Anthony Doyle: Charlie said about the link between patient growth and then revenue similar in ex U.S., there will be some puts and takes, right? There’ll be some peaks and troughs for these quarters that are bigger quarters that are smaller, depending on which rower selling into. But overall, the trend continues to be really strong.
Operator: Next question is from Maurice Raycroft [ph] of Jefferies.
Unidentified Analyst: This is Yaw for Maurice [ph]. Congrats on a successful quarter. I guess — our first question is on patients on free drug program which went down from 34% in Q1 at peak to about 30% by the end of Q2. Can you maybe provide more color on what you saw in Q3? And where do you think that will be by year-end?
Jon Stonehouse: Charles?
Charlie Gayer: Yes. So good question. And we said we were at 30% at the end of Q2. I noted on the prepared remarks today that essentially, that number is a little over 30% in Q3. What we saw in Q3 is a couple of factors that affected that. And these kind of wobbles are going to happen as we make that long-term progress towards 85% paid. But in Q3, we saw some Medicaid patients moving temporarily, we think, to free product as some of the COVID release funding ended. We also saw — it’s re-enrollment season insurance companies. And so some patients actually moved as their switching plans temporarily to free product. And then the other piece that is driving up just a little bit, the percentage of free product is that as we’re improving our processes to get people to pay, we’re actually slowing down a bit to get better results.
So when new patients come in, we’re keeping them on the Quick Start [ph] program for a little bit longer to make sure that we’ve got a really comprehensive case for the insurers so that we actually improve the percentage of paid. And we’re seeing that paying off, so amongst our commercial segment which is about 60% of our patients, we now see that over 80% of them on paid therapy. And so that’s one1 of those trends that gives us confidence in the long term that we’re going to get to 85%. As far as where we’re going to end the end of the year, I don’t even want to make a prediction. I think it’s — this is all about that longer-term progress. And as Jon noted, we don’t expect a meaningful change in 2024 but the percentage changes will start to improve in 2025, ’26 and ’27, that’s when we’ll start to notice it.
Unidentified Analyst: Got it. That makes sense. I guess a quick follow-up on the third quarter sales. We — are you now seeing more patients coming from [indiscernible] patients or converted patients in the U.S. And should we assume maybe more of a revenue growth ex U.S. are from prophy [ph] patients?
Charlie Gayer: So in the U.S., the trends are really the same. It’s that roughly 50-50 split between patients coming over from Pros or Protein Naive [ph] at least most recently that they’re not on prophy [ph]. That has been — it’s not exactly the same every quarter like anything else but it’s been really consistent over time. Ex-U.S. yes, we get a lot more patients who are protein naive because the prophy market in general has trailed the U.S. ex U.S. but that’s starting to change. And so we get some switches from other prophy ex U.S. but most of it is people coming on to prophy for the first time now that they can do it with a targeted oral therapy.
Operator: The next question is from Brian Abrahams of RBC Capital Markets.
Unidentified Analyst: Everyone, this is Naveen [ph] for Ryan. Congrats on the quarter. And we really appreciate some of the color that you gave around some of the sales trajectory that you expect for the coming years. On that, I just wanted to ask Slide 4, some of the data that you had regarding net patient growth and also some of the discontinuations. It seems that perhaps some of the discontinuations are levelling off or perhaps maybe changing dynamics. Could you maybe speak to whether you are seeing improvements in the retention rate and whether that’s affected by your kind of push to better educate patients? And then I have a quick follow-up as well.
Charlie Gayer: Sure. No. So good analysis of the data. Yes, I think we have seen it improve certainly from what we experienced very early and in the launched it is exactly that. It’s setting expectations. We do that all the way through everything that we can do with health care providers to make sure they talk to their patients when our patient services teams, talk to patients, they set expectations. And we think that, that has really paid off. The market is getting very familiar now with ORLADEYO. Physicians and other health care providers know the drug that have confidence in it patients now know a lot more and they have confidence in it. And in a condition like HAE, where stress can cause attacks, having confidence in your therapy is important. So we think that’s all part of the pattern settling out and we’re very confident in this pattern going forward.
Unidentified Analyst: So and kind of like a follow-up to that, can you also speak a little bit to the trial progress for ORLADEYO in pediatric patients with the sprinkle formulation? And is there perhaps anything you could tell us about what those retention metrics might look like within the pediatric patients so far? And if any differences in the GI tox that you might be seeing in this population?
Charlie Gayer: So the trial enrollment is going well. I’ll defer other questions to tomorrow. In our R&D Day, we will be addressing that amongst our other programs. But what I’ll say is the trial is going well and there’s a huge need, there’s a need for an oral therapy across the market, as you can imagine, in pediatrics, no parent or caregiver likes to inject their child and their child likes to be injected. And with HAE, fortunately, a lot of the kids don’t become symptomatic until puberty but about 4 and 10 patients actually have their first [indiscernible] by age 5. And so there’s a huge need to have an oral therapy that can prevent attacks so that these kids can live a normal life. And that’s what we’re shooting for. And we think we’re optimistic we’re going to have a great product to do that.
Jon Stonehouse: A really good indicator of you’ve got something of real need for patients is when your enrollment goes really well and enrollment is going really well in this trial.
Operator: The next question is from Jon Wolleben of JMP.
Unidentified Analyst: This is Catherine [ph] on for Jon. I just have a quick question about kind of just what’s been working well in the ex U.S. launch of ORLADEYO, I know you kind of — gaining ground with reimbursement dynamics. But any other color you could provide?
Charlie Gayer: I think, sure, a couple of things. I’ll touch on the reimbursement first because that ex U.S. anywhere getting access to products, having someone pay for it is really critical for patients to be able to get their therapy. So an example that I’ve cited before in the United Kingdom, where ORLADEYO is covered NICE approved ORLADEYO for patients with 2 attacks, HAE attacks or more per month. Whereas other modern prophy therapies like Expire [ph] were limited to patients with 2 attacks a week or more which is a very small segment of the market. And so our team has been able to take advantage of that and really help out of patients with ORLADEYO. And then I think the other factor is just what I mentioned on one of the earlier questions which is until a few years ago, there were — there was very little availability of modern prophylaxis outside of the U.S. And so the patient community, the physician communities in these different markets, we’re just not used to using prophylaxis.
