We'll turn it over to you to tell us the Pelthos story, and, you know, can chime in with questions at the end if we have time.
Great. Thanks, Jeff, I appreciate it, thanks again for allowing us to share an update with you. It's been a busy 7 or 8 months here, for sure. It's great to share our accomplishments and what we progressed. Please just take a moment to take a look at the legal disclaimers. Just a little bit of highlight of where we are on a high level. Pelthos is a commercial biopharmaceutical company focused on growing differentiated pediatric cutaneous infectious product portfolio that we have. Most recently, we did have a couple of synergistic acquisitions in Xepi and Xeglyze, that we'll spend some time on later. Really, our focus right now is ZELSUVMI, and we'll spend the most time on that.
We do have strong potential revenue streams going forward with, we think, very attractive gross-to-nets that we've shared publicly, and I'll share a little bit today. Importantly, we're really disciplined and looking for a creative, cost-efficient product acquisition model and have an experienced management team here to execute. Our portfolio, as we sit here today, is ZELSUVMI. That's our lead asset, and again, we'll spend the most time on that. That was launched in July of 2025. We were able to acquire Xepi in late 2026, sorry, 2025, and expect to launch that in late 2026. Xeglyze, as we exited 2025, that will be kinda mid-2027 for us.
Just to focus on a few things on the slide, just key data points to ground everybody, our ticker is PTHS. The stock price early December was in the 25s. It's a little lower than that right now, we do have 8.9 million common shares outstanding on a as converted basis. Market cap's a little bit over $200 million. We did have cash at close of Q3 of $14.2 million, since then, we did raise $18 million in a convertible note in November. There was also another debt that we took on through Horizon that is a $50 million top line, we took down $30 million at close.
Importantly, there's been a lot of investment in Pelthos, and actually the predecessor company, the majority of that, which was over $400 million over time. As I mentioned, this is a commercial execution story. Just a little bit about the management team. Myself as CEO, I have over 30 years of experience in the pharmaceutical industry. Majority of that has been on executive teams leading build-outs of start-up companies and successful exits. I spent almost half my time at Salix Pharmaceuticals, where I was there from the initial build-out to the sale in 2015 for a little under $16 billion, and then BioDelivery Sciences, where as President and Chief Commercial Officer, again, another exit when Collegium purchased for a little over $600 million.
Frank's got a lot of experience in leading early-stage companies over 30 years and has raised more than $400 million in his career. Importantly, Sai, our Chief Commercial Officer, has a lot of experience in the sales and marketing side, and a lot of time spent in the derm space, specifically, where he was once the head of marketing for the Otezla brand , a highly successful brand. He was also on COSENTYX and DUPIXENT as well. We have a very prestigious board that has a lot of experience in company formation, especially in commercial execution. Peter Greenleaf is our Chairman. He's also the CEO of Aurinia. Todd Davis is on the board. Ezra Friedberg. I'm sorry, Todd is the CEO of Ligand Pharmaceuticals.
Ezra, Matt Pauls is the CEO of Savara. Rich Baxter, Andy Einhorn is our most recent add, and Andy has a wealth of experience as a CFO and in the finance side of things, and Dr. Rich Melamed, and then obviously myself as well. I'll spend, again, the bulk of the time on ZELSUVMI and our commercial launch and success, but I wanna set the kind of the foundation here around talking about molluscum a little bit. Specifically, ZELSUVMI is indicated for the treatment of molluscum contagiosum in patients 12 years of... sorry, one year of age or older for up to 12 weeks.
It's a topical nitric oxide-releasing compound. We've been able to capture a gas, turn it into a powder at the API state, and then into a gel at the drug product stage, where it's actually applied to patients. Really the only company that's been able to do that over time. Molluscum itself is a highly contagious poxvirus. You can see the picture here. There's three lesions. Just to give you some background, in our study, our largest study, B-SIMPLE4, there was over 20 of these lesions in place on average in the study. See about 6 million new patients a year. It actually self-resolves, but it takes up to 13 months on average for it to resolve, and it's not uncommon for patients to have this for up to 5 years.
This is truly a disease of the young and really those with, kind of immature immune systems. 80% of the patients are 10 and under, 90% are 20 and under. What's really interesting is that, in the age of one to 10, which is really that peak incidence, 73% of those children go untreated. What we see in the claims data is that dermatologists, pediatric dermatologists are more likely to treat in some way. Most of the time in the past, it's been a destructive modality, so probably 50%-60% of the time, they would treat that way...
in the pediatrician's offices, they're more likely to kinda take a wait and see approach and see if it just goes away, and probably only treat 10%-15% of the time. It just doesn't fit as well in their practice to treat, just the dynamics of the practice and, not set up to do these procedures. If you don't treat molluscum, you end up with kind of infection, persistence, and spread, so autoinoculation, and you see where patients will get it behind their knees and then scratch it, and then transfer it to another place 'cause they touched with their hands. It's also very contagious to others.
The literature suggests that if you have more than one child in your household, that there's a 41% chance if one gets it, that one of the others will get it as well. You see a lot of kind of secondary issues with molluscum, and number one is the risk of secondary bacterial infections. You also see a worsening of atopic derm, and itching, and redness with it, and inflammation. When you see prescriptions written, a lot of times you'll see a topical antibiotic, topical steroids that they feel comfortable giving to children, but these are really treating these kinda sequelae to molluscum, not really treating the virus itself. Nitric oxide has been known to have antiviral, anti-inflammatory, antibacterial, and antifungal properties. What's really interesting is you see a big impact on the kids, even though this self-resolves.
See kids withdrawing socially. They have a lot of anxiety when people are asking about this disease state, and especially when they find out it's contagious. They may be asked, the kids may be asked to cover up, to wear extra clothing, to put bandages, may not be able to swim in a pool, contact sports may be eliminated. What we see is, in general, the number one reason that patients are presenting in office is parental anxiety. They're seeing how their children are being treated by others and seeing how the kid is withdrawing due to this. When a doctor goes to decide what they're gonna use to treat this, they take into account a number of factors, and we see basically three things.
It's age of patient, location of lesions, and number of lesions, and that's really important as we kinda talk about the options and how ZELSUVMI fits in. Currently, or before ZELSUVMI was on the market, there were other treatments, all in office, I'd mentioned before. They require visits quite often. They're usually not a one and done. They can take two, three, four, five, six visits. They tend to be more painful, destructive treatments, so the different things they use are cryotherapy or freezing lesions. They can curette them or even blister them off. The issue you have, though, is it's also a burden to the parent and the kid as far as absenteeism goes.
You'll see where people have to be pulled out of school, miss work, to take a child in to be treated multiple times over a great period of time. You also do see some things off-label being used here. You see a lot of kind of homeopathic things like tea tree oil or apple cider vinegar, but those really have unproven efficacy in this space. Kind of thinking back to, and going back to the destructive side of things, you can imagine if there's a 4-year-old who presents with 30 or 40 of these lesions in a very sensitive area, it can get difficult at times to treat these lesions.
It's hard to, you know, curette 30 lesions out from under these, like, a kid's arm, or in their groin area, or behind their legs, for example. With ZELSUVMI, what's really important here and a big differentiator is that we're the first and only at-home prescription treatment. It really empowers the parents to do something about this, and especially in the pediatrician space, where they may say, "Let's just wait and see." They now have something that is safe and efficacious that I can give to the parent to go home and treat. Because typically when you're taking your child in, you want something done, especially when you have anxiety over how they're being treated. ZELSUVMI is a daily, a product that's applied daily, has a really attractive safety profile.
Most common side effects we see are application site pain, which most of it is mild, 12%, and 6% is moderate. You know, that's very different than what you would see if you were looking at things like cryotherapy and curettage. Again, I've mentioned this, it's the first FDA-approved medication that can be applied at home by patients or caregivers. Obviously, it's really important to have not only good safety, but efficacy. In fact, the largest trial ever done in molluscum contagiosum was for ZELSUVMI, or B-SIMPLE4 trial. That trial was over 55 different sites. Across all of our patients in our label, they average about 6.7 years of age.
There were 3-70 lesions. We actually, in those studies, looked at patients from 6 months and above. Again, our indication is one year and above only, though. What we see within the study was that in the B-SIMPLE4 outcome, about a third of the patients had complete clearance at 12 weeks. That's a really high bar if you talk to KOLs and thought leaders. They kind of view this disease state very much like they do acne and psoriasis, where if you can reduce lesion count by 50%, it's clinically meaningful.
As you look at these, some of these secondary endpoints and subanalysis, you can see that mean lesion reduction and median lesion reduction had a large significant difference between the active ingredient ZELSUVMI and the vehicle, and importantly, works very quickly. You start seeing a difference even at week two and week four, and then it spreads that differential spread over time, especially on the median lesion count. What's really important again, is that the thought leaders will tell you that if you can get to at least 50%, that's clinically meaningful. In fact, in this study, when we went to parents or caregivers, who didn't have complete clearance when they were treated, their kids didn't have complete clearance, and asked them, was it clinically meaningful to them?
Almost 80% said, "Yes, it was. It made a difference in my child's life." And what's also very difficult about these studies is, if a patient presented with 20 lesions in the study, we treat those 20 lesions. If those completely cleared, but another lesion or two popped up, that is not complete clearance, and so it doesn't just map those original 20, it's including any that may present also during that time. That's the profile of the drug, and now let's talk a little bit about kind of our execution and what we've seen commercially. We have our own sales force that we built out. We actually started with 50 sales representatives, and we launched on July 10th.
We found that out of the gate, we had really nice uptake, and the idea here was to get into market, see what the uptake curve looked like, what market access looked like, and then decide to invest more. In fact, we had such a nice uptake in our business, we saw that within nine weeks, we were paying for our sales force. We decided to kind of reinvest into the commercial team and added another 14 territories. As an example of a couple areas that we didn't have covered, we didn't have St. Louis, Kansas City, Minneapolis, Seattle, San Fran, Utah, Salt Lake City, Utah, Memphis, Oklahoma City. Some very large metropolitan areas that, again, out of the gate, we didn't cover.
We're in the process of finalizing this expansion. We'll be at 64 as we go into March. We spend about half of our time calling on dermatologists and pediatric dermatologists. The other half is on pediatricians. We're able to cover about 10,000 of the top molluscum treaters with that group. Alongside that, we also built out a very strong sales training, marketing, and commercial operations and market access team. A couple of things that we're working to do is increase our awareness, not only across HCPs, healthcare providers, as well as patients. I think one of the things that works really well for this specific disease state and drug is that it's young families, they spend a lot of time on social media.
We can do a lot of digital marketing there that's very cost effective and targeted. You can see us on all the social media platforms. We're out at all the different important medical conferences as well. One thing that's been, we think, hugely successful is our YouTube promotional video that we launched on December 11th. As we sit here today, we're about at about $3.5 million views on that commercial, with really good view times where people are actually watching it and paying attention. And that number has been growing every day as we, you know, every day since we've launched it. A little bit about our uptake. Our uptake in Q3 and Q4 has not only met but exceeded our expectations.
You see there were 27, a little over 2,700 units dispensed or prescribed in Q3 of 2025. We announced this at our Q3 earnings call. That generated about $7.1 million of net revenue for us. Of that, about $4 million was demand, and $3 million was getting stocking out into wholesalers. In Q4, we experienced 129% growth quarter-over-quarter in our units. We have guided towards our GTN in Q3 was 25.3%.
We do see that going up a little bit in Q4, due to the fact, a couple of things, our Medicaid patient mix went up a little bit during the quarter, also we did enter into our first PBM agreement in just on December 1st, with a large PBM that was kinda under indexing, and it was the most difficult to get a prescription through. We did invest there, so it went up. Going forward, for 2026, we believe we'll be in that high 30% range of GTNs. We can't share at this time the Q4 revenue. Well, we'll be reporting our earnings here in about three weeks. Importantly, we have also seen significant uptake in our prescribers.
You can see those are unique, so the number of HCPs that wrote at least one script in each of those quarters, total over 2,800 through the end of the year. Based on the recent Symphony data, we're now approached with just over 3,500 prescribers of the product, so we're continuing to build. As a matter of fact, the last data point, the week of 2/13, we added more new prescribers that week than we ever have. Also on the same theme here, we hit all-time highs on our NRx count that week, TRX units at 620, which puts us at about a $65 million gross run rate for a yearly run rate.
Those are gross dollars based on our WAC and 620 units being dispensed. Importantly, we haven't just given away script here. These are also paid-for scripts. We do think not only the sales force is a catalyst for us, but our market access improvement over time here. Again, we did that contract as we exited Q4 on the commercial side, we were at 49 as we entered January. We're probably in the low to mid 50% now for commercial lives covered. Medicaid is now probably over 90% covered lives. We have very good coverage there. As we exited the year, you can see our payer mix.
It was predominantly commercial and cash and assistance program, Medicaid being about 28.9%, very low Medicare utilization here. Again, this is the disease, the young, for the most part. That's ZELSUVMI. Again, we're real excited about where the product's going and where it's heading. We've really built some nice momentum over the last two or three weeks coming out of the holidays, which is kind of a downturn for molluscum. We did an announce Xepi being acquired, this was in November. Just a couple facts about Xepi, but it is an approved asset with exclusivity out to 2032. It treats impetigo, which is the number one skin infection seen in children. It also represents about 1%-2% of all visits to the pediatric office.
We like this because it has strong synergy with our existing commercial infrastructure for ZELSUVMI, really not having to add more than a couple headcounts across the organization, and those will even overlap with Xeglyze, that I'll talk about in a second. But it's basically the same call point for our sales force. This is a highly efficacious product that would been put on the back burner and wasn't being manufactured for a bit, and we were able to acquire it at a very fair rate, I think, upfront. And right now, the kind of the go-to treatment here is Bactroban topical or a generic mupirocin, the generic for Bactroban.
What we hear and what we're seeing is that there's huge concerns over mupirocin resistance right now, where it's not working as well, in treating impetigo, even very just common, non-complicated impetigo. They're having to use more topical antibiotics and other therapies too, so we think this is a nice fit. We see about 3.3 million-3.5 million new cases of impetigo on a yearly basis. The other product that we're really excited about adding, again, we announced this at the end of December, early January, but it's Xeglyze for the treatment of head lice. Again, this is a product that's FDA-approved, but it's never been launched. We only paid $1.8 million for it. There are no royalties or milestones attached to it. Exclusivity out to 2034.
There are about 6 million-12 million cases of lice each year in the United States, and kind of similar story that I gave with mupirocin, but there's increasing resistance to the current therapies being used to treat lice that are OTC and prescription. What's really unique about this product is it's truly, in its label, a one-and-done product. What I mean by that is you use it, put it on for 10 minutes, rinse it out, no need to comb out the eggs, because it works against the lice and eggs, both. A lot of the other products, if you use them, you have to treat, wait 7-14 days and see if you need to treat again, because they don't kill the eggs necessarily. Again, it gives really strong synergy with our current infrastructure.
Targets are the same. We will not change our targets for ZELSUVMI. We anticipate launching this in the back, very back half of the first half of 2027. We have the next 10 months to focus on ZELSUVMI, and then 6 months with ZELSUVMI and Xepi, and then we'll layer in Xeglyze. Just a really brief, our NITRICIL platform, which ZELSUVMI is built around, there was a lot of work done on that platform over time, other indications. Just want to be clear that the top 3 indications here actually belong to Ligand, the rights to those. Ligand was our Pelthos within a subsidiary, as a subsidiary of Ligand for a long time. We do have the rights to external genital warts. We're evaluating whether that's somewhere we would like to be or not.
Then we're also gonna evaluate if there's other indications, but that would also entail us going back to Ligand, and we would have to in-license those. There's surely an opportunity for us there, if we like it. We actually make the API also as a company, and Ligand is a substantial shareholder of their company as well, and has two board members on our board. Just real quick, their, our Channel, Pelthos had merged into Channel on July first. There were some legacy products within Channel, looking at sodium channel modulation for the treatment of pain, specifically Nav1.7 pipeline. There's three different programs here.
The one that I think right now is the most in front of us, and we think promising, is the eye drops for chronic and acute pain. But right now, what we're working to do is find a way to optimize or monetize this for the company going forward, and ultimately would like to get the cost of it off, get it off our balance sheets going forward, but also retain some upside and value going forward. Obviously, it sits outside kind of where we're focused as a core company right now, but do believe there's value here going forward for the company and for shareholders. Just to summarize, we have a portfolio of FDA-approved products. I think what's unique about them is they're all NCEs.
They're not reformulations or 505(b)(2)s. We also have patent lives, specifically with ZELSUVMI, which I didn't mention earlier. We have patent life to 2035, currently composition of matter, but also the chance for that to be extended as there is patent term extension pending, that would take it to August of 2037. Also mentioned we make the API. There's a lot of know-how there, institutional know-how there to make it, so we think that's also another challenge. Really unmet needs in the markets we went into, we were really careful about looking at the markets and seeing if we could truly provide value to patients and healthcare providers if we acquire these products. Again, barrier to entry here around, you know, the patents and also the manufacturing.
It allows us to have some leverage here. We've got now we built out our infrastructure, commercial infrastructure, sales team, marketing, training, and now we're gonna be layering in multiple assets on top of that and really diffusing the cost over multiple products. We're really in a strong financial position. We mentioned, kind of where we were at end of Q3. We've also added additional capital over the last 3-4 months that we feel provides us a really good runway here going forward. We're also positioned with what we built out to be potentially a partner of choice for other acquisitions and opportunities. As we go forward, we'll continue to evaluate. We're very busy right now, very focused on getting ZELSUVMI right.
You know, if the right opportunity, the right thing came in front of us, we would definitely evaluate it. We mentioned the pipeline on the back end there. There's We think there's a chance to get some value out of the Channel clinical programs going forward, but also the possibility to work with Ligand, you know, on a go-forward basis on any clinical stage programs for the NITRICIL platform, the ZELSUVMI. With that concludes my presentation. Really appreciate it, and just appreciate the opportunity to share. Like I said, it's been a very busy eight, seven, eight months for us, but also very successful, and really excited about continuing to be able to share how we progress our business going forward.
Great.
With that, Jeff?
Yeah, fantastic. Thanks, Scott. You know, obviously, ZELSUVMI's off to a strong start. It only launched in July, if my memory serves.
That's right.
I guess the question, what are you seeing in terms of physician reception? You really have these two different populations. You've got the pediatricians who weren't treating before, and then the derms, pederms, who were treating and now potentially have another option. I guess looking at those two different groups of physicians, what is the reception that your sales reps are getting here? You know, how enthusiastic are they about the product? What's sort of the pushback, if you will, on, you know, initially piloting patients and then broadly adopting?
I guess first and foremost, what's really important here is we've been getting positive feedback just on the receptivity by the parents and the patients. They think it's kind of a novel way of getting there. They like the fact that it's at home versus having to go into the office, that's resonated across all the different eight types of physicians. Also, the nurse practitioners and physicians assistants are actually making up almost 50% of our prescriber bases in that kind of NPPA world. I think universally, we've heard that they've been very happy with the rate of clearance, number of lesions being cleared, and also just the utility, be able to, again, not having to go into the office, drag the kid in, into the office there.
I don't think it's been all that different across the specialties, Jeff, but I think, you know, one of the opportunities I think we have is to get, you know, the pediatricians more comfortable with actually treating and understanding the value of treating versus just watching. Interesting, about probably half the patients who get to a derm are referred by a pediatrician because they said, "Let's just wait and see." The lesions multiply, and all of a sudden, the parent's like: I need to do something, and then they pass them on. We'd like to be able to, like, kind of stop that referral process, if that makes sense, and get a treatment.
Excellent. Thank you very much, Scott. Unfortunately, it looks like we are up on time. Really appreciate the time and the update here. Obviously, looking forward to updates on scripts and progress when you guys report your year-end update in a couple of weeks. Hope you guys have some great meetings for the rest of the conference.
Thanks, Jeff. Appreciate the opportunity again.
All right.