Cogstate Limited (CGS) Earnings Call Transcript & Summary

Cogstate is a neuroscience technology company that makes computerized cognitive tests for diagnosing and assessing neurological diseases, mainly Alzheimer's. These tests are used as clinical endpoints to measure cognition in clinical trials. Cogstate has been used in over 1,800 academic studies and dozens of late-stage clinical trials. They're by far the largest and most validated computerized cognitive tests in the world. The Alzheimer's space is exciting right now because the first-ever disease-modifying therapy for Alzheimer's was approved in June of 2021, Aduhelm. Aduhelm's approval should drive additional R&D and clinical trials work for Alzheimer's drugs as well as support, a newfound need for everyday people to test their cognition at home. We are honored to have Brad O'Connor, CEO of Cogstate, with us today. As a reminder, if you have any questions during Brad's presentation, feel free to ask them using the Q&A button on the bottom of the Zoom screen, and we'll get to them after he finishes up his presentation. Thank you, Brad, for being here. The floor is yours.

Thank you, Ian. Good afternoon, everybody. As Ian mentioned, Cogstate is a technology company focused on health care. We have essentially a software offering that is scientifically and commercially validated that involves our proprietary digital assessments. We wrap around that software some services, particularly in respect of one of our markets. Essentially, what Cogstate technology does is it measures cognition. When we talk about cognition, it's not an intelligence test. It's talking about how your brain is functioning. Cognition is the endpoint or the thing that you would measure to try and determine whether somebody is suffering from something like Alzheimer's disease. We sell that technology into 2 main markets, into clinical trials where our customers are large pharmaceutical companies who are running clinical trials. In that context, our software is used as an endpoint in the trials to try and determine quite whether the drug is making the people think better. So an efficacy indication in an indication such as Alzheimer's disease or it might be used as a safety endpoint where you're worried about a side effect having a negative impact on the way that people are thinking. In that part of the business, it's a contract sales business. So we'll sign a contract at the beginning of the clinical trial that will outline a scope of services, the technology we will provide and the services that we will provide over the life of that study. So we have 2 key metrics. The first is the value of sales contracts we signed or the level of bookings in any period. And then the second metric is obviously the revenue that rolls off over the length of the clinical trial. That gives us really good visibility in respect of future revenues because we have this large contracted revenue base. The other opportunity and really the emerging and very exciting opportunities, what we call the health care market. So that's the use of our technology by primary care physicians or in fact, by individual consumers in their own home. So this is -- if I'm worried about -- if I'm worried about my memory and I go and see my doctor and say, "Doctor, I'm worried about my memory." What does the doctor then do? How does the doctor ascertain whether, in fact, you are suffering from a memory complaint? So it's a large market that we're going after for digital health care solutions. The approval, as Ian mentioned of the first ever Alzheimer's therapy is very positive for us. We have really strong existing relationships with large pharma companies. We have a strong balance sheet and the company is profitable, and I'll take you through that through today's presentation. So there's 3 key themes that are impacting our business in a positive way at the moment. I'm going to talk you through those in detail. So the first, as Ian mentioned, is the drug approval. The second is that we've just recently licensed our technology to Eisai under a global license in respect to that health care market. I'll talk to you about that. And then the third theme is the adoption of virtual assessments. So let's dig into those in a bit of detail. So as Ian mentioned, the first ever Alzheimer's disease therapeutic has been approved by the FDA. You've probably read about this. This drug Aduhelm has been developed by Biogen in conjunction with their development partner, Eisai. It was given the accelerated approval by the FDA on the 7th of June. They've also submitted applications to regulators in other jurisdictions. The really interesting thing here is -- because you may have read about -- Aduhelm is also known as aducanumab. That was its development name. And you may have read about some of the controversies surrounding this -- the study and how these drugs come on to the market with respect to the accelerated approval that was granted by the FDA. What people are all -- don't seem to be focusing on this March is that the FDA is also in June granted breakthrough therapy designation to 2 other therapies, 1 called lecanemab, which is also being developed by Eisai and Biogen, and a third drug called donanemab that's being developed by Eli Lilly. Each of those other 2 drugs, very similar to Aduhelm. They're both monoclonal antibodies. They're a monthly infusion that acts to reduce levels of amyloid plaques in people's brains. Eli Lilly have announced that they intend to lodge their biologics license application or the new drug application in respect to donanemab later this calendar year. Our expectation is you're actually going to see probably 2 to 3 drugs on market within the next 12 to 24 months. And so we believe that the controversy, if you like, around Aduhelm dies down as other drugs hit the market. So we believe that's really positive for our business. It's positive for our Clinical Trials business as more people invest in Alzheimer's disease research as the bar has effectively been lowered and people have seen a path to market in Alzheimer's disease, which has previously been a very hard area to get drugs on market, but we also believe it's really positive for our Healthcare business. So I'm going to talk to you now about the second area there, which is the Eisai license agreement. So in October of 2020, a little less than a year ago. Cogstate licensed our technology to Eisai globally for the use of our technology in that health care market, so in that doctor's market in the direct-to-consumer market. So who is Eisai? So Eisai is a large pharmaceutical company listed in Japan on the Tokyo Exchange, market cap of about $24 billion, around USD 6 billion of revenue for the year to 31st of March. Eisai had been focused on dementia for a long period of time. They actually launched Aricept, which is still the leading symptomatic treatment of Alzheimer's disease back in 1997. Eisai have partnered with Biogen, and they jointly develop each other's Alzheimer's disease assets. So obviously, we've got the Aduhelm approval in June. And then they're developing lecanemab, which was, as I said before, granted a breakthrough therapy designation in June also. That's currently in Phase III trials. The commercial terms of that Eisai agreement is -- we've, in fact, got 2 agreements, 1 that's Japan-specific and 1 that's global. So I'm going to focus mainly on the global agreement today. So it's a 10-year license agreement focused solely around that health care market, so excluding the work we do in the clinical trials market. The commercials from that is we received from Eisai a USD 15 million upfront payment. That was received in December of 2020. The -- then on top of that, we will receive from Eisai a royalty on all revenue they generate from the sale of our technology. Over the course of the 10 years, that additional royalty cannot be less than $30 million. Obviously, it's our expectation that it will be much more than that, but it cannot be less than $30 million. Eisai are responsible for all software development, so they will pay Cogstate to continue to develop our software to make it applicable for these markets. They'll manage all regulatory issues, and they're responsible for all sales and marketing activities. All of the data collected throughout -- through the use of Cogstate technology will be jointly owned by Cogstate and Eisai. This is a really significant opportunity for us. So the target audience or the target market for this technology is not people who are suffering from Alzheimer's disease. So the issue for us is not, well, what's going on with Aduhelm. We're seeing people aren't -- doctors are saying they're not going to put people on drug, et cetera. Our revenue isn't linked to prescription of drug. And our target audience isn't necessarily people suffering from Alzheimer's disease. It's everybody who's worried about Alzheimer's disease. So think of it like a cholesterol test. Cholesterol tests aren't used by -- only by people who suffering from heart disease. It's used as a measure, as a checkup to see whether you're progressing towards that and whether that requires treatment. So we're talking a really large market agreement with Eisai, pulls out 4 key markets being the U.S., EU, China and Japan. Over 320 million people aged over 65 in those markets are alive. So the TAM is enormous, right? So this is an enormous opportunity for us. And with the release of the first-ever disease modifying therapies, suddenly, there's a reason for assessment of cognition. The other thing that's really positively impacting on our business is the move to virtual assessment in clinical trials or what's referred to as decentralized clinical trials. This was happening pre pandemic, but certainly has kicked up in intensity throughout the pandemic. So we believe that that's a permanent change, that this is not -- that people -- certainly, people will go back to a form of at-hospital, at-site assessment, but all of the protocols that we're seeing include some aspect of remote assessment in those protocols now, at least the opportunity or the capability of offering that remote assessment. And we believe that this market -- so the clinical trials market is actually ripe for disruption. Conventional clinical trials where a centralized trial, where patients are forced to go to a research hospital to undertake this trial, are really good for the hospitals, really good for the sites, but they're very expensive for the pharmaceutical companies. And it's actually quite inconvenient to the patient, sometimes traveling hours to be assessed as part of these clinical trials. So they're slow and expensive. And the move to a decentralized trial is actually patient-centered. So the pharma companies, our customers really like it, and the patients really like it. And so the question is, how well can you assess it? Can you assess those people when they're in their own home? And obviously, when you're trying to assess somebody virtually over a computer, digital assessment or digital-native assessments, assessments that are desired to be delivered by a computer have an obvious advantage. And so we're seeing a real increase in demand for our technology solution as people are moving to these virtual trials. To give you a sense of what that starts to look like, the graph here shows our quarterly sales bookings. So this is not revenue. It's bookings in our Clinical Trials business. You can see on the right-hand side of that this current September 2021 quarter. So outstand -- and this was released towards the end of August, so about a month ago now. You can see that outstanding result in this quarter. That includes 1 really large Phase III clinical trial, where that trial is being run completely remotely and Cogstate's digital assessments are key to the design of that decentralized clinical trial. So we believe that this is, as I said, we believe this is a permanent change that has a really positive impact on our business. I'm going to quickly run you through our financial results now. So these are our June 2021 financial results. I'll point out that, as an Australian company, Cogstate works for 30 June year-end. So these are annual results. I should also say that all figures I'll talk to are U.S. dollars. Cogstate reports in U.S. dollars. So a record level of clinical trial contracts executed for the year to June 2021 of $47.3 million. And again, just to remind you that the previous graphic I showed, showed that we signed $35 million worth of contracts in the first 7 weeks of the September quarter. So we're off to a flyer in what we would call the 2022 year. As at the end of 30 June, Cogstate had over $100 million of contracted revenue that was going to roll off in future periods. So really strong revenue base, up 150% on where that was a year earlier. The group recorded just under $33 million worth of revenue, which is 44% up on the prior year. A profit before tax of $5.8 million, that did include some abnormals. So when you normalize that, a profit before tax of $3.9 million for the year, really strong second half result there. We actually -- we recorded a small loss basically breakeven for the first half of the year. So then a really strong second half results. So we're starting to see that momentum through the business. Really strong operating cash flow in the business, $16.8 million operating cash inflow through the year, obviously impacted by that upfront payment that was received by Eisai, that $15 million. That $15 million was actually $13.8 million net of costs associated with that deal. So a $3 million normalized operating cash inflow from the rest of the business. Cash balance or net cash balance at the end of June of $22.4 million. So really strong cash position, no debt, profitable cash flow positive business. When you have a look -- I mentioned before that record level of contracted revenue backlog. The question I normally get then is, well, how does that revenue roll off over time? And this is what this crap shows you. So you can see that for the financial year '22, so the year ending 30 June '22, this current year, Cogstate started the year with almost $30 million worth of revenue locked in. So again, just as a reminder, we did $33 million worth of revenue for fiscal '21. At the start of fiscal '22, we'd already secured almost $30 million. Through those contracts we've signed in the first quarter, that amount has increased to approximately $35 million worth of revenue under contract. So we know we're growing revenue from '21 to '22 year. What's really exciting is, when you look over to the next group of columns to the right, financial year '23, already $25 million worth of revenue locked in for financial year '23. When we add the revenue from the contracts have been signed in this 1st September quarter, that amount increases to about $33 million of revenue locked in for fiscal '23, right? So we're seeing really good revenue growth and really good visibility in respect to that revenue growth. The graphic on the right-hand side of the screen there really just gives you an indication of -- through our total revenue for each year, how much of it was locked in at the beginning of the year? And essentially, what that's showing you is slightly more than half of the revenue from each year was represented by the amount that was already on hand or was represented by the existing book at the beginning of the year. So that what we call backlog coverage is around sort of the mid-50%. Now we expect that percentage to increase over time, so that means that the revenue in any year will be more driven by the value of contracts on hand at the start of the year. So looking to the '22 outlook. I've talked to you already about the revenue under contract. So looking at really good revenue growth into this year. We expect the contribution margins to remain pretty consistent in the business, the gross contribution margins, and that our financial model should hold pretty well. Our operating expense is expected in the range of 31% to 33% of revenue. That's a 5 to 7 point improvement on fiscal '21. So EBIT margins for fiscal '22, we expected to be in the range of 15% to 18%. As we push forward beyond '22 into '23, we expect those EBIT margins to increase into the low 20s. To the extent that we're successful with respect to the rollout of our technology with Eisai, then there's the opportunity to increase those EBIT margins even further. Because you'll understand that the sale of our technology into the health care market is a pure technology sale with margins in the 90%-plus. So in terms of our investment case, we have record revenue backlog with really good earnings leverage in the business. There's enormous momentum in the clinical trials part of our business. And we're just getting going on the -- what is the huge opportunity in the health care part of our business. We have transitioned to profit in financial year '21, and we expect to continue to be profitable and to grow that profit into '22 and '23. We have significant leverage to Alzheimer's disease treatment, both through our Clinical Trials business and our Healthcare business. We believe that Alzheimer's disease R&D is at the start of an enormous growth trend. We've seen this in other indications in the past, and we believe that trend will continue. So it's not a case of I will know they've sold it and everyone will stop investing in Alzheimer's disease. These first treatments, we expect that subsequent treatments will be -- will have much better impact for patients, and we expect that, that R&D amount will increase substantially over the coming periods. We have unique technology and really large addressable markets. The technology is really well developed. Over 500 peer-reviewed publications supporting the validity of -- the scientific validity of our technology. We have really large customers, the likes of Eli Lilly, Eisai, Biogen, Novartis, Pfizer, using our technology within their clinical trials business. So it's scientifically and commercially validated. We have a really strong balance sheet, as I said, over $20 million of net cash, no debt. We've also had some really recent positive exposure. So just earlier this week, as part of [indiscernible], Bill Gates released his latest blog, including this video on YouTube highlighting what is happening in Alzheimer's disease and really focusing on the development of reliable, affordable and accessible diagnostic tools. In that video, he highlights 3 different diagnostic technologies that are making their way on to market. One was the blood assessment where people can analyze amyloid through a blood test. There's a second one, which was a retinal scan, again, looking to analyze the level of amyloid through scanning of retinas. And the third was Cogstate's technology, focusing on the fact that what Cogstate say can do is take cognitive technology, put it in the palm of people's hand on their smartphones and really be able to leverage that data and identify the very earliest signs of cognitive change, so when people need to start talking to their doctor. A little bit about what's been happening from a capital markets point of view. You can see our share price graph over on the right-hand side of the screen there. So we've been on a good run of life late as we've transitioned to profitability as we've signed this commercial agreement with Eisai and as we're getting out into market. About a AUD 400 million or approximately USD 300 million market cap currently. The company is really tightly held, almost 85% of stock held by the top 20 shareholders. On the left of the screen there, you can get a sense of some of those shareholders. So good institutional holders. We actually don't have that much of a retail following. It's really institutional investors on our register. I've identified on the -- at the top left there those institutional holders with more than a 5% holding. You can see in that list, Eisai is one of our shareholders, owning approximately 7% of the company. A lot of insiders, so approximately 35% of the stock held around the boardroom table, long-term holders, including our Chairman, who is actually one of the founding investors in the company. So note there's a couple of codes for you, both on the OTC market and on the Australian market, which is our home market. And with that, I'll open up to questions.

Thanks, Brad. First question is, what is the TAM for clinical trials -- or the Clinical Trials segment? And how much market share does Cogstate currently have?

Yes. So TAM in Clinical Trials is a little hard to estimate because it involves assessment of -- not every trial will measure -- every clinical trial measure cognition. Obviously, in areas like Alzheimer's disease, you will, but not every clinical trial. So it's a little hard to get. But look, we -- and -- our current estimate is that Cogstate has less than 5% of total addressable market in clinical trials. So we see a lot of growth there. The question I usually get after answering that is, so what are the competitors in that space? And largely, our competition is still a standard new psychological assessment. So it's -- the competition is really a doctor, so a neuropsychologist or a neurologist sitting opposite a patient using a standard neuropsychological assessment. That might be a paper-based assessment or it might be a paper-based assessment that's been converted to a digital assessment on a tablet, but it's still a doctor sitting with the patient. That's really our main competition. So we're really still at the start of that digital adoption curve.

So the Bill Gates mentioned that you had in your earlier slide, I think, along with that, there is a -- there's at least one other company that is working on blood tests, which might be approved in the next 1 or 2 years. And given what you may or may not know about them at this point in time, what can you say about competitively how that might impact you guys?

Yes. So it's actually not competitive. It's really positive for us. So the development of easier -- so tests that make it easier to measure amyloid are really important in terms of the acceleration of R&D in Alzheimer's disease clinical trials. So there's 2 aspects that you want to measure in clinical trials. So there's the biomarkers. So things like the blood test measuring the level of amyloid plaques that are building in people's brains. And then there's a functional assessment. So how is that biomarker? Or how is those amyloid plaques presenting in a functional sense? And so the functional assessment is cognition. And so you actually want both of those things. So the development of easier-to-use, less costly, less invasive biomarker assessments is actually really positive for our business.

When might the health care market become material and what kind of royalty rate do you have in that space?

Yes. So I'll answer the second part of that question first. So the royalty rates are under disclosed, but it's low double digit. So I think in the 10, less than 20% royalty. And when does that become significant? We think certainly not in fiscal '22, not in this current year. I mean we're expecting good revenues from that. But at the moment, we're factoring the minimum revenues from that, which is about $4.5 million in very rough terms in terms of royalty revenue in fiscal '22. We -- and that's really -- we still don't have product on market yet. So product will be going on to market in the U.S., certainly in this half year, this current half year. And then I think, as we move into '23 and '24 financial years, that revenue opportunity really starts to gather momentum. And that will be linked, of course, with more marketing that's going on with respect to more Alzheimer's therapies on market.

Is there any opportunity for patients in therapy do like periodic testing or either for positive results or maybe when their memory is declining and they may need to increase medication of some kind?

Yes, exactly. I think there's -- so there's a number -- as we think about the opportunities for use, we think about them first as at-home consumer use, right? So I can't remember where my keys are. Is that important? Or have I just -- am I just busy, right? So is there something going on? That's sort of step 1, that constant assessment. And you want to make that as easy as counting the number of steps you're doing in a day, right? You just want your phone to essentially do that for you. The second market is then, "Okay. There's something going on. I go to see my doctor." What does your doctor do then? So easy, again, tests that are simple, easy to use, noninvasive, low cost, but don't take physician time. And that's the critical aspect. Because in the context of a standard consultation, physicians don't have time to measure your cognition. So how do you do that in a low-cost way where the physician is getting data, then working up an assessment as to whether somebody needs to go on drug, right? So which will be both biomarker assessment combined with the cognitive assessment. And then once somebody is on drug, how do we measure how that patient is responding to drug? In the U.S., you'll be more aware than almost anywhere else in the world, that the payers will want to take people off drug the moment that they've not seen treatment response or the moment this patient is getting -- is progressing in their Alzheimer's disease and they're getting more sick and therefore are not expected to get a benefit from this ongoing treatment, right? So at least annual assessment of cognition is part of that treatment protocol.

Is there any chance for a secondary use or monetization of the data that is collected and co-owned by Cogstate?

I think there's a huge opportunity for that. We actually -- I mean I think we've got to walk before we run. We need to be collect, we need to be on market. We need to collect the data before we worry about how we're going to commercialize data that we don't even have yet, but I think over time that opportunity is enormous. Even just to be able to identify rates of Alzheimer's disease -- so any expert you talk to will tell you that Alzheimer's disease is widely underreported and underdiagnosed. We have no idea of the rates of Alzheimer's disease in the United States, let alone what's happening in poorer countries. So this data is just not even available. So as simple as that kind of thing, through to how valuable this data would be to health insurers. If we want to -- do you identify this in packages, by ZIP code or by area or other things? So we think there's enormous opportunity with respect to commercialization of that data. And as I said before, Cogstate owns a right to that data jointly with Eisai.

So have you thought about 31:14 listing to the NASDAQ at all?

We have thought about it. We -- obviously, we have good opportunities for growth currently. We're very much focused on the business at the moment and executing on that. It remains something for us to consider. We don't think the time is quite right yet, but we might consider it at some point in the future.

Can you talk about how Eisai is rolling out Cogstate in Japan and if they will do a similar strategy in the U.S.?

Yes. So I mean, you need to understand that the Japanese market is quite unique and quite different to the United States. And of course, the health care systems are quite different. That said, the strategies will be relatively consistent in that they'll focus on a direct-to-consumer launch. So the product in Japan has launched to consumers already. There's -- it's called -- in Japan, it's called NouKNOW, spelled N-O-U-K-N-O-W. So nou, N-O-U, in Japanese means brain, so it's know your brain. And so they've launched a consumer product there, and then that will complement the medical device or the physician tool. And so largely speaking, the approach will be similar in the United States and elsewhere. Eisai is currently preparing for launch of that consumer tool within the United States and also preparing for launch of the consumer tool in other regions within Asia currently. So again, we expect to have those on market this half year.

What about competition from functional cognition tests by cognitivity, neuroscience and Cambridge cognition?

Yes, yes. So all relevant competition, you start to get into issues. How do you separate yourself from those competitors? You start looking at levels of scientific validity. How good is the test? How sensitive is this test? Those kind of things. As everyone listening today will understand, having a better test or having better science doesn't always win the day. Sometimes it comes down to marketing as well, right? So there's a number of things. We believe we're at the start of really essentially a land grab in this area where there -- and you see this in lots of digital spaces where you -- where a dominant player will get out and own a lot of the market and then people will pick at that over time. So we think that's the state that the industry is in currently, which is why we're keen to get product on market very early. The advantage that Cogstate has is we will have a large pharmaceutical company supporting our sales and marketing activities. And obviously, that pharmaceutical company has invested interest in identifying people with cognitive decline because they have 1 drug on market already, and they have the second leading drug coming through trials currently. So they've got a vested interest in identifying those people. And so that gives us a real advantage with respect to our marketing investment and our just boots on the ground in terms of sales representatives calling on primary care physicians.

Typically, after a patient has determined that they are affected by Alzheimer's, how frequently do they need to be tested? And is there a recurring revenue opportunity there?

Yes, yes. So I think -- so interestingly, the level of testing that goes on is probably at its highest prior to a diagnosis of Alzheimer's disease, right? So when you're seeing decline, but it's not quite the decline that you would see -- that would categorize actual diagnosis of disease, actually tends to be the most frequent assessment. And that could be as often as every couple of months or every 12 weeks or something like that. And then on a diagnosis, we would expect assessment at least twice per year, but you -- but that could be more depending on the individual and depending on the position and the treatment that's ongoing.

You mentioned the Eisai rolling out of DTC test in both Asia and U.S. in the near term. Is the rest of the Asian market any different from the U.S.? For example, should we be expecting faster or slower ramp in countries like China versus the U.S.?

It's a good question, and I think it's probably too early to be able to answer that in terms of the speed of ramp. We're still coming to grips with that ourselves in terms of -- and I think the speed of ramp of that, particularly on the direct-to-consumer side, will be largely based around marketing. So it's -- there's a couple of factors that play here. So there's the buildup of demand. So how -- what is the level of consciousness or the level of understanding of the importance of brain health within that community. And then how aware are those individuals made of assessments like Cogstate that are available to them? So I think those things come into play. And they are different in every jurisdiction, and they're different depending on the marketing team, I suppose, within each of those areas. So I haven't really answered that question for you other than to say it's -- there's going to be differences and it's a bit early to tell at this stage.

What are the benefits Cogstate has, if any, in terms of data collected to date versus an upstart competitor?

I think...

And...

Sorry. Go on.

I was going to say there's a follow-on to that. Does Cogstate benefit from some sort of network effect or continued test strengthen your technology?

Yes. So it's an excellent question. So to the first part, the data that we have at the moment really supports the claims that we can make. So if you want to say that our test is sensitive to Alzheimer's disease, you need to follow people who have developed Alzheimer's disease over a period of time. And that just -- it literally just takes time. Also, what we know is that the first sign of Alzheimer's disease can start 20 years before diagnosis. And so following people for a long period of time, as we've done in nearly 3,000 studies now allows you to make these claims, is the first thing. The second thing in terms of the network effect is a really good and really intelligent question. That -- once what we believe is -- I said before, we believe that this is an element of a land grab about what's happening now. So we want to get out there. We want to be the dominant player in the market. If we can be successful in that, we believe that once somebody has taken an assessment, there's -- we developed a switching cost if they wanted to change. So when we test somebody, we do 2 things. The first time we test you, we will compare you to a normative database and essentially tell you are you normal. The second time we test you rather than -- we still compare you to the normative database, but we compare you to you. So are you the same as you were last time we tested you, right? And then what we develop is a series of assessments and we can say how have you changed over time. And that's a much more sensitive assessment than comparing you to a normative database. So then -- to the question that was asked, is there a network effect? Once we've got that trajectory of this is what you look like, if you switch, you lose all of that data, right? And then essentially you're starting again. So we believe that's really compelling.

So last question. Probably the -- you've talked about Alzheimer's a lot. That's the biggest cognitive disease. I know that there's other cognitive diseases out there that can cause memory loss and issues like that. Can you talk about what those other opportunities are and how they might impact Cogstate in the future?

Yes. So it's an excellent question, and we have really focused on Alzheimer's disease today. So Cogstate in our clinical trials work, we've worked in more than 70 different indications, everything from oncology to hypercholesterolemia to a bunch of rare diseases through to Alzheimer's disease, schizophrenia, multiple sclerosis, Parkinson's disease. So we work across a range of different indications. We think there's a huge opportunity. If you establish that when you go to your primary care physician, this is how you measure cognition, regardless of the reason that you want to measure cognition. Maybe you want to measure cognition because you've fallen off your bike and you hit your head, you're suffering a concussion and you want to understand am I actually suffering a concussion. Once we've established within a primary care setting that this is the way you measure cognition, the reason that you want to make it recognition doesn't really matter, right? So think of it like a thermometer. Measure your temperature. I won't tell you you've got the flu where you've got an infection and just tell you you've got a temperature. That's what cognitive testing is like. So we think that's an enormous opportunity. And to give you an example of that, Eisai released a sleep drug at the end of 2019. And they've developed around that some supportive technology called My Sleep Log, right? So and it just -- it allows people -- they can use it with Alexa and they can essentially establish a sleep diary. One of the things that Eisai has now done in the last few weeks is to launch cognitive assessments in relation to that sleep drug. So when you wake up in the morning, you can test your level of alertness, right? So completely outside of Alzheimer's disease, nothing to do with it, but really looking at sleep, alertness, quality of sleep, those kind of issues. So we think there's enormous application outside of Alzheimer's disease. But for now, the real -- the really exciting opportunities are in Alzheimer's disease.

Brad, thank you for taking time out of your Saturday morning. It's really appreciated.

Always a pleasure, Ian.

Thank you.