Good morning, and welcome, ladies and gentlemen, to Cytokinetics' conference call. At this time, I would like to inform you that this call is being recorded and that all participants are in a listen-only mode. At the company's request, we will open the call for questions and answers after the presentation. I will now turn the call over to Diane Weiser, Cytokinetics' Senior Vice President of Corporate Communications and Investor Relations. Please go ahead.
Good morning, everyone, and thanks for joining us on the call today. Robert Blum, our President and Chief Executive Officer, will lead us off today with an overview of today's announcement. Elisabeth Schnieders, Senior Vice President of Business Development, will speak to the multiple components underlying the deals before Ching Jaw, our SVP and Chief Financial Officer, will summarize the financial terms of the deals and how they inform our financial outlook. Next, Fady Malik, our Executive Vice President of R&D, will discuss the impact of these transactions on the development program for CK-274 before Robert provides final comments and opens the call for questions. Please note that portions of the following discussion, including our responses to questions, contain statements that relate to future events and performance rather than historical facts and constitute forward-looking statements. Our actual results might differ materially from those projected in these forward-looking statements.
Additional information concerning factors that could cause our actual results to differ materially from those in these forward-looking statements is contained in our SEC filings. We undertake no obligation to update any forward-looking statements after this call. Now, I will turn the call over to Robert.
Thank you, Diane, and thank you everyone for joining us on the call this morning. This morning, we announced a series of transactions, and included amongst those deals is a licensing collaboration, a funding deal, a royalty monetization deal, and the sale of our common stock. These deals are with RTW Investments and its affiliate funds, as well as with JIXING Pharmaceuticals, and is focused to CK-3773274 or CK-274, our next-in-class cardiac myosin inhibitor that we're developing for the potential treatment of hypertrophic cardiomyopathies. The total committed capital to Cytokinetics under these deals is $250 million. In addition, we're eligible for an additional $200 million in development and commercialization milestone payments, plus royalties on future sales of CK-274 in certain Asian countries.
As you'll hear in more detail from my colleagues, these deals afford us an opportunity to expand and accelerate our development program focused to CK-274 in multiple indications and across a wider span of geographies. These deals reinforce our commitment to rapidly and broadly advance our cardiac myosin inhibitor program and to hopefully deliver a next-in-class medicine that could meaningfully impact underlying challenges of hypercontractility in patients suffering from hypertrophic cardiomyopathies. We have built our company by leveraging both innovative science as well as deals, and we're pleased to enter into another set of transactions to diversify our access to capital and extend and expand what we believe is an industry-leading cardiovascular pipeline anchored in pioneering muscle biology and pharmacology.
Libby, Fady, and Ching will now elaborate on the details of these several transactions and the implications for how we plan to dial up the further development of CK-274. With that, I'll turn the call over to Libby to review the specifics of the deals.
Thanks, Robert. In connection with these agreements, Cytokinetics has granted JIXING Pharmaceuticals, a new company formed by RTW focused on the development and commercialization of innovative medicines in the People's Republic of China, an exclusive license to develop and commercialize CK-274 in the Greater China Region, including Mainland China, Hong Kong, Macau, and Taiwan, and in accordance with Cytokinetics' planned global registration programs. In exchange, Cytokinetics receives an upfront payment from JIXING and is eligible to receive payments related to the achievement of development, regulatory, and commercial milestone events for CK-274 in the field of obstructive hypertrophic cardiomyopathy and/or non-obstructive hypertrophic cardiomyopathy and other indications. In addition, JIXING will pay to Cytokinetics tiered royalties on net sales of CK-274 in the China region, subject to certain reductions. JIXING will be responsible for the development and commercialization of CK-274 in China in coordination with Cytokinetics.
Development will be initially focused on hypertrophic cardiomyopathy. Ji Xing will have the opportunity to participate in Cytokinetics' global pivotal trials of CK-274 and registration program. Cytokinetics and Ji Xing have also agreed to terms related to matters of manufacturing and regulatory affairs. Under a separate agreement with investment funds managed by RTW, Cytokinetics is eligible to receive funding for our development and commercialization of CK-274. The funding will be available at Cytokinetics' option upon the achievement of certain clinical trial milestones. In exchange for exercising options for funding, Cytokinetics has agreed to make royalty payments to RTW.
Specifically, upon our initiation of a global registration program for CK-274 in each of obstructive HCM and non-obstructive HCM, Cytokinetics is eligible for funding from RTW in the amount of $45 million each in exchange for a 2% royalty payable by Cytokinetics on sales of CK-274 in the U.S. and certain European countries. If Cytokinetics takes down the full $90 million in development from RTW, we would be responsible to pay RTW a 4% royalty on sales of CK-274 in the U.S. and certain European countries, subject to royalty reductions for other indications. Under a royalty purchase agreement between Cytokinetics and RTW, we have agreed to sell our rights to receive certain payments on potential future net sales of mavacamten, a cardiac myosin inhibitor, in exchange for a one-time payment.
The payments and closing of the transactions contemplated by the royalty purchase agreement are subject to customary closing conditions. Lastly, Cytokinetics and RTW have agreed to common stock purchase agreements, which provide for our sale and issuance of 2 million shares of our common stock, subject to certain trading and other restrictions. With that, I'll now turn the call over to Ching to elaborate on these deals with regard to the financials.
Thanks, Libby. As previously mentioned, these deals combine to provide Cytokinetics with $250 million in committed capital. These payments break out as follows. First, an upfront payment for the license to CK-274 in China. Second, $85 million for sale of our royalty on mavacamten. Third, up to $90 million for the funding of CK-274. Fourth, $50 million for sale of common stock equal to 2 million shares at $25 per share. In addition, we're eligible for another $200 million in milestone payments for development and CK-274 in China, plus royalties on sales. Taking into consideration the capital from these transactions, we expect to end 2020 with at least two to three years of forward cash, even as we plan to expand the development program for CK-274, alongside plans to co-commercialize omecamtiv mecarbil with Amgen. We will update our pro forma financials during our Q2 earnings call in August.
Finally, these deals reflect our longstanding corporate development strategy to secure capital to fund our business by principally leveraging strategic partnerships. Now I will turn the call over to Fady to speak to the expanded development programs.
Thanks, Ching, and good morning, everyone. These transactions announced today enable us to extend the reach of the development program more globally by synchronizing development in North America, Europe, and now China. Specifically, the funding enables us to expand our development program geographically and to consider in parallel a range of additional indications for CK-274 beyond obstructive HCM, including non-obstructive HCM, and also those patients with hypercontractility associated with heart failure with preserved ejection fraction or HFpEF. In essence, these deals provide us the opportunity to accelerate execution of our next-in-class development program and undertake key activities in parallel. Importantly, this funding meaningfully contributes to our ability to deliver on the promise of our pioneering science in the area of muscle biology directed to an expanded array of indications.
In terms of specifics regarding the development program associated with CK-274, these deals ensure that we can conduct a planned phase III clinical trial of our next-in-class myosin inhibitor in patients with OHCM in North America, Europe, and China promptly after we have results from REDWOOD-HCM and we receive feedback from regulatory authorities. Our current goal is to initiate a phase III registration program in 2021. On a parallel path, we can be planning for the conduct of clinical trials with CK-274 in NHCM and HFpEF also in the 2021 and 2022 timeframe. We look forward to partnering with the team at JIXING and have been impressed with their professionals and the rigor with which they approach development. With that, I'll turn the call back over to Robert.
Thank you, Fady. In summary, these corporate developments announced today reflect and reinforce our unwavering commitment to the promise of our cardiac myosin inhibitor program for the potential treatment of patients suffering from diseases associated with hypercontractility of cardiac muscle. To be clear, this was a competitive and rigorous process. Over the past year, we have engaged with multinational and regional pharma and biopharma companies, as well as a wide array of royalty buyers, and we believe we have optimized on our objectives with this deal to expand the development program for CK-274, diversify access to capital, and monetize our pioneering leadership in the cardiovascular arena. After considering a multitude of alternative deals and partners, we're pleased to have completed these transactions with RTW Investments and JIXING Pharmaceuticals.
RTW has a proven track record of investing in companies with innovative science. The team at JIXING has complementary development expertise to that of our own. Operator, with that, we can now open up the call to questions, please.
Thank you. At this time, if you would like to ask an audio question, please press star then the number one on your telephone keypad. We'll pause for a brief moment to compile a Q&A roster. Your first question comes from the line of Joseph Pantginis with H.C. Wainwright. Joe, your line is open.
Good morning, Joe.
Good morning, Robert. Good morning, everyone. Thanks for taking the questions, and congratulations on today's announcement. Continues your long-standing record of delivering these kinds of transactions, so great job. I have two questions. First, from a logistical standpoint, I was just curious if you could provide any update with regard to projected timing for initial REDWOOD-HCM data and how enrollment might be going with regard to COVID-19. More importantly, how do you feel today's transactions and increased, I guess you could call it as you did, a global reach for CK-274 potentially closed the timing gap between you and mavacamten?
Excellent questions. Maybe I'll turn to Fady please to answer the first one, and I'll take the second one.
Yeah. Joe, I think REDWOOD-HCM is back and beginning to screen and enroll patients. As you know, we suspended enrollment for a bit of time. We now have several sites that are activated and actively screening patients. We're continuing to open more sites both in the U.S. and Europe. We've got geographic diversification to help us with COVID-19 as well. We still expect to complete enrollment in the first cohort and to have data from cohort 1 to inform the start of cohort 2 in early 2021.
With regard to your second question, Joe, I think this deal factors very importantly into that strategy to narrow the gap between CK-274 and mavacamten. Mavacamten, as you know, was the subject of very encouraging phase III results recently in the EXPLORER-HCM trial. At the same time, there's an opportunity with the next generation drug candidate to demonstrate some advantages potentially, especially as could be extending into China. We'll have more to say that over time with regard to where this could ultimately play out in terms of time to market. We do foresee that by going forward, not only in an expanded geographical way, but also in multiple parallel indications, we're in an enabled position to move with next-in-class properties to what hopefully can translate into an expansion of the category to the benefit of both mavacamten and CK-274.
Great. Thanks, guys.
Thank you, Joe.
Your next question comes from the line of Jason Butler from JMP Securities. Jason, your line is open.
Hi. Thanks for taking the questions and congrats on the transactions. Just wondered if you could give any more specifics about how the additional capital and capital certainty impacts your plans to advance other indications. Any plans that we might see an NHCM or any other indications begin to start phase II trials in the 2021 time period, for example?
Yeah, most definitely. I'll speak to that and ask Fady too also. As we highlighted throughout 2019, given our pioneering science in this space, we foresaw where there were opportunities in connection with this mechanism in obstructive HCM, of course, but also in other populations where hypercontractility complicates the management of these patients. I think Cytokinetics, much like it was original in pioneering the therapeutic hypothesis in obstructive HCM, has been generating both preclinical data as well as clinical understandings about how CK-274 can move forward in these other indications. I'll turn to Fady maybe to be a bit more specific about how we're thinking about these populations, in particular, given the mechanism of action.
Good morning, Jason. I think going back to our R&D day in 2018, we telegraphed our thinking in terms of NHCM and HFpEF, in particular a population of heart failure with preserved ejection fraction, where patients' etiology of their condition is hypercontractility. We think there is a sizable population with this phenotype, although it doesn't make up the majority of today's HFpEF population, which in many ways has become more driven by diabetes and obesity. The ideas here are to focus on markers of their condition that define a population where the disease etiology is more central and cardiac in nature and develop a trial around that to look at initially function, say, in terms of symptoms and then potentially eventually to move on to thinking about outcomes in these patients.
I'll also mention that tomorrow, as many of you know, we're convening an investor day that'll be early here in California, and we'll elaborate on these strategies as it relates to the biology and how that biology mechanistically translates to our build of a cardiovascular pipeline and a franchise. We'll speak to how matters of corporate development combine with commercial development, enabling that to become a sustainable business. To your question, Jason, with regard to the mechanism and the biology and how that then extends, we'll go into some more detail, both with management and physician panel experts. We won't be committal yet about what studies we will be adding to the roster in 2021, but we do foresee that we will be proceeding forward in parallel in these multiple indications.
Great. Thanks for the questions and looking forward to the discussions tomorrow. Thanks.
Thank you, Jason.
Your next question comes from the line of Jeff Hung with Morgan Stanley. Jeff, your line is open.
Good morning, Jeff.
Good morning. Congratulations on the deals, and thanks for taking the questions.
Thank you.
I guess, first, can you talk about the opportunity for CK-274 in China and Taiwan, such as HCM prevalence?
Yeah. Obviously, in doing this deal, that's something that we and RTW and Ji Xing were able to investigate through, in each case, our proprietary primary market research. I don't think we want to go at this time into too many details about that, because obviously this is a nascent opportunity that will be evolving over time in connection with the clinical research. I think we would be better suited to perhaps speak to that to you and others more as that becomes more tangible.
Okay, great. You indicated that it's tiered, but are you able to indicate what the size royalty you are eligible from Ji Xing?
Yes. We can speak to that. It's mentioned in the 8-K that was filed also. It's a royalty that is ranging with escalating sales from low teens to high teens.
Okay. Thank you.
Thank you.
Your next question comes from the line of Charles Duncan with Cantor Fitzgerald. Charles, your line is open.
Hi, Charles.
Good morning, Robert, and congratulations to you and the team. Pretty innovative approach to funding these programs. I guess I had a question on CK-274, one on the mavacamten royalties, and then one on the common stock. Just quickly on CK-274, I'm wondering if you could provide us an estimate of the percentage of direct development expenses for CK-274 that you anticipate in the next couple of years that could be covered by this funding. Also perhaps provide a little bit more color on the clinical profile that I think you mentioned for CK-274 that may be particularly important as you envision in Asia.
I'll start and then maybe turn it over to Ching to speak a bit more to the financials, and then maybe, Fady, you can pick up with the remainder of the question. Obviously, for having access to committed capital of $250 million, this goes well beyond the costs that we foresee in the clinical research associated with CK-274. We are not obligated, but we have the option to take down funding from RTW. As we have better clarity on what our financials will look like in 2021, this deal affords us certain latitudes to be able to do that in exchange for a low single-digit royalty. The REDWOOD-HCM study is an ongoing phase II trial that we expect will conclude in 2021.
A Phase III study in obstructive HCM is, we think, in the range of each of those tranches of capital that we'd be pulling down, enabling us, we think, to be able to fund this program through this deal. As you can appreciate, the company has a lot of moving parts, and amongst those moving parts is also our buildup of the commercial business to support co-commercialization of omecamtiv with Amgen. We expect and hope that'll be happening in 2021. We wanted to enter into a series of transactions that gave us latitudes. We can pull down capital from different sources. It could come from milestone payments that are earned under our collaboration with Amgen. It could come from this funding, both that which is going to be already on our balance sheet and that which will be available to us.
Maybe I'll ask Ching to kind of speak a bit to for our indicating we should have over two years of capital at the end of this year, how he's thinking about that.
Hi, Charles. This is Ching here. Thank you for your question. As Robert said, and as I alluded during the call, that with this deal and the $250 million committed funding, we expect to end 2020 with at least 2-3 years of forward cash. As you might appreciate, it depends on the indications that we decide to go into, as Fady alluded to during his presentation, that we might consider development in HFpEF, and this funding allows us the kind of flexibility that we didn't have prior to consummating this deal as to the scope and the timing of all these development programs. I could tell you that we're on track with our current year spending, to the guidance of $105 million-$115 million net cash spending for the year. With this, we are well positioned for 2021 and 2022.
Perfect. That's helpful added color. Appreciate that. Regarding the mava royalties, I just need a clarification on that. The amount that you've received from RT or will receive from RTW, does that cover 100% of the royalties? Really, how did you establish a value on that? Does it depend on revenue levels, and protect from the downside and frankly, I wanted to know your perspective, if you think this is mava royalties were a key driver to questions that you've been receiving from investors, or do you believe that the royalties were largely overlooked by many investors in your recent discussions and not really a driver to Cytokinetics share value recently?
Yeah. Very good question.
May be harder for you.
Very good question. We are selling the entirety of our retained royalty on mavacamten, and that will be going to RTW subject to some closing conditions. As far as how it was valued, obviously something like this gets valued both by each of Cytokinetics and RTW and also independently by other third parties, including analysts who follow Cytokinetics. With that said, only a couple of analysts who are following Cytokinetics, I think, ascribed value to that at this juncture. Therefore, I think it would probably be reasonable to say that this wasn't properly calibrated in expectations for the company and represents upside.
Okay. Final question regarding common stock that was purchased. Is that free to trade? If not, when would it be free to trade?
That is also elaborated on in the 8-K. It is subject to trading restrictions. Ching or Libby, do you want to elaborate?
Yeah, maybe I can start, and Libby, you can chime in. It has a two-year restriction on trading. If we were successful entering phase III development with obstructive and non-obstructive HCM, then that period could be further extended until we have the results from those studies.
Okay, very good. That's a good deal. Appreciate your taking my questions. Congrats on this funding.
Thank you, Charles.
Your next question comes from the line of Ted Tenthoff with Piper Sandler. Ted, your line is open.
Good morning.
Hey, thanks very much. Hey, good morning. Congrats on the deal. I wanted to get a little bit more of a sense of what JIXING Pharmaceuticals is going to be and what they're going to be bringing in China in terms of development and regulatory capabilities. Thanks so very much.
Yeah. I'll start and then maybe Fady. This is an exciting new company that RTW is supporting, not unlike the way they've helped launch other companies that have been, I think, built around very innovative science. In the case of Ji Xing, this is a company that is comprised of people who have a lot of expertise in China pertaining to cardiovascular drug development and regulatory affairs, medicine, and commercialization. I think in that way, they impressed us with their commitment to this science and this opportunity, in ways that went beyond, in many instances, how we were discussing with other third parties. Fady, do you want to speak to that?
Sure. I think with JIXING, one of the things that attracted us was that the company as it's being formed has a strong focus to cardiopulmonary medicines. As a consequence, they've built an expertise in this area, attracting in development cardiologists with deep expertise in terms of development obtained at large pharma, as well as regulatory experience with folks that have experience with the Chinese regulatory authorities or have worked there. They're quite articulate on the operations side and also significant experience at conducting trials in the China region. This affords us to work with a company that is like-minded to us, that very much is focused in the cardiovascular space and deeply knowledgeable about it.
What's nice about this deal and the timing of this deal is it enables us now to begin coordination and planning activities to the enabling of the inclusion of China in a phase III registration program from the get-go, much like was the case in the registration program for omecamtiv mecarbil. I think that goes a long way to increasing the probability of success for what could be ultimately approval in China than to try to do that as an add-on later.
Great. Thank you. Makes a lot of sense. I'm looking forward to the R&D day tomorrow.
Thank you.
Your next question comes from the line of Salim Syed with Mizuho. Salim, your line is open.
Good morning, Salim.
Great. Hey, good morning, Robert, and congrats on the deal. Looks like a good deal. I had a few, if I may, if that's okay.
Sure.
Sure. Thanks. Maybe we can start with the mavacamten royalty. From judging what the payment is, $85 million here, it looks like you guys are putting about $1 billion peak sales on mava. Is that the correct way to think about it? Could you comment maybe what your assumption is on hypertrophic cardiomyopathy mavacamten pricing?
I don't think I want to go into that. That's what you guys do so well. Obviously, we have assumptions associated with timing of approval, geographies in connection with approval, and sales ramps and peak sales, and it's, for mavacamten, not limited solely to obstructive HCM in the U.S. I don't think it would be proper for us to articulate our assumptions like that in a public way in this format. Granted, we believe in mavacamten. This is a compound that I think is an excellent compound around which we think they're going to be doing some very important cultivation of a market, development of a market, and it's a product that we anticipate can be highly successful. Although, as we've discussed many times, with that said, we also think there's room for a next generation product that can be benefiting both mavacamten and CK-274.
We had to do a lot of simulations and scenarios, different indications, different geographies, ultimately to get to what we thought was a proper value. I don't think our numbers here are that different for this value than what you and a few other analysts modeled. In that way, I think it's consistent with that benchmarking. Maybe that's the best thing I can do on a call like this.
Okay. Appreciate it. To me, it seems like there's this massive disconnect with what people are modeling for mavacamten in MyoKardia models, which seems more like $2 billion plus, and what you guys are saying in terms of implied pricing.
To comment on something like that.
Thank you. Second, you didn't really talk about CK-271 at all. Could you maybe comment on how this deal changes your perspective on development of HFpEF in particular, whether you'd like to develop HFpEF with CK-274 or CK-271? How does this deal change that? Because obviously now you have 100% economics on CK-271, and you're giving up some of the economics on CK-274 for a potentially massive indication.
Yeah. It's a very good question. I don't think our strategy there is so solidified yet. In large part, CK-271 is moving forward in phase I with an opportunity for us to consider down the road how it might be developed to complement or supplement what we're doing with CK-274. CK-271 is positioned, in some ways, as an insurance policy. As long as CK-274 continues to look very promising in obstructive disease, and as we may extend that to include non-obstructive, that could also include HFpEF. In that way, it might very well be that CK-271 is positioned as a backup, but doesn't go forward on its own. We haven't made any of those decisions. Fady, I don't know if there's anything more that you want to add.
No, I don't think so. I think it's still early in terms of our thinking about development there and specifics. We'll probably have more to say in the near future.
Okay. Got it. Third, this one a little bit more on the competitive process here. I think this is the second time in Cytokinetics' history that you've actually partnered with a financial partner, with RTW here. The other one was Royalty Pharma, I believe. Curious why you didn't choose perhaps one of the pharma partners who would've been able to argue perhaps higher synergies and offered you some sort of opportunity in commercializing 274 in Europe, which seems like you would need a separate partner for Europe if you wanted to commercialize there?
It's a very good question, and as we've discussed for a few years now, Cytokinetics has been talking to multinational companies as well as regional companies about a more classical licensing and collaboration agreement. As we've done that, we've been firstly informed by the fact that many of those deals for a product at this stage would have required us to cede certain responsibilities, rights, decision-making, and other activities in connection with development and commercialization in territories where we wanted to preserve that ourselves. It was about six to nine months ago that we began to shift our strategy primarily to enable us to gain access to capital without giving up on those rights in North America and Europe, where we still could choose to do that down the road if ever that were something that we felt motivated to do.
These deals don't preclude that possibility, but it also enables us to move forward, pedal to the metal, as we see fit, bring this through registration programs, and then we can always decide if we're benefited with regard to reach frequency and commercialization in partnership with another company. I'm not going to say never with regard to even partnering in HFpEF, depending on what might be required for a global registration study. That still might benefit from the kinds of capabilities internationally that a company like Amgen has been able to provide to us for omecamtiv mecarbil, and that might prove to be the case in HFpEF, too. Doing these deals enables us to proceed through those registration programs, before we have to make any meaningful commitment that way, I think is maybe the way I'd put it.
Okay. Last from me, just on reldesemtiv. Ching, you mentioned at the end of 2020, you think this additional capital could give you 2 to 3 years of runway. You've talked about in the past how you wanted to lower your cost of capital for reldesemtiv development. Does this transaction lower your cost of capital for development there?
It does. I'll turn to Ching to elaborate, but we won't be making any committal statements today about reldesemtiv, but rather we'll be considering all of this together in connection with how we'll approach our Q2 earnings call. Ching, anything you want to say about that?
Nothing really, Rob. I think you summarized it well. I think for the time being, we're still considering the opportunities, but part of it will become more clear during the Q2 call.
Great. Congrats again, guys.
interactions we've been engaging with key opinion leaders. We're finalizing protocol. We have a very good handle on what that phase III trial looks like. Now that we've got these deals done, we can speak more credibly to what our cash runway looks like. We can contemplate that together with our other colleagues in the management team and also our board, and decide whether or not this is sufficient in order to be able to lean forward on reldesemtiv or do we still want to see the GALACTIC-HF data? That's something that we'll be discussing in these next few weeks.
Okay, excellent. Thanks so much for the clarity, guys, and congrats again on the deal.
Thank you.
Your next question comes from the line of Gil Blum with Needham & Company. Gil, your line is open.
Thank you.
Hi, everyone, and let me add my congratulations on the deal. I'm very impressed. It seems like there's a very strong buy-in from RTW, considering you guys got a $90 million for an earlier stage asset and $85 million on a royalty stream for a later stage asset. Seems interesting to me.
Only maybe kind of a technical. Should we expect to see a significant uptick on 2021 R&D expense now that you can expand development of CK-274?
Ching, do you want to take that?
It's too early to say, to be honest, because there's still various parts of development program that we have to hash out together with Fady in terms of how we proceed in 2021. I'll tell you that in our Q2 earnings, we might give a bit more guidance and precision on this question.
Yeah, maybe just to elaborate on what Ching said. In 2021, we'll still have costs associated with REDWOOD. We would be potentially adding these costs associated with additional clinical trials for CK-274. A lot of it has to do with METEORIC-HF and where we are with METEORIC-HF in 2021 in terms of whether total development expenses will be going up, albeit, as you know METEORIC-HF expenses are reimbursed by Amgen. This is as much a timing matter as it is associated with activities, and we aren't yet in a position where we can point precisely to how all those things relate to one another.
Yeah. Thank you very much for providing the clarity and we look forward for the R&D day tomorrow and your quarterly reportings and also readout for omecamtiv that's coming up.
Lots going on indeed. Thank you.
Your final question comes from the line of Jeff Hung with Morgan Stanley. Jeff, your line is open.
Hey, Jeff.
Hey, thanks for taking the follow-up questions. I wanted to clarify a previous question. You said that you expect to end 2020 with two to three years of cash. Does that take a registration program for reldesemtiv into consideration, or is that separate?
Yeah. Ching, I think you may have answered that, but if you want to do it again, I can defer to you, and then I'll add to that.
Okay. So two to three-year forward cash is really an estimate, Jeff, for the time being. We haven't really come to a decision to start the phase III trial in ALS for reldesemtiv. As Robert elaborated earlier, we might come to that decision sooner than what we had previously said, which was we would wait for the GALACTIC-HF data. We might still do that pending the directions of how we want to take CK-274. Robert, do you want to elaborate further?
Yeah. Even if we decided today to start a phase III trial for reldesemtiv as soon as possible, it would still be no sooner than the fourth quarter. Therefore, we're poised to do that if that appears to be the best thing for the company. Now that we have these deals concluded, we want to consider that possibility, and in parallel with how we consider that, we'll probably be seeing results from GALACTIC-HF. As you know, GALACTIC-HF results are on schedule for our Q4 announcement. When we say two to three, I think it's encompassing of what could be many different scenarios, including moving forward with reldesemtiv. One of the key variables in that equation is, are we earning milestone payments from Amgen?
The way we've built the company from a corporate development standpoint and a financial standpoint is we have a multitude of different cash flows that can be coming in to lend support for our expansion of our pipeline from omecamtiv to CK-274 and also reldesemtiv. All this will become a bit more clear tomorrow when we talk about our franchise building strategy. In terms of specific runway, as Ching points out, this is a soft projection to what we think could be the case at the end of the year, subject to us needing to make a number of decisions.
Thanks. That's helpful. Can you remind us what the royalty is for mavacamten? I think in the past you said low single digits, are you able to disclose what the percentage is?
We have been only saying low single digits. We're not enabled by these deals to be any more clear than that. Under terms of confidentiality, we need to be maintaining that we're selling the entirety of the royalty we have. We can't say what that is.
Okay. Thank you.
Thank you.
This concludes our question and answer session. I will now turn the call back over to Robert Blum for closing remarks.
Thank you, operator. Thank you to all the participants on the teleconference today. Thank you for your continued support, your interest in Cytokinetics. Obviously, these deals announced today lay the foundation for what will be an expansion of our business, our expansion of our cardiovascular pipeline. Putting in another plug for our investor day tomorrow, we'll be in a position to speak much more comprehensively about these strategies, both from the science and medicine standpoint, but also from the corporate development and commercial development standpoints. We hope that you'll join us for that call tomorrow. With that operator, we can now conclude this call.
Thank you. Ladies and gentlemen, this concludes today's conference call. Thank you for participating. You may now disconnect.