Better Therapeutics, Inc. (BTTX)·Q3 2023 Earnings Summary

Executive Summary

• Q3 2023 was a transition quarter: FDA authorization (July) and commercial launch (October) of AspyreRx, with initial prescriptions, while operating expenses fell 51% YoY and net loss improved materially to $5.9M ($0.15 EPS) from $11.4M YoY .
• No product revenue recognized in Q3; management reiterated revenue will begin post-launch and expects to share revenue guidance only after 2–3 quarters of commercial experience; pro forma cash was ~$9.5M including October ATM proceeds, with runway into Q1 2024 .
• Payer coverage is the core near-term catalyst; management signaled advanced discussions and targeted first commercial payer agreement by year-end; BD partnership and FDA Breakthrough Device Designation submission for MASLD/MASH also targeted by year-end .
• Stock reaction catalysts: first payer coverage decision, BD partnership announcement, and Breakthrough Device submission outcome; runway and Nasdaq compliance risks remain (reverse split authority approved; going concern highlighted) .

What Went Well and What Went Wrong

What Went Well

• FDA authorization of AspyreRx (De Novo) and completion of commercial launch preparations; management: “We made tremendous progress in Q3…” (Frank Karbe) .
• Operating discipline: total operating expenses down to $5.3M (−51% YoY) driven by R&D, G&A reductions; net loss improved to $5.9M vs. $11.4M YoY .
• Real-world evidence program reached 1,000 participants; MASLD/MASH LivVita study results published, supporting Breakthrough Device submission plans .

What Went Wrong

• Pre-revenue quarter; management reiterated revenue will begin post-launch and formal revenue guidance will wait 2–3 quarters, delaying visibility .
• Liquidity and going concern: cash $6.6M at quarter-end; runway only into Q1 2024; dependence on ATM raises and financing; Hercules loan amortization resumed Nov 1 .
• Nasdaq deficiencies and shareholder-approved reverse split authority highlight listing risk amid limited market cap and bid price compliance .

Financial Results

KPIs and Operating Details:

Expense Breakdown (Q3 2023 vs. prior periods):

Estimates vs. Actuals (Q3 2023):

Note: S&P Global consensus unavailable due to missing CIQ mapping for BTTX; third-party reference shown solely for context .

Guidance Changes

Earnings Call Themes & Trends

Management Commentary

• “We made tremendous progress in Q3, which included the FDA authorization of AspyreRx and the completion of the work required for a commercial launch in early October.” — Frank Karbe, CEO .
• “Our current focus is on demonstrating commercial traction… Securing payer coverage is a critical element… advanced our discussions with multiple commercial payers…” — Frank Karbe .
• “Cash and cash equivalents were $6.6 million on September 30, 2023… In October 2023, we raised $2.9 million through our ATM facility… extends our financial runway into the first quarter of 2024.” — Company release .
• “Our plan is to begin sharing guidance once we have obtained a solid understanding of our launch dynamics, which we expect to take at least two to three quarters of commercial experience.” — Management on call .
• “Self-pay option… price is $65 for a 90-day treatment period… providers [are] complimentary on this price point.” — Diane Gomez‑Thinnes, CCO .

Q&A Highlights

• Payer coverage path: Management emphasized varied payer processes, growing funnel of engaged payers, and success advancing reviews with key decision-makers; PDT category novelty cited as a hurdle but long-term proposition compelling .
• Guidance: Company will defer revenue guidance until 2–3 quarters of experience post-launch to understand dynamics .
• Financing/Loan: Confirmation that Hercules loan amortization restarted on November 1, indicating resumed cash outflows for debt service .
• Commercial footprint/geographies: Initial target geographies and sales focus aligned with payer efforts to optimize early traction .

Estimates Context

• S&P Global consensus estimates were unavailable due to missing CIQ mapping for BTTX; therefore, we cannot present SPGI-based consensus comparisons for revenue or EPS this quarter.
• Third-party summaries indicated Q3 EPS of $(0.15) was a $0.05 beat and revenue was $0.00 (inline), consistent with pre-revenue status pre-launch .
• Implication: Sell-side models should focus on payer coverage pace, cash-pay adoption, and RWE/health economic evidence shaping reimbursement and trajectory.

Key Takeaways for Investors

• Coverage catalyst: First commercial payer decision (targeted by year-end) and BD partnership announcement are the most immediate stock movers; monitor VA FSS progress for access to Veterans .
• Liquidity runway: Cash into Q1 2024 suggests urgency for coverage traction and financing; expect continued ATM utilization or strategic capital, with going concern and Nasdaq compliance risks top of mind .
• Commercial execution: Early prescriptions and $65 self-pay offer may seed utilization while coverage ramps; the $750 WAC sets the reimbursement anchor .
• Evidence momentum: RWE enrollment completion and GLP‑1 adjunct data strengthen clinical/economic narrative; Breakthrough Device submission for MASLD/MASH could expand optionality .
• Operating leverage: Expense base down materially; note one‑time reversal of a $1.5M payroll accrual in Q3 (non-recurring tailwind to expenses/liabilities) .
• Debt service: Hercules amortization resumed Nov 1; rising interest costs constrain runway, adding execution pressure on coverage and partnerships .
• Trade setup: Near-term trades hinge on coverage headline timing/quality; medium-term thesis depends on sustained uptake, reimbursement breadth, and evidence translating into payer economics.