Good morning, ladies and gentlemen, and welcome to the Medexus Pharmaceuticals Fourth Quarter 2022 Earnings Call. At this time, all participants have been placed on a listen-only mode, and the floor will be open for questions and comments after the presentation. It is now my pleasure to turn the floor over to your host, Ms. Victoria Rutherford. Victoria, the floor is yours.
Thank you and good morning, everyone. Welcome to the Medexus Pharmaceuticals Fourth Quarter and Fiscal Year 2022 Earnings Call. On the call this morning are Ken d'Entremont, Chief Executive Officer, and Marcel Konrad, Chief Financial Officer. If you have any questions after the conference call or would like further information about the company, please contact Adelaide Capital at 480-625-5772. I would like to remind everyone that this discussion will include forward-looking information that is based on certain material factors or assumptions and is subject to risks and uncertainties that could cause actual results to differ materially from historical results or results anticipated by the forward-looking information.
In addition, during the course of this call, there may also be reference to certain non-IFRS financial measures or non-GAAP measures, including references to adjusted net loss Adj usted EBITDA, which do not have any standardized meaning under IFRS and therefore may not be comparable to similar measures presented by other companies. For more information about both forward-looking information and non-GAAP measures, including a reconciliation of each of adjusted net loss and Adjusted EBITDA to net loss, please refer to the company's management discussion and analysis, which along with the financial statements, are available on the company's website at www.medexus.com and the company's corporate filings on SEDAR at www.sedar.com. I would now like to turn the call over to Ken d'Entremont.
Thank you, Victoria, and thanks everyone for joining us on the call today. We continue to make progress on our growth objectives and are achieving several exciting initiatives that we believe will have a meaningful impact on our business going forward. During the fiscal fourth quarter that ended March 31st, 2022, we achieved revenue of CAD 20.3 million compared to CAD 17.6 million for the same period last year or 15% growth year-over-year. I am pleased to report that this represents the strongest fourth quarter at Medexus to date. The CAD 2.6 million increase is primarily attributable to an increase in the net sales of IXINITY during the quarter as pharmacy and wholesale customers return to buying patterns better aligned with patient unit demand. Rupall and Rasuvo also had solid sales during the quarter.
Fourth quarter Adjusted EBITDA increased to CAD 1.1 million compared to -CAD 1.6 million for the same period last year. The CAD 2.7 million increase is primarily attributable to the increase in net sales of IXINITY in the fourth quarter of 2022, and a CAD 0.9 million expense related to a one-time destruction of IXINITY inventory in the fourth quarter of 2021. We produced a net loss of CAD 5.3 million for Q4 compared to a net loss of CAD 10.5 million for the same period last year. Our adjusted net loss, which adjusts for unrealized losses or gains related to our convertible debentures, included in net loss was -CAD 4.6 million compared to -CAD 5.2 million for the same period last year.
As at March 31st, 2022, we had CAD 10 million in cash and cash equivalents, with CAD 11.2 million in total available liquidity. Overall, we are pleased to have achieved CAD 76.7 million in revenue for the year, which compares to CAD 79.7 million for fiscal 2021. The Adjusted EBITDA for the year was negative CAD 3.9 million in 2022 compared to positive CAD 8.2 million last year. Turning to our specific product lines, our core business remains strong. We are excited about new and potential additions to our product portfolio, which we believe will generate growth momentum over the coming years. Unit demand for IXINITY continues to grow.
During the fourth quarter of 2022, we saw sales normalize as pharmacy and wholesale customers have now worked through much of the recruit inventory and returned to buying patterns better aligned with patient unit demand. We continue to invest in the manufacturing improvement initiatives, and we expect the resulting operational efficiencies to ultimately improve the gross margins for IXINITY over the coming quarters. We are also continuing to invest in a phase four pediatric study that, if successful, will expand the IXINITY product label to include the pediatric population of patients under 12 years of age with hemophilia B. Medexus expects the analysis and clinical study report to be completed in the first quarter of 2023.
Once completed, a successful study could support a significant expansion of the indicated patient population for IXINITY, and we are exploring approaches to address this potentially expanded market. Rupall continued to see strong unit demand growth, achieving 31% growth for the trailing twelve months ended March 31st, 2022. Continuing its trend as one of the fastest growing antihistamines in the Canadian prescription market. Again, this growth reflects a severe allergy season across Canada and a successful sustained execution of our sales and marketing initiatives as physicians continue switching patients to Rupall from either generic prescription antihistamines or over-the-counter products. Turning to Rasuvo. On a unit sold basis, Rasuvo continues to maintain its strong market position and in fact increased its market share in the United States for the trailing twelve months ended March 31st, 2022.
However, increasing competition in the U.S. branded methotrexate market continued to negatively affect Rasuvo product level revenue. We implemented an effective, unit level price reduction to defend the product's market-leading position. On Metoject, even with a generic entry in the Canadian methotrexate market in calendar 2020, Metoject saw unit demand increase in the trailing twelve months ended March 31st, 2022. Again, product revenue was negatively impacted by a similarly motivated decrease in effective unit level prices. We continue to work towards conclusion of the litigation against the generic competitor, and a trial date has been set for calendar Q1 2023. We will continue to update shareholders on the material developments in this matter. These existing products have primarily driven our performance to date.
We also actively pursue opportunities to complement our existing portfolio by licensing and acquiring new products. For example, we recently acquired the exclusive rights to commercialize Gleolan in the United States and Canada. Gleolan is currently used as an optical imaging agent indicated in patients with glioma, as an adjunct for the visualization of malignant tissue during surgery. We estimate Gleolan's annualized revenue to be between $12 million and $16 million. We expect to complete the transition of full responsibility for commercialization of Gleolan in the United States from our partners at NXDC and begin recognizing full product revenue in fiscal Q2 2023. Our U.S. relaunch of Gleolan will complement our existing commercialization rights to Gleolan in Canada, where we executed a full commercial launch of Gleolan in February of 2021.
As we have discussed in the past, we continue to be excited about treosulfan. We expect that it will become a leading agent for the use of conditioning regimens as part of allogeneic hematopoietic stem cell transplantation protocols, or allo-HSCT. This is a therapeutic area of strong strategic interest for us. We recently shared the results and analysis of the pivotal phase III clinical trial of treosulfan conducted by our partner medac. We were very encouraged by these results and would like to point everyone to a presentation made by Dr. Filippo Milano, who reviewed the results of the pivotal study. Dr. Milano is a physician-scientist whose research is focused in the area of stem cell transplantation to treat blood cancers. You can view Dr. Milano's presentation on our investor relations section of our website.
In June of 2021, we received a notice of compliance from Health Canada to commercialize treosulfan, which we currently market in Canada under the trade name Trecondyv. We have now fully launched in the Canadian market and expect that the commercial experience we're gaining in Canada will serve us well if and when the FDA approves treosulfan in the United States. Our partners at medac continue to collect data requested by the FDA in May of 2022 to complete medac's resubmission of their new drug application for treosulfan. The data collection process is progressing well, and medac continues to expect to respond to the FDA's information request in July of 2022, which would be well within the 12-month timeline required by the FDA's Complete Response Letter.
A final FDA decision is expected two to six months after the FDA considers medac's NDA resubmission to be complete. If the FDA approves treosulfan, we'll then be obliged to pay certain milestone payments to medac that would range anywhere between $15 million-$45 million, depending on the terms of the FDA's approval. We continue to believe treosulfan could eventually overtake the current market-leading product in the U.S., busulfan, which realized $126 million in annual U.S. Sales prior to genericization. In the meantime, we do not expect to make any additional milestone payments to medac until we have received FDA approval. We are evaluating options to finance any milestones that may come due with a number of interested capital partners. We also continue to explore.
We also continue to regularly explore additional complementary product opportunities in both current and planned therapeutic areas in both the United States and Canada, and regularly evaluate various other transaction opportunities based on our strategic plan. A key component of our growth strategy will continue to leverage our infrastructure through new product acquisitions and partnerships. We will continue to look at optimizing our portfolio and leveraging our resources with the goal of executing near-term accretive transactions to achieve our sales growth targets over the coming years. In the meantime, we continue to work to increase revenue, develop and leverage our commercialization infrastructure across products and maintain strict financial discipline. I will now turn the call over to Marcel, who will discuss our financial results in more detail. Marcel?
Yeah, thank you, Ken. I'm also very pleased with our strongest fourth quarter of Medexus to date. Total revenue for the fiscal fourth quarter was CAD 20.3 million, and for the full year was CAD 76.7 million. This compares to revenue of CAD 17.6 million and CAD 79.7 million for the three and 12-month period ended March 31st, 2021. The CAD 2.6 million increase in fiscal fourth quarter 2022 versus the prior year fourth quarter is primarily attributable to an increase in net sales of IXINITY, Rupall, and we saw initial Gleolan sales. Rasuvo continues its strong performance, which is efficiently supported by moderate allocation of sales personnel. As a reminder, our product revenues can vary from quarter to quarter based on the timing of large orders.
For example, revenue for the third quarter fiscal year 2022 benefited from a large late December order totaling approximately CAD 2 million, which was originally anticipated to be received in the fourth quarter of fiscal 2022. Gross profit was CAD 10.1 million and CAD 37.9 million for the three and 12-month period ended March 31st, 2022, respectively, compared to gross profit of CAD 8.8 million and CAD 42 million for the same periods last year. The gross margin was 49.8% and 49.4% for the three and 12-month periods ended March 31st, 2022, respectively, compared to 50% and 52.7% for the three and 12-month period ended March 31st, 2021.
Full year 2022's gross profit includes a CAD 1.9 million charge in cost of goods sold compared to our fiscal year 2021, caused by additional expenses related to the IXINITY manufacturing process. Without that additional expense, the gross margin for the full year this year is more in line with the gross margin for full year 2021. We've undertaken an initiative to improve the IXINITY manufacturing process and continue to invest in its initiative, which remains ongoing. Preliminary results for this initiative have been encouraging, indicating improved yields. Selling and administrative expenses were CAD 9.9 million and CAD 44 million for the three and 12-month period ended March 31st, 2022, compared to CAD 10.3 million and CAD 36.2 million for the three and 12-month periods ended March 31, 2021.
The full year increase is primarily attributable to Medexus's significant investment in personnel and infrastructure to support its anticipated future growth, including continued essential preparation for a potential commercial launch of treosulfan in the United States. Research and development was CAD 0.8 million and CAD 5.9 million for the three and 12-month periods ended March 31st, 2022. This compares to CAD 2 million and CAD 4.6 million for the three and 12-month periods ended March 31st, 2021. As mentioned, we continue to fund the IXINITY pediatric study for which we expect in the first quarter 2023 to complete the analysis and clinical study report, as well as our ongoing IXINITY manufacturing process improvement initiative.
Adjusted EBITDA for the three and 12-month periods ended March 31st, 2022 was +CAD 1.1 million and -CAD 3.9 million, compared to -CAD 1.6 million and +CAD 8.2 million for the three and 12-month periods ended March 31st, 2021. IXINITY sales have now normalized, and the increase in Adjusted EBITDA in fiscal year Q4 2022 compared to the same period last year is primarily attributable to the increase in net sales of IXINITY in the fourth quarter 2022, as well as CAD 0.9 million expense related to a one-time destruction of IXINITY inventory in the comparative period.
Net loss for the three and 12-month periods ended March 31st, 2022 was CAD 5.3 million and CAD 2.9 million, compared to a net loss of CAD 10.5 million and CAD 28.3 million for the same periods last year. The net loss includes an impairment charge of intangible assets of CAD 1.7 million. Most of that impairment is related to medac, based on our year-end assessment of the impact of Accord's generic entry. This has resulted in a revised forecast and discount rate. We and medac intend to continue taking all appropriate steps to enforce the intellectual property rights on the medac's relevant Canadian patent rights. We initiated a patent litigation against Accord in 2020, and a trial date has been set for the beginning of calendar year 2023.
Also included in net income or loss is a non-cash unrealized gain and loss on fair value of the embedded derivatives in our outstanding convertible debentures, which are sensitive to, among others, fluctuation in our share price. We believe that adjusted net income or loss provides a better representation of performance of our operations because it excludes non-cash fair value adjustments on liabilities which may be settled for shares.
Our adjusted net loss for the three and 12-month period ended March 31st, 2022 was negative CAD 4.6 million and negative CAD 24 million, compared to negative CAD 5.2 million and negative CAD 7.6 million for the three and 12-month periods ended March 31st, 2021. Cash and cash equivalents was CAD 10 million at March 31st, 2022, reflecting an increase of CAD 0.4 million during the fourth quarter and a decrease of CAD 8.7 million over the entire fiscal 2022. Our available liquidity was CAD 11.2 million at March 31st, 2022, which consisted of CAD 10 million in cash and cash equivalents, and an undrawn credit of CAD 1.2 million available under our ABL facility.
We're pleased with our quarterly performance and continually exploring various financing strategies to enhance our liquidity to support our execution of our business plan, which includes an eventual launch of treosulfan in the United States. We're exploring various options to bolster liquidity both pre- and post-FDA decision, including to fund any milestone payment amounts that may become payable as a result of the FDA decision. As mentioned during previous earnings results, no further milestone payments will be owed to medac unless and until the FDA approval of treosulfan is obtained. Furthermore, we want to reiterate to investors that we do not expect the CRL for treosulfan to result in any default on our credit facility.
Operator, we will now open the call to questions.
Ladies and gentlemen, the floor is now open for questions. If you have any questions or comments, please press star one on your phone at this time. We ask that while posing your question, you please pick up your handset if listening on a speakerphone to provide optimum sound quality. Please hold while we poll for questions. Thank you. Your first question is coming from Andre Uddin of Research Capital. Andre, please ask your question.
Hi, Ken and Marcel. Just was wondering if you could discuss your marketing plans for Gleolan in the U.S., and also when would you start booking revenues? Is that gonna be fiscal Q2 of 2023? Thanks.
Hi, Andre. Thanks for the question. The plan for Gleolan is to utilize a lot of the infrastructure we'd already built for treosulfan. There's pretty significant overlap of institutions that do both stem cell transplantation, glioblastoma resection. There's a good overlap there. They're the key oncology centers. We're using infrastructure we've already built for treosulfan. We will add sales representatives. In fact, we're going to double the number that NXDC had. That will happen when we start to commercialize our own product, which is the point at which we would book full revenue. The quarter we just reported, Gleolan really had, you know, a small impact. It was only one month and half of the product revenue.
Going forward from August, we expect to book full product revenue, and we do expect to grow the product with the relaunch of the brand, and the extra selling resources.
Can you also give us a bit of an update on the competitive landscape of IXINITY and also how you expect that to grow this year? Thanks.
Yeah. The growth that you're seeing in the quarter now is both from patient demand and correcting the channel. I think a lot of it's due to correcting the channel, as we discussed previously. We're largely done with that. Going forward, we do expect to see some competition from gene therapy late this year. Again, it's uncertain as to what impact that will have. As you probably know, gene therapy is expected to be extremely expensive, therefore would only really be targeting the most severe patients. We don't expect to lose significant number of patients, but we may lose some high volume patients.
The sales team has been doing a great job at adding new patients, so growing demand through the addition of new patients, and their task has gotten a lot easier, obviously, as things start to open up post-COVID.
That's great. Just one more thing, actually. Could you just talk a little bit about, in terms of the pricing you mentioned something on the call about Rasuvo? How much did the price actually drop this quarter?
I'll speak to the strategy behind that and then let Marcel speak to the numbers. Strategy, clearly, we are the market leader. We've got the strongest unit sales base, so we will defend that base. Usually that means, if a competitive threat comes, we will make sure that we hang on to any contractual business by adjusting price.
Yeah. In terms of Rasuvo's performance for this quarter, we're seeing at this point a pretty steady. It's a strong performance quarter and that is anticipated to go forward. Obviously going forward, we will see an impact on pricing that we're obviously trying to offset with as much as we can through other initiatives. But this is a product for the quarter at least that has been quite steady compared to other quarters for Q4.
Great. Thank you.
Thank you. Your next question is coming from Scott Henry of Roth Capital. Scott, please ask your question.
Thank you, and good morning. Just a couple questions. First on Gleolan in the U.S. Can you talk about the economics for that product in the U.S.? You know, how we should think about how much of the profit you will keep. The royalties paid out, will that run through the cost of goods sold, or will that be in the SG&A?
Thanks for the question, Scott. Gleolan, we said previously, current revenue is between $12 million-$16 million. It's at the higher end of that range as we're finding out now. We think we can grow that. The penetration of Gleolan into the U.S. market is much less than other developed markets, primarily in Europe, so we think there's good potential to grow it. The economics, the way it's working currently is, we're currently booking about half of the product revenue now. When we take over the distribution in August, we'll book 100% of the product revenue and the economics back to the licensor is about 50%. It'll go back through cost of goods.
Now, is that 50% of profits or 50% of revenues?
50% of revenues.
Okay. Okay, great. Thank you. Then when you think about fiscal 2023, obviously revenues will get a bolus from Gleolan. How should we think about the rest of your business? Do you expect continued strong growth in 2023? Just trying to get a sense of, you know, what your expectations are looking out the next year.
Yeah, I think it varies product by product. IXINITY, I think, we return to more historical revenues with some growth built in. Product demand, patient demand, is increasing. But we also remember we had those two or three quarters where we were correcting the channel. That's behind us. We're gonna show pretty strong growth on IXINITY as a result of those two factors. Rasuvo and Metoject, these would be more or less steady. They're mature. We've got very strong market positions with those products, so we're looking to maintain those. Rupall, I think we showed again another really strong quarter, 31% growth for Rupall, you know, many years after launch, so we would expect that to continue as well.
We've added Gleolan, and we do expect to grow Gleolan. We will be doubling the sales resources on Gleolan than it's had historically, so we think there's good potential in Gleolan.
Okay, great. Final question. On treosulfan, do we know that it's a six-month review, or will they tell you that after they accept the filing? Is that firm?
Yeah. They will tell us within 30 days after accepting the resubmission. The timeline can be either two months or six months. We've been assuming six months, but it could be a surprise to the upside.
Okay, great. Thank you for the color, and thank you for taking the questions.
Thanks, Scott.
Your next question is coming from Justin Keywood of Stifel. Justin, over to you.
Good morning. Thanks for taking my call. I was just hoping to clarify the timeline for treosulfan and to build on the prior question. If I understand correctly, if the submission is for the end of July, will the FDA communicate the review timeline at the end of August? Is that how to think of it?
Thanks for your question, Justin. Certainly, we expect that medac will get it in by the end of July, and then the FDA has 30 days to communicate the review period. We certainly expect that at some point during August, we will know the timeline to a decision point.
Is there any risk that the process can be disrupted, if there is a request for additional data or some other items?
Yes. I think that risk always exists. You know, there have been many data requests that have gone back and forth. Many had been satisfied prior to this resubmission. We're really down to what we think is three, two of which were very straightforward, one of which requires some data collection, which is ongoing, which we think will be completed soon. There's always the risk that they could ask for something else or more information or a recalculation of something. That risk exists, but we've been through this process, you know, many times with them now, so we hope that we're starting to narrow down the questions.
Okay, thanks. Those were my questions.
Thanks, Justin.
Your next question is coming from Prasath Pandurangan of Bloom Burton. Prasath, over to you.
Hi, good morning. I had just the one. How do you think about potential capital raising options, as we get closer to a milestone payment, in terms of your equity raise or asset sales? Could you elaborate on that?
Yeah. Thanks, Prasath. That's a good question. Obviously, we're moving towards the original PDUFA date. We had been working on raising the capital for the milestone payment. The preference at that point was debt. We had pretty much organized a good debt provider that would allow us to take care of that. We're thinking of all options now. Obviously, equity markets are awful. That option certainly isn't preferred. There's always the debt option. There's always the option of even selling current assets. You know, I think we've got many different options to deal with that. We also have the option of deferring some of those payments.
We're working with medac all the time, just to make sure that we have an optimal launch. Our preference would be to use our capital or our cash, to execute an excellent launch, which would be in line with medac's desires. Thank you.
Ladies and gentlemen, as a reminder, if you wish to ask any questions or you have comments, please press star one on your handset at this time. Okay, there appear to be no further questions in the queue. I'll now hand back over to Victoria.
I think Victoria is actually gonna hand it over to me. I just wanna thank everybody for joining us on the call today. Our base business demonstrated incredible strength with IXINITY sales normalized, strong performance out of Rasuvo and Rupall, and sales beginning to benefit from another severe allergy season. On top of this, we expect to begin recognizing revenue from Gleolan in the U.S. partway through fiscal Q2 and fully in fiscal Q3. This is a drug that we estimated generated $3 million-$4 million in revenue in the last full quarter before we licensed the product. For treosulfan, our partner medac's collection of the recently requested data by the FDA is progressing well, and we are confident that we'll see an FDA resubmission in July.
We're looking forward to a very strong 2023 and look forward to updating investors. Thanks very much for joining the call today.
Thank you. Ladies and gentlemen, this does conclude today's conference call. You may disconnect your phone lines at this time and have a wonderful day. Thank you for your participation.