Arcutis Biotherapeutics, Inc. (NASDAQ:ARQT) Q3 2023 Earnings Call Transcript

And my last question is about the SLR loan agreement, the modifications to financial covenant. I just want to make sure that I understand correctly that the original threshold or minimum threshold remains for year 2025 and 2026.

Frank Watanabe: Great. Maybe let me take your second question, and then I’ll have Todd address your first question, and John address your third question. So yes, look, I think with regard to our breadth and depth, we’ve talked about this before. There are about 13,000 targets that we are targeting with our sales force. They represent over 90% of the relevant prescriptions in dermatology. Out of that 13,000, about 9,000 are currently writing. So there clearly is an opportunity to expand the breadth of our prescribing base. I don’t think we will ever get all 13,000 of them, because you have some doctors who just are ultra conservative and are never going to change from using their old topical steroids. But I think we’ll eventually get very high penetration.

And we’ve been adding roughly about 500 doctors a month for quite some time now to that prescribing base. I think we were sitting at 7,000 in the last quarter, right, something like that. So we will continue to expand the prescribing base. I’m confident of that. And I think as Todd mentioned, I think the foam could actually help us with that broadening of the prescriber base. And then I think you also are correct that there’s an opportunity for a lot of deepening of the prescribing base. If you look at the topical steroid market today compared to the topical non-steroidal market, the topical steroid market is about 20x the size of the non-steroidal market, right? So even doctors who are writing 10 ZORYVE scripts are probably writing 20x that in topical steroids.

And so there’s an immense opportunity for us to continue to expand that market. And that really gets back to my earlier comment about the conversion. We are at early stages of the conversion process, but we’re exactly where we’d expect we would be in terms of conversion. And if you look at any number of other markets, you can get a pretty good sense of how that’s going to progress in the coming quarters and coming years. And we feel very confident that, that conversion will happen as it’s happened in other markets, just because the new nonsteroidals offer doctors and patients so many benefits. Todd, do you want to maybe talk about what sort of the lift looks like for us getting into Medicare and Medicaid, both financially and operationally?

Todd Edwards: Yes, Medicare and Medicaid, as I mentioned in the opening remarks, there’s approximately 3 million patients that are in play here. And if you think about Seb Derm, it’s more so on the Medicare side and atopic dermatitis on the Medicaid side. We’ve been actively engaging in the Medicaid space to be able to secure coverage for patients in 2024 preparation for the atopic dermatitis launch. In addition to that, we’re having conversations with the big three PBMs relative to the Part D plans in Medicare, with the ambition to secure that coverage in the first half of 2024. I think what’s very important to note here, especially with the Medicare is that is the Arcutis’ repricing strategy, given where our price point is and it’s below the CMS specialty tier, we will very likely be able to gain this coverage in Medicare with a nominal impact on our gross to net. So we’re actively engaged, and those conversations are progressing.

John Smither: Let me that the…

Frank Watanabe: Yes. And then if you want to…