Great. Welcome everyone to the Piper Sandler Healthcare Conference. My name is Biren Amin. I'd like to welcome our next company. We have LENZ Therapeutics and their CEO, Eef Schimmelpennink. So, welcome, Eef. Maybe to start, you know, clearly an exciting year for LENZ with FDA approval of VIZZ. And then, you know, the launch a few months ago. If you could maybe just talk about, you know, last eight, nine weeks, since the product's been launched into the U.S. market, how's it tracked compared to your expectations internally?
Yeah. Great question. Thank you for hosting us here. So it's going extremely well. We're very pleased with what we're seeing. And I know many of you in the room here, but for the few that I've not met, we have developed a presbyopia eye drop, an eye drop that you put in the morning that restores your near vision. It's very, very effective. We obviously got our FDA approval end of July. And we launched, as you've mentioned, early October. So from the moment of launch onwards, we've really been focused and we've been very clear about that on this quarter. It's all about ultimately getting doctors to recommend us. So the stages there are first driving awareness, what we shared in our earnings call in November.
So we're already at 90% awareness for the brand name VIZZ and for the product, which is, we think, phenomenal for a product that, for a brand name that's only been, you know, out there for a couple of months. The second step in that phase is really for doctors to drive or to get confident with the product and get some experience, usually on themselves, some of their office staff, and then, you know, a handful of patients. We do that by, you know, handing out a lot of samples. So there's over 7,000 offices that had samples when we had our earnings call early November. And obviously, that number keeps growing.
First things that they do usually if they get these samples is open up a pack and put it in their own eyes, like I said, in the eyes of some of their staff members, a couple of patients. And then the next phase is to actually get them ready to write scripts, and what we've shared is that we're doing very well there. In the first four weeks, there were already over two and a half thousand doctors that were writing scripts. We had over 5,000 filled prescriptions in the first four weeks only. And obviously, that's a trend that, you know, we see continuing and something that we're very, very pleased with. So, yeah, that's in short what we saw in the first, let's call it, eight or nine weeks now.
I guess any key learnings from the first eight weeks that you feel that you could apply going forward?
Absolutely. So, you know, the one thing that we're obviously extremely pleased with is that we're not hearing it doesn't work. This product works and it works on pretty much everyone. So I know many of you are doing KOL calls, you know, doing your own checks. We can pretty much guarantee if you put a drop of VIZZ in your eyes, you're gonna be able to see up close again. You'll be able to read your text messages, you know, read that fine print that you're struggling with, as a presbyope. So that's what we're hearing. That feedback is great. That foundation of the product is there.
The other thing that we're hearing is that, and we saw some of it in a clinical trial already, that it does improve distance vision as well for a significant group of people. And they usually, you know, remark that things are crisper, clearer, more vivid. That's that distance vision impact. Now, that's anecdotal. That's not a label claim, but it's definitely something that comes out of the market. So the product does what it needs to do, and it does it very rapidly. Within 10 minutes, 15 minutes, you know, people are, will see that near vision improvement, and it lasts for the full workday. You know, anecdotally, again, we're hearing 11 hours, 12 hours, you know, 10 hours. So really, you know, on top of the clinical profile that we had. So very pleased with that efficacy profile.
Obviously, it makes it a great, a great jumping-off point for, you know, people to try it, like it, and then move on to buying a script.
On the safety side of things, any key learnings since the launch, you know, from the data that was developed from the clinical trial?
Yep. So this has always been, and we've seen it in our clinical trials as well, a very comfortable, safe product to use. And we see the same thing in the market now as well. The one AE that we were most focused on is that there is a development of a mild headache. We actually don't hear much of that. So that's great. You know, that's the one that we were in the clinical trial most focused on, but we're not hearing a lot of it in the market. If you look at the ocular AEs, just like with many eye drops and other products, you know, there's a little bit of a sting on instillation that people notice. Very short-lived, like usually 15 seconds, 20 seconds, only on the first drop. Doesn't really happen anymore on day two, three, four.
Similarly, there's a little bit of hyperemia that you can expect, like again with many other, other products. And again, importantly, very short-lived, very transient. You know, if it happens, it's gone in about 30 minutes and very tachyphylactic. So, you know, it's important to keep using the product. Use it day two. It's already a lot less. Day three, four, five, it's mostly gone. So neither of these are hurdles for adoption, we feel. And, you know, what we've changed around the messaging there is that, as always, and with any product, it's important to prep your patient well for what they can expect. And in our case, it's put a drop in your eye. You're gonna be able to see up close again within 10 minutes- 15 minutes. Gonna last you a full workday. You may see a little bit of distance vision improvement.
Just realize that on that first day, if you put the drop in, it might sting a little bit, might get a little bit of hyperemia, but that goes away very quickly, and if you use the product a couple of days in a row, it no longer occurs, and that seems to be a message that is landing very well, and is a very easy one for doctors to actually work with.
What about the headache profile? Anything to note, compared to the clinical studies?
Yeah, it's a lot less, it seems. So in the clinical trial, we had about, you know, 10%-11% placebo-corrected on headaches. We're hearing about it sporadically now. And if we're hearing it, it's very short-lived. It's very mild. People, like, if you look for it, sometimes people say, "Yeah, I think I feel something." It's more like a pulling sensation. Again, very short-lived. And again, highly tachyphylactic. And we saw it in the clinical trial as well. But again, a lot less than we saw.
And, you know, we've heard some feedback that, you know, there's some dimness as well. It's kind of been characterized as, you know, you putting on sunglasses. Your thoughts there in terms of patients, you know, kind of getting used to it or the effect going away?
Yeah. No, it's again something that we saw in our clinical trial. You know, not unlogical. If you shrink your pupil down very rapidly to below two millimeters, you know, you will, for most people, for some people, experience a little bit of dimness. Again, it goes away real quickly. Basically, you neuroadapt within six, seven, eight minutes for most people. It's again not a hurdle for adoption. It's not that you're stumbling around in the dark. It just feels a little darker in that first period. Interestingly, also that is something that people get used to very quickly.
Like they do two, three, they're looking for it and go, "Hey, I don't really notice it anymore." So overall, I think the most important thing here is that it's a product that works in a population that's very large with a comfort profile that's, you know, very easy to use.
You know, so early phase of the launch, you know, you've had your sales force out, detailing eye care professionals, the direct-to-consumer advertising. I think that starts in Q1. Talk about, I guess, the focus there. What's your target audience with the DTC campaign?
Yep, so we're starting the DTC in Q1, and the reason for that is that we wanna make sure that we use this quarter to really, like I said, you know, make sure that we have a strong foundation of doctors that are familiar with the product, know how to talk to the patients about it, and are ready to prescribe, so that's the focus, but now you don't wanna start sending 'cause it's a very DTC-sensitive population. You don't wanna start sending a lot of consumers into doctors that are not aware of the product, so that's why we're pacing it to Q1. That's actually a lot earlier than what you would see with most other companies 'cause they'll need to make sure that all their patients are on formulary. That's something that we don't have to deal with, so Q1 we'll start DTC.
You may have seen that we announced Sarah Jessica Parker as our spokesperson for the brand. If you think about our DTC strategy, basically a pyramid with her at the top. She needs to make sure that you, you know, stop scrolling. You basically, you know, wanna see what, what she's up to. She pulls you into our website. You'll learn about the product. Underneath that, there's a lot of local influencers that, you know, you actually subscribe to. So those are the ones that you already follow. They'll be talking about the product, and we'll start that in Q1 as well. And then there's a lot of digital advertising that obviously wraps around all of that. The good thing with our patient population is that we can target them very easily. What we don't need to do is drive a lot of patient awareness.
If you struggle with looking up close, you'll know that. We don't need to explain that to you. The groups that over-index into a willingness to try a drop, an eye drop and use it, you know, the big groups are people that have been or are wearing contact lenses. If you become a presbyope, that actually drives you out of contact lenses. This drop allows you to stay in contact lenses. So highly interested group, very easy to target. Similar people that have had LASIK in the past. So, you know, you can target them very well. They've paid money to be glasses-free. Now they hit 40, 45. They think that the LASIK is wearing off. That's actually not what's happening. It's that they're actually becoming a presbyope. Again, this drop allows them to stay glasses-free.
And then you have the active aging group, you know, people that, you know, like to play sports without glasses or care about their aesthetics. Each of these groups alone is well over 10 million people. So those are groups that we can very easily target. We see use in those groups, but definitely also outside of it. So it's not that it's only for those groups. It's effectively a drug that works for the majority of the 128 million presbyopes out there.
So right now, there's absolutely zero DTC campaign. So clearly, media awareness is near zero. What's driving you know the 5,000 patients that have been prescribed this in October? What's kind of driving their interest? Is it you know that they found this in you know through Google or some other searches, or they're just going for the regular eye exam, get introduced to it? So.
Most.
Most, mostly the latter. So these are patients that are coming in for the eye exam, doctors that are enthusiastic about it, and that talk to them about it. And basically, they say, "Okay, you know, I now have a new solution. It's literally an eye drop that you can use. Are you interested? If so, I have a sample pack, and I'll write you a script. Try it." They'll prep the patient. Patient uses it and goes on to order the product. So that's the majority of the scripts that we're currently seeing 'cause indeed, there's hardly any consumer advertising ongoing at the moment. So anything outside of it is organically at the moment.
And then once the advertising starts, which platforms are you gonna be advertising on? Gonna be TV media, social media, or both? And what's kind of the target audience? Is it that 45 to 65 group, metropolitan areas? Is that kinda like the cohort of, you know, a patient that you're potentially going after?
The nice thing with, you know, the nowadays digital marketing is that you can fine-tune it very easily, and you can test a lot of different things. So our marketing campaigns are gonna be focused mostly digital. Many of these people, you know, get their info or scrolls on Instagram, Facebook, TikTok, YouTube. So that's where a lot of it will go. Non-linear TV, as well. So, you know, we'll Hulu, Hulu is your Disney's. And we can target that very easily to, you know, the different groups, so that's what we'll do. You can fine-tune it almost on a minute-by-minute. So we can test something in Houston and compare that to New York and see what works where, and then adapt as needed.
And so then you also have a sampling strategy currently.
Yep.
I think about 10 samples per site. There's, I think, maybe about 70,000 samples currently available in the marketplace as of end of Q3 or your Q3 results. Talk about, I guess, what drove that strategy in terms of offering 10 samples per site. Why that number? Why not something that's, you know, 50 or 100 samples per site?
Yep. And it's not a fixed number. So we start with roughly 10 per site. And it's a great reason for a rep to come back. So you drop off your first 10 samples. You come back, you know, three, four weeks later, and you check how many there are. You also know how many scripts that doctor has written. So if there's zero samples left and he or she has written 30 scripts, you'll load them up with more samples. If there's 10 samples left but 20 scripts written, you have a different discussion 'cause we want samples to actually go with the script.
We want patients to experience the product 'cause a patient that's tried it, liked it, and bought it, and bought the product, we would expect to be much more sticky than somebody that tried it, which frankly is what happened with VUITY. They sold the promise. People bought the product but never refilled because they didn't really like it. So we want this to be very different, and that's why we wanna have as many samples out there as needed. So initially, you start with 10. You don't wanna make it a, "Here's 50 samples," and you can hand out, you know, five to a patient or, you know, 10 to your neighbors or, you know, have people use it like that. So it's really a fine-tuning there. But again, you know, those numbers will go up as we see doctors prescribe.
You know, so we talked about efficacy and safety, in the real world. Pricing. You know, products priced at about, I think, about $79 for a one-month supply.
Correct.
There's a discount on a three-month supply. Any feedback from consumers, patients on the price point?
Yeah. That price works. Like you see it with our scripts. Frankly, you saw it with the VUITY scripts. I remember VUITY, it was like three, four years ago. Clearly, we've had quite a bit of inflation. Day price at $79. The pricing at $79. We're not hearing back that this is excluding a lot of people. So the price works. We've done a lot of pricing work on that. The $79 indeed is if you buy one script. If you go through e-pharmacy, you can also buy three scripts at a time for under $98. That works out to six to $66 a pack. Bottom line for us, literally, the P&L bottom line is identical between the two. So for us, if you think about how that, you know, price is, it works out the same.
It's independent of whether it's retail channel or e-pharmacy, whether it's a one pack or a three pack.
And so patient gets a sample. Do they walk out with a script normally?
Ideally, yes. That's definitely not happening in all the cases just now. You know, doctors are still really in that, you know, driving confidence phase. They wanna hear back from their patients. But the ideal, you know, patient journey going forward ultimately is patient comes in, hears from the doctor, "Hey, here's a, an eye drop," or comes in asking about this because they've seen the DTC. They get consulted, get the right exam, and leave with a sample pack and a script. Try the product. They like it. Get some e-pharmacy script. It's literally on your phone. Just go through the details. It gets shipped to the home, shows up a couple of days later. If they prefer to go to CVS or any other pharmacy, it gets sent there, and they pick it up there.
What's the split between retail versus e-pharmacy?
Yeah. It's very early now. So, eight, nine weeks in. The retail channel has only been fully stocked for a couple of weeks. So it's too early to really draw any conclusions on what that, you know, script balance is. You know, that's more a Q1, Q2 thing. I think when once things are stabilized, we'll be able to get more insight on that.
Today, what's the demographic from the e-pharmacy? You're clearly collecting data from the e-pharmacy.
Yep.
In terms of demographics of patients, location. Any trends that you could share with us as far as, you know, from the e-pharmacy scripts that have been filled in terms of the types of patients that are filling it?
Yep. Absolutely, so we did a lot of work upfront to make sure that we had our targeting correct and our patient demographics correct. And the first eight, nine weeks are spot on. So if you look at where this product gets written, it's about 80% optometry, 20% ophthalmology. That's what we thought. It's exactly that number. Our highest decile target doctors are writing the most. That's what we expected. That's what we see back. So our targeting, and that's what the sales force is based on, is correct. And then from a patient population on the e-pharmacy side, we can, you know, we have all that data. What we see is that, as expected, it's slightly female. So 60%-40%, female, male. Product gets used in all different age groups, but definitely a little bit more in the 45-55 years.
55, 65, and then 65 and over. Again, we see it being used everywhere, but definitely more in those younger populations.
In the e-script database, do you get to collect for data points such as, you know, they've been on readers or multifocal lenses or post-LASIK? You know, anything to suggest that, okay, the cohorts that are actually using this? Anything, any data points that you could get from that, e-form?
No, that's not data that you get.
No.
Basically, you get age, male, female, where they are. You don't get patient names, obviously. We do see indeed that it's more, you know, your question was, we do see the uptake higher in, you know, the more urban areas. You know, Florida, New York, Texas, California, and then the big cities in there is where there's a lot of demand. Again, doesn't mean that it's nothing outside of it. But that's, again, very much to what we expected.
One of the pushbacks is, you know, if a patient has a reader, why would they pay $79 a month for an eye drop? What would you say to that?
So this is a convenient solution. When I was not using the drops before we launched, I had 12 pairs of readers constantly everywhere around, and all I'm doing all day is on off, on off. This is a drop in the morning, and I'm good to go until, you know, late in the evening. So it's a convenience solution. It's something that you don't realize until you not have to wear and to use your, your reading glasses. So that, that's what we're selling. This is not, you know, a replacement for a $2 reading glasses. This is getting you back to what your vision was before you were turning 44, 45.
What are the assumptions on daily use versus, you know, on average, how many days a week do you think patients will use the eye drop?
Yeah. It's a very interesting question. So anybody that we surveyed in our clinical trials or in general, they go, "Well, if this works, why wouldn't I use it every day of the week?" You know, just like I use my contact lenses or my, you know, my normal eye glasses. That's the feedback that we're getting. That would mean 10 refills a year. So basically, five, six days a week. We wanna be conservative in our assumptions. This market gets big real quick. So we're actually cutting that number in half. So we're saying, "That's all great that people are saying that, but let's for now assume that they're using it three days a week, five refills a year." That's the assumption that, you know, we've been basing our numbers on for the last couple of years.
You know, so if we talk about the $3 billion market that we've been speaking of publicly, that's a 6% penetration ultimately or 8 million users, $79 a pack, five packs a year. That already gets you a three to a $3 billion market. It's interesting to see what will come out over the next couple of quarters and years. I think if you think about what are some of the key KPIs the first half year in 2026, I think most of us will be focused on what are your new patient starts. And then, you know, as we move into the middle of the year, second half of the year, how is that translating into stickiness? So what is that refill rate that we see of those patients?
I guess when DTC starts in Q1, you know, what are the company's assumptions in terms of an inflection point on launch, right? Because to date, it's largely been sales force detailing to ECPs. But, you know, with the DTC, you know, DTC, now you're gonna have increased consumer awareness. They're gonna go into the doctor's office for a prescription. What's the time that you would expect starting, you know, when the campaign hits in Q1, when the company expects that you're gonna start to see an uptick in prescription volume?
Yeah. So normally, on average, with a DTC campaign, that's like anywhere between six to eight, seven weeks before you really see that impact. And if you think through that, you start the campaign, patient sees it, needs to get interested, makes an appointment, goes to see the doctor, tries it, orders it. There's a period of time that just takes, like getting an appointment possible, but obviously, it's booked up. So that's just the, you know, the first couple of months. So that's why we think that, you know, that inflection point will happen, you know, in roughly a couple of months after we, in earnest, start the DTC.
And when would we start to get clarity on compliance refill rates? Would that be more like mid-year?
Yeah, probably. So the challenge with, I think any data, but definitely on products that go through e-pharmacy, is that it's not easy to track through Symphony or IQVIA. So they will, at some point, get better at tracking the retail side of our volume, but not so much on the e-pharmacy side. So for the first couple of quarters, you know, we'll help you with just sharing what we've actually sold. Ultimately, they'll start to narrow that gap and they are obviously then giving NRXs and RRXs. But I think that's more of a mid-year proof point.
And you've got two competitors that are potentially entering the market over the next, you know, 12months-15 months. I think BRIMOCHOL has a PDUFA in January 2026. Phentolamine, I think the sNDA is gonna be filed shortly with approval by end of 2026. Your thoughts on, you know, the VIS profile compared to both of these agents?
Yeah. Like we'll take anyone seriously, obviously, as we shoot. This is a product that you can compare very easily from an efficacy point of view. And the mechanism of action is really simple. You need to get to a small, pinhole pupil. You need to be below 2 mm to really drive near vision improvement. So what you can do is compare our profile initially to VUITY. VUITY's smallest pupil size was 2.3 mm, and it very quickly got back up. That led to one in four of patients even noticing an effect, and then lost statistical significance after three hours. Our profile's remarkably different. We have 99% of people that below 2 mm at half an hour, keeping the majority there for 10 hours, which leads to a profile that's at least three times more efficacious, at least three times longer in duration.
You know, our 10-hour data is better than VUITY's peak efficacy, but also in a six times larger population. If you now compare the BRIMOCHOL product, that's effectively the same profile as VUITY, and phentolamine is a very different profile. And that doesn't get down below 3 mm even. So again, we'll take anyone seriously, but we truly think this is a Category 1.
Perfect. I think we're about out of time. Thanks, Dave.
Yeah.
This has been a pleasure, and looking forward to tracking the launch closely.
Absolutely. Thanks everyone.