William Blair’s Post

Transcript

Basically, one of the pain points when we first look at obesity data is just how do you compare what is important, what is not important? And we want to maybe discourage, you know, investors from just, like, jumping into conclusions about the weight loss being reigned supreme and ignoring all the other parameters. And we also saw some of these, you know, kind of squiggly charts looking at just various different. Assets and how the weight loss trajectory goes over time, but that is well is important because it's a weight loss drug, but it loses out on some of the important information about the tolerability. So in our formula we have 4 components. You know obviously the weight loss we picked week 12 because this is probably the most available data point. Some earlier stage assets don't have 24 weeks or 36 week data. And also this is also a time when you know a lot of the patients would have gone through initial steps of the dosis scalation and because of that you'll get a pretty good idea regarding the tolerability profile. So those are kind of the components we're playing with. So we have the weight loss at 12 weeks, the frequency of vomiting, frequency of diarrhea, frequency of nausea and we have a correction factor. So basically the question that we're asking there is. Is this drug? More tolerable or less tolerable than Terzett petite? If it's less tolerable than we have a penalty. If it's more tolerable, which you know, at this point we haven't come across anything that's better than well tolerated intersite, then you know, you have a plus, you know, kind of a bonus point if you will. And then there's a penalty factor because we think that the tolerability profile and also the perceived, you know, I guess patient experience. Not on a linear scale, the more. Had the higher the frequency, the less tolerable it would feel for the patient. So the the higher the the the frequency, the. The the higher the penalty. So we have also adjust just for that. So overall it'll give you one number and I think it's meant to compare within the same class, not necessarily for the entire obesity space, but you know kind of a quick and dirty way of assessing some of the potential for for investigational agents. So that's one kind of thing that we highlighted in the report. A second thing that we highlighted was we also looked at. You know, the potential revenues from some of the companies that we initiated on and juxtaposed that to Novo and Eli Lilly's product offerings on a consensus perspective and he's basically the conclusion there is that hey, while there's little little guys right now, you know if they can continue to show differentiation, you know that duopoly or it's going to it's going to get broken up over time and so. Maybe right now is a duopoly going out, we might see a more fragmented obesity landscape. And then the third thing that I would highlight from the report is we kind of, you know, positioned each modality. So it could be small molecules, mono agonists, dual agonists, triple agonist and various different mechanism of actions and kind of do a one to one mapping. So it's not perfect, you know, because we're making a lot of generalizations. Here, but based on patients BMI, so you know, Brad, you kind of talked about the, the, the, the role of orals, right? So you know, maybe that's more, you know, kind of geared towards the lower BMI individuals and maybe maintenance. And then for the triple G from Eli Lilly, maybe that's for BMI that's 354040 plus. So we also kind of have that chart in the report just for for for investors to. Kind of step back and gain a bigger picture of you about the space. Yeah, I wanted to ask you about oral specifically. So it sounds like you're saying they might be appropriate for the lower BMI patients? Should we, So it sounds like you've actually kind of answered my question, but I'm going to ask this anyway. Like should we be thinking about orals in the context of can they be better or equal to injections or you saying that, you know, maybe you start on an injection and orals will be maintenance therapies like over the longer term or maybe they're for those certain lower BMI patients. And and also a big question that I think. Scientifically, some people are wrestling with if you have any opinion is the small molecule versus peptide debate. I know people who are working on peptides have strong opinions about small molecules, but where do you come down on all of that? Yeah, I, I, I guess maybe it a general perspective it more options is definitely better. I think you know what we learn again and again for every single therapeutic class or a disease setting, it's you can always break it up into smaller pieces. And, and therefore that's the reason why we have that kind of chart for investors to navigate by BMI is just to convey the idea that obesity is not just. One disease is actually a spectrum. So because of that there, there will be different options for, for, for different individuals. And yeah, so for, for, for oral drugs. I think the conventional thinking is that, you know, it's a chronic disease and therefore orals would be a better, better option for for patients. So that remains to be proven out. You know, we'll, we'll get over a good front data, you know, phase three and we'll get a better sense of. You know, head-to-head comparisons, you know, between the injected, you know, Terzett Petite, for example, we govy and an orphan goodfriend down the road. And and so yeah, so there's a lot of unknowns, but I would say maybe, and this is probably a higher conviction call, I would say maybe outside of the United States for countries who have less medical infrastructure resources. Having a modality that can be bottled up and have a long shelf life, no temperature requirement, you know, having that modality is very beneficial for for for patients. And so the one advantage I would say is potentially for low resources, low, low, low resource countries to have the option to gain exposure to to the small molecule good one agonists.