Adrian Adams: And then as it relates to your comments on Spherix, I think where they have a projected 12% . And again, just stepping back to some comments we’ve made, Laura and I know you’re very familiar with these. And in relation to the key measure that we see of our success is the market share evolution amongst the acute branded market with prescribers and it’s that 4.3% number that we’ve already achieved that we’re very pleased with. And whilst we’ve not obviously given guidance in terms of peak sales potential, what I’ve always mentioned is that in this marketplace, if one looks at all those patients in that post triptan segments of the market, close to 2 million patients, so — and that’s the market we’re operating in competitive with the gepants.
If based on the kind of price evolution that we see, if we just got a 5% share of that, just a 5% share of that overall market that would lead to kind of peak sales revenue potential in excess of 400 . So the Spherix number of 12%, whilst you could always dilute those numbers and assume some optimism in that, it points to the very real potential there is with this product is if we continue to execute, invest into the opportunity, the one thing that does not change with this market, first is the continued churn over that will create ongoing opportunities for Trudhesa. Secondly, the consistent tolerability and efficacy profile we see with Trudhesa and it’s not that’s going to drive the overall market share evolution towards that kind of peak projected revenue potential.
So it’s not that gives us that very nice optimism for the future. And as with all things, as you know, I think the most important thing is execution and having incentive schemes and strategies and practice to make sure that you invest into that opportunity appropriately and drive that market share. So again, I think we’re very pleased with the evolution we’ve seen to date and we’ll look forward to further increasing and enhancing that this year and into the future towards that peak sales potential.
Operator: Next question comes from the line of Sean Kim with JonesTrading.
Sean Kim: I got just one quick question on the gross to net discount. So I noticed that there has been some improvement in the fourth quarter in terms of gross to net. I am just wondering what the trend might be in the first quarter of this year and the rest of the year.
Adrian Adams: Okay. Len, do you want to touch on that?
Leonard Paolillo: Sure. Yes, there was certainly improvement in the fourth quarter. That’s a result of both the improvement as a percent of our prescriptions that were approved by payers versus Quick Start as well as much less pressure on the co-pay card co-pay mitigation for approved patients. As you move through a year, patients often hit their out-of-pocket maximum and the burden on the co-pay card begins to go down, providing some benefits on gross to net. That does reset in Q1. So while we have seen our percent approved jumped, we did see a bit more pressure on the co-pay card. That being said, our percent approved is going to continue to escalate throughout 2023. And as in previous years and across most brands, the pressure on the co-pay card is going to begin to diminish.
So we should see very good net price evolution throughout the course of ’23. Our managed care contracts and government business which are the other levers or distribution schemes which again is a lever of our gross to net, are all very stable.
