Good day, ladies and gentlemen, and welcome to the Jazz Pharmaceuticals Second Quarter 2014 Earnings Conference Call. Following an introduction from the company, we will open the call to questions. I will now turn the call over to Kathee Littrell, Head of Investor Relations at Jazz Pharmaceuticals.
Thank you, Sarah, and thanks to each of you for joining our investor call. Today, we reported our second quarter financial results and updated our 2014 financial guidance in a press release. The release and the slide presentation accompanying this call are available in the News and Events section of our website. With me for today's call are Bruce Cozadd, CEO; Matt Young, CFO; Russ Cox, COO; Jeff Tobias, CMO; and Mike Miller, Head of U.S. Commercial. Following some remarks, we'll open the call for your questions. I'd like to remind you that some of the statements we will make on this call relate to future events and our future performance rather than historical facts and are forward-looking statements.
These statements include future financial results and commercial development and regulatory plans, expectations and projections, and the potential timing of future events. Examples of forward-looking statements include our 2014 financial guidance, anticipated growth prospects for our products, planned commercial efforts, including the rolling launch of Defitelio in Europe and related pricing and reimbursement approvals, expected and potential interactions with regulatory agencies regarding Xyrem and other products and product candidates, anticipated regulatory submissions, anticipated litigation-related events and the timing thereof, and the timing and other matters related to planned and ongoing clinical trials, including enrollment in and the results from and costs associated with those clinical trials. These forward-looking statements involve numerous risks and uncertainties that could cause actual results, performance and results to differ materially.
These risks and uncertainties are identified and described in today's press release, the slide presentation accompanying this call, and under Risk Factors in our Form 10-Q for the quarter ended March 31st, 2014, and our Form 10-Q for the quarter ended June 30th, 2014 that we expect to file shortly. We undertake no duty or obligation to update any forward-looking statements we make today. On this call, we will discuss several non-GAAP financial measures, including historical and expected 2014 adjusted net income attributable to Jazz and the related per share measures and historical and expected 2014 adjusted SG&A and R&D expenses.
We believe that these non-GAAP financial measures are helpful in understanding our past financial performance and potential future results. They are not meant to be considered in isolation or as a substitute for comparable reported GAAP measures. Reconciliations of GAAP to non-GAAP financial measures discussed on this call are included in today's press release and the slide presentation accompanying this call. Both are posted in the News and Events section of our website. I'll now turn the call over to Bruce.
Good afternoon, everyone, and thank you for joining us. We're pleased with our strong performance in the second quarter and the significant progress we've made year to date. This year, we acquired Gentium and commenced our launch of Defitelio in the European Union, acquired the rights of Defibrotide in the U.S. and the rest of the Americas from Sigma-Tau in a transaction that closed yesterday, scheduled two pre-NDA meetings with FDA in the third quarter to further our understanding of the regulatory pathway forward for Defibrotide in the U.S., acquired rights to JZP-110, presented JZP-110 phase IIb data at the 2014 SLEEP meeting in June, met with the FDA and defined our phase III program for JZP-110, and received notification of issuance of a new patent related to Xyrem with an expiry in 2033.
Our financial performance in the second quarter included revenues of $291 million, up 40% compared to the second quarter of 2013, driven by increased sales of our key products, Xyrem and Erwinaze, and the addition of sales of Defitelio. We realized adjusted net income attributable to Jazz of $128 million in the second quarter, reflecting the attractive margins in our business. GAAP income attributable to Jazz for the quarter was $44 million. I'll now update you on our sleep and hematology oncology franchises, including information on key commercial, legal, regulatory, and clinical development activity during the quarter, and then end my section with a few comments about our new board member and the new members of the senior management team at Jazz. Matt will then review our financial results for the quarter and provide comments on our guidance.
I'll start my comments with our sleep franchise and our lead product, Xyrem. In the second quarter, market demand was strong and the average number of active Xyrem patients grew to approximately 11,750 from 10,700 in the same period of 2013. During the second quarter, we were very pleased with our strong volume growth of 11% year-over-year. There was significant improvement in the operations of our central pharmacy partner, ESSDS, following the problems in the first part of the year previously discussed during our first quarter call. We have made substantial progress, but we remain focused on ensuring timely prescription fills and refills for Xyrem patients and will continue to work closely with ESSDS to meet patients' and providers' needs.
Efforts to expand Xyrem prescriptions written by our low to mid-decile physicians have contributed to our sales growth year-over-year. Our 20 new sales representatives got off to a solid start in the first half of 2014 and are delivering strong results in their territories. We also continue to refine and identify new physicians that have not previously been part of the Xyrem call universe. These physicians are diagnosing and treating narcolepsy patients and offer new opportunities for education by our sales representatives on treatment with Xyrem. In late May, we implemented a narcolepsy disease awareness initiative in eight U.S. cities. We believe that the disease awareness initiative over time will increase the number of patients diagnosed with narcolepsy and may help reduce the time from disease onset to diagnosis.
Early data demonstrate that there have been over 200,000 hits through the TV web link known as morethantired.com since the launch of this campaign, with roughly 75% of those hits from the eight targeted markets during the first month. There have been approximately 4,900 completions of the narcolepsy Epworth Sleepiness Scale with a score total greater than 10, with approximately 70% of those in the eight targeted markets. Finally, over 4,100 hits have occurred on the physician finder page, with approximately 70% of these lookups occurring in the targeted markets. We'll be able to provide an updated report next quarter.
Finally, we remain on track to initiate a pediatric narcolepsy study of Xyrem during the second half of 2014. Turning to a brief legal update on Xyrem. Patent litigation against four ANDA filers referencing Xyrem continues in the District Court in New Jersey. We have sued Roxane, Amneal, Par, and as of last month, Ranbaxy, for infringement of our patents related to Xyrem. No trial dates have been set in any of the cases, although we anticipate the trial of a portion of the case against the first filer, Roxane, could occur as early as the first quarter of 2015.
Between late June and early August, Roxane, Amneal, and Par initiated petitions with the Patent Office for Covered Business Method, or CBM, post-grant patent review of our patents covering the Xyrem restricted distribution system. The first step in this process is an opportunity for the patent owner to file a preliminary response to the petition addressing whether the petition meets the requirements for CBM review. We do plan to file responses. The Patent Office then decides whether to institute the review. We expect the Patent Office to rule on whether review will be instituted for any of the patents subject to the CBM petitions during the first quarter of 2015.
Turning to a brief regulatory update on the Xyrem REMS. As previously disclosed, we initiated dispute resolution procedures with FDA at the end of February regarding modifications to our deemed REMS that FDA was seeking to impose and received FDA's denial of our initial dispute resolution request during the second quarter. We have submitted a request for further supervisory review to the next administrative level of FDA and expect to receive the agency's response to this level of appeal in this quarter. Next steps will depend on the response from FDA. Now I'll briefly discuss Xyrem intellectual property.
Our current Xyrem patents on Xyrem expire between 2019 and 2033. On July 8, we were awarded a patent on a new method of administration of Xyrem when a patient is also being administered Valproate. The new patent expires in 2033, has been listed in the Orange Book, and is related to safety information that has been incorporated into the dosing and administration section of the Xyrem label. Valproate is commonly administered in mood disorders, seizures, and migraine. Studies show that patients with narcolepsy use more psychiatric medications than the non-narcoleptic population. This new patent is a result of our continuing investment in research to further understand the safe and effective treatment of narcolepsy patients with Xyrem. On JZP-110, we were pleased to present the JZP-110 phase IIb data at SLEEP 2014.
The phase IIb study was a 12-week study with patients exposed to 150 milligrams per day for four weeks, followed by 300 milligrams per day for eight weeks. The responses observed in the phase IIb trial were robust on measures of daytime sleepiness, including the Maintenance of Wakefulness Test and the Epworth Sleepiness Scale, and were similar to those observed in the previous phase IIa study. Adverse events were similar to those observed with other wake-promoting agents. Physicians attending the meeting expressed strong interest in participating in the future development of JZP-110. The end of phase II FDA meetings went well from our perspective. We discussed the proposed phase III study designs and potential regulatory pathways for patients experiencing excessive daytime sleepiness associated with narcolepsy and separately with obstructive sleep apnea.
Early next year, we anticipate initiating one phase III study in narcolepsy and two phase III studies in OSA. We plan to use accepted 12-week efficacy endpoints such as the Epworth Sleepiness Scale and the Maintenance of Wakefulness Test. Long-term safety data will also be collected. As we've previously communicated, we expect that the program cost will be approximately $100 million, and that the majority of that spend will occur in 2015 and 2016, with the goal of an NDA submission in the 2017 timeframe. As to JZP-386, our deuterium-modified sodium oxybate compound licensed from Concert, enrollment of patients has begun in a first-in-human trial that is evaluating the safety, pharmacokinetics, and pharmacodynamics of JZP-386. In order to identify a safe and tolerable dose or doses for subsequent study and determine whether JZP-386 is potentially suitable for once nightly dosing.
We expect to complete enrollment later this year and to provide an update on the outcome of the study once we and our partner Concert have evaluated the data and determined next steps. Now on to the Hematology Oncology franchise. First, let's turn to Erwinaze, which continues to perform well. We continue to educate healthcare providers and centers on identifying hypersensitivity reactions to E. coli asparaginase in acute lymphoblastic leukemia. At the recent American Society of Pediatric Hematology/Oncology meeting, we hosted a very well-attended medical education program focused on building on asparaginase therapy to improve outcomes. Our clinical study of Erwinaze in young adults initiated during the second quarter. We are continuing to add study sites both in the US and EU, and plan to enroll approximately 30 patients in the study.
As to JZP-416, formerly known as Asparec, this molecule is a recombinant pegylated Erwinia chrysanthemi asparaginase that is administered intravenously. We are working with the Children's Oncology Group on the first U.S. study of JZP-416 and expect to initiate the dose confirmation phase of this study in children later this year. The Defitelio launch in Europe is progressing well. Since March, we have launched the product in Germany, Austria, and the U.K., as well as in Italy under a special reimbursement law. We are on track to launch Defitelio in several Nordic countries this month. During the rest of 2014 and in 2015, we anticipate launches in France, Ireland, the Netherlands, Italy under final pricing and reimbursement approval, and many of the largest Eastern European countries.
Our key focus in Europe remains establishing solid pricing and reimbursement in order to maximize access for patients in need, and we continue to engage in pricing and reimbursement submissions throughout the EU. Now a brief US regulatory update on Defibrotide. We are continuing to seek to address FDA's comments and questions with respect to a potential NDA filing and have two pre-NDA meetings, a CMC and a clinical meeting scheduled with FDA this quarter prior to finalizing our submission strategy. At the clinical meeting, we plan to discuss, among other things, the final data package that would be part of our submission for Defibrotide for the treatment of severe VOD.
If our FDA meetings are successful, we anticipate that NDA submission could occur in the first half of 2015, depending on our ability to acquire and remediate key information in the data package, and of course, assuming that we will not be required to complete any additional clinical trials prior to the submission. Although the NDA submission remains our priority, our Defibrotide development team is also evaluating the potential to study Defibrotide in other indications, such as early treatment of VOD, prevention of VOD, and prevention of acute graft-versus-host disease. Now a few words on our board and management team. Elmar Schnee joined the company's board of directors on August 1st.
He previously served as a director of Gentium from May 2012 to April 2014 and brings to our board of directors over 30 years of international commercial and general management expertise in the pharmaceutical and healthcare industries, as well as detailed knowledge of the Gentium business. We continue to build bench strength in our leadership team as we grow and expand our global operations. In addition to the promotion of Matt Young to CFO and the addition of Mike Miller as head of U.S. Commercial, we promoted Russ Cox to COO and hired Paul Treacy as our head of Technical Operations, replacing Fintan Keegan, who is retiring this month.
Paul has a long tenure within the industry and most recently held positions within Johnson & Johnson's subsidiary companies, including Head of CMC Manufacturing and Supply Chain for Janssen Alzheimer Immunotherapy and General Manager, Centocor Biologics. We also recently added Frederic Godderis in the role of Global Head of R&D Operations. Frederic brings nearly 20 years of industry experience, including leadership roles in project management and R&D operations, and was most recently at Johnson & Johnson and Janssen Alzheimer Immunotherapy.
Finally, we recently hired Craig Parker as our new Head of Corporate Development. Craig brings more than 20 years experience to Jazz with a strong track record of accomplishments in planning, strategic analysis and corporate development, as well as 12 years as a biotechnology sell-side analyst. I look forward to him joining Jazz later this month. Matt, let me now turn the call over to you.
Thanks, Bruce, and good afternoon, everyone. We are pleased with our strong performance in the second quarter as we saw adjusted EPS attributable to Jazz increase by 43% year-over-year. We expect continued strong top line growth for 2014, driven by growth in the sales of Xyrem, Erwinaze, and Defitelio. We are increasing our total revenue guidance to be in the range of $1.125 billion-$1.165 billion, and maintaining our adjusted EPS guidance to be in the range of $8-$8.25. Net sales of Xyrem for the quarter were $191 million, up 43% from $134 million in the second quarter last year.
We are increasing our guidance for Xyrem net product sales to a range of $765 millio -$780 million for 2014 based on three factors: improvement in bottle volume growth during 2Q to low double digits versus mid single-digit growth during the first quarter, a price increase of 8% on August 1st, and improving gross to net resulting from lower than expected coupon utilization. We continue to expect high single to low double-digit bottle volume growth in 2014. Turning to Erwinaze's second quarter worldwide net sales were $48 million, up 7% from the same period in 2013. We are reaffirming our guidance for Erwinaze's net product sales in the range of $185 million -$200 million for 2014. This reflects a 3% price increase in the U.S. in early July.
For Defitelio defibrotide, second quarter worldwide net sales were $20 million compared to pro forma net product sales of $10 million in the second quarter of 2013. During the second quarter, sales benefited from an increase in shipments to distributors. In early July, we made the decision to discontinue the cost recovery program in the U.S. so that patients in the expanded access program will now receive free drug. As you know, the U.S. program constituted only a small percentage of revenue. We are increasing our previous defibrotide net sales guidance to a range of $60 million-$65 million. We announced today that we have closed our transaction with Sigma-Tau to acquire the rights to defibrotide in the Americas.
The $75 million payment that was due to Sigma-Tau on closing was paid from cash on hand and will be recorded under GAAP expenses as acquired in process research and development in the third quarter of 2014. In the second quarter, Prialt net sales were $6 million compared to $5 million in the same period in 2013. Turning to operating expenses, adjusted SG&A expenses for the second quarter were $80 million or 28% of total revenue, compared to $63 million or 30% of total revenue for the second quarter of 2013. The increase in adjusted SG&A expenses reflected the inclusion of expenses from the acquired Gentium business, higher headcount, our narcolepsy disease awareness initiative, and other expenses arising from the expansion of our business.
Adjusted R&D expenses for the second quarter were $17 million or 6% of total revenues compared to $8 million or 4% of total revenues for the second quarter of 2013. The increase was primarily related to increased costs associated with development of our sleep and hematology oncology product candidates. We anticipate higher R&D expenses as we advance our clinical development programs and regulatory efforts, including the full spend associated with Defibrotide following the completion of our transaction with Sigma-Tau. We are maintaining our 2014 guidance on adjusted SG&A in the range of $315 million-$325 million and increasing our guidance on adjusted R&D to a range of $65 million-$75 million.
As of June 30, 2014, we had cash and cash equivalents of $268 million, current and long-term debt of $1.2 billion, and available capacity under our existing revolving credit facility of $125 million. We are continuing to pursue attractive opportunities to expand our business through our corporate development initiatives. During the second quarter, the main uses of cash were the repurchase of our ordinary shares, the purchase of most of the remaining outstanding shares of Gentium, transaction-related payments, estimated tax payments, and capital expenditures. We repurchased approximately 184,000 of our shares at an average cost of $127.96 per share during the quarter, leaving us with $140 million remaining in our previously announced $200 million share repurchase program.
In closing, we are pleased with our progress year-to-date, including integrating Gentium, launching Defitelio in the European Union, acquiring rights to JZP-110, completing the transaction with Sigma-Tau for rights to Defibrotide in the Americas, and executing on important commercial R&D and regulatory milestones, all of which we believe continue to support our short and long-term growth strategy. Thank you for joining us on the call today. I'll now ask Kathee to make a brief comment about our Q&A session.
Thanks, Matt. We request that you limit your questions to a maximum of two at a time, and then feel free to reenter the queue if you have further questions. With that said, I'll turn the call back to the operator to open the lines for your questions.
Ladies and gentlemen, if you have a question, please press star followed by one on your phone. If you would like to withdraw your question, press star two. Our first question comes from Louise Chen from Guggenheim.
Hi. Thanks for taking my questions. My two questions are, first one is on your capacity to do another M&A deal before the end of the year. Is that something that, you know, we could potentially look forward to? Secondly, how should we think about R&D costs for 2015? You had mentioned $100 million in clinical trial costs for JZP-110 in 2015 and 2016, but I'm wondering what else should we think about and how should we think to grow it year-over-year between 2014 and 2015? Thanks.
Thanks, Louise. With respect to corporate development, as we've often articulated, we will continue to be active. We are happy that we've been able to complete three transactions this year so far, and excited about continuing to build on the already well-established team here. That said, it's, as you know, difficult for us to predict the timing of when we will actually get, you know, a transaction done. We remain proactive, and we continue to believe we see a significant number of opportunities both in our existing business areas and beyond that. We'll keep at it and hopefully be able to do something, but we can't say exactly when.
With respect to R&D expenses, we've specifically talked about the cost of the overall JZP-110 program being consistent with our previous comments, in the neighborhood of $100 million, the majority of that spend being in 2015 and 2016. We do expect overall R&D expenditures as a percentage of sales and in dollar terms to go up. We, and again, provide guidance just for 2014. While we expect the guidance range we said this year, I think with other programs maturing across our sleep and hematology franchises with respect to both new products and life cycle management, we would anticipate some rise in R&D expenses going forward.
All right, great. Our next question comes from David Amsellem from Piper Sandler.
Thanks for taking the question. My two are as follows. Bruce, I guess you sounded a little bit cautious on the central pharmacy issues going forward. I guess maybe I'm reading too much into the commentary, but is there a risk that there could be bottlenecks again regarding the central pharmacy on Xyrem? Then the second question is on Defitelio. At the risk of putting the cart before the horse, I just wanted to get a sense of how you would think about pricing in the U.S. Maybe give us a sort of a set of benchmark comparator products, if you will, or just help us think about pricing vis-à-vis Europe. Thanks.
Yeah. Thanks, David, for the questions. On ESSDS, you know, the caution in my voice, I think will go right back to the comments I made on the first quarter call and that I think Russ and Mike also made, which is our goal is to get to a point where we're on top of, current operations, the metrics are all good, but we also feel confident that we won't see a recurrence of problems. In other words, that we build in surge capacity and flexibility to, you know, to deal with any issues that arise in the future.
And you know, while I think we're pleased with the progress that's been made over the last several months, and I think you certainly saw that, you know, the pull-through of the demand we've been generating in the second quarter was good. I think a couple of months' performance is too short for us to be able to say, you know, problem definitely in the rearview mirror. So i don't mean to sound overly cautious other than this, to us, was not just a couple month exercise.
This is really about building excellence in terms of how we service patients and physicians that we have high confidence in for the long term. On your second question, Defitelio pricing in the U.S., I think it's probably too early for us to be commenting on that. You know, as I said, our real focus right now is defining a regulatory pathway and seeing if there's an opportunity to get this in the hands of physicians and patients sooner rather than later.
All right. Our next question comes from Marc Goodman from UBS.
Bruce, maybe you can talk about Defitelio and the pricing in Europe and just how these conversations are going and you're rolling out, you mentioned some of the Nordic countries. So how is pricing there? How should we think about the pricing in Italy now versus what it will be and how, you know, Ireland, Netherlands? Are all these prices generally the same or, you know, relative to where you are? And then just on Xyrem, can you talk about these eight cities that you've rolled this program out into? Are you seeing sales yet?
I understand the metrics that you were talking about before. How much lead time, you know, on the sales, and are we going to see those sales? And then just so I understand, just as a follow-up kind of to the previous question on this quarter. I mean, there was a lot of nervousness obviously going into this quarter because of what happened with the call center. Did the call center just work as we thought this quarter? I mean, everything was just ticking along because obviously the volume growth was generally in line with what we would have been expecting even last quarter.
Yeah. I'm trying to figure out how that was two questions, Mark, but you're good. Pricing in Europe. I think we'll try to avoid going literally country by country in our commentary. In general, I would say we have been pleased by the responses we've had to our pricing and reimbursement submissions, you know, relative to our expectations when we announced and closed the Gentium transaction earlier this year. Russ, do you want to add anything on that before I go to the other questions?
I would just say that, you know, if you look at where we are referenced in Germany and Austria at EUR 426, you know, that was a good basis point to start. As new countries come online, we'll continue to give you information as we go.
Yeah. On the disease awareness initiative for narcolepsy, the real goal there is to make a dent in the very large undiagnosed narcolepsy population, which in the U.S. is estimated to be larger than the currently diagnosed and treated market. We know that many patients do go years before they get to the right diagnosis. There's still some time that happens between a diagnosis and treatment, and treatment can include, but is not limited to Xyrem. In terms of seeing, you know, a flow through to sales, that's not something we're expecting in the near term. Obviously we'd love to, over time, see a larger pool of patients being treated for their disease. On the comment about nervousness, you know, I understand there may have been some nervousness out there.
If you go back to our comments in the first quarter, I think we're pretty clear that we reiterated our Xyrem guidance for the year. We said we obviously couldn't undo the first quarter and get that business back, but that we were pretty confident about our business going forward. You know, we're pleased to see that confidence was, you know, well-placed in terms of our second quarter reported results. You know, we don't take the rest of the year for granted either.
We got to get out there and do our jobs every day. I wouldn't say around our table there was nervousness. There was honestly disappointment in ourselves and in the central pharmacy that we didn't do what we're supposed to do, which is make sure that those prescriptions are timely filled or refilled. And you know, we obviously took that seriously and wanted to do everything we could to fix that as quickly and as well as we could.
All right, great. Our next question comes from Mohit Bansal from Wells Fargo.
Thanks for taking the question. I have two. First one on M&A. Your deals have generally shown a consistency in terms of being orphan light products and all the commercial characteristics that come with that. I'm wondering to what extent you'd be willing to look at things that are outside that range of characteristics that you've looked at so far, whether it's commercially or in terms of size of deal. My second question is on Xyrem pricing. You've taken your second increase this year. I just wonder, as we look out down the road, as the product gets bigger, how do you feel about your flexibility to continue to take the types of increases that you've been taking? Thank you.
Okay, Mohit, on your first question, in terms of the consistency of the types of transactions we've done, you know, I don't think we necessarily define our target opportunity space as being solely limited to orphan. We definitely look for products that make a significant difference to the patients who would use them, that are differentiated, that have good exclusivity. The other thing we're specifically looking for are that those patients would be treated by a specialist group of physicians that we could target with an efficient sales force. In many ways, our lens that we're sorting opportunities through has more to do with the effectiveness of our commercial activities rather than just a count of the raw number of patients out there.
It's some combination of the number of patients out there and how efficiently we can get to those patients. Matt, anything else you want to add on our targeting? No, I think that's it, Bruce. The second part of the question on a price increase, maybe I'll hand over to Matt.
Yeah, Bruce, thanks. On the pricing, we don't comment on forward-looking pricing actions, but I think the trend of our price increases is there to see. I will say that the reimbursement levels for Xyrem remain high, meaning in a very good place. As with all specialty products, we've seen rises in PAs and step edits, and Xyrem is no different in that regard. I think payers are ensuring that these patients are adequately diagnosed with narcolepsy. We have not seen any overall changes in the reimbursement landscape for Xyrem.
All right. Our next question comes from Jason Gerberry from Leerink Partners.
Hi, thanks for taking the question. First, just can you guys comment at all exactly with respect to Xyrem legal regulatory front, what level of the FDA you're currently submitting your appeal and how many appeals you think you have with the agency? Figured I'd give that one a shot. Then, secondly, on Defitelio, can you just comment at all on the quarter, to the extent there was any launch stocking? As I look at the second half, what's implied by the guidance, it looks like a little bit of a slowdown relative to the Q2 run rate. I'm just wondering ahead of a few country launches, why that might be. Thanks.
Yeah, Jason, on the formal dispute resolution process with FDA, our initial formal dispute resolution filing went back to the people who had made the original decision with respect to our deemed REMS to final REMS conversion. We're now at sort of the first level up from that. There are several potential layers above this. It's a little too early for us to say what will happen. It very much depends on the response we get from FDA, and it depends on who at FDA has been actively involved in the responses we do get.
But i think we've been pretty consistent in our commentary that we sort of thought we needed to get at least one level up within FDA before we get, you know, a different set of eyes looking at issues that we think are very important to patient and public safety. On the Defitelio guidance and what that implies about second half versus first half, maybe I'll have Russ comment on that. Yeah, I would just comment that I wouldn't look at this as really stocking per se.
I would think of this as thinking about as countries come online and ultimately determining the timing of when they go from a name patient program actually to a full-on launch and just building in the modeling to be conservative there. So i think that if you know, think about how those respective countries come online, we're reflecting the timing of that.
Okay. Thank you.
That said, I do think we had a couple of distribution partners in markets we're not commercializing indirectly ourselves who had some orders filled during the second quarter. You know, a little uncertain on our part as to how quickly those orders would recur.
Got it. Thank you.
Okay. Our next question comes from Oren Livnat from JMP Securities.
Thanks, guys. A tremendous quarter. If I could just shift to the pipeline a little bit. You know, I have conversations around JZP-110, and there seems to be a pretty big disconnect out there about if successful, where you see this thing potentially positioned. Can you maybe help us frame it on the spectrum of, you know, one end competing directly with Provigil, Nuvigil at somewhat comparable brand pricing with better efficacy? And then at the other end, you've got a Xyrem lifecycle extension, and there's obviously a lot of room in between with regards to pricing and who you're targeting. Can you maybe help us understand what you envision this pie being?
Yeah. Oren, thanks for the question. You know, in terms of how we think about JZP-110, a couple comments. The first is, as we've described the market opportunity to you and in some of the slides we've shown historically, you'll note that we start by looking at those patients with narcolepsy or OSA who experience excessive daytime sleepiness that is not adequately addressed by other available agents. You know, we haven't done our phase III. We haven't got a regulatory approval. We're not out there selling the product. There's lots of time between here and there.
I would say in general, we're looking at addressing a patient population that is unable to tolerate or doesn't get adequate efficacy from the other agents, rather than necessarily going right at them for, you know, competing to get the patients in the first instance. To the sort of second part of your question, we don't see this as a, you know, a Xyrem lifecycle management opportunity. You know, Xyrem obviously has a different indication for the treatment of cataplexy and EDS in narcolepsy patients. You probably remember that the majority of Xyrem patients, certainly in our clinical trials, also do take a stimulant as well. So they're taking Xyrem at night, and then they're taking stimulants during the day and getting additive benefit of those two agents. So i wouldn't think of JZP-110 in the same category as Xyrem.
If I could just follow up with a simple tax rate question, too. I think the last time, I could be mistaken. I think the last time we heard from you guys on guidance for this year were maybe high teens similar to 2013. I think you're trending through the first couple quarters slightly ahead of last year. I'm just wondering, just going forward through the rest of the year, where do you see us shaking out, and what's the trend directionality look like?
Yeah, thanks. With respect to our cash ETR, I would expect still high teens% is the right thing to think about, Oren. We have seen it trend up slightly with respect to business mix where that occurred geographically, what products, and then also with some of our R&D expenses, it had pushed the tax rate up slightly, but we don't anticipate a significant deviation from where we are.
Thank you.
All right. Our next question comes from Gregg Gilbert from Deutsche Bank.
Thank you. I have two. First on JZP-110. I don't know when we're gonna see the final details of trial design, but maybe you could share some of the goals you're trying to achieve in phase III that go beyond the simple approvability in light of the particularly robust results that we're seeing in phase II. My second question for Bruce and Matt is on BD. Your strategy has been well articulated. My question is whether or not you're seeing any possible deals that would materially diversify your cash flows in one fell swoop while still honoring your core criteria that you've laid out. Thanks.
Okay, Greg, let me have Jeff take your first question on goals of the phase III program for JZP-110.
Right. For JZP-110, you're right to point out that there are the approvable endpoints, which Bruce has already talked about, an objective MWT and subjective Epworth Sleepiness Scale. We certainly intend to look at other potential outcomes or beneficial outcomes that would add to the overall profile of the product. We have a few things that we're exploring right now that might be, you know, pretty interesting, some of which have not been done before. As we start finalizing these protocols, we'll share more of that. That is certainly part of our thinking as the trials move forward.
I'll let Matt take your second question.
Yeah, thanks, Greg. I'd say, as we've said before, we are certainly willing to consider transactions from a business development perspective that are very big or continue with a strategy of some smaller deals. I think one large transaction that might immediately diversify us is one solution to a particular objective. You know, we believe through the course of again, doing three deals this year, adding some development programs, the sales of which could also be a substantial diversification of our revenue and add to our growth in the out years is also an important strategy. We're gonna continue to look at all of those things. And so we obviously can't comment on any specific activity, but certainly any and all of that is on the table for us.
Thank you.
Our next question comes from Ken Cacciatore from Cowen and Company.
Hi. Thanks, guys. Had a question on the Flamel sodium oxybate reformulation. Just wanted to know, if this progresses through the clinic, would they need to eventually certify to your distribution patents? At what point would they need to do that? And at what point could you enter into litigation to maybe enact a 30-month stay? Would you have to wait for an approval? Could your patents end up tying them up well beyond any timeframe in which you're working on your reformulation? Secondly, on the discussion around BD, just wondering, as we go forward here, has there been any change in the value of potential assets? Are they becoming more expensive, less? Just a little bit of commentary on what you're seeing around valuations as you look at potential acquisitions. Thank you.
Yeah, Ken, you know, in terms of your first question, I don't think we're gonna comment on other people's products or programs specifically. I will say anyone wanting to either an ANDA to Xyrem or 505(b)(2) Xyrem data is gonna need to certify to all Orange Book listed patents. That's just the way it works. Yes, we would have the opportunity to litigate if there's a basis for litigation. Yes, that would trigger a 30-month stay. On the second part, asset values and how they're changing, maybe I'll have Matt comment on that.
Sure. Thanks, Ken. With respect to asset values, we continue to see opportunities out there that we've proactively been evaluating, where hopefully value and risk align. You know, I think there's always more than the dimension of value when you're looking at various product opportunities or product development opportunities. That said, you know, in certain spaces with a very well characterized and understood asset in the public domain, it certainly in some cases has been fully valued, and I think you and others have commented on that. But there are always opportunities where that isn't the case from our point of view.
That's why we say it's very difficult for us to predict the timing associated with trying to get a transaction done for what we're looking at. But we continue to believe, again, that value and risk will align, and we'll be able to continue to pursue activities that will bring new products to Jazz.
Thank you.
Okay. Our next question comes from David Buck from The Buckingham Research Group.
Yes, thanks for taking the questions. Just a couple of quick ones for Xyrem. If we look at the 11% volume growth that you saw in the second quarter, how much of that would you say is potentially some catch-up from lost sales in the first quarter? Would you expect to sustain that type of level of growth, you know, as we, at least for this quarter, or, you know, somewhere somewhat less?
Secondly, on the Erwinaze product, growth is a little bit slower year-over-year. Can you touch base on whether there's anything in terms of inventory supply that affected the quarter? Then finally, just to clarify on the answer to the question on 505(b)(2) applications, my understanding is the gating factor is basically a filing of that 505(b)(2) that would lead to the certification. Is that true? That's it. Thanks.
Yes, I'll take that last one first, David. I think I didn't fully answer Ken's question, so thanks for giving me that opportunity. Yeah, that' s the trigger for litigation, not product approval. Correct. On the Xyrem question on volumes, you know, I think as we said at the end of the first quarter on our call, we can't really go back and recapture lost volume for the first quarter, meaning that a patient who didn't receive a timely refill and went without drug for a week doesn't take twice as much drug the next week and shouldn't, if any patients are listening.
So there's no catch up in that sense. You know, were we coming out of a period where shipments were low, where we had some higher shipment days coming into the quarter? Maybe. There could be a little bit of that. Essentially, what you saw in the second quarter was our shipment volumes very closely tracking the growth in patients and underlying demand. You know what exactly that means for the second half, you know, I can't tell you anything more than the guidance we've given you, in terms of Xyrem revenues and the guidance that we expect full year volume growth will be, high single or low double digit. That probably is enough on that one.
On Erwinaze, I think we've tried to condition people over the course of the past seven or eight quarters that percentage growth in Erwinaze tends to be pretty lumpy. We're talking about a very small number of patients being treated with the disease. I don't think there's a meaningful, you know, quote-unquote, inventory effect, with this product. Again, you know, some of our international Erwinaze sales do go through distributors, and there's different timing of shipments, but we don't really see much of an impact on that on the total reported sales.
Okay. Our next question comes from Gary Nachman from Goldman Sachs.
Hi. Bruce, could you talk about the increased call volume at ESSDS and getting Xyrem filled? Has that changed at all, or is it starting to come down? It seems like you're managing the process better, but I'm curious on the actual volumes, if that's changed. Secondly, where exactly is the additional R&D spend going this year? It seems that more of the heavy spending really hits next year, and you guys took up the revenue guidance, but not EPS. I'm curious if that's just you guys being conservative. Thanks.
Yeah, let me take the second question, then I'll have Mike comment on call volume at ESSDS. You know, we took up the R&D spend guidance in part for a structural reason, which is we just closed a transaction with Sigma-Tau concerning Defibrotide, and prior to that transaction closing, Sigma-Tau was sharing development expenses with respect to Defibrotide with us. So a piece of what you're seeing in the changed guidance is just we're on the hook for 100% rather than 50% of that spend. In terms of where we're spending the money, you know, we are in clinical trials we weren't in last year and getting ready to initiate clinical trials end of this year, early next year that are new for us. So the level of activity has gone up substantially.
Remember JZP-110 was a transaction we closed in January of this year. If you look at the range of clinical activities we have across getting started on the pediatric side with narcolepsy with Xyrem, as well as JZP-110, and then what we're doing with Erwinaze in the young adult population, as well as the follow-on JZP-416, and Defibrotide and a registry trial with Creal. There's just a lot more activity than there was last year. Mike, maybe you could talk about call volume at ESSDS. Sure, Bruce. On the call volume, remember that Q1 had sort of a constellation of events. You had the Affordable Care Act, you had people re-upping in terms of the seasonality of the year, and weather.
When service levels began to falter, that actually generated more calls. What we've seen in Q2 has been a step up in all operational metrics, including timely fills, refills, answering the phone, drops and abandonment, things of that nature. We're very pleased around the operational metrics. It's not necessarily the call volume, but how the operational metrics are actually directionally heading. We're very pleased with the way they are heading.
Okay. Thank you.
Okay. Our next question comes from Annabel Samimy from Stifel.
Hi. Thanks for taking my question. I have a couple. First on JZP-386. I was glad to see you just initiated the phase I studies. Can you give us an idea of when you expect to see some data from that and what you're looking for in terms of determining whether you can move straight into phase III? Regarding the Xyrem patent, it seems like it's a bit of a carve-out of the population who takes Valproate. What % of the population actually takes that, and can you carve out something? Was that the patent that you were waiting for, or is there an additional family of patents that you're still waiting for? Thank you.
Let me have Jeff take the first part of your question, which is expectations for what we're looking for in the JZP-386 data.
Just as a recap, we have initiated the trial. We expect it to conclude this year. We'll be working with Concert in the evaluation of those data. It's not as straightforward, you know, although we have certain criteria we expect to see in the performance of the product, there are a lot of different pieces you need to look at, not just PK, but also PD issues. Looking for what would provide the potential for a product that could have once nightly dosing, not have too long of a half-life because you don't want it lasting all day long. Something that could be evaluated in additional studies. So t here's gonna be a fair amount of work to be done and certainly evaluation of the data once it's available to us.
Annabel , on the second part of your question on the use of Xyrem and Valproate together, we certainly know it happens. It's not uncommon. We don't have perfect data on every script that's filled on that we can give out. But it is important in that population to recognize the interaction between the drugs and lower the dose of Xyrem. And I think for safety reasons, that's important for these patients. So we do believe that's important information for them and their treaters. You know, is there another family of patents out there?
We're not gonna comment on that specifically, but I will say you noticed that this one had an expiration date later than the 2024 date that had previously been our latest to expire patent. We certainly had told people that there were patents working their way through the system that could have new expiration dates beyond 2024. This certainly is such a patent. We do continue to have additional Xyrem-related patents working their way through the PTO. Can't say with confidence exactly when they'll issue or if they'll issue, but there are others in process.
Thank you.
All right, our next question comes from Douglas Tsao from Barclays.
Hi, good afternoon. Bruce, maybe looking ahead on the hematology oncology franchise, if you could talk a little bit about Asparec and how you see that, you know, sort of changing the dynamic for the ALL franchise.
Yeah. Doug, on JZP-416, you know, a couple things about that product that we think are interesting. One from a patient perspective is it's a pegylated product which we believe would offer the opportunity for less frequent dosing. Erwinaze given IM or even given IV, which it is in Europe on label, and of course we have a PDUFA date at the very end of this year on potential for IV use in the U.S., is dosed Monday, Wednesday, Friday, Monday, Wednesday, Friday. JZP-416 would offer the possibility of less frequent administration and more convenience to patients. Beyond improvements that would be visible to the patients, we also like the fact that the recombinant production technology might give us a means to a more flexible supply chain.
We've highlighted that historically, you know, we are somewhat capacity constrained with respect to Erwinaze production and this would have a meaningful difference on production. You know, obviously need to get through the clinical trials and get something to FDA and European regulators to consider. We view this as being a potentially very good product for the patients with ALL.
Do you see the potential opportunity, you know, because given the dosing advantages of Oncaspar, do you see this as potentially sort of moving Asparec up in terms of the treatment, you know, the sort of chrysanthemi-derived asparaginase sort of moving up in the treatment paradigm?
Yeah. You know, it's conceivable, but I think we've been cautious to tell people that unless we saw a meaningful advantage to JZP-416 to patients, our expectation is that physicians would probably go with E. coli-derived asparaginase that's got, you know, more history, more data, and reserve the Erwinia-derived asparaginases for those patients who can't tolerate or develop a hypersensitivity reaction to the E. coli asparaginase. It's not completely out of the question, but we're certainly not trying to guide people to expect that it would move up in the treatment paradigm.
Okay. And if I can jump in with one final question on Erwinaze. You know, as you said, sort of growth tends to be a little lumpy. I know you sort of went through a period, you know, where you had some initial initiatives that sort of really reaped a lot of benefits in terms of, you know, volume improvements. Are we sort of now waiting for some of the data in the AYA population to mature before we sort of see another step up in growth rates there?
Yeah. You know, I would say something that I've said before, so it's not intended to be new information, but I sort of feel as though we've penetrated the pediatric hypersensitivity opportunity fairly well. That's not to say there's no potential growth left there, but we've made great strides in making sure that most of the centers that would logically use the product are aware of how to use it and when to use it. I think we still have some work to do on educating treaters on appropriately recognizing hypersensitivity reactions and knowing when to use the product. We think we've made great strides in the pediatric hypersensitivity opportunity.
The other growth opportunities we see, including the adolescent and young adult population and the potential for greater use of therapeutic drug monitoring, are essentially changes in behavior. That's not the way things are done now. You know, predicting when changes in behavior will occur is a little bit trickier from our perspective. I think there is that growth opportunity out in front of us, but how quickly it occurs is not as easy for us to predict. Mike or Russ, you wanna add anything to that?
No. The only other thing I would add is, you know, we have a number of accounts that continue to come online, and we've seen good growth from that historically. We're seeing that some of the accounts that we are seeing come online now are not necessarily just pediatric, but also adult, and that's something to watch for going forward.
And also add that some of the treatment sites are using therapeutic drug monitoring, but it has not been broadly incorporated into protocols. They remain good growth opportunities for us, but they need to develop.
Okay, great. Thank you very much.
Our next question comes from Bill Tanner from FBR Capital Markets.
Thanks for taking the questions and congrats, Bruce, on a great quarter. Had a question for you. Looks like you had a second CBM patent review filed, I guess, for the 737 patent. I think in your prepared remarks, you mentioned that you were preparing a response and being unfamiliar with the process. Is this something the response would pertain to the first review request? Would it be something that would pertain to both? Are these gonna play out potentially in parallel or sequentially? Then I had a question for Russ, if I could.
There have been a couple requests on the part of the ANDA filers for CBM related review, and essentially you can think of us as responding to each of those requests. They're separate. It's gonna feel like a clump to all of you because they were all submitted in roughly the same timeframe. I would suspect our responses would be roughly in the same timeframe. I would expect early next year, the decision on whether the PTO will review these under that CBM procedure would also come out in roughly the same timeframe. Technically separate, but not a big difference in the time periods.
It may be an unfair question to ask, but is it? Would there necessarily be the contemplation that you might have a different outcome from the review? I mean, granted, these are, you know, business method patents, but is it? Do you believe it's possible that, you know, one of the reviews might succeed and the other one might not? Or is that just unknown at this point?
Yeah. Unknown at this point, Bill. I think the, you know, the important thing for people to understand right now is this is a separate and distinct process from the litigation in the court.
Yep.
Remember that given the bifurcation of that litigation, the distribution system-related patents, at least in the Roxane situation, were not stayed and were not moving forward. Now there is a process that's at least kicked off, although it itself is a long process, to take a look at those patents in a different jurisdiction.
Got it. Then just Russ, as it relates to the numbers of patients, I think the average numbers increased by about 150 Q-over-Q in the first quarter, about 350 this quarter. I'm just trying to understand a little bit better. Is it a little bit more of a rebound from the first quarter in terms of numbers of patients? Then I don't recall the company ever actually mentioning it, but I'm just curious on the average number of patients. Is that just you know, the average at the beginning or the end? Or how is that actually calculated?
Yeah. I'll take the second part of the question first. It's a pretty crude measure, sort of averaging the beginning and ending active patient number. You know, that active patient number doesn't always translate into exactly when people get prescriptions filled.
In each month, and most of them are getting it monthly. It doesn't track perfectly to commercial bottles 'cause it includes patients who are not, you know, it includes patients who get free drug under our patient assistance program. So they're not gonna track perfectly. We give that number more to give you guys some transparency into what fraction of the diagnosed and treated narcolepsy patients out there are active on Xyrem, to give people a sense for the number of patients getting Xyrem therapy as it might relate to your view as to the impact on payers or the healthcare system and sort of the rare nature of this important disease. But again, it's a relatively crude number.
On the, you know, specific pattern of growth in this, you know, we emphasized in the first quarter a little more than we usually do the growth in number of patients, just to show you the disconnect we had in the first quarter between the growth in patients versus what we actually shipped in drug in the first quarter. I don't think we've seen any major change in that growth in patients, which has continued to be fairly steady.
Okay. Thank you.
Our next question comes from John Newman from Canaccord.
Thanks for taking the question. Just two quick ones. Bruce, I may have misheard you, but I thought that when you were talking about the meetings with the FDA, you may have mentioned that one of the things that they may have asked you to do or you'll be looking to do is finding some of the data on the studies that have already been completed. I just wondered if that's the case, and if you could talk a little bit more about it. The second question I had is kind of a broad general question.
I'm just curious. This is more of a longer term issue, but it seems like at some point in time, third quarter next year at the latest, we'll be switching over to ICD-10. I'm just wondering if you think that may have any impact at all, on your business. I know it's been pushed off a couple times, but I'm just curious. Thanks.
Yeah. On the first question, which related to Defibrotide and our efforts to see whether we've got a fileable package, I did mention that we needed to get some data, and let me have Jeff talk about that for a second.
Sure. When the original data package was compiled, utilized, of course, CRF information, that covered only sometimes high-level assessments. For example, did something resolve or something not resolve? There were also some processes that were done, again, with high-level documentation that FDA wanted to see more detailed documentation on. Those are some examples of things that we're going out now to be able to satisfy that request.
Yeah. John, on your second question, the ICD-9- ICD-10 conversion process, while I know that will be a big process for healthcare providers and much of the healthcare system, I don't think has any particular differential impact on Jazz Pharmaceuticals.
Great. Thank you for taking the questions.
All right, our next question comes from Irina Koffler from Cantor Fitzgerald.
Hi. Thanks for taking the questions. I just wanted to follow up on the covered business method patent issue, just since I'm not as familiar with this process. What is the end goal of the generic filers in submitting these? What are they hoping to achieve, if it doesn't color your litigation at all? Can you help us understand the downside risk of what happens if they prevail in this discussion at all? Then the second question is, if the FDA wants you to conduct additional clinical work in Defibrotide, for VOD, is that something that you've contemplated and would go on and invest in? Or would you skip that and just develop it for the other indications? Thanks.
Yeah, Irina, good questions. On the first one, the covered business method patents, I think the import here is, it's a way for the ANDA filers to contest whether these patents should have been issued. In other words, are they valid patents? This isn't specifically about whether their products infringe these patents. It's just should the patents have been issued.
You know, this is sort of a novel situation, you know, challenging, you know, the Xyrem Success Program and our controlled distribution system under the Covered Business Method review process, which, you know, at least if you go back and look at the history of how this came into being, was specifically set up to address, you know, patents relating to financial transactions, and the question of how broadly you define that and what ought to fall within that, I think is an interesting question. But the import, just so all the investors and potential investors out there understand it, is essentially the ANDA filers asking whether these patents are valid patents or should be invalidated.
On Defibrotide, you know, if the FDA were to suggest that additional clinical work needed to be completed before bringing the product to market, would we do that? I think we said when we acquired Gentium, and even before the recently closed transaction where we got the rights to Defibrotide in the Americas, we said that was a potential outcome. In fact, I think we said at the time we announced the Gentium deal and closed it, that might be the more likely outcome.
That was prior to our Type A meeting that we had in April of this year. Yes, that is a possibility for us. We still think the investment we made in this product would be a great investment for our investors. Right now we're very focused on whether we can get the product to market a little bit sooner, based on existing data, as was the case in Europe.
Thanks.
Our next question comes from Chris Hamilton from R.F. Lafferty.
Sorry, my question's already been answered. Thank you.
All right. Our next question comes from John Boris from SunTrust.
Thanks for taking the questions, and congratulations on the quarter. First question has to do with JZP-386. If you look at the, I guess, slowing of the metabolism of the product and the potential for accumulation with deuterium, just your thoughts around how do you ensure that you get an adequate or ideal or optimal PK/PD curve. I think you mentioned on the call that you obviously wanna flesh out any issues that could potentially be related to that. Then I believe you're conducting the clinical in Europe. Just your rationale for doing it in Europe versus U.S. and did the FDA get the FDA's blessing on conducting the trial there. Then also on the clinical, relative to...
Relative to the off-spec trial that's ongoing, which also uses a similar substance on the product to extend the half-life. They're required to conduct a 58-week safety study. Can you maybe give some insight into how you think the FDA might view some of the longer term safety studies that might be required for that molecule? Then a second question just related to JZP-110. I know you mentioned that physicians are very excited about the profile, but just any thoughts you have from the phase II data that you presented. Did you have an opportunity to take that to managed care, present the profile to managed care and any thoughts on how they responded to the profile? Thanks for the questions.
Yeah. I'm sorry. John, could you repeat your question? We got cut off somehow.
Okay. The JZP-386 question has to do with. Can you hear me okay?
Yeah, we can hear you, John.
On JZP-386, question just has to do with the extension of the half-life of the drug to optimize once daily dosing. You indicated that you certainly wanna figure out in the phase I clinical trial the PK/PD issues that could be associated with a formulation on that compound.
Yeah. John, let me jump in. I heard the first two parts of your question, and when you hit prospects, we lost you . On the two parts of the question, then I'll let you jump in if I miss anything. On the difference in metabolism and what we're looking for, you know, this is the first trial in humans. We wanna see what data we get. You know, I'll remind you that in terms of what the perfect profile would be, I don't think anyone knows the answer to that question because it hasn't been studied. Xyrem with its relatively short half-life and its twice nightly dosing has been extensively studied. There's good data out there.
What would happen if you gave different profiles of sodium oxybate regardless of how you achieve that through deuteration, drug delivery technologies, a different, you know, completely different compound, you know, exactly what that would do to efficacy, to safety, no one knows, I think, and we're certainly talking to all the experts. I can't really comment on what the ideal profile would be. We certainly have some ideas of what we think ought to work and ought to be beneficial to patients and let's see what profile we actually get and whether early data, including the PD data, would suggest that we've got something interesting. In terms of the decision to do the first-in-man trial in Europe, really that was just experience.
That was, you know, our goal and Concert's goal was to generate data sooner rather than later. That was the quickest path we saw to do it, and so that's what we're doing. It did not reflect any particular feedback, positive or negative from FDA. It was just the path we saw to get there fastest.
The trial didn't appear on ClinicalTrials.gov, so did the FDA review it or not review it?
We have not submitted the U.S. IND at this point.
Okay. No, that's great. Thanks for asking that part of the question. Just JZP-110.
On JZP-110, what did you wanna know?
Okay. Question has to do with you. You certainly indicated that the profile from the phase II clinical trial data that you presented, that physicians, you know, have certainly embraced it and see it highly differentiated versus Provigil and Nuvigil. Have you had an opportunity to take that profile since a lot of physicians are losing their ability to prescribe through tiered structures, take that to managed care and what kind of feedback, if you have, has managed care given you about the profile on JZP-110 as you're about to, you know, spend $100 million on the clinical development of the compound?
Yeah. Certainly before we closed the deal with Aerial, we did significant market research. Sorry for the sound of the redial in the background. We certainly did market research to understand what the needs were out there from a patient perspective, a treater perspective, both in the narcolepsy and the OSA populations. We believe that bringing out a product, if successful, that would meet the needs of the roughly half of the diagnosed and treated narcolepsy patients who can't tolerate other stimulants or don't get the benefit they need in reducing their EDS symptoms, you know, particularly if they've tried and failed other available agents, is a pretty compelling value proposition.
I think the same thing could be said of OSA patients who despite being on CPAP therapy and trying other drug therapy, similarly, aren't getting the relief from the excessive daytime sleepiness that they need.
Thanks a lot for answering the questions.
Yeah, no problem.
Okay. Looks like there are no further questions in queue, so I'll turn it back to Kathee for closing remarks.
Okay. Let me hand it back over to Kathee.
Thank you. Thank you all for joining us today. We're planning to attend the Canaccord Genuity and FBR healthcare conferences in the third quarter, and we look forward to seeing many of you there. Thanks, and have a good evening.
This concludes today's call.