But we would expect kind of progression throughout the year on NexoBrid. So again, Epicel can vary a bit, as we know from quarter-to-quarter. I think it’s safe to assume that NexoBrid will continue to build during the year. So there will be a degree of seasonality, certainly in NexoBrid. But just to bring it back, I wouldn’t assume anything materially different on MACI, and again, Epicel is a typical quarterly volatility.
Ryan Zimmerman: Thank you for all that color. That’s very, very appreciative. Maybe just to ask on NexoBrid, I think people were hoping it would kind of get rolling pretty quickly here. You’re guiding to kind of a similar level from the fourth quarter. Talk to us about kind of how the process is going. I mean, clearly, there’s interest, you wouldn’t have that many sites ordering this early if there wasn’t. But how do you think about kind of the early adoption of NexoBrid from what you’re seeing so far a couple weeks in the launch? Thanks for taking questions.
Nick Colangelo: Yeah. Hey, Ryan. This is Nick, I’ll start and then, Joe, can kind of talk about sort of the dynamics of the distribution system. But from our perspective, as you referenced, whether it’s our market research or independent work that others have done, I mean, there is this high level of interest from surgeons in NexoBrid. There’s no doubt about that. Obviously, we — the team’s done a great job on in terms of the onboarding of burn centers and we’ll continue to keep adding those burn centers. With the delay last year, there was an interruption to sort of the onboarding process for many centers when the product did become available. Obviously, those that were farther along were able to kind of finish out that process and start making some initial orders.
And with respect to other centers where they had really kind of put things on hold, it was a re-engagement process. And all of that’s going really well, obviously. Importantly, we think about this, obviously, as we’ve always said, over the long-term, when you’re changing the standard-of-care for what burn surgeons have done for the last several decades in terms of their eschar removal protocols, et cetera, those things take time. But making great progress, and importantly, we take great care to make sure we support the initial patient applications and treatments. The outcomes have been great. The surgeons’ feedback has been great. So, we think we’re kind of where we thought we’d and sort of making the progress that we would expect.
Joe Mara: Yeah. And just to add a little bit as well on the NexoBrid side. So, first, as Nick said, obviously, the metrics have been very strong to start. The clinical feedback has been very positive. So, those are great signals. I think it is important to understand, we’re early in the launch, and a couple of things just to point out, which is, again, the distribution on NexoBrid is very different than MACI and Epicel. And just as a reminder, we have a 3PL that kind of manages our inventory and then the distribution network that’s in place consists of multiple specialty distributors. Some have multiple locations and we recognize revenue when those specialty distributors order from our 3PL. The second kind of part of the channel, if you will, is then the burn centers and hospitals order from those FTs. It might be the one that they typically work with, most likely or some different products at their centers.
So when they order, that drives additional orders from our FTs each quarter and then leads to our quarterly revenue. And then lastly, it’s important to remember that both the FTs and the hospitals will keep some level of inventory, which can vary and impact ordering patterns. So just briefly, as you kind of think about the first couple quarters of launch, again, Q3, that was, if you remember in Q3, we got commercial availability very late in the quarter. So that was essentially the FTs kind of ordering from a channel perspective in Q3 and we didn’t really get into the market and start treating patients until Q4. That’s the quarter where hospitals start ordering from FTs and kind of it’s in the market, et cetera. And generally, I think what we’ve seen is a lot of the burn centers that were more physicians, sorry, more familiar with NexoBrid, some of the burn surgeon KOLs, as well as the hospitals that were farther along in the P&T process, even when things were disrupted last year.
So that was as anticipated that leads to essentially some initial stocking at hospitals. And now as we get into Q1, we’re seeing continued use on patients. We’re seeing some of those hospitals start to use that inventory that can then lead to some reorders. And at the same time, as Nick mentioned, the team’s working to add new centers on top of the ones that have already ordered and working through some of those administrative challenges at the burn centers. So I think as these dynamics play out, particularly early in the launch, it’s going to take some time for ordering patterns to normalize at both the FTs and the hospitals, which is anticipated, I would say, at kind of this point in the launch. And lastly, again, we have one quarter of history and still a few weeks left in Q1.
And again, unlike MACI and Epicel, we have a ton of history and data. We won’t know exactly what those FT orders look like until we get later in the quarter and so there’s still a range of outcomes, I would say.
Ryan Zimmerman: All fair. Thanks guys for the very comprehensive answers. Appreciate it.
Joe Mara: Thanks, Ryan.
Nick Colangelo: Thanks, Ryan.
Operator: Thank you. One moment for our next question. Our next question comes from Mike Kratky with Leerink Partners. Please go ahead.
Mike Kratky: Hi, everyone. Thanks for taking our questions. Can you speak to how you’re thinking about how quickly you can get traction in the new target surgeon population once you get arthroscopic approval? I mean, do you get the sense there’s pent-up demand from surgeons that are not currently using MACI presently, but will start doing implants once you have arthroscopic approval?
