Earnings Labs

Jazz Pharmaceuticals plc (JAZZ)

Q1 2019 Earnings Call· Wed, May 8, 2019

$201.92

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Transcript

Operator

Operator

Welcome to the Jazz Pharmaceuticals Plc First Quarter 2019 Earnings Conference Call. Following an introduction from the company, we will open the call to questions. At this time, all participants are in a listen-only mode. [Operator Instructions]. As a reminder, this conference call is being recorded. I will now turn the call over to Kathee Littrell, Head of Investor Relations at Jazz Pharmaceuticals.

Katherine Littrell

Analyst

Thank you, Joelle. And thanks to those of you joining our investor call. Today, we reported our first quarter 2019 financial results and reaffirmed our financial guidance for 2019. The press release and the slide presentation accompanying this call are available on the Investors section of our website. On the call today are Bruce Cozadd, CEO, and Matt Young, CFO. Joining for the Q&A session are Dan Swisher, President; Mike Miller, our Executive Vice President, U.S. Commercial; Allen Yang, Head of Clinical Development and Acting CMO; and Jed Black, Senior Vice President, Sleep and CNS Medicine. I'd like to remind you that some of the statements we will make on this call relate to future events and performance rather than historical facts and are forward looking. Examples of forward-looking statements include those related to our future financial and operating results including 2019 financial guidance and goals, future growth and growth strategy, product sales and volumes, supply challenges, product launches, regulatory approvals, ongoing and future clinical trials, and other product development activities and corporate development efforts. These forward-looking statements involve risks and uncertainties that could cause actual events, performance and results to differ materially. They are identified and described in today's press release and the accompanying slide presentation and under risk factors in our Form 10-K for the year ended December 31, 2018 and our Form 10-Q for the quarter ended March 31, 2019 which we will file shortly. We undertake no duty or obligation to update our forward-looking statements. On this call, we discuss non-GAAP financial measures. We believe these measures are helpful in understanding our past financial performance and potential future results. They are not meant to be considered in isolation or as a substitute for comparable reported GAAP measures. Reconciliations of GAAP to non-GAAP financial measures discussed on this call are included in today's press release and slide presentation available on our website. I'll now turn the call over to Bruce.

Bruce Cozadd

Analyst

Good afternoon, everyone, and thank you for joining us. The first quarter of 2019 was highlighted by clinical, regulatory and operational progress. In March, FDA approved Sunosi for the treatment of excessive daytime sleepiness or EDS in patients with narcolepsy or obstructive sleep apnea. We're looking forward to bringing this novel, differentiated therapy to these underserved and undertreated narcolepsy and OSA patient populations. We launched Xyrem for the pediatric indication in March following our successful implementation of the Xyrem REMS for pediatric patients and their caregivers. On the R&D front, we were pleased to announce positive topline results from our JZP-258 Phase III study in narcolepsy patients and we look forward to submitting data for presentation at a Fall 2019 medical meeting and discussing our planned NDA submission with FDA. In addition to these significant accomplishments, we delivered strong top and bottom line growth, while continuing to make substantial investments in global R&D and commercial operations to advance our pipeline, support multiple product launches and growing strength in our commercial portfolio. After providing details on some of our key commercial, regulatory and R&D activities, I'll turn the call over to Matt to update you on our financials. In March, we received FDA approval of Sunosi or solriamfetol, the first dual-acting dopamine and norepinephrine reuptake inhibitor to treat EDS associated with narcolepsy or OSA. Sunosi's approval is an important milestone for Jazz as we continue to develop and bring to patients new treatment options for chronic and often debilitating sleep disorders. We are preparing to launch Sunosi midyear following a DEA scheduling decision. Launch preparation activities are in full swing our sales force expansion is complete. Our sleep sales representatives will promote Xyrem and Sunosi following launch. We are actively engaged with payers to communicate the value of Sunosi as we…

Matthew Young

Analyst

Thanks, Bruce. And good afternoon, everyone. In the first quarter, we continued to deliver strong top and bottom line growth, in line with our current expectations. Revenues increased 14% to $508 million compared to $445 million in the first quarter of 2018 due to the strong growth of our key sleep and hem/onc products. As a reminder, first quarter 2018 net sales included Prialt, which we invested last September. Xyrem net sales for the quarter were $368 million, up 16% from $317 million last year. For 2019, we are maintaining our Xyrem net sales guidance in the range of $1.53 billion to $1.57 billion and our expectation for mid-single digit volume growth. Turning to Erwinaze, net sales for the quarter were $61 million, an increase of 20% compared to the same period in 2018. We expect significantly reduced product availability in the second quarter, as well as further supply disruptions throughout 2019, creating quarterly variability depending on the timing and extent of those disruptions. We are maintaining our Erwinaze net sales guidance for 2019 in the range of $160 million to $195 million. First quarter Defitelio net sales were $42 million, up 18% from $35 million in the same period of 2018. We're maintaining our guidance for Defitelio net sales for this year in the range of $155 million to $180 million. Vyxeos first quarter net sales were $29 million, an increase of 10% over the first quarter of 2018 and an increase of 13% sequentially from the fourth quarter, primarily due to the contribution from EU sales. We are maintaining our Vyxeos net sales guidance for this year in the range $120 million to $150 million. This guidance assumes our commercial initiative successfully lead to increased growth in the US in the latter half of the year. We're encouraged…

Katherine Littrell

Analyst

Thank you, Matt. We kindly request that you limit yourself to one question and a follow-on on the same topic during this call, so that everyone has an opportunity to ask a question today. We will gladly address any additional questions after the call or you can reenter the queue. With that said, operator, please open the line for questions.

Operator

Operator

Thank you. [Operator Instructions]. Our first question comes from Brandon Folkes with Cantor Fitzgerald. Your line is now open.

Brandon Folkes

Analyst

Hi. Thanks for taking my question. On Sunosi, could you share some of the feedback you've had from your initial engagement with payers to date?

Bruce Cozadd

Analyst

Yeah. Brandon, we're probably not going to have a lot to say on that. Maybe Mike can tell you a little bit about what we're trying to accomplish in those discussions, but we're probably not going to say a lot in detail. Go ahead, Mike.

Michael Miller

Analyst

Yeah, Bruce. As you said, we are in early discussions with the payers. Our goal really is to create access. There is about 10%, 15% open live count right now with about a six to nine-month moratorium by most payers. But I think, importantly, meanwhile, while we're working with the payers to gain access, we'll be offering a suite of services that will allow really engineering successful trial with these patients and Sunosi.

Brandon Folkes

Analyst

Okay. And maybe just one follow-up on that. Maybe if I frame it a different way, would you characterize your discussions so far as in line with what you would have expected?

Michael Miller

Analyst

As I said, I discussions are early and we will give you an update, I think, of the Sunosi investor call later on.

Brandon Folkes

Analyst

Okay, fair enough. Thank you.

Operator

Operator

Thank you. And our next question comes from Umer Raffat with Evercore. Your line is now open.

Umer Raffat

Analyst · Evercore. Your line is now open.

Thanks so much for taking my question, guys. My question is on pipeline, but I'll have a question and a follow-up on two different things. My first one is on – an easy one – solriamfetol. Can you maybe just lay out for us the efficacy relative to modafinil or armodafinil just so we sort of have a sense for that, especially as we head into launch? I don't know there's a clear answer to that, but I just want to hear it from you. And the second one was on the CD123 bispecific that Macrogenics has, they noticed that in AML setting, they don't have any responses if it's relapsed AML and they pointed to low CD123 receptor density as being a reasons. So, when they put their bispecific again, they didn't see much responses. What I was curious about is in the dose expansion that's happening with your ABC, it all appears to be happening in relapsed AML setting. And I just wanted to understand that better and have you seen responses in relapsed AML as the CNS is going into that expansion cohort? Thank you.

Bruce Cozadd

Analyst · Evercore. Your line is now open.

Okay. Umer, maybe I'll have Jed take the first part of your question, which is really around solriamfetol efficacy, what we see and maybe a comment about modafinil efficacy. Just as a reminder, we've not run head to head trials. We're talking about trials in similar patient populations with similar endpoints.

Jed Black

Analyst · Evercore. Your line is now open.

Yeah. The question is something of course that we have been interested in from the time we started looking at it. And it was the efficacy profile of solriamfetol in the concept study and the follow-up study that really got us excited about it. And we've seen those data now replicated in the pivotal trials very nicely. And so, as Bruce noted, there's no head-to-head data. I would refer you to the literature on modafinil, look at the endpoints with modafinil and armodafinil versus solriamfetol. And I think that that tells the story.

Bruce Cozadd

Analyst · Evercore. Your line is now open.

But, again, our trials and typically trials of other agents have measured both objective endpoints like the maintenance of wakefulness tests, they've measured subjective endpoints like the Epworth Sleepiness Scale. And in our trials, we see, for solriamfetol, really strong efficacy across the endpoints, across time of the day from early in the day to late in the day and we see that effect sustained when we do longer-term follow-up studies with patients.

Jed Black

Analyst · Evercore. Your line is now open.

And a very consistent dose-response profile.

Bruce Cozadd

Analyst · Evercore. Your line is now open.

So, with that, maybe I'll take the second part of the question and direct it over to Allen Yang. Just as a reminder, the antibody drug conjugate program we're referring to is an ImmunoGen program. We do have a relationship with ImmunoGen. We have the option to opt into to one or more of three programs they have, two of which have been identified. But just as a reminder, we're not running these programs ourselves. Alan, do you want to comment on the question.

Allen Yang

Analyst · Evercore. Your line is now open.

Sure, Bruce. Thanks. So, Umer, I think I'll take your second question first and comment on additional data. Again, as Bruce alluded to, this is an ImmunoGen program that we're collaborating with them. They've been excellent collaborators. They've given an update of their data at the most recent ASH meeting for both of their programs. And I think the question – your first question alludes to CD33 expression levels compared to CD123. As you know, there's been multiple agents directed to both of those antibodies, antibody drug conjugates bispecifics, et cetera. And CD33 is more highly expressed. If you look at all of the data in aggregate from different molecules, it's very interesting that CD123 seems to be a very exciting target. Whether it's less amenable to relapse refractory disease because it's expressed at lower levels compared to CD33, I think that that data is still immature, especially with the ImmunoGen compound or overall in the field. I think it's challenging. If you look at Mylotarg and CD33, it took fairly large studies to prove its benefit in upfront disease, although they could see responses in relapse refractory. And I think the same thing is true of CD123. overall we're very happy with both of these ADC conjugates. I think they have single-agent activities and there is a pathway to approval for both of these agents. They are single agents because there's precedence for that, but then there's a possibility of combinations. And those combinations could include hypomethylating agents, which is traditionally done, or combinations with Vyxeos. And I think that's why we're so excited about these programs.

Operator

Operator

Thank you. And our next question comes from Jason campaign with Bank of America Merrill Lynch. Your line is now open/

Jason Gerberry

Analyst

Hey, there. Thanks for taking my questions. Just a couple on JZP-258 regulatory strategy. Would you anticipate getting orphan drug status? I know that Avadel got orphan drug status. So, I would think that the population parameters would enable you to get orphan status, but just curios where that stands? Do you intend to use the priority review voucher for this application and are there any issues with getting your REMS sorted out before you can actually file this product? Any color you can just provide on those regulatory elements of 258 would be really appreciated.

Bruce Cozadd

Analyst

Yeah. Jason, good questions. I don't think we're going to comment in any great detail upon our regulatory strategy. Obviously, we studied JZP-258 in the same patient population as sodium oxybate or Xyrem, which does have orphan drug exclusivity. On the PRV, we haven't said which program of our current programs or programs we could bring in the future through corp dev would be the best use of that asset. So, no comment at the moment. And in terms of REMS, we certainly are working to make sure we submit as part of our NDA the best REMS to ensure that physicians and patients understand how to access this new medicine and that we make that as seamless as possible as we can for our prescribers and patients, given our long experience including some improvements to our REMS over the years. So, we want to get that right. I wouldn't describe that as issues. I would just describe that as making sure we thought it all through before we submit to FDA.

Jason Gerberry

Analyst

Bruce, can you at least comment, would the specialty pharmacy that you use for 258 be the same for Xyrem?

Bruce Cozadd

Analyst

No comment at this time.

Jason Gerberry

Analyst

Okay.

Operator

Operator

Thank you. And our next question comes from David Amsellem with Piper Jaffray. Your line is now open.

David Amsellem

Analyst · Piper Jaffray. Your line is now open.

Thanks. So, just on Xyrem, I believe you have said in the past that contribution from ped is in the guidance. Is it possible for you to talk about how much contribution either qualitatively or quantitatively will be there? And then, just remind us how you're thinking about the opportunity. That's number one. And then, on Sunosi, I know you're talking about additional indications down the road. Are you exploring any indication that's outside of the sort of wakefulness promoting agent realm? Thanks.

Bruce Cozadd

Analyst · Piper Jaffray. Your line is now open.

So, David, on Xyrem peds, we haven't broken out how much of our guidance is specific to that. And there are a number of reasons for that, including the fact that, of course, we were aware that some pediatric patients were being treated before we got the formal indication from FDA last year. So, there is some pediatric business in there already. And, obviously, we're early in this launch, but we're very excited to get this data out. People haven't had data before that gave them a good sense of how this drug performs in this specific population and we know there are a significant number of pediatric patients who are undiagnosed and we hope now successfully treated with narcolepsy. So, no specific guidance, but we think could be very meaningful these patients and provide some growth in the future. On Sunosi, we're obviously aware that agents like this, although ours is a new mechanism of action. Have successfully been explored in conditions outside of wakefulness and we're contemplating that and what our best path forward is. As I said, our intent is to come back midyear with an indication of where we're going next as we continue to explore the full potential of solriamfetol.

David Amsellem

Analyst · Piper Jaffray. Your line is now open.

Thank you.

Operator

Operator

Thank you. And our next question comes from Ami Fadia with SVB Leerink. Your line is now open.

Ami Fadia

Analyst · SVB Leerink. Your line is now open.

Good afternoon. Thanks for the question. I had two follow-ups to topics that were discussed. First, just with regards to Sunosi, you've mentioned the 6 to 9 month timeframe before which payers got to cover products. How should we think about the launch trajectory of the product in context of that? And when should we start to expect meaningful revenues into next year? And then, just with regards to JZP-258, can you compare and contrast maybe the potential for – the risk benefit around switching patients from Xyrem to 258 depending upon whether or not you use a separate specialty pharmacy to launch 258? Yeah, I think that summarizes the question. Thank you.

Bruce Cozadd

Analyst · SVB Leerink. Your line is now open.

So, on the first part of the question, Ami, the 6 to 9 month moratorium was something we built into our thoughts for guidance for this year. Recall that when asked about Sunosi guidance, we said minimal revenues in 2019. There are a lot of other things we need to accomplish earlier than launch to make sure people are aware of this treatment option, its benefits and to do some education particularly in the OSA market about the importance of recognizing and treating EDS. And at the time of our investor call around launch, we'll want to give you some more insight into metrics you can use and we'll be using to gauge early progress in that launch. On the JZP-258 question, I'm quite sure I followed what the question is. You'll recall in the study that we just conducted, we included patients who were naïve to oxybate who then went on to JZP-258. We included patients who were on Xyrem already and were switching to 258. And, obviously, one of the things we're trying to learn, although this was not the primary objective of the study was how patients could, in fact, move from Xyrem to 258 and we'll take all that learning into account as we figure out again our launch plans, our REMS plans, our distribution plans. But I don't view that as a significant concern. Just, again, something where we want to provide good information.

Ami Fadia

Analyst · SVB Leerink. Your line is now open.

All right, thank you.

Operator

Operator

Thank you. And our next question comes from Gary Nachman with BMO Capital Markets. Your line is now open.

Gary Nachman

Analyst · BMO Capital Markets. Your line is now open.

Hi. Good afternoon. On Vyxeos, could you give us a split between the US and EU in the first quarter? It sounds like more of the growth is coming from the EU. So, how's the market forming there? And talk about why you're confident you'll be able to return to growth in the US over the course of the year. Are you getting more traction with reimbursement, use in the community setting? Just some more detail on that. Thanks.

Bruce Cozadd

Analyst · BMO Capital Markets. Your line is now open.

So, Matt, I don't know if we're providing a specific breakdown. Remember, we're showing significant growth in Europe, in part because we're comparing back to the periods where it was on the market or it was just becoming available. So, not surprising we're seeing growth there, although I have to say we're very pleased with how things are going early on. Matt, anything else you want to say on that.

Matthew Young

Analyst · BMO Capital Markets. Your line is now open.

No, I think we said early on in our guidance that Europe to represent up to 10% [ph] of the contribution. It's running a little ahead of pace. And so, I think we feel good about the contribution from the EU thus far in the quarter and, in particular, also against the health technology assessments and, ultimately, on our path to secure reimbursement across a bunch of geographies that were executing well as it relates to that. so, dynamics are setting up well for success in Europe, but we did see growth in both markets.

Bruce Cozadd

Analyst · BMO Capital Markets. Your line is now open.

And, Mike, maybe you can comment a little bit about what your expectations are for progress across the year.

Michael Miller

Analyst · BMO Capital Markets. Your line is now open.

Yeah. So, we continue to target the academic centers and have expanded our reach into the community where about 40% AML maltreatment exists today. And most of our new account growth is actually coming out of the community area. The AML market is more noisy than it has been in terms of promotional activity, but we feel very good about where we sit as the standard of care for fit secondary AML where we have an OS benefit against 7 plus 3 [ph] and we can derive meaningful complete responses that translate to good transplant outcomes.

Gary Nachman

Analyst · BMO Capital Markets. Your line is now open.

Okay, thank you.

Operator

Operator

Thank you. And our next question comes from David Risinger with Morgan Stanley. Your line is now open.

David Risinger

Analyst · Morgan Stanley. Your line is now open.

Thanks very much and thanks for all the details. I'm just curious about your expectations and plans to compete with the [indiscernible]. So, are you expecting that product to launch later this year? And if so, do you need to do anything with your commercial efforts to ensure your rate of [indiscernible] starts is high and so on and so forth? Thank you.

Bruce Cozadd

Analyst · Morgan Stanley. Your line is now open.

Yeah, David. I don't think we've got any particular insight into [indiscernible] regulatory progress other than the company that has the rights to the drug has said they intend to get approval and launch this year. In terms of our commercial efforts, I think we remain focused as we have them on ensuring people understand the benefits and risks of our product, how to use it safely. As you know, we've continued to grow the product many years after initial introduction. We've continued to study the drug whether that's through the recent pediatric trial, studying oxybate in new and we think better form with the lower sodium content both in narcolepsy and, of course, we have an idiopathic hypersomnia trial going as well. And we want to make sure people understand what makes our drug so efficacious. We know that narcolepsy is underdiagnosed and undertreated. A different treatment option being available for patients may expand treatment, could even lead to improved diagnosis of narcolepsy, and I think that's a good thing for narcolepsy patients.

David Risinger

Analyst · Morgan Stanley. Your line is now open.

Thank you.

Operator

Operator

Thank you. And our next question comes from Greg Fraser with SunTrust. Your line is now open.

Greg Fraser

Analyst · SunTrust. Your line is now open.

Thanks very much. It's Greg Fraser on for Gregg Gilbert. Vyxeos, are you still anticipating interim data from the collaborative study with MD Anderson this year and how are you thinking about the potential importance of that data?

Bruce Cozadd

Analyst · SunTrust. Your line is now open.

Allen, you want to take that?

Allen Yang

Analyst · SunTrust. Your line is now open.

Sure, Bruce. Thanks. Yeah, again, I think the challenge here, Greg, is that we don't control that data. That's an MD Anderson study with collaboration. Our hope is that they enroll very quickly, but again the final decision to present the data or not in an interim form rests with MD Anderson. In terms of importance, I think it's incremental. I think they are doing two very important combination studies for us. The combination with Mylotarg and a combination with venetoclax. There will be other studies that will be coming online as well. But, again, combination data is just part of our strategy. We plan to make Vyxeos the backbone of AML therapy. So, there will be other additional studies that we'll have to do looking at younger patients and sort of lower-risk patients as well.

Operator

Operator

Thank you. And our next question comes from Ken Cacciatore with Cowen and Company. Your line is now open.

Ken Cacciatore

Analyst · Cowen and Company. Your line is now open.

Thanks, guys. I just want to drill down a little bit on the Sunosi opportunity. Let's say, wondering if you have any data on the percent utilization of Provigil and Nuvigil in that market? And then, also maybe your sense from speaking with clinicians on the failure rates of Provigil and Nuvigil. So, as you go through managed care, obviously, we want the best tiering possible, but I would think that just getting on formulary if there is high rates of failure in the first line agent would still be not bad positioning for you. So, can you give us a little bit of context around that. Thank you.

Bruce Cozadd

Analyst · Cowen and Company. Your line is now open.

Yeah. Ken, I think your question was specific to OSA, but I'll just say slightly different characteristics of the narcolepsy in the OSA opportunities. We see a fairly high treatment rate, but also a fairly high abandonment or failure rate with other agents. In the OSA market, I think the biggest thing to take into account is that most patients are not treated. Those that are may, in fact, have stepped through other therapies and not have the impact they'd like, but I think the bigger driver there is a lot of patients with EDS that's either unrecognized or recognized, but not drug treated. And in terms of your comments on managed care and access, I think we've been consistent in saying for years we wouldn't be surprised if patients stepped through a generic drug that's available before they get to Sunosi. And one of the things that made us excited about this opportunity is the high rate of patients that have voiced dissatisfaction with existing therapies, primarily for not having enough efficacy; in some cases, tolerability issues. As I think Jed so well said earlier, this led us to our interest in this agent in the first place. It was recognizing there was a real market opportunity for a differentiated agent with, hopefully, answers to some of the problems patients have been describing.

Ken Cacciatore

Analyst · Cowen and Company. Your line is now open.

Thank you.

Operator

Operator

Thank you. And our next question comes from Jessica Fye with J.P. Morgan. Your line is now open.

Jessica Fye

Analyst · J.P. Morgan. Your line is now open.

Great. Thanks so much for taking my question. Quick one on Xyrem net price this quarter. I think the deck has volume was up 5% percent and sales grew 16%, which implies a healthy price contribution, but I think it might be somewhat more than the list price increase. Is there anything that you can kind of offer in terms of what would explain that?

Bruce Cozadd

Analyst · J.P. Morgan. Your line is now open.

Yeah. Jess, nothing really to say. There are not any big wide swings in gross to nets. You know our price action earlier in the year. So, the rest of what you're seeing is just differences in terms of Q1 results. So, nothing really more to say there.

Michael Miller

Analyst · J.P. Morgan. Your line is now open.

Yeah. Jess, this is Mike. I would say that, in this most recent quarter, we did – I think our field reimbursement folks and our central pharmacy did a really good job of getting through the payer churn. So, I think when you use the comparator of Q1 2018, that may explain some of the lift. We also grew patients about 6%. So, all the math works.

Jessica Fye

Analyst · J.P. Morgan. Your line is now open.

Thank you.

Operator

Operator

Thank you. And our next question comes from Liav Abraham with Citi. Your line is now open.

Liav Abraham

Analyst · Citi. Your line is now open.

Good afternoon. Bruce, can you just update us on what you're seeing on the business development front. I think, last year, you said you would be disappointed if you didn't execute on a transaction. Maybe talk a little bit about your outlook this year as you are almost in the middle of the year both from a supply perspective as well as pricing dynamics in the market? Thank you.

Bruce Cozadd

Analyst · Citi. Your line is now open.

Yeah. Maybe I can do this in conjunction with Matt. I'll just say we're busy and we're busy across the board. We're looking at opportunities across sleep and adjacent areas and hem/onc and adjacent areas. We're looking at things across market or near-market products back to earlier development. We're looking at things across geographies as we continue to expand our geographic footprint. So, there is a lot out there to look at and we're honestly excited by a number of the opportunities we see. I think it would be a good complement to our capabilities and what would fit with our sustainable growth strategy. Matt, maybe I can ask you to comment a little bit on price and how that translates into actionable deals.

Matthew Young

Analyst · Citi. Your line is now open.

Sure, yeah. Just at a high level, valuations in many pockets do remain high, depending on where you're looking. And it's our job to navigate through that and we believe we can still find value in that regard. We continue to see, as Bruce alluded to, interesting [indiscernible] at all stages across our key franchises as well as in some spaces between them. And, obviously, also want to be thoughtful about how we feather in potential deals from an operational perspective just to make sure we can execute on our existing business, but we continue to be hard work and our expectations remain favorable that we can complete successful transactions this year.

Liav Abraham

Analyst · Citi. Your line is now open.

Thank you.

Operator

Operator

Thank you. And our next question comes from Irina Koffler with Mizuho. Your line is open.

Irina Koffler

Analyst · Mizuho. Your line is open.

Hi. Thank you for taking the questions. Can you give us an update on the PBL agreement on Erwinaze and whether there has been any progress in renewing anything? And the second question is on Xyrem REMS for pediatric. Just wanted to verify that you've enrolled all of the remaining pediatric patients that you were going to enroll or is there still a process underway that could lead to some potential disruption in the enrollment? Thanks.

Bruce Cozadd

Analyst · Mizuho. Your line is open.

So, maybe I'll take the second question first and then ask Dan to comment a little bit about PBL. On the pediatric REMS, I think we did a really spectacular job of planning to make that as seamless as possible for patients, caregivers and prescribers, and I think we're largely through that transition of patients who are already on the Xyrem. So, we do not anticipate that that will cause any perturbation in sales growth. Dan, do you want to talk about pediatrics?

Daniel Swisher

Analyst · Mizuho. Your line is open.

Sure, yeah. So, with PBL, we remain very focused on operational issues, near-term [indiscernible], very kind of batch to batch. We can get those batches out. And as you know, even without any kind of renewal, we've got rights to the program through 2020 and inventory beyond. We continue to think we are the best partner for this program. We've got the relationship with the ALL doctors and look forward to engaging and putting our best foot forward. In terms of updates to the process, it's really PBL's process, so we can't comment on so status and timing. It's up to them to provide those updates.

Irina Koffler

Analyst · Mizuho. Your line is open.

Thank you.

Operator

Operator

Thank you. And our next question comes from Annabel Samimy with Stifel. Your line is now open.

Nick Rubino

Analyst · Stifel. Your line is now open.

Good afternoon everyone. This is Nick Rubino on for Annabel. Thanks for taking our question. We just have a quick one. Now that the data are out on the low-sodium products, have you had any further discussions with those physician population regarding the number of patients they believe could benefit from having this option available?

Bruce Cozadd

Analyst · Stifel. Your line is now open.

Yeah, I would say we put out a quick top line release just to let you know that our primary and key secondary endpoints were highly statistically significant, positive to generally comment on the AE profile. But I would say we have not yet made data public. We'll do that in an appropriate medical meeting this fall. That'll give us a lot more opportunity to engage with folks about what it means. I think the data we have released has made it easier for us to say we believe the product works and will be an important new treatment and improvement for patients, but I think let's wait until we have more data to share to have additional conversations. And then, in terms of a number of patients, I think there's no patient who is benefiting from the high-sodium load of the existing Xyrem products. We think this would be an improved product for all patients currently taking sodium oxybate. And we've said historically, we know there are patients who don't get Xyrem therapy because their physicians are concerned in the case of those patients about the high-sodium content. And so, we do believe that moving to JZP-258 may open up additional opportunity for a broader patient population.

Nick Rubino

Analyst · Stifel. Your line is now open.

All right, thank you.

Operator

Operator

Thank you. And our next question comes from Akash Tewari with Wolfe Research. Your line is now open.

Akash Tewari

Analyst · Wolfe Research. Your line is now open.

Hey, thanks so much for taking my question. This is more just generally focused on why the low end of guidance wasn't kind of up given the beat that we saw on Xyrem. Just digging into the low end of guidance and if you compare the product specific low end of guidance and compare that to the low end of the guided total product revenues, we're seeing about a gap of $70 million. And if you can assume that about $20 million of that is other, what is explaining that additional $50 million gap given that there is a limited amount of JZP-110 baked into 2019 numbers? Thanks so much.

Bruce Cozadd

Analyst · Wolfe Research. Your line is now open.

So, Akash, I'll take the second part of your question and I'll ask Matt to handle the more product specific one. Just in general, when we provide guidance ranges, if you're a fan of Monte Carlo simulations, it's unlikely with independent variables you're going to get all of the low-end or all of the upper end, and so that gives us the ability to narrow our sort of top end and bottom end guidance a little bit more than if you just added up the low-end and the high end of every revenue number or every expense number. So, I think that's most of the explanation for the narrower bottom end. But, Matt, maybe you can comment on the product guidance.

Matthew Young

Analyst · Wolfe Research. Your line is now open.

Yeah, just as it relates to Xyrem specifically and overall individual product guidance, which we've maintained, really, again, while we've had a strong first quarter, it's relatively early in the year, the guidance we've provide in February. We now are here in early May. So, at this juncture, we feel it's prudent to maintain our posture despite a really successful first quarter across the product portfolio. But, again, at least calling out one specifically, we mentioned the timing variability related to Erwinaze supply. So, we certainly had a strong quarter there, but are anticipating a weaker one to follow as it relates to that specifically. So, again, taking into consideration just how we're running through the year, at this juncture, we thought it was appropriate to maintain guidance.

Akash Tewari

Analyst · Wolfe Research. Your line is now open.

Great. That's super helpful. Thanks.

Operator

Operator

Operator, this will be our last question coming up.

Operator

Operator

Thank you. And our last question comes from David Maris with Wells Fargo.

David Maris

Analyst

Thank you for fitting me in. The stock's about where it was on average last quarter when you spent $100 million on the buyback, and so it would seem that you maybe have another couple quarters to go on the current authorization. So, what are your thoughts and how should investors consider the ability and expectation for buying back stock beyond the current authorization in light of the clearly palpable excitement that management has about the panoply of potential deal targets? Thank you.

Bruce Cozadd

Analyst

Yeah. So, David, a good question. I can't speak for the whole board and preannounce what we're going to do at the end, but I think we've got a good track record over the last few years as we come up on using up our authorization. You've seen us increase that authorization multiple times. And I think we've got a great cash generation in the company, a strong balance sheet and that gives us the capability to both invest in new assets through corp dev, continue to grow our existing business and be buyers of our own stock when we think it's at levels that make that a good move for our shareholders. And we certainly have felt and continue to feel, at current levels, that it's a pretty easy decision for us to be buyers of our own stock. So, my anticipation, although it will be a full board decision, is that we feel similarly that we'd want to balance our desire to buy back stock when we feel it doesn't reflect full value, while maintaining great flexibility to do corp dev which we think can diversify our growth drivers moving forward.

David Maris

Analyst

Great, thank you.

Operator

Operator

Thank you. I'm not showing any further questions at this time. I would now like to turn the call back over to Kathee Littrell for any closing remarks.

Katherine Littrell

Analyst

Thank you, Joelle. Thank you all again for joining us today. We will be participating in the upcoming Bank of America and RBC healthcare conferences and hope to see many of you there. This now ends our call.

Operator

Operator

Ladies and gentlemen, thank you for participating in today's conference. This does conclude today's program. And you may all disconnect. Everyone, have a wonderful day.