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the ipsen numbers are what ipsen sells their toxin to galderma for. Galderma then marks it up and sells to doctors. guessing at 70% GMs = similar to what Evolus does. So divide ipsen numbes by 0.3 for rough estimate of Galderma sales would be my guess.
Where are you getting your Galderma sales data from? Think that is worldwide sales for dysport and fillers? whereas your Botox numbers are USA only.
Evolus Q1 2024 Earnings:
Estim Revenue: $57M, Real: $59M (beat by $2M - 3.5%), down 1.7% from Q4 2023 Rev: $60M. (Botox down 14% QoQ)
cash burn: $10.6M
interest on debt: $4.7M
cash: $97M (they raised $47M in secondary March 2024)
debt: $120M (@14.5%)
year on year quarterly revenue growth: 42% (Botox down 5% y/y)
Jeuveau ordering Accts since 2019 launch: 13K
New accts: 700
Q1 2024 Botox Cosmetic : $389M (-14% QoQ, -5% YoY)
Evolus reports May 7th after close
Estim Rev: $57M, loss of 8 cents/share.
Q4 2023 Rev: $60M COGS: $19M
Key items: cash burn, interest on debt, cash balance, year on year revenue growth, QoQ revenue change.
Revance reports May 9th after close
Q4 2023: RHA: $34.5M, Daxi: $24M
Key items: RHA/Daxi Revenue growth YoY and QoQ, cash burn, cash balance, GMs, Daxxify vial unit growth QoQ, and CD launch progress and expense management.
Compare to Abbvie's Botox/filler sales for same quarters.
thank you for the feedback boraborak. So it sounds like you and your contacts have not tried Daxxify so you have no year over year purchase comparisons?
I too am hearing about multiple sales rep departures (in the 10 to 15% range) and territory reshuffling and that new account growth and growing existing accounts had been slow but hearing that they are starting to gain some traction since the Daxi price cut and rebates this past quarter. The 40K rebates that are expiring this month should have helped to get new patients to try Daxi and for Revance to be able to market directly via text in the future to these 40K new patients. This program should be extended IMO. Even $25 to $50 helps to move the needle and reduce friction points in getting clients to transition to Daxxify.
The strategy of lowering the price and changing the messaging to acts fast and lasts and the $75 rebate to get injectors and patients motivated to try it appears to be working. What strategic change on price, messaging, rebates, etc would you make? This is not a marketing issue. This is a getting word of mouth out issue and my 800 patients are acting like Daxxify ambassadors in my geography. Do you feel that the product is not gaining traction in well established accounts?
Call For Doctors/Med Spa owners on this Board to Share Daxxify Sales Data
As you all know, I am a long time injector of Daxxify since Prevu Dec 2022. I launched conservatively to a small portion of my practice, and since that time, Daxxify has taken over 80% of my own NT business (not including my nurse injectors). I used to be Botox only. This is the biggest revenue shift that I have seen in my practice in 20 years.
I am also seeing gradual adoption of Daxxify from many of my nurse injectors the past 3 quarters and we did over 6 figures of Daxxify purchases (over 400 vials) in Q1 2024. The march $75 rebates did help to get us to buy more Daxxify and to entice clients to try Daxxify. This represents over 500% growth over the Daxxify vials I used in Q12023. Although I am still the largest single injector of Daxxify in my organization, my nurse injectors, as a group, exceeded my total vials injected in Q4 2023 and have continued to grow their percentage of Daxxify used within my company.
I am seeing a 54% Daxxify adoption rate within my practice (7 of 13 nurses who trialed it in Q2/Q3 2023 are now ramping up sales in a meaningful way = 10 or more vials a month of Daxxify purchases). 25% are ramping up at a slower rate and 25% tried it and kind of gave up and couldn't quite figure it out or didn't want to take the time and effort to. This implies that roughly 50% of experienced nurse injectors will take 6 to 9 months to get comfortable with their injection outcomes and sales pitch before blowing it out, these nurse injectors tend to be our more authoritative and expert injectors - the type of nurse injectors that clients trust implicitly with 10 or more years of experience. These nurses are the heavy lifters in the NT industry that typically do 40 to 70 vials of NT each month. They likely account for 50% of the US NT market. They are my heavy hitters and largest profit centers. Moreover, the transition to Daxxify is making our organization more profitable with higher client satisfaction rates.
Emmanow, Edcoolidge, Boraborak38, others: would you be able to share some of your Daxxify purchase data for the board to gain some color on traction of Daxxify within your practice?
Perhaps the better question to Ms. Dtox would be: Do you feel the pricing change last fall and the change in messaging early this year and injectors getting more experience with the product have helped to course correct Daxi and do you feel that the worse is behind the Daxxify commercial launch?
Daxxify dysphagia rates reported at 2.7 to 4.2%:
https://www.biospace.com/article/releases/u-s-fda-approves-first-therapeutic-indication-for-revance-s-daxxify-daxibotulinumtoxina-lanm-for-injection-for-the-treatment-of-cervical-dystonia/
Based on the ASPEN OLS study, symptoms continued to improve with successive DAXXIFY® treatments at doses up to 300U, while adverse events remained low.15-16 In particular, dysphagia rates (difficulty swallowing) remained low (2.7% for ASPEN-1 and 4.2% for ASPEN-OLS), further supporting DAXXIFY’s safety profile.15-16
Botox at 19%
https://www.botoxone.com/cervical-dystonia#:~:text=The%20most%20frequently%20reported%20adverse,%2C%20and%20headache%20(11%25).
The most frequently reported adverse reactions following injection of BOTOX for cervical dystonia include dysphagia (19%), upper respiratory infection (12%), neck pain (11%), and headache (11%).
I would expect that dysphagia rates with botox have dropped over time as technique has improved.
Revance also detailed Dysphagia rates in their presentation at the shareholder meeting last September and I believe that presentation is available on the Investor relation page of their website.
40 units of Jeuveau at $3.60/unit = best price: $144 COGS
40 units of Daxxify at $2.75/unit = best price: $110 COGS
Price them both the same and office makes $34 more profit with Daxxify.
I also feel strongly that 40U Daxxify will last longer than 40U Jeuveau.
I see your point and I feel your frustration. I am a significant share owner so I feel your pain. However, I am seeing Daxxify gaining significant traction in my practice and across my industry contacts. This supports my belief that the company has done enough to course correct and that patient investors will be rewarded sooner rather than later. I don't pay much attention to the first 12 months of a commercial launch. The numbers that will matter most to me is Q2 2024 vs Q2 2023 year over year growth comps and each quarter after that out to mid 2025. Over 10 years of drug development and $1B spent and I suspect we are a 18 to 24 months away from knowing if this will be a blockbuster drug for Revance.
We get it that you want Foley fired...you have made your point. Not once have you conveyed what strategic changes you would make that he is not doing. I totally disagree with you that he didn't make any changes or the right changes. I feel he is well on his way to course correcting and now the injectors have to do their job to get the word out and grow the user base. You can't wave a wand and have it happen over night. All rapidly growing cos started at 0% marketshare and no one should expect them to be at 20 to 30% in 2 years. The iphone took 8 years to get to 20% cell phone market share and it has stayed around there the past 10 years with no further market share gains on a unit basis. the iphone had only 2% marketshare after 2 years. Do you not consider the iPhone a huge success because of that slow growth?
If I made you CEO today, what press release or interview would you put out to shareholders that you feel will change shareholder outlook for the stock? He made a video 2 to 3 months ago and broadcast it to all accounts. Did you watch it? Do you want him to do videos monthly, weekly, daily??? I feel his message was right. Doesnt need to repeat it weekly because the share price keeps dropping. He got the pricing right, he is re engaging accounts, his messaging is right on duration now. what more should he do that other CEOs are doing? When was the last time you heard from Carrie Strom or Motazhedi and what did they say/convey that made their message to shareholders so much more powerful.
I see your points and do not disagree with you.
I feel Daxi pricing and messaging have improved greatly and injectors are gradually figuring out the injection pattern, managing patient expectations, and gaining confidence in the sales pitch. Sales reps and management are reengaging with injectors in a more positive, generous, and humble manner. It is now time for Daxi sales to grow. Focusing on the past or what should have been done is a waste of time now. The share price more than takes those mistakes into account, and the financing should be done if they are right about cash flow break even by 2025.
This was a tough decision that diluted shareholders out 18% of all future gains. I was not happy about it. Short term Athyrium debt levels are manageable now and I am certain 3rd Tranche interest rate would have been too high for ST capital and similar to Evolus' interest rate of 14%. I would have passed on it if I was CEO and felt confident in reaching cash flow break even by 2025. They should finish Q1 with $310M cash.
Can Revance demonstrate meaningful revenue growth quarter over quarter and in year/year comps that will give institutional investors a strong reason to enter the stock and push valuations higher?
What will it take to get institutional investors back in?
Compounded Daxxify quarterly revenue growth of 15 to 20% next 4 quarters. I expect Q1 to show the usual seasonality with a pickup in Q2. If Q1 Daxxify sales come in at or above the $24M they did in Q4 2023, I feel it will be viewed as bullish.
Evolus vs Revance revenue growth comparison post commerical launch April 2019 and April 2023. Revance launched to a limited number of accounts in Dec 2022 (less than 300 accounts), and then full commercial launch in Q2 2023.
https://stockanalysis.com/stocks/eols/revenue/
Evolus Market Cap: $830M
Revance MC: $480M
Jeuveau Sales first year after commercial launch: $45.4M
Daxxify Sales first year after commercial launch:$84M (85% greater): $15.4M, $22.6M, $22M, $24M (Q1 to Q4 2023)
Daxxify cost/vial significantly less than Jeuveau.
Revance sold well over 2x more vials of Daxxify than Evolus sold Jeuveau vials in the same time period post commercial launch. Granted that Daxxify units used per treatment are likely 10 to 65% greater than Jeuveau because of FDA label. Still, this implies more people treated with Daxxify in year 1 of sales than Jeuveau.
Jeuveau did $200M in sales in year 5 post launch = 4.4x what it did in year 1 and that was despite Covid. If Revance simply achieves a similar trajectory as Evolus, that gets them to $370M in Daxxify cosmetic sales by 2027. I believe they will beat this number by a significant margin.
Evolus quarterly sales:
Dec 31, 2023 61.00M
Sep 30, 2023 50.02M
Jun 30, 2023 49.35M
Mar 31, 2023 41.72M
Dec 31, 2022 43.65M
Sep 30, 2022 33.90M
Jun 30, 2022 37.16M
Mar 31, 2022 33.91M
Dec 31, 2021 34.66M
Sep 30, 2021 26.68M
Jun 30, 2021 26.10M
Mar 31, 2021 12.24M
Dec 31, 2020 20.58M
Sep 30, 2020 17.66M
Jun 30, 2020 7.81M
Mar 31, 2020 10.50M
Dec 31, 2019 19.45M
Sep 30, 2019 13.17M
Jun 30, 2019 2.31M
Dr. Jody Comstock was one of the first 20 injectors post FDA approval to trial Daxxify and present her findings to the Daxi prevu doctors in December 2022. She has lots of experience and is one of the biggest Daxi injectors in the USA. Her description of the Daxxify nuances are spot on. Injection pattern, the number of units used, and pricing all matter for achieving durable and aesthetically pleasing results at the best cost/performance. In my experience, having talked to no less than 20 Daxxify injectors the past 1 year, most good injectors reach the same conclusion and gain confidence in injecting Daxxify over 6 to 9 months. The not so good injectors struggle and give up and help to generate the negative mentions so prominently featured in social media and message boards.
Revance upper management (CEO, COO, etc) is hosting dinners across 4 major markets this month to get in front of both high usage accounts and accounts that didn't embrace Daxxify after the commercial launch.
Hugel got FDA Approval earlier this month for Letybo with plans to commercially launch by 2nd half of 2024. This is a Korean made Botox competitor that is the leading NT in Korean. It has already entered China, Europe, Canada and Australia. Feeling here is that they will compete well on price, and unlike Revance, they are already profitable. I have yet to hear about pricing and hear that performance is similar to Botox. They need to hire and train a salesforce so I am not sure on when they truly start selling to doctors.
https://www.prnewswire.com/news-releases/hugel-receives-us-fda-approval-for-its-botulinum-toxin-letybo-302077919.html
https://www.prnewswire.com/news-releases/hugel-achieves-record-high-revenue-and-operating-profit-302061497.html
$70M in total sales of NT and filler and $12M net profit last quarter of 2023.
With recent secondary completed, the 3rd $150M tranche of Athyrium facility is no longer needed. This would have been short term credit at a high cost. The financing concerns should now be in the rearview.
Total debt = $427M
$287M 1.75% CD maturing 2027 and conversion price $32
$150M 8.5% Athyrium debt due to begin payback 2nd half of 2024 to 2026
Estimated Cash end of Q1 2024: $315M
Current shares outstanding: 104M
Market Cap: $561M
EV: $670M (2.4x 2024 Revenue)
2024 Revenue Guidance: $280M
A couple quarters of 20% Q/Q Daxxify revenue growth (or solid Y/Y revenue growth comps) should help.
They launched prevu for CD with some 20 to 25 docs in September after FDA approval with goal of doing 2 consecutive treatments to gain real world experience and 6 months of trial data. Some 300 patients have been treated to date with over 100 of them on their 2nd round of treatment as of the Q4 earnings release. Assuming the first patients got injected by mid to late September and then re-dosed by mid to late December, then these patients should be completing their 2nd treatment by mid to late March. hearing that doctors started conservative and were allowed to increase patient dosing as clinically indicated during their 2nd treatment.
Why do I feel they are going slow? Because of how bad the launch for Daxi cosmetic went. As you may recall, they launched the early prevu trial in late September 2022 (after FDA approval) with 20 or so doctors. They were allowed to finally inject the frontalis and lateral canthal lines in their own way. The frontalis zone had not had any coordinated and well run long term injection studies at that point despite frontalis being the trickiest zone for NTs. But, instead of waiting 3 to 5 months to gain real world experience from these first patients, they launched the full prevu trial to 400 doctors in December 2022 (less than 3 months after the first 20 or so Prevu docs got to treat their first patients). These doctors did not have any real world data with regard to if Daxi cosmetic would truly last longer in frontalis or lateral canthal lines. They also noted issues in the Frontalis zone with injection pattern but had not fully worked through what was causing those issues or how to deal with them before the prevu launch in December. In summary, they rushed the aesthetic launch with only 2 to 3 months of real world data and zero real world experience on Frontalis duration past 2 to 3 months.
$61M in cash and 14.5% interest on debt. They will likely burn through another $5 to $8M cash this quarter and if Revance attacks their sales growth this year they will need to raise via secondary or additional debt. My guess is they will issue secondary soon and that will pressure shares. $60M cash versus $350 to $500M cash for revance is a dangerous place to be for Evolus.
Also hearing rebates have helped to win back some business and incremental orders in the context of Q1 seasonality. The rebates launched early February and are good until the end of April. $75 off helps to lubricate friction points, especially those patients who are price sensitive. Accounts getting $75 rebate for each vial purchased. Estimating $2.5 to $3M in rebates to help move inventory.
There is very little demand for short acting fillers in aesthetics. I can see using these for conditions like temporary muscle spasm/strains to allow the injured muscle to heal when all you need is 2 to 4 weeks duration but expect the short acting NTs to generate very little sales in Aesthetics.
Agree with you Dew. If this debt overhang conflict is true, and large institutional investors were concerned about near term debt levels and were not able to check that box before making any significant investment in Revance, then we should expect the share price to remain above the $6.25 secondary price in the coming weeks/month...this alone will be a bullish sign. Next catalyst will be if they move forward and commit to the 3rd tranche of the Athyrium facility this month. They should end the current quarter with around $310 to $315M and if they access the $150M 3rd tranche that will take them to $460 to $465M.
I suppose it would be similar to how some people felt when they bought a Tesla and then Musk dropped prices a month later. But a car is a much larger expense and is a durable and long lived purchase. I have never stopped buying apples at whole foods or resented Whole foods because of a price drop. Especially since the pricing I got was the exact same pricing others were being offered at the time. It's not like I was given a much higher price compared to other accounts at the time. furthermore, this is not a durable and expensive Capital equipment cost that would render a business less competitive in the long run. An account buying 25 vials at $385 originally overpaid by $1400 compared to current pricing; that product has already been used and that additional cost did not break their business or render them non-competitive...they still made money selling it.
I believe the few accounts griping about this will quickly forget now that the current vial price is so much better: $275 vs $656 Botox. Why would anyone be upset with significantly lower pricing?
this article was likely produced on chat gpt based on style and inaccuracies
add up all the large institutional buyers and mutual funds and you will see that they now hold over 90M shares and that doesn't include insiders and retail investors. Current share ownership is over 110M shares. That usually means short selling to new owners is leading to double counting shares: over 20M shares have been double counted by my calculations because of shorts. I doubt that much of this is due to delayed reporting on share ownership as most 13G/D are fairly current by mid quarter.
I respectfully disagree Emannow. During commercial launch the customer is the injector and with time you eventually migrate to DTC marketing more and more once the brand is established. Revance does not have enough cash to launch a nationwide DTC marketing campaign. It is much more effective to spend $3M giving away $75 coupons = 40,000 patient treatments with many treatments going to first time Daxi patients in new accounts. Revance needs 3 to 5K reordering accounts to get Daxxify into 500K patients asap before word of mouth marketing starts to take hold and injectors get the positive feedback which will allow the hockey stick adoption from 2025 to 2028. I am guessing they are approaching 250K patients right now that have tried Daxxify.
My practice just launched the rebates this past Tuesday and I have already added over 10 first time Daxxify users in 2 1/2 days as a single injector and I have used around 20 rebates. Rebates are being given only to clients who use a minimum number of units so 2 out of 3 Daxxify patients are getting the rebate so far. This is a very fast and atypical adoption rate. I am having very little pushback on them switching from Botox despite their Alle coupons.
$100M in quarterly revenue should get us close to non-gaap operating cash flow breakeven. that is 65% y/y revenue growth.
My Q4 2024 revenue targets:
$40M RHA
$45M Daxi Aesthetic
$15M Daxi Therapeutic
With $400M annual sales run rate and a clear path to $1B sales by 2026 and no need for further financing should allow stock to trade at or above $3B EV by early 2025. This does not factor in a disorderly short squeeze.
IMO, any non-dilutive financing with no increase in debt will be viewed as highly positive by institutional investors and I expect shares would rally significantly on this news.
This is one of the big overhangs in the stock that allows shorts to hold their positions.
Would be nice to see some large insider buys in the coming months and then follow that up with news of Daxxify aesthetic gaining significant sales traction by Q2 and news that the CD training/launch goes according to plan and neurologists get formally trained by May/June and revenues in CD start to trickle in by Q3 and materially contribute to revenue by Q4.
Emannow: the $75 rebates we just got are allowing for significant savings and helping to get the treatment price down significantly.
For example: I charge 25% less per unit of Daxxify at $9/unit than Botox at $12/unit. My Daxi Lite treatment is 1.25U Daxi to 1 unit of Botox and typically this dose is slightly stronger than Botox, kicks in quicker, and lasts just slightly longer. A typical client that gets 40 units of Botox pays $480 and usually has a $20 Alle coupon so leaves paying around $460, they transition to Daxi and get 50Units at $9 = $450 minus the $75 rebate = $375. So Botox $460 vs Daxi at $375. A savings of $85 over Botox and some 20% cheaper to the patient. If I were to do the full strength 2U Daxi to 1U Botox the client would pay 80 units x $9/unit daxi minus rebate of $75 = $645 (40% greater price than Botox treatment but typically lasts 40 to 75% longer than Botox). I am no longer doing full strength Daxi for most of my clients as I found that it was either too strong a dose and past the sweet part of the dose/response curve (where doing more units adds no significant duration gain), and we tend to see more compensatory muscle recruitment when we use too much NT in the frontalis or lateral canthal lines which doesn't have as good of an aesthetic outcome.
FWIW: My current dosing prediction is the sweet spot for Daxi will be a ratio of 1.25U to 1.65U of Daxi to each unit of Botox and that this dose will end up costing patients between 10% less than Botox to 30% more than Botox and will typically last 10% to 50% longer than Botox while making injectors 30 to 50% more profit per injection when compared to Botox. Historically, this improvement in price/performance for the patient, and profit per treatment to the injector has led to rapid and significant market share gains. The rapid adoption phase hits once the product gets around 10% market share (which would be around $55M a quarter in Daxi sales) and is consistent with most hockey stick adoption graphs.
In the above example: patient that gets 40 units of Botox pays $480 and usually has a $20 Alle coupon so leaves paying around $460, they transition to Daxi and get 50Units at $9 = $450 minus the $75 rebate = $375. So Botox $460 vs Daxi at $375. A savings of $85 over Botox and some 20% cheaper to the patient.
Injector profit:
Daxi: $450 minus cost of Daxi at $2.75/unit x 50 units = $313 (26% more profit per injection over Botox)
Botox: $480 minus cost of Botox at $5.80/unit x 40 units = $248
Agree, and he reiterated that they have enough cash to get them to cash flow break even in 2025. Not sure what to make of it, but sounds like we should consider the possibility that they do not need to access the 3rd and final $150M tranche of the Athyrium notes (NPA).
If we assume:
1) they don't access the remaining 3rd Tranche of $150M of the Note Purchase Agreement (they have to decide on what to do with it by March 31st)
2) they likely need to raise $50 to $75M in cash to have an adequate cash cushion to get to cash flow break even in 2025.
Then some sort of non-dilutive licensing deal with a significant cash infusion may make up the cash needs and help to strengthen their balance sheet.
My guess would be Teoxane for European rights to Daxxify with an up front payment of $50M. Teoxane already owns 7.4% stake =$6.55M shares in Revance so this would only help Teoxane recover some of its unrealized share losses.
Dew/others: would love to hear your thoughts. We will have our answer by March 31st on Athyrium 3rd tranche.
NPA details:
The notes issued pursuant to the First Tranche and Second Tranche bear interest at an annual fixed interest rate equal to 8.50%. The First Amendment modified the variable interest rate adjustment for the Third Tranche from Adjusted Three-Month LIBOR to Adjusted Three-Month Term SOFR. If the Third Tranche of Notes Payable becomes committed, the Notes Payable will then bear interest at an annual rate equal to the sum of (a) 7.0% and (b) Adjusted Three-Month Term SOFR for such interest period (subject to a floor of 1.50% and a cap of 2.50%). We are required to make quarterly interest payments on each Notes Payable commencing on the last business day of the calendar month following the funding date thereof, and continuing until the Maturity Date.
Pursuant to the First Amendment, the Company is required to repay Athyrium the outstanding principal amount of the Second Tranche notes in installments on the last business day of each March, June, September and December (commencing in September 2024), in each case, based on the following principal amortization payment schedule: 2.5% in September and December 2024; 5.0% in March and June 2025; 7.5% in September and December 2025; and 10.0% in March and June 2026; followed by repayment of the Second Tranche in full on September 18, 2026.
yes, that makes sense. I would at least triple that number for US sales by galderma. I believe Evolus purchases Jeuveau for some $55 to $65/vial from their korean partner/manufucturer Daewoong and they sell it for around $400/vial but give lots of free samples and coupons to their accounts which offsets their GP margin significantly.
thank you for sharing this chart. my only question is the ipsen sales as those seem off. where are you getting that data for Dsyport sales in North America?
Evolus/jeuveau growth significant this past year and well above anything that I expected them to achieve so kudos to Davis Motazedi.
Abbvie had a solid Q4 in Botox sales but also pushed lots of rebates out.
with regard to CD and April 1st J code grant this week:
All initial trial patients enrolled with the first 20 neurologists are on their 2nd treatment now for CD. Started in September and all got retreated at approximately 3 months post first treatment. Dosing was 125 and 250U but hearing that some docs now up to 300 to 400U with no significant increase in AEs and signif improved duration over Botox with much less Dysphagia rates with Daxxify. This is consistent with less migration of Daxxify outside of the treated muscle and the theoretical MOA.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8648634/
Median duration of effect, as determined by time to loss of 80% peak treatment benefit, was 24.0 weeks for DAXI 125 U and 20.3 weeks for DAXI 250 U (Fig. ?(Fig.4),4), which is longer than the median effect duration of 12–14 weeks reported with onabotulinumtoxinA, abobotulinumtoxinA, and incobotulinumtoxinA [4, 5, 47]. DAXI was generally safe and well tolerated, with dysphagia reported in 1.6% of subjects treated with DAXI 125 U and 3.8% of subjects treated with DAXI 250 U [13]. This is considerably lower than the incidence of dysphagia reported in registration trials of adults with cervical dystonia treated with onabotulinumtoxinA (19%), abobotulinumtoxinA (15%), and incobotulinumtoxinA (13–18%) [4, 5, 7]. The median duration of dysphagia events was 14 days, which is also substantially less than has been reported for other BoNTAs in cervical dystonia.
Expect they start the Prevu trial of around 200 CD injectors in May. These injectors will be able to buy and bill on April 1st, and although I don't expect any significant CD sales to materialize until late 2024/early 2025, the increased duration, less Dysphagia, and significantly lower price should help to get these CD docs to convert quickly from Botox to Daxi. Ethically, they will have a tough time explaining to their patients why they plan to keep them on Botox when it has less duration, costs more to the patient/insurance co, has higher copays, and higher dysphagia rates. Feel that word of mouth will spread quickly in CD discussion groups/message boards. There is no doubt that Allergan will have counter measures to blunt adoption/migration to Daxxify and likely why they guided conservatively on CD sales in 2024.
Capital World now up to 13.6% stake
Also, Palo Alto Investors is a small $1B MD run fund with only 30 or so healthcare holdings and they have been a big Revance holder for some time and own 5.2M shares (5.8% owners for such a small fund). Revance used to be a 10% holding for them when Revance was $25 to $30 a share. They do deep dive research and hold long term typically.
https://www.pa-investors.com/default#People
It took Apple 8 years to achieve sales of 250M phone units a year (out of a total of just over 1B phones sold annually). The iphone is considered to be a blockbuster product. Why did apple "FAIL" in their launch (less market share than Revance in their first year). They achieved less than 2% global phone unit market share after year 2....pathetic!! What novice invested in Apple in 2007 at $6 a share with such pathetic unit iphone growth? Apple also had a huge DTC budget behind them while Revance has done no DTC marketing. Furthermore, Apple currently has 20 to 25% market share of the global handset market and that has stayed relatively flat the past 10 years; but their share price has continued to do well despite no further market share gains.
The first 12 months of a commercial drug launch is generally shorted by Hedge funds. We need the "short the launch" crowd to cover and I suspect that day is fast approaching. Growth rates become clear once we see 1 to 2 years of Q/Q growth, and being that the commercial launch was in Q2 2023, we will have our first real Y/Y quarterly growth number in Q2 2024 and we will get a much more accurate growth trajectory after seeing Y/Y quarterly growth numbers over 3 to 6 quarters into mid to late 2025.
Let's hope the recent changes and improved messaging help to accelerate sales growth in the coming quarters.
I agree with your last post Emannow. I believe that Mark Foley has made significant changes and fired many on his team to realign their biz. This was not an easy time for him and these are tough decisions that needed to be made. I feel their pricing is very generous and exactly where it needs to be to gain market share. In my experience, every large account that is highly profitable knows how to price their NTs. We do not allow Revance, allergan, galderma, evolus, merz to dictate pricing for us. We know what we need to make to stay happy and we price it accordingly with a good feel for price elasticity and profit/injector/hour for our geography. If we get too greedy we will lose patients...we understand this dynamic. Market forces in this business tend to be efficient as word of mouth on pricing and injector skill spreads quickly. It's why all top national accounts tend to have similar unit pricing over time in each geography. With regard to Daxxify, we didn't have a feel for duration in frontalis and lateral canthal lines at the time of product launch in December 2022. We had to figure it out and we did. Pricing was initially much higher with high minimums to get to lower pricing tiers on Daxi: the lowest tier at launch was $330/vial and the highest was $420/vial.
I am using 2 concentrations of Daxi in my practice: 1 that lasts longer and runs 30 to 50% more expensive and one that lasts similar to slightly longer than Botox but is 5 to 10% cheaper. Clients have been trying out both and deciding for themselves which one they prefer. I have an 86% conversion rate of Botox patients to Daxxify once they trial it. Half of the remaining 14% that go back to Botox go back because they had a big alle coupon with cost savings for Botox or bought a botox rebate in the past. They don't go back to Botox because they didn't like Daxi. We are seeing some 7 to 10% that don't get the duration benefit of Daxxify and we see this variability across most NTs. I can't explain it.
Today, the top Daxi injectors have a much better feel for duration of action and aesthetic in all facial injection zones and also have highly competitive pricing at $275/vial since the September price drop. Injectors that are new to Daxi are benefitting from the learnings of the early adopters.
I am also hearing about rebates coming and a loyalty program launching this year that will further aid in branding and consumer marketing in addition to patient treatment cost savings.
yes sorry. Meant more than 2/3 in Q4.
compared to Q3 earnings release:
Revenue from reordering accounts represented approximately two-thirds of DAXXIFY revenue in the third quarter, the majority
of which was generated in the month of September.
I was looking to clarify that the percentage of revenue from reordering accounts increased in Q4 from Q3. If we were seeing a drop off in reorder percentage over time would confirm that daxi is not gaining traction.