Brian Bernick
Analyst · Stifel. Your line is open
Thank you, Rob. And I too wish to extend my thanks to the FDA for their willingness to reconsider our application and allow us to resubmit our NDA for TX-004HR. This is an exciting time for TherapeuticsMD and should be an exciting time for both clinicians and patient. During the last 20-plus years that I've practiced gynecology, I've personally observed the multiple challenges clinicians and patients have faced prescribing and using existing FDA-approved therapies for VVA. TX-004HR was created to answer those needs and it gives me great pleasure today to announce the next steps for the resubmission of our NDA for approval to the FDA. TX-004HR is a small digitally inserted, rapidly dissolving, bioidentical estradiol vaginal soft gel. It dissolves completely without the massive discharge of the other products. It is digitally inserted without the need of an applicator into the inner, outer part of the vagina, whether the woman experiences discomfort and has a mucoadhesive that holds it in place allowing the patient to easily insert it and be ambulatory. It is estradiol vaginally, which is what clinicians are comfortable with, and it is dosed identically to the existing products of Estrace, Premarin and Vagifem, which is daily for two weeks followed by two times a week. Accordingly, there is no educational hurdle to overcome for which this represents the natural switch. The proposed unique packaging is a starter pack filed by a monthly maintenance dose pack that we believe will further enhance division and patient acceptance. A key barrier with the current therapies is the required education around both placement and dosing. Much like a Z-Pak or Medrol Dosepak, we believe that our unique blister packaging, identified by the week and day, will help simplify dosing and reduce the time it takes clinicians to educate patients. Important is the strong efficacy data for both dyspareunia and vaginal dryness, with its two-week onset of action, which is within the first prescription versus up to 12 weeks in multiple refills with the other products. And most exciting is, of course, the near absence of systemic absorption in the 4 µg and 10 µg doses. This opens up markets to other prescribers, like primary care providers and oncologists, as well as consumers that have declined therapy because of the concerns of estrogen exposure. Our 4 µg dose has the potential to be the new lowest dose available, which would be 75 times lower than Premarin cream, 25 times lower than Estrace cream, and still 2.5 times lower than Vagifem. We believe all these attributes will improve patient compliance, resulting in long-term usage. Therefore, we believe that TX-004HR, if approved, has the potential to be a best-in-class therapy and expand treatment options for the estimated 32 million women across the United States, suffering from symptoms of VVA. And now, I will turn it over to Dr. Mirkin.