Catalyst Pharmaceuticals - Earnings Call - Q1 2025
May 8, 2025
Transcript
Operator (participant)
Good day, everyone, and welcome to today's Catalyst Pharmaceuticals' First Quarter 2025 Financial Results Conference call. At this time, all participants are in a listen-only mode. Later, you will have an opportunity to ask questions during the question-and-answer session. You may register to ask a question at any time by pressing the star and one keys on your telephone keypad. Please note this call is being recorded and that I will be standing by should you need any assistance. It is now my pleasure to turn today's program over to Mike Kalb, CFO. Please begin.
Mike Kalb (EVP and CFO)
Good morning, everyone, and thank you for joining our conference call to discuss Catalyst's first quarter 2025 financial results and business highlights. Leading the call today is Richard Daly, Catalyst's President and Chief Executive Officer. We are also joined by Jeff Del Carmen, our Chief Commercial Officer. Further, for the Q&A session, Dr. Steve Miller, our Chief Operating Officer and Chief Scientific Officer, will be available for questions. Before we begin, I would like to remind you that in our remarks this morning and in the Q&A session, we will make statements about expected future results, which may be forward-looking statements for purposes of federal securities laws. These statements relate to our current expectations, estimates, and projections, and are not guarantees of future performance. They involve risks, uncertainties, and assumptions that are difficult to predict and may not prove to be accurate.
Actual results may vary from the expectations contained in our forward-looking statements. These forward-looking statements should be considered only in conjunction with the detailed information contained in our SEC filings, including the risk factors described in our recent 2024 Annual Report on Form 10-K filed with the SEC on February 26, 2025, and our First Quarter 2025 Quarterly Report on Form 10-Q, which was filed yesterday, May 7, 2025, with the SEC. At this time, I'll turn the call over to Rich.
Richard Daly (President and CEO)
Thanks, Mike. Good morning, everyone, and thanks for joining us. Catalyst delivered an outstanding start to 2024 with continued excellent execution, strong demand for our rare disease therapies, and continued progress on key strategic priorities. These results highlight our sustained momentum and growing impact in the patient communities we serve. Total net revenues grew 43.6% year over year to $141.4 million, with meaningful contributions from each of our products. These results highlight the strength of our portfolio and the effectiveness of our commercial execution. With a strong cash position of $580.7 million and disciplined operational management, we are well positioned to drive long-term growth while advancing our strategic priorities. Let's turn to the specifics of our commercial performance, beginning with FIRDAPSE. FIRDAPSE continues to demonstrate outstanding performance, maintaining its position as the only evidence-based approved product in the U.S. for Lambert-Eaton Myasthenic Syndrome, or LEMS.
In the first quarter of 2025, the brand delivered another strong quarter of organic growth, generating revenue of $83.7 million and an increase of 25.3% year over year. Performance was driven by continued adoption among newly diagnosed patients and a modest tailwind from normalized prescription activity following temporary disruptions related to the Change Healthcare cybersecurity incident in Q1 2024, the effect of which we expect to level out in Q2 2025. Mike will discuss the impact of the Change Healthcare cybersecurity incident in more detail in his remarks. In addition, since the 100-milligram label expansion for FIRDAPSE approved in May 2024, we've seen an increase in the average daily dose of FIRDAPSE. The 100-milligram enhancement offers providers greater flexibility to individualize therapy based on patient needs. We expect the average daily dose to increase in the near term.
As we have stated in the past, approximately half of all LEMS diagnoses are associated with cancer, in particular small cell lung cancer. We continue to work with the National Comprehensive Cancer Network to improve the understanding of the relationship between LEMS and cancer, the role of VGCC testing, and the benefits of treating LEMS-associated cancer patients with FIRDAPSE. These initiatives reflect our strategic approach to extending FIRDAPSE's market leadership and positioning the brand for durable long-term growth. This continued performance reinforces our confidence in delivering FIRDAPSE's 2025 net product revenue forecast of between $355 million and $360 million. Now turning to AGAMREE. AGAMREE delivered a solid performance in Q1 2025, marking its first full year of commercial availability following a March 13, 2024, U.S. launch.
Net product revenues totaled $22 million, compared with $1.2 million in Q1 2024, reflecting the impact of a full quarter of sales compared to the prior year, sustained organic uptake, and increased confidence in AGAMREE's potential as a differentiated corticosteroid treatment for Duchenne muscular dystrophy, or DMD. AGAMREE continues to source patients from branded and generic competitors in a balanced manner, as it has since launched, and the patient retention rate remains robust. We believe these are indications of the market sensing AGAMREE's potential benefits. Prescriber engagement continues to build, supported by the full deployment of our dedicated AGAMREE field team in April 2025. These early commercial indicators position AGAMREE for broader market reach as a foundational complementary corticosteroid therapy within the evolving DMD treatment landscape. This momentum continues to support our full year 2025 net revenue forecast for AGAMREE of between $100 million and $110 million.
On the clinical front, we're advancing the SUMMIT study, our five-year real-world evidence-based study evaluating long-term outcomes in DMD patients treated with AGAMREE. During the first quarter of 2025, the SUMMIT study advanced with the activation of additional sites and continued progress in patient enrollment. We hope that the results of the SUMMIT study will provide long-term real-world evidence of the benefits of the treatment of AGAMREE. Finally, FYCOMPA. FYCOMPA delivered solid results in this quarter, driven by steady demand and disciplined execution to maximize near-term value ahead of the anticipated generic entry on or after May 23, 2025. Net product revenue for the period was $35.6 million, representing a year-over-year growth of 17.1%, driven by sustained performance, strong patient preference, and the product's well-established clinical role in seizure control.
As we approach the end of exclusivity, we remain focused on ensuring continuity of care and managing the brand's value through well-planned transition. As discussed previously, we expect a measured revenue decline post-patent expiry. Our teams are fully prepared and executing against a defined strategy to manage this evolution effectively. We believe that FYCOMPA remains on track to deliver on our 2025 full-year net product revenue forecast of between $90 million and $95 million as we continue to maximize near-term value. In parallel, we remain committed to expanding access to our rare disease therapies in markets outside the U.S. In January, our sub-licensee, Daito Pharma, successfully launched FIRDAPSE in Japan, making it the first approved treatment for LEMS. This important milestone expands access for an estimated 1,200 LEMS patients and addresses an important unmet need in the Japanese rare disease patient community.
In Canada, our sub-licensee, KAI Pharmaceuticals, which also markets FIRDAPSE in Canada, is advancing regulatory plans for AGAMREE. In April of 2025, Health Canada accepted the new drug submission under priority review, with potential of approval by year-end. If approved, AGAMREE would be the first authorized treatment for DMD in Canada, addressing a patient population of more than 800 individuals and making a meaningful advancement in care of this underserved DMD community. While these license agreements are not expected to contribute materially to revenue, they are aligned with our broader mission to advance health equity by expanding access to our therapies for underserved patient populations. We continue to take strategic action to safeguard the long-term value of the FIRDAPSE franchise. In January, we reached a favorable settlement with Teva, restricting U.S. generic entry until February 25, 2035, subject to certain conditions.
Litigation with the two remaining first filers remains ongoing, and we remain confident in the strength of our intellectual property portfolio. However, there could be no assurances that we will prevail in this litigation. Business development continues to be a core growth lever for Catalyst. We remain disciplined in our approach, prioritizing opportunities with strategic synergy, clinical differentiation, and the potential to drive long-term value. With a robust pipeline of evaluations underway, we believe that we are well positioned to execute transactions that further enhance our leadership in rare disease. As we advance through 2025, we remain firmly focused on executing our strategic priorities and sustaining operational excellence, with a strong foundation, a high-performing team, and a clear path to value creation. We believe that we are well positioned to deliver durable growth while continuing to elevate care for patients living with rare diseases.
We are reaffirming our full-year total product revenue guidance of between $545 million-$565 million. We believe Catalyst is well positioned to create meaningful value for patients, healthcare providers, and our stakeholders. With that, I'll now turn the call over to Jeff Del Carmen, our Chief Commercial Officer.
Jeff Del Carmen (Chief Commercial Officer)
Thanks, Rich. Good morning, everyone. Q1 marked another record quarter for our commercial organization, reflecting strong execution across the portfolio and continued demand for our innovative therapies. As Rich mentioned, Catalyst had an excellent start to 2024, driven by the combination of sustained organic growth of FIRDAPSE, stable revenues from FYCOMPA, and the steady adoption of AGAMREE. Q1 total net revenues of $141.4 million position Catalyst well to achieve our combined 2024 total revenue guidance of $545 million-$565 million. Also, I am pleased to report that we successfully completed the commercial field team restructuring, establishing dedicated sales teams for AGAMREE and FIRDAPSE. This realignment strengthens our focus within each therapeutic area and sets a strong foundation for future growth. Let me walk through key performance highlights by product. First, I'll start with FIRDAPSE performance.
Q1 FIRDAPSE net product revenue of $83.7 million represents a 25.3% increase quarter over the same quarter last year, a direct result of strong new patient starts and a low annual discontinuation rate of approximately 15%. Prescription approval rates were greater than 90% across all payers, government, or private commercial insurers. We continue to see strong leading indicators in April, furthering our confidence in achieving FIRDAPSE full-year net product revenue guidance of $355 million-$360 million in 2025. As we look ahead, our strategic growth initiatives remain a key driver for organic growth. We continue to maintain a pipeline of greater than 500 potential LEMS patients in various stages of their diagnostic journey who have not yet started treatment with FIRDAPSE, representing roughly 50% of our new patient enrollments each quarter.
Furthermore, we are particularly excited about the opportunity in cancer-associated LEMS, where we are expanding our focus to the Community Oncology Channel, which manages the majority of cancer care in the U.S. We are confident that potential VGCC antibody screening arrangements with GPOs in the second half of 2025 will help accelerate LEMS diagnosis rates in the approximately 90% of small cell lung cancer LEMS patients who are currently undiagnosed. Next, I would like to discuss AGAMREE. We are proud of the continued early market momentum of AGAMREE and its growing presence in the market as a breakthrough treatment for DMD, as evidenced by Q1 net product revenue of $22 million. Since the commercial launch of AGAMREE in March 2024, 93% of the top 45 DMD centers of excellence and 224 unique healthcare providers have submitted an enrollment form for AGAMREE.
We continue to see transitions to AGAMREE from both corticosteroid segments, 44% from prednisone and 44% from EMFLAZA. Approximately 85% of shipments are successfully reimbursed, which is aligned with our forecast. In addition, our dedicated AGAMREE salesforce is actively executing targeted educational initiatives to reinforce AGAMREE's potential for differentiated value, driving durable patient uptake, and strengthening our competitive position. AGAMREE's net product revenue for 2025 is expected to be between $100 million and $110 million, reflecting its continued market adoption and commercial momentum. Lastly, I would like to provide a brief overview of FYCOMPA. FYCOMPA delivered solid Q1 net product revenues of $35.6 million, further fortifying our revenue diversification. Looking ahead, we are closely managing the upcoming FYCOMPA loss of exclusivity. While we anticipate revenue impact in the second half, we have mitigation plans in place to appropriately minimize brand erosion.
We remain confident in our full-year 2025 net product revenue forecast for FYCOMPA of between $90 million and $95 million. To summarize, our commercial organization continues to execute with precision, supported by a strong field force and focused strategies across our portfolio. Following a strong first quarter and sustained momentum across the business, we are confident in reaffirming our full-year 2025 total revenue guidance. We believe that we are well positioned to seize the growth opportunities ahead, and we remain focused on driving operational excellence, enhancing patient access, and scaling our commercial impact across our entire product portfolio. I will now turn the call back over to Mike.
Mike Kalb (EVP and CFO)
Thanks, Jeff. Our performance during the first quarter of 2025 has set us on pace for another strong year, driven by our solid financial performance, financial discipline, and strong execution. With the continued success from the launch of AGAMREE in mid-March of 2024, along with the continued performance of FIRDAPSE and FYCOMPA, we have set the groundwork for what promises to be yet another strong year in 2025, and we reaffirm our 2025 full-year total revenue guidance that we provided in February. We remain steadfast in our commitment to driving growth, leveraging strategic arrangements, and expanding our portfolio to capitalize on emerging opportunities throughout the year. Our total revenues for the first quarter of 2025 were $141.4 million, a 43.6% increase when compared to total revenues of $98.5 million for the first quarter of 2024.
Product revenue net for our lead product, FIRDAPSE, was $83.7 million, a 25.3% increase year-over-year compared to $66.8 million in Q1 2024, primarily driven by an increase in sales volumes, a portion of which is attributed to a delay in patient claims to certain non-Medicare payers in certain states resulting from the Change Healthcare cybersecurity incident that occurred in the first quarter of 2024 and was resolved in the second quarter of 2024. The first quarter of 2025 also reflects a small amount of revenue for shipments to sub-licensees outside of the U.S. Product revenue net for the first quarter of 2025 for AGAMREE was $22 million compared to $1.2 million in the first quarter of 2024. As mentioned earlier, AGAMREE was made commercially available in mid-March 2024. The results underscore continued growth and increasing prescriber engagement.
Product revenue net for the first quarter of 2025 for FYCOMPA was $35.6 million compared to $30.4 million in the first quarter of 2024, which included a reduction in variable consideration or gross to net, resulting from a decrease in wholesaler distribution fees in 2025. We expect that product revenue net for FYCOMPA will likely decrease once the patent protection expires, which occurs on May 23, 2025, for the tablets, and on December 15, 2025, for the oral suspension. Net income before income taxes for the first quarter of 2025 was $71.3 million, a 145% increase year-over-year compared to $29.1 million for the first quarter of 2024.
We reported GAAP net income for the first quarter of 2025 of $56.7 million, or $0.47 per basic and $0.45 per diluted share, an increase of 144% year-over-year compared to GAAP net income for the first quarter of 2024 of $23.3 million, or $0.20 per basic and $0.19 per diluted share. As a reminder, in the first quarter of the calendar year, like many companies in our industry, we are impacted by the reset of patient insurance deductibles. Cost of sales expense was approximately $17.9 million in the first quarter of 2025 compared to $12.5 million in the first quarter of 2024 and consisted principally of royalties. AGAMREE royalties paid to the product licensor increased by 2% when AGAMREE's net product revenue exceeds $100 million in any calendar year.
The company is also required to make a $12.5 million milestone payment once AGAMREE's net product revenue reaches $100 million, which will be capitalized once achieved and amortized as part of cost of goods sold over the remaining estimated useful life of the intangible asset. Non-GAAP net income for the first quarter of 2025 was $86.6 million, or $0.71 per basic and $0.68 per diluted share, which excludes from GAAP net income amortization of intangible assets related to our acquisitions of FYCOMPA, AGAMREE, and Ruzurgi of $9.3 million, stock-based compensation expense of $5.9 million, the income tax provision of $14.5 million, and depreciation of $115,000.
This compares to non-GAAP net income in the first quarter of 2024 of $46.8 million, or $0.40 per basic and $0.38 per diluted share, which excludes from GAAP net income amortization of intangible assets related to our acquisitions of FYCOMPA, AGAMREE, and Ruzurgi of $9.3 million, stock-based compensation expense of $8.2 million, the income tax provision of $5.8 million, and depreciation of $86,000. Our effective tax rate for the first quarter of 2025 was 20.4% compared to 20% for the first quarter of 2024. We expect the 2025 annualized effective tax rate to be relatively consistent with the 2024 annual rate of 24.2%. For the first quarter of 2025, the difference to the statutory federal income tax rate of 21% was primarily driven by state income taxes, fluctuations in the value of investments, and anticipated annual permanent differences.
The effective tax rate is affected by many factors, including the number of stock options exercised in any given period and is likely to fluctuate in future periods. Further, we are required to pay royalties based on net product revenue to the product licensor for FYCOMPA following the loss of exclusivity, which will occur later this month for tablets and in December 2025 for the oral suspension. The royalty rates are higher if there is no generic entry following loss of patent exclusivity than they are once generics enter the market. As a reminder, royalties for FIRDAPSE increase by 3% when net product sales exceed $100 million in any calendar year. As a result, we expect cost of sales to trend higher as the year progresses.
Additionally, I would like to note that AGAMREE also carries a royalty in the range of low double-digit to mid-20%, depending on sales achievements within a calendar year. Further details on our royalty obligations for AGAMREE are disclosed in our Q1 2025 Form 10-Q and are expanded upon within the MD&A section. Research and development expense was $3.9 million in the first quarter of 2025, up from $2.6 million in the first quarter of 2024. During the three months ended March 31, 2025, research and development expenses consisted of costs for company-sponsored research and development activities, support for selected investigator-sponsored research, and support for our commercial activities.
The company anticipates full-year 2025 research and development expenses to range between $15 million and $20 million, excluding the impact of any additional acquisitions, reflecting investments in the SUMMIT Study and the start of initiatives to investigate the potential for AGAMREE's label to be expanded in the future. SG&A expenses for the first quarter of 2025 totaled $46.9 million, flat as compared to $46.9 million in Q1 2024. However, at this point, SG&A expenses are expected to increase modestly over the remainder of the year, reflecting personnel additions during 2024 and the strategic alignment of dedicated commercial teams supporting FIRDAPSE and AGAMREE, which became effective in the start of the 2025 second quarter. As reported, we ended the first quarter of 2025 with cash and cash equivalents of $580.7 million compared to $517.6 million at December 31, 2024.
The increase in cash of $63.1 million was largely driven by $60 million in cash generated from operations of our business. We believe our current funds continue to allow us the financial flexibility to fund our existing R&D programs, meet our potential contractual obligations, and support our strategic initiatives, business development, and portfolio expansion efforts, leading to long-term growth and value creation. More detailed information and analysis of our first quarter 2025 financial performance may be found in our quarterly report on Form 10Q, which was filed with the Securities and Exchange Commission yesterday, May 7, and can be found in our investor relations page on our website at www.catalystpharma.com. With that, I will turn the call back over to Rich. Rich?
Richard Daly (President and CEO)
Thanks, Mike. As you heard throughout today's call, Catalyst enters the remainder of 2025 with strong momentum, strategic focus, and a clear commitment to delivering value across the rare disease portfolio. We are executing with discipline, advancing initiatives that support near-term performance, and taking steps to create long-term value and growth. The quarter's results reflect the strength of our execution, the resilience of our model, and the depth of the talent across the organization. I want to thank our employees, partners, and stakeholders for their continued dedication. As we look ahead, I'm confident in our ability to drive meaningful impact and sustain value. Thank you for joining us today. I'll now turn the call back over to the operator for questions. Thank you.
Operator (participant)
Thank you. At this time, if you would like to ask a question, please press the star and one keys on your telephone keypad. You may remove yourself from the queue at any time by pressing star two. Once again, that is star one to ask a question. Our first question will come from Joon Lee with Truist Securities. Please go ahead.
Austin Rana (Company Representative)
Congratulations on the quarter and the beat. This is Austin Rana on for Joon. Thanks for taking the question. Just a couple from us. So FIRDAPSE saw a 25% growth from last year. How much of that would you say is strength in this quarter versus weakness in last year's Q1 due to the Change Healthcare impact? As a follow-up, could you remind us what proportion of FYCOMPA patients are on the tablet formulation versus the oral suspension formulation? Thank you.
Richard Daly (President and CEO)
Austin, thanks for the question. As we alluded to, there was some shift in the business due to the Change Healthcare. I'm going to turn it to Jeff to address the question, and then Jeff will also address the FYCOMPA question as well.
Jeff Del Carmen (Chief Commercial Officer)
Sure. Austin, regarding the strength of the business, we always say 15%-20% growth is what we aim for for FIRDAPSE, and that's the range that we fell in Q1. It's about 15%-20%. We saw strong enrollments, low discontinuation rates, and we continue to see great leading indicators in April too.
Richard Daly (President and CEO)
Yeah. So just to really put a bow on that, if you were to back out the effect of Change Healthcare, you'd still be in that 15%-20% range. Is that right, Jeff?
Jeffrey Del Carmen (Chief Commercial Officer)
Absolutely.
Richard Daly (President and CEO)
Yeah. Austin, is that clear?
Austin Rana (Company Representative)
Very clear. Thank you. And then just on the proportion of FYCOMPA patients that are on the tablet versus the oral suspension formulation.
Mike Kalb (EVP and CFO)
Percent of tablet versus tablet versus oral?
Richard Daly (President and CEO)
It's probably about—I'm sorry.
Mike Kalb (EVP and CFO)
Okay.
Richard Daly (President and CEO)
It's about 15%. I'm sorry. It's about 98% tablet.
Austin Rana (Company Representative)
Okay. Thank you. Very helpful.
Operator (participant)
Thank you. Our next question will come from Samantha Semenkow with Citi. Please go ahead.
Benjamin Peluchan (Company Representative)
Hello. This is Benjamin Peluchan for Sam. Thanks for taking the questions. How is the uptake of FIRDAPSE among small cell lung cancer patients trending? Are you seeing an impact from your patient screen efforts in this population? How should we think about growth from small cell lung cancer versus idiopathic patients over the next several quarters?
Richard Daly (President and CEO)
Thanks for the question, Benjamin. I'm going to turn it over to Jeff.
Jeff Del Carmen (Chief Commercial Officer)
Our current mix for all our LEMS patients currently on FIRDAPSE, about 20%-25% are cancer-associated LEMS patients. Our goal for this year is to really focus on our VGCC antibody screening arrangements with GPOs and community oncologists. With that, again, we want to focus on screening and helping these patients, that about 90% of small cell lung cancer patients with LEMS are currently undiagnosed. Our goal is to help them get diagnosed. In 2026, that's when we'll be able to help these patients transition onto therapy. That's our goal. In the long term, we expect that 20%-25% to grow to potentially 30%-35%.
Benjamin Peluchan (Company Representative)
Thank you.
Operator (participant)
Thank you.
Richard Daly (President and CEO)
Is that helpful, Ben? Okay. Great.
Operator (participant)
Our next question will come from Joel Beatty with Baird. Please go ahead.
Joel Beatty (Analyst)
Hey. Congrats on the quarter, and thanks for taking the questions. The first one is on business development activities. In the past, you've put a lot of focus on that. I guess we're currently in what a lot of people are describing as a rapidly changing macro environment. What are your current thoughts on business development, and are there any recent impacts on that?
Richard Daly (President and CEO)
Thanks for the question, Joel. We remain focused on our strategy, which is looking at immediately accretive or nearly immediately accretive opportunities. The dynamics in the market are many-fold, as you point out. We see this as a really beneficial opportunity for us. We continue to see inbounds at about 80%. The opportunities that come to us are—or the opportunities we are assessing, 80% of them are coming to us de novo. We like that. The capital markets, while they are in turmoil, we think present an opportunity for us, which we like as well. Because of our strategy looking at opportunities that are near the finish line and going commercial, we think this remains relatively unaffected by the regulatory environment and changes in the regulatory environment. We see this again as beneficial for us and the strategy that we have.
While it's unsettling, I think in general for our strategy, I think it reinforces our strategy. We feel good about where we stand as a company and the strategy that we have.
Joel Beatty (Analyst)
Great. That's helpful to hear. As a follow-up on FIRDAPSE, for cancer-associated lungs, any anecdotes or things that you've seen working at a smaller scale, perhaps, that helps give you confidence in the strategy that you're taking to increase the diagnosis rates of the antibody and see that lead to treatment?
Richard Daly (President and CEO)
When you say smaller scale, can you clarify?
Joel Beatty (Analyst)
Is this something that you've maybe been able to kind of test in certain locations or trying to get into the antibody test? Are we still kind of early in these efforts? Anything—or maybe another way to ask is that you've had a lot of success in non-cancer-associated lungs marketing, this is a different approach. What kind of gives you confidence that you can be successful in this setting as well?
Richard Daly (President and CEO)
Great. Okay. I think let me start, and then I'll turn it over to Jeff. I think what you're asking is, in our dialogue with the oncology community, have we seen interest in this? The answer is a definite yes. We're talking to these larger groups, and there's been a consolidation of these oncology practices in larger groups. In our dialogue with these oncology groups, we're seeing a definite interest in this because they realize that, as Jeff has alluded to in previous discussions, 90% of the patients with small cell lung cancer-associated LEMS are not getting treated. They see the dynamic. They see the unmet clinical and medical need. When we talk to them about it and the ability to diagnose and then thus treat with a definitive treatment, there is a definite interest. Jeff, you're closer to the subject.
Do you want to address it?
Jeff Del Carmen (Chief Commercial Officer)
Absolutely. There have been significant ad boards that have been done with these thought leaders over the last year or two years. Like Rich mentioned, significant interest among these key opinion leaders. Also, our goal is to help provide frictionless testing for these patients so that these 90% of patients that are undiagnosed can get tested and hopefully diagnosed. In those discussions, these physicians, again, they see the unmet need for these small cell lung cancer patients. There is significant interest out there in the oncology community.
Richard Daly (President and CEO)
Joel, is that helpful?
Joel Beatty (Analyst)
Yes, it was.
Richard Daly (President and CEO)
I just want to correct one thing. I believe I misspoke before when the question came up about the split between oral and solid tablets. It's actually 85%. I apologize. It's 85% are tablets and 15% is oral solution on FYCOMPA. My apologies to the group.
Operator (participant)
Thank you. Our next question will come from Charles Duncan with Cantor Fitzgerald. Please go ahead.
Charles Duncan (Managing Director)
Hey. Morning, Rich and team. First of all, congratulations on the first quarter performance. Secondly, thanks for taking our question. I had a question on FIRDAPSE and the guidance that you've given. It's uncommonly tight. I guess I'm wondering, you've been tracking like 500 patients for several years, and about half of them—or I guess the new-to-brand or new patient starts come from that pool—I'm wondering if you could give us some color on how you're setting that guidance. If I look at, call it, a 15% growth thus far this year, that's closing in on 390, not 360. I'm wondering, what is the source of your conservatism with regard to FIRDAPSE guidance?
Richard Daly (President and CEO)
The source of our conservatism, Charles?
Charles Duncan (Managing Director)
Yeah. Yeah. I mean, in terms of new patient adds or persistence or growth in average daily dosing, where do you stand on what the most important trigger there is?
Richard Daly (President and CEO)
Okay. Jeff, do you want to take that?
Jeff Del Carmen (Chief Commercial Officer)
Yeah. Hey, Charles. Good morning. As far as what I can talk about are the leading indicators for us in our core business. We've seen it over the last 15 quarters now, that 15% growth. Like you mentioned, the 500 patients or so that are our pipeline patients that are somewhere in their diagnostic journey for LEMS, we have significant resources or sources to continue to backfill the patients after they get on therapy to find new leads so that we always have about 500. Our discontinuation rates remain low at 15%. Over time, we see what our trend is for our net new patients each month, any given quarter. That is what helps inform us about where our growth is and our confidence. This is our sixth year out. We kind of understand where the trend is and where we're headed.
That is what gives us the confidence. Hopefully, that helps, Charles. I do not know if there is any follow-up question that you can ask that can point me in the direction that you want me to go.
Charles Duncan (Managing Director)
No, I think that that's good. I understand the confidence, but I definitely think it's conservative, my perspective. Maybe we'll move on to FYCOMPA. That is, you mentioned measured revenue decline, and that makes sense for an epilepsy indication. You said that this year you have measures in place. Could those measures also apply to next year? I know you're not guiding to next year, but is it inherent in the use of FYCOMPA that use may continue for those patients into next year?
Jeff Del Carmen (Chief Commercial Officer)
You know, Charles, there tends to be a stickiness, for lack of better terms, for anti-seizure medications. So there is an opportunity there for patients to—or to minimize brand erosion over time. We haven't given that guidance, as you mentioned, for next year. But yeah, I mean, there is an opportunity to minimize brand erosion continuing into next year.
Richard Daly (President and CEO)
I think the challenge with that, Charles, is that the six-month exclusivity period ends at the end of this year. While we do not know it, we would expect additional generics to enter the market. At that point, while we have not given—as Jeff has alluded to—we have not given guidance for 2026, we all know the way that price is inversely proportional to the number of players in the generic market. I think it just becomes tougher to control.
Charles Duncan (Managing Director)
Okay. Last question on BizDev. Helpful color so far. In terms of the market and the environment, it does seem like it favors your approach and your task position. I'm wondering if you have specific goals for this year to get a transaction done, or is that something you don't want to commit to at this point?
Richard Daly (President and CEO)
I would not say we have a specific goal to get a transaction done. We have a specific goal to get the right transaction done or right transactions done. I think we have been very, very good as a company in bringing in the appropriate assets, and we want to continue that trend. We want to make sure we bring in the right assets. We have looked at a lot of opportunities, and for a number of reasons, they do not fit us and they do not make sense for us. It would be unfortunate for us to bring in an opportunity that did not fit us culturally, financially, structurally. All of those things have to fit. We are, I think, a very discriminating buyer of assets and acquirer of assets. We want to continue that because we think that is beneficial for shareholders and beneficial for us as a company.
I'm not trying to parse words, but we have a goal to do the right deal.
Charles Duncan (Managing Director)
Okay. Thanks for taking all my questions.
Richard Daly (President and CEO)
Thanks for your support too, as well.
Operator (participant)
Thank you. Our next question will come from Rohan Mathur with Oppenheimer. Please go ahead.
Rohan Mathur (Analyst)
Hey, this is Rohan on for Lee. Thanks for taking the question and congrats on another really strong quarter. Just one from me on AGAMREE. As you see the SUMMIT study progress, what aspects of AGAMREE's profile do you think will resonate most with prescribers, especially those who have yet to incorporate it into their own practice? Thank you.
Richard Daly (President and CEO)
Thanks, Rohan. Gary, we have Gary Ingenito, our Chief Medical Officer on the line. Gary, do you want to take that question?
Gary Ingenito (Chief Medical Officer)
Thank you, Rich. Yes, Rohan. I think that the demonstration of bone health, bone density, and the effects on cardiac will be some of the key findings that confirm the differentiation of AGAMREE, which we see based upon our preliminary data. We will do it again in the long term with real-world evidence.
Rohan Mathur (Analyst)
Got it. Just a follow-up, how do you sort of plan to quantify that in SUMMIT?
Gary Ingenito (Chief Medical Officer)
In SUMMIT, we will be looking at fracture rates, bone age, bone density, and development or prevention of cardiomyopathy.
Rohan Mathur (Analyst)
Thank you.
Operator (participant)
Thank you.
Richard Daly (President and CEO)
Thanks, Rohan.
Operator (participant)
Our next question will come from Jason Gerberry with Bank of America. Please go ahead.
Jason Gerberry (Managing Director)
Oh, hey, guys. Sorry, I joined late and missed everything so far on the call. Apologies if this has been addressed. Can you remind me with the strength of the FIRDAPSE quarter? Just wondering if there's any pull forward at all. Just trying to think through the quarterly progression of sales. Furthermore, if you can speak to whether you're starting to see strength in performance of the small cell lung adoption on the LEMS side there. Thanks.
Richard Daly (President and CEO)
Jason, thanks. We'll turn that first part of the question over to Mike, and then we'll turn the second part of the question over to Jeff.
Mike Kalb (EVP and CFO)
Yep. Hey, Jason. Thanks for the questions. Thanks for the support. On FIRDAPSE Q1, and we did note it, I would look at it as let's start with we've said consistently 15%-20% growth, and we maintain that notwithstanding the strong growth in Q1. Some of the Q1 2025 compared to Q1 2024 is actually the Q1 2024 Change Healthcare cybersecurity incident and that impact timing into Q2.
Richard Daly (President and CEO)
If you back that out, Jason, just to clarify, if you back out what happened in Q1 2024, we are still in the range of a growth of 15%-20%. Is that helpful?
Jason Gerberry (Managing Director)
Yeah. Definitely.
Richard Daly (President and CEO)
Great. Did you just ask the second question? We are all clear on where we stand for your second question?
Jason Gerberry (Managing Director)
Yeah. Just how 1Q may have been impacted at all, sort of the momentum you're seeing on small-cell lung LEMS pick up relative to, I guess, baseline or year-on-year comp.
Jeff Del Carmen (Chief Commercial Officer)
Sure. Jason, let me get you the baseline where we're at. It's about 20-25% of our current FIRDAPSE patients are cancer-associated LEMS patients. Our main focus this year is to get VGCC antibody screening arrangements in place with community oncologists, GPOs. Where we expect to see growth in the percentage of our patients to be cancer-associated LEMS patients will be in 2026 and beyond. That's where we expect the opportunity to be realized more. Again, this year, we're hopeful that we can help those 90% of patients that are currently undiagnosed, the small cell lung cancer LEMS patients that are undiagnosed. We want to help them get tested and diagnosed.
Jason Gerberry (Managing Director)
Got it. Okay. Thanks so much.
Richard Daly (President and CEO)
Thanks, Jason.
Operator (participant)
Thank you. Our last question will come from Sudan Logan with Stevens. Please go ahead. Sudan, please make sure that you're not muted.
I'm sorry. Congrats on the call. This is Felix for Sudan Logan. I have a quick question on FIRDAPSE. Given the high percentage of the undiagnosed LEMS patients, can you please give us color in terms of the proportion of the penetration that you have so far on FIRDAPSE? What will contribute the percent penetration to increase, given that you have initiative to increase diagnosis?
Richard Daly (President and CEO)
Thanks for the question. We have said recently at JPMorgan on our conference, we said we believe that size of the market is about $1.2 billion in today's prices, so no price increases, etc. If you just look at our sales last year, about $300 million, that would mean we have about a 25% market penetration across the board. We believe there is significant upside in this market for us. This consistent growth that Jeff alluded to, the 15%-20% we have experienced for some time, we believe that we can sustain that. Given this cancer-associated LEMS initiative and continuing to push on the idiopathic side or non-cancer-associated LEMS, we believe that there is a significant opportunity to continue to grow this market, and we are really excited about it. Jeff, any comments?
Jeff Del Carmen (Chief Commercial Officer)
Like Rich mentioned, I mean, significant opportunity in both segments of the LEMS prevalence. We expect to see more opportunity to help the small cell lung cancer LEMS patients moving forward. Right now, the idiopathic LEMS, the penetration is strong. However, there is still plenty of opportunity. The 500 or so pipeline patients, those patients that are somewhere in their diagnostic journey, the vast majority of those patients are idiopathic LEMS patients. So plenty of opportunity to help them in the short term as well. Both segments, significant opportunity remaining.
Richard Daly (President and CEO)
Thanks, Alex. Appreciate it. Any other questions?
Thank you.
No questions from my side. Thank you very much.
Thank you.
Jeff Del Carmen (Chief Commercial Officer)
Thank you.
Operator (participant)
Ladies and gentlemen, this does conclude today's program, and we appreciate your participation. You may disconnect at any time.