I would now like to introduce Arvind Sood, Vice President of Amgen Investor Relations. Mr. Sood, you may begin.
Okay. Thank you, Natalia. Good morning, everybody, and for those in Europe, good afternoon. I'm delighted that you could join us today to discuss the approval of Aimovig, which is an important addition and innovation for migraine patients. Joining me this morning are Anthony Hooper, who's Amgen's Executive Vice President for Global Commercial Operations, and Paul Hudson, who's the CEO of Novartis Pharmaceuticals. Both Tony and Paul will make some opening comments, following which we should have ample time to have a dialogue and to take your questions. Also joining for the Q&A session will be Dr. Elliott Levy, who is Amgen's Senior Vice President of Global Development. We will use slides for our presentation this morning, and a link was sent to you separately. A quick disclaimer that our presentation may contain forward-looking statements. With that, I would like to turn the call over to Tony. Tony?
Thank you, Arvind, and good morning, everyone. I really am delighted to be with you today, together with my good friend and colleague, Paul Hudson from Novartis, to discuss our newly approved product, Aimovig, an innovative new medicine that we believe will be a real game changer for migraine patients. I'll speak first about migraine, a disease that continues to be underappreciated, underdiagnosed, and undertreated. I'll discuss Aimovig and its many advantages, as well as our strategy for bringing this exciting innovation to patients. Before I do, let me ask Paul to say a few words. Paul?
Thank you, Tony. It's such an exciting moment for me personally, for the teams, and more importantly, for all of the migraine patients that are struggling. From our perspective at Novartis, we're delighted to partner with you. We have a rich history, you know this, in neuroscience for nearly 70 years. We've reconfirmed our commitment to the long term with our AveXis deal this week. More importantly, this is all about those patients that are struggling and need some help, and delighted to be part of it, Tony. The teams have done an outstanding job to get us to this point, also be thanked, I'm sure. I look forward to joining you for questions.
Thank you, Paul. If we can now move to slide three. Migraine, as a disease, is much more than just a bad headache. In fact, migraine is a very serious, very real disease that ranks as one of the top 10 leading causes of life years lost due to disability. A list that includes other diseases such as cardiovascular disease, Alzheimer's disease, diabetes, and cancer. Migraine affects three times as many women as men, and migraine patients spend three times more on healthcare than those without migraine. About $11 billion per year in the U.S. Migraine is also a disease that strikes people in the prime of their lives, most commonly affecting those between the ages of 25 and 55.
Migraine is particularly costly in terms of lost productivity, largely due to missed days of work, with indirect costs estimated to be around $12 billion per year in the U.S. Dealing with debilitating pain for as many as three straight days and living in constant dread of the next attack is hard enough. Many migraine patients also worry about losing their jobs, and with it, their long-term financial stability. Despite the devastating impact of migraine on patients, their families, and society, options to prevent migraine until now have been repurposed therapies that were not designed specifically for the treatment of this disease, including medications such as anticonvulsants, antidepressants, and antihypertensive medications that are decades old. 80% of patients discontinued therapy within one year due to side effects or lack of efficacy.
All that changed with yesterday's approval of Aimovig, the first new medicine in decades designed specifically to prevent migraine. Aimovig is the first and only therapy specifically designed to prevent migraine by targeting and blocking the CGRP receptor. With this new product, we will target the approximately 3.5 million patients in the U.S. currently receiving preventative migraine therapy. There is a tremendous pent-up demand amongst this population for a medicine that will deliver powerful efficacy with very favorable side effect profile. Aimovig is the first and only therapy specifically designed to prevent migraine by targeting and blocking the CGRP receptor, differentiating us from potential future competitors. Aimovig is the only CGRP receptor antagonist and offers convenient, low volume, self-administered monthly sub-Q dosing. Another differentiator for Aimovig is that it's a fully human monoclonal antibody and does not, of course, contain any non-human sequences.
We've seen constant and sustained efficacy in clinical trials across a range of episodic and chronic migraine patients, including difficult-to-treat patients, such as those who have actually failed on two to four previous prior preventive treatments. In our trials, many patients achieved at least a 50% reduction in migraine frequency, with one in five achieving at least a 75% reduction. Aimovig has an extensive safety database of over 3,000 patients with adverse events similar to placebo. To further assess Aimovig's safety profile, we've conducted studies in combination with triptans, as well as a cardiovascular treadmill study with angina patients. With respect to tolerability, a key drawback with many other migraine treatments, 95% of patients were able to stay on Aimovig during our clinical trials. We also have an ongoing five-year open label extension study to further advance our data set.
Aimovig is approved as a preventative treatment of migraine in adults. The recommended dose is 70 milligrams once a month, injected subcutaneously and available in our reliable SureClick auto-injector. Some patients may benefit from 140 milligram dose. The 140 milligram dose will initially be delivered using two 70 mil auto-injectors, and we plan to submit an SBLA for a 140 milligram SureClick injector imminently. With Aimovig, no loading dose is required. Importantly, there are no dose-dependent safety signals identified in our pivotal clinical trials. With Aimovig, physicians don't have to think about a trade-off between the two available doses. They can simply choose the dose that they believe is best for their patients based on the clinical data. I also note that there's no difference in price between the 70 and 140 milligram doses. In today's environment, we know that in addition to safety and efficacy, access.
We have priced Aimovig with the goal of ensuring access for the appropriate patient population with minimal utilization management criteria. We've also priced Aimovig below the specialty threshold to ensure that patients' out-of-pocket costs are manageable. We've had good engagement with payers and PBMs on Aimovig, and by and large, they are supportive of our price. We are providing rebates that will ensure reasonable utilization management criteria, reasonable co-pays, and access for appropriate patients. We believe that the payers recognize that there is a clear and longstanding unmet need in migraine, and that including Aimovig on their formularies represents a good investment on behalf of patients and their employers. We're excited to be partnering with Novartis to bring this important innovation to market in a highly coordinated and focused approach.
Both Amgen and Novartis will call on healthcare providers that we've actually identified that represent the vast majority of our market opportunity for Aimovig. We began engaging these physicians several months ago to help further educate them on the burden of disease associated with migraine and to provide resources to assist them in improving patient care. In terms of patient activation, our Speak Your Migraine efforts via social media have engaged more than 2.2 million people since last August. Strong evidence that migraine patients are eager for new solutions to help them better manage their disease. The Aimovig Ally program has been created to help patients start and stay on Aimovig as prescribed. The program includes a free two-month trial of Aimovig, and for eligible patients with commercial insurance, the Aimovig co-pay program can help reduce out-of-pocket expenses to as little as $5 per month.
Looking ahead, we will wait to launch our TV campaign until we've created appropriate awareness among healthcare professionals. In the meantime, we look forward to our launch next week. In closing, we are really excited about this opportunity to offer a new and innovative therapy to migraine patients desperate for a new treatment option. They and their physicians have waited a long time for this day to arrive. Aimovig is a differentiated CGRP receptor antagonist, offering convenient, low volume, self-administered monthly sub-Q dosing where two doses are available, giving physicians the flexibility to prescribe what they believe to be best for their patients. Our clinical program has demonstrated sustained and consistent efficacy in a robust data package of over 3,000 patients, including those who are very difficult to treat.
The safety and tolerability profile of Aimovig is similar to placebo, with a very low incidence of injection site reactions. Together with Novartis, we really look forward to redefining migraine prevention for patients, physicians, and payers. Let me stop there and Paul and I are available for questions.
Excellent. Thanks, Tony. Natalia, why don't you go ahead and open it up for Q&A, and if you can just review the procedure for asking questions again, please.
Thank you. Ladies and gentlemen, at this time, if you would like to ask a question, please press star one on your telephone keypad. Again, that's star, then the number one to ask a question. Your first question is from the line of Ying Huang with Bank of America Merrill Lynch.
Hi, good morning. Congrats on the FDA approval. A couple of quick ones. One is that I know you set the price at about $5,900 at the gross level, but can you give us a little bit color on what kind of rebate or growth net adjustment we should expect? Secondly, have you started to talk about the contract agreements with big PBMs, including Express or CVS? Thank you.
Thank you. Yes. We set the list price for a year of treatment at $6,900, which works out about $575 per month. Clearly, in today's world, with the present rules around engagement, we are required to offer rebates to both payers and insurers in order to get access to a better utilization management criteria program. We believe the product will be used after patients have failed, and that's always been our strategy, and therefore, the utilization criteria should state that. We've had active discussions with all the large PBMs and a number of the insurers, and we continue to be very encouraged with the responses we get, and we look forward to some early contracts being signed in the not-too-distant future. Obviously, we don't normally disclose the rebates we are negotiating.
Let's take the next question.
Your next question is from the line of Michael Yee with Jefferies.
Thanks for the question. Congrats on the first approval here. I guess my question was following along with that. Many physicians believe you have to fail, perhaps things like BOTOX in the chronic setting. Maybe you could just talk about what type of management criteria you might expect or what would be expected in the chronic setting, how that might differ from the episodic setting where there are different drugs approved. I guess just talk about what type of barriers might be expected and how well you can work with payers to reduce these barriers. Thanks so much.
In most cases, we would expect a patient to have failed on one or two previous preventative therapies and have tried a triptan. In none of our discussions has BOTOX been a step through, step edit, or a potential one.
Your next question is from the line of Umer Raffat with Evercore ISI.
Hi, guys. Thanks for taking my questions, and congrats on the approval. Just early feedback from investors on the price has been positive. This is Mike Dufort, by the way. It's been positive. It's actually priced less than GLP-1 for diabetes. Just from a payer perspective, how likely do you see the value-based contracting with Aimovig and anti-CGRPs in general? I know Harvard Pilgrim Health Care has floated this idea in the not-too-recent past. A quick follow-up is, can you give us any sense of gross margins for the product and needle gauge size used? Thank you.
Those are about three questions all there. Let me try and get through a couple of them. As a company and together with Novartis, we've always felt that value-based contracts are essential as we go forward. Our product has clear levels of efficacy, which become fairly predictable in the short period, and therefore, we look forward to signing value-based contracts with those who wish to do them with us. The rebates themselves will depend on the size of the plan and the impact of the utilization management criteria. There's a range of contracting that does take place. Obviously, I'm not in a place to disclose those. On the needle gauge, I actually don't have that, and if I get that in the next couple of minutes, I will come back to you. I am told that it's a very simple SureClick injection.
It's a low volume, quick and easy, and we have not had any real issues with patients injecting themselves using the SureClick.
Your next question is from the line of Terence Flynn with Goldman Sachs.
Hi, thanks for taking the question. Maybe just was wondering how you guys plan to use your first-to-market advantage. Obviously, a number of competitors have potential approval dates coming later on, but how are you thinking about that advantage, Tony? Can you give us any commentary regarding your commercial footprint, you versus Novartis and maybe the number of docs that you're targeting out of the gates? Thanks a lot.
We don't think we're first to market because we think we're the only one in the market at the moment, Terence. We are the only CGRP receptor antagonist. I keep reminding payers about that. In fact, our mode of action is fundamentally different. Being first to market is a huge and distinctive advantage. It is clear that there's a large pent-up demand in the marketplace for a drug that truly is designed to treat migraines such as Aimovig is. We look forward to having a large bolus of patients coming in quickly. We have worked actively with the payers to ensure access will become available fairly soon, that the patients who are eligible are able to get on the drug quickly. Our Aimovig Ally program, too, will assist patients to test the drug quickly.
By the time competition arrive, a large number of patients will already be on this drug, and those benefiting, of course, will have no reason to change. In terms of the market size, both Novartis and ourselves will obviously be calling upon the headache specialists, neurologists who treat diseases such as migraine, and then a number of primary care physicians who have practices where we see high levels of prescription for diseases like this.
Your next question is from the line of Geoffrey Meacham with Barclays.
Hey, guys. Congrats on the approval. Great job. I'm sure the payer reception to price is going to be quite good. I know you have a broad label, but practically, do you think the positioning will be initially after triptan or BOTOX use? Does that change over time? Then another related question is, are there differences between the U.S. and Europe with respect to sequencing of CGRPs? Thank you.
We think that most patients have touched a triptan somewhere along in their lives. Obviously, we're talking about patients that are already on preventative or have been on preventative therapy. Each of the utilization management criteria will change depending on the plan. In theory, it's a continuation of you have to have failed one or two, and you have to have touched a triptan. There are numerous patients, of course, who have gone through that already. Let me turn to Paul and ask Paul if he wanted to comment about the sequencing in Europe.
Thanks, Jeff. No real specific differences. It is worth reminding everybody that there are approximately 2 million patients on prophylactic treatment today in Europe. They're all at different stages, of course, but we think there is a significant opportunity for the majority of those to be considered. We're worrying a little bit less about sequencing at this point. Clearly, there's a bit of a journey to go. We won't get approved until Q3, hopefully, and then we have our reimbursement sort of rolling from there. We'll get more actively into those conversations as we get approval.
Your next question is from the line of Ronny Gal with Bernstein.
Good morning everybody. Congratulations from me as well for this important approval. Questions about the access to the patients. First, do you expect point-of-care rebates to patients? Do you expect now that it's under a specialty tier to have anybody with co-insurance or just co-pays? Timing for starting a TV campaign around this drug. Is this something you want to wait 6 months for, or something we should expect earlier than that?
Ronny, thanks for the question. I'm glad you're aligned with the pricing over here. We specifically made sure that we went below a specialty tier to ensure we didn't get stuck with co-insurance. Most of the plans have aligned with us that this will be a co-pay, no co-insurance. We're working hard to make sure that the burden on patients is as low as possible, in fact. As regards the TV, we will follow the pharma guidelines and will not go to TV for at least the first 6 months. We want to spend time ensuring that the healthcare providers really understand the drug, the disease, and the value the drug brings to patients. Did I miss one of your questions? Ronny, was there anything else you had? I think I've lost Ronny. Okay. I also just got the information.
It's a 27-gauge needle on all our SureClick injectors as well as the pre-filled syringe. Can we go to the next question?
Your next question is from the line of Tim Anderson with Bernstein.
Thanks. This is a question for Paul. I had the chance to meet with Vas and Joe late last year. They used the phrase wild card when talking about the commercial potential of the CGRPs, which obviously anticipates payer pushback. These were CEO comments. Paul, would you concur with use of the term wild card when looking at the commercial potential now that you know the pricing?
I think when that statement was made, it was really in context of the type of environment we would be launching into. Of course, price or more importantly, value we could bring. I don't think it was at all associated with just how extraordinary this medicine is or the value it brings to patients. I think you've seen the decision taken in the U.S. to price absolutely responsibly. Maintaining similar logic, we would hope that we remove some of that wild card component as we get to launch. The slight difference will be, of course, this rolling reimbursement situation that I mentioned earlier. It'll come on in more of a gradual rollout. I'm feeling very confident clinically. The data, we need to see the label, finalized price, and then we can be more specific.
Perhaps feeling less wild card than we were this time last year.
Your next question is on the line of Matthew Harrison with Morgan Stanley.
Great. Good morning, everybody. Thanks for taking the questions. I guess two from me, Tony. First question is, can you talk a little bit about how you think about persistence, and do you expect any of the plans to require patients to have some threshold of response to stay on the drug? Second question is, it sounds like this is inherent from your comments, it sounds like you believe that most of the plans will have access pretty quickly. These plans aren't going to wait and try and wait for other drugs to be approved before giving you broad access. Thanks.
Thanks, Matt. I think the plans have been talking to the same headache specialists as we have. It's been a long time since I've seen a level of excitement that I'm seeing amongst these neurologists who've spent their lives and dedicated their lives to treating things like migraine and had to suffer with suboptimal products for treatment. We see a very high level of excitement and urgency around being able to get access to products for patients that have struggled for decades. I think the payers are clearly seeing this unmet need and the excitement around what a product like Aimovig can do. At the same time, I think the vocalization of needs by migraine patients themselves is more than I've seen for some time now.
I think when you go out to run a focus group with migraine patients, it is amazing how responsive they are, how much they've thought about the disease, how much they've thought about it impacting their lives. I think the feedback they're getting from the physicians, from patients, and even from employers who understand the devastation of absenteeism and presenteeism. I was talking to a CEO just the other day who was starting to realize that having an employee with a migraine at work is a real concern because the impact on judgment is such. We've not been told that anything will be held or kicked down the road. No. All the plans have agreed that this is a logical intervention. The price appears to be right. The rebates have been discussed, of course, and negotiated.
It looks like all the plans will be thinking similarly. Some of them are linked back to the timing of their P&T committees as they go forward. From a persistency perspective, I would imagine that some of the plans will be doing a reverification at month 3 and at month 6. That will become part of the UM criteria going forward. It's one of those diseases where patients will fundamentally know whether they're responding to drug or not. Thank you.
Your next question is from the line of Cory Kasimov with J.P. Morgan.
Hey, good morning, guys, and let me add my congrats as well. Thanks for taking the question. I guess I'm just wondering, as a once-a-month product, what do you expect for real-world compliance rates? Can you remind us what you saw in your clinical trial experience? Thanks.
Thank you. I will.
Clinical trials, of course, are never representative of real life. We saw a 95% persistency rate in the clinical trials. We do believe that with a symptomatic disease like migraine, patients will know very quickly if they miss a dose, right? The convenience of a simple once-a-month sub-Q injection, we believe will be pretty high. We know that with Repatha, at the moment, our persistency is quite high there, too, with patients are going beyond a year. I would expect this to be a fairly high number in comparison to the normal seven, eight months on oral products for chronic care.
Your next question is from the line of Salim Syed with Mizuho.
Yeah. Hi, guys. Congrats on the approval. Just had a question around the pricing for the 2 packages you guys have. And maybe I'm just missing it, but what protocols or things are in place that would prevent a doctor or a patient from getting the 2 times 70 milligram and spreading that across 2 months if they're taking 70 milligrams per month?
Good question, Salim. Thank you. It is clear to us, based on the clinical data, that both the 70 milligram and the 140 milligram should really be available because different patients respond differently to different doses. Our recent phase IIIb trial, the LIBERTY trial, which actually included all patients that already failed on two to four previous preventive therapies, used only the 140 milligram dose, and we got an exceptionally good response in those patients. We didn't want to come to market with an inability for physicians to make a quick decision about 70 or 140. The 140 milligram SureClick will only be available in the next couple of months, we will make a double-pack 70 milligram available at the same price as 70.
I understand and accept that there might be some splitting that happens, but once the 140 milligram is on the market, we will no longer supply the double-pack 70.
Your next question is from the line of Graham Parry with Bank of America.
Thanks for taking my question. Firstly, a question for Paul. The product's obviously being priced for access in the U.S., and could you just help us understand whether that's a good analog for European and ex-U.S. pricing? Secondly, with this product, you see quite a large heterogeneity of patient responses. I'm just wondering, were payers interested in pay-for-performance contracting here? Some sort of setup where they're only actually paying for patients who are responding to the drug as opposed to the low responders. Thirdly, if you could just give us your thoughts on access and penetration into the Medicaid population. Thank you.
I'll take that and maybe I'll leave Tony with the Medicaid question. I think what I can tell you on price at this point is that we are really focusing on the value we bring. The data is compelling. I think we've been, again, incredibly responsible in the U.S. in trying to find the perfect position for patients, for payers, and of course, for us. We'll strive to do the same ex-U.S. Count on that. As for paying for responders or non-responders, Graham, I think I heard that question correctly. It's our intent, where local regulations allow in the countries that we're responsible for, to try and provide an opportunity for a patient to demonstrate they're a responder either through access or samples, depending on the local regulations.
That really we remove that from the table, and we've already got into a situation where we know patients respond, and therefore, the question of levels of response thereafter become a matter of the clinician and the patient to decide what happens next. Maybe I should add, and I should have mentioned earlier, Tony mentioned it very elegantly. There is such a noise, you may have seen it on the social networks today, around the patients wanting to step forward and desperate to try something new and breakthrough, that we think many will come forward in wanting to confirm that it does work on them, and we will be there for them, bearing in mind I'm not expecting approval till Q3.
As regards your question on Medicaid, we estimate anywhere between 10%-15% of our patients will be Medicaid-type patients.
Your next question is on the line of Kennen MacKay with RBC Capital.
Hi. Thanks for taking the question. Wondering if you could give us a head count of what the Amgen and Novartis Neuro sales force looks like now or any coloring to MSLs as well. Also wondering if or when you may provide us with some sales guidance or even sales aspirations. Thank you very much.
Okay. Together with Novartis, we intend covering the most influential national and regional KOLs and a large number of existing prescribers for migraine as we continue to prospect. Obviously, we'll be using different sales organizations, those that have specialty skills, those that have primary care skills, and they've all been trained. In fact, they've been trained, as we speak right now, on the new label. We don't normally disclose what the sizes are, and we really don't give product-specific forecasting.
Your next question.
Take the next question. Yeah, go ahead.
Your next question is from the line of Trung Nguyen with Credit Suisse.
Hello. Trung from Credit Suisse. With a bolus of patient interest, but a lack of initial managed care access and a short window where you're going to be the only CGRP on the market, can you give us some more color around your free trial program and sampling? Because of this, how should we think about the correlation between prescriptions and revenues? Cheers.
As I said early on, we're pretty close to agreeing a number of access situations with PBMs and insurers. I look forward to focusing the majority of our effort on opening up access to patients with the existing plans. The feedback we've had to date has been fairly positive. In the interim, however, for those who do have a need, the Aimovig Ally program is a two-month available program for patients who qualify. Of course, we will be assisting physicians as when required with samples. The sales will be the sales, and the prescriptions will be the prescriptions, I'm afraid. We will report one as a company, and prescriptions are reported independently.
We have a question from the line of Luisa Hector with Exane.
Hi. Thanks for taking my question. Still along the same lines, just thinking about the ramp-up, because obviously you're talking about the Aimovig Ally program for two months, free samples. The access could come through quite quickly, but you've got the strong patient demand. Should we be quite conservative in year one and expect this to really take off from 2019? Could you give us a sense of how quickly the drug may become profitable? Just returning to the sales force, can you just remind us in which regions you're promoting, whether there's any joint marketing in any regions, please? Thank you.
Let me start with the last one first. We are co-promoting in the U.S., so the teams are joined at the hip. It is the Novartis Amgen team that has done the strategy work, the marketing work, the execution work, the consolidated medical work. Amgen has led the contracting and the pricing negotiation. We both collectively are in the field with the sales organizations. Amgen has the right in Japan for this product, and the rest of the world is run and managed by Novartis. As regards the uptake, I think an uptake of a product like this, which is chronic disease, is always on a different curve, where one is actually having to build an annuity over time. There will, of course, be a beginning where some patients will be on samples and some will be on the free goods program.
We will move as rapidly as we can to ensuring that once a patient's plan accepts the drug, puts it on formulary, that we'll actually switch those patients to their formularies. Natalia, let's take one last question. After that, Tony may want to make some concluding comments for the call.
The final question is from the line of Ken Atkins with Cowen.
Hi. Thanks for taking my question. Could you maybe elaborate a bit on your plans for expanding the label, for instance, to the pediatric migraine population? Thanks.
I'm going to ask Dr. Elliott Levy to answer that one, our head of development.
First, I just want to point out that we are coming to market with probably the largest data package in the area. We're the only company that created an instrument for evaluating the impact of the product on patient-reported outcomes. We have with the MPFID, which appears in the label, it's the only validated patient-reported outcome measure that's fully compliant with the latest FDA guidance on PROs, and it's one of the very few PROs to appear in any FDA-approved label. We've also done, I think, important work understanding the safety profile of the product, as Anthony mentioned, with a triptan interaction study and a CV treadmill study which provided information about our product that may not be generalizable to the other products that have a different mechanism of action.
As for any first entrance to the market in a new field, especially a field like migraine, there are many questions that remain to be answered. We are evaluating expanding into a number of other headache types. You mentioned pediatrics. We think that the pediatric area is quite important. There's a growing appreciation of the frequency and the disruptive effect of migraine in children, and we're moving forward very quickly with a program to secure indications in both school-aged children and in adolescents.
Tony, do you want to make any closing comments?
Thank you then. First of all, thank you again for joining us at what is an early hour in California, but perhaps a working hour for you folks. The more Paul and I talk to patients, the more we realize how devastating this disease is. The realization of how we can actually change the course of people's lives and the ability to come back to being fully contributing citizens wherever they live is very special. Paul and I have spent some time with key opinion leaders, listening to their needs as physicians who've been trying to treat migraine patients for many years, and I don't think that we've actually seen a group of people more excited than this group about this new innovation that's coming to market.
I think what we've done with the payer environment has really laid the ground for an early access for patients. There's minimal bureaucratic hassle and/or utilization management criteria that's required to get access to patients. We bring into market what we consider to be a differentiated first and only in class CGRP receptor antagonist that is differentiated to other potential products that might come to market. Last but not least, coming to market with Novartis in the U.S., who have a strong recognition in the neuroscience area, a strong link with the medical groups in that area, makes us a strong, powerful unity of force. We look forward to delivering real value to patients, to physicians, and to payers. Thank you so much for your time.
Great. Thanks, Tony. Thank you, everybody, for your participation.
Of course, the investor relations teams will be around, if you have any other follow-on questions, feel free to reach out to us. Thanks again.
Bingo. This concludes today's presentation. Thank you for your participation. You may now disconnect.