Thank you very much. Thank you everyone for joining us this morning. I am Shawn Patrick O'Brien, CEO and Managing Director for Mayne Pharma. I am joined by my colleague, Aaron Gray, our CFO, and Kimberly Parker, our General Counsel. We wanted to update you on our business after completing the sale of our US Generics business and announce our on-market share buyback program. Slide number two is our disclaimer slide. Let me take you through our proposed agenda on slide three. As noted here, we will start with the highlights of the last seven months, then take you through our Women's Health business or BPD update, and then the Dermatology PPD update, followed by international update. Aaron will cover the business transformation, the costs, and our capital management program. I will then conclude on the outlook and open up the call for questions.
On slide four, over the last seven months, we've fully executed on the transformation strategy we laid out to become a more focused business with significant growth opportunities. This transformation will continue for years to come. Our first big move on slide five was at the beginning of October. It was the sale of Metrics Contract Services for $475 million or 16.5x EBITDA to Catalent. This transaction was transformative for the company, and we're still providing TSA services to Catalent to complete the transfer of the business. Our next transaction in December was to secure the U.S. commercialization rights for the TXMD women's health assets, for which we paid $140 million upfront or 3.8x EBITDA in our hands. This transaction allowed us to become one of the leaders in women's healthcare in the United States.
One month ago, we completed the sale of our US Generics business to Dr. Reddy's Lab for $90 million upfront with up to $15 million in two-year contingency earn-outs. This transaction cleared HSR approval in record time and without a banker involved. We are pleased we secured a 10-year supply agreement for the products manufactured in our Salisbury facility. However, it will take up to 18 months to fully wind down all the lagging financial responsibilities associated with this business. As a result of these transactions, we've repaid approximately AUD 360 million in syndicated debt facilities, paid a special dividend of AUD 47 million in January. We've looked at securing new debt facilities as we wind down our receivable-based revolver. With the recent $90 million payment from Dr. Reddy's, Mayne Pharma is in a very strong net cash position of AUD 135.8 million.
to support the growth of our women's health and dermatology franchise and improve the operations of our international business. On slide six, we've not only changed our business platforms, but we've changed how we run our business significantly over the last seven months. Previously, I've shared with you how I look at people, products, and processes being aligned on how we focus on the delivery, on the needs of our patients to drive profitable growth. This summary here look at some of the key people and process changes we've made in the last seven months. With a new U.S.-focused leadership team who are driven to create commercial and operational excellence that satisfies the needs of our customers profitably, which will in turn drive shareholder value.
On slide seven, we previously have shared our strategic priorities for fiscal year 2023 and 2024 to successfully implement our new commercial strategy for NEXTSTELLIS in Australia and get to break-even run rate as soon as possible. Secondly, to deliver positive EBITDA growth for women's health in the U.S. with the full franchise of ANNOVERA, IMVEXXY, BIJUVA, and NEXTSTELLIS, along with our prenatal vitamins. Third, to continue to improve our margin and patient access, both in dermatology and women's health through our differentiated channel strategy. Fourth, improve our dermatology pro-product profile with better assets and continue to look at accretive assets to bring into our women's healthcare infrastructure. Fifth, we wanna continue to accelerate the Australian growth of our specialty-based pharmaceuticals, our international sales, and our CDMO business under the leadership of Grant Schwartz.
Let me provide you more details on the progress we've made on the women's health franchise. On slide nine, within our branded products division, we have built a leading U.S. women's healthcare business. We have the infrastructure in place to successfully compete in the U.S. market with over 100 salesforce members that are able to reach our target customers with the right level of frequency. In addition, we are focused on reducing access barriers for the patients with our unique approach. We will show you how our marketing mix is accelerating the growth of the women's health business in combination with our direct-to-consumer campaigns. We are positioned to leverage the full implementation of Affordable Care Act when it comes to benefit, and patients will be not paying any out-of-pocket costs. Let's focus on NEXTSTELLIS on slide 10.
Previously, I've communicated we did not launch this product in the way I would have had I been here at the launch. I am pleased that our new commercial approach continues to show productivity. We've seen solid second half growth today from copayments. Speaking wrong here. Copay improvements and the new targeting strategy is working. I will show you that the step changes in our commercial thrust and how it will deliver benefits to NEXTSTELLIS moving forward. We launched our full DTC campaign in February, which has driven increase in visits to NEXTSTELLIS website and driven OBGYN appointments for patients who are interested in NEXTSTELLIS. While our 5% weekly new Rx growth rate that we saw in February has not been maintained consistently, we've seen steady growth, with 10 out of the last 17 weeks showing weekly all-time highs for the number of cycles dispensed.
In the third quarter, we've seen NRx is up 30% and TRx is up 18% versus Q2. We feel activity is accelerating because of the changes in our commercial approach, and we're seeing monthly cycles up 27% in March over December at 26,596 cycles. We expect this growth to accelerate going forward as the larger, more focused sales force has dramatically increased our sampling program. With this increased activity and positive momentum, we expect that NEXTSTELLIS to get to a break-even weekly cycle run rate in the first half of fiscal year of 2024. I'm pleased to share this slide with you which shows clearly a stepwise improvement of our commercial efforts.
Looking at the green line, we show since December, our calls are up 50% from 12,000 a month to 18,000 calls with our target customers. These calls have become more productive as we've seen the number of calls with signatures increase fivefold from 2,400 calls a month in December to 12,000 calls per month in March. Research has shown in the birth control market, you can't oversample in this market, you can only undersample. We've increased our sampling 150% since December, with over from 20,000 samples per month to over 52,000 samples dispensed out in the month of March. These commercial efforts will not produce immediate results. They have a lag effect on prescription productivity.
In the next few slides, I will show you how this increase in commercial effort is starting to drive increased growth in the NEXTSTELLIS business. On slide 12, we're pleased to see a 20% increase with NEXTSTELLIS new Rx in March over February. Since the beginning of January, we've seen all-time weekly highs for nine out of last 16 weeks or 10 out of the last 17 weeks. Those seven weeks without all-times high, four of them actually were during weeks with U.S. holidays. Our repeat prescriptions have been lagging from new Rx levels, and we're closing the gap through better patient targeting, which we initiated in late December. On slide 13, we're pleased to see that our monthly cycles are up 27% in March over December levels.
This graph on slide 13 shows our weekly cycles are up over 7,000. This increase has been benefiting from our increased DTC levels and our full sales and marketing mix that we're delivering into the birth control market, as demonstrated in the previous two slides. Our DTC campaign, as illustrated in slide 14, initiated back in August and stimulated increase in website traffic, which leads to patients asking for NEXTSTELLIS at their OBGYN appointments. We reduced our DTC investments in November through January, which tends to be a more expensive as the results are less impactful when you look at your share of voice during the holiday period. Since February, we've had a full launch of our streaming video DTC program and our social media, which has led to record levels of activity on nextstellis.com.
Overall, we're pleased with the progress we are making with our new commercial strategy in NEXTSTELLIS and expect to see increased productivities from these commercial activities going forward. Next slide. On December 30th, we completed the transaction to acquire the TXMD assets, which are accelerating our vision to become a leader in women's health in the United States with these additional products. On slide 16, we summarize how the integration of these new products into the women's health commercial platform is going and tracking to our business case. Our launch of these products occurred on January 12th. However, roughly 45 days of inventory were in the channel, which is more than we expected. This resulted in outstanding rebate claims which may impact a clean integration.
There is a mechanism in place for working capital adjustments going forward, and right now that magnitude may be in the $5 million-$7 million range. The attractive menopausal market for IMVEXXY and BIJUVA is a slightly different target than our birth control franchise. We've increased our sampling program recently and commenced a DTC campaign for ANNOVERA and the menopause brands with encouraging website visitation increases. We plan to launch the lower strength BIJUVA in fiscal year 2024, which should attract new menopausal patients looking for bioidentical hormones to treat menopausal symptoms. ANNOVERA was impacted by access channel inventory, and those TXMD and trade demand started to normalize recently to plan. The prenatal vitamins are creating access to new customers and opening up no-seed doctors who were previously were unable to seed.
We're pleased with our third quarter results in that we demonstrated the acquired franchise revenue was up over the previous quarter under the TXMD ownership. In summary, this acquisition is delivering the plan, and we're pleased with the results so far. Slide 17. There's a lot of noise in the unit sales, and I wanna give you a little description. If you follow these on through Bloomberg or IQVIA. Back in May of 2022, TXMD sold VitaCare, which was their specialty distribution channel for their products. Since that time, the products were moving through the big three and gives more visibility to those companies, such as IQVIA and Symphony, who track the prescriptions and units sold, and that's why you see an uptick.
It wasn't a change in the actual demand in the market, but an actual change in how the products were being recorded in the market. Since we acquired these products, we've been funneling them through our differentiated channel strategy, and you're not seeing the big change in the demand. Just a little bit with BIJUVA. We will continue to see fewer scripts recorded accurately through IQVIA or Symphony than what we're actually seeing internally. We're pleased that the entire franchise has increased sales in our first quarter in our hands over that experience by TXMD in the last reported quarter Q4 of calendar year 2022. Next slide. As mentioned previously on slide 18, we introduced DTC campaigns for ANNOVERA and our menopausal franchise. We're seeing an uplift in their website activity for ANNOVERA, BIJUVA, and IMVEXXY.
This campaign is effectively working to generate the awareness we want. We're overall, as I said previously, pleased that this franchise is delivering to our business case. Shifting to slide 19, I wanna highlight some of the PPD franchise or dermatology franchise. On slide 20, previously I communicated we see the dermatology franchise as a tail 2-9. The first nine we reported negative net sales. With our actions on the channel discipline and effective management of new launches and appropriate channel supply agreements, we are strengthening the contribution margin of our dermatology franchise. We're pleased with the launch of Doryx MPC 60 mg and ORACEA and how they're being accepted in the marketplace. We will continue to execute our differentiated channel strategy through specialty pharmacy growth, online platforms like GoodRx to improve patient access of our products.
On slide 21, the dermatology business performance is improving with delivering on positive contribution margin, we've seen a gross to net and pricing stabilization across the key products as we expected. We are actively managing our business here. We expect that this will help sustain our contribution margin going forward and return to a positive contribution margin that we're seeing in the third quarter of fiscal year 2023. This is also driven by the impact of our new product launches of Doryx MPC 60mg in February and the authorized generics of ORACEA in March.
The business remains focused on the development of a differentiated channel strategy for patient access, which will improve the attractiveness to future dermatology partners as we continue to add new products to this portfolio that improve the contribution margin in a, what we call a capital light fashion as we've done in the past. Slide 22 really illustrates how we've returned the volume growth on the left-hand side and that we've normalized our gross to net in the third quarter going forward. Let me shift to highlight some of our international business and how that is progressing. Slide 24, we're seeing growth internationally as we improve productivity of our facility. This is paramount to improve our business because we have, in the past, have not been able to supply to demand.
We continue to make progress on launching KADIAN in the opioid substitution market and recently signed an agreement to develop KADIAN in Japan for the pain indication. Domestically, we have launched ACTIKERALL for actinic keratosis. The Salisbury facility is developing its relationship with Dr. Reddy's to ensure that we can deliver on our 10-year supply agreement going forward. Last, our NEXTSTELLIS is starting to show that it's not tracking to plan, and we are implementing what we've learned in the U.S. and leveraging that going forward so that we increase our sales force messaging and thrust in the Australian marketplace. Look, I mean, at the slide 25, there are three major areas that we're improving our approach in the development of the Australian facilities.
First, manufacturing strategy is focused on cost efficiency and reliable supply at the best quality. Grant and the team are doing a good job on improving and changing the culture within the facility. We're focused on revenue growth, not only through the efficiency improvements, but new business development in the with existing customers and expanding our reach into opening new markets. Then locally, we're looking at how we implement best-in-class metrics to drive efficient sales execution as we've learned in the U.S. Last, we are differentiating our contract development and manufacturing as a differentiation for growth in the target areas of the business. I'm gonna hand the microphone over to Aaron, our CFO. He can bring us up to date on the cost and the capital management. Aaron?
Thank you, Shawn. If we would go to slide 27, please. At the half, we put forth a goal to reduce our admin expenses by between 10% and 15%. The efforts that we've undertaken throughout fiscal year 2023 have resulted in reductions to date on a full year run rate basis of approximately 9%. We do expect to achieve or exceed our goal here as we continue to keep the pressure on cost. We remain focused not on a single OpEx number, but rather investing where appropriate in the most efficient manner possible. For fiscal 2023, the majority of our investments were made in the women's health portfolio with NEXTSTELLIS DTC and women's health marketing and distribution to support the expanded portfolio.
Cost efficiency and productivity will continue to be areas of focus into the future as we look to further leverage the simplified structure. In addition to the reductions of the 9% of admin, we are working through reductions related to the divestment of the retail generics business. Retail generics direct OpEx base in the past was approximately AUD 7.9 million on an annual basis. Some of these costs, such as direct personnel and logistics charges, come out of the business quickly, and some of the costs take a little bit longer time.
The approximately $6.7 million of the OpEx base is expected to come out by the end of fiscal year 2023, with a further amount up to a total of about $15.7 million, which we are targeting to take out over the coming 12 to 18 months. The cost that we are targeting to remove exceeds the direct cost because we are also reducing admin and support functions where possible, to the extent that those functions also supported the retail generics business. On to slide 28, please. Slide on caital management. Beginning in October, the company has executed three major transactions. Quick update as of now, none of these three transactions is fully complete. We closed the transactions, there's more work to do.
The company plans generally to stay on a conservative footing as we complete all the open aspects of these transactions. The company does have net cash, as Shawn mentioned, of AUD 135.8 million as of April 30th. The receivable facility is not expected to require funds on hand to reduce it as it is going to be repaid via collections for outstanding receivables. We are planning to hold significant cash for the near term as we complete some of these different transactions. The company is still evaluating options for a working capital facility to provide flexibility as we wind up the receivable facility, that's a structural wind up, that has been a good source of liquidity for us in the past. We are looking at options to replace that facility.
Expected capital needs for the near term are expected to be largely driven by completing those transactions. We have some remaining liabilities related to the MCS divestment. We have begun, but have to complete the restructuring and closeout of remaining product liabilities net of the portion that was transferred with the retail generics business. We have several integration topics with both the TXMD transaction and the retail generics transaction that can require which can result in temporary cash outflows that the nature of the transaction as we constructed it enables us to recover. There are some timing effects there that we need to keep cash on hand to be prepared to bridge.
We will continue to invest in the women's health business where such investment has a proper return, and we do remain open to evaluate complementary and accretive opportunities in both women's health and in dermatology. The capital needs of the business involve some uncertainty right now, which fits pretty well with the board's decision to maintain a conservative balance sheet and stay on a conservative footing. However, we do acknowledge and agree that some return is due shareholders, hence the board has announced today the capital management plan and the on-market buyback. I'll hand it back over to Shawn, I think.
Thanks, Aaron. Looking at the next slide, our strategic priorities for fiscal year 2023 and 2024 to drive shareholder value are clear. Bring NEXTSTELLIS to breakeven run rate as fast as possible in Australia and United States. Deliver EBITDA growth in our women's health franchise by leveraging our full portfolio. Continue to create access through our differentiated channel management and improve the margin of our products. As Aaron said, secure accretive assets to dermatology and women's health that we can leverage our commercial footing in the United States. To accelerate the growth in Australia with our specialty business there, our international sales, and improving the productivity of our Salisbury facility. The outlook for the remainder of the year is looking favorable.
Fiscal year 2023 has been one of significant business transition with the completion of the sale of MCS and retail generics and the acquisition of the women's health portfolio. The job is not done. Comparison to the prior period statutory accounts will be impacted by the treatment of businesses disposed as discontinued operations. Accordingly, Mayne Pharma provides the following comments to provide the market with its progress on continuing operations. First, the momentum continues to build across our women's health franchise. Following the acquisition and investment in new products as well as our sales and marketing capabilities to support contraception and menopause and specialty brands of prenatal vitamins.
While the anticipated timing for NEXTSTELLIS to achieve its breakeven run rate is now the first half of 2024 based on our current growth rate, the performance of the whole portfolio is delivering steady revenue growth and positive margin contribution in the second half of 2023, with the acquired assets more than offsetting NEXTSTELLIS' investments for growth. Following the stabilization, dermatology has now returned to delivering positive net revenue and contribution margin during this half. This momentum is anticipated to continue through the re-remainder of the half, supported by the recent product launches of ORACEA and MPC 60 mg. Our operational excellence plan implementing for the international business will take time to gain traction. As a result, the flat performance is expected to continue through the second half of fiscal year 2023.
Overall, the continuing business are expected to deliver positive revenue and contribution margin in the second half of 2023 versus the first half of 2023. Return to profitability will be delayed to fiscal 2024 due to stranded costs from the retail generic business and the time required for changes made to NEXTSTELLIS to deliver that top line growth. At this time, the largest driver of earnings improvement remains NEXTSTELLIS, but we're encouraged by the results we've seen recently in the prescription growth and cycle growth. We expect the fiscal year underlying EBITDA to be aligned with the consensus of the two analysts covering Mayne Pharma. This concludes our presentation. Operator, we will now open up for Q&A.
Thank you. If you wish to ask a question via the phones, you will need to press the star key followed by the number one on your telephone keypad. If you wish to ask a question via the webcast, please type your question into the ask a question box and hit submit. Your first phone question comes from Melissa Benson from Wilson. Please go ahead.
Hi. Thanks for taking my question. first question's around NEXTSTELLIS. It seems, you guys might have put through a pricing increase in January. We've kind of seen a little uptick based on the cycle announced there. I mean, firstly, is that accurate? I guess secondly, if it is, have you kind of seen what kind of acceptance, I guess, has there been to any price increases there?
Melissa, it's Shawn here. your question on price increasing, yes, we did put a price increase for NEXTSTELLIS in January, and that's had no negative impact on how the product's being reimbursed and in the marketplace. we continue to see the script level increase as we reported. All times high, 10 out of 17 weeks since the beginning of the year.
Yeah.
There's been no negative impact to that price increase. Obviously, no matter how much you put it up, it doesn't all drop to the bottom line, based on rebates and co-pays and contract negotiations.
Would we say that of that pricing increase, there has been a net incremental benefit to you guys, even if there are those kind of intermediaries taking some chunk? kind of should we think of it as a net equal to you?
No. It's a net positive, Melissa.
Okay. Excellent. Thank you. Perhaps one follow on around NEXTSTELLIS, who's the winning sales force, the winning health sales force. You mentioned that's now up to 100 reps. I mean, how should we think about that in terms of the maturity of that sales force? Are you expecting to add reps still in the coming 12 months? Perhaps if you could kind of share any kind of what does a mature sales rep in that kind of portfolio, what are your kind of targets for someone like that at maturity?
I wanna make sure I'm answering your question right. We have 91 reps in the field, nine managers managing that group in the field. Of that team, there's 20 of the reps that have prior TXMD experience. Some of them been hired two years ago and some of them recently just after the transaction. You know, the age maturity, if that's your question, is, you know, late 20s to.
Sorry, maybe I should clarify.
Yeah.
That wasn't my question. I think it was more them being mature in terms of, you know, developed in terms of understanding the sales force that they're selling. When they get to maturity, I guess, as you would call kind of a NEXTSTELLIS sales rep, where they're kind of, they've gotten all their territory sorted and they're kind of operating at full capacity. Sorry, I should have clarified.
Yeah. Good, good question. So in the end of January and early February, we completed the training exercise for, you know, the new TXMD people to be trained on NEXTSTELLIS and the entire prior team to be trained on all the acquired assets for birth control with ANNOVERA and menopause for IMVEXXY and BIJUVA, and then how to leverage the prenatal vitamins to gain access and 'cause they're well accepted in the marketplace. Generally, that process of, you know, where to go get your business, how to effectively communicate, is about a three-month journey to six-month journey to get to be fully productive in the sales force. We're gonna continue to see sales, individual sales force productivity gains as a result of that.
It's also enhanced by our retargeting exercise and going after Yaz more so than Lolo in the past. If you look at what we've done is close the gap between NRx and repeat scripts. The ratio between NRx and repeat scripts were low because we were going after the patients that had bleeding issues with Lolo. Those issues may not be drug-related, but biologically related to fibroids or endometriosis. They were gonna suffer from bleeding issues on whatever birth control mechanism. We saw 11% increase in repeat RX the week before, and we're gonna continue to close that gap by having the right targeting. It's a combination of skills, ability and having the analytics behind the team to drive them to the right customer with the right message.
That's helpful. Perhaps one more, if I could. Just around the gross to net stabilization you've seen in the dermatology business. Kind of a two-part. First, how is kind of the co-pay use within, I guess, that segment trending? Then secondly, are you kind of confident in your new 'cause you obviously changed how you're kind of forecasting and accounting for those accruals. Now you've kind of had a little bit of time to test that. Are you now confident that that's kind of adequate and we won't see repeat of the last half?
I'm confident we're not gonna see the repeat of last half, but I'll let Aaron give you the details on that question.
Hey, Melissa. In general, I would say that your first question is how is the co-pay support trending? Co-pay support is trending in line with the volumes. We've had to increase, from a rate, from a take perspective, the co-pay support rate, the rate at which people use the co-pay cards, we've had to vary the amount of co-pay support on certain products. In some cases, that's meant increasing co-pay support, and in some cases, that's meant reducing co-pay support. When Shawn earlier in the presentation mentioned that we were managing each asset, we are making certain decisions that we will not take losses. We won't have loss leaders in the portfolio, from a derm perspective, just to build out the portfolio. We've made adjustments across the last three months to the co-pay support.
In general, I would say it's nominally higher than what it's been in the past. That mix is going to be heavily skewed by the volumes coming from the new products.
Okay.
It's a little bit of wait and see on the new products because we've, you know, we're just now getting into the uptick of volumes from those products. That was the first question. I'm sorry, I forgot the second question.
I was just asking around the new way that you're forecasting accruals.
Yeah. Okay, good. Yeah, perfect.
Yep.
Yeah. What the new method, we actually looked at it yesterday and have been discussing it tonight. The new method is w orking well. We believe we may actually be a little bit over-accrued. It's something that we have to go through some empirical evaluation and analytics to confirm. We've begun that process. If anything, we are not under-accrued, let me say that.
Okay. Excellent. Thank you.
Thank you. Your next question comes from Elyse Shapiro from Canaccord. Please go ahead.
Morning. thanks for taking the question. maybe just take a step back again on that U.S. women's health sales force. how many reps do you think you'll end up with? do you have all the key geographies covered?
Thanks, Elyse. We're quite comfortable with the size of our sales force right now to be able to penetrate both the contraceptive and the menopausal market. We're getting the right level of reach and frequency with the portfolio we have. Right now we don't anticipate increase in the size of the sales force. We have filled in by increase. We didn't cover the northwest of the United States previously, and we filled that in after the acquisition of the ANNOVERA and the menopausal products. We have really good coverage geographically with the 91 territories and nine managers covering that field force. The one thing we are gonna be changing is increasing our medical affairs effort into the marketplace.
We've had recent change in our medical and leadership and, are gonna be more customer-facing with our medical affairs group and expanding our reach and ability to, influence the market on the benefits of E4 and, NEXTSTELLIS.
Okay, thanks. Of the kind of onboarded therapeutics and the reps, are you seeing them selling kind of higher volumes of NEXTSTELLIS now or do you think they're still skewed towards their previous products?
I wanna make sure I heard the question. Are we seeing the nboarded TXMD reps selling more NEXTSTELLIS now?
Yeah. Yeah.
They certainly.
They weren't selling any before, like, I guess how much rooms or growth do you see in those reps specifically?
In the new TXMD reps and the new reps we brought on that weren't TXMD, as I mentioned to Melissa, you know, they wouldn't be at full productivity yet. We did finish the training exercise at the end of January, beginning of February, and their full productivity will continue to increase for the first six months. At the same time, we're enhancing their productivity with, you know, more samples and more tools and better call targeting approaches. We've accelerated our CME programs in the marketplace dramatically.
We're, as I said earlier, we're gonna enhance our medical affairs team, and then you combine that with the TPC, you look at the whole, you know, marketing mix that we're delivering for NEXTSTELLIS is that, we're just starting these early hints of the fruits of that change in strategy based on the data I showed you here today.
Thanks. Maybe just one more. How aggressively are you looking at, you know, new acquisitions or new product additions to either women's health or derm? Do you anticipate being able to fund that with the existing cash?
We're in a good situation there in the women's health and becoming the second largest commercial thrust in the market behind Organon in the women's health. There's opportunities always being thrown our way. As Aaron said before, we're gonna only look at accretive deals that we can bring into the business. We're not looking to do big transactions at this point to bring in assets of that nature. Looking at dermatology, I've been very clear that we need to improve the quality of assets we bring in. You're gonna see continuous, what we call capital light approaches to bring in quality dermatology assets.
We've demonstrated with our current partners what we can do with dermatology products and drive market share, and that is being seen as attractive to other dermatology product developers. We will continue to bring in assets that are appropriate from our financial situation and able to deliver on our criteria of being accretive from the get-go.
Got it. Thank you.
Thank you. Your next question comes from Jason Korman from Viburnum Funds. Please go ahead.
Hi, guys. Thanks for providing the update. Just a few questions I had. Firstly, I was just trying to understand the April cash balance of AUD 239 million. Let me just step through my math here. If we take the AUD 175.5 on the balance sheet at 31 December, deduct the special dividend, which was about AUD 47 million, and add the upfront sale proceeds for Retail Generics, which was about AUD 140 million, I get a figure closer to AUD 268 million versus the AUD 239 million number. That, I guess, implies that there's been a negative AUD 30 million free cash outflow in this period. Is that correct?
Jason, yeah, we have had some negative cash outflows. Some of that cash outflow relates to the TXMD transaction. We have a networking capital true-up mechanism as part of the deal that we did. Basically, TXMD had to estimate their open, you know, liabilities, their receivables, and we paid for the net balance, something like $13 million net. What we have seen and what we have put forth as a claim is an amount which is approximately $10 million higher than what was transferred at the time of closing. We have not finalized those numbers yet, there is some amount of cash out related to that situation. We also have a number of timing effects related to prepaids on the TXMD assets.
We had to put out prepaids related to co-pay advances, we'll be booking that as a prepaid on the balance sheet. We've had a couple of integration charges that have come in, NEXTSTELLIS has not been at breakeven, continues to consume cash. We did also buy inventory related to the ORACEA transaction, really, it's normal working capital need. Yes, there has been cash out Since, based on the numbers that you put forward.
Thanks. I guess, you know, another way to think about it is perhaps the upfront, the true upfront cash cost of that TXMD acquisition, are higher than what was, perhaps known at the time it was announced.
No, I wouldn't look at it that way. We paid what those assets were represented to us. We paid in line with what the third-party auditor certified. What we've seen is that we've had to pay some additional. We've taken on some additional charges. We knew this business has a great deal of uncertainty, especially with gross to net adjustments. We knew that there was a risk that this could happen. The agreement is architected to give us a mechanism to recover these. We have an initial recovery mechanism, which is the review that's underway right now. We have an additional mechanism down the road related to the longer running liabilities. We have a couple of ways to get that back.
We could request immediate payment of those, or we could deduct those against future prepaid royalty obligations. From a business side, we believe those are recoverable, and we do plan to book those to the extent they hit the P&L as receivables.
Okay, thanks. Then just sort of generally on TXMD, I guess we've opened these assets now since the start of this year. In the first half results, you guys indicated that you expected it to make an incremental contribution of roughly $73 million in underlying EBITDA. What has been the actual contribution from those assets in the first four months of the year?
Based on the first quarter, I've got revenue figures here. The first quarter, we had approximately $15.8 million of revenue. The profitability or the margin thereon is somewhat better than what they were performing at historically in TXMD's hands. Our OpEx invest is in line with our plan. We've got roughly $1 million of additional charges related to integration of the assets. Our OpEx is excluding those integration costs, our OpEx is in line. In terms of what they deliver, we expect them to deliver as much or more as what we've talked about when we purchased the assets.
It's on track. The first quarter's contribution is on track with a run rate that would deliver that AUD 73 million annually.
Yeah, it's on track with one caveat, the integration month. Obviously, when you purchase a business, an integrated business, it would be lovely if day one was 100% full throttle revenues and profitability. That's not a reality. In fact, this is probably one of the quickest integrations I've seen. We had approximately 30 days, an estimated 30 days revenue impact related to the cut over of the inventory that TXMD had sitting in the channel. The reduced buying behavior from our, when we took over the assets, and then as mentioned, some of the gross to net adjustments. Those were the topics that are still under discussion. The first quarter performed quite well, normalized for that integration period, that first 30 days.
We continue to monitor on a weekly basis how the assets are performing against the business case, and we don't see any reason for concern at this time.
Right. Thank you. Just one last one from me. You know, you provide a sort of bridge to a net debt position. I'm just a bit curious about how you guys are thinking about the receivables facility in that context. I think I heard you say, Aaron, on the call, which would follow my understanding, but that receivables facility is, you know, effectively quarantined to a certain pool of receivables and is non-recourse and would not be paid off via cash, but rather by the receivables that are linked to that facility. If that's all correct, it would seem to me that it's probably not accurate to include that in your net debt calculation without accounting somewhere in that same calculation for the receivables which sit against that.
In other words, it seems to me more like an operating liability with a directly linked and completely offsetting operating asset. Do you have any comments on that and whether it's appropriate to be including that in a net debt calculation?
I mean, it's feedback received. That's what I would say. Feedback received. In general, we expect that receivable facility to wind down, and I think we've been transparent that we would not use net cash on hand right now to pay that facility. I think anything beyond that, as long as we're transparent and open about it, becomes maybe a little bit of a debate in semantics, but we'll take a look at it.
Great. Thank you. That was all I had. Appreciate the time.
You're welcome.
Thank you.
We have a number of written questions, so Operator, are there more questions? Are there more people online?
Apologies. Sorry. There are no further phone questions at this time. I'll hand over now for webcast questions.
Would you like to go first or should I?
The first question I have here in women's health, does OpEx of the $50 million for existing franchise and $20 million for the acquired assets enable revenue to scale? What level before do you need to add more OpEx? We're comfortable where we are in the total OpEx that we have for women's health. The only thing that we expect to be changing that I've communicated already in this conversation is medical science liaisons. That is a, you know, a detriment that we had at launch. I've communicated this before, and we're taking action on that to improve that. We've increased the number of speaker programs in the marketplace to educate the market on NEXTSTELLIS and the benefits E4. That's really the only changes we see.
We, you know, we have this partnership with GoodRx, so we get high productivity out of our DTC spend. We're just gonna continue to monitor to make sure all our investments in our women's health franchise are showing to be productive and do the right market research to understand that. You know what they say in marketing, half of your marketing spend is misspent. If you do the right work to figure out not to spend that half of the marketing cost that's unproductive, that's what we're here to do. We wanna make every dollar count in marketing, but we're very comfortable with the level of investment we have for women's health to drive the growth forward for the entire franchise.
The next question is, how does Q1 2023 TXMD product sales compare to Q1 2022 under TXMD? The way I read that question is we're talking calendar quarters, so that would be, basically Mayne Q3 compared to the Mayne Q3 of last year. The TXMD sales, and this is per the TXMD Investor Relations website. This is not a Mayne figure. Pulling that off of the TXMD Investor Relations website, net revenues for Q1 of calendar 2022 were $18.9 million. Net revenues for Mayne for the comparable period, remember I mentioned the 30-day revenue integration topic, our revenue for the same period would be $15.8 million. That is that question. This is another question here, which is quite a good one. Do you wanna go ahead?
I'm sorry.
Go ahead.
Did you have one? Another question here, which is quite a good one. Can you provide some more color on expected capital needs on closing Retail Generics and TXMD and why these are temporary timing effects? This is a very good question on TXMD. TXMD represented certain assets and liabilities to us. As I mentioned, these have some variability, and so to the extent that those estimates were off, we would potentially have to put cash out in order to be able to continue to do business with some of those suppliers. Per the agreement, the liabilities actually belong to TXMD. It's a my watch, your watch, agreement.
Because these liabilities were given rise to or raised under TXMD's ownership, however, we have this true-up mechanism that enables us to pay and expect recovery so that we're not caught in the middle of a fight trying to keep the lights on and keep the business running. The true-up mechanism basically is that we have one major true-up, which is the review period is happening right now for the initial net working capital calculation. As I mentioned, we've sent some figures over to TXMD and are in the process of reviewing. We have additional true-ups in the future for the longer-term gross to net adjustments, which primarily touch returns.
To the extent that the returns in the future are different from what was transferred to us, that would lead to either a payment on the part of Mayne Pharma towards TXMD or a payment from TXMD to Mayne Pharma. It's a true-up mechanism. I believe that the majority of the true-ups will happen here in this first period, but again, noted there. These are traditionally very difficult to estimate as it's a combination typically of expiration date and inventory sitting in the channel. The channel includes specialty pharmacy, where you have very limited visibility to the inventory. The other on the Retail Generic side of the business, there are certain charges which are auto-deducted or certain charges which are simply assessed to us. These charges. We have split lots.
Let me talk about the split lots. A split lot is if we bought a large quantity of product and we sold through part of it and Dr. Reddy's will sell through the remainder of it as part of the inventory that was sold to Reddy's, they would the split lot would be according we would basically true- up. There will be certain bills related to any GTN deductions that are paid by Mayne Pharma, and certain bills which are paid by Dr. Reddy's. At the end, at the true-up window, we will basically look and say, "Mayne sold a certain percentage of the lot, which is a known quantity today, since we're not selling them anymore.
Dr. Reddy's had the remainder." The question then becomes, how much did each party actually put out? There are a number of mechanisms, whether it be a lot ID number or the labeler code. There's a lot of things that are inherent in the product, which could point the cost back to us. This is some of the liabilities which during this cut-over period, we may end up having to pay and then try and recover. Not try. We will recover the monies at the appropriate time per the agreement.
Thank you, Aaron Gray. There was a question, are you saying NEXTSTELLIS gets the contribution breakeven in first half 2024, excluding TXMD? Previously, management had been focused on delivering 350,000 cycles before I arrived. As I communicated at the first half earnings back in February, we're focused really on accelerating the growth rate of NEXTSTELLIS and getting it to a breakeven run rate as fast as possible. Early in February, we saw three weeks in a row of 5% growth on NRx that led us to believe that we could get there by the end of June of this year if we continue on that rate. As I said, we've had record months, weeks of prescription volume.
Some of them, seven of the weeks were not records, and we had some growth periods that were around 1%. Now, with the current run rate, average run rate, we see that happening in the first half of 2024. There's opportunity for us to improve on that, some earlier in 2024 with the impact of what we're seeing commercial or commercial efforts that we've demonstrated in the slide presentation here today. That is a clear goal. It's a number one strategy to get a breakeven run rate for NEXTSTELLIS on its own. The entire women's health franchise is delivering contribution margin, as we said it would.
We're very pleased so far, as both Aaron have indicated, that the transformation into becoming a leading women's health company in U.S. is delivering and delivering to plan.
Next question I have: excluding the capital requirements, is the overall business already at cash breakeven or better? The way I would like to answer that, there's still a great deal of uncertainty in some of our business. We still see NEXTSTELLIS growing strongly, although still consuming cash. We have TXMD performing well and generating cash. We have the dermatology business returning to positive contribution and returning to cash generation. We have the international business. Excluding the capital requirements is a tough one to try and answer, but in general, all the businesses are expected to be at a positive contribution and we are still looking looking forward to the company in the near future, returning to positive cash generation. I can't provide guidance on when that will be.
I do not expect that to be during the half, the second half because of the.
Stranded costs.
Yeah, because of the stranded cost topics and because of the lagging retail generics and the cash out to TXMD, the delay in some contingent items, et cetera. In general, all businesses are performing at a positive contribution, and we expect that to continue and then to benefit based on the growth of some of the different products, both in dermatology and in women's health.
Well, thank you for your questions and your time. You know, overall, we're very pleased with the business, the progress we're making in our strategic transformation over the last seven months. There's more to be done to optimize the growth of the business we have in our hands today, and we're focused on that. I'm really thankful for the entire Mayne team and how they are adapting to my performance-driven culture. We're doing what we said we would, and I'm pleased that we're able to deliver on our promises. Thank you for your time.