Greg Went
Analyst · Cowen and Company. Please go ahead.
Several questions there, Ken, Greg, thank you for those. Let me take the tolerability first. The tolerability we are seeing, we comment on the last call that we attributed some of the prescriber experience to tolerability concerns. And it really does show up in two places. One is physician adoption as they have their initial experience with GOCOVRI, and we observed and I commented on in my prepared remarks that if a physician did not properly account for the renal impairment state and dose put too higher, but initial dose of GOCOVRI, that could and we noticed that did lead to some negative physician experiences. As you recall, way back to the second quarter call, we talked about some of the trialing and the [indiscernible] experiences, and I would talk chuck [ph] some of those [indiscernible] not being favorable to that. So we made a change, we learned, we made a change, and we've seen a substantial increase in the utilization of the 68.5, just the pace based upon the messaging we rolled out in the fourth quarter. So, we think that one is receiving well right now. We think there's a better dialogue going on between our team and the offices to make that happen. The other major measure of tolerability is how do people persist on the product? And clearly, we are seeing a level of persistence, a level of durability that matches nearly our clinical trial experience with GOCOVRI, which is very much in contrast to what physicians are used to with add on treatments in this area. There's just -- the evidence is very strong. So it's really not -- that's not the phenomena we're working with. The phenomena that we are seeing and that we are driving hardest towards is where we have an understanding of the OFF dyskinesia axis and the benefit that GOCOVRI can provide, and it maybe the underlying scientific rationale. In those areas, where we see the greatest success, we are attempting to learn as much as we can from those -- what our sales force is doing in those areas, what's happening in those geographic areas, and really apply those learnings broadly to the rest of the country. And we're still in the process of doing that, Ken, and are focusing our energy right now on those lessons learned and bringing -- rolling out to the field those tools that we think will allow them to recognize better and message more successfully to drive that initial adoption. Finally, we have altered our free drug program, so that people can experience GOCOVRI prior to completing, just making it more readily-available prior to completing their coverage process, and we think that may and hopefully be a great driver here over the next couple of quarters to get the TRx's growing to where they need to grow for us to achieve our goals.