SC Pharmaceuticals at H.C. Wainwright: Furosex’s Strategic Expansion

On Tuesday, 20 May 2025, SC Pharmaceuticals (NASDAQ:SCPH) presented its strategic vision at the H.C. Wainwright 3rd Annual BioConnect Investor Conference. CEO John Tucker highlighted significant advancements with Furosex, a diuretic designed for heart failure and chronic kidney disease (CKD) patients. The company emphasized growth potential through recent FDA approvals, Medicare redesign benefits, and an upcoming auto-injector launch, despite facing a notable stock price decline.

Key Takeaways

• SC Pharmaceuticals is focusing on Furosex to address unmet needs in outpatient diuretic therapy.
• IDN sales surged 12 times from 2023 to 2024, showcasing strong market penetration.
• The Medicare Part D redesign is expected to reduce patient expenses and increase drug fills.
• An auto-injector version of Furosex is set to cut costs by 75% and expand market reach.
• The company plans significant sales growth driven by nephrology, Medicare changes, and sales force expansion.

Financial Results

• IDN sales increased by 12 times from 2023 to 2024, reflecting successful targeting of integrated delivery networks.
• Recent FDA approval for the CKD indication in March, followed by its launch in April, is anticipated to boost market opportunities.

Operational Updates

• The sales force was expanded in October, with expectations of a positive impact on sales.
• The Medicare Part D redesign, effective January, caps patients’ maximum out-of-pocket expenses at $2,000 annually, potentially increasing drug fills.
• SC Pharmaceuticals plans to file an NDA for the auto-injector next quarter, which is expected to reduce the cost of goods sold by 75%.

Future Outlook

• The company anticipates a significant sales inflection point through the remainder of 2024 and into 2025.
• Key growth drivers include Medicare redesign, sales force expansion, and the nephrology indication.
• The auto-injector launch, planned for mid-next year, aims to enhance market penetration and reduce costs.

Q&A Highlights

• SC Pharmaceuticals is leveraging IDNs to maximize Furosex’s value proposition.
• The company sees substantial potential in the nephrology market, particularly among cardiorenal patients.
• Agreements with major PBMs in Medicare ensure no quality limits on reimbursement.
• The inclusion of Class IV heart failure patients has broadened opportunities in advanced heart failure clinics.

For more details, readers are encouraged to refer to the full transcript below.

Full transcript - H.C. Wainwright 3rd Annual BioConnect Investor Conference 2025:

Doug Zhao, Senior Analyst, AC Wainwright: We’ll get we’ll get started. So I’m Doug Zhao, senior analyst at get started. So I’m Doug Sal, senior analyst at AC Wainwright. Up next, we have SC Pharmaceuticals represented by the company’s CEO, John Tucker. So with that, we will sort of jump right in.

And so my first question is, so, John, do think the Celtics are still gonna win in six?

John Tucker, CEO, SC Pharmaceuticals: I might have been wrong about that. Right? And we lost Tatum. So

Doug Zhao, Senior Analyst, AC Wainwright: So I think it’s always helpful if, you know, if you can just provide a quick overview of the company and your commercial product and what the unmet medical need that it solves.

John Tucker, CEO, SC Pharmaceuticals: Sure thing. And, Doug, thanks for allowing us to present. So SC Pharma, think the name says a lot of what we do. We we’ve really been focused on on delivering drugs that are proven safe and effective, but are delivered in the highest cost setting of care, the hospital, with the worst patient outcomes, the hospital. But they’re trying to, create novel deliveries to drive that care out of that high cost setting of care into the lowest cost setting of care where the best outcomes in, which is the patient’s home.

Our first product, Furosex, is a % bioavailable furosemide delivered through an on body patch pump that the patient wears. Patients can wear this at home, do anything they want to do. They’re heart failure patients. So they’re probably not out running marathons. But they want to be home with their family, their friends, their neighbors, their pets.

And our technology and our product allows them to do it. The unmet need is simply this. We have six and onetwo million patients in The United States with failure. Four million times these patients annually will have a worsening heart failure event. So it’s not every patient.

It’s probably about one million to one point two million of them will have a worsening heart failure event where the oral Lasix, the oral diuretic they’re on, just stops working. Its bioavailability goes down to as low as ten percent. So this patient is taking on fluid. The diuretic, which is supposed to manage their fluid, can’t keep up. So its bioavailability goes down to about ten percent.

The patient’s getting worse and worse. Diuretics not working. Patient’s putting on fluid, can’t get out of bed, can’t walk up the stairs. The patient will inevitably end up in a hospital. So what we’ve done is been able to deliver 100% bioavailable furosemide, equivalent to the IV they get in the hospital, but allow them to do it at home to prevent that need for a hospitalization, to intervene earlier when that patient first starts struggling.

There’s no need anymore for patients to be sitting home for two or three weeks, hoping hoping that oral eventually works. Can’t get out of bed. Can’t get up the stairs. Can’t go get the mail. That’s what we’re that’s what we’re doing.

Doug Zhao, Senior Analyst, AC Wainwright: And I think one of the things that you, you know, sort of have two settings of use, I think, and think one of the early focuses was on sort of as you described to prevent a patient from being hospitalized. But I think that there has also seen some adoption in terms of as a patient is discharged right shortening the length of stay. And so how do you see the balance between use right between preventing a patient from going into the hospital at all or reducing the length of stay and preventing that patient from coming back to the hospital?

John Tucker, CEO, SC Pharmaceuticals: So we kind of look at it a little differently now. We’re looking at a kind of a pre IV patient post IV patient. So we really want to catch this patient when they first start failing on the oral diuretic. You’ll have days, maybe a couple of weeks, to intervene right there. Don’t let this patient get so sick that they have to be hospitalized.

We know every time a patient’s hospitalized for heart failure, for fluid overload, that they’re going to have worse and worse outcomes. The next hospitalization is closer. Eventually, death is closer. We need to intervene early, right when that patient first notices they’re a couple pounds over their dry weight. These patients all know their dry weight.

Or when they can’t get their slipper on because they’re having swelling in their foot. Walk up the stairs, they’re short of breath. Uh-oh, it’s happening again. Call that doctor right then. Intervene with furosex.

We’re not going to get every patient. Some patients are going to wait too long. They hate going to the hospital. These are heart failure patients. They have horrible outcomes.

No socomial infections, COVID. These patients go in. It’s it’s a bad experience for them. So we’re not gonna catch all of them, though. Some of them are gonna are gonna end up in the hospital.

So we have a couple different opportunities to intervene with that patient. They get in the hospital. You’re absolutely right. They’re in for two days. They’re stable.

They just need to finish the job. They need to finish the diuretic job, and they can finish that at home. Discharge them at day two, give them three or four days of phorosics, and they’ll clear their fluid overload. These patients are in the hospital now over five days. Five days just to get an IV diuretic that they can now get at home.

It doesn’t make any sense. There’s also the opportunity We know fifty percent of these patients are discharged, quote unquote, wet, where they have residual congestion. Why does that happen? It doesn’t happen in Germany.

Germany, they keep them in the hospital for twelve to fifteen days. Why? They don’t want patients bouncing back. In The United States, you just can’t do that. You can’t tie up a hospital bed for twelve days for a simple congestion patient.

So there’s pressure on the physicians. Get the patients out of the hospital early. You do that, they have a tendency to bounce back. Furosex is perfect. Patient’s been discharged, let’s say day two, let’s say day five, let’s say day six.

They’re discharged, come for their post discharge visit, residual congestion. Right there, intervene aggressively, get phorosics, keep them from being bounced bouncing back into the hospital. CMS recognizes this problem. And in fact, they institute a hospital readmission reduction program to penalize hospitals for excess readmissions. Furosex is the best tool.

Keep them out. If they do get in, get them out quicker or keep them from bouncing back.

Doug Zhao, Senior Analyst, AC Wainwright: And I’m curious, do you see in hospitals that, have worse readmission data, right, higher rates of readmissions, are you seeing them embrace four zero six, or is there still a bit of an education that you need to to to to them to understand the value that four zero six can provide them?

John Tucker, CEO, SC Pharmaceuticals: There there’s a lot of education at the hospital. You know you have the rank and file cardiologists who are admitting patients. If they’re not employees of the hospital, sometimes do I really care if there’s a high readmission rate? They care about their patients. A patient’s been in the hospital for five days, they don’t want them bouncing right back.

Part of our IDN strategy is really where the value proposition is strongest is is an integrated delivery network where the physicians are either owned or aligned financially with the hospital. The hospital owns the pharmacy. And so the alignment there and the ability to impact those early discharges and those prevention, even at the emergency room. We’re seeing some IDN hospitals. Patient shows up the emergency room, they get a quick cardiac consult, they send them home on on FEROSIX.

They get them stable and send them home. So really our integrated delivery network strategy is all about that, is really is really capturing the value proposition of of the of the product where the value can be can be saved by the IDN. And that’s that’s really what we’re we’re focusing. Our IDN sales were up 12 x from ’20 excuse me, from ’24 to ’23, a big gain last quarter, and we’ll have an even bigger gain this quarter. It’s much easier for physicians to write.

It’s in their EMR. They can order it right there. It’s easier for patients to get it. It’s on campus. And it’s easier to prevent that admission at the hospital or to early discharge them.

Doug Zhao, Senior Analyst, AC Wainwright: And and and obviously, you’ve been talking about IDNs, and I’m just curious, you know, sort of IDN is a catchall phrase that’s used. We have smaller IDNs, sort of local ones, although you also have sort of national IDNs or sort of almost a national scale like like a Kaiser. Do you see differences in how different IDNs operate, and are there best practices that you see? And and how do you sort of collect data, if you will, or or access some of the data that some of those IDNs are generating, if they are generating it, to sort of provide that teaching to to to to other places?

John Tucker, CEO, SC Pharmaceuticals: Yeah. So we’ve we’ve developed IDN protocols internally that we will, if an IDN asks us for, hey, what’s best practice? Cleveland Clinic just came on board. Two years knocking on that door until they finally came on board. They’re going to be our biggest IDN outside of Kaiser.

But they’ve created their own protocol. Cleveland Clinic has a protocol that’s blessed. And you could take that to some of the smaller IDNs. So each IDN, as you said, is different. You have the really large ones, the closed systems like Kaiser.

The VA is the largest IDM in the country, but Kaiser is the second. Really different. They’re very closed. But they’re actually using four zero six in all of their home health care discharge. And they’ll create data and write a paper on that to provide best practices.

We’re doing the same thing with Cleveland Clinic. They’re using it a little differently. Northwell here, again, home health care here in Long Island, they’re using it. So we have our own protocols. We’ll work with the Cleveland Clinic to disseminate their protocol.

Kaiser will actually produce papers and publish that. We’ll create another more data, more noise, and more protocols. The protocols are key, especially for the smaller IDNs that need them.

Doug Zhao, Senior Analyst, AC Wainwright: And you recently won approval for the chronic kidney indication. And how does that expand the opportunity? And how do you anticipate nephrologists using the product? Is it in a similar manner, or is it different than the original cardiologist target?

John Tucker, CEO, SC Pharmaceuticals: There’s about seven hundred thousand patients that have CKD without heart failure. If you look at a Venn diagram, you’re going to have all of these heart failure patients. You have all of these CKD patients. And a lot of them have both. The kidney and the heart work really, really closely together.

So what we’ve noticed we received approval for CKD back in March. This is CKD without heart failure. And launched in April into nephrologists. Some of the things we’re hearing is, where have you guys been? I manage all of the fluid from the cardiologists down the hall.

So we think the 700,000 patients great. Unique opportunity adds to the TAM. But the real opportunity is in those patients with what we call cardiorenal disease, where they have both heart failure and kidney, where we’ve been indicated in, but you’re hesitant to go into nephrology without that kidney indication. So we’re really seeing an uptick in heart failure treatment as well as kidney treatment and the cardiorenal treatment in nephrology. We think nephrology is going to be a big chunk of our business.

We’re looking at the early returns. It’ll be a faster launch than cardiology. I can promise you that.

Doug Zhao, Senior Analyst, AC Wainwright: And when you say that, is that just given the fact that there is some familiarity with the product because you’ve been on the market for a while? Or is it just that they are more receptive to the message that you’re sending?

John Tucker, CEO, SC Pharmaceuticals: Yeah. I I think it’s both, Doug. I mean, we did our ATU baseline in cardiology before we launched, and then and we did our baseline ATU awareness trial and usage in nephrology before we launched. And it was about threefold higher in nephrology. They’re more aggressive in treating.

This is what they deal with, fluid, all day. It’s fluid. As I said, they’re, in some cases, are actually managing the heart failure of the cardiology patient. They use words like, I’m going to get this patient totally dry. You don’t really hear that kind of language from cardiologists.

They’re a little more conservative in how they use diuretics, not nephrologists. They’re pretty aggressive. They’re going to write probably bigger scripts. You know, they’ve asked if they can use two devices at the same time or two in a day. So they’re very aggressive in in in getting the fluid off.

Doug Zhao, Senior Analyst, AC Wainwright: And and I’m curious from a reimbursement standpoint when you say, you know, they’re asking to use twice two two at a time. You know? And I I don’t think you’ve generally, you know, have quantity limits in terms of reimbursement, but how are you thinking about that? And is do you have to to communicate with payers just to the extent that they start to see this increase in the quantity being prescribed for for individual patients that they might start to think about, imposing sort of quantity limits?

John Tucker, CEO, SC Pharmaceuticals: Yeah. So, you know, we’ll see some quantity limits in state Medicaids typically at four. But the important thing on a quantity limit for us, they write for four, gets filled, the patient utilizes another script a day later. So it’s not an annual quantity limit. It’s not a monthly quantity limit.

It’s a script quantity limit. But we really haven’t seen that. We have agreements with the three big PBMs in Medicare to not institute quality limits. And we haven’t really seen it. Again, if the patient needs the drug, the doctor is going to write the drug.

And the plan, now that know all of our patients have had to fail on oral diuretics, that’s to the label, that’s how they’re managing it. But we really haven’t seen restriction that way in quantity limits.

Doug Zhao, Senior Analyst, AC Wainwright: And last year we talked about adding nephrology. I think it’s worth briefly touching on the fact that last year you added class four heart failure patients. And, you know, obviously you have a little more, you know, sort of, experience with that or just that’s been on the market a little long with that indication. What are you seeing from that, and how did that sort of impact the opportunity for you?

John Tucker, CEO, SC Pharmaceuticals: So it really did two things for us. One, it opened some doors, Cleveland Clinic, a perfect example. You didn’t have class IV heart failure. A lot of their patients are class IV heart failure. Kind of come back to us when you have that.

So I mentioned Cleveland Clinic again. It’s going to be a big driver this year for us. So it opened doors in advanced heart failure clinics where they have a lot of Class IV patients. It also has impacted our script size. These patients a lot of these patients are on, I’ll call it, maintenance diuretic therapy where the doctor might write 12 and have them take this Monday, Wednesday, and Friday, put it on in the morning, call me if there’s a problem, check-in every Monday morning.

You don’t have to come back to the IV clinic anymore. You don’t have to be hospitalized to get fluid off anymore. So it has caused our script counts to go up a bit with the class IV patients.

Doug Zhao, Senior Analyst, AC Wainwright: And one thing that you talked about in the first quarter was the impact of the Medicare Part D redesign that went into effect in January. And, you know, it sounded like it was a a a modest headwind in the first quarter, but you sort of think that it’s going to ultimately be a significant tailwind for you. Maybe just walk through how you see this driving to your benefit over, you know, not just the course of 2025, but maybe over the long term, what this does for you in particular.

John Tucker, CEO, SC Pharmaceuticals: Yeah. It’s a little complicated, but, you know, something obviously one drug on the market right now, it’s a Medicare reimbursed drug, 70%, seventy five %. So, like, last year, our biggest headwind to to net sales, to volume fill were patients out of pockets in Medicare. We made a decision. We thought the value of the drug we still believe the value of the drug allows us not to give 15% rebates to the PBMs.

And we didn’t. And then we did have some patients with high out of pockets. If a patient has a $2,000 out of pocket, there’s a good chance they’re not going to fill the drug. That was definitely a headwind last year. We saw it last year with a cap.

Now they said there was a hard cap. It really wasn’t. It was a soft cap at about $8,000 That when patients got through that cap in November, December, our fill rates went up. And when our fill rates go up, when a doctor can write a drug and it gets filled, they will write more drug. So this year, we had this full redesign of Medicare where patients’ out of pocket cap, the maximum they can spend in a year is $2,000 And CMS also allowed them to smooth that, to actually spread that over twelve months.

I think CMS was disappointed. We were at a conference two weeks ago where CMS had only 200,000 patients as enrolled in smoothing. Those are probably patients, oncology patients, Parkinson’s patients, who know they’re going to hit the cap. But our patients are heart failure patients. They have a lot of comorbid diseases with them.

So we’re really we were really pleased with how the redesign is going to help our patients. And it’s all about getting drug to patients. So our patients have $2,000 caps on all their meds for the year. What we saw in January, patients hadn’t hit their caps, didn’t smooth. We had that same headwind January and February.

We saw in March patients started hitting their caps or hitting a portion of their cap. Maybe they spent $1,000 already now. Oh, it’s only $1,000 I can smooth that over nine months. So we’ve seen more and more patients in March, especially in April and May, that have hit their caps, that are that have $0 co pays or low co pays and are filling drug. And what that does, obviously, it helps our unit shipped, helps our net sales, but really drives influx of demand here, March, April, May.

And we think it really is a big tailwind to us. Plus, I also think we expanded our sales force in October. It takes a couple of quarters for them to have an impact. We’re clearly seeing in April and May, March to a degree, the impact of that sales force expansion. And now you throw the kidney indication on top of that, which is just another accelerator.

And that’s why we’re so excited what we’ve seen in the last two and a half months and what we really think we’re going to see through the balance of the year and play now next year. And then next year, we’ll have our auto injector on the market, which we just think is going to be so much easier for doctors and patients. This is a five hour wear. That’s a five second push and takes our COGS down 70%, but really is going to drive penetration with the auto injector.

Doug Zhao, Senior Analyst, AC Wainwright: And I’m curious, you know, in terms of the auto injector, how does it fit into the strategy? Because I hear your point, and we’ve certainly heard it in other instances where patients like the simplicity of the infusers, you just sort of stick it on and forget about it, but it is a little bit of a limiter in that over the time that you have to wear it, can’t shower, have to worry about it falling off. So I’m just curious from your perspective how you see the eventual mix shaking out. Do you think most patients will ultimately gravitate to the auto injector or do you think it will sort of the mark will ultimately segment out?

John Tucker, CEO, SC Pharmaceuticals: Well first off the current for us it’s on binding infuser, the feedback from doctors, from patients, from nurses has been incredibly positive. This is the first thing that’s kept them out of the hospital. Works in thirty minutes. It works every time. It’s predictable.

It’s reliable. It’s doing wonderful. But to your point, I think there are a subset of patients that doctors say, I’m not sure. They can’t shower. Do they want to wear this around the house?

So that auto injector takes care of any of those limitations. So what we look at is about a ninetyten split. We won’t probably pull the OnBody off the market. For patients that have struggled with fluid overload, struggled with hospitalizations, struggled with 25 visits annually to an IV clinic, to have something that works, reliable, they trust, they have confidence in, we’ll keep that on the market for those patients. But we think eventually it’d be a ninetyten split, 90% auto injector.

Doug Zhao, Senior Analyst, AC Wainwright: And then you know so obviously you think from a patient convenience standpoint there are advantages from a corporate level, what do you see as the big advantage of the

John Tucker, CEO, SC Pharmaceuticals: auto Huge advantages. The big thing, obviously, is our COGS, which impacts our emergence. Our COGS go down about 75% with the auto injector. Huge, right to the bottom line. Again, we think it ramps up penetration.

It extends our IP to 2,040. And in a more kind of technical term, it eliminates waste in our supply chain. It really simplifies our supply chain as well. And it’s a lot better for the environment less plastics, no motor, no battery. So it’s just got advantages across the board.

And and we’re really excited. We’ll be filing the NDA next quarter, have it on the market next year. So we see these growth accelerators really playing out through the balance of this year, into next year and then another accelerator with the auto injector mid next year.

Doug Zhao, Senior Analyst, AC Wainwright: And I guess just sort of in closing, what do you think are because you’ve been coming out of the first quarter, you’ve been very sort of upbeat. What do you think are the three biggest drivers to drive sort of an inflection in sales through the rest of 2025?

John Tucker, CEO, SC Pharmaceuticals: I think the Medicare redesign clearly for us is going to be one. When patients can fill their drug, again, it helps our net sales, helps our unit ship, But really, it’s kind of a halo impact and docs write more. The continued expansion of the sales force or the expansion of the sales force we did, seeing all of these reps now participating, It takes time to build this business. This is you just need to walk in and start shifting doctors from one oral drug to another oral drug. You created a market.

These reps that have been out there a little while are really driving sales. The new reps are participating. So those two things, plus just the organic growth the product has when it gets on the market and does really well for patients and docs. But then you accelerate that with the kidney nephrologists, and we really think those are the big drivers for this year, into next year, and beyond.

Doug Zhao, Senior Analyst, AC Wainwright: Okay. Well, I think we have to wrap wrap there. So thank you very much, and look forward to subsequent updates through the rest of the year.

John Tucker, CEO, SC Pharmaceuticals: Great, Doug. Thank you very much.

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