Register for free to join our community of investors and share your ideas. You will also get access to streaming quotes, interactive charts, trades, portfolio, live options flow and more tools.
Register for free to join our community of investors and share your ideas. You will also get access to streaming quotes, interactive charts, trades, portfolio, live options flow and more tools.
what am I missing guys? Please walk me through the graphs they presented at ASDS and your interpretation because they are not a 1 point improvement from what I read as 70% of the trial participants had a severe GLS score which is 3 and to drop to none or mild is a 2 to 3 point drop on the scale, not a 1 point drop as Evolus had done in their past 20U trial. I am open to hearing out clear explanations. Be quantitative with your explanation of the graph and make specific reference to where on x and why axis labels I should be paying attention and how many weeks and percentage of responders so I can follow your logic.
This was Evolus' best reporting quarter as a company. Kudos to their CEO, David Moatazedi, for giving them a legitimate chance to become profitable. I had serious doubts about this and may now be shifting my view. They are clearly taking biz from Allergan and grew revenue Q/Q in the weakest quarter of the year. Their double dose Jeuveau study, despite not being peer reviewed, showed longer duration albeit at a much higher concentration than all NTs. Appears to challenge Daxxify duration claims but also at 40 to 50% higher cost of materials to Daxxify. Daxxify still outperforms on a NT cost/Duration basis against all current NTs.
Let's see where Daxxify sales come in. The typical Jeuveau practice is sensitive to NT pricing and is the ideal customer for Daxxify migration at the lower price point for Daxxify with less vials to buy to get to the lowest price tier.
agree. they beat my revenue and cash burn estimates substantially. Did not expect them to grow Q/Q. So this is much better than my expecations. Cash flow statement seemed off to me. Anyone have a chance to look it over? waiting for 10Q.
70% of patients were severe and 30% were moderate so the severe had to show at least a 2 point improvement to get to none or mild. Median duration to get back to none or mild was 26 weeks as shown in presentation I linked to. This was a close apples to apples comparison to sakura except that the NT was double concentrated at 16U/0.1cc. I view the results as solid, but guessing that they may have ptosis issues when injecting frontalis in practice at these high doses.
Evolus Presentation at ASDS last Friday evening showed Jeuveau achieved 26 weeks duration before return of glabellar lines to pre treatment baseline.
https://s29.q4cdn.com/603291515/files/doc_events/2023/Jan/30/updated/2023.01.30-analyst-call-extra-strength-phase-ii-study-interim-results-website.pdf
For comparison to Daxxify in JAAD in 2020 (Sakura):
https://www.jaad.org/article/S0190-9622%252819%252932459-4/fulltext
Jeuveau performed equal to Daxxify.
Note: price of Jeuveau averages $120 more per vial than Daxxify to the practice.
Jeaveau Pricing: best pricing: 240 vials run $370/vial ($89K order which very few practices can afford), 60 vials run $415/vial ($25K order), 30 vials $460/vial ($13,800 order)
Daxxify Pricing: best pricing: 150 vials run $275/vial ($41K order), 50 vials of Daxi run $295/vial ($14,750 order). You need to place an $89K order for Jeuveau to get their best price and that still comes out almost a $1/unit more expensive to Daxi's best pricing of $275/vial for a $41K order.
Botox: averages over $5.50 per unit for most accounts after quarterly rebates are taken into account. However, Allergan has been sampling aggressively the past 9 months since Daxxify commercially launched to help lower the overall cost of Botox to their customers and make it more competitive to Daxxify pricing.
The average account buying Daxxify right now is paying $295/vial compared to Evolus paying over $420/vial. If you buy 30 vials of Jeuveau, pricing goes up to $460/vial which is $165/vial more than Daxxify.
Assuming exact pricing to client and a typical injector doing 30 vials a month: the Daxxify injector makes 3000 units x $1.25/unit = $3750 more profit/month = $45K more profit per year. Busy injectors who do 100 vials a month make $150K more per year injecting Daxxify than Jeuveau using the same amount of toxin assuming double strength Jeuveau dosing and equal duration for both toxins.
My guess is when they did proof of concept internal testing for Jeuveau 8U/0.1cc they may have had a slightly higher ptosis signal and decided to hyperconcentrate it to further reduce the risk of migration and brow ptosis. Their ptosis rate was similar to Daxxify at 2% in this trial.
overall impression: this trial showed better results than I expected for Jeuveau. Congrats to Evolus for a well done study. However, its higher price per unit leaves it less competitive to Daxxify and being that they don't produce Jeuveau (its made by their Korean partner), they likely will not be able to drop prices much lower as they are still burning significant cash each quarter with very little cash remaining.
Evolus reports earnings today after the close of trading and I will be paying close attention to their cash position and revenue for the quarter and how it compared to last quarter and the prior year. I expect their quarter over quarter Jeuveau revenue to be down 10% but up 30% year over year.
Thank you for replying and nice to meet you 10nisman. Guessing you are at ASDS so that makes you an MD most likely. Care to give us color on what Mark said or what his body language told you? Are you using Daxi? thank you in advance and enjoy ASDS
Thank you Dew. I hope your estimates are better than mine for Q4!!
Evolus never got blocked from selling Jeuveau because of litigation between Allergan and Medytox. They were business as usual except for temporary slowdowns in sales during covid shutdowns in March 2020, etc
https://stockanalysis.com/stocks/eols/revenue/
That is correct. I want individuals in the know who have unique insights to post their revenue estimates. I have unique insights based on the growth I am personally seeing in Daxxify adoption, and because I have closely followed all other NT launches in the past 15 years (like dysport, xeomin, and, most recently, Jeuveau in 2019), I understand seasonality, competition, rebates/promos for Botox cosmetic day Nov 15th, the relative level of product sampling from the various NT makers that I am seeing and from my close industry contacts, etc..
In the event that you don't have a revenue estimate, then tell me which Revenue number it would take to make you add, sell or hold your position. At least this forces us to act objectively so we don't drink your own kool aid. I have revenue growth targets that need to be reached for me to accurately value Revance and maintain my conviction and much of it involves year over year growth in Daxi cosmetic of over 100% by 1 year of full commercial launch in June 2024.
edcoolidge and emmanow and all other active posters: your revenue estimates for Q3 and Q4? Not letting you guys hide/retreat on this. : ).
This lets us know which posters we can take seriously and which ones we can ignore. It also creates value for the board and its readers.
Dew: if your Q42023 revenue estimate of $90M+ is anywhere near that number and revance will explode toward $40 in no time. It took Evolus 4 years to go from $10M/quarter in Jeuveau sales to $46M last quarter which is 15% quarterly growth, taking into acct 2 to 3 quarters of little to no growth due to covid lockdowns.
My Q4 Daxi revenue range is $34 to $38M which is 35 to 50% Q/Q daxi rev growth. 25 to 30% compound quarterly rev growth for Daxi cosmetic next 8 quarters gets Daxi cosmetic to $600M in annual sales run rate by year end 2025, then add in Daxi therapeutic and RHA and we should be at $1B annual sales run rate by end of 2025 at margins in the mid 70s with only slight increase to opex and EPS of $2.50 and a 30x PE gets us to $75/share by late 2025.
If we can eliminate the need for any further secondary raise next 12 months and the shorts will need to cover in a highly disorganized manner that makes all valuation pricing worthless.
Technical Analysis:
broke above 10day EMA today which it has done 3 times prior the past 6 months but failed each time with no follow through volume.
There are no doubt the momentum/technical traders positioning themselves this week to trade any breakout and will pile on even heavier if it gets above the 50day MA which is currently in the $12.40 range.
What will confirm a breakout to me
Stays above 10 day MA and then moves toward $10 fast
2 to 4x daily avg volume
RSI above 50
Expectations for Revenue must be for a pretty bad miss for Q3 that is below the flat to slightly down Q over Q revenue guidance they issued Sept 19th.
My Daxi sales estim for Q3 is $25/26M. Disappointed that not a single person on this board has made a prediction on Daxi revs for Q3. If you don't have any idea of Daxi sales for Q3, then how do you know what kind of sales would be a beat in your mind and give you conviction to buy more or what sales would be a miss and cause you to not buy more or even sell?
Would love to hold all on this board accountable for their calls (bullish/bearish). Maybe we all chime in and get an average and then we can call out those who are most accurate. my ego is not too big to admit if I am wrong. Dew? lead us off.
my understanding was that it was discontinued in September so still had revenue in Q3. Was that not the case?
My Q3 2023 Income Statement Estimates:
Daxi: $26M
RHA: $27M
Service/HintMD: $3.5M
Total Rev: $56.5M
Cash Burn: $64M
Ending Cash: $307M
$150M still remaining in Credit facility to March 2024.
I do not expect them to give guidance for Q4 on the call.
Would love to hear your estimates.
The Daxi price drop was formally announced at the investor conference on Sept 18th and word did not get out to most accounts until the week or two after so that it likely only had 12 days of contribution to Q3 sales at most.
Hindsight is 20/20. I have continued to add shares based on my conviction. Remember that commercial launch didn't really start until May/June and new account adds are accelerating with each passing quarter. As I mentioned in that post in late August, it will take most new accounts 6 months to get comfortable with Daxxify and get the positive feedback from patients 4 to 6 months after their initial treatment. This feedback is what will motivate injectors to place follow on orders. This is not a 6 to 12 month investment for me this is a 3 to 5 year play based on my expectations for significant Daxxify revenue growth between now and 2030. I expect the first significant follow on orders to kick in this coming quarter and gain traction in 2024/2025 which will allow management to give much more accurate guidance in the coming years.
Funny story, I bought Tesla at $2.50/share back in 2012 when I placed my deposit for one of the first Teslas ever made. That investment initially pulled back 30% to $1.80 or 30% loss for me before then taking off to $400/share. I do not sweat the initial 30% hit to my stock trade. But I am very upset with myself for selling out at $4/share within a year of my purchase. That sale cost me $9M in LT cap gains.
I promise I will not make that mistake this time around if we can get this stock moving back in the right direction.
I believe Teoxane does $300M a year in global dermal filler sales with Revance helping them substantially to grow sales in the USA the past 3 1/2 years.
By my estimates, Teoxane paid just under $60M to acquire these additional 4M shares: dollar cost avg of around $15/share.
Teoxane is privately held by their founder/CEO - Valerie Taupin. She founded Teoxane 20 years ago and was at the Revance analyst day investor conf last month where she met with KOLs, Revance execs, and sell side analysts.
Teoxane only makes dermal fillers so in-licensing a competing NT would allow them to better compete against Allergan in Europe.
There is no doubt that Revance will partner with someone strategic to launch Daxi in Europe in the not too distant future.
One thing we can all agree on is that the volume of posts on this board has increased exponentially the past month and that has always been a good indicator of a top or bottom for me. : )
Anyone feel that Mark Foley may have set the bar low for Q3 guidance in order to set the company up for a beat in Q4 Daxi revenue or even a pre announcement for Q3?
Lower pricing announcement didn't really hit the market until after 1st week of September and his guidance to flat Q3 sales may have not taken into account the full impact of the new pricing. Granted, that with only 12 days of sales after the investor conference it would have only a small impact on Q3 sales acceleration.
A preannouncement in October would definitely help to solidify a tradeable bottom here and bring in the momentum traders.
1) How does info on injection technique and amounts to use get out?
the medical affairs departments can distribute articles that have been published when asked specifically about an off label issue.
injectors share insights and you tube/social media videos are useful sources for getting the word out
As injectors, we know what to ask and how to gain key injecting pearls from qualified and respected injectors in our industry.
Xmedica.com released a CME program on Daxxify in march that had Key opinion leaders discussing their real world experience with Daxxify. This program was likely viewed by several hundred injectors who gained CME credits and learned about Daxxify.
2) What happens to injectors that are getting bad outcomes or charging too much?
If an injector is not getting great outcomes or charging too much, and they hear that a competitor is charging less and getting great outcomes and they start losing clients to them, that becomes a big motivator for them to figure it out fast so they don't lose their clients to that competitor. Normal market forces are very efficient in cash pay businesses like aesthetics and why the top 20% of practices take over 80% of the volume. If a competitor of mine is 50% more expensive than me, it doesn't take the hair stylists long to disseminate that info to their salon clients. You can rip off clients once or twice, but not much longer than that. They eventually shop you out based on word of mouth. This especially happens during recessions when clients become more cost sensitive. The expensive practices usually lose business during recessionary cycles.
revance recommends we price Daxi at 25% per unit cheaper than your regular botox price:
So if you are at $12/unit botox then they advise you charge $9/unit Daxxify. If you use 2x the units of Daxi, then a Daxxify treatment runs 50% more than Botox, but if the client sees 50 to 80% greater duration then it is a both a cost savings to the patient and a time savings by having less office visits each year, less needle sticks, etc.
So the patient benefit is clearly there.
The practice owner makes 82% more profit per treatment using Daxi instead of Botox when pricing it like this, but also sees the patient fewer visits so they typically will make the same profit each year on a Daxi patient while working 40% less. This assumes the injector is getting the lowest price tier for Daxi at $3.30/unit compared to Botox at $5.30/unit ($5.30/unit is the lowest tier price for Botox for large accounts after taking quarterly rebates into account and those are paid back to the account after the quarter ends). Botox regular price is $6.35/unit.
A typical patient using 40 units of Botox at $12/unit pays $480/treatment minus any Alle coupon (typically $20 to $30). The same patient doing 80 units of Daxxify would pay $720 or 50% more than botox but without any coupons currently (revance does not have a loyalty program like Allergan's Alle in place at this time).
Assuming 2 Daxi office visits a year: $1440 (6 month duration). If 2.4 visits a year (5 month treatment interval): $1728.
Assuming 4 Botox visits a year (3 month treatment interval): $1920 minus $80 in alle coupons: $1840. If 3.5 Botox Visits a year (3.5 month treatment interval): $1680 minus $70 alle: $1610. Overall, price is slightly better for Daxxify if it truly gets 60 to 75% greater treatment duration, but many clients I see are super happy with convenience of just 50% longer duration and are thrilled to death when they get close to 6 months duration compared to their prior 3 month Botox duration.
For the injector: 80 units of Daxxify at $9/unit - $3.30/unit cost = $456 profit per treatment. (70% greater profit per treatment for Daxxify)
Compared to Botox: 40 units at $12/unit - $5.30/unit cost = $268 profit per treatment (42% less profit per treatment for Botox)
I typically see 60 Botox clients for Neurotoxin a week = $16K profit/week with Botox.
Assuming I dont add new patients to my schedule then with Daxxify I will see 36 patients a week at same profit. I work 40% less and make the same amount of money.
I can then choose to add new patients to my practice going forward to fill the gaps in my schedule vacated because of my transition to Daxxify.
I hope I made the bull case for both the patient and provider in switching to Daxxify. I don't believe a lot of the analysts have truly worked the numbers to see the cost/benefit analysis in a clear way. This will become abundantly clear as new injectors gain confidence in their injection patterns and amounts as they follow up with their patients over the first 6 months, manage client expectations, and price it per unit as Revance recommends.
Will be a completely new salesforce for therapeutic and likely 1/4 the size of aesthetic.
Cash burn a real concern to institutional investors, add to that the issues with frontalis dosing and injection placement, Daxi revenue growth that is below expectations, and the ATM share dilution and you get downward pressure on shares.
Then add the "short the commercial launch" play typically seen in pharma and shorts win the short term stock battle. But, 15M shares short can only make money when they cover, and I don't believe that will be an easy position to exit.
Revance is now a 'show me the revenue growth" play.
In general, you can't promote a product for an indication until you have FDA approval and that includes a training force. The aesthetic salesforce was hired to promote RHA and was then expanded to sell Daxi.
Training for CD should ramp up similar to timeframe of Daxi for aesthetics with perhaps some prevu sales materializing in late December/early 2024.
They will not get reimbursed for off label use so this will be CD only.
CD injections should have less learning curve and sales friction as insurers will push for it based on duration and cost savings and benefits to patient.
It would be suspicious to me if job listings/hiring for therapeutic Daxi team doesnt materialize in the near term at Revance, but they also may not have expected the 1 week early approval so will wait for more clarity here.
best of luck. I have been using Daxxify since December with over 250 treatments to date on 150 patients. It has exceeded satisfaction rates of all prior Botox competitors by a wide margin and is gaining rapid adoption in my practice. The product has a high satisfaction rate as long as you get the frontalis right. This has been its main issue and requires dose and placement change to get right in many patients. I manage expectations, do close follow ups and clients appreciate our intense focus on optimizing duration and outcome. This product will do very well in the coming years as word of mouth really starts to kick in.
disclosure that I am long with a significant position.
incomplete frontalis injection where 70% of the upper muscle is paralyzed and the remaining lower 30% isn't can lead to compensatory movement of the less paralyzed portion and this overuse can lead to more lines in the lower frontalis which is perceived by the patient as this stuff doesn't work or doesn't last long. The portion that is not paralyzed contracts stronger to make up for the loss of the upper frontalis which got the high dose. I have long suspected with all NT injections that the muscle fatigues and this may be causing some of the headaches. with botox, we sometimes see headaches in the first few days before the toxin diffuses to the lower frontalis and takes away the tension type headache.
Like a tug of war where 2 of the 5 members of a team on one side need to work overtime to make up for the loss of their team members against a fully staffed opponent. Again, goes back to my theory that he was not spreading the Daxi low enough to reach the lower frontalis. I suspect my tips to him will lead to a change of heart. This is all part of onboarding a new product that injects slightly differently than others and is consistent with its theory on MOA: that the peptide causes it to stay local and remain bound more tightly to the nerve terminal because of electrostatic forces.
would you be willing to share a chart showing the exact number of Daxxify units you used when you trialed it and where they were placed?
are you reconstituting with 1.25cc bacteriostatic saline? same push volume as Botox?
are you injecting 2 units daxxify to 1 unit botox?
are you spreading the Daxxify units by injecting 2 rows across frontalis instead of just one row? the daxxify appears to not migrate as far as botox and therefore not seeing migration from glabella up to lower frontalis. Guessing the peptide may be responsible for its localized stickiness to the nerve terminal and minimal spread. Also not seeing it diffuse down frontalis when placed too high in a single row.
Many injectors are scared to inject neurtoxin too low fearing ptosis so the lower frontalis is not getting sufficient spread or units and clients perceiving this as lacking duration or efficacy or both when what they are truly seeing is compensatory muscle contraction in the lower frontalis in response to upper frontalis being injected and no migration/diffusion up from glabella zone into the lower frontalis.
My tip to you would be 2 to 2.4x Daxi units to 1 unit of Botox that you typically do for frontalis and 1.8 units of Daxi to every 1 unit you use in the Glabella (not 2x). Spread the daxi into 4 to 6 injection points across 2 horizontal rows across frontalis with each point getting 2 units of Daxi = 20 to 24 units total daxi in frontalis. The goal is even spread across the frontalis and lower injection points than you typically do for botox just above the brow ridge. Note: This is for a client that previously got 10 units of Botox in frontalis = 2 to 2.4x daxi to botox ratio for frontalis. If they were getting 8 units botox then do 16 to 19 units of Daxxify across 2 injection rows.
Follow up in 2 weeks and see how they look, make any tiny adjustments. charge 25% less per unit than Botox. Use 2x the units of botox so price is 50% greater than their botox treatment. Manage expectations by saying it will cost 50% more and get you 50% greater duration. When I tell them 50% more and they get 75% more duration they are ecstatic. If they are only getting 3 months from botox, I want to see if we can get you to 4 1/2 months or greater is how I sell it. Will take you no more than 6 months to perfect your pattern assuming you do close follow ups and gain enough client feedback to make your sales pitch more confident.
EOLS reported just now:
Cash and cash equivalents at June 30, 2023 were $41.7 million compared to $31.5 million at March 31, 2023. The cash balance at June 30, 2023 included additional borrowings of $25 million under the company’s credit facility with Pharmakon. For the second quarter of 2023, net cash used for operating activities was $13.3 million, which included the $4.4 million license milestone expense. Net cash used for operating activities in the second quarter of 2023 was lower than the first quarter of 2023, representing continued progress toward cash flow breakeven. Evolus continues to expect its existing cash will fully fund it to sustained profitability in 2025.
EOLS Ending Cash:
Jun 23: $41.7M (after drawing down another $25M from credit facility. $25M still available by Dec 2023) cash burn of $15M for this quarter.
Mar 23: $31.5M
Dec 22: $53.9M
Sep 22: $65.6M
Jun 22: $84.5M
$100M draw from Credit facility at 13.8% Interest = $3.5M interest per quarter. This is a floating rate loan that has risen by 4% since early 2022.
They will need to draw down the remaining $25M by December which gets them to $125M at 14% interest = $18M annual interest expense.
Let's see how they guide Q3 revenue as I estimate $25M in cash burn next 2 quarters and will finish year with $40M in cash after last credit draw down.
Evolus earnings call August 2nd after market close. Let's see how much cash they have left. They have an ATM facility that is in place to sell shares in open market.
credit facility details below from their 10Q:
$75M and may have accessed an additional $25M in may as detailed below at SOFR: 5.3% + 8.5% = 13.8% x $100M = $13.8M/year interest = $3.5M/quarter interest going forward.
$53M drop in cash over 9 months
EOLS Ending Cash:
Mar 23: $31.5M
Dec 22: $53.9M
Sep 22: $65.6M
Jun 22: $84.5M
On December 14, 2021, we entered into a loan agreement with Pharmakon. Pursuant to the terms of the agreement, Pharmakon agreed to make term loans to us
in two tranches. The first tranche of $75.0 million was funded on December 29, 2021. We received net proceeds of approximately $68.7 million from
Pharmakon, after issuance costs and debt discounts. On December 5, 2022, we entered into a Second Amendment to the loan agreement to extend our option to
draw down the second tranche of $50.0 million until December 31, 2023. On May 9, 2023, we entered into a Third Amendment to the loan agreement, which
provides for the advancement of the second tranche of $50.0 million in two installments: (i) $25.0 million to be advanced on May 31, 2023 and (ii) $25.0
million to be advanced on December 15, 2023, subject to the terms and conditions of the Pharmakon Term Loans. We are required to pay interest only under
the Loan Agreement until March 2026, after which we make seven equal quarterly payments, each in an amount equal to 1/12 of the outstanding principal
amount of the loan. We pay the remaining principal of the loan on the maturity date. The Pharmakon Term Loans will mature on the sixth year anniversary of
the closing date of the first tranche. The term loan bears an annual interest rate equal to the Secured Overnight Financing Rate (“SOFR”) (subject to a SOFR
rate floor of 1.0%) plus 8.5%, and matures in December 2027. The proceeds of the Pharmakon Term Loans are used to fund our general corporate and working
capital requirements.
RE EOLS:
https://finance.yahoo.com/quote/EOLS/cash-flow?p=EOLS
Are you at all concerned by EOLS dwindling cash? They are paying high interest on their credit facility and I anticipate the need to draw down another $50M asap or a secondary offering which will pressure shares down again.
Watching cash and seeing how much cash burn happened in Q2 despite revenue beat.
Practices that bought RHA fillers prior to Daxxify launch and qualified for the "RHA Next program" by making a specific volume of purchases from Revance in 2022 were given priority for PrevU and got 3 months exclusivity to Daxxify before phase 2 of the Daxxify launch which is scheduled for March/April (estimated to be an additional 800 to 1200 accounts). Phase 1 PrevU was only 400 accounts. To qualify for this next phase 2, accounts needed to commit to a certain amount of RHA filler purchases and to partner on RHA fillers in order to gain access to Daxxify in phase 2 of the launch. Phase 3 will be less restrictive and I am told it will follow 3 to 4 months later and likely add another 800 to 1500 accounts. Sounds like 2000 to 3000 accounts expected by phase 3 this summer. I am not sure if phase 3 will require RHA purchase. Final phase 4 will be full commercial launch late this year or early 2024. They are rewarding accounts who partnered on RHA with earlier access to Daxxify, this has created lots of FOMO in the aesthetics space as the number of accounts seeking access to Daxxify is significantly greater than what they plan to launch to over the next 6 to 8 months.
There are some 20,000 Allergan Botox accounts in the USA, many of these have multiple injectors and locations. The top 3000 likely do 50% or more of all Botox volumes. I suspect Revance will be going after all this low hanging fruit in the first 3 phases out to September.
These results are not insignificant. Any trained injector can see that the Botox side definitely has more movement with less complete paresis of the Botox side. Also, results on Daxxify side look better. This was expected per 4 week data from Sakura trial which they mention in the video: Daxxify had a higher response rate than Botox.
Revance recommended pricing per unit for Daxxify is 25% cheaper than Botox but using double the units means it will be 50% more expensive per treatment to the patient, but if duration ends up being significantly longer then it will be justified as it saves patients 1 or 2 visits a year to their injector which saves time, gas, and the emotional trauma of being injected.
Here are some details of Daxi vs Botox Economics to both the Patient and Injector:
Botox: $6.35/unit but typically runs $5.50 to $6/unit after rebates for most accounts. Hearing the largest Allergan accounts that do very big volume get the price down to the $5.25 to $5.40/unit range after quarterly rebates, but most accounts pay $5.50 to $6/unit.
Daxxify: $3.30/unit if purchased in volume and $4.20/unit is the highest price when purchased in the minimum amount.
20 units Botox: Cost of NT to doctor at $5.75/unit: $115. Cost to patient at $12/unit: $240/treatment or $720 to $960 per year for 3 to 4 treatments per year.
Profit to injector: $115/treatment every 3 to 4 months: $345 to $460/year profit for 20 unit Botox patient every 3 to 4 months.
40 units Daxxify: Cost of NT to doctor at $3.30/unit: $132. Cost to patient at $9/unit (25% off Botox per Revance recommended pricing): $360 (50% more than Botox) or $720 to $864/year.
Profit to injector: $228/treatment every 5 to 6 months: $456 to $547/year profit for 40 units Daxxify patient coming in every 5 to 6 months.
Injectors at this pricing delta between Botox and Daxxify make more money injecting Daxxify doing 20 to 50% less work depending on the duration delta.
Patients slightly save money over the year with Daxxify over Botox at these pricing levels without placing any value on their time for the convenience of fewer office visits, less needle sticks, less gas, etc.
These calculations assume Daxxify, at 2:1 dosing over Botox, achieves at least a 50% longer duration over Botox. Based on Sakura results, I suspect it will get close to that.
Moreover, when you consider that Jeuveau and Xeomin, which are 40 to 50% cheaper than Botox on a unit cost basis, but typically have 2 to 4 weeks less duration of action than Botox when dosed 1 to 1, and that this duration delta alone has limited their market share to less than 10%/each, it truly highlights how important duration is to the patient.
The original collagen based fillers used to last 3 to 5 months maximum in the early 2000s, but as soon as hyaluronic acid based fillers, that last 12 months, like Restylane and Juvederm were launched in 2004 to 2006, Collagen filler market share vanished almost overnight. Duration matters, and doctors that stuck to collagen because seeing patients every 3 to 5 months was more profitable to them than offering up a longer lasting filler, eventually lost all of their business to doctors who were offering HA fillers that lasted 12 months. Doing what is best for the patient has always been the winning strategy in Aesthetics.
What does this mean: if Daxxify truly last 50% longer than Botox, then this transition from Botox to Daxxify will happen just as fast as the transition from Collagen fillers to HA fillers: less than 3 years.
Also very few comments about the substantial dysphagia rate reduction in the daxxify group which is significant and unappreciated by analysts and many injectors thus far. Clinically, it may imply that we could see improved precision targeting of muscles with a more complete paresis of the targeted muscle. Stated otherwise, the NT would stay in the muscle where it's injected rather than being "washed away" or diffuse to other muscles that are not targeted.
Theoretical reason for this:
If the positively charged peptide excipients, which electrostatically coat the negatively charged neurotoxin (NT) (like hundreds of bandaids on our skin), help the NT to get close to and attach to the negatively charged nerve terminal and reside there longer to maximize receptor mediated endocytosis, like Revance has theorized and shown in several simple studies of the mechanism of its longer duration, then this would help to explain both its longer duration and low AE and less dysphagia profile. For the peptide technology to work right, it requires just the right amount of peptide to fully coat the NT without any excess and this ratio of peptide to NT was highly studied to get the perfect ratio.
Dr. Steven Dowdy at UCSD was involved in much of this research for Revance when they were attempting to develop a transdermal NT. This allowed their IPO some 8 to 9 years ago but never achieved the treatment goals they had hoped so they course corrected to injectable NT indication and how we got Daxxify today.
Highly suspicious and they deferred to past studies rather than addressing their own fresh data.
But we don't care about old trials, we care about this specific head to head with the exact same PIs and the exact same scales and the exact same raters. I would be willing to wager that one or both of the 20U Botox and 20U Jeuveau arms went to almost 22 weeks and that would take the wind out of their sails for their 40U Jeuveau arm. To leave it out, and make some excuse why they left it out, when they clearly have that data, and also make it known that that data will not be released until after June screams to me the following:
1) We are running out of money in 4 quarters and will need to access our high interest credit facility before year end.
2) We need help with a secondary offering and need to position Jeuveau as almost equal to Daxxify duration so that the secondary can be done in the least dilutive way.
3) We need to counter what is about ready to happen as Daxxify goes full commercial launch over the next 6 to 12 months
4) Our reps need to be able to say that we got to 26 weeks of duration in a study on a very low bar scale, to counter Daxxify's 24 week median duration for none/mild (a much higher bar for efficacy) so that we don't lose patients and HCPs to Daxxify.
Did it seem like analyst questions were T-ball pitches so as not to harm their chances to possibly win their banking biz?
Evolus phase 2 interim data show that it failed to get substantial increase in duration to justify the added cost.
Remember, Daxxify showed a median duration of none or mild for 24 weeks. Return to baseline typically takes another 2 months and was likely in the 7 1/2 to 9 month range. Daxi trials had a 2 point improvement for many trial subjects out to 24 weeks. This is a very high bar.
The evolus study measured time to get back to baseline or full muscle contraction ability.
Also no mention of duration for the botox 20 and jeuveau 20unit arms. I find that highly suspicious. They likely also went over 20 weeks duration and that makes the 40unit jeuveau performance not look much better. Evolus did not want us to see this limited upside despite 2x the dose.
Why pay 2 times the price for 15 to 20% more duration with jeuveau when daxxify 40 units will get you 100% more duration. Youre on the flattened part of the dose/response curve with diminishing returns.
Hope an analyst makes a request for the botox 20 and jeauvea median duration data on monday. If not, then the analysts were handpicked is my impression.
Either way, this is failure in my view for evolus and I suspect their share price will begin to reflect this.
no more need for capital after last raise.
Agree,
$9B neurotoxin market by 2029 with 30 to 70% market share for Revance. then add in $250M to $350M in annual filler sales which is conservative estimate.
= $3B to $6.5B in sales assuming 30 to 70% market share at 90% plus gross margins and valuation of 6 to 8 times sales =
$18B to $50B market cap. Abbvie paid $62B for Allergan some 2 1/2 years ago and half of that was for Botox when it was doing $3.6B total annual sales = 8 times sales multiple.
current market cap at 82M shares = $2.7B at $33/share
Price target 2029 at 110M fully diluted share count = $163 to $450.
What is not being factored in is:
1) the perfect hedge for anyone owning Abbvie stock is to hold RVNC shares,
2) momentum and technical traders piling in as market share and revenue keep growing rapidly and unabated the next 3 years as Daxxify displaces Botox.
3) Revance likely to be one of the few companies growing in a recession year and gaining a reputation as the Botox slayer. Will be a favorite stock for Analyst upgrades.
4) perfect short squeeze candidate as the stock outpaces most other shares and lures in shorts who can't fully appreciate their potential.
For this reason, I believe the biggest and most rapid gains will be realized between fall of this year and fall of 2025.
This study is a higher number of units in a more concentrated dose. Clearly looking to counter Daxxify launch momentum, and Evolus is clearly banking on this study to save them and make them more competitive. Evolus is now down to $50M Cash and still bleeding out $10M plus a quarter. They claim they will generate profit by Q4 2023. They have $50M credit facility still available at high single digit interest rate. This study is critical for their survival. Releasing report this Saturday and formal conf on monday with big press release means they likely have solid data and that may add some competitive risk to Revance and Allergan.
their toxin is Jeuveau and sells for $350/vial for higher tiered accounts. their toxin is consistently weaker than Botox on an equal unit basis and less duration. They are attempting double the units in a very concentrated dilution in an attempt to get to 4 1/2 to 5 months duration. They have only shown 1 grade improvement on Wrinkle severity scores as opposed to Daxxify's 2 point improvement which is a much greater paresis when assessed clinically. I will be watching what grade improvement they are assessing in this trial. If it is only 1 grade improvement, it will not threaten Daxxify.
Botox at 20 units = $106 to $126 cost of toxin at best and worst price tier
Jeuveau 40 units = $140 cost of toxin at best price tier
Daxxify 40 units = $132 (at best price tier)
If Jeuveau is able to get results of 4 1/2 to 5 months compared to Botox 3 to 4 months it may help their marketing push.
My guess: the same cost of Daxxify = 40 units will likely outperform Jeuveau by 1 month at same cost of toxin.
Those photos to any trained injector show a significant increase in muscle relaxation/paresis on the Daxxify treated side, but based on Sakura trial data it was clear that 2 to 1 dosing of Daxxify to Botox would yield significantly stronger results than Botox. The current thinking is a dose of 1.5U of Daxxify to each unit of Botox will achieve similar efficacy at 2 and 4 weeks, but it remains to be seen how long a duration of action a 1.5U Daxxify to 1 Unit of Botox treatment ratio achieves. Will be interested to see how this trial progresses at 3, 4 and 6 months.
not when it is a split face trial. If all 5 notice longer duration, stronger effect and quicker onset, that ends up being pretty significant in most cases. Any physician injecting a neurotoxin that causes 5 out of 5 brow ptosis in their patients will view that as significant. Same here.
Stated otherwise: if 5 people were served 2 different bowls of soup 5 days apart, and all 5 died within 15 minutes of eating bowl of soup 1 but none died after eating bowl of soup 2, most individuals would avoid bowl of soup 1 and infer that it is more likely to kill you than bowl of soup 2.
Same with this, if all 5 subjects see longer duration with one neurotoxin over the other, then most likely this data is real and actionable.
I get that an N of 5 is way too low for a RCT showing significant duration improvement on a 2 point improvement in wrinkle scales. That trial requires N of 150 to 400 typically to power up strong statistical significance.
Botox vs Daxxify Split face trial with 5 participants agreeing to have half their face injected with Botox and the other half Daxxify in 1 to 2 unit ratio as in the FDA trials. Trial started around Christmas and follow up videos with results will be posted soon after Trial days 1month, 3 months, 4 months, and 6 months. nothing better than a split face trial imo to assess duration, toxin strength, and results.
Cost of Botox is $630/vial but all accounts receive rebates which help drop price down as low as $520/vial. Most accounts pay around $600/vial.
Hearing that Daxxify just released pricing as low as $330/vial if the account buys 150 vials at a time = $50K order.
Both Daxxify and Botox vials contain 100 units.
Large Botox accounts can run through over 100 vials a month at $10 to $13/unit to patients. That's over 50% margins to MD.
100 vials x 100units/vial = 10,000 units per month x $6 profit/unit = $60K profit/month from Botox alone. Each injection takes 5 to 10minute of injection time and average client gets 30 to 40 units per treatment. Add dermal filler volume etc.
Will let you guys do the profitability calculations yourselves for Daxxify compared to Botox and cost to patient on an annual basis.
Suffice it to say that MD and Patient will both benefit from move to Daxxify. Less office visits and longer duration. MD makes more per treatment and has room for more patients because of this.