David Hong

David Hong followed up on the Sleep-wake franchise payer contracts, asking about the possibility of renegotiations during the year and the potential for step edits or other restrictions by payers favoring multi-source generics.

Answer

Sam Pearce, Chief Commercial Officer, acknowledged the possibility of payer renegotiations if significant market events occur, but noted the material rebates for XYWAV. She emphasized that physicians and patients value the low-sodium option due to high comorbidity rates, suggesting strong commitment to navigate step edits. Phil Johnson, EVP and CFO, cited past examples where physicians were motivated to step through AG requirements to access XYWAV, reinforcing its unique value.

David Hong followed up on the Sleepwake franchise's payer contracts, asking about the possibility of payers renegotiating terms or implementing step edits and other restrictions that might favor multi-source generics.

Answer

Sam Pearce, Chief Commercial Officer, acknowledged the possibility of payer renegotiations in response to significant market events but highlighted the material rebates associated with XYWAV and the strong physician and patient preference for the low-sodium option, even if step edits were introduced. Phil Johnson, EVP and CFO, added that past experience showed physicians were highly motivated to navigate step edits to ensure patients received XYWAV due to its unique safety advantage.

David Hong asked about the breakdown of Alzheimer's disease agitation (ADA) prescriptions between community and long-term care settings, Axsome's sales force deployment plans for these segments, and if Bristol Myers Squibb's Cobenfy for Alzheimer's disease psychosis (ADP) could become a competitor in ADA.

Answer

Ari Maizel (Chief Commercial Officer, Axsome Therapeutics) stated that approximately 60% of ADA prescriptions are community-based and 40% are in long-term care facilities, and Axsome views ADA and ADP as separate indications, not expecting much confusion or competition from Cobenfy, as agitation is the most burdensome symptom.

David Hong inquired about the breakdown of Alzheimer's disease agitation (ADA) prescriptions between community and long-term care settings, Axsome's sales force deployment strategy for these segments, and whether Bristol Myers Squibb's Cobenfy for Alzheimer's disease psychosis (ADP) could compete with Auvelity in ADA.

Answer

Ari Maizel, Chief Commercial Officer, noted that approximately 60% of ADA prescriptions are community-based and 40% are in long-term care facilities, and the sales force will be deployed accordingly. He views Alzheimer's agitation and psychosis as distinct indications, not expecting significant competition or confusion from Cobenfy, as agitation symptoms are the most prominent and burdensome.