Kristen Kluska: Awesome. Thanks for that response. And just the last question for me is, if you could talk about the metrics you’re seeing from a prescriber basis, specifically, is it more levered towards certain prescribers adding more patients versus getting new prescribers entirely on board or is it a blend of the two?
Adam Grossman: The answer is it’s both. It’s yes and it’s yes. Obviously, the doctors who have seen results, they’re very, very quick to be able to identify new patients and get those patients on. The number of prescribers grows every month, every quarter. We’re smashing all of our internal estimates and our numbers, Kristen. The prescribers are pretty much strictly immunologists. The majority of our sales are in the outpatient setting. I can tell you that existing prescribers on a buy and build basis, once those physicians take title to the product and know that they’re going to get reimbursed, they feel comfortable about adding patients. Certainly, there is a cost outlay for any IG that a doctor with an infusion practice in his office — in their office.
They do take some risks there, but I think that folks are truly comfortable now at this point and we’ve done a lot of great education out there, both on the market access side and on the medical side. So, I think, you’re going to see that prescriber base continue to increase. I think you’re going to see same-store sales increase and it’s the drug. I mean, I like to think that it’s our great marketing strategy and medical education stuff. It is, but the drug also does a lot of the talking.
Kristen Kluska: Thank you.
Adam Grossman: Thanks, Kristen, so much.
Operator: Thank you. One moment for our next question, please. And it comes from the line of Gary Nachman with Raymond James. Please proceed.
Gary Nachman: Great. Good afternoon, guys, and congrats on all the progress and good luck to you, Brian. We will definitely miss you. So, Adam, maybe just talk more about your plans to explore developing a hyperimmune product to treat pneumonia. What led to that decision and why do you think it could be a $300 million to $500 million opportunity? How you get there? And just reiterating that there’s no impact to profitability. So, just explain how that’s going to happen. And then also just, what are other hyperimmune products that you could potentially pursue? When could we hear about those? So, oh, and also just getting a sense of your capacity as you potentially expand into these other products while you’re still trying to obviously grow ASCENIV.
Adam Grossman: All great questions. Thank you, Gary, very much. So, strep pneumonia, we’ve — I actually checked this before we got on the call, because I figured someone was going to ask me, but we’ve been publishing data about strep pneumonia since 2020, 2021. As we said, I believe in our press release earlier this year where we announced that we were going to embark on this program. It’s in the top 10 leading causes of death. It’s the leading cause of community acquired pneumonia. We look at the world very practically, Gary. We look at this as there are vaccines for people who can receive vaccines. And when you look at immune compromised patients, they do not respond well, or they do not respond at all to vaccination.
So, one of the leading issues in primary immune deficiency, in cancer patients, in post-surgical patients, in the elderly that are hospitalized is strep pneumonia and we feel that there’s an opportunity here to sort of bridge this gap. And again, we don’t know if it’s going to be treatment or if it’s going to be a prevention. There is still work that we have to do. Again, it’s very early. I think that we’ve got, look, we built our plasma center network, Gary, so that and I think that this touches on your second part of the question too. We built this plasma center network, not only to secure our supply chain, but also because it allows us to evaluate novel things with plasma donors. That’s where everything we do starts from. So we have evaluated and we’ve established a method to stimulate antibody using commercially available vaccine in our plasma donors and we’ve measured these antibody titers and we see that they’re developing protective opsonic titers.
That’s the first step to ensure the control of the raw material and we make raw material. Once you can make raw material, then the rest, I don’t want to say is the easy part, but we’ll put the product into animals earlier at some point this year and we’ve got IP out there and we’re going to evaluate and see. Roughly based on the data that I recall, it takes roughly 10 days for an immune competent person to develop seroprotection when they’re vaccinated with the commercially available vaccines. I think I’m right. If I’m wrong, shoot me. But I think it takes about 10 days to seroconvert. So, just on a very practical basis, if you’re a vaccine naïve elderly patient who is immune compromised just because they’re elderly and you’re hospitalized in the cardiac unit or you just had surgery, because you fell and broke your hip and you’re hospitalized, for those reasons.
And many institutions, their protocol is to provide a vaccine. Well, you’re not doing anything to protect the patient, because it takes 10 days if you’re immune competent to develop seroprotective antibodies to all the different serotypes. So if you look at the way rabies is treated, tetanus is treated, hepatitis B is treated post-exposure. You provide a globulin and a vaccine to protect that seroconversion period. So we think that that could be an opportunity. It could be another opportunity to follow what we’ve done with ASCENIV. When you think about it, if you make a tighter IG for the primary immune deficiency population, that’s easier to manufacture, let’s just say, because the plasma supply is a lot easier to obtain. You’re not looking for these naturally occurring high-titer RSV donors, which is what we do for ASCENIV.
