Simon

Simon from Cantor Fitzgerald sought clarification on the discrepancy between Fanapt's volume increase and its sales increase year-over-year, specifically asking about the impact of gross-to-net adjustments, Medicare benefit redesign, and commercial copay support. He also asked if these trends are expected to stabilize or continue.

Answer

Kevin Moran, CFO of Vanda Pharmaceuticals Inc., explained that a small reduction in net price, primarily due to the Medicare benefit redesign (IRA) and increased commercial copay support for the bipolar indication, caused the script growth to outpace revenue growth. He noted that the Medicare fee phases in over five years, but generally, gross-to-net is expected to be consistent unless there are significant business or payer dynamic changes. He highlighted that Bysanti's gross-to-net dynamics are significantly more favorable (mid-30s%) compared to Fanapt (around 50%) due to a new Medicaid URA calculation.