Anthony Petrone: How are you, Adam? Thanks, and congratulations another good quarter. I was on the second quarter 2020 earnings call and turned the page a few years, and it’s a huge difference. You have in a press release, Adam, that your prescriber base and patient base for ASCENIV continues to grow. You’re getting at net new prescribers as a common statistic out there for therapeutics companies as well know NRx statistics. Can you disclose I guess kind of where those are trending broad strokes? How many new prescribers are coming on Board each quarter, I guess on average? And maybe what percent of this target comorbid primary immune deficient market do you think is penetrated by ASCENIV at this point? It seems like we’re just getting started here and then I’ll have a couple thoughts for Brian.
Adam Grossman: Thanks, Anthony. We are expanding the depth of our products penetration and our medical messaging, and that’s really what is translating into this accelerated growth. There are more prescribers. And again, I think it goes back to the answer that I had to Kristen’s question around the early adopters and the prescribers that are out there. I mean, look, the best way to convince a physician to use a drug is another physician telling them, my patients have done well on this drug, plain and simple. I mean, I can hire all the reps and all the medical affairs people and I can put my name and lights all I want, but when a colleague is at a symposium or at a medical conference with another colleague and they’re saying, hey, do you use this stuff?
And they say, I actually do and I like it. That’s the kind of advertising and promotion and benefit that you can’t buy. It just happens because it’s real world. So it’s really that people are getting comfortable with the product. There the price is certainly unique for an IG. It’s priced on the higher end of the hyperimmune, if you will specialty IG scale. But I think that that the benefits and the outcomes that they’re seeing in the real world, people understand why it is what it is. It’s special plasma that the drug is made from. And it’s only made in this way by ADMA. And I think that really, it’s the grassroots marketing effort that we’ve taken to our story, to our commercial, throughout the commercial launch of the product that really is translating into increased number of patients going on the product.
We’re really only having these conversations in the immune deficient world that’s where we spend our time, that’s where we focus, Anthony. So all the product use is really coming from primary and secondary immune deficient patients that are not doing well on IG, that have comorbidities, that are getting sick. And I think that once a doctor tries the product and sees results in that patient, they’re faster to put their second patient on. And really what you’re seeing is that because we have a larger number of prescribers, they’re getting more comfortable in saying, you know what, I can advocate for these patients with payers to get therapy because of these comorbidities and they’re not afraid that they’re not going to get reimbursed anymore.
We’ve been — I think we spent a lot of time over the last year-and-a-half talking about durability. And a lot of the analysts, including yourself, had questions, well, Adam, how durable is this? Is this a one-off quarter? How do you know this is going to happen every quarter, every quarter? And I think time, time is the only thing that I couldn’t rush and demonstrate to all of you that its — these patients are like an annuity. They — it’s the razor blade model. You need a razor blade every month. You need your infusion every three to four weeks for the rest of your life. And if you do well on ASCENIV, and if you’re thriving on ASCENIV, even though some of my market research suggested that people would come off therapy, they’re not, they’re staying on in multiple years of therapy.
And we’re just seeing it compound. So hopefully that answers your question. But really, it’s the clinicians that have said to my team, thank you, thank you for making this product, thank you for moving the peg forward. You’re giving us an option for these patients and they’re doing well. That’s what sells drug.
Anthony Petrone: Absolutely. And the follow-up should be, Brian, maybe a little bit on gross margin here, well above our estimate in the quarter drove the EBITDA beat to some extent here, of course, so a couple of questions. One is you referenced that at least there were some ASCENIV batches that were successfully transitioned to 4,400 liter pool. Are we reading this right that that product can be fully transitioned to 4,400 by the end of the year, early 2024? And if so, what does that do to gross margin? Does that represent upside to this 40% to 50% target in the outer years? Thanks again and congratulations.
Brian Lenz: Sure. Thank you, Anthony. So regarding ASCENIV, we’ve certainly seen more upward mobility or more utilization of ASCENIV than we originally forecasted. And with regards to the 2,200 manufacturing batches of ASCENIV transitioning getting FDA approval not long ago to the 4,400 liter batches, they pretty much sold out of the 2,200. The gross margin going from 2,200 to 4,400 is certainly very meaningful. I would say that historically, we were looking at 80% to 85% gross margin per ASCENIV in that 2,200 liter range. Say now we’re higher than 85%, probably closer to the upper 80%s some point in time, maybe even low 90% range for ASCENIV as we continue to sell only 4,400 liter batches.
Skyler Bloom: Anthony, it’s Skyler. To be clear though, in the third quarter gross margin has been 36.6%. You’re not seeing any monetization of the 4,400 liter ASCENIV right. It’s on a go-forward basis and it really materially will not kick in until the beginning of next year is the way that we think about it.
