosed a based foremost, first achieve sinusitis. and of we'll versus and we for of only CS, on treated approval believe as the First diagnosed FDA-approved we treated those for treatment

can care. access in that we believe and opportunity X/X our opportunity commercial within footprint primary current create an We of a partner for attractive

encouraged indication diagnosed belief achieved much This adoption nasal was achieve quarter polyp a been that we the a prescription date. XXXX, of of are what of sinusitis. has condition significant the supports XHANCE with In We the more commonly in to magnitude third product our can filled. chronic by X millionth of

by recognized with Importantly, we physicians encouraged practice. that has real-world in as growing benefits are become patients, using and product both XHANCE, experience the a also offering

all our finding the physicians physicians of and XHANCE comparatively are to market benefits. patient chosen on perceptions that treatment the offers large and treat suggest physician to patients, rate have research high patients meaningful both number both addition and an In refill

independent Among have from decision publication shared physicians, Thought with and both a in place XHANCE recognized having in CRS communities as a experts we at reported care distinct leading by nasal seen as ENT for a Allergy the sinushealth.com. and tool stepwise polyps Leader

the plan covers side, lives indication. XX% On in XHANCE are approximately that the of for approved payer today commercial a

to alternatives, has of to chronic proposition increase significant factors to sinusitis. there business. we an drive success believe and XHANCE in offers the long-term our approved if Given an economic our to there future coverage XHANCE potential multiple CS in and indications is belief the Those opportunity expansion the potential obviously compared clinical support value of the that approval include see is

data polyps late XXXX, physicians are with a from focus our there our in polyps, III new ReOpen Of also the to in compelling chronic clinical we but CS of approximately million serious Based the nasal physician believe treat are diseases. these the for treated that clinical a large nasal Phase may current the in program population to by As patient indication the million a only the physicians, lead on up visits value nasal and recognition X approximately of using are experience patients not annually. deployment. XX commercial patients to ultimately by of to to specialties XHANCE inflammatory or reminder, economic those, and payers

then and June and quarter. calling last our and noted said, months let the That Turning physicians that be prescriptions for year to for for me Slide new due July we the the offices seasonality. expectations fewer to On challenging discuss were XXXX summer and we a full including on believe what now reps on third results to our greater-than-expected based call, physicians factors, XX. review

net new million addition, rate market than would and of and sales increase program, territories In we to drive prescriptions revenues fall necessary initiatives deliver filling share promotional sales to a vacant the in we At ReOpen data us time, that full million a $XX our year market achieve for other would the the XHANCE vacancy XXXX. from the and including enable believe greater to had $XX rebound season typical allergy territories. materials, exacerbation that

the a INS to market gains for be on based the September, for trends anticipated August partial XHANCE. both in appear rebound observed we October, And data available In share the not and but continuing.

written prescribing grow, for payer that believe prescriptions decreasing of physician continues we Although proportion constraints, XHANCE writing the to is being and indications XHANCE off-label filled. believe especially of interest actual we in

In XXXX. full remainder revenues addition, factors, growth not these have the no $XX of delivered the and expect for expected in longer of gains million filled other share gains prescriptions. of between support for year to yet $XX the their expect share to we market now year the Because programs million volume expected

XXXX, third a which period. any were same prescriptions which over component written third includes prescriptions for of new prescriptions by XXXX, the increase INS approximately the XX,XXX In a for increased market X% there large modest to any physician, compared allergic XHANCE, quarter condition, rhinitis quarter for while our

of increased increase first first XXXX, months period. months the XXXX, For same there approximately X% X the while the INS new XX,XXX X X% the of market to prescriptions over a compared were

XX,XXX XHANCE, Slide which X% same XXXX third increased to to period. there for In XX. over the market while XXXX, prescriptions compared third quarter flat were quarter Turning approximately is total the

approximately For the period. same the total while of for to first a there the X% of XXXX, months X% the first increase prescriptions over months compared XXXX, XXX,XXX X were increased X XHANCE, market

and Breadth depth quarter of Slide XXXX physician number measured XXXX. of to market total X.X% was XX. did to who prescribing quarter filling XHANCE is unchanged of third the physicians quarter year. XXXX prescriptions from Turning of the have to increase compared third by patients share XHANCE in third prior

Regarding had breadth, third least of increase third X,XXX XHANCE, patient physicians quarter a of fill quarter X of XXXX. in prescription XXXX, XX% to compared an at

who than to depth, prescriptions in more physicians physicians XX the X,XXX grew XXXX the Regarding from as had with in this third by well, increasing patients XXXX that X% number segment. XHANCE by quarter of the third number quarter approximately of filled the quarter with

turn the discuss to financial to call Jonathan performance. now third I'll over quarter

Jonathan Neely

Thank you, Peter.

Slide Turning to XX.

The the recognized third repeat to year. onetime the did approximately third this million. in decrease net XXXX OptiNose not of million X% third rebates XHANCE quarter the the of $X.X quarter net compared we XXXX of of of XXXX, is $XX.X of primary a revenues of in disputed refund reported, that decrease revenue million $XX.X year-over-year As a driver of quarter

revenue increase better net For X year. measure of a September performance. that XXXX, of may XHANCE X% to reason, months the for million, year-to-date an XX, compared ended results $XX.X be prior the

of purchased on a to Slide per prescription revenue compared of XXXX. from XXXX the network, decrease our in available data third we from per the revenue directly X% was and XHANCE to XX. Based received Turning data third average of $XXX net for prescription prescription quarter preferred parties pharmacy on $XXX of third quarter

have driver refund. disputed of the growth net individual for revenue this some. than $XX of less and may prescription ended by XXXX of XXXX stands prescription this been the more increase without in are rebates X% quarters average in $XXX months As quarter. The per an September $XXX, informative thus year-to-date be of items approximately mentioned, net the quarter is that did per XXXX. revenue the I difference Net quarter repeat lower to X just onetime of per XXXX not XX, would onetime refund influenced compared Year-to-date, the revenue to of prescription primary is that third third at

effect a program proportion insured quarter net by We had we was made to number commercially As the that by per prescription deductible. reducing discussed our in offset to co-pay revenue of intended of on net the our contract change that revenues per XXXX revenue of the to revenue prescription decreasing plans, high revenue the intended plans of and increase we commercial in believe year. which start increase the co-pay average the at assistance patients both change effects have and per second fills change call, part prescription effect a this the and and net assistance due early increases volumes the government through believe the We increased and and in of helped have per prescription increasing to plans rebate prescription. rates of

XX. Turning to Slide

year operating net XXXX both We full have for expenses. guidance our for and revised revenues financial

reasons the Previously, be expect for we between $XX to million million million between XXXX. now $XX $XX earlier, be to expected net net the Peter XHANCE year $XX discussed to to For full revenue revenue we million.

Second, $XXX $XXX full average now per for exceed year full net to the average the per for we prescription approximately be of Previously, XXXX. revenue net year XXXX. expected we to expect prescription revenue

approximately be the the which expenses of to of compensation. now stock-based in expectations prior million compensation. year $X full million, operating in million $XXX approximately stock-based of expect range to from million of $XXX $XXX was to from million from again, XXXX For million, we expenses operating range down That's $XXX $X which the

expenses, to operating program because in launch. expenses research CS expect CS materially reductions to of operational decrease because continuing related compared a the promotional cash for operating XXXX of and to conclusion reduce the use opening alluded to will XXXX, With his of to XHANCE Peter we as while comments, both and of efficiencies to respect position our that in natural successful

December morning, Peter for in XX-month September XX, remarks. I trailing the will release noted revenue the covenants. press XXXX, back our XX, with agreement to the as call Finally, amended and this eliminate to over we Pharmakon turn now closing XXXX, Peter?

Peter Miller

Jonathan. Thanks,

creates Before we our supplemental pleased moving XXXX that open a the overall, CS CS, of launch that third to for nasal an business polyp it that submission now with made excellent enormous the opportunity headwinds, pad like moment nasal XHANCE. that scale the be clinically progress And a for to some ever call facing in important relative our the up like take a is are is reiterate we created I'd is quarter NDA would Q&A, and potential to business achieving product while has achieved for to towards polyps. to believe first we Q&A. the an of by in approval I'd

Operator

from [Operator with Santangelo Instructions] Our Glenn first Jefferies. comes question

Glenn Santangelo

a not you're on in shortfall assumes me. then maybe in relates of I guidance, quarter. prescriptions decrease to related of you it to billed. just And improvement you're point, pattern sort at fourth change again could it XQ the seeing that if really kind on but being to no in want some kind to that all to in really want if prescribing comments was the wondering just of XQ? number related more follow And unclear sort I confirm of revenue as It any seeing the the the sounds a to this you're of like of the elaborate up I was the quarter. problem, case making the

Peter Miller

I thing physician works. data prescribing on is the we interest. which we believe and actually The that, question. And really physician it, really interest based Well, to so is this what pretty that. thanks in That's are be for is Glen. and sure. isn't our the true, understand Glen, that's Glen, patients know that in the it for physicians I you proven think we product way sources, good seeing one an we issue growing, think of view, And know know communicated

polyp are number with product high it prescriptions not was historically actually a the on of as is correct what You're we're the proportion the the that filled is nasal focusing seeing indication. payers being to as limiting that especially as

encouraged such it can the said, that have improvement an get area. I as write us find it. makes clearly the to and that we ways in continue physicians So to address We feel constraints that to payer

and to to we October. the September time, early at Regarding Jonathan, in add into trends XQ. the there? just and believe that to Glen, trends We we anything guidance have XQ, that's led to -- at in in we going just, look point do saw did to you have continue, have are this what those

Jonathan Neely

think I well No, said. that's

Glenn Santangelo

reduction through cash to And you and out now filing in at next sheet, that how out? an that playing sort we expenses when could standard you cash and of maybe In given based you're feel maybe sheet you see expense also of that's ask via of assume know expenses in can to the that want would some other on this there you push materially burn the there equation. type kind understand XQ next some right, the to doing on have the XXXX. you current XX-month the NDA get the the confident I quick do side the question about of make incremental but review, said decrease you much. of plan on be to expenses the the one commercial year supplemental launch that talk I And release, balance you just I you it almost case, around the Maybe the balance you the And expect end maybe on look so sort into rate, But I partnerships, of year. won't why at enough approval. if

Peter Miller

thing to we that have really to handle majority for the opportunity here part, unique built about take the going it. the of one Jonathan that then on first significant portion let expansion a we Glen, I'm and is of necessary But of the label capitalize the I'm that's the opportunity. all CS, deployment really going to that

managers have -- chronic polyp So territory nasal against market, we are the deployed the really the writers but the best are already physicians will for not our best sinusitis. writing of only who who be

a really So other launch, the to a prepare there for for additional of need unlike launches. significant not is expense lot

you make I'll then I'll comment the and So questions. let other Jonathan, that handle

Jonathan Neely

Yes.

obviously way expenses program year, the significant with in trial I clinical the the of that Glen, we're plan for come reductions are the end operating the think, so remove there's from going of natural thinking And to will expense the about next expense amount that R&D line. a

thing to wanted for we're from the thinking the come had of at Maybe, sales touch also on we when business about XXXX. support expected with the But points the thoughts to we the ask more What expectation be chime your can an future. look and look early little to what date timing marketing, I we've want actually look the of XHANCE other -- you is submission. indication you value the our on on that in capital date be that spend communicated efficient we driver for touch should for filing. Previously, the sNDA position Ramy to the that in how XXXX maybe action or end I is FDA. about polyps Ramy, CS, preserve about in SG&A can a for think to and significant be at particular, with to capital in we and us launch the think which to nasal bit

Ramy Mahmoud

Thanks, Jonathan.

still you quarter. We in FDA the think, I fourth a with that the date do and not action to talking put associated We're the clock understood XX-month large correctly. about this Glen, filing expect delay.

The content got in filing not response And us from period meeting about extended the of We're of allow about optimize course, FDA to of so pre-NDA back to talking the we to talking the during is the in itself, time. of we're that, purpose submission an weeks. few a September. comments the

many product, range into in wants to you Peter the to is which already better And typical managed in be commercial already doctors also a allow something make of of is distribution that's -- that launch channels. just We for baked that understand course, care most think sure launch, in are organization indication. the in I'll new saying, that covers meeting the what reiterate and for are the product for of drug place already things things to was FDA think that product. of that else to the place contracts the that all the of having footprint us are already The those prescribing about we do the filing. productive are going in of is the our purpose

you sort are things lot think normally in already a that the a of of So in of place. launch

Peter Miller

it it's that the last label potential audience is on we're expansion, -- the have Glen, to unusual that rapid the just those And comment factors. uptake exact I'm familiar guidance growth this have and of such calling has what of in a any as to those broad because product giving -- all in that, potential, but the target reasonably they're if making not the certainly you and has area, because you're I'm or all expansion already of will, with reasonably rapid a

Operator

next comes with from Sandler. Amsellem Our Piper question David

Isaac Somekh

Isaac This on David. is for

on regards or force that in XXXX. to efforts in your volume year front, is your Just are adjust the -- thinking your I how current this needed strategy you And penetrated the the us do product payer here tell a universe? or sales now few in constraints are with growth position do we've us so revamping a on seen all? how the from you for your mean, you call at think commercial to

for whole versus quickly, then as X. the volume growth that And was category previous this a sluggish noticed sort of year the quarter I

if be coming takes about we and quarter helpful. revised But for and XXXX? there any the in covenants quarter. requirements think Pharmakon approach them, you of that be what's here color you sales do can't puts covenant super color helpful? you the And would would noticed lastly, And really meet how any So the on the the this

Peter Miller

chime our Vic, you like encouraged Isaac. feel we adjustments I'll the thing Relative couple. if the Isaac, a continued is to data take call, suggests on strategy, potentially the to can the by much, pieces. in prescribing of I filled are a are the on we -- polyps. of mostly, terms the proportion with mentioned, impacted I seeing, payer being prescriptions. people said, What in some constraints the that I'm limiting very missing is to we first are by being I you of as really the the driving around the as in interest written as those said mentioned product thanks nasal call, Well, we're

the sort our dampening around we've expected, effect more that's led obviously than change And that the that seen year. honestly, of our the we occurring for to thoughts in projections

a In good we sales terms a have the believe the interest of very that done changing strong in driving we has force prescribing. job strategy, very

ultimately number data, when group, X,XXX they're obviously the the of that significant prescriptions believer to good -- we that make prescriptions get and audience. for the need call in what the call through. then a we what our -- we our the a -- physicians, shift large of We have is pull to physicians written filled giving focus that in writing Isaac, have because our some the we sales have where force sure a tools to which mentioned of doctors, lot we they that

payer And issues. they obviously managing the are

an to our have product be doctors to to effectively a We that just that to more to get the better, pull-through to in will, to to addition we focus, way that the more getting that's focus what said, So going from interest in audience. we I other to we efficacy But it sizable management, standpoint, have to you side. applied on need that broadly if are drive a done. have -- groups, physician do frankly, broader need translate the find reasonably have we evidence have continuing and there's number we a of is as

penetration, we continue in just can to even believe polyp the of grow. terms In business, we nasal

gets you sure are side. have end, are interest in as to that I'll in will. on said, the the Jonathan, question just work We continue to on back -- making We pulled the I through if covenants. let we generating you address writing

Jonathan Neely

on category. also I is August, question are kind the the One that this than I'll what what's about QX. to deeper both Isaac, pointed and part historically maybe you was take basis. into a Yes. seen we August months, year-over-year And and June, remind what summer think a on category summer been saw to of your of for July over we July trough growth in thing

did we has to What trough September, in of That may the a a kind is good inside market. fall. return growth basis. year-over-year that to fall, net the the the see return look X% well to a what there like of which obviously, typical includes But volumes was on that summer as capture as of more

Pharmakon in this On the agreement. we noted release the the the covenant entered in side, press as amendment Q morning, we into fourth the

and Pharmakon XX-month revenue trailing waived QX the covenants. QX

historically it that agreement, was seen is into we've relief at point addressed in the where you've leave on we think points we just as I'll come that that. And those I that that things. needed what time

Operator

with Nachman Our BMO next question comes from Markets. Gary Capital

Gary Nachman

Okay. Great.

you're delay you feedback are the to What First, much the What filing? Ramy, CS elaborate said causing indication, looking of the things when broader was more slight FDA some were there any specifically you content. the surprises considering needed could maybe the from there? more. for You

could a color more give on that. little you maybe So bit just

number So that's one.

done. accelerate on partnership is reasonable able get get well. that And possibility do that much do in you be a specialty able a possibility that planning a would primary Peter, two, It that to also you how you're maybe as What's you'll assuming own deal to to frame would the area. that like discussions just be your I'm the CS done? Is have of been to more there sounds it on of but time your own, primary then any even care? for care And

Ramy Mahmoud

much that very you question. thank for Gary, Okay.

at meeting So was -- said, the end the of as we September. pre-NDA

Just quick the meeting purpose the planned of with the reminder, discussion helps primary as submission. pre-NDA a that clarify a FDA of to content have a is to

other takes see to of and in I'll and rather of way. few to helpful be the a reason by to would you submission review. of review we that's And It presented that to go complete conversation, question we that expect a sort turn that is and their kind tables figures, Peter, would why of of kinds early little different them the do incremental than consequence end all of identified part the it the you. to the in and XXXX. tables weeks the So that took additional which a things number as the be through like a over those work, that generate they to of XXXX, facilitate the to time figures

Peter Miller

on really about for partnering, the they is Gary, chronic try patients allergies. treated heard substantial that who sinusitis. I'll in Really, refer option primary And have begin real Their sprays. care, or only care. do not opportunity the care the into audience the million ENT a you've is many say they There's is good intranasal primary being have treatment in thing to X options primary us really times. there with as Yes. patients opportunity patients

on substantial So there's doctors, there. done all the we've we opportunity just continue to work a believe care based with primary

there. So I'll start

opportunity, we interested of timing we've the to it's there a Gary, of as that know, who's partnering, couple a that. -- of you is times, Regarding believe partnership, we've I of find as question reiterated, continue said and a as a the the someone will in because

range a done deals well it's If post at across of have approval. preapproval that as you as been historically, look

So maximization relative the to value deal. there is on partnering our focus

partnership continue opportunity. confidence I take that said, I have a to advantage as we primary have of to the And care will

-- a I force primary not X,XXX could are by way, a on about there's patients we doing reasonable there call that as we own, shift currently. in are doctors many to our -- care believe, that sales is Regarding actually it and doctors Gary, primary of they allergy that plans the there do number of our write as on, mean significant that see some ENT larger the offices. care CS our

sales X,XXX with own to on very thinking those now in significant our now, care our advantage our team -- a be could in own portion our take right the to space well our redeploy of deploy right care way plans a force. opportunity. think I So not against opportunity with a efforts But are sales of very capitalize primary what we or doctors the sales primary to good could expand is

Gary Nachman

guys decrease a you that will Okay. XXXX materially. expenses maybe just When Great. And follow-up. say

polyps, the And what's you to quantify of that any magnitude in doing backfilling do that, team you way? all modifying be able restructuring? So said, at like you how the any year could sales you you there, Just in think able will if you nasal will if order be just vacancies. you'll be And not next or you grow are to. real

Peter Miller

Yes.

it, of really side feel team, we our sales the On good about sales Gary.

product, As on, that real we've the we as we side. said, know team interest in that, especially is the driving said, on written

in giving that payer all the of more to get the them on pull-through end with focused constraints. the have order team, the We get tools to because back

nasal So indication. our polyp is sales grow continue even this business the in team really belief can a to

And the Jonathan, rest. view. our handle right now, I'll that's of let you So sort

Jonathan Neely

Yes.

expense so precise operating And for our connection of to operating has in fourth call. expenses, with in a provide practice guidance terms typical a our specific been quarter number earnings Gary, XXXX

in if But million were with probably point magnitude to $XXX the not what order I expectation But operating about future. XXXX. operating to be remove of for today good level. a But if going a we're towards expenses for specific our target that's So significant more of create for the and you change. were we'll start expenses, come back that's the one XXXX, some our about thinking momentum way of expense for would current be at at R&D XXXX, you component expectation here to think to look a specific

Operator

Ku comes Cowen. next Stacy with Our from question

Stacy Ku

a have few. We

that potential the maximize avenues outright what value average ex for thoughts U.S. noted rights. as They are net to considering for was as your And detail describing discussions, would we prescription? Any XXXX, first, pricing company this follow then dynamics thank be on had the underlying all creation, revenue kind in So the Atres. next strategic another prescription, so net updated year, options color for expectations of what conversations question about additional are a and by recently you your were you up follow-up, we appreciated. per for per initial saw with for think acquired you

So Peter, updated appreciate commentary. any we

Peter Miller

one. first the second take take you let I'll I'll one. John, the

Jonathan Neely

Yes.

what I historically terms for talked more So operating in done I we've think, XXXX expectations expenses our our per call. we've full revenue year expectations Stacy, is earnings of think about prescription, for again, QX in and revenue, connection with

talk So in to turn over of Peter today per next for I'll again, about to of I revenue the the And it to set back rest prescription don't think we questions. have an year. expectation terms

Peter Miller

consider that the we've stop value on opportunities going we there. frame and And shareholder on singular I'll accomplish could Yes. very clear value that to focus front Stacy, within been optimizing our are really And that that. is creation all

Operator

from question comes Folkes next Brandon Cantor. with Our

Brandon Folkes

year? imaging. just off-label this driver the anything we negatively headwind, what to is, point want I'm in script interpreting open insurer how kind terms the do in terms that at sure to Or elaborate can of on in in of you back this of CS that I think just the down data come I of only

as then well. a nasal percentage scripts maybe getting in XHANCE Just us helpful. a anything there just sort the And they headwind remind stuff then be have requirements polyps you in off-label putting year-to-date actually CS in off-label in like and been Or of the polyps just are stations the nasal would years? is this the more can headwind that at of of scripts? that And scripts approved for --

Peter Miller

for thanks Yes. Brandon, the question.

-- understand a plans doctors it are you really, that asking are think well, the if it that increased will, because patient test nasal we has enforcement, essence, for polyps, I have limitation indicated we, of to nasal the that polyps. Brandon, pretty you've stood in the is

of has is really issue that we're polyp the indicates of our And so outside writing. that, of around data having payer because issue the of that potential the nasal are And obviously as a chronic has patients than in product are belief smaller that the sinusitis. which works how segment the limiting polyps us with group because their know, you much not is to nasal an the physicians majority environment,

approvals, have we Within Brandon, nasal rates. high approval polyp

code, So nasal physician it if for rates the we approval has a high right diagnoses -- if have the very polyps. patient diagnosis

working shouldn't is, that -- the we know continue because team based continue on we say we and our what pull-through, with based on but build this interests. believe that we to by can can sales way, we know, to believe I that we drive So physician business we prescribing to call trends, why what can we the grow on current

work and necessary that tools just offices We sure all the giving team make approvals make have the the the to happen. the sure sales is to doctors to

larger, the many by this So CS bodes opportunity a the CS much payer what our going are to to that of believe for are way, population substantial indication. with obviously contracts is is we contracts, our we have the because

our see becomes of something for So something of large is when uptake be contracts a the in once business, CS that and written get is business potentially that could therefore, uptake the that could nice approved, we indication. very is we the potentially

writing X,XXX terms being there that are being the doctors but business in it's Brandon, the total, large of label, roughly is In broadly. driven written reasonably off a portion by

do is doctors the of of much nasal -- approval the approved when is rate way, -- issue is indication interesting, than polyps, not lower writing most It segment me. though so the percentage, a written outside that. write outside high physicians necessarily nasal of is population won't get the by polyps, excuse is of broadly nasal even our it's there on our it So product a reasonably are polyps, outside the way, the is of gets CS Brandon, that doctors than not What's for product. approved. By that

all think lead we I label, reasonably believe business. with we But with have see the sales still indication, larger of And substantially substantially absolutely have sort pull-through. the on really the on can said, that large, of so CS we to more get our We again these larger focused, business. us polyps. could a CS we it's team can factors we nasal think as a headwinds

Operator

I back like Miller am the at showing this conference to no for I time. Peter turn remarks. closing now would further questions to

Peter Miller

everybody, Yes. morning. forward touch. appreciate joining interest and look the in this Well, us being to We thanks, for

Operator

conference today's Thank call. you for concludes This participating.

disconnect. You may now

OptiNose (OPTN) 10 Nov 222022 Q3 Earnings call transcript