Krystal Biotech, Inc. (NASDAQ:KRYS) Q3 2023 Earnings Call Transcript

Krish Krishnan: Yeah, I will start with the second one first. Predominantly, derms [ph] is the profile of the community physician, but that varies three two. It could be a dermatologist, some of the patients go to blood transfusion centers, probably getting tired of going to dermatologists and managing palliative at home in the past. But in terms of the start form itself, we like to accept a very high quality stuff. Sometimes we make exceptions when there is an urgent need or a request by the physician. But by and large, the start forms are highly audited. In terms of providing any kind of guidance on how many is in the queue that we’re trying to convert, I think it would be a bit premature, and not right for me to talk about that. But I will say that we expect now with access in place, we expect the pace to be just as good if not better going forward.

Ritu Baral: Got it. And then I just wanted to ask a follow up on the persistence rate. How are you defining that 96%, is it patients who are reimbursed and who either skip a week, or are they — are you finding — are you telling patients who skipped like, two weeks I don’t intend to resell and I’m just wondering how that 96% is defined? Thank you.

Krish Krishnan: It’s basically I mean to simplify, look if your look by the week sometimes once in a while somebody misses a visit, for some personal reason or schedule. But most of the patients on drugs today are at four vials a week, whether they’re recessive or dominant. So when I say compliance is really high it means we’re shipping four vials a week to a patient at the moment.

Ritu Baral: Got it. Thank you very much.

Krish Krishnan: Four vials a month, I’m sorry. I meant to say month.

Operator: Thank you. The next question comes from a line of Carly Kenselaar with Citigroup. Your line is now open.

Carly Kenselaar: Great, good morning. Thank you for taking my questions. Two questions for me. First, on the reimbursement side, just wondering if there has been any surprises with respect to the policies insurance companies are putting in place, particularly as it relates to the payer process, just anything unexpected there? And then the second question is if you can just remind us what proportion of patients — of the identified patients are tied to Centers of Excellence in the U.S.? Thank you.

Krish Krishnan: On Access Carly, thanks for the question Carly. On Access things have been relatively smooth, there’s nothing unexpected. We have a good system of offering contracts to payers. If they are accepting then they get eligible for the price gap. So both on the commercial side and on the government side, Access has been at a good pace like we’re pleased. We expect to get the J Code finalized, officially published in January, which is I think on time based on when we got approval. So overall, pretty pleased, nothing unexpected. In terms of patients at the Center of Excellence, that’s a great question. It’s a tough one because a lot of patients who once saw or saw a physician at a Center of Excellence, a lot of them are actually stuck and gone back to the local community in the absence of an approved drug.

And so trying, what we like to the way we think about it is the number of active patients present really at the Center of Excellence. And so — which is why, if you look at the start forms for the — if you think about like only 46% came from the Center of Excellence, we believe there is demand left at the Centers of Excellence, limited by the two factors I mentioned. One, physicians wanting to literally have a patient visit prior to getting them on VYJUVEK, which happens in rare diseases are quite a bit. And it’s a tough one to overcome because they’d like to see their patient talk to them about it, at least some of them. And the second is something we’re trying to educate around which is when physicians decide I’m going to put a handful of my patients, see how those works, before opening the gate to the remainder of the patients, and that we disagree a bit with and we’re using our medical affairs to work very closely with these scale ups, to convey the urgency of getting the patient on drugs.

Carly Kenselaar: Okay, that’s very helpful. Thank you.

Operator: Thank you. The next question comes from the line of Dae Gon Ha with Stifle. Your line is now open.

Dae Gon Ha: Hey, good morning, guys. Thanks for taking the question. Thanks for the first call and congrats on the progress Krish. Maybe one more on the VYJUVEK before switching over to KB407. In terms of the third quarter, I guess, can you talk about sort of the cadence of start forms that kind of came in, I know you don’t want to talk about sort of the queue but what can you qualitatively say about that and bearing in mind the holiday season is upon us, is that cadence at all kind of representative you think or at least 20%-30%, how should we think about that from a modeling perspective? And then second question on KB407, just wondering if you can narrow that guidance in 2024, is it closer to ECFS or NACFC and just looking at the competitor’s recent data, it seems like expression of the protein may not necessarily be representative of clinical profile, so can you maybe remind us what’s the differentiation that you think you’re going for? Thanks so much.