Glaukos Corporation (GKOS) Earnings Call Transcript & Summary

All right. Okay. It's Patrick on the Medtech team. As you all know, disclaimer, I'm just not even going to read it. You all know that one. You've heard it about 25 times and it's very boring. What is not boring is obviously having Joe, Alex and Chris here from Glaukos' COO, CFO and Head of IR communions, respectively. So massive. Thank you for agreeing to do this and to join.

Thanks for having us.

I mean there's plenty to talk about. There's one topic that consumes a lot of oxygen in the room. But you are like -- probably makes sense still to go there. Maybe it's worth -- I know that there's a couple of people in the room who are newer to the story. So maybe just a quick overview of iDose, the proposition, why it's exciting, just to level set everybody before we go in a bit more detail.

Yes. I appreciate the question. And I might actually start off with a broader conversation, a level setting around interventional glaucoma generally speaking, and iDose being one of the most important vehicles to achieve that. And I think we're -- a lot of the enthusiasm around Glaukos and where we're heading as a company centers around the product side of iDose for good reason. What really is happening fundamentally in our industry is so important and that's the idea that glaucoma really should be a disease that's treated proactively instead of reactively. And historically, with the lack of products that had the right risk-benefit equation available to do so, patients were relegated to years of chronic drop and more drop and incremental drop therapy before they ultimately progress to very invasive late-stage procedures. But that paradigm is really shifting and iDose is a big part of that. You can now take the benefits of these topical therapeutics, which do work. The challenge is patients don't take them because it's an asymptomatic and slowly progressing disease. And it doesn't matter which publication you look at out there, there's all kinds of different statistics, but the one thing that's aligned is the patients simply don't take them, they don't adhere to the topical prescription regimens that are prescribed to them. And as a result, their disease progresses. But you had to have solutions that were minimally invasive enough to make sense of shifting that patient to a different type of treatment paradigm. And iDose through its scale and sort of easily understood mechanism of action becomes an elegant way of really taking on that patient burden of adherence and delivering that medication in a safe, effective way, 24/7 and over a sustained period of time. And that's what I think gets folks both excited in terms of the overall opportunity associated for the industry and Glaukos specifically in terms of driving that standard of care shift, but then specifically what it means for iDose as a product and for us as a company.

I thought one of the things you were saying earlier was quite interesting in one of the meetings, which was a lot of the ophthalmology landscape is a kind of one-and-done patient in-out process. And you could argue bits of glaucoma historically had also been that way inclined. How do you think and how have your discussions with the practices, whether it's private equity, the practices themselves been in relation to -- are you going to own this patient journey for a revenue stream and a clinical perspective for a prolonged period of time? How is that discussion going?

I mean I think it's a pretty profound shift for them in the way they think about the practices themselves and the inner workings of the practices. If you think back to that point of the way glaucoma has been largely cared for historically, the vast majority of practices didn't spend as much time caring for the glaucoma patients. It was either relegated out to glaucoma specialists or optometrists who are writing the scripts that were out there, and for the average, more cataract and refractive oriented practice. They spent most of their time as they practice focused on referral networks associated with cataract and refractive or LASIK procedures and for good reason. They could do the right thing for the patient. They can make a difference in that patient's life. And from a business perspective, it made sense to their bottom line as well. They didn't have that opportunity in glaucoma because the simple act of writing scripts, more scripts and more scripts after that is not really a business model nor is it something that's particularly rewarding in the context of care for these patients who they watch continue to progress, and ultimately, they couldn't do much to stop that. So now you fast-forward to where we're at today and that ability to take care of a patient for 10, 15, 20 years of their journey having them as a part of the practice, now they move from a patient that used to largely push to the side from a day-to-day care perspective to someone that becomes the cornerstone or the anchor of the practice. And I think one of the most encouraging things that we've seen in the early days of the iDose launch, and even for the last 12 to 18 months as we've been preparing for that with iStent infinite and otherwise in having these interventional glaucoma conversations is the receptivity to that. Now it's not to minimize the fact that there's a lot of work. It's one thing to have a strategy, a concept, a belief amongst these physicians and the practices themselves, but then to go out and actually do it, to change how you do scheduling, to change how you do your OR time, to change how you manage these patients and bring in an awful lot of new folks who become that cornerstone, there's a lot of work attached to that. But the good news is that's the path that we're on, both as an industry and we as a company in those practices that are part of that.

I get that it's incredibly early in the launch. But how -- what feedback are you getting from the field in terms of the doc experience, the type of patients who are being treated. I get the volumes at the moment are extremely low and inflecting, but what's the composition of that looking like at the moment?

It's been very encouraging. So you think -- first and foremost, it has to make sense clinically. The outcomes need to match the expectations that were both ahead of and obviously seen as a part of the clinical trials. And that's been a really positive part of these, I'll call it, early days of the launch is the physician feedback has been terrific in terms of -- in various settings and different patient types, in the different stages of disease, that intervention with an agent that they know works, and quite frankly, works really well. But by bypassing the cornea and the compliance considerations, being able to deliver that and then seeing the results these folks are seeing is very encouraging. Now, we have to continue to watch that over a prolonged period of time, make sure you're continuing to replicate what we've seen in the long-term clinical trials, which we certainly expect, but that initial tactile feedback from the surgeons and their hands has been good, both in terms of the outcomes and also in terms of the surgical procedure itself and the elegance of delivering iDose intraoperatively. So I think those things are there. In terms of the patients and the type of selection that's there, it's varied. I mean I think what you see for a lot, if you're a doctor who, for example, has been doing a DURYSTA or similar type, really DURYSTA from that standpoint, this becomes a logical thing that now as those DURYSTA patients are ready for a different intervention, you can do that. If you're a doctor who does a lot of SLT as first-line or second-line therapy, as the benefits of that SLT start to wear off, bringing iDose in as a next-generation solution makes a lot of sense. For a lot of patients, they have consistent chronic complaints about the fact that either whether it's the cost of the drops to the patient or whether it's the -- just the burden of having to remember to take 2 or 3 different drops, 2 to 4 times a day, everything that's there. They now can have that conversation with the patient saying, "Well, we do have an alternative solution for you. It's newly approved, et cetera." Assuming you have the right insurance, we'll consider that for you. We're seeing that across the board there and kind of aligned with what you'd expect in terms of the potential patient population.

Maybe it's worth for the audience, giving a sense of what about calling it, like reimbursement confidence essentially or that side of, because you have the J code and then there's also the pro fee, but that's also giving the clinicians that confidence that the cycle of being actually paid is working its way through and how that interplays with the demand for iDose as we move through the year?

Absolutely. Yes, whenever you think about procedural pharmaceuticals, certainly in the case of iDose, you have to break it down to its constituent parts from a reimbursement standpoint. There's the facility fee for doing the procedure. There's the professional fee for the doctor and their time. And then there's obviously the payment of the J-code. I often say that the earliest phases of a launch like iDose, it's all about reimbursement confidence, especially associated with the J-code. There's a hierarchy of needs there, and making sure that the drug itself is being paid is first and foremost. That was true as we had the miscellaneous code, but even more so now that we're getting into the permanent J code and that's being commercialized. And so from that standpoint, we continue to make the progress that we expect. These things always require more work than you would like to see. But the J-codes were uploading the system of all the MACs and then you go through a process of narrowing down the various technical issues that they have in terms of adjudicating those claims. But we've made a ton of progress on that. And every day, we continue to make progress on that. We're seeing those payments flow through. In some of the cases, in certain MACs, we're seeing them flow through on a timely basis, where you're seeing much more typical payment terms of 10, 15, 20, 25 days. So all those things are encouraging and across the board, we're knocking that down. That will happen. Obviously, to the extent that you're doing an on-label procedure with an approved J-code, it's just an administrative process, not really a risk process per se. And so we expect across all these MACs and across all these procedures, they will ultimately get paid and every day is good. As that reimbursement confidence box gets checked, then you get to have the much more enjoyable conversation of clinically, where do you try to adopt this and how do you ship the standard of care and all those type of things associated with it, and we're seeing that. And so in varying ways, as J-codes are paid, some accounts start, they'll take another step. Rather than doing 1 or 2, they'll do 5 or 10. Others are getting the green light to be moving forward much more freely and so it's just one account, one situation at a time as they get paid and then really opening that up for them. The last of those, I think, there are many gating items, you need everything about this from a reimbursement standpoint, [indiscernible] Medicare fee-for-service, turning on commercial policies, Medicare advantage policies, et cetera. And then -- but it's equally the professional fee side of this as well. And we saw the first of the pro fee schedules to be published with Noridian, which is an encouraging step. We are seeing payments across, although it's sporadic as you would expect until you have a pro fee scheduled. And we're in that process of continuing to knock that down. And volume really drives behavior there. So I think as the J-code confidence drives increasing volumes, you'll see more and more of these MACs ultimately put the pro fee on a schedule here in the coming months and quarters, and that's prealigned with what we expected from the initial launch.

Is it fair to say that some of the initial pro fees are landing in that sort of $700 sweet spot? Is that kind of initially where we are landing?

Yes, I think it's probably safe to focus on the one schedule we have. Obviously, there's payments across the board, across all the MACs. In general, the payments are aligning with glaucoma stand-alone procedures, which is what you'd expect. And when you look at published fee schedules across the board on that, they kind of arranged in that $600 to $1,000 range. And in the case of Noridian, it's, I think, roughly $650 to $800, $850 with the majority being in that $700 to $750 range.

That makes sense. And how do you think -- it's obviously very difficult for you guys. You don't want people to get ahead of themselves. How are you thinking about this? Forget '25, more midterm, more than 20 million potential patients cutting that down? Like how big could iDose be in an idealized scenario for Glaukos?

Yes, I'll probably stop short of giving a specific number on that. And I think you're right. I mean, obviously, the blocking and tackling associated with any launch is real. And there's always operational considerations as you're making your way through these things. But along the way, you continue to see affirmative steps of customers and conversations that I think give you increasing confidence around that long-term potential. Again, stopping short of an exact number, what I will focus on is that there's a lot of opportunity here. The most prevalent statistics that are often quoted is there's a little north of 20 million potential eyes that have high pressure and/or glaucoma in the U.S., 12 million to 13 million of which are diagnosed at any given time and 10 million roughly that are actively treated. And so when you think about a product like iDose, it has a wide open label for the treatment of patients with ocular hypertension or glaucoma, it's a very large opportunity. And that's notwithstanding the challenges of making sure that you're getting all these building blocks put in place the right way, whether it's reimbursement or operational. But it gives us the confidence that we are going after a pretty large TAM here and doing the right thing for the patients clinically is ultimately what drives the utilization within that TAM, and we feel really good about the way iDose performs in that context.

Obviously, that patient pool dose of selection and some of them are multiple sets of drops and some are on 2 and some are on one. Do you have an expectation of who is going to be the heaviest user early on for iDose out of that pool or are you kind of agnostic about it?

Well, I think there's -- I kind of look at it in terms of -- there's the lowest-hanging fruit in terms of where the utilization curve will pick up first. And again, for those patients who've already entered into the interventional treatment paradigm, the doctors had that conversation with this patient or maybe they've even had MIGS in combination with cataract surgery before and they've seen the benefit of having an interventional approach. For those patients, they're already in that treatment paradigm. So continuing that journey with iDose and/or other products makes a lot of sense. Those are patients who've already made the decision to have a procedure and hopefully benefited from elimination or reduction in drop utilization and as a result, most importantly, a slowing in the progression of their disease. If they're there, that doctor conversation around continuing that course of therapy makes a lot of sense. But beyond that, there are large swaths of patient populations. There is a fairly large percentage of these patients who are intolerant to topical medications for a whole host of reasons. There are patients that have been on drops for a period of time and because of the cornea specialists or the glaucoma specialist, the comprehensive doc, will diagnose this as a severe dry eye as a result of it. There's a large percentage of patients who have been on the topical medications who have severe hyperemia and persistent hyperemia, that bloodshed eyes, that aesthetically in terms of the feel of the eye is not what people want to have. There's a significant portion of these patients who have memory issues, obviously as severe as Alzheimer or dementia, but even less severe in terms of just the typical aging process and what that can do to your memory and the ability to remember to take your medications. There are a lot of patients who have physical limitations in this age group. It's hard enough for me to put in eye drops. And you imagine now for a lot of these patients trying to do that 2, 4, 8, 12 times a day and get that installation in and get it accurate and not have it be a mess, even if they physically can do that, is a real challenge for many of these patients. So I think the conversation is meeting the patient where they're at in the journey. And like any other pharmaceutical launch, there's those where that's a lower-hanging fruit exercise and those were -- will work much harder over the course of the next 2, 5 and 10 years to drive that standard of care.

I definitely feel like I have memory issues, so I sympathize. Any launch, one of always the challenges of devices and things of that is all the launches of this bit always looks exactly the same, but there's obviously a big difference in that. And that had been like a continual like -- is there like a nonnumerical thing that you guys are looking for, something that you're like, okay, this is absolutely about to go prime time. I mean, of course, it's like it's a very exciting product already. But is it like certain KOL feedback that you're getting or a certain type of patient that's adopting it or something that you entirely been like, "Okay, now we feel extremely confident that this is a massive blockbuster." Is there anything you can think of?

Well, I think you see some of the lead indicators that I referenced earlier in those initial conversations and when you're kind of bringing together what the clinical community knows the right answer in terms of proactive management of a disease like this, combined with what the, I'll call it, the practice management side and what that can mean from an opportunity standpoint there. When you see that resonating with these practices and physicians the way even in these early conversations, it gives you that incremental confidence. Now I will say the same thing that we often talk about with our sales organization, our commercial organization in general. To your exact point, I think the opportunity set in terms of both the number of patients and what iDose can do for that can drive strong performance over a period of time simply because the opportunity is so large and the use cases are so varied and obvious. The challenge that we have as a commercial organization, and I think as an industry is, are we doing everything every day to put the building blocks in place for that broader interventional glaucoma revolution, if you will, over the course of the next 5 and 10 years versus harvesting the low-hanging fruit of the next 2. And so much of what we're doing as an organization is continue to put that front and center while we focus on the blocking and tackling, of course, of the early stages of execution for iDose. But we're putting as much effort around that broader, I'll call it sea change as we are tomorrow's element of the iDose launch. That's the best we can do as a part of that. And I think we've proven over the last decade plus, we're pretty good at pioneering these markets, and we're going to do the same thing in glaucoma for the stand-alone patient.

Pivoting a little bit. I had a client who threatened me with physical violence unless I asked you about AMD. So maybe worth level setting the audience the opportunity set and also more broadly, I think the pipeline because you're not the iDose company. There's a lot else going on?

Yes. And I think we respect the number, frequency and depth of the questions around iDose. It's clearly an important part of the value proposition as it exists today. But you're right. I mean there's so much more, and we've been hard at work for some time. We were very fortunate over the last 10 years to bring in an awful lot of talent into the development side of our organization and really build multiple platforms. iDose is an essential one of those platforms, obviously serving the glaucoma patient. But when you take a step back, whether it's bioactivated pharmaceuticals in the case of where we're going on keratoconus and rare disease, whether it's the topical cream-based formulations with iLution in that platform, which is much more relevant to a broad array of APIs and potential formulations across a wide swath of diseases in ophthalmology or whether it's bioerodible technologies, which we've chosen intentionally to deliver for retinal conditions in the case of what you're saying on AMD, and it's probably been a little lost on a shuffle of iDose. And again, we understand that, but it's a pretty exciting opportunity. When you look at, and it's early, and I'll quote Tom on this, he's been saying it for years about iDose, it's terribly exciting, terribly early, but it's a game-changing shot on goal. We've shown the data from the animal studies that we've done that were pretty translatable in terms of duration of effect. And from a single administration and injection of our product, we were controlling retinal leakage for up to 2 years. And you compare that to the existing standard of care, and that's a pretty meaningful shift in the management of that disease. Now, we have to see it play out as a part of, obviously, human clinical trials, which we're now in. So the first -- the objective of our early studies are, of course, to assess safety much more than efficacy or duration of effect. But there's an awful lot of excitement around what that can mean as a fourth or fifth pillar, however, you look at it within Glaukos over the coming 5- and 10-year period.

I've now avoided my physical violence.

Yes, good. Check the box.

I mean -- but in relation to the pipeline as well. You already have exceptional gross margins. You're at a place where your top line might end up accelerating quite a bit. How are you guys thinking about even the ability to reinvest because there's a scenario where you flip to very, very profitable very quickly. That's not off the take. You know what I mean, like how do you think about at interplay?

Yes. No, that's a great question. And when we think about, right, because we do have high gross margins right now and -- but we do have a really deep, rich pipeline. Some of which Joe just referenced and a lot of programs, we haven't even publicly announced yet, but we've been active in acquiring early-stage technologies, and there's a lot to do. We also work for a CEO that's very ambitious and wants to continue to fund that pipeline. So we're going to try and balance that equation the best that we can. I think in the near term, our focus will be on generating cash flow, right, getting back to breakeven and then starting to build up our balance sheet on the cash flow side. And eventually, we'll turn at some point in the mid to longer term to a focus on profitability. We're not there yet. We want to continue to invest, build out those pipeline products that we think are valuable to investors. And there's no reason in the long term that this business can't be 30-plus operating margins with a really strong R&D presence still. But a lot of it depends on what Joe does with iDose and Epioxa behind that, et cetera.

Yes. So much of it is -- I mean part of the goal and objectives of it is if we can build those franchises fast enough, that it's inevitable, obviously, that you'll start driving the cash flow associated with it, even with the ambitions that we have from a development perspective. So we'll see.

There's been a notable tick-up in the rest of my coverage universe is interest in the glaucoma space. I'll make it meaningful while on stage. One -- a few years ago, one CEO had described it as the back order of ophthalmology. That's not true anymore. And a lot of them are investing a lot of money now trying to sort of look at it? How do you feel about that competitive environment about others trying to row in the same direction as you guys?

I mean, I actually think it's great. And so first, I wouldn't disagree with that statement historically, maybe not just a couple of years ago, but a bit before that. Certainly, when Glaukos went into pioneering MIGS in combination with cataract surgery, that was absolutely the case. You would go to the major ophthalmology conferences and glaucoma would be on the last day where most people are gone. And today, now it's on the Friday. It's a major part of where things are going, and it's probably the biggest area of transformational investment, and we played a big role in that. It's been a shift over the course of a decade, at least in combination with cataract surgery and now certainly is a part of this broader opportunity. The way we kind of look at it from the perspective of competitive landscape in this is that the more voices right now rowing in the same direction in making the adjustments that are needed to really treat these 10 million and 20 million patients the right way, the better. And so from that standpoint, we welcome those voices, and we welcome that rowing in that direction. And again, if a patient on average lives with this disease 20 years, there's plenty of room for multiple interventions that many companies can benefit in doing the right thing for these patients. So from that standpoint, it's nice to have them on board and welcome to the pioneering journey.

I love that. I mean on that topic of MIGS and thinking about stents, in many ways, the core part of the business, maybe worth giving people an update of how we stand, infinite. Some of the noise that happened last year and the recovery that you've now seen, I guess, for the whole industry in some ways?

Well, I think obviously, back in 2022, we faced the adjustment when they combined the codes from a category 1 standpoint and what that meant on a relative economic basis for the doctor, and some of the impact there. We were really pleased in 2023 to get that back into the growth column, how they're going in the right direction. I thought we weathered that storm in terms of the right thing clinically for physicians quite well. And then ultimately getting back in the mid-single-digit type growth was a step in the right direction. Obviously, we've seen a meaningful uptick in that over the course of this year. I think there's multiple drivers. But a big part of that is that the stand-alone utilization of iStent infinite is now an economically viable procedure. And so you started to have both the professional fee schedules get published, combined then with the changing of APC assignment where it became a viable procedure for these practices. And again, that enabled the practitioners that be focused on the clinical conversation of which I always say how and why would you be treating a patient who's headed down that path [indiscernible] without at least considering iStent infinite along way given the results we've seen clinically and now commercially with it. And so thankfully, an increasing number of surgeons and procedures are in alignment with that view, and we've seen the benefit certainly in the performance of that business. We said both in the first and the second quarter, that was mid-teens growth for us on a year-over-year basis.

How internally are you juggling the focus to ensure that a [indiscernible] conversation iDose doesn't consume so much attention that the base -- you know what I mean, like the juggling of the priorities?

Well, I mean, you have to have the right incentives alignment. Obviously, that drives a lot of behavior in the commercial organization. The organizing principle here though is still all around interventional glaucoma. The products are servants to the master that is shifting the standard of care. And so when you think about it that way from a marketing perspective or an organizational perspective, and then you put in place the kind of incentive structure we've always had, which obviously has separate pools of compensation that if you deliver on both provides a multiplier effect or vice versa, if you're struggling in both areas. So I think we've got the right structure to continue to do that. It doesn't mean, and I think I called this out on the second quarter call that it is one thing that we watch for and you may even see some, I'll call it, relative headwinds to the growth profile that's in franchise as the sales organization leans harder and harder into the iDose launch. But I think from a relative ROI of every minute of that salesperson's time, that will make sense, both for them and for us and ultimately for the investment community.

Long term, like, to what degree is that like a halo effect from owning that patient journey in totality relative to some players who are already operating in a segment of it?

Yes. Well, I mean I'm sure there will, and I think there is. From our standpoint, what we hope is that by having products across the spectrum, we can be more impartial and really having that holistic conversation around why and where to deploy technologies versus trying to be having a bias towards one particular. I think ultimately for clinicians and for these practices, that's a refreshing approach because then they can say, it's not so much about I'm hearing the pitch on this. It's more, I'm hearing the pitch on why I should be intervening these patients, and I have multiple tools from which to deploy to manage that disease over the course of 10 and 20 years as we've talked about. So I think that's where the halo comes in is the credibility associated with being able to really look at it from their perspective in managing the disease versus being beholden to any one individual product and the features and benefits. There's not any one panacea. Glaucoma is a heterogeneous disease with a lot of different factors that drive it. And anybody who tells you differently is focused on a single product. So that's why from the very beginning, we've tried to develop a full portfolio to go after it, and I think we've done a great job in doing that.

You made some interesting comments earlier today around seasonality. We all know that on the guide and the 3Q, aware of that, but more for the broader system of seeing in the U.S., slightly more seasonality in that August time frame than maybe historically? It might be worth sort of explaining what you mean by that?

Well, it's been an observation, and we'll see whether those trends continue this year and into the future. We just noticed that historically, all new seasonality existed, particularly in markets like Europe and Japan, et cetera, and Canada, where everybody goes to the warm. But the -- but in recent years post-COVID, we've certainly seen more of that in the U.S. And it's not any one product or anyone. It's different franchises, everything within that. You just see a little bit more aggressive holidaying, if you will, from the surgical community over the month -- kind of the July, early August time frame, and you always saw some of that. But it definitely seems as a relative measure to be a little bit more pronounced in recent years in the U.S. versus what we have historically seen.

On that sort of seasonality componentry as well, if you end up having a -- that's hypothetically a bigger Q3 than expected, let's say, iDose, since I'm coming in ahead of schedule. Should we be careful around the 4Q about getting carried away on that side of things? Or do you -- would you take that as a sign of the -- the reimbursement pathway is getting adopted faster than expected? How should we think about that?

Well, I have to say, I hope you don't get carried away always when it comes to the sort of forecasting of anything near term, and I think it pays to be cautiously optimistic when it comes to that anytime you're going through a launch like this. I think we'll continue to take one step at a time. We'll do our best to give directional views on how the launch is going in each stage of that. If you take a step back from -- back when we first launched the product or announced the approval in December of last year, we talked about taking sequential steps forward with iDose, certainly as you turned on the various elements of the reimbursement equation. But the real goal ultimately was to make sure that you were lining up some of these things so that 2025 could be a special year for the company. And so everything that we can pull forward, we're not resting any given day. We're going to try to drive as much of that in Q3 and in Q4 and ultimately. But I think so much right now is about setting those foundational building blocks, getting that streamlined, getting the J-codes paid, getting the professional fees set with the schedules. So just similar to what we saw with iStent infinite coming into this year, we start to see the same thing as we transition into 2025 for iDose and beyond.

Last one. I want a prediction from you guys. How many quarters do we have to see before the sell side stops throwing its guestimate of what iDose revenues was in the quarter, hoping that you'll make a comment about it. When will people give up? Or when will they give us the [indiscernible].

Yes, I can't make any promises. It's a matter of open conversation for us. We always want to be directional. I think that the very nature of iDose is that you really can't hide from it in the context of the quarter in and quarter out performance. I think that most analysts are going to be relatively close to it, just simply because of the quantity of it relative to the existing stent franchise. Whether or not we'll give that level of specificity, in some ways, I understand it and certainly from a modeling set. But at the end of day, you want us to drive growth. And our focus is on doing that across the whole portfolio within the U.S. and obviously then internationally and in the other business units. So I don't know that we'll get as granular as you want, but I think you're going to be able to get pretty close anyway.

Joe, Alex, Chris, thank you so much for joining us.

Thank you.

Thank you.