SC Pharmaceuticals at The Citizens JMP Life Sciences Conference: Strategic Growth Insights

On Wednesday, 07 May 2025, SC Pharmaceuticals (NASDAQ:SCPH) presented at The Citizens JMP Life Sciences Conference 2025, focusing on the commercial success and future prospects of its flagship product, Furosex. President and CEO John Tucker highlighted the company’s significant revenue growth and strategic initiatives, while also addressing challenges such as market competition and regulatory hurdles.

Key Takeaways

• SC Pharmaceuticals reported $36 million in revenue for 2024, with projections of $73 million for 2025.
• The Medicare redesign is expected to significantly improve patient affordability and increase prescription volumes.
• The company plans to submit an NDA for an auto-injector version of Furosex in 2025, aiming to reduce costs by up to 75%.
• Recent label expansion for CKD patients and an expanded sales force are anticipated to drive future growth.
• SC Pharmaceuticals holds a strong cash position with $76 million at the end of 2024.

Financial Results

• Q4 2024 revenue was reported at $12.2 million.
• Full-year 2024 revenue reached $36 million.
• Analyst revenue estimates for 2025 project a growth to $73 million.
• The company ended 2024 with a cash balance of approximately $76 million.

Operational Updates

• Furosex was commercially launched for CKD in March 2025.
• The sales force expansion in Q4 2024 increased market reach, particularly in high-volume accounts.
• Furosex offers 99.6% bioavailability, providing effective treatment comparable to hospital-administered IV furosemide.
• The Medicare redesign, capping patient out-of-pocket costs at $2,000, is expected to boost prescription fill rates.

Future Outlook

• SC Pharmaceuticals plans to launch an 80mg auto-injector, reducing cost of goods sold by 70-75%.
• The company is targeting growth through CKD label expansion and increased focus on nephrology and pre-dialysis CKD patients.
• Fill rates are expected to rise to 60% by Q4 2025.

Q&A Highlights

• The initial focus for CKD patients is on stages two and three, with nephrologists aggressively treating fluid overload.
• The auto-injector is projected to become the dominant product, capturing 90% of the market share.

For further details, readers are encouraged to refer to the full transcript of the conference call.

Full transcript - The Citizens JMP Life Sciences Conference 2025:

Jason Butler, Biopharma Analyst, Citizens: Everybody, thank you for joining us at the Citizens Life Science Conference. I’m Jason Butler. I’m one of the biopharma analysts here at Citizens. Excited to kick off this conference this week. Specifically excited to be joined by our first company SC Pharmaceuticals.

SC Pharma is a company focused on the cardio renal space, is launching a product called Furosex. Had an exciting announcement just a few weeks ago with a label expansion to to patients with chronic kidney disease. So excited to be joined here by John Tucker, President and CEO. So John, thank you for being here.

John Tucker, President and CEO, SC Pharmaceuticals: Thank you, Jason. Great. Jason, thank you very much, and thanks, JMP, Citizens for allowing us to present the story. As Jason mentioned, really patriot centric, just focused on cardio renal. Commercial stage company, which I know nowadays is pretty important.

Commercial launch of Ferosex, we did 12,200,000.0 in q four. We haven’t done q one yet. We’ll be doing it doing it next week. 36,000,000 for the first for the full year in 2024, our first full year. Analysts have us at about 73,000,000 for this year.

We feel good about that. Strong financial position, 76,000,000, almost $76 at the end of twenty twenty four. Patent protection on our current product, which is our OnBody five hour infuser to 2,035. We’re really excited about our auto injector program. The IP goes out to 2,040.

It changes the delivery from a five hour on body wear to a two and a half second push, lowers our COGS by about 70%, seventy five %, which really flows to the bottom line. Long term growth initiatives, we got an expansion in the second half of last year in class four heart failure, which are the sickest patients in heart failure. New York Heart Association class four, we originally approved for two and three. As Jason mentioned, we announced we’ve received approval and expansion in chronic kidney disease. We received that in March.

We actually launched that last Monday, already seeing scripts for kidney from nephrologists, and then our auto injector submission in 2025. External growth factor which we think will be the most impactful for us this year is the Medicare redesign. I know for some companies it’s not a great thing. For us, it’s a great thing. Lowering patients out of pockets to $2,000 cap this year, allowing them to smooth that $2,000 over twelve months.

We’ve already seen the positive impact on this. Now you get a little GTN hit in the first quarter, but we’re seeing in March, April and May a big increase in our fill rates, increase in scripts written, and that all means an increase in units shipped and then revenue. So we think for ’25 and ’26 that redesign is a real tailwind at our back. Talk, let’s see if I can get this moving. Heart failure, about a $10,000,000,000 market opportunity in The US, about six point five million patients annually.

We don’t look at really count patients, we count events, how many times these patients have a worsening heart failure event. And it’s about four million times. So it’s about a million and a quarter patients that cause these four million events. Congestion’s the hallmark, fluid overload, that’s why they’re getting hospitalized. In fact, in patients 65 years of age and older, it’s the number one reason for admission and readmission into the hospital, which causes it to be incredibly expensive for CMS, for Medicare.

About a third of all Medicare Part A and Part B spending is on heart failure patients. And really, an HVOR standpoint, the real benefit for the system is treating these patients outside of the home, avoiding the admission and the costly readmission. This just kind of puts it in a graph. Patients with heart failure are about eleven percent of the total Medicare population. So eleven percent of the population is driving forty one percent of the admissions and fifty three percent of the readmissions.

This is what’s really driving the cost. These are why these patients are so expensive. So what’s our solution? So what these patients, this is really a bioavailability game. These patients are on oral Lasix, oral Furosemide, maintenance dose, almost all six and a half million patients are.

It’s when they have a worsening event of heart failure. Again, the hallmark of that is fluid. That the bioavailability of the oral goes down to 10%. So the patient’s getting worse, and the medicine that’s supposed to help them get better is actually working less, they need 100% bioavailable furosemide. That’s what they need, 100% bioavailable Lasix.

Before furosemide, the only place you could get that is in the hospital, or for some patients they go to IV clinics four or five times a week having to go there and sit in bed for five hours. So we’ve developed a pH neutral formulation of Furosemide. The IV has a pH of 9.5, you could never give it subcutaneously. It would be like putting detergent under the skin. It’s indicated to treat congestion due to fluid overload in patients with chronic heart failure and now with chronic kidney disease.

It’s an on body infuser. It’s smaller than an iPhone but the patient just simply opens it up, drops the cartridge or drug in, peels off the three ms tape on the back, puts it on their stomach, presses the button. That device, that drug device combo, it’s regulated, it’s a drug, replaces a day in the hospital. It’s as simple as that. Patients aren’t running marathons, they’re heart failure patients, but they want to be home.

They want to be with their friends, their wife, their husband, their children, their neighbors, their dogs. They don’t want to be in the hospital. We keep them out of the hospital. And for those patients who first start having signs of congestion, I mean, they can’t get out of bed. They can’t walk up the stairs.

They can’t go get the mail. Treat early with furosex. It’s a bio, how we deliver the drug is a biphasic delivery. We give them a bolus dose of thirty milligrams in the first hour. That gets them diuresing, getting the weight off, and then it’s a smooth delivery of 12.5mg each of the next hours for four hours, and this will get the fluid out.

The bioavailability 99.6%, and equivalent diuresis, equivalent amount of fluid overload as that day in that hospital, that IV. You’re going to be feeling better in thirty to sixty minutes. You’re not going to be going to the hospital. You’re not going to be admitted through the ER. You’re not going to go to an IV clinic five days a week to get fluid off.

You’re going to do it at home. Here’s our pivotal study, also our marketing study really, shows PK equivalent to the IV. That’s all we wanted to do. Say you were getting equivalent PK and PD, which is the diuresis, the amount of urine you’re getting out. And it’s the same with our drug as it is with the IV, which is exactly what we wanted to show.

This was the basis of approval. That was our phase three pivotal study. We’ve also done post marketing studies. Freedom HF study, which really what we did is patients showed up at the hospital, fluid overload, randomized them to treatment as usual, go to the hospital, or furosex. And we saw a difference in the primary endpoint here is heart failure related costs, saw a difference in $17,000 in how you treat these patients.

You hospitalize them, you’re driving up the cost of healthcare. You give them for o six and send them home. Ninety six percent of the patients in our study never went to the hospital in that thirty day period. One hundred percent of the patients in the comparative group did, and thirty percent of those were readmitted to the hospital. Then we did an at home study.

So this is a study saying if you’re in an acute you can take Ferosex and avoid being hospitalized. In our at home study, we went a step further. We said, okay, patient shows up at the doc’s office, so they’re not ready to be hospitalized. They’re having signs and symptoms of congestion. Randomize them to phorosics or throw the kitchen sink at them.

Double their oral, triple their oral, add a non loop diuretic, send them for an IV. And we saw statistical significant difference across the board in weight loss, in Dipsnea score, which is the biggest symptom, the shortness of breath. In hospitalizations, in quality of life, every metric we measured showed a difference between throw the kitchen sink at them or just give them fluorosis. So, what is this patient? Again, patients are stable.

I like to say this is an acute intervention in a chronic disease. These are heart failure patients. There’s again about a million, one point two million of them. They’re on their orals, they’re doing fine. All of a sudden, dietary non compliance, exercise non compliance, just progression of disease, they start taking on fluid.

The fluid retention again is the hallmark of heart failure. And what this decompensation, what this fluid overload does, is it causes the bioavailability of the orals to decrease dramatically and variably, down to 10%. So what do doctors do? They double the oral, they triple the, they do everything to keep that patient from being so sick they have to go to the hospital. Because we know, and the doctors know, when a patient gets that sick, and they have that much fluid, we’re talking thirty, forty pounds of fluid, they’re structurally damaging their heart.

You’re going to see the next admission and the next admission getting closer and closer together. So what we’re doing is intervening right there, right when they start that fluid retention to keep them from going in the hospital. This is the story I’ve talked about it enough. It’s highly variable bioavailability of oral furosemide. Ten percent one day, twenty percent the next day, you don’t know.

The doc doesn’t know, the patient doesn’t know. Furosex, ninety nine point six percent predictable, works every time. When we talk to doctors and especially the patient testimonials we hear about, boy, I’ve been in the hospital five times in the last year for fluid overload. I have your product, I don’t go to the hospital anymore. So it’s really doing what it’s supposed to do out there.

Again, the testimonials from physicians and patients has been amazing. Here is our opportunity for intervention. There’s what we call the prevention period where that patient first starts having signs. Again, they’re a heart failure patient. This isn’t a primary care drug.

Our call audience is cardiology. They’re at the cardiologist because they have heart failure. They start to have worsening signs. Hey, doc, my slippers aren’t fitting cause of all this swelling in our extremities. My fingers, I can’t get my wedding ring off.

I walked to get the mail and I was really short of breath. Intervene there. Right there. That’s furosex. Right there.

Don’t let that patient get worse. Treat that patient. Yeah, maybe you can double the orals and wait ten days and hope and pray that you got enough on. Don’t do that, use furosex. We’re not going to get 100% market share.

These patients will, some of them will end up at the hospital. Fifty percent of patients that get discharged from the hospital after worsening heart failure event have residual congestion, they’re discharged wet. They are at risk of bouncing back into the hospital. So what CMS did because of this problem is they actually introduced a hospital readmission penalty for these hospitals that have excess readmissions. Think of it from a CNS standpoint, they just paid $12,000 to the hospital for this patient, to care for this patient.

The patient goes out, they’re back in the hospital in two weeks, another $11,000 12 thousand dollars CMS said enough with it, we’re going to penalize you, your Medicare, they’re going to withhold Medicare dollars from hospitals for excess readmission. If a patient is discharged wet, and sometimes they don’t know, but what we’re seeing, especially in our integrated delivery networks, they’re discharging at day two. They would never do it before fluorosis because they worry about bounce back. Finish the job at home, Get them stabilized, give them two days of IVs, send them home with Furosex, finish the job. Don’t worry about readmissions.

The patient’s discharged, they come back post discharge visit day three, day five, they’re still residually congested. You’re really worried as a cardiologist that patient is bouncing back, give them Furosex, give them three days of Furosex right there. Talk about the commercial opportunity, I mentioned the six point five million patients. There’s about four million events that these patients contribute to. We think about half of them are addressable with furosex.

Some of them will resolve. Some of them, doubling the oral will work. Excuse me. But there’s about two point one million times where we can intervene at our average cost of therapy, and this is a fully disposable, they use it once, they throw it away, they put another one on the next day. This is our average cost per episode of about $4,700 gives us about a $10,000,000,000 market opportunity.

This is a really interesting opportunity where your stakeholders are aligned. I’ve done this a long time and you have stakeholders that have different incentives. Here with the payers, why are the payers incentivized for Ferosex? They want to avoid Medicare, they want to avoid that 12,000 to $20,000 admission. Right?

They don’t want to pay that. Ferocious gives them the opportunity to not pay it. That’s where the payers are aligned. Hospitals, everyone’s like, hospitals love full beds. They do.

Hospitals love full beds. They don’t like full beds of heart failure patients. Two reasons. One, they overstay the DRG, diagnosis related grouping payment, which pays three point nine days. They stay five point two days.

They overstay the DRG, and then they bounce back and the hospital gets penalized. And now what the plans are doing, CMS penalizes the hospitals with the Medicare withholding. The plans are now cutting the reimbursement 50% on any patient readmitted within thirty days of initial discharge. So hospitals are acutely aware. What do hospitals do when they’re worried about readmissions?

Like they do in Germany. Germany’s readmission rates are half of ours. They stay in the hospital twelve days. For simple congestion, you can do diuretic management at home. So that’s what hospitals do, then the hospital administrator comes to the doc and says we’ve to cut down our length of stay.

Furosex allows them to do both. Cut down your length of stay and reduce readmissions. Doctors, it’s a failure of diuretic management if a patient gets so sick that they have to be hospitalized, these are heart failure patients. They are the most vulnerable to bad outcomes in a hospital. Not just the cost, nosocomial infections, COVID, heart failure patients.

They are the sickest of the sick. Doctors do not want them in the hospitals, and they also know if they have an event where they have 30 pounds of fluid on, that they’ve structurally damaged their heart and that next hospitalization, that next worsening heart failure event is closer and closer. And these patients, these are our moms and dads, aunts and uncles, they don’t want to be tethered in a hospital bed for five days. Again, they’re not going to run marathons, but they want to do what they want to do. They want to be home, they want to be with their neighbors, they want to walk their dog.

So we have a situation where all of our stakeholders are aligned. Next slide here. Here’s our net revenue by quarter, again, growing nicely, 12.2 in Q4 twenty twenty four. Doses filled by quarter, this is really the leading metrics to net revenue. We saw 13,300 in Q1.

We haven’t announced it, but I’ve said it publicly. We’ll ship more units to patients in Q1 than we did in Q4. We do have a little GTN headway in Q1. Q1’s tough for a Medicare drug, all the out of pocket resets. It’s tough for every commercial drug.

But what we’re seeing, again, I spoke earlier, is this Medicare redesign. We can get into why it’s bad for some companies. If you’ve been paying 60% rebates to be on preferred formula, if you’ve done that as a company, you’ll get no more access from the Medicare redesign. All you’re going to get is an additional mandatory rebate of 10 to 20%. Last year we had no contracts, no contracts in Medicare.

So, yeah, we had high co pays in about thirty, thirty five percent of our patients. High co pays. The patient has coinsurance and they have a $4,000 bill, we’re going to lose that patient. They’re going to probably end up in the hospital or they’re going to have to struggle through doubling and tripling the oral. This year, with the redesign, that cap is $2,000 Our biggest headwind has been removed.

And what we’re seeing was tough in January and February, no patients had gotten through their cap, It changed in March and we’re seeing patients enroll in smoothing where they can take that $2,000 and spread it over the whole year. Or patients, these are heart failure patients, they have a number of comorbidities, they’ve hit their cap. So in March, we saw our units shipped go up. April, our fill rate went up dramatically. Our fill rate went up, our unit shipped went up, and when that happens, the doctors write more because they know patients can get it.

So all of those dynamics we’ve seen, now it’s early in Q2, but we really feel like this is going to be a big driver for us this year, and that we’re going to see our fill rates continue to go up. We’ve said publicly be to sixty percent in Q4. More scripts as docs can write more. So we couldn’t be more excited about what we’ve seen March, April, and the May. So some of our long term growth initiatives, I mentioned these, Class IV heart failure, the sickest of the sick patients.

Their doses per script for a normal patient is five or six. These patients are being used kind of preventatively where the doc knows this patient needs enhanced diuretic response every week. So they’re writing 12 fluorosics, they get three a week, put this on Monday, Wednesday, and Friday, and you don’t come see me anymore. Call me on Friday, call my nurse, let me know how you’re doing. So higher script value for class four.

CKD, nephrologists deal with fluid all the time. In fact, what we’re seeing is a lot of heart failure with co concurrent CKD is actually treated by the nephrologist. We think our heart failure use will go up now that we’re calling on nephrologists. They deal with fluid every day. It’s what nephrologists do.

We’re really excited about what we’ve heard initially. We’ve already seen scripts coming in and we launched last Monday. The eighty milligram auto injector as I mentioned, we’ll be filing for that later this year. Game changer in a lot of ways, I mean it’s the same patient, but there are patients that might not love wearing a five hour infuser. This is two and a half seconds.

It’s the same auto injector they use for Wegovy. Patient will put it, well they’ll just take the cap off, put it to their side, they’ll get a day of therapy. Lowers our costs by 70%. It gives us just so much flexibility if we did want to go discount, which we haven’t done and I don’t want to do. If Medicare plays out the way we think, we’re not going to have to.

This is going to flow to our bottom line. And then the extended commercial reach, we expanded the sales force in Q4. We’re starting to see the benefits. It takes two quarters really see the benefits of an expanded sales force. It’s expanded our reach, but maybe more importantly, really given us that frequency and those high volume accounts we need to be in every week.

So we’re really thinking this is one of the reasons we’re seeing the inflection of growth in late Q1 and Q2. To talk about CKD, it’s an unmet need in fluid overload. These patients are on diuretics, they’re failing on diuretics. We consider this pre dialysis. The patient’s pre dialysis.

What we’ve heard from nephrologists, they’re going to use it during dialysis. We’re not contraindicated there. We’re not indicated there. They can use it there. Some doctors have said, boy, I’m going use this in advance.

Maybe I can delay dialysis by doing that. Again, it can lead to multiple clinical complications. Because the kidney and the heart work so close together, you have fluid overload due to CKD, you are going to cause problems cardiovascularly down the line. And again, untreated fluid overload lead to additional renal complications, quality of life, and it’s the same kind of value prop. The DRG is pretty close to the same.

These patients are going to be hospitalized unless you can get that fluid off. Opportunity, it’s about seven hundred thousand patients in CKD that don’t have heart failure. So again, we’re looking, when we say cardio renal, what’s cardio renal mean? It means patients with heart failure and chronic kidney disease. So we really have three indications: heart failure, chronic kidney disease, and cardio renal where the patient has both.

But if we exclude all of the patients that have heart failure, it’s about seven hundred thousand patients with a $4,700 cost of therapy is about a $3,300,000,000 market opportunity. Pre launch readiness, we did all the things you do. KOL outreach, identification, a ton of market research, marketing materials based on the market research, the positioning, the messaging. We started calling on them in late Q4, the big ones, because we’re indicated for heart failure. So we’re into nephrology talking about the patients with heart failure.

So we’re getting a bit of a running start. Our ATU, which is an awareness trial and usage before launch in kidney was three times what it was before we launched in cardiovascular. So we think we’re going to have a much quicker uptake in nephrology. Talk a bit about the auto injector. There’s a picture of it.

We did our pivotal study back in August of twenty twenty four. We’ll be able to submit the NDA this this year. Again, the patented 02/1940, it’ll aid our penetration. We love our product. It’s doing amazing.

The Onbody Infuser patient physician response. This will open up some new patients to the opportunity, and again the COGS benefit is huge. Here’s our PK study, the goal was to have bioavailable equal to the IV, we showed that. We had to do pharmacodynamic endpoints because the PK isn’t the same, it can’t be the same, you’ve an IV peak. But what we were able to do is show similar PK and similar PD, diuresis, naturesis.

So met the primary endpoint, achieved all of the secondary endpoints and it was safe and well tolerated. So in summary, the commercial launch accelerating now due to the expanded sales force, due to the redesign, due to the kidney. And we haven’t seen the impact of the kidney yet. But again, we’re seeing the inflection point we’ve been waiting for, we’re seeing right now, what we saw last month and in March. Great patent protection, and there are growth initiatives coming into this year.

So that’s the story.

Jason Butler, Biopharma Analyst, Citizens: Thank you, John. Maybe I’ll just start off with a couple of quick questions. Can you just give us the initial experience in kidney? What are the types of patients that the adults are trying to draw on?

John Tucker, President and CEO, SC Pharmaceuticals: Yeah, so again, if you’re a dialysis patient, it’s not going be part of the bundle. So it’s not at the dialysis center. It’s not there. What we’ve heard, and where they’re trying it, is our patients that are dialysis and they still have excess fluid and they can use this in between dialysis. That’s not really where we’re positioning it.

Nephrologists are way more aggressive in treating fluid. They use words like, I gotta get this patient totally dry. You’d never hear a cardiologist say that. So they’re way more aggressive. In fact, with our auto injector, we’ll be able to have a second dose at forty mg, So the doctor, especially the nephrologist, go to one hundred and twenty mg.

But they’re really looking at stage two, stage three patients as kind of the sweet spot. They identify stage one, they’d use it there too, but it’s really two and three. But they’re really aggressive. They’re, again, some of them are thinking, this is going to delay dialysis. Now we’re not indicated, we can’t promote there, but that’s just the market research.

But it should be two and three patients early. They write lots of doses. It’s again, it’s just a, when you do the market research and you look at the things that they react to versus what a cardiologist, cardiologists are much more conservative in managing fluid than a nephrologist.

Jason Butler, Biopharma Analyst, Citizens: And I’m just looking out longer term, how do you see the auto injector and the OnBody coexisting? Will the OnBody still have value in it?

John Tucker, President and CEO, SC Pharmaceuticals: So for patients, and again, the experience we’ve received hearing from these patients, the patient’s been in the hospital 10 times in the last two years with fluid overload, and you now have a product that keeps him out of the hospital, but keeps him home. Mean, that story about that gentleman with his dog and how he’d have to try to find someone to take care of his dog every time he was hospitalized. I think they’re probably going to have some reluctance to move off something that’s dramatically changed their life to something new. And there are some doctors who like more of an infusion than a bolus. So our plan is to keep both products on the market.

We will aggressively move the market to the auto injector. I’ve said this publicly, we think it ends up ninetyten, 90% auto injector and 10% on body. Alright.

Jason Butler, Biopharma Analyst, Citizens: Well, thank you very much, Don.

John Tucker, President and CEO, SC Pharmaceuticals: Thank you. Appreciate it. Okay.

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