Greetings, and welcome to the Evofem Biosciences first quarter of 2022 financial results call. At this time, all participants are in a listen-only mode. A brief question-and-answer session will follow the formal presentation. If anyone should require operator assistance during the conference, please press star zero on your telephone keypad. As a reminder, this conference is being recorded. It is now my pleasure to introduce your host, Amy Raskopf, Evofem's Vice President of Investor Relations. You may begin.
Thank you. Good afternoon, everyone, and welcome to the Evofem Biosciences Q1 2022 results call. If you haven't done so already, I encourage you to access the presentation that accompanies this call and the press release we issued at market close, both of which may be found at evofem.com under the Investors tab. Before we begin, I would like to remind you that remarks on this call will contain forward-looking statements, which are made only as of today, May 4, 2022. For more detailed description of important risk factors that could cause our actual results to differ materially, please refer to our annual report on Form 10-K and our most recently filed 10-Q. With that, I'll turn the call over to Evofem's CEO, Saundra Pelletier.
Thank you, Amy. Thanks to everyone for joining us today. I am proud that today we are reporting our third consecutive quarter of improved operating results. We significantly improved gross to net. We increased Phexxi net product sales. We reduced our total operating expenses, and we improved our loss from operations. This testifies to our ongoing disciplined approach to fiscal improvement. On the call today, I'm going to provide color on the trends and initiatives that we believe will drive further revenue growth and enable us to achieve our stated guidance and build long-term value for shareholders and the women and prescribers who rely on Phexxi for hormone-free contraception. The most important development is that last week we received confirmation from one of the largest PBMs in the nation that they will add Phexxi to their national template formularies with no restrictions.
First, though, I'll ask our CFO, Jay File, to review the financial results. Jay?
Thank you, Saundra. Today, I'm going to focus on the first quarter of 2022 results relative to Q4 of 2021. Net product sales increased 19% to $4.3 million, driven by significant improvement in our gross to net percentage. Our gross to net decreased to 38% for the first quarter of 2022, a 30 percentage point improvement since the fourth quarter of 2021. This improvement was driven by the positive impact of adjustments to our patient support programs in January 2022. We believe the more favorable GTN is sustainable and that it will remain around this level or better going forward. R&D costs were $10.4 million, reflecting higher enrollment in the first quarter for the registrational Phase III EVOGUARD trial of Phexxi for the prevention of chlamydia and gonorrhea in women.
This study is fully enrolled, and these expenses will start to decrease as women exit the trial during the second and third quarter. Selling and marketing costs decreased by nearly 50% to $12.7 million. This was due primarily to lower direct-to-consumer spend in Q1. G&A costs were $9 million, predominantly higher due to outside services in Q1. As a result, total operating expenses decreased 19% to $33.2 million, and our loss from operations improved to $28.9 million. We continue to expect 2022 net product sales will be in the range of $30 million-$35 million based on the current business, with momentum building in the second half of the year. Gross to net will remain in the 35%-40% range for the foreseeable future, trending toward the lower end of that range in the second half of the year.
We continue to believe this, coupled with significantly lower R&D costs as patients exit the EVOGUARD trial, will give us the cash flow breakeven on a quarterly basis by the end of 2023. At the close of Q1, we had $2.8 million in cash and cash equivalents and $4.2 million in unrestricted cash. We raised $10 million in gross proceeds through two unsecured debt transactions and net proceeds of approximately $5.4 million from our equity line of credit. An additional $0.3 million was recorded as other receivables since it was received after the quarter close. An important note, this morning at our annual meeting, our stockholders of record approved a reverse stock split of Evofem's common stock.
The reverse split is intended to increase the per-share trading price of the company's common stock to enable Evofem to satisfy the minimum bid requirement for continued listing on the Nasdaq Capital Market. With that, I'll turn it back to Saundra.
Thank you, Jay. Our first quarter results demonstrate that we are consistently delivering quarter-over-quarter growth. All indicators give us confidence that we are on track for another strong quarter in Q2, and we are right on track to achieve our 2022 revenue guidance of $30 million-$35 million. I want to walk you through the underlying reasons we are confident in this guidance. First, some insight on demand. We had forecasted that Phexxi total prescriptions and dispensed units would be soft for the first eight to 10 weeks of 2022 and then rebound. That is exactly what happened. New prescriptions of Phexxi increased approximately 30% from February to March. The anticipated dip in January and February relative to December was caused by two underlying reasons.
First is the annual reset of patient healthcare deductibles, which affects consumer discretionary spending and impacted all contraceptive brands and the industry as a whole. The second are the adjustments that we intentionally made to our patient support programs in January 2022, most notably the termination of denial conversion. This significantly increased the profit margin on Phexxi units dispensed and supports our continued net sales growth. The rebound came on the early side of our expectations, and we attribute this to our sales force driving more than 2,300 new first-time Phexxi prescribers. In April, we entered into an agreement with vitaCare to provide enhanced white glove support services to women prescribed Phexxi who choose to use this avenue to obtain their prescription. VitaCare will help the Phexxi patient understand coverage, identify available savings opportunities, and facilitate communication between the healthcare provider and the payer.
We believe this new agreement and high level of patient interface will significantly streamline access to Phexxi and lead to more patients filling their Phexxi prescriptions. Turning to sales and marketing. We will have a strong presence at the ACOG annual meeting starting this week on Friday right here in San Diego. ACOG is the largest and the most prestigious gathering of U.S. medical professionals in obstetrics and gynecology, and more than 4,000 attendees are expected at this year's meeting. We secured a prime, high-traffic location for our stunning Phexxi booth. We're hosting an educational seminar on Friday morning for healthcare providers to learn more about Phexxi from one of the nation's leading OBGYNs. We'll present new data from the Phase III AMPOWER trial on Saturday afternoon.
Additionally, we will launch the Let's Make It Personal campaign at ACOG, which is designed to support healthcare providers in their patient-centered contraceptive counseling and understand how Phexxi plays a role throughout her reproductive journey. ACOG is an ideal venue to highlight the post-hoc analysis of the AMPOWER trial. These data show that 99% of pregnancies were prevented per act of intercourse in this study. This is very useful data for our sales force to share with prescribers as they identify who the Phexxi woman is. Moving to access. We continue to make tangible and meaningful progress this year. In January, the U.S. Department of Labor and Health Resources and Services Administration updated contraceptive guidelines to ensure women have access to all FDA-approved contraceptives, including Phexxi, at zero copay under the Affordable Care Act.
We believe these new guidelines make it clear to insurers that barriers to access, such as step edits, claim denials, and prior authorization letters must end. The Department of Labor guidelines took effect immediately, but certain plans remain non-compliant. We are gratified that elected officials in the House and the Senate continue to call for heightened enforcement and adherence to the new guidelines. As mentioned in my opening remarks, we received confirmation last week from one of the largest PBMs in the nation that they will add Phexxi to its national template formularies with no restrictions. These template formularies are used by employers and downstream payers nationwide, and we expect an additional 28 million lives will gain unrestricted access to Phexxi in the next 60 days.
In addition to increasing access to Phexxi, this agreement will also directly reduce our operating expenses by removing prior authorizations from Phexxi prescriptions for this PBM, which has the highest volume of Phexxi PAs of any payer in the nation. With each PA currently costing us $35 to process, this agreement is a very big win for Evofem on all fronts. Additionally, one of the largest plans in Utah has removed its prior authorization on Phexxi, and the largest payer in Hawaii will add Phexxi to all of its commercial formularies on July first, which is another fantastic win by our team. We commend these plans for removing barriers to access and for doing what's right for women. In 2022, we are re-energizing our business development efforts, which are predominantly focused on opening new markets for Phexxi outside of the U.S.
In 2021, our previous business development consultant received significant interest around Phexxi in Asia and Europe. We believe, we believed that we would be able to close a deal by year-end. However, when the offers came in, none of them met our requirements of a significant upfront payment, milestone payments, and an ongoing revenue stream. We are thrilled that Karina Fedasz has joined Evofem as the Head of Business Development. Karina brings a high degree of business savvy and demonstrated expertise to effectively execute on our strategy. Karina will evaluate and close on good deals that appropriately value the asset and reflect the opportunities in contraception and STI prevention. She is singularly focused on forging the right deal with the right partner at the right terms, blending an upfront payment, milestone payments, and royalties on future product sales.
We look forward to the results of her focused and strategic work through the remainder of the year. We continue to seek opportunities to leverage our sales force for co-promotion of synergistic women's health products and explore other strategic relationships with potential to add value to our shareholders. Turning to R&D. In Q1, we completed enrollment of the Phase III STI trial, EVOGUARD, which is evaluating Phexxi for the prevention of chlamydia and gonorrhea in women. We look forward to reporting top line data by the end of October this year. Positive outcomes would enable FDA submissions for these potential new indications in the first half of 2023. The CDC estimates there are four million new cases of chlamydia infections and 1.6 million new gonorrhea infections annually in the United States, which correlates to $962 million in direct medical costs.
According to the CDC, every sexually active person is at risk of catching these common infections, and there are no FDA-approved prescription preventative measures. Right now, the choices are condoms or abstinence, and around the world, public health experts and advocates are highlighting the need for new preventative measures. To reiterate the timeline, we are on track to report top-line STI data by the end of October. Positive outcomes would enable FDA submissions in the first half of 2023. Once the submissions are accepted for filing, we expect a six-month review because Phexxi has fast track designation for both potential new indications. These are significant near-term inflection points for Evofem and our shareholders. Finally, our research efforts also have led to the very recent publication of sexual satisfaction data in The Journal of Sexual Medicine.
In this manuscript, investigators reported that 88.7% of women using Phexxi improved or maintained their sex life. We collected this exploratory data from the Phase III AMPOWER trial to increase the understanding of women's sexual experience with Phexxi beyond just pregnancy prevention. With that operator, I would like to open the call for questions.
Thank you. We will now be conducting a question answer session. If you would like to ask a question, please press star one on your telephone keypad. A confirmation tone will beep and your line for the question queue is active. You may press star two if you would like to remove your question from the queue. For participants using speaker equipment, it may be necessary to pick up your headset before pressing the star keys. Please ask one question and one follow-up question, and then re-queue for additional questions. One moment please while we poll for questions. Thank you. Our first question comes from David Amsellem with Piper Sandler. Please go ahead.
Hey, thanks. Just a couple. First, can you give us a bit of a refresher on how we should think about your priorities regarding spend? I know you've cut some costs, but you know, there's obviously some degree of promotion intensity here. Can you talk about how we should think about the long-term trajectory of sales and marketing spend? Secondly, just remind us, once we get to sort of a point where most patients are getting covered at no copay, what is the right way to think about the steady state to gross to net once you've gotten to that point? Thank you.
Jay, do you want to start?
Hey, David, good to hear from you. Yeah, I'll address both of those questions for you real quick. On sales and marketing spend is really going to be the primary driver, at least in the short term this year for reduction. We have stated, I think even at the year-end call, about a $50 million reduction in OpEx for the year, and that's going to be largely attributable to a reduction in marketing costs directly associated with the DTC media aspect. R&D itself will obviously continue at a level very similar to last year because we're wrapping up the trial and there's a large majority of women wrapping up on EVOGUARD that will start dropping out, majority through second quarter and a little bit in the front end of Q3.
You'll see that start dropping dramatically. G&A should remain relatively flat. Going forward, you know, I think you can expect some degree of increase in sales and marketing as we prep for the STI addition of the indication for Phexxi. I think most notable, some increases to our sales force size will likely occur. Aside from that, you know, we will be spending some time over the next year or so developing what that marketing plan looks like. You know, it might not necessarily be as extensive as we had to do for Phexxi because we're not starting from zero, but that will be definitely an item of discussion and we'll give more guidance on this as we get closer to that. In regard to gross to net, obviously, we're super happy about the 30 percentage point increase.
It's direct reflection of the copay adjustments we made at the beginning of the year, largely attributable to turning off denial conversion. We do anticipate, you know, best case scenario, you're not going to get much better than 20-ish%. That's with everything in a perfect environment, which we know doesn't quite operate that way, because we do have distributor costs and other aspects that roll up into GTN. I think it's probably a healthy way to say maybe in a perfect environment it'll fall somewhere best case around 30% and maybe into the higher 20s, but I wouldn't go any further than that. Again, that is if the stars align and everyone's playing on a level playing field.
That's helpful. Thank you.
Sure.
Our next question comes from Annabel Samimy with Stifel. Please proceed with your question.
Hi, this is Stacy calling in for Annabel. Congratulations on the continued growth and thanks for taking our questions. A couple that we have is, first of all, how is vitaCare's engagement with patients different than Nuvera, and why would they be getting a higher response rate translating into fulfillment? Secondly, how are you providing assistance or coverage prescriptions for those without actual coverage? I guess lastly, any thought or extra color that you can provide us on ex-U.S. partnership, are they holding out for Phase III data or are you? Thank you so much.
Yes. Great. One of the things when we talk about white glove, the new vitaCare relationship, they really understand the space very well. What I mean by that is that there's gonna be a much more engaged interface with the patient, ensuring that they're getting the refills, making sure the refills are timely, but also engagement with the provider. It's actually gonna be a full circle. We feel like that enhanced engagement is really gonna matter with the busy lives of women that, you know, we just wanna make sure that they're having consistent and constant follow-up. That's the difference, which I think is going to make a really, I think, important, you know, refinement. Also, you know, it's really gonna provide us more patients.
We feel like they're gonna not only engage the patients that we have, but they're gonna. The patients that are interested, they will engage them, give them the information they want, which will ultimately lead to more prescriptions. We do anticipate this relationship will actually grow our base of patients as well. Then the next question on ex-US, right, is it ex-US?
STI timing.
Yeah.
Oh, STI timing.
Any color on ex-US partnership?
Yes. The STI timing has actually remained consistent. We do still intend to deliver top-line data on our STI study by the end of October. We, as Jay mentioned, you know, the positive of that too, it will consistently decrease our output of cash, you know, because this study was an expensive undertaking, certainly well worth it. The one thing that we consistently see, by the way, that's actually growing, is that as our sales force continues to talk to doctors, one of the things that they continuously share with us and also that we get from market research as we go out to young women on college campuses, is that we hear them talk about their concern about their ability to get pregnant when they want to, and is using hormonal contraception impacting that.
We know that chlamydia, by the way, is one of the number one reasons for infertility. We also know it causes pelvic inflammatory disease. We really feel like this is going to be a very significant opportunity for women and for shareholders because again, we will be the only product that prevents both of these. Chlamydia is the number one most diagnosed and prescribed STI, followed by gonorrhea. That's very exciting. To quickly transition to your ex-US opportunity. The one thing that I hope I made clear in the script is that we really know that we needed a focused executive that will be deliberate spending all of their time because this asset is worth it.
When we say the right partner with the right opportunity, we want a partner that has a footprint already that understands that when you're in women's health, there are certain challenges, but there's also significant opportunity. We know that the upfront is important, but also the revenue stream that's gonna be forthcoming can also be very significant. We feel very optimistic that we have brought a person on board that not only understands business negotiation, but in her history she's also had roles as a CFO. She understands the financial piece, the negotiation piece, and already in the short time she's been here, she's already made very significant inroads. I would tell you that that's what was necessary, is we needed a full court press so that we could get the economics that we wanted.
Now in the past, we could have done a deal, but it certainly would not be representative of the value of this innovation, and that's why we took a step back. Now we're taking 10 steps forward, so to speak.
Amazing. Thank you so much. That was very helpful.
Okay, great.
Our next question comes from Yi Chen with Laidlaw & Company. Please proceed with your question.
Good afternoon and thanks for taking the questions. Congrats on the very solid quarters so far. Just a few quick ones, given I'm a little bit new to the story. The first is that, would you be able to name that PBM that lifted all the restrictions, or is that still kept confidential?
Well, hi, Yi. Nice to speak with you. I would love to name the PBM, but I can tell you that a poison dart gun is being pointed in my direction. But we are not allowed to, unfortunately, but it is definitely one of the top three PBMs in the nation. Unfortunately, we can't get the name out yet, but it is a large win because there are 28 million lives covered. We're very, very excited about it, I can tell you. You know, it certainly will be forthcoming, but we just needed to give out this important teaser because it's really gonna be very, very game-changing.
Okay, great. One more follow-up here is that, would you be able to report any of the numbers of boxes shipped over this quarter?
Yeah. Jay, do you wanna hit the units shipped?
Yeah, no. We're just pulling it up here on the piece of paper. As far as units dispensed in the first quarter, there were 27,053.
You know, I'm gonna just give you an indication. I'm gonna jump in too because we have, you know, TRx and units dispensed and I know. One of the things that I think is important when we message that, look, you know, January and February were, you know, tough for everybody, but here's what we've seen so far. I mean, already as an example in March, this is just from a TRx standpoint. In March we had over 9,300, a little more than that, TRx. We're already midway through April and we are beyond 4,500. We are going to surpass March in April, which we feel great about. You know, being realists, we wanted to manage everybody's expectations and say January and February were gonna be truthfully fine by most people's standards.
We knew that we did the rebound in March and now April we're seeing the upswing. I think you're going to feel good about the fact that, you know, the curve is now adjusted and on an upward trajectory.
Okay, great. That's very helpful. Maybe just squeezing one more. In terms of the first quarter figures, is that something within your expectation or beyond or how would you characterize that? Thanks.
You know, I'm sorry, could you say that one more time? It broke up a little bit. I apologize.
The first quarter figure, the sales figure, is that within your expectation or beyond or how would you characterize that numbers?
Yeah, I would actually tell you it was exactly in our expectations, frankly.
Say that one.
Yeah. We've tried to be very mindful, you know, that this guidance that we're giving is guidance that is attainable. You know, we feel good about it. You know, we wanted to use this call as an opportunity to share why we are confident about it.
Okay, great. That's very helpful. Again, congrats.
Thank you.
Our next question comes from Ram Selvaraju with H.C. Wainwright. Please proceed with your question.
Thanks for taking my question. Firstly on the commercial front, I was just wondering if you could provide us with a bit more color on efficiency initiatives that you've undertaken that you see as being particularly central to ensuring that you can maintain the same level of commercial impact even though you're managing costs?
Yes. Hi, Ram. We didn't know you were gonna be on the call. We're so happy you are, by the way. Nice to hear from you. Here's what I would tell you is that I think your point is important, right? That lowering the cost, how are we going to maintain and grow, frankly. One of the keys which is an obvious statement is increased access, right? As plans open up and do the right thing, we are seeing that it is really been so critical and so important.
I mean, look, one of the things that our new chief commercial officer has said after being in the field is that there's nothing more frustrating when we go in and we talk to doctors. They say, yes, they are gonna write Phexxi, they write it and then the patient calls back an hour later and says they can't get it because their plan won't cover it. Obviously that demotivates the doctor because the doctor takes that time for patient counseling and it's very, very frustrating because a lot of the physicians who are writing Phexxi, they are convinced that that is the right product for those patients. Access, continuing to open up access.
This win in Hawaii, this win in Utah, this win with this PBM, I can tell you if you were to go in the field with our sales force right now, you would think that we, you know, fed them all happy pills. Everyone is very excited and motivated. Also though I would tell you that we really are leaning into grassroots. What I mean by that is that college campuses are open. We are excited to forthcoming announce that we are going to do a big college campus initiative around sex education days where we will have providers writing prescriptions and really talking about sexuality and how bodies work, but more importantly about hormone-free contraception.
We are gonna lean into that which is a very cost-effective way to build a base of users, not only immediately, but users who have a long time in their fertility years and hopefully be Phexxi users for a long time. Then finally, interestingly, we've also used grassroots to go to a lot of pregnancy meetings. Women who are getting ready to deliver and concerned about what contraception form they will use and they obviously don't wanna have hormones in their breast milk. It's been a very, interesting time for that as well. The other thing too I want you to know is that a very, very big positive that we have made. We have made some changes organizationally, not just with the head of the commercial team, but within our marketing team.
One of the things that we've done is made some serious shifts away from very expensive marketing agencies so that we can be less reliant on them. We've brought in some people who by the way have a level of creativity, who have worked at agencies who are saving us extraordinary amounts of money and coming out with new ways to deliver the message that is not only eye-catching, but is very hard-hitting. I would also tell you that at ACOG, one way we're going to keep growing script is with this new messaging. This ad hoc data, by the way, was important because, look, one, it's factual. It's already part of our study results. It's just a new way to look at it.
When you look at pregnancies per active sex, it makes physicians much more comfortable to prescribe Phexxi, and it helps them identify a broader base of who is this Phexxi woman. We're also doing that. The final thing I want to say is that we have also made a concerted effort with our IT department to move a lot of our commercial analytics in-house, away from outsourcing. How does that help us build our base? Well, we now get more data quicker, real-time, and we can adjust. We can adjust geographies, we can adjust the way that we are pushing messaging. One of the things when we knew we had to do this decreased spend, right, we are soberly realistic around here.
We've said, "Look, we have got to make sure that the base that we built, that the investment that we made last year, not only do we maintain it, but we've got to build on it." I would tell you that we are being scrappy, we are being creative, but a lot of the things we brought in-house are really helping us move the needle real time. I know that was a long answer, but it was required to give you all the things we're doing. It's not just one thing. It's a lot of things simultaneously to make sure that we're building this brand.
Okay. Can you just remind us about the projected commercial window for the product, specifically in prevention of STIs, given your QIDP status. Once it gets commercialized, you know, what you anticipate the length of the commercial window to be?
Yes. Right now, we have coverage through 2033. We will get five additional years exclusivity, to 2038. We feel confident that that gives us a very solid opportunity for world domination. No. To really build on our base with Phexxi for contraception. The one thing, Ram, I think that we've discussed this with you, is that no matter what contraception a woman's on, she is still at risk of getting chlamydia and gonorrhea. It's actually not just our hope. It's actually our thoughtful understanding that any woman, no matter what contraception she's on, will want to protect herself from chlamydia and gonorrhea. We feel like it's really going to be a huge base of opportunity. The bottom line is five additional years to 2038.
Just lastly on that front. You know, assuming that you obtain label extension, label expansion in the STI prevention domain upon positive data from the EVOGUARD study, what kind of additional resources might be required? Maybe just describe them qualitatively to ensure appropriate and adequate promotional activity in this additional indication.
Yeah. One thing that we do know is that we would like to increase the size of our sales force. I wouldn't say dramatically, but I would tell you that on the high side, 25, and on the low side, 15, and we're doing an analysis to really make sure that we are going to be able to address all the appropriate targets. From an additional resources, I also would say that, you know, I think Jay indicated a little bit, and, you know, I want everybody listening to understand it's not like we're going to go crazy. We don't think that we have money trees around here or won the lottery. It is going to be important because the clinical seriousness of untreated chlamydia is something that a lot of people don't realize. They don't know about it.
I would tell you that when I've talked to, and we've already done diligence with doctors who do IVF, and they say the number one question they ask women when they're having challenges to get pregnant is, have they ever been treated for chlamydia? 60% of the time, it's asymptomatic. We really want to make sure that we are educating young women that if they are concerned about their ability to get pregnant when they want to, that, you know, it is important to make sure that they are looking at all of the things that they're doing for their health. We will invest a little bit in the education platform. We would like to grow the sales force. Jay, is there anything else that you might have talked about that I might be missing?
No, not necessarily. I think it's just the standard, obviously, getting conversations ahead of launch with HCPs, really developing exactly what the label expansion means for these new indications, and really developing the marketing story around it and how we deploy that. As I had mentioned, the huge benefit for us is that, we're not starting from zero. We will already have a significant market penetration. We're not starting from zero with patients. So we'll have a great foot in the door, so it won't require as much spend as it did for the commercial launch in September of 2020. And then, you know, to keep in mind too, the other thing, we've reiterated a couple times now, we're currently anticipating break even by the end of 2023. That's just on contraception.
With us launching this extra indication on top of it will take us to even further heights.
Thank you.
There are no further questions at this time. I would like to turn the floor back over to Saundra Pelletier for closing comments.
Thank you. To close, I just want to take a quick moment, and I want to say a thank you to our shareholders. When you look back at Evofem Biosciences and you look at our journey, you will see a dedicated team who took an idea through clinical trials to the FDA and finally to patients, providing the first breakthrough in contraception in decades. We delivered innovation and we're filling a previously unmet need, offering women control of their reproductive health and choices that they did not have before. Our path to this point has not always been easy. We continue to navigate obstacles that are common to innovative, publicly traded pharmaceutical companies. For now, you should know that this highly qualified, capable, and tenacious team is working to continue our success. All signs are that 2022 will be our year.
We've spent this call talking about our plans and expectations, but I want to summarize with five key points. One, reducing costs. We remain committed to reducing costs by $50 million in 2022. We're cutting burn at every turn with no fluff anywhere in our spend. The decisions we make are calculated and focused on wins that will increase and drive value. Two, increasing revenue. We're doing this by driving demand through our sales and marketing initiatives, through our partnership with vitaCare and through ongoing GTN improvements. Three, expanding Phexxi access. We continue to work to win coverage from new payers. We will not stop until all women have unobstructed access to Phexxi. Four, driving our STI prevention program forward by completing the EVOGUARD trial and gaining approval with Phexxi for the prevention of chlamydia and gonorrhea.
Five, entering into licensing agreements to get Phexxi access to international markets. We work tirelessly and proactively on these initiatives to make this company a success, to build value for our shareholders, and to bring innovation to women. We are on the precipice of change. We appreciate the continued support as we narrow the gap toward our goal of achieving cash flow breakeven no later than the end of next year and profitability thereafter. Finally, I would be absolutely remiss if I didn't address the recent new information about the viability of Roe v. Wade. When women are denied safe legal abortion, the importance of access to FDA-approved contraception is greater than it has ever been. Thank you for standing with us as we continue to ensure that women's needs are met. Have a great rest of your day. Thank you again.
Ladies and gentlemen, thank you for your participation. This does conclude today's teleconference. You may disconnect your lines and have a wonderful day.