@Ipsum nice summary of the presentation.

The way I am thinking about $BOT is as follows - as I reflect on yesterday and try and fit all the pieces together.

Analyst projections have anchored on rather conservative market penetration assumptions. At one level, this makes sense: the product is expensive and will need payor support (for which $BOT have done a lot of work); it is not alway effective; and there are some mild/moderate side effects. But with the market so large, how can you even begin to put down some sensible assumptions?

Answer: study the case of Qbrexa and then also consider Japan.

There is a related product in the market in the US: Qbrexa, which has not achieved a very high penetration. The low uptake of Qbrexa may be down to a combination of limited efficacy, the minor/moderate side effects and pricing. Another factor is that Qbrexa is applied with wipes, which are arguably not as convenient for the patient as the applicator for Sofdra.

While SOFDRA and Qbrexa have "similar" profiles (I know this is a very loose statement, and is meant to imply broadly comparable), I think there are some important differences. However, I suspect the analyst projectionss are being anchored by the real world experience with Qbrexa.

I believe a major factor is Go To Market execution.

Qbrexa was launched in late 2018 by Dermira, who marketed the drug for 3 years, prior to selling it to Jorney Medical Corporation ($DERM) in 2021. $DERM refocused the sales and marketing strategy, significantly reducing spending and spending only 3% of what Dermira spent, growing prescriptions by 58% over 3 years, reaching 123k total prescriptions in 2023 and looking like its going to be up 9-10% this year. (See slide below from recent $DERM presentation).

Just to be clear, with each refill at 30 days, then 150k prescriptions this year is only about 12-13,000 patients. Tiny, in the context of the market. The key here is that $DERM is quite a small business - market cap of US$105M - and as the slide below shows, they are taking a very disciplined approach to sales and marketing, spending only 3% of the large investment put in by Dermira.

This is where the management team of $BOT comes in. Their track record in dermatology is impressive, and they are not showing up to create a $100m company!

The webinar gave a deep dive into the sales, marketing and distribution platform that $BOT have built ahead of the launch. They aim to reach some 1 million customers before the sales reps even hit the ground in early 2025. Telehealth is a key differentiator here, and a significant proportion of customers said they'd be more likely to try the product if they can get it without having to visit a physician!

In July, Euroz Hartley (EH) reported that Kakken has sold 350,000 units of ECCLOCK (the name for SOFDRA in Japan) in the last 12 months in Japan. That's treating almost 30,000 patients in Year 4, in a much smaller market, with marketing by a highly diversified company - not a dermatology specialist. Clearly, the product is capable of gaining market traction. ECCLOCK sales in FY23 grew by 67% over FY22, although it does now appear to have plateaued - based on one quarter of data.

For these reasons, I have formed the view that I think SOFDRA is going to do materially better than Qbrexa.

In context, EH's TP of $0.47 only requires 33,000 prescriptions in 2025 and 139,000 in 2026, getting to 500,000 by 203-2031. But in Japan, a market one-third the size of the US, Kakken has gotten to 350,000 scripts in Year 4 and are growing strongly. If the US can replicate the success in Japan, then 1.5 million scripts by 2030 is conceivable - still only a tiny portion of the potential market. But what if the Go To Market execution in the US is significantly better than Japan?

So, despite all this, we come back to the low penetration of Qbrexa. $DERM aren't dummies - they also have a telehealth channel, and product awareness is high due to the large splash in 2018-2020 by Dermira. And that brings us right back to where we started. The analyst projections - I believe - are anchored by the Qbrexa experience.

Conclusion

The strong $BOT management team, the pre-investment in the Telehealth sales and distribution platform, the patient survey data and support from IHhS, the prework done on payors AND the read-across from product experience in the Japanese market, leads me to believe this is limited downside for this product and a very large upside.

So, I now see this as a sales, marketing and distribution execution risk story. What's certain in my mind, is that we are going to learn a lot about this next year as the initial sales reports come through, and we get to see what the execution looks like.

Will it truly fill an unmet need in the market, or will it be Qbrexa 2.0?

@Ipsum If the attached timline is anything to go by, there doesnt seem to be much to push the share price around, until the new year.

Once sales are reported in some fashion, then there will be something to really talk about, I guess.

So does that leave room for the SP to come off a bit in the meanwhile?