All they had were androgen steroids or some other very nonspecific drugs. Now they have access to those drugs. And so it’s changing how they view treatment and everyone is aligning around the global guidelines which says that one of the modern prophylaxis therapy should be considered for all product, all patients and that’s what we see happening.
Jon Stonehouse: I think one other thing is like the U.S., Charlie and [indiscernible] and Europe have done a great job of building a really good team, really experienced team that hit the ground running and data access and there’s some challenges in Europe. They work closely with Jinky’s team and they’re — just like in the U.S., when they see a challenge, they adapt and adjust and it’s been really impressive to watch the European team.
Unidentified Analyst: And then I just have one more question about the asset opportunity. I know that you’re going to kind of save the developmental pipeline for tomorrow but just you can comment on that.
Charlie Gayer: Sure. Just to add a small piece to what I said earlier. The pediatric market in the U.S., I think we’ve said this before, we think there the neighbourhood of 500 patients who are probably with HAE and symptomatic. And not all of those will need prophylaxis right away. But the real key with where HAE therapy has evolved is that now there are options, what the experts — they really see patients growing up without — in a very different environment than even 10 years ago. So kids today can grow up, they can get control of their attacks. They can do all normal school activities, everything else. But the goal is to be completely normal. And that just hasn’t happened with previous generation. So just the availability of prophylaxis for pediatric population. And we hope soon an oral prophy product is what’s really going to change the lives of these kids and these families, frankly.
Jon Stonehouse: I can remember and this isn’t that long ago, 10 years ago, when you had talked to young women that had HAE and they weren’t even sure if they wanted to have children and now you can live with HAE at a very young age and manage your HAE. So we’re so excited about this formulation. Bill Sharon [ph] and I have been chased that patient meetings for a decade from mothers that are saying go faster and it’s really exciting that we’re on the cusp of getting that.
Operator: The next question is from Liisa Bayko with Evercore ISI.
Liisa Bayko: Sorry about that. I just want to follow up on an earlier question regarding the linear growth of 200 patients per year. What kind of underlies your confidence that you can continue growing at that rate? How many patients would have cycled through by I guess, 29. Would all patients have touched ORLADEYO at some point? Are there benchmarks you can point to? Is that pretty typical to see just continued new patient adds at a consistent level from like launch. It seems like at the early launch period, you might have a different trajectory. So that’s why I was just curious about the kind of 200 patients being added per year.
Jon Stonehouse: Charlie is going to answer the first part but I want Jinky to dive in as well because she’s got insight to the future as well [indiscernible].
Charlie Gayer: Yes. And Liisa, we realized that the ORLADEYO launch is not like your classic rare disease launch of the past. And I think it’s a point Jon made earlier, this is — and Jinky was making in her comments. It’s a crowded market. And I may steal some of Jinky’s thunder but she said it but these patients are sticky. And so it’s this is a slower moving but consistently moving launch. And then I think, Jinky, maybe can you comment on again, reiterate how we use the data. It really comes down to the insights and the data that we get from Jinky and her team.
Jinky Rosselli: Yes. I mean we triangulate, right, because it’s imperfect in every way in terms of the rare disease market and data availability. So we take the market insights and the research that we do all the methods that I described in the remarks and basically model that out. And to our physicians and our patients are telling us the demand is — they’re still saying that they want more. The minute that changes that landscape changes, we’re all going to know about it because we consistently call every quarter. I say that demand and the numbers that Charlie are using in this model are our numbers, right? So essentially, we’re triangulating based on what the market is telling us and then marrying it the actual ORLADEYO and that ramp within our sort of database world patients to give us that confidence.
Charlie Gayer: I’ll come back to one other point which is to address your question, Liisa, about are we patients going to cycle through. That ultimately is our goal. But if every patient cycles through ORLADEYO, we’ll come back and talk to you about how this has changed. It’s more than $1 billion. We don’t need every patient to go through to get to $1 billion. On a monthly basis, any given month, 5% to 10% of the patients with new forms [ph] are actually patients who dropped off at some point in the past and are coming back. So there is that component. But if we reach 4,000, 5,000 patients in the U.S., we will easily get steady state sticky patients by 2029.
Liisa Bayko: Okay, great. And then, just a question on the pediatric. How many pediatrics would be eligible for your calculation?
Charlie Gayer: So we think the number in the U.S. market, the number of kids could be in the 500 patient range who could be eligible for prophylaxis. That doesn’t mean 500 will be on ORLADEYO or any other prophy. But the pediatric side of the market is one that is still going to evolve because it’s only been in the last few years that prophy has even been available. It’s all injectable right now. And so we think that our views on that could change but we think 500 patients is a pretty decent estimate right now.
Jon Stonehouse: And Liisa, one other thing I’d add, it’s hard to quantify but I think we’ve seen this the adolescent population is the halo effect that happens in families. Remember, it’s a hereditary disease and what see is when adolescents have done really well in a family, all of a sudden, the mother or the father who has HAE like, well, maybe I should try that. And I think the same thing is going to happen with pediatric patients.
Liisa Bayko: Okay. And then just a quick question just on the expense side. It looks like you’re kind of higher towards the end of this year and the fourth quarter for your guidance. Is that how we should sort of think about the run rate going forward into next year? Maybe you could just provide some color on the kind of the expense trajectory into the fourth from beyond.
Anthony Doyle: Yes. We’ve given a revised range based on what we see. And so based on where we are and what we will share with everybody tomorrow at the R&D Day, we’ll give some additional flavor specifically around R&D expenditure. But I think we’re well positioned to see growth in revenue. I think we will see some additional growth in that OpEx line. But we are always going to be a very thoughtful around capital expenditure and making sure that the things that we invest things that we think will create value. We will give some more additional details more.
