Earnings Labs

Corcept Therapeutics Incorporated (CORT)

Q4 2018 Earnings Call· Tue, Feb 26, 2019

$46.96

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Transcript

Operator

Operator

Good day everyone and welcome to the Corcept Therapeutics Conference Call. Today's call is being recorded. [Operator Instructions] At this time, I would like to turn the call over to Charlie Robb. Please go ahead sir.

Charlie Robb

Analyst

Good afternoon, thanks everyone for joining us. Earlier today, we issued a press release announcing our fourth quarter and full year financial results and reviewing our clinical progress. A copy is available at corcept.com. Our full results will be available when we file our annual report on Form 10-K with the SEC. Today's call is being recorded. A replay will be available through March 11, at 888-203-1112 from the United States and 719-457-0820 internationally. Passcode is 6598298. Statements during this call other than statements of historical fact are forward-looking statements based on our plans and expectations and are subject to risks and uncertainties that might cause actual results to differ materially from those such statements expressed or implied. These risks and uncertainties include, but are not limited to our ability to generate sufficient revenue to fund our commercial operations and development programs. The protections afforded by intellectual property. The availability of competing treatments including generic versions of Korlym; our ability to obtain acceptable prices or adequate insurance coverage and reimbursement for Korlym; and the scientific regulatory management and financial risks related to the development of our product candidates. These and other risks are set forth in our SEC filings, which are available at our Web site and the SECs Web site. On this call, forward looking statements will include those concerning our 2019 revenue guidance and expected growth in 2019 and beyond. Our stock repurchase program, physician awareness of hypercortisolism and the selection of Korlym as the best of medical treatment for many patients. The timing, cost and outcome of our lawsuit against Teva Pharmaceuticals USA, and the recently instituted Inter Partes review. The clinical attributes of relacorilant; data from the dose finding portion of our Phase 1/2 study of relacorilant plus Abraxane; and the progress and results of our…

Dr. Joseph Belanoff

Analyst

Thank you, Charlie, and thank you everyone for joining us today. 2018 was a transformative year for Corcept. Our revenue increased by $92 million and our non-GAAP net income increased by $45 million. Our cash nearly doubled to $206.8 million, even after we purchased 1.8 million shares of common stock. Our commercial growth was built on a solid clinical foundation. The increasing number of physicians in all parts of the country who identified patients with Cushing's syndrome and are treating them with Korlym. We expect the number of physicians prescribing Korlym to continue to grow. There are at least 10,000 patients with Cushing's syndrome in the United States. In fact, as I mentioned before, there could be several times that number -- times that number of patients, many who could benefit from Korlym have not yet received it. We took important steps in 2018 to protect and extend our Cushing's syndrome franchise. Charlie mentioned the patent was allowed in December and which we recently included in our lawsuit against Teva the 214 patent. I want to remind everyone that this patent is legally significant because it is medically significant. Patients taking Korlym can sometimes benefit from drugs covered by the 214 patent, which included commonly prescribed antiviral, antifungal antibiotics anti-depressive to medications. The 214 patent and the corresponding instructions in Korlym's label tell physicians how to do this safely. For patients whose health depends on receiving both Korlym and one of these drugs, this is a meaningful medical advance. I am proud that our research made it possible. Of course, this legal matter should not obscure the progress we made in 2018 advancing our plan successor for a Korlym, relacorilant. As many of you know, Cushing's syndrome is caused by a tumor that either produces cortisol or causes the body…

Operator

Operator

[Operator Instructions] We will go first to Adam Walsh with Stifel.

Adam Walsh

Analyst

So, the first question is just on the article that came out that was kind of negative on Korlym and I thought you guys did a nice job in refuting that in an 8-K that you put out. I'm just curious to know, when you know some of the allegations were kind of harsh and directed at physicians. Have you seen or heard of any kind of change in Korlym prescribing behavior based on some of the allegations in the report? That’s the first question. Then the second question is just, are you aware of any other companies working toward a generic Korlym at this time?

Dr. Joseph Belanoff

Analyst

So, first of all, I really do appreciate the question even though of course obviously the basis of it is something that is just you know sort of beyond unfair, both the Corcept and more importantly really to the physicians that we have been working with. The answer is, although, it is never pleasant to have someone cast dispersions on your character in print even if it's in is sort of a one-man band foundation/blog. The answer is our physicians have not to my knowledge been deterred. They continued to prescribe Korlym because for the reasons they prescribed Korlym all along. They thought it was for the benefit of their patients. So, I haven't seen any impact of it other than irritation and having one's good name dragged through the mud for no good reason whatsoever. So, if I have a little bit of energy behind that is because it's just outrageous. So that's the answer to that question. As for another generic entry, no, I mean we would -- first of all, if we had any material news, we disclose it, but I am aware of nothing.

Operator

Operator

We will go next to David Buck with B. Riley FBR.

David Buck

Analyst

I know you've reiterated the guidance for 2019, which obviously, coming off a strong 2018 does imply some slowdown in revenue growth year-over-year as we're in 2019. Can you talk a little bit about the impact, if there is any patient's enrolling in relacorilant trials or competitive trails at Cushing that might be effecting some of the patient counts? And how do you see the dynamic for Korlym this year? There -- are you gaining share chair? Are you losing share perhaps to patients who might be on free drug, research drug? And what -- I know you had it figured the facing action earlier in January. Is that sort of the decision for the year? Or would you reevaluate that going into the second half?

Dr. Joseph Belanoff

Analyst

Thanks, David, I think I followed your questions in there. And so just I want to make sure to get the whole audience understands really what you're asking, which is that, we now have obviously an ongoing study with relacorilant at the same time we have our first generation commercial product available to patients. So couple things to point out. First, is this, the relacorilant study is both in the United States and in Europe and in fact, in the Phase 2 study, I think because Korlym is not available in Europe, the enrollment was about 70% at the European sites. I don't know if that will be true in the Phase 3 study, but certainly they will have a fair proportion of it. Nonetheless, you make a good point. There are places where in fact the patient could in fact -- could have gone a Korlym, could in fact enter the relacorilant study that certainly is a possibility, obviously, hard to know in advance how much that happens. But we try to make our best estimate of that in putting together our revenue guidance. So, our revenue guidance takes into account that possible phenomena. Was there a second question?

David Buck

Analyst

Yes, so I was just…

Dr. Joseph Belanoff

Analyst

You are right. To-date this year, we have not taken a price increase with something that we really look at every quarter and all I can say is the same answer we've always given you, which is it is always something were examining and obviously, we will announce if there is such a change, but to-date we have not made one, but we analyze that on the quarter-by-quarter basis.

David Buck

Analyst

And maybe if I can sneak 1 in as well, Joe. When you switch especially pharmacies, this is, obviously, brought up not by the same one-man band or blog, but there's some conjecture about the change in specialty pharmacies who to obtain and have that might have benefitted revenue. Can you maybe give a review of what might give a decision to change specialty pharmacies and what services are being provided that might not be provided by the open?

Charles Robb

Analyst

David, this is Charlie Robb, I'll answer that one. And the answer is as we switch pharmacies because we thought we knew the teams that had established Optime and we thought they would do the best job working with physicians and patients to get our drug out there and getting into the patient's hands who had been prescribed that dose. That was the motivation for the change. What is the sort of -- I think the implication -- so not your question, but the folks who have sort of ask about that switch is that somehow were using our pharmacy to stuff the channels, so to speak, or somehow inflate or manipulate our revenues. And there are a number of problems with that argument. The fundamental one is, both at Dohmen, our predecessor pharmacy and at this pharmacy, we sell directly to patients. So there is no channel. Every month as a patient requires Korlym, we ship it to them, we are paid, there is no pharmacy purchasing drug from us that we would dump revenue into. So, that's the -- first of all our revenue at the transparent -- the pharmacy is sort of a completely transparent. It has no impact on our revenue whatsoever. And separately, to the extent one wonders whether Optime or Dohmen before it, or in this case let's just focus on Optime is an independent entity. Obviously, our pharmacy is an important relationship for us. And so that reason, it is a matter for our annual audit by our auditors who look very closely at our relationship to Optime to ensure that we are independent, which we are in every sense, legal, financial and otherwise. Does that answer your question?

David Buck

Analyst

I think it does.

Operator

Operator

We will go next to Charles Duncan with Cantor Fitzgerald.

Peter Stapor

Analyst

Hi, this is Pete on for Charles. I have a couple questions on the Phase 3 GRACE study. I don’t know if you can give us a little bit of information about how many sites are been activated, and whether you have identified patients?

Dr. Joseph Belanoff

Analyst

Okay, so I think that's an important point to I'm glad you gave me an opportunity to answer that. Yes, we're really at the very beginning of the study. The U.S. studies are just coming up right now. We're not -- we're going to do that overtime and sort of not identify specific sites, which have come up as they come up causes to keep updating it. The European sites are not yet up. They will expect them to be up in the second quarter and we will go from there.

Peter Stapor

Analyst

And for the randomized withdrawal portion to study, how many patients do you believe is like minimally required in order to be properly powered?

Dr. Joseph Belanoff

Analyst

Yes, so, the answer is somewhere between 65 and 70.

Operator

Operator

We will go next to Matt Kaplan with Ladenburg Thalmann.

Matt Kaplan

Analyst

I want to focus on -- I wanted to focus in on the Teva litigation a little bit and specifically what the two, the newly issued 214 patent kind of gets you in terms of that litigation beyond the I guess the two initial patents and the three other patents that are involved in that litigation with them?

Charles Robb

Analyst

Well, this is Charlie, Matt. I'll answer that. So without commenting on the other patents, right, I think that the difference, the one quality, the 214 patent has that the other patents do not is a direct read on the Korlym label. And that is considered by many people be in especially powerful thing. And that's really the difference. It's the first of our patents that has that express connection. And that's really about all I can say.

Matt Kaplan

Analyst

And then in terms of the sequence and the next steps in that litigation, you mentioned the Markman hearing. When do you think that that will occur? And then I guess I missed the timing of the potential trial that happens?

Dr. Joseph Belanoff

Analyst

Sure. Well, the schedule only goes to the Markman hearing which is -- and doesn’t go to the Markman hearing, rather the schedule ended December 30 of this year, at which date we and Teva have to propose our dates for the Markman hearing. Now so after that, if timing after that best we can give is sort of typical timing. So with the proposed dates submitted at the end of the year typically the hearing will be held not too long after that.

Charlie Robb

Analyst

So it would not be an unusual for example for to be in January perhaps February.

Dr. Joseph Belanoff

Analyst

And then again just speaking typically trial would take place about a year after the hearing, which is why -- so, we are talking January or so of 2021.

Matt Kaplan

Analyst

And just to dig into your pipeline and the timing of the grace study, I guess it's early on in that study, but I guess you had mentioned previously that would take you roughly two years to complete that study. Is that still what your thoughts are?

Charlie Robb

Analyst

Yes. I mean, again, I just sort of run the numbers for you, Matt, just to make people aware. As said we have 60 sites that we expect to come up for the study, it's about 130 patients. So, it's essentially two patients per site. The period of study really in total is approximately nine months. And so that's our best estimate at this point. Obviously, we are at the very beginning of that we will know better as it's going along, but we have the seismic study and a Phase 2 study from which to base our information. But I can just tell you we just finished the investigators meeting there is a lot of enthusiasm so lot of it is based on what we saw in the Phase 2 study. So we are going to work as hard as we can to make that go as quickly as we can because we really do think that relacorilant has some significant advantages that Korlym doesn't and we are really anxious to bring this in the market as quickly as we can.

Matt Kaplan

Analyst

And then just a question on your pipeline and I guess specifically thinking about the Phase 1/2 data that you are anticipating at the upcoming ASCO meeting. What should we look for at that data in terms of the update incremental information from prior ASCO?

Charlie Robb

Analyst

Yes, essentially it's the information which has been added since last year. I know some of it in some sense that kind of given away because the investigators in the ovarian cancer study have already voted based on that data to proceed to the Phase 2 study. So obviously they saw sufficient information to think that it controls really substantial study 180 patients study was warranted and that study has begun. But yes, the specific answer is essentially the update in information in that Phase 1/2 study.

Matt Kaplan

Analyst

And that would drive the decision in terms of initiating a different work in the pancreatic study?

Charlie Robb

Analyst

Yes, as I said, in ovarian cancer, it was very clear. We still are collecting the last data in patients with pancreatic cancer. But maybe it's worth just, if you're interested just a little bit of detail on that. Basically, the information we have seen so far have been very potent responses in individual patients. That does not prove that the drug works. That's just great for those individuals, but there's no comparator group with that. Ovarian cancer, it's easy to form up comparator group. There is known sort of late life therapy might look like and having our drug to it or not is actually produces a distinct result. It’s a little tougher in metastatic pancreatic cancer because sort of sadly it sort of end-stage nothing really works and basically the patients who all ended our study, their choices were essentially hospice or our study. There wasn't much else for them to offer. And in order for the data to be good enough to really proceed to a study that really would be our pivotal study is a big gulp and that's really what were analyzing right now. The last few patients are in that. We obviously -- we will take that or look at that with the hard eye and see where we are. But it isn't that stage and these are cancers, these are particular cancers or one where unfortunately there is not a lot else for these patients and that's a factor and the decision as to what we do.

Matt Kaplan

Analyst

And then last question in terms of the Phase 1/2 trial of the 281 plus XTANDI in the prostate cancer setting. When can we see some initial data from that?

Dr. Joseph Belanoff

Analyst

Well, we're hoping that we'll actually be able to determine the dose that's really the portion of the study right now and then enter on Phase 2 later in the year. So, I can't tell you because it’s not done yet, but I mention to see all this results to myself and getting on to the next portion of the study.

Operator

Operator

We will go next to Alan Leong with BioWatch News.

Alan Leong

Analyst

I want to ask some couple of questions about the antipsychotic-induced weight gain and it's exciting that you've positioned three differentiated Phase 2 trial. Joe, it's been difficult for previous drugs to get traction here and they too looked at the same three conditions. One, weight gain reversal; two, prevention; and three, over an array of a typical antipsychotic, that had -- excuse my question. Can you comment while it's been particularly difficult to achieve treatment effects?

Dr. Joseph Belanoff

Analyst

Alan, I apologize if I didn’t hear everything you said, but is it why other drugs are not work so well is that the question?

Alan Leong

Analyst

Yes, especially, first we've been looking at they're trying to achieve reversal prevention and do it over a range of our antipsychotic. Where have they fallen short?

Dr. Joseph Belanoff

Analyst

I think I understand the question. Yes, well, just to back-up a little bit for context. This really is a thorny problem. You know, I think that many of you know, I know Alan you know that I'm a psychiatrist by training. I actually still see the occasional patient, and these medications while they are terrific in terms of producing psychosis all have this metabolic Achilles' heel where they cause substantial weight gain, insulin insensitivity, and really I think a very diminished or shortened life for these patients and these patients must take the medication. So, it's really is a dilemma, and we've been working on this frankly, for a very long time. And one of my greatest disappointments, frankly, of course, that was that as well as Korlym worked. There was no path forward for it because of the notoriety of the drug is the abortion pill and that was really a very frustrating thing. As you know, we published all that information it's in peer-reviewed journals, but the test wasn't a path forward for Korlym. And we thought that GR antagonism, GR modulation really was an effective treatment we saw it in animals, we saw it in the first studies in humans, but it really took getting to the second generation of molecules that were in the abortion pill to really go forward. Now as to why other people's drugs haven't worked so well, I don't really know that I don't really know the answer to that. But I will secondly what you said it's been unfortunate as a practitioner to see that the other drugs have not worked very well. And so just in all fairness, what we have so far are really two important things. One, we have the actual human data in controlled studies with Korlym indicating a significant effect size and a significant clinical effect. And two, I can tell you that in the animal models CORT118335 is immensely potent compound significantly more potent than Korlym and that's a good sign. We don't have information in humans yet will be getting that as the year goes along, and then on to next year, and my hope is that we will be able to reproduce what we've seen in animals and what we've seen with Korlym, but only time will tell that. We have not yet treated the first patient with antipsychotic induced weight gain with this medication.

Alan Leong

Analyst

How would an SPA label and really how does the FDA overall deal look? Would it differentiate reversal as to this prevention? Or is it playing overall mitigation? Or are we really too early in the bargain so the FDA to have a view?

Dr. Joseph Belanoff

Analyst

The answer is that, before I answer that specifically, let me sort of differentiate things. Because I think this is an important thing people need to think about. This is very different than a weight gain prevention program or weight gain a loss program. There is essentially in the general population. This is really for essentially something that physicians have induced by giving another medication which their patients are required to take. And I think the FDA really looks at that in a very different way. Now I think that it would be wonderful the way the medication work would be to not only prevent weight gain, but actually reverse the weight gain that these medications are causing. And we have been able to show that in animal models that this class of drugs and particularly COR118335 does both. But before we really talk about how the FDA is going to deal with our specific program, we really need to generate human data and obviously we don't have that so far.

Dr. Joseph Belanoff

Analyst

Well, listen, thank you all for calling in. Appreciate everyone's time today and look forward to updating you as 2019 goes along. Thanks.

Operator

Operator

And this does conclude today's conference. We thank you for your participation. You may now disconnect.