Good morning, ladies and gentlemen. My name is Chad, and I will be your operator today. Welcome to Knight Therapeutics Inc. Q1, 2022 Results Conference Call. Before turning the call over to Samira Sakhia, President and CEO of Knight, listeners are reminded that portions of today's discussion may, by their nature, necessarily involve risks and uncertainties that could cause actual results to differ materially from those contemplated by the forward-looking statements. The company considers the assumptions on which these forward-looking statements are based to be reasonable at the time that they were prepared, but cautions that these assumptions regarding the future events, may, many of which are beyond the control of the company and its subsidiaries, may ultimately prove to be incorrect. The company disclaims any intention or obligation to update or revise any forward-looking statements, whether as a result of new information, future events, except as required by law.
We would also like to remind you, questions during today's call will be taken from the analyst only. Should there be any further questions, please contact Knight's Investor relations department by email at info@knighttx.com or via phone, 514-484-4483. I would like to remind everyone that this call is being recorded today, May 12, 2022. Would now like to turn the meeting over to your host for today's call, Samira Sakhia. Please go ahead, Ms. Sakhia.
Thank you, Chad. Good morning, everyone, and welcome to Knight's Q1, 2022 conference call. I'm joined today on today's call with Amal Khouri, our Chief Business Officer, Arvind Utchanah, our Chief Financial Officer, and Jeff Martens, our Global VP of Commercial. I'm excited to report that in the Q1 of 2022, Knight's revenues were CAD 63.8 million, which represents an increase of CAD 17.7 million or 39% versus Q1, 2021. In addition to the CAD 7.1 million of contribution from Exelon, we had revenue growth across all our therapeutic areas, driven by market penetration of our key promoter brands and an increase in patient treatments due to reduced COVID-19 restrictions.
On the business development front, we just announced that we entered into an exclusive license distribution and supply agreement with Helsinn for two products for Canada, Brazil, and select LATAM countries. Now that we have completed our organizational changes in the executive and senior management team, we are focused on continuing to leverage the platform and growing the business while finalizing the implementation of the ERP and the quality management systems and optimizing our manufacturing structure. We expect to complete the ERP implementation in all entities except the Argentinian affiliates by the end of 2022. Turning now to the NCIB. During the Q1 of 2022, we purchased approximately 1.7 million common shares for an aggregate cash consideration of CAD 9.1 million at an average price of CAD 5.29 per share.
Subsequent to the quarter, we purchased an additional 893,000 common shares for aggregate cash consideration of CAD 4.8 million or CAD 5.33 per share. I will now turn the call over to Jeff to provide more details on our product results.
Thank you, Samira. Building on our hard work of 2021, our efforts in 2022 remain focused on the executional excellence of our new product launches while delivering competitive growth for our mature promoted portfolio. In the quarter, we delivered growth across all therapeutic areas. In addition to Exelon, we had growth of CAD 5.3 million in our oncology, hematology portfolio, which includes the contribution from launches of Lenvima, Halaven, and Rembre. As for our antifungals portfolio, you may recall that these products are used in patients who are immunocompromised, mostly post-treatment for oncology or hematology conditions. As these treatments resumed versus Q1, 2021 lockdowns, there was a return to normal utilization of our antifungal products. Consequently, we saw an increase of CAD 5.8 million in our infectious disease sales versus Q1, 2021.
I will now turn the call over to Arvind to go over the financial results.
Thank you, Jeff. In the course of this conference call, I will refer to EBITDA and Adjusted EBITDA, which are non-IFRS measures. Knight defines EBITDA as operating loss or income excluding amortization and impairment of intangible assets, depreciation, purchase price accounting adjustments, the impact of accounting under hyperinflation, but to include costs related to leases. Adjusted EBITDA excludes acquisition costs and non-recurring expenses. Since Samira and Jeff have already covered revenues, I will go straight to gross margin. For the quarter ended March 31st, 2022, we reported gross margin of CAD 32.4 million or 51% of revenues compared to CAD 20.1 million or 45% of revenues in the same period last year. Excluding the impact of hyperinflation, the gross margin as a percentage of revenues would have been 53% for the Q1 of 2022.
The increased gross margin dollars and as a percentage of revenues is due to product mix, including the acquisition of Exelon and its related revenues recorded as a net profit transfer. Our total operating expenses for the Q1 of 2022, excluding the amortization of intangible assets, increased by CAD 4 million compared to Q1, 2021. The increase is mainly driven by an increase in variable, such as logistics expenses as a result of higher sales, compensation, consulting and professional fees, as well as an increase in selling and marketing activities related to key promoted products, including Exelon. Moving on to Adjusted EBITDA. The Adjusted EBITDA was CAD 13.3 million for the Q1 of 2022, an increase of CAD 7.7 million or 139% compared to the same period last year.
The variance is due to an increase in gross margin, offset by an increase in operating expenses. Now moving on to net losses on our financial assets, which are not reflected in Adjusted EBITDA. In the Q1 of 2022, we recorded CAD 16.4 million of net loss measured at fair value through profit or loss, of which CAD 16.3 million was unrealized. The loss is driven by the significant decline in the share prices of the publicly traded equities in our strategic fund investment due to general market conditions. Finally, we generated cash inflows from operations of CAD 12.9 million for the quarter ended March 31st, 2022.
The cash from operations is driven by our operating results, as adjusted for non-cash items such as depreciation and amortization, net loss on financial instruments, unrealized foreign exchange loss, and change in working capital. I will now turn the call over to Amal to provide an update on business activities.
Thank you, Arvind. As Samira previously mentioned, this morning, we announced that we have entered into with Helsinn an exclusive license distribution and supply agreement for Akynzeo for Canada, Brazil, Argentina, Uruguay, and Paraguay, and Aloxi for Canada. Akynzeo is the first and only fixed combination of a 5-HT3 and NK-1 receptor antagonist that is approved for the prevention of chemotherapy-induced nausea and vomiting. A single dose of Akynzeo, given with dexamethasone, has been shown to prevent chemotherapy-induced nausea and vomiting for up to five days. According to IQVIA, sales of Akynzeo in Canada and Brazil were approximately CAD 7 million in 2021. Aloxi is a second-generation 5-HT3 receptor antagonist with a duration of action up to five days after chemotherapy administration. Both products are highly synergistic with our oncology portfolio and commercial footprints in Canada, Brazil, and the remaining countries.
We will begin commercial activities related to the products following a transition period from Helsinn's current licensees by the end of this year. Upon transition, Knight will start recognizing revenue on a country basis. In addition to adding revenue in 2022, this transaction further validates our strategy of acquiring and licensing innovative products on a Pan-American ex-US basis. We will continue to focus on leveraging our Pan-American ex-US footprint to build our portfolio along our three-pronged growth strategy, which includes acquiring products or companies with strong sales and licensing innovative pipeline assets and developing our brand generic portfolio. I will now turn the call back to Samira for concluding remarks.
Thank you, Amal. Now turning to the financial outlook. For full year 2022, we expect revenues to be in the range of CAD 260 million-CAD 270 million, an increase of CAD 5 million on the upper end of the range as compared to previously disclosed revenue guidance. The guidance on revenues is on a non-GAAP basis as it excludes the impact of IAS 29. This is due to the difficulty in predicting Argentinian inflation rates. The guidance is also based on a number of assumptions which are described in our press release. Should any of those assumptions differ, the financial outlook and the actual results may vary materially. Looking ahead, we remain committed to building a leading pan-American (ex-US) specialty pharmaceutical company.
With over CAD 155 million in cash equivalents, and marketable securities, and the fact that we generate cash from operations, which positions us well to continue to execute on our strategy to in-license and acquire innovative pharmaceutical products, as well as developing branded generic portfolios. Thank you for your support and confidence in the Knight team. This concludes my formal remarks. I'd like to now open up the call for questions. Chad?
Thank you. We will now begin the question and answer session. To ask a question, you may press star then one on your telephone keypad. If you're using a speakerphone, please pick up your handset before pressing the keys. To withdraw your question, please press star then two. At this time, we will pause momentarily to assemble our roster. The first question will come from Doug Miehm with RBC Capital Markets. Please go ahead.
Yeah. Good morning. Two questions. The first has to do with the new products that you just licensed in. I'm curious about, given how complementary they are to your portfolio, is this something that you sought out yourselves based on, you know, introduction in the marketplace, or is this something where that company Helsinn approached you? The second question, maybe more for Samira Sakhia, just has to do with management changes in the company in South America. Maybe you could go into a little bit of detail about some of the changes you've made and why you're excited about those. I'll leave it there. Thank you.
Good morning, Doug. This is Amal. I'll answer your first question, and then turn it over to Samira. We, as we've been saying, we're always on the hunt for opportunities within our therapeutic areas and for opportunities that fit within our portfolio. We're always almost always proactively contacting different companies for opportunities. This is no exception.
The one thing that I would say, and what I'd really congratulate the team on is the fact that they did chase this down and what really gave us a bit of a competitive edge because we'd know that we were dealing with competitors in some of the independent markets, like where you take Brazil or Canada. Where we stood out is our unique footprint, and it made it, for that partner, it was a great opportunity to have one partner for all of those regions that they were looking to license out. For the second question, as you know, we've been changing our executive team. As of today, we have a full team for what we need.
You saw the addition of Susan, Monica, Daniella near the end of last year and the addition of Leopoldo earlier this year. As all of these teams get into place, what they have been doing, and we've been doing a little bit of this ourselves, but also really looking at the next level down, whether it's country leadership, whether it's a director in a certain team, and we've really been making those changes going forward. If I take the organizations that we acquired two and a half years ago, there is not an executive at Knight that is part of the former Biotoscana team. There is not a country leader. There is not a director, except for maybe one, that really is from that former organization. It's not because they weren't great or.
It's just the way we work, where we have the drive to execute as well as the focus on financial results, and really continued execution. Today, we have a great team. There is obviously and always going to be ongoing work to make sure we always have the right people, the right structure for where the business is going. You see the execution over the last year, where we had great results. You see the results of Q1, the fact that we just upped our guidance, and that's really execution on the strategy that we set out to do.
Okay, great. That's very helpful. Thank you.
Thank you. The next question will be from Endri Leno with National Bank. Please go ahead.
Hey, good morning. Thanks for taking my questions. Good quarter, by the way, congrats. Just have a few for me. I'll start with a little bit with the guidance. I mean, given Q1 results and the updated guidance that you gave, it seems like revenues should be a bit, I mean, flattish throughout 2022, I mean, if we are to assume with Q1. If flattish meaning quarter-over-quarter, is that a fair statement, or did you expect certain cadence over the next three quarters?
A couple of things. One of the reasons we up to guidance is because we just announced a new product that we expect to start recording some revenues related to that in the back end of the year. The second thing that I will say when it comes to quarter-over-quarter, I'm really not going to comment because there's a couple of things that I know. Our top line is going to be lumpy, and it's for multitudes of reasons this year. We don't know what the COVID impact is gonna be. In Canada, we're going into summer, seeing lightening of rules, everything is great. Brazil, Argentina, Chile, preparing to go into winter. We don't know what's gonna happen.
The second thing, and you probably saw that, is that we know that we'll be transitioning Exelon in June in Brazil and transitioning Exelon in May in Colombia. That in itself is going to cause lumpiness as we make sure that the channel has adequate inventory and no disruption in supply. Lumpiness is gonna be there. We are working hard to obviously grow our sales, and to grow our sales not through just selling into the channel, but creating demand. Jeff's team has done a great job over the last year, and we can expect to continue to execute on that.
Okay. T hat's great color. Thank you, Samira. Related to that, but still a separate question, as it were, you said you're working also hard to create demand and then to increase sales. Can you talk a little bit about marketing activities? Are they now in full force? Any costs associated with these? How should they trend over the course of 2022?
I'll start with the cost and the trend end. As we said, Q1 was a bit. Q1, we saw treatments advance. The front half of Q1, there was little to no activity because of Omicron in most of our territories. In the back half of Q1, everybody went back into the field. Q2, Q3, we do expect travel and field activity to increase, so costs should increase. As far as R&D things are happening, I'll turn that back over to Jeff.
Yeah. I guess the, w hat I'll comment on, is some of the just product performance that we've seen over Q1 versus Q2. Acuvia is showing some strong growth in our launch products. Nerlynx with growth over 13%, Trelstar 53% over prior year. Also with Lenvima in Brazil and Cresemba in Brazil, we've also seen some nice growth there as well. 74% growth with Lenvima and also Cresemba with 35% growth. I think our launches are going quite well. Activities have resumed. The team, to Samira's point, are investing and we're seeing the return on some of those investments.
Okay. That's great color. Thank you. The second part of my question just relates to the Akynzeo, if I'm saying it correctly. I was wondering if you can talk a little bit about whether sales were impacted in 2021 at all, and whether you expect a similar improvement to what you're seeing in your oncology portfolio for this year.
Hi, Endri. This is Amal. I mean, the whatever COVID impact you would have seen in general on oncology treatments would have had the same effect on a product that is used for as a supportive therapy for oncology treatments. When we saw during COVID oncology treatments going down because patients weren't going in, weren't getting diagnosed, weren't getting treatment, whatever impact, negative impact that had on the oncology therapies themselves had similar impact on supportive care therapies for oncology. Again, going forward, without lockdowns, patients going back in for treatments, there will be whatever again, whatever uptake you'll see in oncology treatments will translate into this product as well.
Okay. T hat's great. Thank you. The last one for me is still related to Akynzeo and the other drug. Do you anticipate any costs associated with the transfer? That would be the first one. The second part perhaps for Jeff is, were they being promoted well or efficiently in your view before? Will you need to make any investments in that end to get better promotion and what not?
Sure. I think your first question was,
Cost of transfer.
Yeah, cost of transition. Thank you, Samira. Again, this product fits right into our footprint and our portfolio. We're not really expecting to add any significant infrastructure behind it because it fits right in. We may be adding some, you know, some small number of headcounts here and there just to optimize structure, but that'll be it. We're really not expecting any negative EBITDA impact from the product this year. Next year, we're expecting positive impact. In terms of how the product was being promoted or not, again, this is a product that was launched in Canada in 2017, in Brazil in 2018. There had been some level of promotion from Helsinn's current partner who are transitioning that to us.
Again, it's a great fit within our portfolio, so we're gonna be promoting going forward.
Well, that's great color. Thank you. Yeah, good quarter. Thanks.
Thank you. The next question will be from Justin Keywood from Stifel GMP. Please go ahead.
Hi. Good morning. Congrats on the improved quarter. I had a question on the infectious disease portfolio. Seems to be a pretty healthy increase. Was any of that related to the two products that help manage COVID-19 symptoms o r was that just regular use of those medicines?
Hi, Justin. The increase is really due to the fact, and I think we said it in Q3 and in Q4, that Q4 was negatively impacted by inventory in the channel. What we're really seeing in Q1 is normal utilization. There is a bit of COVID, but it's not materially different from Q1 last year.
Are you able to quantify that amount?
Pardon me? We don't provide revenue by products. It's not material.
Okay. Do you expect the medicine to be used going forward to manage COVID-19 symptoms still, or should we not expect that?
We're not forecasting any utilization for COVID-19 in the guidance that we've provided.
Okay, great. Then on the guidance, just to follow up on an earlier question. The 260 to 270, I believe that's CAD 5 million higher. With Q1 at above 60 million, that leaves about CAD 200 million to be achieved this year. How should we expect that to contribute in the subsequent quarters or any color around that?
We don't really guide towards quarters. As we've seen over the last couple of years, seasonality, COVID. During this time, it's extremely hard to predict. What our business is driving towards is achieving and hopefully exceeding that CAD 270 million target that we've set out. The quarters will be lumpy for a whole slew of reasons. Basically, we know that we're gonna hit the guidance that we've provided. We don't know how that'll phase over the quarters.
Understood. Thank you for taking my questions.
Thank you. The next question will come from Scott McAuley with Paradigm Capital. Please go ahead.
Morning, everyone. Again, congrats on the great quarter. This may kind of be related to what you've touched on before, but it seems like there's been quite a bump in the Brazilian revenues kind of quarter-over-quarter, with some declines in kind of other parts of LATAM. Is that, again, more related to that lumpiness or is there anything else fundamental going on there?
It's not really, but the issue really is about the lockdowns that we saw last year. Brazil is our biggest business. This year, coming out of the uptick where we saw it happening is in Brazil. We do see obviously growth in Colombia and Argentina as well. The rest of LATAM, I can't. It's too small. Like, made up a whole bunch of different things.
Got it. No, that's great. Then second lastly for me, just on the margins, it's especially the EBITDA margins. You know, this kind of significant growth compared to last year overall, and kind of the year before. Is this a level that you're comfortable with moving forward? Are you know, looking at opportunities? I think you say you're completing that integration of the LATAM operations kind of by the end of this year. Are there opportunities to improve that, or are you happy where you are, going forward?
No. As kind of Jeff mentioned also earlier, we had in Q1, kind of because teams were locked down for, let's say, at least half of the quarter, we really didn't have commercial or medical spend in Q1 to the level that we would normally have. As we go into Q2 and Q3, where things like conferences and meetings are all happening, we expect. EBITDA margin in Q1 is disproportionately higher than what we expected for the year. What we do expect is kind of in the mid-teens, which is where we ended up for the year last year.
Got it. No, that helps a lot. Again, congrats, that's it for me.
Thank you. The next question will come from Rahul Sarugaser with Raymond James. Please go ahead.
Good morning, Samira and team. Thanks so much for taking our questions. Actually, just one question for me today. Congratulations on the in-license, Akynzeo and Aloxi. This is CINV, the market we know a little bit about and recognizing that it's pretty competitive space in North America and in Europe. Obviously we're not that familiar with it in LATAM. Could you give us a sense for, you know, what the competitive environment these drugs will be in LATAM and as a result, the profile and whether you'd be looking at expanding the geographic coverage for these drugs? Thanks.
Rahul, is your question specifically for Akynzeo or in general?
Yeah, CINV competitive environment and as a result.
Okay.
Yeah.
Sure. I mean, you know, within CINV, as you may know, there are really two main mechanisms of action that are used, 5-HT3 antagonists and NK-1 antagonists. As I mentioned earlier, Akynzeo is the only fixed-dose combination that contains both MOAs. It is a unique product, both in Canada and LATAM and other parts of the world. Also the NK-1 antagonist molecule that is in Akynzeo is quite unique as well compared to other molecules with the same MOAs. In terms of how the market looks, the bulk of the market, again, same applies in Canada and LATAM.
The bulk of the market is really made up of the 5-HT3 antagonists, which are also used for postoperative nausea and vomiting, so they're not really only for chemotherapy-induced nausea and vomiting. In Canada, we do have an NK-1 antagonist as a monotherapy. That's one product we have here. Again, Akynzeo is quite different, quite unique because it's a fixed-dose combination. It's an oral product. It's given as a one dose that continues acting for five days versus, you know, if the patient takes one 5-HT3 versus an NK-1, it's multiple doses. Even the NK-1 on its own, it's multiple doses per cycle. So the product's quite well-differentiated.
In LATAM, in Brazil specifically, I'll mention Brazil specifically. There isn't even an oral NK-1 antagonist that's available. Akynzeo's profile, there's even, I would say, a bigger unmet need in Brazil. Again, in both markets and outside of our markets, the product is quite unique.
Terrific. That's very helpful. Thanks again for taking our questions. Wishing you the best of luck for the next quarter.
Thank you.
Once again, if you have a question, please press star then one. The next question is from David Martin with Bloom Burton. Please go ahead.
Yes, good morning, and congratulations on the solid quarter. My first question, you had mentioned o n your last quarter's call that there was going to be some pricing pressure, as LATAM governments tried to recover costs of COVID. I'm wondering, have you seen any more than what you saw three months ago? Do you expect any more, or is it all in the numbers now?
It really depends on the product. We will continue to see it throughout the year as certain agreements get negotiated. We saw a bit of it now. We know that as the year progresses, we'll see more.
Okay. Another thing, in response to one of Justin's questions, I think you said, with the infectious disease products that Q4 was impacted by inventory in the channel. Flipping into Q1, were they stocking back up their inventories, or had they worked them down to where they wanted them and this is a steady state, reflection now?
Sure. What we had at the end of Q3 was inventory in the channel, and they bled through that inventory in Q4 and had normal levels at the end of Q4. This is where we're seeing that steady state. One of the things is, as Jeff mentioned, like these products normally get used in people who are immunocompromised post-oncology treatments. Because we saw treatments in oncology, we're getting utilization of our products in infectious diseases. This is steady state. We don't have like, excess inventory in the channel coming out of Q1.
Okay. I think going back to earlier in the pandemic, you got a real bump in sales of your infectious disease products because of COVID. I know the oncology was working against that, but wasn't COVID rather a substantial amount of sales at one point?
From what you're saying now, it sounds like it's diminished to almost nothing. Is that fair?
Yeah. In Q2 and Q3, if you look at our revenue number, and we did disclose, I think for the year last year, we had between CAD 13 million- CAD 16 million in our infectious disease sales, disease product sales that were related only to treating COVID. That's not the only things that they're used for. It's basically fungal infections. Think about a patient who's immunocompromised for whatever reason they're in the ICU. Normally, these patients are in the ICU post a treatment for a transplant, for hematology, for oncology, and they will develop an invasive fungal infection. If patients are coming in for the right reasons, our product will be used. If, unfortunately, they're coming in for COVID and also develop a fungal infections, our products are there to treat them in those cases as well.
What we saw in the middle of last year, especially in markets like Brazil, Mexico, Argentina, was that the hospitals were crowded with patients with COVID, and that's where our product was used.
In your Q1 numbers, use for treating COVID was de minimis?
Minimal.
Okay.
Yes, exactly.
Okay. Thank you. That's it for me.
Ladies and gentlemen, this concludes our question and answer session. I would like to turn the conference back over to Samira Sakhia for any closing remarks.
Thank you for your confidence in the Knight team and for joining our Q1, 2022 conference call. Have a great morning.
Thank you. The conference has now concluded. Thank you for attending today's presentation. You may now disconnect.