@Arizona and others following $BOT, I'm not surprised by the $BOT SP action today, in the context of three factors:

1. The recent sell-off in the absence of tangible news
2. The new bullet points you've highlighted (Slide 15), which will be interpreted as "things are going well"
3. A pretty significant sell-off of risk assets today, thus making $BOT appear attractive (at the margin) as a place for money "on the move" to go.

I think this just underscores that $BOT will continue to be volatile (that's up and down!) on both minor news and the absence of any news. It is all just noise at this stage.

Heavens only knows what the share price moves will look like when we get some real information!

Seriously, because of this, I'm not even thinking about trying to trade any short term volatility. Because who knows when we'll get a material update! If you are a $BOT holder, you have to accept this and recognise it can go either way. When there is "real" news, I imagine there might not be an opportunity to react.

@mikebrisy I am inclined to agree with you.

Once some sales data comes through to these data hungry share holders, the share price reaction will be swift in either direction.

This adds some detail to the presentation, small interview Howie did recently. I do think their was a Euroz conference for insto's yesturday / last few days but I can't find anything specifically to back it up aside from another couple of different companies with presentations dated for Euroz march conference.

A game-changer in dermatology | Finance News Network

One thing to note is they are saying the refills exceed their expectations and they have previously said they are targeting 8-10.

What I don't understand is why they say that.

They are buying the copay down to zero and no patient interaction is required for the refills, they are sent automatically the patient has to do nothing as far as I am aware to get 11 more after the first one. I do expect some churn once they have had 1 year worth as they would need a repeat appointment but expect Botanix will be initiating follow up contact as people roll off the autorefills to try and re-sign them up.

I don't think the churn will be that noticeable for the first 12-18 months (churn will only really start April / May next year unless they knock it out of the park for the first 2 months) and assuming they are looking to sell it within 2 years it won't matter. We would only be churning off a low base for the first 6 months of next year so it is probably only really measurable after 18months unless they report it specifically.

@Schwerms

like you I had a search yesterday for the conference and came up short.

I have heard Matt use the 8-10 refill figure in the past and I wonder if this is a way to be conservative and to allow some room in the forecasts for some customers to drop off?

Just me theorising.

Are they buying the co-pays down to zero? I thought this was just a short time situation for PEP program participants so, they could collect feedback and iron out any issues with their operations?

> They are buying the copay down to zero and no patient interaction is required for the refills, they are sent automatically the patient has to do nothing as far as I am aware to get 11 more after the first one.

Good point. Some patients will stop using Sofdra, either because it's not effective or they experience side effects. Some might cancel, but others may continue to receive refills even if they aren't using them.

Does the 8-10 rate factor in some of this churn straight up? What sort of visibility will management have over the percentage of patients using Sofdra daily vs simply receiving refills automatically?

My assumption is the 8-10 factors in some drop off over the first 12 months and frames any churn at 12 - 18 months to be less dramatic.

@Ipsum So let's say I am using SOFDRA (while I am lurking on a FB Hh Forum, and I do find Januaries in QLD a challenge, I am fortunate not to be a sufferer).

Assume that after trying it for 3 weeks, I get only partial relief and I don't like the head aches, dry mouth, blurry morning vision, and I stop. The refill arrives, and it just sits in my bathroom cabinet. Do 10 more refills arrive and pile up in my bathroom cabinet? Or does something stop the process?

I'd have thought they'd have some text message to say, "Your Sofdra refill is getting issued in 3-days, Press STOP to cancel."

Why else would they assume 8-10 reflls?

This is an interesting point, because it is highlighting a gap in my understanding of how the process works in detail. It is important to understand that, because it governs how churn plays into the revenue growth profile, and can lead to under- or over-estimation of the s-curve from initial quarters of data.

It would seem the Howie/BOT playbook is at least in part: “Lets jack up the price to the insurers of this relatively inexpensive molecule and then discount it back. So in this way the consumers buys the first dose, it arrives and irrespective of whether it works for them or not and the little bottles just keep arriving at their doorstep, and the cheques at our bank account for the next 11 months. Howie & Co have been around marketing and distribution of dermatological drugs in the US for some time, so he is no novice to all this. It would be useful to question him on the details of how all this is supposed to work.

It is hard to believe the insurers would not be awake to the above potential drain on them and have a mechanism as mikebrisy has suggested to prevent or at least ameliorate.

If not then I suspect the market itself will put a pretty hefty discount on the initial BOT revenues/profit stream as these kind of situations generally do not persist. Someone eventually wakes up and puts a stop to it.

From several years ago I recall the case of Freedom Insurance, an ASX listed seller of personal insurance.  Freedom managers were always very cagey about how they marketed their products. In the Hayne Royal Commission we learnt their “sales force” consisted of commission renumerated backpackers who did telephone hard sell. In an egregious example of the company’s “marketing” efforts we heard a young man with Downs Syndrome with no understanding of what he was signing up to being sold life insurance.   Pretty disgusting stuff.

Not saying with BOT we have the likes of the above going on - however investor caution warranted!

Hi Mike / Schoonie,

In the interview below is where Matt says no interaction is required due to buying the co-pay down to zero, this was the first interview it clicked with me / was worded that way.

He also said regarding the insurance, the insurers essentially said during price discussions if you stick with this price point we will leave you to do your thing.

Regarding the insurance drain, AI says the US insurance market estimated to be 1.76T, even if Bot were to do 1B in revenue, 1B of 1706B is such a tiny figure probably not that noticeable when spread over the entire market of individual insurers. think it is 0.058% of the total market at 1B revenue.

From my understanding with the 'no interaction' it would be up to the end user to ring up and say, can you stop this, which doesn't seam that likely of an outcome if it has no cost and you may still use it at some point so may as well have the rest turn up. Probably also a bit of the "who cares better get my money worth from my insurance" as well.

I also think they use the 8-10 to account for the churn of overall users.

It is a very cunning system if it works.

**

The US health insurance market is estimated to reach $1.76 trillion in 2025 for gross written premium, with a projected growth of 3.03% annually, reaching about $1.99 trillion by 2029. 

""

Botanix Company Webcast @ Lytham Partners 2025 Investor Healthcare Summit - YouTube

> Do 10 more refills arrive and pile up in my bathroom cabinet? Or does something stop the process?

> I'd have thought they'd have some text message to say, "Your Sofdra refill is getting issued in 3-days, Press STOP to cancel."

@mikebrisy yes, that is my assumption about how it works. And it is an assumption!

I'd assume this would lead to some waste which would be a problem for the insurers. All the language does suggest refills are automatically sent.

Here's a YouTube video that demonstrates the process with CVS: https://www.youtube.com/watch?v=9UJrQ2-H400

Botanix are working with UpscriptHealth however, and there aren't any details I could find on the getsofdra.com website about how refills work, but we know automatic refills are available.

I found another site, upscriptvision.com which looks like it is built on the same platform as getsofdra.com. The FAQs include:

> CAN I SET UP AUTO-REFILL?

> Yes! If we’re shipping your prescription, you can enroll in auto-refill at checkout or later within your account. You may cancel auto-refill at any time in your account or by contacting Customer Service.

This is the same process described in the CVS video, so this maybe the standard process for an automatic refill of presdcription medication.

Here's another one: contrave.com, a weight loss drug, also appears to be on the UpscriptHealth platform. They have automatic refills as well and include this note:

> Note: Certain products that are prescribed for regular use will automatically enroll you in the auto-refill program.

I would not be surprised if Sofdra is an auto-enrolled auto-refill product as well.

Even with a text message to tell the patient they are receiving a refill there will be some number of patients that have stopped using the treamtent that will neglect to cancel their orders. It's not costing them to receive the order so there is little incentive to stay on to of unused deliveries.

Why would insurers put up with this? I'm not sure, there's a few parties involved here. Upscript will no doubt benefit from the number of untis shipped, so there could be a short term incentive to maximise delivery over actual active users? The US health system is impressive in many ways but I wouldn't count cost efficiency among them.

> If not then I suspect the market itself will put a pretty hefty discount on the initial BOT revenues/profit stream as these kind of situations generally do not persist. Someone eventually wakes up and puts a stop to it.

@Scoonie Yes, I agree. The early numbers, particularly refill rate, maybe higher than the long term rate.

On Reddit I found this post in the hyperdydrosis group:

I like to think any spam accounts are the result of over enthusiastic sales people rather than any official marketing campaign!

@Scoonie I have no experience working first hand with health insurers on the Pharma side - in the US or anywhere else for that matter.

It seems amazing that whoever is negotiating the arrangement between $BOT and the payor wouldn't be on to this. It's not as if Sofda is unique in this respect. Otherwise, the potential for waste is staggering.

But what you say about $BOT front loading the payment on the initial dose make sense.

This might be worth firing in a question to $BOT ahead of the next investor call, or perhaps later in the year if we can get Matt Callahan back to talk to us.

I asked my BA to have a sniff around the topic, and below is what they came up with. My takeaway is that I think you are right. $BOT are commercially astute and have probably loaded the payment in favour of the initial dose, pushing this as far as they could get away with. (Obvious thing to do if you are commercially minded!! ... oh, all those up front costs of the platform, all those field force mouths to feed ... yada yada yada,)

------

Report from my BA ChatGPT4o

Pharmaceutical companies are generally paid at each refill, not just on the initial prescription. However, the exact payment structure depends on several factors, including the drug type, insurance coverage, and the agreements between manufacturers, pharmacy benefit managers (PBMs), and insurers.

1. Payment Structure for Refill-Based Drugs

• Retail and Specialty Drugs: For most retail and specialty drugs, insurers (payors) reimburse pharmacies each time a prescription is filled or refilled. This ensures that the pharma company continues to receive revenue as long as the patient remains on therapy.
• Chronic Medications: Drugs for chronic conditions (e.g., insulin, blood pressure meds, statins) typically have ongoing reimbursements for each refill.
• Specialty and High-Cost Drugs: Some high-cost specialty drugs may have step therapy or prior authorization, where payors may monitor adherence before approving refills.

2. Payment Distribution: Initial Fill vs. Refills

• For Most Drugs: Payments are typically evenly distributed across the initial script and refills.
• For Specialty Drugs: In some cases, the first dose may have a higher payment due to:
• Higher administration costs (e.g., infusion drugs).
• Starter doses requiring different formulations or packaging.
• Loading doses (e.g., biologics) that involve a higher initial dose before transitioning to maintenance doses.
• For Maintenance Medications: If the drug is for long-term use (e.g., cholesterol or diabetes meds), payors do not front-load the cost on the first script but rather distribute payments across all refills.

3. PBMs and Reimbursement Considerations

• Pharmacy Benefit Managers (PBMs) play a key role in negotiating drug prices and setting reimbursement schedules.
• Rebates and discounts may affect how payments flow between pharma companies, pharmacies, and payors.
• Some PBMs or insurers may have policies where they lower reimbursement for refills to encourage cost savings.

Bottom Line

• Pharma companies are paid at each refill rather than only on the initial prescription.
• For most drugs, payments are even across fills.
• Specialty drugs or biologics may have higher initial payments due to front-loaded costs.

It would be very helpful to know exactly how it works, to me when they say "no patient interaction required" it's just keep sending them but it seems very logical that some sort of text is sent...

we are getting a very good collection of questions together for one of the Botanix guys if @Strawman can get one to come for a talk with us?

Sorry to pester you strawman, I've marked this as what MikeBrisy described in his AI-Media post as a fat pitch and have swung hard at it.. so very interested to hear from Botanix as I am sure a lot of others on here are.

@Ipsum nice detective work. Yes, it makes sense.

On socials ,,,

Yes, sadly there appear to be several suspicous Sofdra reviews on sites like Drugs.com, Reddit and the FB group I am on.

Telltale signs are:

• Anonymous posters or posters who have no history prior to their Sofdra posts
• Very well-written posts, with clear key messages, distinct from language typical of the forum, several linking through to the IHsS site, which is promoting Sofdra.
• Unbalanced ... citing very good response and very little on side effects in a way that seems inconsistent with what we know from the clinical trials. For example, in a random sample of 10 users you are almost certainly (>99%) NOT going to have 10 reporting a significant positive respone with no mention side effects.

Who's doing it? I can't imagine that this would be sanctioned by the company. These are industry veterans, and it would only take one whistle-blower to blow up the whole thing. Might it be Sales Reps. Don't know. Seems unlikely as the sites are global and unlikely to help in a specifici geography (even if it increased a customers willingness to try.)

More likely, its unethical $BOT ASX retail investors!

Hi Mike, a lot of reviews come from the *other* forum, they own to to writing some or most of them. The screening is very minimal to leave a review and the same person can leave multiple..

I've put out a request for Howie, but will give it a nudge. Would love to get an update since the last time we chatted (July 2024)

https://vimeo.com/981648740/55be1a4784

@Scoonie , I believe the pricing was already preset by the Qbrexza rate, Sofdra got a slight premium above that as it is better based on the trial data.

Botanix has a much higher gross to net than Journey got with Qbrexza though. We are netting $450 US think journey was only getting $200.

I hope with the experience of management this is all above board but they were all part of medicis which got sold and then had the vaelent / philidor drama but I didn't pick up anything online showing that anyone that is currently with Botanix was caught up in it, it looked like Valeant going rogue with the platform a while after they acquired it.

TLDR - Vaelent bought medicis for the platform and medicis products, the product was on the decline in sales, not sure if they new or realised or cared but then they were doing a dodgy with the platform (it was originally called medicis alternate fullfillment) this was version 1 of the current Botanix platform that they sometimes refer to

There is nothing really around on it apart from a post on cafe pharma when they were hiring with people saying they would be hesitant to go and work there as "those guys were caught up in the medicis / vaelent / philidor saga. It is a bit of a Rabbit hole to go down but I didn't find anything, but turning up something suspicious here wouldn't look good with how they are doing the refills here.

Botanix Pharmaceuticals / Sofdra Launch | Cafepharma Message Boards | Pharma Sales, Device Sales, Lab Sales

interested to hear anyone else's thoughts who has the time to dig through it...

I have been under the impression that BOT were aiming to "pre sell" as many refills as possible upfront. Ie: 11 refills.

The 8-10 refill figure allowing for customers who decide they don't like it.

The whole way along this has seemed quite remarkable. I have no experience in the insurance game and I don't know if this is a common practice in the US. But it does seem incredible.

For example, I understand that the Japanese need to "reapply" via a health care pro each time they want more SOFDRA.

In the US the insurance coverage and the refill system as I understand it does some something magical to the potential sales numbers.

It does seem to me that insurance companies would not want SOFDRA be bought for people that don't want it.

It would be prudent to understand the insurance and the refills a whole lot better than I do.

Good discussion, folks

HELD

@mikebrisy "More likely, its unethical $BOT ASX retail investors!" Haha, hadn't thought of that. Yes, quite likely!

@Schwerms Nice work.

There is not much to go on there, interesting non the less.

"This is not a direct hire position. It is a one-year contract position. The company is an Aussie-based one that has never had a US-based salesforce before. Mixx holds the contract, and the 26 reps hired will be employees of Mixx."

A one year contract position would give BOT time to scope out where this is all going.

I'm having a little dig around, but havent found any BOT staff related to the vaelent / philidor drama.

@Ipsum I have read forums where posters who claim to be share holders, state that they are making up/writing reviews for SOFDRA.

@lpsum I've read the same, Sadley there is a lot of money writing reviews.

Thanks Andrew, that original interview put me onto Botanix, my membership was worth it just for that

There's another post on there where they say it is a 2 year contract with some share options and they hope to sell it within 2 years

Gray market option...

The implications for excess sales of SOFDRA due to no motivation for user to stop repeats if they find SOFDRA is ineffective, or they have side effects they don't like are interesting and likely to support sales and reduce churn stats initially as pointed out.

However, add the motivation that users who have insurance coverage could get a script for 12 repeats and then sell them on the gray market to suffers who don't have insurance in the US or sell them overseas!

Now things start getting very interesting and the cost implications to insurance companies may prompt a response in time which could see a requirement to change the refill process. Or it could just lead to significantly more sales - something to watch out for.

"Show me the incentive and I will show you the outcome"

@Schwerms Yes they were all one liners, so not packed with info, but the idea that they are building a takeover target is certainly in line with what the company has intimated previously.

@Tom73 There is a little niche for someone. I would never have thought of that.

Surely SOFDRA isn't the first product to be sold in this way. Insurance companies must be all over this stuff.

We could have something like A2 milk did with the baby formula and the Chinese daigou market..