Cara Therapeutics, Inc. (NASDAQ:CARA) Q4 2022 Earnings Call Transcript

Operator: Our next question comes from Jason Gerberry with Bank of America.

Jason Gerberry: Just thinking about the TDAPA piece a little bit more, how important is it that you build up a more material volume level to generate good pharmacoeconomic argument for the pricing levels that have been so far established during the TDAPA window? And I think to what Oren was getting at, your TDAPA could run out in April 2024 with your cash runway, the first half 2024. So, it seems like it’s a really critical aspect of the longevity of this launch for the IV. And then, are there any milestones you anticipate realizing in 2023?

Chris Posner: Hey Jason, it’s Chris. I’ll tackle each of those. I’ll go in order. How about that? Make it easy. So, your first question on urgency around utilization. I would say, as a commercial guy at heart, I mean, regardless of TDAPA, there’s always a lot of urgency in getting a product to patients as fast as possible. I do agree with you though that TDAPA heightens that sense of urgency but I’d also remind you, we’re still within the first year of launch. So, I know CSL Vifor and their JV partner Fresenius has every inclination, and we see these very encouraging trends that I’m encouraged throughout the year that this is going to be a really, really good trajectory that we’re going to see in terms of utilization. The second question was around how important is TDAPA and when it expires, the durability of the sales.

I’ve always said, I’ve been at the helm for a little over a year. And I’ve always said that I still regardless of funding and et cetera. This product will be available if TDAPA continues. And I do believe strongly in the durability of this drug, unlike the analog parsabiv, where there were alternatives, namely a generic oral Sensipar. There are no alternatives. We are the first and only FDA approved drug. And I would find it highly odd that if patients are on therapy that they would be removed from therapy and given back to a non-standard antihistamine that certainly does — has limited in terms of efficacy and safety. So I still feel very strongly the durability, but I’m also quite pleased with the efforts from both companies, Cara and CSL Vifor in terms of moving the needle at CMS.

And I think CMS has a real open mind to look at the post TDAPA payment mechanisms. So, we’ll see how that plays out throughout the year. And your last one, any milestones? Yes, we would expect a Japanese milestone pending approval that we would expect in the second half of this year.

Operator: Our next question comes from Oren Livnat with H.C. Wainwright.

Oren Livnat: Sorry, just that one follow-up on guidance. And I understand historically, you’ve been quite conservative on that front. I think last updated November, which was still for first half ’24 runway, but that was based on I think you said, if we just flatlined the current product run rate, and spend what we think we’re going to spend, we would make the first half 2024. But of course, you expected the product to grow. Now, it sounds like maybe, in your answer to I think it was David’s question. You put it a little differently, which is based on our internal projections, I mean, clearly, you’re not basing it on this quarters run rate of sales, because it’s artificially depressed, right? But I guess I’m trying to figure out is are — in your guidance are you projecting, I guess, a more traditional ramp to the year and that’s how you get there or is it still like, look, if we went back to sort of an underlying demand number that we think we were at this quarter and flatline that, that’s our still quite conservative guidance?