Impel Pharmaceuticals Inc.

Impel reported first-quarter 2023 net product revenue of $4.4 million, compared with $1.8 million in the same period of 2022. R&D expense was $3 million versus $3.7 million a year ago, while SG&A was $22 million versus $19.8 million. Net loss was $30.1 million, or $1.27 per share, compared with a net loss of $27 million, or $1.17 per share, in Q1 2022. As of March 31, 2023, cash and cash equivalents were $35.5 million. For 2023, management reaffirmed Trudhesa prescription guidance of 80,000 to 110,000 prescriptions, with the midpoint representing 64% growth over 2022. Management also said net price per prescription is still expected to be in the $400 to $500 range by year-end.

Adrian Adams framed Trudhesa as being early in a large, growing migraine market and emphasized a disciplined commercialization strategy focused on 11,000 target physicians, mostly neurologists, headache specialists, and high-prescribing primary care doctors. He highlighted growth in new patient starts, expanding prescriber breadth and depth, and a new targeted DTC campaign using social media and influencers rather than television. His tone was upbeat and confident, repeatedly pointing to momentum in March and April as evidence that the launch is tracking well.

Management said the first-quarter pricing reset from QuickStart adjustments reduced volume but improved net price, and Leonard Paolillo said reimbursement had risen from 60% at the end of Q4 to 72% in Q1 and 75% in April. He reiterated confidence in a $400 to $500 net price per prescription by year-end and said other GTN levers were stable. Adrian Adams also said the company was pursuing additional capital and was optimistic about sharing progress near term, while the balance sheet at quarter-end showed $35.5 million in cash and cash equivalents.

Analysts focused on net pricing, the impact of the expanded sales force, DTC spending, and whether the company might eventually guide revenue instead of prescriptions. Management said the sales-force expansion from 60 to 90 reps had improved productivity and that the broadened target list to 11,000 physicians was helping both depth and breadth of prescribing. On guidance, they said prescription momentum in March, April, and May gave them confidence in the 80,000 to 110,000 range, while revenue guidance was not being provided yet because gross-to-net is still evolving. They described the DTC campaign as cost-effective and mainly social-media based.