Neurocrine Biosciences, Inc. (NASDAQ:NBIX) Q4 2022 Earnings Call Transcript

Our trial in Phase 2 is designed to give us an initial estimate of benefit risk and the safety and tolerability. And so I think when we read the data from that study, we’ll be able to have a much better understanding of how we might differentiate from a tolerability and safety point of view. And then in terms of the broader activity with the M1/M4 dual agonist, beyond schizophrenia, we believe there is a significant degree of opportunity for this platform in diseases impacting cognition all the way through from Alzheimer’s to neuropsychiatric disorders that are impacted with deficits in cognition. And in addition, I think your commentary around bipolar also makes sense in terms of the mechanism of action here.

Kevin Gorman: And so the only thing I would add is that we have been in — had a very deep research program in the muscarinics all of them for the last several years. And with that, coupled with our collaboration with Sosei Heptares, positions us uniquely out there in the muscarinic world in that we can test the hypothesis in man with a number of specific compounds, an M4 specific agonist, an M1/M4 and an M1. And so we’ll be able to tease out and elucidate exactly the pathways that are involved here and be able to choose the right compound, the right mechanism for the right disease.

Operator: We will take our next question from Evan Seigerman with BMO. Please go ahead.

Evan Seigerman: Hi, guys. Thank you for taking my question. I would love to know some of the puts and takes of tardive dyskinesia in the long-term care setting. This could be a significant driver just given population dynamics. I guess kind of, one, what is the plan for reaching these patients to providers or patients, assuming that DTC is probably not in the question here — or out of the question here? Thank you.

Eric Benevich: Thanks for your question. And certainly, I agree that this is an exciting opportunity for us that we’ve been looking forward to really for years. So how do you create leverage within LTC? As I mentioned before, these are facilities that are essentially run by nursing staff 24/7 with providers that rotate through, whether it’s the medical directors, the consultant psychiatrists, the nurse practitioner, the consultant pharmacists. And our team really has worked to understand what are the dynamics locally in terms of these facilities, who are the facilities that the providers are rotating through, what’s the relationship with the LTC pharmacies? And this kind of building what I would call an outside-in account management approach so that you can work with a number of providers, but really affect a much larger number of facilities.

Obviously, we do a lot of education. We go in and do in-service programs for the nursing staff and for the entire care team really in those facilities to help them to recognize TD movements, flag those residents, and bring them to the attention of the providers so they can do a full differential diagnosis. And so it’s a team approach. It’s a more complicated environment than what you see in most outpatient clinics. And in some ways, it’s more similar to what you might see, for example, in a hospital environment in terms of how you need to sort of manage those accounts. So we’re excited about the opportunity. We are seeing good progress there. It’s not nearly as developed, as I mentioned earlier, as the psychiatry and neurology business segments.

And that’s because essentially, this is just getting off the ground for us with INGREZZA. And so in some ways, 2023 in LTC is akin to 2017 for what our launch was like in psychiatry and neurology. So we feel good about the progress we’re making, and you’ll hear more about that as we move through the year.

Evan Seigerman: Great. Thanks.

Operator: And we’ll take our next question from Ami Fadia with Needham. Please go ahead.