Thanks so much for joining our 46th Annual Healthcare Conference. I'm Stacy Ku, one of the biotech analysts, and I'm here with my colleague, Vis Shah. We're happy to be hosting LENZ, and we have CEO Eef Schimmelpennink . I'm sure joining us soon will be CFO Dan Chevallard and CCO Shawn Olsson. Eef, if we could just get started with maybe some opening remarks on the LENZ launch, maybe some key learnings since the early October product availability.
Yeah. No, happy to do that. Thanks for having us, and good to see so many of you here in the room. A lot of familiar faces, some new ones. For the new ones, which frankly, I think there's only one or two, but we've launched a presbyopia eye drop in October of last year. Actually got approval in August, launched it into the market in October. Think of this as a once a day eye drop that can replace your reading glasses. You put your eye drop in in the morning, you get up to 10 hours or more of near vision improvement. We launched that, as I mentioned, in October, and we're very pleased with what we're seeing at the moment. We're in month, let's call it four or five of our launch.
It very clearly is a category built. What we're seeing at the moment is that the product undeniably works. You know, we had phenomenal clinical study results coming out of our phase two and phase three studies that obviously allowed us to get the product approved. You always wanna see how that translates in the market. What we're seeing is that the real world experience on the product is great. I know many of you are doing your own doctor calls or, you know, reading Guidepoint's articles, we're doing the same thing. I'm in the field often and there's no doctor that you talk to that you ask, "How do you like the product? How's it working?" that's gonna tell you it doesn't work. No, the product clearly works. We're seeing it on the patient side as well.
You know, our sampling strategy from the beginning has been to make sure that we almost flood the market with samples. We have some 15,000 currently target doctors that by now all have samples. The idea is that as a presbyope comes in, they got counseled on this new option, they get the sample, they can try it's a five-day sample pack, then if they like it, they can move to buying a script. We're seeing that happen. A good thing, and it's way too early to actually start putting % on it, but if we look at that group of patients that had their first product in Q4, we're seeing that stickiness that we wanna see being there. You know, very encouraged by what we're seeing in the data there.
Again, you know, without putting percentages to it, what we're seeing is that patients that maybe started with a 1-pack are moving on to a 3-pack. You know, e-Pharmacy can buy a 3-pack, that clearly is a signal that they're liking it. We're also seeing patients that as a furro-first order are just buying a 3-pack. That stickiness that we're looking for is great. That's the consumer side. You know, lots of great feedback there. A very, you know, nicely growing patient base. The other base that's growing very nicely and rapidly is the doctor base. We shared with the street in January that back then we already had 6,500 prescribing doctors. That number is growing very nicely, very rapidly, you know, over the ensuing months.
We'll start to share more details probably in our next earnings call around what that number is. You know, for now, good to assume that that group is growing very nicely. You know, if you compare it to more recent launches in eye care, MIEBO, XDEMVY, TYRVAYA, we've got, you know, multiples of where they were with their prescriber base at this stage in the launch. Like I said earlier, same feedback. They like the product, they're using it, they're seeing success in their practices. With that doctor base, sorry, in place, what we're now focusing on is how do we make this a more frequent part of their discussion with more patients?
You know, very clearly this is a category built, and just like with any new market or any new category, you need to get them to switch their habits. How do you make sure that they've got that very simple 10-second, you know, talk track on their new patients? "Here's a new option. It's an eye drop. If you wanna try it, I've got a sample. This is what you can expect." Get them to do that, and as well, make sure that they think about this as not only an option for their emerging ametropic presbyopes, so people that do not have any vision correction that maybe come into an eye care facility for the first time. It works in them real well, but it also works in pretty much every other presbyope. That's the second thing that we're focusing on with our sales force.
Just to cap off, you know what we're doing is really leaning in on that. We're actually expanding our sales force. We're doing that because we see the demand. We see that there's a large, you know, number of doctors that are approaching us that are outside of our current target doctor group that are asking about the product because they have patients coming in. We're also obviously continuing to lean in on the DTC side, and I'm sure as the questions come in that we'll talk about that both a little bit more.
Okay. No, it's okay. From a high level, when it comes to drug launches, obviously key is the drug doing what it's supposed to be doing? Clearly the feedback you're hearing is very positive.
Yeah.
Maybe talk about durability when it comes to VIZZ, maybe talk about some of the other surprises when it comes to efficacy.
Yeah. Like I said, the efficacy is clearly there. If you look at our label, it's for 10 hours, up to 10 hours. You know, we're hearing 11, 12 hours. That's all anecdotally what we're getting back. You know, we can pretty much guarantee, and we saw it in the clinical data, but we can also now base it on real world data that if you're a presbyope, you put a drop of VUITY in your eyes, within 15, 30 minutes, you're gonna be able to read your text messages. You know, that wow effect, as we've always been talking about it, is real. You know, that's what we're hearing from people. If you go on TikTok or any of the other channels, you'll see a lot of people that go, "Wait, what?
An eye drop that can help me see up close again? I didn't believe in it, and I was skeptical, but it does that. It works, it works quickly, it works long, and it works for pretty much everyone. You know, again, very positive feedback on the efficacy.
Of course, when it came to. You talked about the sampling and expectation setting, really allowing a consumer to figure out whether or not they can use this drug. Of course, it also came with some of the early feedback on some of these really transient tolerability issues when it comes to. We say tolerability as a large umbrella, obviously.
Sure.
Some of the initial hyperemia, potential dimness, maybe some of the other AEs that are associated with the class of drugs. Just help us understand what from a sales perspective, you very quickly mobilized to try to help clinicians work through this dynamic. Jus. maybe remind us how you all handled it?
No, absolutely. If you think about this product like any product, you know, there's some potential side effects. Importantly, they're all mild for a majority and are very short-lived and transient. What we saw when we launched the product is that the hyperemia, the eye redness is something that in some patients happens. It's very transient, you know, only lasts for about 30 minutes, if it happens for most patients, and then on day two it's less, on day three it's less. That's something that as we launched the product, we noticed and we very clearly, you know, started to communicate to doctors on, make sure that your patients are aware of that this is something that might happen. It's normal if it happens to you.
It's also gonna go away real quick, and with a couple of days of use, it doesn't really happen anymore. A good thing is that the one that, the, the side effect that we were when we launched most focused on, you know, the headaches, which is what many miotics cause. The aceclidine caused it less than pilocarpine or carbachol, which are the two other miotics. We're actually hardly hearing anything about that in the market, so very pleased with that. Put it all together, it's a, it's a, you know, a drug that works extremely well, that has some mild, very temporary side effects that if they happen with a couple of days of use, you actually very easily get over that. Again, that's what we're seeing in the market.
Yep. Appreciate that you and especially Shawn has always been very transparent with some of the expectation setting.
Yep
... when it came to the sales force and the clinician base. Okay. As you broaden out the launch, the KOL feedback we've heard is that everyone should get a retinal exam before getting this. Obviously, can be viewed as a little bit of a rate limiting step, but it really makes sure you're finding the right patient. There has been a FAERS report around retinal tear, so maybe provide some background on that patient and what has the sales force done with that information?
Yeah. A great question. Especially some of the other miotics carry a risk of retinal detachments and retinal tears. What we already saw in the clinical trial, but more importantly, what we saw in the literature is that aceclidine active ingredient is actually iris sphincter-specific, ciliary sparing. Ciliary muscle is what causes the tension on the retina. We're seeing that in our data now. Like if you look at VUITY at this stage of the launch, they had 34 retinal detachments and retinal tears. We've got the one that happened early on in a patient that had a very long history of retinal issues that had surgery on it several times. That clearly she'd have not gotten this product. You know, for most KOLs are actually saying this is not causal.
I think importantly, what we're seeing now with so much more use, imagine that obviously we've had thousands and thousands of patients on the product on scripts, but also many, many more that are trying it on a sample. We're still at that one case. Now, the background rate is 25 per 100,000. Again, even at the background, you should start to see more. I think that confidence in the product is great. It's showing that, you know, not causing those very serious side effects. I'm very pleased with that. Frankly, in the healthcare community, this was never really an issue. It was something that obviously and got attention from the street. There's not a lot of doctors that really follow this.
These things become issues when your KOLs start to notice it and start talking about it. And clearly from a KOL perspective, they go that, yeah, this is not an issue that we expect with this miotic. You know, we might see it with others, but not with this one.
When we look at maybe the history of retinal detachments not tear, with VUITY, and you look at the prescriptions, you actually see a pretty quick, precipitous drop. Of course, with you all very early days, but we're not seeing that.
Right
We of course still have to ask, do you believe that you're seeing any impact from the retinal tear case when it comes to clinician prescribing?
Yeah. No, we don't. This happened in October and again, it's a one-off case that did not impact us at all. In fact, the opposite is starting to happen now, what people are indeed looking at, hey, with VUITY I saw 34 by now. You know, the background rate is 25 per 100,000 in the general population. It's higher, you know, with as age goes up. All the data points to the fact that this is a very safe product.
Okay. Obviously the initial launch was very clinician-focused, worked on expectation setting, understanding the patient profile. Of course, in Q1, you initiated your DTC-
Yep
... which obviously now turns the launch a little bit more into a patient demand-driven launch for VIZZ. As we work through all these different, let's say, broadening out of the launch, maybe talk about the DTC campaign, how you're kind of bringing patients in?
Yep.
Provide more details about the salesperson, etc .
Yeah, our DTC campaign is obviously an important part of our launch. You know, if you, if you think about the push and the pull, that's the pull that you're really focusing on there. We're very pleased with our spokesperson, Sarah Jessica Parker, that we launched with in January, back end of January. I know many of you are seeing her in your feed. That's one big part on the digital side that we're doing there, and we'll continue to do and do more of it. There's also the unbranded, which is like truly the VIZZ campaign that's happening. We have a lot of patient testimonials out there, and we're continuing to bring in more.
You might see that there's a lot of influencers that are talking about it, a lot of happy customers that are talking about it. This is all what you wrap around any launch, and that's important to know and realize and we've been saying that from the beginning. If you look at all the Nielsen reports or any of the other data, a DTC campaign takes about two quarters to really get hold. We're in that early phase now. Doesn't mean that we're not looking at earlier signals, and we're seeing those. The first signals that you as a company start looking at is you wanna drive these patients to your website to learn more about the product. We're seeing, you know, dramatic increase in our website visits. You know, very clear signals there.
People need to see an ad, you know, five, seven, eight times, then they get activated, make an appointment, go see the right doctor, get a sample, move on to a script. Those early signals, just like on the refill rate, frankly, are very encouraging. You know, the campaign works. It's now all around fine-tuning. Again, this is how any launch works, any category build, works. We're looking at this huge dashboard every day. You know, what ad works well in what, in what city or what, you know, patient groups, how do you replicate that? How do we do, you know, more of something that we see work and maybe turn down something that, you know, is not effective? Again, that's how launches work, we're in the midst of that. That's the fun part.
As a reminder, your spokesperson, Sarah Jessica Parker, does she use the product?
Absolutely. It's actually one of the things that our sales force has used. If you think back to what we said that, you know, people or doctors think about an early prescribing often, it's in the public domain. I can actually share that Sarah Jessica Parker is 60 and uses it daily. Loves it. It's one of the things our sales force tells doctor that you do realize that she's 60 and using it. We shot a commercial or a skit with Jimmy Kimmel a couple of weeks ago. You know, from the team that was there, you were hearing it. You know, people are using it. People are liking it. It's definitely a much broader group than just that ametropic patient.
One thing that we had underappreciated when it came to maybe your website and then connecting patients to the clinician, is, let's say, the level of, I would say focus that came from the sales force, for selection of clinicians went to really ensure that you are maximizing expectation setting. Maybe talk about, the selection of clinicians on the website.
Yep. There's two parts to that. One, I think, who are the doctors that we're targeting? When we created that panel of targeted doctors, we looked at the VUITY launch and picked doctors that had written VUITY and had written multiple times 'cause those are obviously people that are, you know, confident that a eye drop can work. They got disappointed in VUITY, but that's the base panel that we're going after. That's what we're doing with the 88 reps that we currently have in the field.
What we're seeing is that very early on, and especially as, you know, word got out a little bit more back end of Q4 and definitely into Q1, we're getting tens, hundreds of calls a day from doctors that were not in those 15,000 in the group of 15,000, that were asking for samples, that were asking for a rep to get by. There's a lot of interest in the product there that we're not currently seeing, and that's why we're expanding the sales floor. We're adding another 28, 29 reps. We're splitting the country up more. What that's gonna help us do is increase frequency on those doctors that are already prescribing well and are enthusiastic and help them really understand how do I bring this up in a very natural way as I talk to a patient?
How do I think about patient selection in a different way? It will also allow us to actually start targeting doctors that are not in our current panel. That's what we're doing with the sales force expansion, and that's helping us again to get that, you know, push side of the equation even better in place.
Okay. You talked about it, in your opening remarks, but maybe those repeat prescribers, what signals are you seeing there, especially as it relates to VUITY prescribers?
Yeah. No, you know, people like this product, and it fits them well. You know, we're anecdotally starting to get signals of, "Hey, this is actually helping me build my practice." You know, I was with a doctor, two weeks ago that was saying, "Oh yeah, I had this patient come in on Tuesday. I gave him the sample, and on Wednesday, I had four new patients asking about the product 'cause this guy, this patient had, you know, talked about his friends about it." It is a practice builder. It is, you know, helping them with their revenue. They don't like the whole concept of this is gonna cannibalize on my glasses business. It's non-existing.
Those are things that we're starting to harness so that we can actually, you know, bring that out in a more appropriate way and help them understand this is a practice builder.
Remind us the split, when it comes to prescribers between optometrists and ophthalmologists?
Yep. No, all those things are playing out the way that we expected it. 80% optometry, 20% ophthalmology, which is also how our sales force is set up. You also see different patient groups like or how they use it in slightly different ways as you would expect. You know, the optometrist truly sees this as a alternative to get somebody to be able to read up close or see up close. Ophthalmologist sees this as a, "Hey, I've done a perfect LASIK surgery or cataract surgery." Patients are still not happy with their near vision. This is helping them get there, or are using it in other settings.
Okay. You talked about this a little bit in the beginning, but what do you view as most key as early evidence for a presbyopia market when it comes to eye drops? How large is the patient demand that you think it could grow to? Just remind us, what are the early trends when it comes to someone who's using this?
Yep.
It's a couple different.
Couple questions. Yeah
questions. We can come back.
The market is there. I mean, we know there's 128 million presbyopes. If you have a 6% penetration at our price level of $79 at only 5 scripts a year, so 42% refill rate, it's a $3 billion market. Now obviously, that's gonna take time to build. This is a completely new category. It means that, you know, with if that's where you get to with 6% penetration, logically, you know, with, you know, fewer patients on it, this is starting to become a very relevant market. That's what we're seeing at the moment. Very pleased with the refill rates. We're now really starting to or need to really focus on getting more patients to try the product, convert them to people that are using the product and liking it.
That's a very tactical. It's not even a problem. It's a very tactical execution of any launch. Like, if you've got a product that works, you got a market that's huge, you need to connect those two dots. That's what we're doing at the moment. Again, this is something that is tactics. Like, this is why you have a marketing team. It's why you have a commercial team. This is why you watch this every day and figure out what works. What you see is that at a certain moment, that snowball is gonna start picking up speed. I think we're getting to that moment.
Again, very encouraged with what we're seeing on the refill rates, very encouraged what we're seeing with new patients, very encouraged with the feedback that we're getting from those, both doctors and patients on the product.
Okay. When it comes to the transition from patient demand to maybe, patient use, what trends are you seeing with maybe a split by gender?
If you're seeing, stronger, I would say, refills among a certain patient population, age group, maybe help us understand that piece.
Yep. It's getting to be a little bit of a boring story, but also there, what we expected is playing out. It's about 60% female, 40% male. It skews to what's called 45-65. It's definitely use of the product outside of those groups. We're continuing to look into, like, who's using, what's that patient profile. I think the good thing is that it's not one particular profile. This is not a product that plays well in whatever, you know, a 52-year-old female, that, you know, maybe goes to a med spa. It's much broader than that. That's again, what we're, you know, encouraged by, that, you know, this is working. It's working in a large group, people like it.
Okay. As we think about maybe bringing some of these patients into the office into use, how do you think about net pricing as it relates to maybe that WAC of $79?
Yep. The nice thing is that, you know, we obviously have two, and I think you started with that, two fulfillment channels, if you will. The ePharmacy. People can buy a 1-pack for $79 or a 3-pack that works out to be $66 a pack. Then we have our retail pharmacy, where people can pick it up as well, for, you know, roughly that $79. Very different components, but ultimately, it nets to about $60 on our end. Again, we're exactly seeing it play out like that. Very pleased with how we've set that up, and, you know, confident that that $60 is continuing to be our net.
Historically, you've guided to providing refills or some comments on refills by the middle of this year. When it comes to maybe the three versus one-month breakdown of patient use, are you willing to give us some timeframe for when we could expect an update on that?
I think, like, I like to keep my promises. That, this is one that we continue to, you know, think about as that relevance kicks in around the middle of the year. Again, we're seeing a lot of data now. I don't wanna get too optimistic yet, before we truly start to see that playing out. Like, yes, are we seeing patients that got their first script in October, maybe order the 1-pack, and they've ordered a 3-pack now? That's a positive sign. I'll get even more enthusiastic if that patient orders another 3-pack, you know, by the end of the first quarter, 'cause now you're really starting to see that pull-through. I think what I'll stick to for the moment is that, again, we're encouraged by what we're seeing. People like the products. The sampling is working.
Once they move from a sample to ordering a product, they appear to be sticky. I do think that we need a little bit more time to, before we start sharing some real, some real percentages around that.
Okay. Understood. As we consider the near-term investor focus on prescriptions, maybe help us level set, obviously you've talked about the sampling and the vast amount that's required to really get clinicians comfortable.
patients comfortable. How should we think about maybe the dynamics into Q1 with DTC, two times more sampling? Just help us understand near term?
Yep.
what you expect for VIZZ.
I expect this growth to continue at a very nice pace. I mentioned earlier that for DTC to kick in, it takes a couple of quarters. We started that in January. We are seeing, you know, website increase. We are seeing, we're hearing anecdotally from doctors that they're getting more patients in. This is starting to happen, but to see it translated into scripts will probably take a little bit. Not talking about that, and it's a question that we get often. Before we launched, we told everyone, "Don't look at IQVIA and Symphony." You know, I've never looked at Symphony, to be honest, and what we're seeing now is that IQVIA is definitely wrong. Symphony is picking up some ePharmacy scripts, but it's inaccurate, and that accuracy has definitely not increased over in Q1.
Yeah, that's where we currently sit. It's playing out how we expected it. You know, we didn't expect this to follow the same curve as VUITY did. Just to remind everyone, the only way to get a VUITY script, when they turned on DTC, was to actually buy a product, 'cause they didn't have samples in the market. They also had, like, 280 or 290 sales reps out there. This is different. This is a more steady but much more sustained launch. You know, VUITY probably around this time, you know, month 5, month 6, their launch started to go down. What we wanna make sure is that we don't adapt that and then actually obviously continue to go up.
Again, from what I'm seeing, I'm happy with how we're doing it.
Okay. Obviously, still too early for you all to comment, but for Q1, obviously because of the sample dynamics, we're at two and a half million and $40 million for the year. Okay. In the last few moments before we close, offer some time for closing remarks, we do get the occasional question on competitive dynamics with some other obvious eye drop launches in presbyopia. Just help us understand. Our view is that for other drugs to be successful, LENZ also has to be successful. In general, what's your view about the other products?
Yep. No, yeah, I always wanna stay appropriately level-headed in around these questions. The market is huge and could support, you know, several good products. I think we're, you know, a new competitor to the market. It's gonna help to remind the doctors that, "Hey, here's another opportunity." Ultimately, these products are all around efficacy. You know, this is not a product that is a label to label. This is a product where the patient, "Here's a sample. See if you like it." Our efficacy is so dramatically different, like it's not close. There's not a single investor that asks us to explain, "Well, you know, are you guys really better?" I think that's so abundantly clear that as we see it, we welcome everyone to the market.
We're happy to do the, if you will call it, Pepsi challenge against any other product. I'm pretty confident that the effects and the near vision improvement will be very different and a different experience.
Okay. To close, at this valuation, we hear from a lot of folks doing work, trying to understand the VIZZ launch to be more constructive. What's most underappreciated in your view by the street right now? We just talked about a lot of different nuances, but maybe pick a couple key points, and then where do you have the most confidence for VIZZ?
Yeah. I think what's underappreciated is this is a story about new patients and refills. I think today is the first time that we've, you know, shared a little bit more openly that on the refill side, we're encouraged by what we're seeing. Driving new patients in is a very obvious pathway, if you will, that we're driving to, which is, you know, get that habit with prescribers to actually talk about this more often with more patients. That's what's called marketing. That's a very, again, you know, very solvable, execution-driven tactic. We believe in that. Like, we would not invest in an additional 28, 29 reps if we didn't see the demand. You know, we would not do that if we didn't believe that there's an ROI there.
This is us, what you're seeing at the moment, connecting those dots between a product that works and a market that's huge. We're gonna get this right. The good thing is that we have, you know, we're sitting on a very healthy cash balance. As much as I, you know, would love to stock to trade at a different level, I think it's, you know, beyond under appreciated, it does not really matter at the moment. We're not raising money. We're not looking to sell the company. Those are the moments where your share price matters. What we need to do is keep our heads down, execute, drive those scripts up. Share price will follow.
Of course, we and the investors are all learning in real time about the VIZZ adoption trajectory, and of course, incredibly early days. We believe the key question for LENZ is whether or not there's a presbyopia market, and if we do see the patient demand and the motivation to try VIZZ, we do believe the drug will be launching with no real competitors, and we believe that's the most compelling aspect of the stock. Thanks so much, Eef, for your time.
Thank you.
Thanks for everyone to listen in.
Thank you.