Alkermes at TD Cowen Conference: Neuroscience Focus and Financial Growth

On Wednesday, 05 March 2025, Alkermes (NASDAQ: ALKS) presented at the TD Cowen 45th Annual Healthcare Conference. The company outlined its strategic transformation into a pure-play neuroscience entity, emphasizing both opportunities and challenges. Alkermes highlighted its self-funding model and growth potential in the neuroscience sector, particularly through its Orexin pipeline targeting wakefulness disorders.

Key Takeaways

• Alkermes is transitioning into a pure-play neuroscience company, focusing on addiction and serious mental illness.
• The company is expanding its Orexin pipeline, with ALKS 2680 targeting narcolepsy and idiopathic hypersomnia.
• Financial guidance for 2025 includes projected revenues of $1.34 billion to $1.43 billion and EBITDA of $2.15 billion to $2.45 billion.
• Alkermes is expanding its neuropsychiatry sales force by 25% to 33% to support growth in schizophrenia and bipolar disorder.
• Phase 2 trial data for ALKS 2680 is expected in the second half of 2025.

Financial Results

• 2025 Financial Guidance: Alkermes projects total revenues between $1.34 billion and $1.43 billion.
• EBITDA Guidance: The company announced EBITDA guidance of $2.15 billion to $2.45 billion.
• Sales Force Expansion: Alkermes is increasing its neuropsychiatry sales force by approximately 25% to 33%.
• OpEx Discipline: A disciplined approach to operational expenses will support sales and marketing expansion and increased investment in the Orexin program.
• Revenue Transition: Alkermes is moving from manufacturing and royalty revenues to reliance on proprietary products, with a $200 million impact from the sale of its Athlone facility and the expiry of a J&J contract.

Operational Updates

• Orexin Program: Alkermes is advancing its Orexin program, with ALKS 2680 in Phase 2 studies for narcolepsy type 1 and type 2.
• Idiopathic Hypersomnia: Preparations are underway for the ALKS 2680 Phase 2 study in idiopathic hypersomnia.
• Follow-on Compounds: Additional Orexin candidates are entering the clinic this year.
• Manufacturing: The company manufactures its drugs in the United States, specifically in Ohio.

Future Outlook

• Therapeutic Indications: Alkermes is exploring additional indications for its Orexin compounds, potentially including other wakefulness and attention disorders.
• Dosing Flexibility: The company aims to develop a molecule with a tolerability profile that allows physicians to tailor dosing across sleep disorders.
• Clinical Trial Design: Alkermes will collaborate with the FDA to determine the ideal length of clinical studies for narcolepsy and idiopathic hypersomnia.
• Growth Strategy: The company is relying on its proprietary products for growth, with consistent growth expected across its portfolio.

Q&A Highlights

• Market Opportunity: There is a significant opportunity in narcolepsy and idiopathic hypersomnia, with many undiagnosed and untreated patients.
• Diagnostic Criteria: New therapies may shift diagnostic criteria towards more utilization of medicines in these patient subtypes.
• Dosing Strategy: Alkermes is studying several doses in Phase 2 trials to determine the ideal setup for Phase 3.
• Tolerability: The Orexin class of medicines has shown to be well-tolerated, with mild to moderate and transient side effects.
• Enrollment Progress: Enrollment for Phase 2 trials is progressing, with data expected in the second half of 2025.

In conclusion, Alkermes’ presentation at the TD Cowen Conference underscored its strategic focus and growth potential in the neuroscience sector. For more detailed insights, refer to the full transcript below.

Full transcript - TD Cowen 45th Annual Healthcare Conference:

Joe, Host, TD Cowen: Everyone, and thank you for joining us on the third day of the TD Cowen forty fifth Annual Healthcare Conference. It is my pleasure to have with us today for a fireside chat the team from Alkermes. We have Chairman and CEO, Rich Popps and EVP and COO Blair Jackson. Maybe if you guys want to just start off with a quick state of the business, obviously, a lot of progress on the commercial front and through the pipeline and maybe what should investors expect over the next twelve months and then we can kind of dive into some of the specifics.

Rich Popps, Chairman and CEO, Alkermes: Thanks, Joe. I’ll be brief. I mean, I think the gratifying thing is that the business is evolving exactly as we have intended it to evolve over the last several years. A couple of years ago, we decided that because what was happening both commercially and in the development pipeline that focusing the company as a pure play neuroscience company made a lot of sense because it would have two really distinctive elements. One would be a profitable and growing commercial business focused in the neuroscience with addiction, serious mental illness, with drugs and schizophrenia and addiction.

And then also this this Orexin pipeline that we were seeing scientifically was maturing really nicely. And our hunch was that that was going to mature into what would be a really exciting lead product in 02/1980 but also pipeline products behind that. So as we roll now into 2025, we simplified the business in a great way. The cost structure is in great shape. Commercial products are driving a billion dollar top line profitable company and that funds the expansion of this Rexn pipeline.

So it’s a non dilutive self funding way of expand expanding and elaborating this pipeline that we think has the potential to be one of the really hot new areas in neuroscience and in pharmaceuticals in general. This orexin pathway is foundational to wakefulness. So it’s called the master controller wakefulness. And I think you all are beginning to see from us and others the data emerging that if you can develop small molecules that can mimic the action of the natural neuropeptide you can drive significant wakefulness. And the first demonstration of that will be in nature’s knockout model which is narcolepsy type one, which is a deficiency of these neurons in this neurotransmitter.

So in the first embodiment it’s replacing a deficient natural neurotransmitter and seeing whether we could recapitulate or approximate the natural sleep wake cycle. But the pharmacology extends obviously well, well beyond that. If you can do that safely and in a well tolerated way, You start narcolepsy type one, the penumbra extends to narcolepsy type two to into idiopathic hypersomnia and probably beyond that into other wakefulness or attention or vigilance indications where that type of stimulus of that circuitry in the brain could be useful. So we feel like we’ve been doing this for a long time. We’ve evolved this business in multiple ways in response to different environmental conditions.

Started as a drug delivery company focused on delivery drugs into the brain then we elaborated into a very, very advanced drug delivery company with medicines that we developed big pharmaceutical companies that drove a significant top line business of royalties. We segued completely from that business now where the top line is all proprietary products that we invented ourselves, developed and got FDA approval. So we have a lot of experience and a lot of scars and a lot of I think real world sensibility that we apply to the development program now. And I think you can see it in the way we’re developing ALKS two thousand six hundred and eighty. So maybe that is introduction, Joe.

Actually, I’ll say one other thing, which is the macro environment is actually central for what you guys do and for what we do too. And it’s something we’re very, very plugged into. And I’ll just say I feel like Alkermes is extremely well positioned in this complicated environment for the following reasons. We are developing drugs that are ones that we feel like payers won’t have an opportunity to really control the tempo of their use. If you’re developing new medicines that are disease modifying to replace existing medicines or improve on what precedes them, it’s very difficult for payers to have the upper hand in restricting access to them.

And that’s why we think this erectin profile portfolio is so important. We manufacture our drugs in The United States. We actually manufacture them in the state of Ohio, which is not irrelevant. We don’t sell our drugs in Europe at lower prices. We don’t for that reason because at lower prices.

And I think that we’ve got a business now with its profitability driven by a diverse top line, go to self fund, not have to rely on the business to use the equity markets to fund our program. We are not capital constrained. And I think that we’ve got the ability to develop medicines that can thrive actually in a price sensitive market. So with that, I’ll stop Joe.

Joe, Host, TD Cowen: And if anyone’s obviously done their KOL checks on the mechanism, it looks like these can shape up to be pretty massive drugs. Maybe just to set the stage, how big of an opportunity is there in narcolepsy and idiopathic hypersomnia? Maybe what’s the unmet need from a oxibate bedtime oxibate standpoint, those that aren’t controlled on stimulants? Kind of where would these kind of fit in?

Rich Popps, Chairman and CEO, Alkermes: Blair, you’re starting to have some color.

Blair Jackson, EVP and COO, Alkermes: Yes. I mean, I think this is a really interesting marketplace because, there’s a surprising number of narcolepsy patients around the world and in The United States. And if you look at the current market right now, it’s about a $2,700,000,000 market, but that’s really only driven by about a quarter of the patients that are being treated. So about sixteen thousand people are receiving the deoxibates, which are really the leading drug in the space right now. The other seventy five percent of the people are being managed by things like antidepressants and stimulants to try to deal with their symptoms.

So it’s a huge opportunity for drugs that can fundamentally change the disease profile. And what’s really interesting is there the diagnostic criteria between NT1 and NT2 can somewhat be blurry. And then when you get into further elaboration of the disease into something like idiopathic hypersomnia, it gets even more a little more nebulous. And I think what’s super interesting about this space is despite the fact that there hasn’t been drugs that have fundamentally changed the disease, you’re still getting a lot of patients being managed by these physicians. And one of the things that’s striking is there’s actually two hundred thousand NT1 and NT2 patients who have the disease, but only about one hundred thousand of them actually get the diagnosis because it’s just not driven by the therapies that are there.

So as these new this new class of compounds come into the space, there’s opportunity to penetrate into the currently treated class, but also to start to shift that diagnostic criteria towards more utilization of medicines in this patient subtype.

Joe, Host, TD Cowen: Perfect. And across the NT1, NT2 and IH subsets that you’ve demonstrated efficacy in so far, you are almost maxing out that that MWT efficacy signal. I guess, what is your expectation for Phase two? Do you need to max that out? Is there an ideal kind of level of benefit of wakefulness?

Rich Popps, Chairman and CEO, Alkermes: Well, I think the most important point to realize is that this is a new therapeutic category and I think it’s incumbent upon us and I think our program is doing this to define the dose ranges and the degree of efficacy driven by those various doses against the backdrop of the variability of the disease. NT1 you almost model as more kind of mono dispersed phenotype. But NT2 IH is a broad amount of variability. Our view is that you want to have a drug that can address all the variability in the patient population, as well as the variability of individual patients’ desires and needs. So in so doing then, you need a drug with a fairly wide therapeutic index, and you want to test it across all those doses in phase one, phase two.

And that’s exactly what we’re doing. We’re actually building a profile of a medicine that we think is we’re building it for the long term. Because we see as Blair said, the differential diagnosis between the various disorders is blurry. And also different patients have different desires for their treatment outcomes. So what we’re hoping is that we can build a molecule that has the tolerability profile and we define it clinically in such a way that physicians will know how to use it across this entire spectrum.

Joe, Host, TD Cowen: Maybe related to that we have heard from our KOL checks that it would be ideal to have a range of doses to kind of tailor the Rex and need to the specific patient. I guess in the Phase two you’re obviously studying several doses but will you be how will you be able to interrogate sort of that dosing flexibility structure? And what’s the ideal setup to kind of enter a Phase three? Would you take four multiple doses per indication?

Rich Popps, Chairman and CEO, Alkermes: I’m sorry. I realize I didn’t hit. As it wishes, which is typical. You’re asking, so what looks like good efficacy? So what the recs in class has shown in general right now, ourselves and others, is the ability to almost peg that MWP test as far out as you want.

And right now, so the construct that people use in the clinic is this forty minute minutes of wakefulness test. And it’s just it’s an artificial setup, right? You put people in a dark room and measure how long they stay awake. And if you have NT1, you’re going to fall asleep in under five minutes. And if you take an oxibator of the current drugs, that five minutes might become ten or eleven, 12 minutes, not very much.

And the erections have shown the ability to drive that to the limit of the test itself. I don’t think you need to go all that way. I think and I think different patients may or may not want to go all that way. And that’s why the range of doses, that’s what got me on this diatribe about the doses. You’re going to want to have a range of doses because if you have dose proportional responses, you’ll be able to dial in duration with dose as well as the magnitude of effect.

So there should be no I think the first principles you want to have a significant space between these drugs and the drugs that precede them, I. E. Modafinil, blocks of base. They’re well tolerated and they’re driving significant wakefulness beyond that. That’s table stakes.

That’s going to get you in the game. And then I think it’s the qualities of the drug from a commercial perspective that separate between the various competitors.

Blair Jackson, EVP and COO, Alkermes: To your question on the clinical trial, I think as we look at the program, one of the things is we have three doses in the NT1 population of four, six and eight. And then we have three different doses in ten, fourteen and eighteen in NT2 and IH. So it allows us to interrogate a wide range of doses across the various treatment profiles. And our goal in the Phase two is really to elaborate the range of dosing, both on the low end and on the high end to characterize what best works for this treatment population. Because we expect to see a little more variability in NT2 and IH than in perhaps NT1, just given the nature of the disease.

So then as we move into Phase three, we’ll set in on the doses that we move forward. It might be three in each dose in each cohort or it might be maybe two. We’ll see what the best range is and that’s what we’ll move forward with.

Joe, Host, TD Cowen: And can you talk a little bit about what you see as the ideal length of a clinical study for narcolepsy and idiopathic hypersomnia? The three kind of leaders in the space are maybe taking slightly different approaches. And when you look at the Takeda Phase three and look at the Syntesta Phase two and then your program, what is sort of the ideal?

Rich Popps, Chairman and CEO, Alkermes: The glib answer is the best program is what FDA tells you to do because they’re the ones who are going to be ultimately reviewing the application. And I think that’s why I think you see a couple of us have very identical Phase II programs. So back to the point about an early dated development in a new therapeutic category, what does FDA want to see? They’d like to see randomized classic parallel design studies with multiple doses being interrogated for a multi week period. So what you see from us and from Takeda has been parallel design studies, multi week, double blind, where patients there’s no move around on the dose.

And so in our Phase two, it’s designed with three doses, six week double blind period where people stay in their dose for that six week period. At the end of the six week period, patients will all go into an open label period where they center on the middle dose for two weeks and then they get to choose their dose. That’s never been done before because no one else has had the flexibility on dosing. So I’ve said before, I think our one hundred and sixty patients that we’ll have data on at the end of this year or the second half from NT1, NT2 for the whole field will be a huge increment of data because it’s the first time we’re going to see a range of doses across NT1, NT2 for an extended period of time, six weeks plus seven weeks looking at efficacy, its profile over time, side effect profile over time and the patient reported outcomes associated with being on these therapies for this extended period of time. I think it’s going to be really definitive in many ways for our understanding the medical and commercial potential of these medicines.

Blair Jackson, EVP and COO, Alkermes: I guess a question on how do you choose the dose range that you wanted we want to do. I think one of the things that we think about when we look at the the clinical trials take the NT1 patient population for example. When they come into our trial, they need to wash out of their existing medications, and that takes a period of time. It’s a few weeks. They feel awful after that, and then they get randomized into the trial.

And on day one of the trial, they know whether they’re in an active or whether they’re in the placebo because just the response is so strong with the orexin programs. So with an NT1 patient group, you want the trial to be as short as possible. It’s not really great for them over that period of time. And so if you look at our NT1 portion of our program, we have we have a shorter period of time in life versus the NT2 where it’s a little longer because the NT2 patients are maybe a little less severe when it comes to that. So as we look at the programs that as we move into Phase three, to Rich’s point, it’s going to come down to what does the FDA want to see.

And with Takeda leading the way from a time perspective, they asked for kind of a three month period of time to test those patients. But I think as you talk to them about the NT1, asking them whether or not they wanna see that level of efficacy or that level of time in those patients, I think that’s a discussion to have with the FDA. And if there’s opportunities to shorten that, we would definitely try to do that.

Joe, Host, TD Cowen: And can you talk a little bit about the ideal dosing frequency and PK of these drugs? Obviously, for programs that are BID, you know they say it mimics the natural sleep wake cycle and kind of pattern of erection exposure during the day. You’re once a day. What do you think related to that? What are the pros and cons?

Rich Popps, Chairman and CEO, Alkermes: Just to be clear I think people with BID medicines aren’t saying that’s what mimics the natural sleep wake natural sleepwake cycle. They’re saying that by dosing it that way, they can more closely approximate the natural sleepwake cycle, which is not bimodal. It’s a natural diurnal pattern. So from our perspective, from the design intention at the outset was to mimic the natural waveform by having elevated rate levels above threshold concentrations diminishing into the evening so patients could go at night. That would be a classic QD or once daily dosing.

The issue with twice daily or three times daily or four times daily is not necessarily the fact you have to take a multiple times a day, but by definition implies that there’s a diminution of activity that needs to be augmented. And trouble with something like this, you can’t dose too late in the day because then you’re worried about insomnia. So it’s better if it’s the natural PK of the molecule is consistent with that sleep wake cycle. So far that’s what we’ve seen in our study. And that was it’s not by accident.

Our background, we think about PK. We have so much background in developing controlled release medicines for injection or for oral. The original design intention was not just potency and selectivity and oral bioavailability, it’s PK because we think that’s the way that we can differentiate.

Joe, Host, TD Cowen: Maybe let’s talk a little bit about tolerability. What is your expectation for maybe what you are going to see from a tolerability standpoint in the phase two? We’ve obviously seen some insomnia which maybe we’ve already touched on. Obviously there’s the urinary urgency, AEs, and then also, some visual disturbances in the initial experience. Which of these are on target?

And can you kind of classify them in terms of ones that you’re maybe concerned about or ones that maybe patients can kind of adjust to over time?

Rich Popps, Chairman and CEO, Alkermes: I think we all benefited from the KATA Phase two data, the eight week data. It was really the first data set that showed the profile of continuous administration of these in the outpatient setting. And I think their data and our data taken together, it’s remarkable how well tolerated this class of medicines is. The effects tend to be mild to moderate transient. And you’ve highlighted the hallmark on target side effects that you see are insomnia and what we call polycuria, others might call urinary urgency, just that you feel this desire to pee.

And it doesn’t correlate actually with more urinary output. It’s just a sensation. And that appears to be dose dependent and also appears to be transient. The previous data set indicated that like the insomnia, it largely presents early in dosing first week or so and then diminishes without a concomitant diminishment in the efficacy. We expect to see that in our study as well.

But again, that theory plus data will answer the question. There’s been a lot of talk about visual disturbances. And a lot of that has to do, I think, with the ominous nature of the terminology. In our Phase 1b study, we saw one case of a visual disturbance in patients with NT2. That visual disturbance was noticing that the lights looked brighter when they were turned on.

That’s great as a mild AE. Mild means it’s noted by the patient, but doesn’t affect them. In the IH patients we had a similar phenomenon where instead of light sensitive blurriness of vision. Again mild and transient at the twenty five milligram dose, which we’re not testing in Phase two. With ends of one, you can’t we don’t know whether it’s on target or what, but that’s what this data set will answer.

In contrast to the 1B, now that we’ve identified that and other any other side effect, you look for it in Phase II. So for example, now in Phase II, all patients will have a baseline ophthalmic exam upon randomization. If you get a visual AE of any degree, we’ll work it up from a license ophthalmic workup because then is it people dilation? Is it something you know we don’t know now? But our expectation is that if it’s on target, it should be consistent with what we’ve seen before which is mild to moderate and transient.

But we’ll know with and that’s the virtue back to this idea of testing multiple doses for an extended period of time. We’ll be able to see if there’s dose response and the transient agent dose response nature of these, if that and any other AE.

Joe, Host, TD Cowen: Can you talk a little bit maybe about just the overall enrollment process, our progress in the phase for the NT1s and the NT2s? Obviously, the NT2 kicked off later, but it seems like due to less competition in NT one maybe those data will come around the same time. How are you thinking about that?

Rich Popps, Chairman and CEO, Alkermes: Yes. They’ll both finish up in the second half. Any of you develop drugs, if you look at enrollment curves, projected enrollment curves curves are very nonlinear because the beginning of it’s all about site initiation. And we’re initiating sites in Europe and The U. S.

And Australia. And some of the bureaucratic processes are massive. It takes months and months to get some of the sites up. So you say, why do you do it? By the time they’re up and running, the study will be almost over.

You do it for Phase three. So you have a big network ready to go when you flip over into Phase three. So our curve looks just like that. It’s very known. And you’re coming out of the holidays, all of a sudden, you know, it’s that’s why I think on our Q1 call, we should be able to give you a great degree of precision about where we are.

But right now, it’s all still settling in that second half.

Joe, Host, TD Cowen: And can you talk about the progress on the Phase two for idiopathic hypersomnia? What are the different sort of endpoints you look at in idiopathic hypersomnia versus narcolepsy and kind of how is progress on launching SW1?

Rich Popps, Chairman and CEO, Alkermes: It’s an interesting disease. You know remember we at the beginning we thought we might not develop this drug for idiopathic hypersomnia but the data from the phase 1b was so clear and we went and met with the KOLs and the patient groups and there’s just a huge need for new medicines for idiopathic hypersomnia. Despite the fact that it’s characterized by excessive daytime sleep it is a very different disease. Patients sleep a lot, they just don’t feel awake. They have a lot of sleep inertia, they have a lot of just different presentation.

And you can confirm that differential diagnosis in a sleep lab but it’s it’s and what’s interesting about it is its adjacency to patients without these diseases, I. E. It’s a more intact erectile system in the brain. And so the fact that we’re seeing wakefulness changes in those patients despite probably not an obvious REXN deficit is interesting. So it’s actually regulated by a different part of FDA.

Narcolepsy is regulated by the division of psychiatry and IH is is is the division of neurology. So we’re actually filing a separate IND with neurology. That’s why we haven’t started studies yet. That that that’s that’s all well underway. So we expect to start the IH study in the next few weeks.

It’s endpoint you don’t use the maintenance wakefulness test. We did in 1B to show the effect but that’s not the coin of the realm. For idiopathic hypersomnia you use certain patient reported scales. The idiopathic hypersomnia severity scale, IHSS and I forget what the primary is. Epworth is the primary.

Joe, Host, TD Cowen: And Blair you kind of mentioned this at the beginning that there’s almost a range between MT2 and IH. What do we know about the size of the IH population right now? Are these patients able to be identified easily? And are you easily to be able to tell who’s an NT2 and who’s an IH patient for trial enrollment?

Blair Jackson, EVP and COO, Alkermes: You know, that’s a it’s a great question. And the answer is no, you can’t really tell them very easily. And in fact, the easiest, the brightest line is between NT1 and NT2 because it’s sort of I mean, you could do it if you were to look at a rex and tone and you’re able to do a spinal tap, but you don’t do that in The United States. So what it really is, is the presence or absence of cataplexy that kind of gets you into that. As you’re looking at NT2 and IH, as to Rich’s point, the disease is a little different, but it’s almost IH is a diagnosis by exclusion.

And so really, it’s people who are struggling with wakefulness, who didn’t really fit into the previous two categories that fill that bucket. So I think as we think of developing these drugs moving forward and providing efficacious drugs that can now be used, I think you’re going to see that population start to expand. Right now, what we know is that there’s eighty thousand treated narcolepsy type one and type two patients in The United States, and that fits what I talked about earlier. There’s about forty thousand idiopathic hypersomnia patients who are being treated right now. How big that total population is though is anyone’s best guess, but it could be quite large.

Joe, Host, TD Cowen: And you do have additional orexin candidates that are entering the clinic this year. Can you talk a little bit about the differentiation of those versus 2,680? And kind of where else can you take this in terms of a therapeutic indication?

Rich Popps, Chairman and CEO, Alkermes: I just want to make one other analogy that we think is relevant and that’s what we’ve seen in the treatment of tardive dyskinesia, which really wasn’t a diagnosis until you have drugs. And so there’s two good drugs there now. And because physicians have an instrument to treat this condition the diagnosis rates go up. I see a direct analogy into these diseases of hyperosolimolence. So our team just got back from Italy.

I was talking to them yesterday for example, IH isn’t a thing in Italy. It’s not it doesn’t exist, so it doesn’t get diagnosed until you have a drug for IH and then so it’s the fluid nature of some of these poorly treated less prevalent diseases.

Joe, Host, TD Cowen: And then, yes, so then maybe some of the follow on compounds, how are they how are they different from 02/1980 and where can you take that from an indication standpoint?

Rich Popps, Chairman and CEO, Alkermes: So the sine qua non to play in any manifestation of these you need highly selective, highly potent orally bioavailable blood brain barrier penetrate compounds. So that that limits the medicinal chemistry space at the outset to structures that can satisfy those goals. Between the various indications we have not been specific and won’t be specific about the particular differences of them, but you can imagine how you might have you might have PK differences or you might have absolute dose differences because what you really want to avoid is substitutability between various indications. That also could involve additional pharmacology. So look what’s happened in the GLP-one space right.

They start with pure GLP-one drugs, then you add GP, then you add glucagon. There’s ways of dimensionalizing the pharmacology based on other known mechanisms that could be complementary to the indications you’re looking at. So we’ve been doing this for a couple years. We have some very good ideas on it. We’re not super keen on sharing them with others at this point.

Joe, Host, TD Cowen: And maybe on the overall business, you did announce the EBITDA guidance of $2.15 to $2.45 for the year on a GAAP basis. Can you kind of go through what goes into that? Maybe some of the changes that we should have you know, been forecasting in 2024 versus what we’re going to see in 2025?

Blair Jackson, EVP and COO, Alkermes: Sure. I mean, we’re coming off a big period of transition for the company as Rich mentioned in his opening statement. And I think we really kind of completed a lot of that activity last year. So as we look at moving into 2025, we see a couple of things. First and foremost, we have a highly profitable commercial organization, three products.

We expect to see consistent growth of those products over into 2025, Libolvie being the fastest growing of the assets playing in that oral antipsychotic space and we have expansion of the sales force and continued DTC activity in that with that drug moving forward. I think when it comes to the cost structure of the company, we’re going to maintain a strong discipline on our OpEx spend. We’re allowing for expansion, but one in sales and marketing for the sales force expansion in our psych franchise. We’re adding about another 25% of the reps, thirty three percent of the reps in the space. And we’re allowing for expansion to increase spend in the Orexin program to allow for movement into the idiopathic hypersomnia indication to get ready for Phase three and to move into some of those expansion programs with the new molecules.

That’s really all that we’re moving up on the spend side. I think the major difference between last year and this year has to do with that transition I mentioned earlier as it pertains to our manufacturing and royalty revenues. We did two things last year. One, we sold the Athlone facility to Novo Nordisk, so we’re transitioning out of some of that manufacturing and royalty revenue. And then number two, we have an expiry of one of our long term contracts with J and J around Vegas Astena.

So that has a net of about a $200,000,000 impact on the manufacturing and royalty revenue, that will that will we won’t see moving forward. But we’ve been planning for our business to transition for that for a number of years, and that’s what we’re gonna see going forward. We are relying on our proprietary products for growth.

Joe, Host, TD Cowen: Perfect. And it does seem like the the expansion of the neuropsychiatry force is gonna put you in a good position to maintain and grow your share in schizophrenia and bipolar even though there are new market entrants kind of entering here. Can you talk about is there an ideal patient for Libol V? Is there an ideal patient for Coben fee? How do you see the market kind of evolving there?

Rich Popps, Chairman and CEO, Alkermes: Libol V’s place in the market is driven by efficacy. That’s it’s it’s it’s raison d’etre and it has the benefit of the vast clinical experience physicians have with olanzapine and now with olanzapine with Libolvii with we’ve recently shown four year data showing you know the maintenance of the weight in this ongoing efficacy. So I think that unfortunately for patients this is a market that’s characterized by frequent switches. So the average length of therapy on an oral antipsychotic is six months. So when we see something like a new entrant come into the market from our perspective operationally it’s much more about maintaining share of voice than, you know, patients don’t get displaced off medicines that they’re on that happens naturally through the course of the disease.

So the sales force expansion benefits both ARISTADA and Libolvi and just keeps Alkermes, you know, share of voice at competitive levels.

Joe, Host, TD Cowen: Perfect. And with that, we are at time. So congrats on all the great progress and more to come this year.

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