Esperion Therapeutics, Inc. (ESPR) Earnings Call Transcript & Summary

Hi, everyone. It's my pleasure to welcome Esperion to the 2021 Credit Suisse Healthcare Conference. We have Sheldon and Joanne joining us. And let me just remind everybody that if you'd like to ask them any questions, you can e-mail me [email protected], and I'll ask those on your behalf. So we do have a long list, and we'll jump right in here.

So we thought we could start with just an introduction of bempedoic acid to people who are less familiar with its mechanism and where it fits within the treatment paradigm?

So Judah, thank you so much for the question. And I'll try to review, as you said, a little bit about bempedoic acid, its mechanism and ultimately, where it fits in the current label. So bempedoic acid, NEXLETOL, is the first oral non-statin that's been approved to lower LDL in over 2 decades. It was developed specifically to reduce LDL-cholesterol while addressing what I'd like to call the Achilles heel of statins, the muscle side effects. So this compound was developed very specifically. Bempedoic acid, it's a small molecule that actually inhibits ATP citrate lyase, which is a key enzyme in cholesterol biosynthesis pathway that acts upstream, actually 2 steps upstream of the HMG-CoA reductase, the target for statins. What's important is that it acts in the same pathway as statins, but it's a prodrug. And it actually requires activation in the liver but not in most peripheral tissue. So this differentiates us that it doesn't have muscle side effects. So that liver-specific action is a key differentiating feature for bempedoic acid. Now by inhibiting ACL, this enzyme upstream, it actually decreases all the substrates needed for cholesterol and fatty acid synthesis. So that ultimately decreases liver cholesterol synthesis and decrease the serum LDL-cholesterol levels by upright regulating LDL receptors. So again, specific drug developed to reduce LDL without the muscle side effect. Now what's also important about the mechanism and again, very unique and differentiating about bempedoic acid is that where it sits in this cascade is not only at the interface of cholesterol metabolism, but it's also at the interface of carbohydrate metabolism. And this very unique compound bempedoic acid therefore reduces glucose and remember that states actually increase glucose and reduces inflammation. So these 2 other features are very unique. If we compare that, for example, to the injectable PCSK9 inhibitors, they don't reduce inflammation, and they certainly don't reduce glucose. The other thing that's important to know is this pathway is one in which Esperion has invested heavily. First with bempedoic acid but we have an entire platform of our next-generation ACL inhibitors because of where this mechanism sits very uniquely in the cascade. And we have seen in our data as well as data from other investigators external, that compounds in this pathway have the potential to improve disease states, like NASH, have the potential to improve kidney disease and even heart failure and pulmonary hypertension. There have even been some suggestion that compounds in this pathway can improve inflammation and maybe even oncology in a variety of cancers. So a really very unique mechanisms that we're acting on. And if you want, I can go into the label and the indication, but there's a lot of science there, Judah, for it.

Okay. Yes. No, I think we'll certainly get into that. Maybe just taking a step back, Sheldon and Joanne, you're both relatively new to the Esperion team. Sheldon, maybe you could help us with kind of what drew you to Esperion as CEO and how the management team has evolved with Joanne being a piece of that recently.

Yes, sounds great. First of all, Judah, thank you. And on behalf of Esperion, it's a pleasure to be here at the Credit Suisse conference, and we appreciate the opportunity that we have today and for everyone that's listening as well. So I've -- unlike Joanne, I'm not a physician, but I've been in cardiovascular medicine, probably since I even sold Mevacor back in 1991 in Pittsburgh, Pennsylvania. And then after that, had jobs at Merck which led me down the cardiovascular pipeline where I managed ZOCOR. I had responsibility for Zetia, Vytorin for a number of years, and Evacetrapib, et cetera, and ran their global cardiovascular franchise. And I was familiar with bempedoic acid, which I believe was ETC-1006 or something like that before it was bempedoic acid. And kind of even summarizing what Joanne had to say, knew that this was a product that was a unique mechanism of action, very differentiated. There's nothing out there like it. And it's always nice to have the ability to commercialize a product that is first-in-class, novel mechanism of action, strong intellectual property. And so drug I followed, even when I went to Sanofi for a number of years managing their global cardiovascular franchise. And when I was called about a potential role at Esperion I was like, I'm really interested in cardiovascular disease and the fact that cardiovascular disease today is still the #1 killer. You'll notice on our backgrounds. And I'll even ask you this, Judah, you don't have to answer, but when was the last time you had your cholesterol numbers checked. And this is a silent killer. And even with all the products that are out there, there is still this unmet need, and that's where we think we have a critical fit. I know we'll talk about the CLEAR Outcomes later, but that's something else that we're excited about and kind of fits into that unmet need. So that's what drove me here is the products and their unique capability. Before I turn it over to Joanne, we've really evolved the management team. We've really brought in experts in specific areas such as sales and marketing. We did not have a Chief Medical Officer in the organization, and I think that's something that we're lacking credibility there. We really need to speak to things such as the CLEAR Outcomes study to lay out eloquently the way Joanne did, what is the mechanism of action of NEXLETOL. Just as an aside, we never had a general counsel. We'll be bringing somebody on to do that as well. So we've really brought on a team of experts who have a lot of seniority. They've been in pharma, both big and small for, in most cases, 25-plus years, and all of us are excited for that same opportunity. So Joanne?

Sure. So Judah, again, thank you. And I didn't mean to dive right deep into that but you can feel I'm very passionate about it. I [ feel ] really strongly in this mechanism. And importantly, as the CMO really need to be the voice for patients, right, in bringing these therapies. So again, moving from the science into where we are current label. Just so everyone understands bempedoic acid NEXLETOL and NEXLIZET, which is the combination of bempedoic acid and ezetimibe, are both indicated currently to reduce LDL cholesterol in patients with a high risk of ASCVD, maybe have a genetic reason for LDL cholesterol elevations. Now these are individuals currently by the label that need to be on maximally tolerated statins. But what we know is that there are many, many individuals that can actually get to the high enough level of a statin, either because of how high their LDL is or because of intolerance to statins and that there is a significant number of individuals who are statin intolerant. And because of that, where, as Sheldon mentioned, we have embarked on the CLEAR Outcomes study to really see about the role of NEXLETOL in patients in reducing cardiovascular risk. Big study, really unprecedented first for a company our size to run it, but just unprecedented in targeting these patients. We've got 14,000 patients, all of which were fully enrolled thankfully before COVID. And the study is moving forward and includes 50% women. So I'm really proud that this company has done that. It includes about 40% diabetics. So it's really targeting a group of patients in whom clinicians have been frustrated that they can't get their LDL to go. So this is really a unique study for us. And it will read out end of 2022, more likely, beginning of 2023.

Okay. Perfect. So maybe just jumping into -- I think some of the headlines have been dominated by the organizational restructuring. But if we take a step back, let's talk about the bempedoic acid launch. And again, you're both newer to the company. Can you give us your assessment of the bempedoic acid launch. It was impacted by COVID. So how would you characterize the impact that COVID has had versus maybe other factors on the launch of this drug?

Yes. I think COVID definitely had an impact, no question about it. But I think COVID was a cloud over some other issues that we had as related to the launch. First, let me say that I think we're still very early in the launch. And as far as I'm concerned, the launch is almost just starting. As you mentioned, Judah, we brought in a new management team. And this takes me back to, so we have this cloud of COVID, you had physicians who are essentially shutting their offices. You had patients who are not addressing their cardiovascular health. We still have patients who are not addressing their cardiovascular health, hence why I asked you the question and everyone listening, when are you getting your numbers checked. But there is still this lack of clear positioning and strategy associated with these products at the time of launch. And COVID just created an additional cloud over that. the typical preconditioning you would do to launch products to really demonstrate that unmet need was not fully accomplished. There is never really a health economic outcomes research group that really shows you what are you paying for, how can you establish partnerships and do other studies which some could consider life cycle management. I actually think it's part of our new structure as we think about how do we work with integrated delivery networks, et cetera, and get the word out there. If I had to sum it up, in one way it is -- or, I guess, a little bit more than one word, but in the phrase, overall lack of awareness. And so it was partly COVID, but it was partly missteps in some of the strategy or lack thereof or the lack of making some very serious strategic choices in order to effectively launch these products, which I think we're, of course, correcting for right now. It's one of the reasons why we've done this restructuring. While we've really have thought about who are the essential individuals in this company to make sure that we can be successful and grow NEXLIZET and NEXLETOL even before CVOT. So before CVOT and obviously, when we get to CVOT, as we've mentioned, we think that's going to be a definitive inflection point for us.

Okay. That makes a lot of sense. And I think we'll go into some of the kind of the sales and marketing changes in a minute. But maybe before that, there have been questions again, tied to COVID around pricing and reimbursement for the franchise. So can you remind people on kind of what was going on from a discounting Co-Pay Card perspective? And how has the prior authorization conversation evolved and how may it continue to evolve?

Sure. Yes, that sounds great. So at the time of launch, there's a lot of again, things that were put into the launch, one of them was this full Co-Pay Card buy down, which essentially allowed patients to get a Co-Pay Card, get their prescription and get the -- get either NEXLIZET or NEXLETOL without a physician having to do a prior authorization. That's great. The problem is, is that we were not only the #1 provider of NEXLIZET and NEXLETOL, but we're also the #1 insurer of NEXLIZET and NEXLETOL. And you never want to be in that situation, as you know, when you're running a pharmaceutical company. And here, we had these contracts with 90% to 95% commercial coverage. We just achieved 60% coverage with Medicare, the Co-Pay Card doesn't apply there, but favorable coverage. So we eliminated that full Co-Pay buy-down card. We -- that was sunset as of August 1st. That also had a notable positive effect on our -- essentially on our net pricing. And as I think about prior authorizations now, unfortunately, that Co-Pay Card really created bad habits. If you think about what I just said, physicians were saying, here Sheldon, here's your prescription, go get it filled. I don't have to worry about it. Now, here Sheldon, here's your prescription I get filled, and Dr. Smith gets a call and says, wait you did document that Sheldon has ASCVD and you need to do that. They weren't used to that. So we've essentially been recalibrating physicians on the fact that they have to do prior authorizations, something that they're familiar with. But what we've also done is we've introduced this program called Asembia, which essentially helps physicians and their back-office staff actually somewhat automate the prior authorization for them. We've just done a soft launch of this so far. We're actually into the full launch now. We have over 2,000 patients in this program. Not all of them have fulfilled drug yet, but we're confident that they will. And we have some areas of the country where this has just taken off. We've others that still need to have education. And I think that's going to be one of the things that we're really going to have to focus on with physicians and helping them understand how to do these prior authorizations again something that they're familiar with. I think as we get into our CVOT, and again, we operate as though the CVOT will be positive. Of course, we don't have any information, but we have to think that way. That will also unlock and make prior authorizations much easier as well. But until we get there, we'll continue the formal education on that.

Okay. Great. And something, we hear, and I'm sure you here as well, as you know, how can you compare the U.S. launch versus the kind of Daiichi mediated launch of the franchise in Europe. So what would you highlight as key learnings maybe from the European launch and translating those to the U.S.? Is there anything you'd like to take from that launch or vice versa?

Yes. So first of all, I want to make it clear that Daiichi Sankyo is a partner of ours, and we meet with them on a weekly basis. We have joint commercial sub teams. They're doing fantastic. They have actually over 28,000 patients now on bempedoic acid, a combination of NEXLIZET and NEXLETOL. If you think about PCSK9 therapies that were launched approximately 6 years ago, in Germany alone, there's about 25,000 patients on PCSK9. So they've essentially surpassed in a little bit over a year of number of patients on PCSK9. They've benefited from a few things. Daiichi Sankyo has been around for a while. They're established in Germany. They have sales representatives who are already selling their drug Lixiana, which is a similar drug to XARELTO or Eliquis. And so for them, selling bempedoic acid was putting another product into their bag. And they already have the touch point with the physician. So that was very helpful. We also already had a relationship as related to the SIC funds, and they also knew how to work the process as it relates to IQWiG and AMNOG, which is the health technology assessment group, if you will, in the country of Germany. So they were really able to hit the ground running. But with that said, Judah, there's still the question of, okay, what is it, though, that's allowing you to take off the way that it's taking off. And so we've spent time to really understand that because we knew, getting back to your first question, our strategy when these drugs were launched were unclear. And what we found is that their strategy, even though they have a much more expansive label than we have in the U.S., for instance, they can speak to statin intolerance, we cannot. They aren't even focusing on statin intolerance. What they're focusing on is for the patient who is on the maximum tolerated dose of a statin and/or that same patient who's on ezetimibe, who still isn't that goal why wouldn't you try NEXLIZET or NEXLETOL before ever having to go to an injectable PCSK9, which lo and behold, while we are doing our market research showed to be the same positioning that would make us successful. And sure enough, we launched our new strategy in April of this year and long answer, but how do you measure how our success is. We did something that's called a STEM analysis where you actually have folks go out and ride with representatives to really gauge how is our strategy working or not. And what we found is that representatives who are using the strategy that I just mentioned, they're killing it, for the lack of better words. And for those that weren't using that strategy, they weren't doing as well. So that strategy works, and it's a great strategy pre-CVOT until we get a CVOT data. So we're very happy with that. We have some new branding that will be rolling out soon that we'll probably show at AHA as well that is very exciting. That really talked about how do you unlock the potential with NEXLIZET and NEXLETOL.

Okay. Great. And speaking of the PCSK9s, I think you've been pretty comprehensive in kind of describing what differentiates you, whether it's this stepwise treatment or price. But one question we get is it does bempedoic acid need to be nervous about inclisiran. So maybe just some thoughts on why that is or isn't a scary and pending potential launch for you?

Yes. I'm going to start, and then I'm going to ask Joanne to comment as well. So I'm not scared at all. I actually welcome the launch of inclisiran because to me, it's another voice out there speaking to exactly what I've been talking to a few times today, and that is lack of education, lack of awareness of patients knowing that they need to get treated. And it's not remiss that Novartis is a very big company with a lot of capital, and they're going to do that type of education as well. I think they're going to be really focused on the PCSK9 compounds that are out there, that being Praluent and Repatha. And we're going to be that ship in the night that sails by that, again, we're the last oral therapy before you'd have to go to PCSK9. Keep in mind, again, our efficacy with NEXLIZET alone is 38%. And we've heard from physicians out there treating patients. They've seen efficacy sometimes more than 50%. So we're not nervous about it. Again, I think it's going to bring more education out to the marketplace. And keep in mind, inclisiran has been launched in Europe now for a few months. And I don't have the data in front of me, but I know from a qualitative perspective because we do follow it, especially in Germany, which is a big market, and it has not really made any impact at all on what's happening there. So Joanne, anything that you'd like to add as well?

Thank you, Sheldon. Judah, one of the things with the PCSK9s, obviously, patients really don't like taking injections. There's even data that for oncology therapies, right, where I think the risk is much more in the individual space, they won't take injections. So that's point one. To Sheldon's point, you have to remember, too, that inclisiran is an infusion. It's in the office. We already know that patients are not going in for their appointments, and we really have a nice oral option for patients that's highly efficacious. And quite frankly, in the majority of patients, whether if it's used alone in appropriate patients or in combination, as Sheldon mentioned, after a statin or after statin and ezetimibe. Our combination does incredibly well and is very well tolerated. And then there's the cost issue, right? So on a cost basis per LDL reduction, we provide a lot of value, we'll have an outcome study that hopefully will be positive. And all that will help drive value across payers, providers and our patients.

Okay. That's great. And maybe moving into the aforementioned organizational restructuring, right? So can you just remind us of kind of the key highlights and what it could mean for franchise growth, maybe from a script's perspective, kind of before and after the CVOT outcome? Have expectations changed, and have you aligned the sales force in corporate to be in line with those?

Yes. So we definitely knew and even when I joined the organization, getting back to a question you asked earlier, we need to be rightsized. We had a tremendous burn on a quarterly basis over $80 million. We know that there's things that we need to do to extend our cash runway to make sure that we get to the CLEAR Outcomes study. And there are some of those things that we could take advantage of right now, and that is rightsizing the organization. So that's what we did. Unfortunately, we had to say goodbye to some of our fellow colleagues and that's never easy. But we did essentially downsize our organization by 40%. We took a hard look at sales and marketing. And what we looked at from a sales force perspective is what would it take to still cover 80%, 90% of our business. And that's the model that we were left with. We have 80 representatives that still cover 90% of our business. We've actually have also enlisted, if you will, a contract sales organization with 10 representatives who will be covering what we call white space. This is an area that our current representatives cannot cover. And these are folks that are doing what we're doing right now. They're working with physicians via different mediums, whether it be Zoom, Microsoft Teams, et cetera. There's actually an interest in a report that came out by IQVIA. I think it was yesterday or 2 days ago that even showed that now 87% or 90% of physicians, they're very specific about 87%, really want to get their message being this type of digital medium. And so that's what we're gearing for. And I think that's an interesting test for us. It allows us to scale up should we need it. Our plan is still to have growth. From second to third quarter, we showed 10% growth. I think we can do more than 10% growth. I don't know if we can do as much as 50% growth, but the answer is somewhere in between. And I think as we test out this platform, of course, we've just gone through some major disruption but we're steadying ourselves now. We've essentially pulled out $100 million in burn in the quarter alone finishing 2021, and I think we're going to be able to show that we will still be able to demonstrate value and demonstrate growth and build awareness of these products until we get to the CVOT CLEAR Outcomes study. Just one last thing. We talked about this fact of integrated delivery networks and partnering with integrated delivery networks. Early in the year, we talked about partnership with UT Southwest, which is something that has already begun. We're working with Dr. Eric Peterson, who is formerly with Duke and DCRI. There's another large integrated delivery network. I don't think we're ready to announce it yet, but it's something that we're working with, I think, is going to be quite interesting as well. So stay tuned for that. So these are the things that's going to take that not just us generating the awareness but others that see the value of the drug. And that's what I'm excited about, that people are starting really to pick up on that. You're going to see that we're going to be showing 3 abstracts at AHA. But what's interesting about that is there's some independent folks that I've been working at Esperion that really see the benefit of ACL inhibition that Joanne mentioned earlier, that have done their own. So we're excited about that as well. So you're going to see more and more of that. That's going to really add to the overall story and complements what we did from a reorganization perspective.

Got it. And speaking of the cash needs, I think you've highlighted recently that I believe there is maybe some covenants tied to $50 million in Oberland cash. Any update on how we should think about that or kind of potential funding sources going forward?

Yes. So let me just start by saying as it relates to bringing in capital or funding, et cetera. We are cognizant of the fact that we need to extend our runway. It's so important for us. If it hasn't been made clear yet, no pun intended, that we need to get to the CLEAR Outcomes study. This will be -- this is an unprecedented study. And I think, again, not a physician practice changing. So we're looking at all strategies to do that, both dilutive and non-dilutive. As it relates to Oberland, we do have a covenant with Oberland. It speaks to the fact that we have to essentially meet a $15 million net sales target. This is something that we're confident that we will be able to meet what they've put in their covenants. But I think it's also important to show and state that Oberland is a partner of ours. I meet with Oberland on a weekly basis. They want us to be successful. They come up with ideas as well of things that we can and should be thinking about. So we have a good partnership with them. We have a good discussion with them and we'll continue that. But again, I think getting back to your growth question, Judah, we're confident that at some point, we will get to that target. And not only will we get to that target, but we'll be consistent in beating that target.

Okay. Great. And I think it's about time to get into the CVOT, the CLEAR Outcomes study. So given the potential to boost the bempedoic acid franchise profile from a successful CVOT, can you talk about the level of confidence in the design of the study and how that's favorable?

So Judah, thank you very much. I think for anyone on the call, if you haven't listened to the webinar with Dr. Nissen on September 13. And he provides a lot of detail. I'll give in brief strokes why we think it's positioned for success. So first of all, as I mentioned, this is a 14,000-patient study, targeting patients with statin intolerance. Because of that, the baseline LDL cholesterol of this study is 139, versus if you look at the PCSK9 inhibitors, but most of those were just under 100. What's important to know around event reduction with LDL cholesterol is that it's based in a linear way to the absolute reduction in the cholesterol, not the relative. So if we have a 20% reduction, that gives us closer to a 40-milligram per deciliter reduction, again, more likely to correlate with greater event reduction than if we started at a lower LDL. The trial also includes 50% women, as I mentioned, who in fact seem to be more responsive to our drug and get greater LDL benefits than the average population. We also have, as I mentioned, 30% diabetics. And this is important because, in general, diabetics have higher event rates and likely more benefit from lipid line. We also have another 30% or so of pre-diabetics. This is important because in statin trials, for example, those individuals on the statin became more likely to be diabetic. We also have, as I mentioned, the glucose and the inflammatory effects. The power of our study is not dictated by those additional incremental effects. So we believe that the additional glucose lowering, additional CRP lowering will actually provide more benefit than what we've powered the study for. And the last thing is we did modeling, actually, Kosh Ray, very high-level key opinion leader in the U.K. modeled what you might expect from our study. And his model, which has been presented suggested that we would have about a 20% reduction in events which is well above the 15% that we've powered the study for. So we're really confident in this study. I also have to tell people that it's been run through COVID. And remarkably, it is accumulating its events, at/or earlier than, we would have anticipated. So we're above 100% on our MACE 3 events. And our primary endpoint MACE 4 were over 80% and those have tracked before. We -- that was October 25 when that came in, and we expected those in December. So all signals are really good for a positive outcome.

Right. That's great. And you touched on it there, but maybe a little bit more on the read-through for diabetic patients and the potential benefit from the lowering C-reactive protein specifically.

Yes. So again, as I mentioned, diabetics are really such an important group. Most diabetics die of cardiovascular disease. So it's really critical that we have therapies for these individuals. Diabetics LDLs are raised, but more importantly, diabetics have very high levels of inflammation due to the metabolic disease. So we really believe that we're a great solution. Diabetics generally don't have very high LDLs. But we think, again, that we provide that additional LDL and metabolic impact for diabetics. In addition, if we don't worsen their glycemic, their glucose control, how great is that for those patients not to have to take a therapy that then is worsening the disease they're trying to manage. So I think there's a lot of upside for us potentially in diabetics. That's being seen today with our current label. So doctors do recognize that, and we do have significant use in our diabetics at present and more hopefully to come based on the CVOT.

Okay. That makes a lot of sense. And then the multimillion-dollar question, how do you think a positive CVOT kind of repositions the bempedoic acid franchise versus today, is it in a label change? Is it in conversations? Is it with payers? What are the most important aspects of a potential positive study?

So, Judah, yes, it's all of those. I think the key is cardiovascular therapeutics and Outcomes study -- having Outcomes is really the holy grail. I think what the CVOT allows us from the minute that it's declared positive or from the minute it's presented is to give clinicians confidence to use the drug, right? And what we've seen with positive outcome studies is prior to the label where drugs were already approved, we do see an uptick. Importantly, it allows us to talk to payers and really demonstrate the full value of the compound, which allows us then to potentially reframe some of the prior authorizations, reframe formulary positioning and again, positions us more for success. Guidelines, right? Right now, we are in guidelines. And just yesterday, we were put in the Polish guidelines for lipid lowering, but there's always the line that says we await outcomes. So a CVOT 1 will expand the label. We'll have an expanded primary label that now hopefully will take out maximally tolerated statins to include a broader primary label for LDL reduction. And then we'll have a secondary label, presumably, for cardiovascular risk reduction. And so again, it really gives us a label that would be on par with any other LDL-lowering therapy. And if we can get the glucose and see reactive protein in there may have the opportunity to go beyond current LDL therapies to provide that additional positive benefit.

Got it. And maybe just to wrap up, Sheldon. So I think people are kind of laser-focused on week-to-week script trends, right? Obviously, there's more going on than just the week-to-week scripts here and there's a longer-term plan. But between now and the CVOT, what would you point to, to get investors maybe more excited about the story as opposed to just awaiting that outcome?

Yes. So I think it's definitely performance, as I mentioned earlier, I'm showing that we can continue to grow NEXLIZET and NEXLETOL. I think some of the partnerships I mentioned earlier to show that we're driving and getting broader awareness. I think just what we did a few weeks ago by rightsizing the organization, putting it on this course to get the CLEAR Outcomes study just from a financially responsible position, should be excited about that. How can we decrease our burn et cetera, and look to say. But to me, it's really going to be about continuing to show growth of these products, not only from a prescription perspective but also from an awareness perspective. And we're going to do everything we can in order to do to fulfill that. And I'm always -- I'm super passionate, gets back to your first question, what drove you to this company, I'm super passionate about anything I engage in. And I'm passionate about these drugs because I know they're efficacious. I know they're safe. I think more patients should be getting treated with them, but we have this awareness issue and that's what we're going to work on to, I think, get people excited long before, as you mentioned, before the CLEAR Outcomes study. But with that said, CLEAR does have to be part of the story as well because there's the reason why many companies don't get involved in cardiovascular medicine because they don't want to make that investment. We're a small company that's made that investment, and we should get credit for that. So I want both. And we'll be speaking about both of them.

Okay. That's great. Now I think that's our full list. If there's anything we left out that you feel like you'd love to add before we close down, let us know.

Well, again, I just want to say, Judah, thank you so much. Thank you to Credit Suisse for allowing Esperion for both Joanne and I to tell our story. We appreciate the questions. I think the takeaway that folks should have is that we've got 2 products that really address an unmet need. They're very efficacious. They are highly differentiated. They're safe. And not only, to your point, do we have the CLEAR Outcomes study that will be coming out in the future. But these drugs are available now. And to the point made earlier, patients shouldn't have to wait in order to get these drugs, and it's going to be our mission to make sure that they don't. And again, I'll leave it with, I hope everyone listening does get their cholesterol checked, I mean that seriously. And again, thank you for the time.

Absolutely. Thank you both for being here and for your participation. And with that, we'll close the session. Thank you.

Great. Thank you. Have a great night.