Executive Summary

No traditional Q4 2023 earnings release or conference call was filed; instead, management provided a January 3, 2024 business update via 8-K Item 2.02 and, subsequently, announced on March 14, 2024 that the company is terminating employees, pursuing strategic alternatives (including an assignment for the benefit of creditors and/or a wind-down), and voluntarily delisting from Nasdaq .
Commercial progress in Q4 centered on distribution enablement: a partnership with Glooko to integrate AspyreRx into its HCP platform to surface candidates and facilitate prescribing, intended to accelerate adoption in diabetes clinics .
Liquidity and operating sustainability were the principal overhangs exiting 2023; prior quarter disclosures showed cash of $6.6M at 9/30/23 and runway only into early 2024, with reliance on ATM financing and cost reductions .
Given the March 14 announcement to explore strategic alternatives and delist, forward guidance is effectively withdrawn; results vs. estimates for Q4 are not available and S&P Global consensus data were unavailable for BTTX (no CIQ mapping) .

What Went Well and What Went Wrong

What Went Well

Strategic channel enablement: Glooko partnership announced January 3, 2024 integrates AspyreRx into a platform used across ~5,000 U.S. clinics, flagging eligible patients for HCPs; management framed it as aligned with identified early adopters and a means to accelerate access .
Commercial launch occurred in early October (Q4) with prescriptions being written; company offered a limited-time self-pay option to support initial uptake while payer coverage gets established .
Continued clinical and thought-leadership presence: from Q3, the company highlighted Real-World Evidence enrollment completion for AspyreRx and new data on concurrent GLP‑1 use, supporting clinical interest into the commercial phase .

What Went Wrong

Liquidity and runway: Q3 cash of $6.6M and commentary pointing to runway only into Q1’24 signaled financial strain; interest expense remained elevated due to the Hercules facility .
Listing compliance deteriorated into Q4: by March 14, 2024, the company voluntarily requested delisting from Nasdaq and plans to file Form 15 to suspend reporting obligations .
Strategic pivot and workforce termination: on March 14, 2024, management announced termination of employees and pursuit of strategic alternatives, including a possible wind-down, effectively halting the standalone commercialization path for AspyreRx .

Financial Results

Note: A traditional Q4 2023 earnings press release with full P&L detail was not furnished; Item 2.02 on January 8 referenced a January 3 press release with cash balance, but the exhibit available centered on the Glooko partnership. The company subsequently disclosed strategic alternatives and delisting (March 14). As a result, Q4 revenue/EPS detail was not reported in the documents reviewed .

Summary P&L and EPS (recent quarters)

Metric (USD)	Q2 2023	Q3 2023	Q4 2023
Research & Development Expense	$2.24M	$1.83M	Not reported
Sales & Marketing Expense	$1.70M	$1.39M	Not reported
General & Administrative Expense	$3.08M	$2.12M	Not reported
Interest Expense, net	$0.56M	$0.52M	Not reported
Net Loss	$(7.59)M	$(5.86)M	Not reported
Net Loss per Share (basic/diluted)	$(0.24)	$(0.15)	Not reported

Footnote: On Oct 30, 2023, management disclosed it would reverse a previously accrued $1.5M 2022 payroll accrual in Q3 financials, impacting reported operating expense and loss .

Capital Resources

Metric (USD)	Q2 2023	Q3 2023
Cash & Cash Equivalents (period-end)	$6.20M	$6.60M
Notable Financing Commentary	“Runway into Q4’23” and additional financing expected; WAC set at $750/90 days	“Runway into Q1’24” aided by $2.9M ATM in Oct’23

KPIs and Commercialization

Commercial launch of AspyreRx in early October; prescriptions being written; limited-time self-pay option while payer coverage develops .
Glooko distribution/identification integration to accelerate adoption in clinics post quarter-end (Jan 3) .

Guidance Changes

Metric	Period	Previous Guidance	Current Guidance	Change
Corporate outlook	FY 2024	N/A	Company terminating employees, pursuing strategic alternatives (including assignment for the benefit of creditors and/or wind-down) and voluntarily delisting from Nasdaq	Withdrawn/ceased standalone operating plan

No explicit quantitative guidance (revenue, margins, OpEx, etc.) was provided in Q4-related filings reviewed. The strategic alternatives announcement supersedes prior commercialization guidance narratives .

Earnings Call Themes & Trends

Topic	Previous Mentions (Q2 2023)	Previous Mentions (Q3 2023)	Current Period (Q4 2023 context)	Trend
Commercialization of AspyreRx	WAC $750/90 days; launch anticipated Q4’23	Launch in early Oct; prescriptions being written	Glooko partnership to identify candidates and streamline prescribing	Execution → Channel enablement
Payer Coverage	Pursuing payer coverage; government channels setup (SAM/FSS)	Advanced discussions; expected agreement by year-end	No specific payer disclosures in Q4 docs; shift to strategic alternatives by March	Stalled/uncertain post-strategic review
Partnerships/BD	Expected BD partnership by YE’23	Expected BD partnership by YE’23	Glooko integration announced Jan 3	Partial progress
Regulatory/Clinical	RWE nearing completion; potential Breakthrough for liver program	RWE completed; new GLP‑1 combo data; liver program momentum	No incremental clinical disclosures in Q4 docs reviewed	Neutral
Financing/Runway	Multiple equity transactions; extended into Q4’23	ATM raised $2.9M; runway into Q1’24; elevated interest expense	Strategic alternatives; delisting announced Mar 14	Deteriorating
Listing/Capital Markets	Reverse split authorization approved Oct 30	—	Voluntary delisting and intent to file Form 15	Deteriorating

Management Commentary

“Glooko is an ideal partner for us to support the adoption of AspyreRx, given the extensive overlap between providers using the Glooko platform and those we have identified as early adopters for AspyreRx. Glooko’s precision engagement has the potential to accelerate access to AspyreRx for patients who may benefit from this innovative new treatment.” — Frank Karbe, CEO, Jan 3, 2024 .
“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. … Securing payer coverage is a critical element for our success. We have advanced our discussions with multiple commercial payers, which gives us confidence that obtaining coverage for AspyreRx is achievable.” — Frank Karbe, CEO, Nov 9, 2023 .
On March 14, 2024, the company announced termination of employees and exploration of strategic alternatives (including assignment for the benefit of creditors and/or wind-down), and voluntary delisting from Nasdaq .

Q&A Highlights

No Q4 2023 earnings call transcript was filed; subsequent disclosures (March 14, 2024) indicate the company is terminating employees, voluntarily delisting, and pursuing strategic alternatives (including potential wind-down) .

Estimates Context

Wall Street consensus estimates: Unavailable. S&P Global/Capital IQ estimates could not be retrieved due to missing mapping for BTTX; accordingly, comparisons vs. consensus for Q4 2023 are not presented .

Key Takeaways for Investors

Strategic review supplants the operating plan: The March 14 announcement to terminate employees, seek strategic alternatives, and delist effectively ends standalone commercialization as the base case .
Near-term equity value likely hinges on liquidation/assignment outcomes rather than growth execution; monitor filings regarding any asset sale, assignment for benefit of creditors, or wind-down details .
Distribution groundwork was laid (Glooko partnership), but payer coverage and revenue ramp did not reach a self-sustaining trajectory before liquidity constraints dominated .
Balance sheet constraints were visible by Q3 (cash $6.6M; runway into Q1’24), with reliance on ATM and facing higher interest expense from Hercules debt .
No Q4 financials or call: investors lack quarterly comparables (revenue/EPS/margins) and guidance; focus shifts to recovery value and potential outcomes of strategic alternatives .
Process milestones to watch: formal delisting, any assignment sale process, proceeds distribution, and disclosure of obligations (e.g., Hercules facility) which could affect residual value .

References

Jan 8, 2024 8-K (Item 2.02; Exhibit 99.1 press release dated Jan 3, 2024: Glooko partnership) .
Nov 9, 2023 8-K (Q3 2023 press release and financial tables) .
Aug 9, 2023 8-K (Q2 2023 press release and financial tables) .
Oct 30, 2023 8-K (reversal of $1.5M 2022 payroll accrual; reverse split authorization) .
Mar 14, 2024 8-K (strategic alternatives, workforce termination, voluntary delisting) .

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