Alkermes plc (ALKS) Q4 2022 Earnings Call Transcript

Alkermes plc (NASDAQ:ALKS) Q4 2022 Earnings Conference Call February 16, 2023 8:00 AM ET

Company Participants

Sandra Coombs - Senior Vice President of Investor Relations and Corporate Affairs

Todd Nichols - Chief Commercial Officer

Iain Brown - Chief Financial Officer

Richard Pops - Chief Executive Officer

Conference Call Participants

David Amsellem - Piper Sandler

Akash Tiwari - Jeffries

Umer Raffat - Evercore ISI

Chris Shibutani - Goldman Sachs

Paul Matteis - Stifel

Uy Ear - Mizuho

Jason Gerberry - Bank of America

Jessica Fye - J.P. Morgan

Marc Goodman - SVB

Douglas Tsao - H.C. Wainwright

Brandon Folkes - Cantor Fitzgerald

Operator

Greetings and invited to nan Alkermes Fourth Quarter 2022 Financial Results Conference Call. My sanction is Rob, and I will beryllium your usability for today's call. [Operator Instructions] Please statement that this convention is being recorded.

I'll now move nan telephone complete to Sandra Coombs, Senior Vice President of Investor Relations and Corporate Affairs. Sandy, you whitethorn now begin.

Sandra Coombs

Thank you. Good morning. Welcome to nan Alkermes plc convention telephone to talk our financial results and business update for nan 4th and twelvemonth ended December 31, 2022. With maine coming are Richard Pops, our CEO; Iain Brown, our CFO; and Todd Nichols, our Chief Commercial Officer.

Before we begin, I promote everyone to spell to nan Investors conception of alkermes.com to find our property release, related financial tables, and reconciliations of nan GAAP to non-GAAP financial measures that we'll talk today. We judge nan non-GAAP financial results successful conjunction pinch nan GAAP results are useful successful knowing nan ongoing economics of our business.

Our discussions during this convention telephone will see forward-looking statements. Actual results could disagree materially from these forward-looking statements. Please spot Slide 2 of nan accompanying presentation, our property merchandise issued this morning, and our astir recent yearly and quarterly reports revenge pinch nan SEC for important consequence factors that could origin our existent results to disagree materially from those expressed aliases implied successful nan forward-looking statements.

We undertake nary responsibility to update aliases revise nan accusation provided connected this telephone aliases in nan accompanying position arsenic a consequence of caller accusation aliases early results aliases developments. After our prepared remarks, we'll unfastened nan telephone for Q&A.

Now, I'll move nan telephone complete to Todd.

Todd Nichols

Great. Thank you and bully greeting everyone. 2022 was a breakthrough twelvemonth for our commercialized organization. We achieved grounds income and double-digit growth, compared to nan anterior twelvemonth for our portfolio of proprietary products driven by execution of our focused commercialized strategy.

The twelvemonth was highlighted by nan ongoing motorboat of LYBALVI. In its first full-year of commercialized launch, we exceeded expectations and delivered beardown results that began to found LYBALVI’s important spot successful nan curen paradigm. LYBALVI’s early motorboat occurrence underscores nan leverage we tin recognize crossed our commercialized platform, which gives america a unique position successful nan neuroscience space.

We launched LYBALVI conscionable complete a twelvemonth agone pinch a wide differentiated explanation that includes some schizophrenia and bipolar I disorder. In its first afloat year, LYBALVI generated nett income of $96 million, which we judge provides a beardown instauration for early growth. In nan 4th quarter, LYBALVI income were $34.9 million, up 29% sequentially driven by robust demand.

Total prescriptions successful nan 4th fourth were astir 28,400, representing maturation of astir 23% quarter-over-quarter, driven by LYBALVI’s differentiated merchandise floor plan and our commercialized execution. The beardown request was owed successful ample portion to summation prescriber breadth and usage crossed a wide scope of patients.

At nan extremity of nan 4th quarter, astir 7,600 prescribers had written a medicine for LYBALVI since its launch, which represents an summation of astir 27% since nan extremity of Q3. As we person mentioned before, driving prescriber breadth continues to beryllium a cardinal privilege for america and provides nan instauration for establishing a important marque beingness and consciousness successful this market.

More than 20,000 patients person been treated pinch LYBALVI done December, Prescriptions successful nan 4th proceed to beryllium evenly divided betwixt schizophrenia and bipolar 1 patients. Approximately 45% of nan prescriptions successful nan 4th fourth were for patients switching from nan olanzapine and astir 55% came from a assortment of different branded and generic medications. This divers root of business demonstrates that physicians are utilizing LYBALVI for a wide scope of patients and not limiting its usage to peculiar diligent phenotype.

In our marketplace research, a mostly of healthcare supplier surveys study a precocious level of restitution pinch LYBALVI and schizophrenia and bipolar 1 disorder, including its efficacy and comprehend their patients are likewise satisfied pinch LYBALVI. Early persistency information is encouraging and accordant pinch different branded oral atypical antipsychotics arsenic we anticipated.

In 2023, our attraction is three-pronged increasing prescriber breadth, further enhancing nan pathway to entree for patients, and building awareness. As we person mentioned before, we judge direct-to-consumer advertizing will play an important domiciled to further thrust diligent and caregiver consciousness of LYBALVI.

DTC campaigns person been shown to beryllium highly effective successful driving marque maturation successful galore therapeutic areas, including psychiatry. Starting an effective run earlier successful a merchandise lifecycle provides an opportunity to seizure a greater effect complete nan life of nan product. Our integer trading run is already underway and we expect to motorboat nan TV constituent of our DTC programme mid-year.

We judge these strategical investments will thrust semipermanent gross maturation for LYBALVI. From a marketplace entree perspective, we are well-positioned pinch LYBALVI for this shape of nan launch. Overall, LYBALVI has been treated akin to different branded agents. In Medicare and Medicaid, we person a pathway to entree for each patients.

On nan commercialized side, we person established a coagulated instauration successful position of entree and we will prosecute pinch nan commercialized payers again this year. Now pinch nan advantage of a year's worthy of marketplace acquisition and data. In nan meantime, eligible patients person a pathway to entree done our diligent and co-pay assistance programs.

We expect LYBALVI 2023 nett income successful nan scope of $180 cardinal to $205 million. We expect gross to nett adjustments will stay reasonably unchangeable successful nan precocious 20% scope during nan first half of nan twelvemonth and whitethorn widen successful nan 2nd half if we find location is simply a use to enhancing nan entree floor plan for nan LYBALVI.

Turning to nan ARISTADA merchandise family. Net income successful nan 4th fourth were $79.2 million, driven chiefly by TRx maturation of astir 7% year-over-year connected a period of therapy basis. We are encouraged by nan return to maturation successful nan [LAI class] [ph]. In 2022, prescriber breadth for nan merchandise family reached an all-time high, driven by our commercialized strategy and attributes of ARISTADA, contempt immoderate persistent challenges successful nan class, specified arsenic ongoing staffing shortages successful curen settings. We expect to proceed to turn our prescriber breadth and extent successful nan coming year.

For 2023, we expect ARISTADA nett income successful nan scope $315 cardinal to $345 million. This scope reflects existent marketplace dynamics and our continued accent connected ARISTADA's differentiated worth proposition. Including its erstwhile each two-month dosing action and nan ARISTADA initiation regimen, some of which are supported by objective information from our ALPINE study.

Moving to VIVITROL. Net income successful nan 4th fourth accrued astir 11% year-over-year to $102 million. Growth successful VIVITROL income proceed to beryllium driven chiefly by nan intoxicant dependence indication, which accounted for astir two-thirds of nan VIVITROL business successful nan quarter.

For 2023, we expect VIVITROL nett income successful nan scope of $380 cardinal to $410 million. As we proceed to beforehand our strategy to thrust maturation successful nan intoxicant limited indication. VIVITROL is simply a analyzable merchandise successful a analyzable curen environment. Our [ANDA litigation] [ph] pinch Teva starting coming and we stay assured successful our position.

Regardless of nan result of that litigation, we judge that nan complexities of this marketplace and nan required capabilities that we person established to support VIVITROL's commercialization will beryllium challenging for imaginable generic entrants. We stay committed to driving consciousness of VIVITROL's inferior and judge it will proceed to person an important domiciled to play successful nan curen paradigm.

LYBALVI, VIVITROL, and ARISTADA correspond a beardown proprietary merchandise portfolio that will service arsenic nan cornerstone of Alkermes apical statement maturation imaginable arsenic a axenic play neuroscience institution pursuing nan planned separation oncology business. This merchandise portfolio and nan operating leverage that we person built into nan business provides important opportunity to thrust maturation and we look guardant to updating you connected our advancement passim nan year.

With that, I will now move nan telephone complete to Iain.

Iain Brown

Great. Thank you, Todd, and hello, everyone. So, we vanished 2022 beardown and are pleased to study financial results up of our expectations for nan year, driven by nan coagulated capacity of our proprietary products and disciplined guidance of our costs structure. The motorboat of LYBALVI was a item for nan twelvemonth and represents a important maturation opportunity for nan institution successful nan ample oral antipsychotic market, leveraging our established commercialized capabilities.

The spot of oral LYBALVI motorboat was an important facet successful our determination to research nan separation of nan oncology business, which we judge will thief uncover nan underlying maturation and profitability of nan neuroscience business. In nan adjacent fewer minutes, I'll return you done nan specifications of our 2022 results, past move to our 2023 financial expectations and underlying assumptions for some nan neuroscience and oncology businesses and past decorativeness pinch our updated semipermanent profitability targets.

Starting pinch our 2022 financial performance, we generated full revenues of $1.11 billion, driven chiefly by our proprietary merchandise portfolio, which grew 24% year-over-year and now represents astir 70% of full revenue. This maturation reflects beardown results from nan first full-year of nan commercialized motorboat of LYBALVI, arsenic good arsenic double-digit maturation for each of VIVITROL and ARISTADA.

From a bottommost statement perspective, we recorded GAAP nett nonaccomplishment of $158.3 million, compared to $48.2 cardinal successful nan anterior twelvemonth and non-GAAP nett income of $57.9 cardinal for nan year, compared to $129.1 cardinal successful 2021. Recall that nan 2021 results included 12 months of U.S. J&J royalties, while 2022 results only included one-month. A full-year of these U.S. royalties would person yielded astir $200 cardinal of incremental revenue.

Now, turning to VIVITROL, successful 2022, we recorded nett income of $379.5 million, up 10% year-over-year driven chiefly by maturation successful nan intoxicant dependence indication. In nan 4th quarter, VIVITROL achieved nett income of $102 million, reflecting 6% maturation sequentially and 11% maturation year-over-year.

Inventory levels were comparatively unchangeable successful comparison nan extremity of nan 3rd quarter. And during nan quarter, we recorded gross to nett favorability of astir $6 million, chiefly related to Medicaid anterior play credits from definite states and little Medicaid billings coming successful than primitively estimated.

Moving connected to nan ARISTADA merchandise family. For nan year, ARISTADA nett income accrued 10% to $302.1 million, chiefly driven by underlying demand. For nan 4th quarter, ARISTADA nett income were $79.2 million, up 5% sequentially and up 1% year-over-year. Gross to nett adjustments were unchangeable astatine 54.6% and inventory successful nan transmission accrued slightly. LYBALVI nett income for nan first full-year of its motorboat were $96 million. For nan 4th quarter, nett income were $34.9 million, up 29% sequentially, driven by continued beardown underlying request growth.

During nan quarter, inventory levels accrued arsenic expected in-line pinch request growth. And gross to nett adjustments successful Q4 were comparatively unchangeable astatine astir 25%, chiefly reflecting nan continuation of little restrictive first commercialized payer coverage.

Moving connected to our manufacturing and royalty business. For nan year, we recorded manufacturing and royalty revenues of $332 million, compared to $541.8 cardinal successful nan anterior year. We saw coagulated maturation of VUMERITY, which was up 32% year-over-year, contributing $115.5 cardinal of royalty and manufacturing revenues and that compares to $87.4 cardinal successful nan anterior year.

Royalties from income of nan agelong acting INVEGA products were $115.7 million, compared to $303.1 cardinal successful 2021. The alteration was driven chiefly by Janssen's partial termination of nan statement related to royalties connected income of nan agelong acting INVEGA products successful nan United States.

Arbitration proceedings related to this matter are ongoing and past month, we announced that nan tribunal had issued an interim award, uncovering that Janssen whitethorn not proceed to waste nan products developed nether nan statement without paying royalties pursuant to nan [Technical Difficulty].

Operator

Ladies and gentlemen, please standby, we are experiencing method difficulties. Our convention will resume momentarily. Once again, convey you for joining us. Please standby, your convention will resume momentarily. Thank you. [Operator Instructions]

Ladies and gentlemen, convey you for opinionated by. Sandy, please continue.

Iain Brown

Okay. Sorry astir that. I deliberation we had a mates of method issues, but we're backmost now. So, I'll prime up again wherever I was talking astir nan manufacturing and royalty business. So, for nan year, we recorded manufacturing and royalty revenues of $332 million, compared to $541.8 cardinal successful nan anterior year. We saw coagulated maturation astatine VUMERITY, which was up 32% year-over-year, contributing $115.5 cardinal of royalty and manufacturing revenues, compared to $87.4 cardinal successful nan anterior year.

Royalties from income of nan agelong acting INVEGA products were $115.7 million, compared to $303.1 cardinal successful 2021. The alteration was driven chiefly by Janssen's partial termination of nan statement related to royalties connected income of nan agelong acting INVEGA products successful nan United States.

Arbitration proceedings related to this matter are ongoing, and past period we announced that nan tribunal had issued an interim award, uncovering that Janssen whitethorn not proceed to waste nan products developed nether nan statement without paying royalties pursuant to nan agreement. We'll proceed to prosecute pinch Janssen and nan tribunal successful further proceedings anterior to nan tribunal’s issuance of a last award.

Turning now to expenses. Total operating expenses were $1.25 cardinal for nan year. Cost of equipment sold for 2022 accrued astir $20.7 cardinal year-over-year to $218.1 million, chiefly driven by higher volumes of cardinal manufactured products. R&D expenses for 2022 were $393.8 million, reflecting focused investments successful nan nemvaleukin objective programme and our earlier shape neuroscience and oncology improvement programs, including nan initiation of a first successful quality study of our orexin 2 receptor agonist program.

This compared to R&D expenses of $406.5 cardinal successful nan anterior year. SG&A expenses for 2022 of $605.7 cardinal accrued $44.8 cardinal arsenic compared to nan anterior year, chiefly related to investments successful nan motorboat of LYBALVI.

Turning to our equilibrium sheet, Alkermes is well-positioned from a rate perspective. We ended 2022 pinch astir $740 cardinal successful rate and full investments and pinch full indebtedness outstanding of astir $293 million. We had a affirmative nett rate position of astir $447 cardinal astatine nan extremity of nan year.

I'll displacement now to our financial expectations for 2023 and nan cardinal underlying assumptions. So, our guidance for nan twelvemonth reflects continued expected maturation of our proprietary products, attraction connected disciplined disbursal management, and finance successful nan strategical priorities that we judge will thrust maturation and worth for shareholders, including continued advancement pinch nan motorboat of LYBALVI, advancement of our orexin 2 receptor agonist programme successful objective studies, and separation of nan oncology business.

The financial guidance we are providing coming reflects nan mixed neuroscience and oncology business for nan full-year arsenic we activity toward nan planned separation, which we presently expect to complete successful nan 2nd half of nan year. As nan twelvemonth and our activity progresses, precise timing of nan planned separation will travel much intelligibly into focus.

Following chat of nan mixed business guidance, I'll outline nan oncology and separation related walk embedded wrong these expectations. Our financial expectations for nan twelvemonth besides bespeak our existent presumption that we will proceed to person royalty revenues related to income of nan agelong acting INVEGA products extracurricular nan U.S. done nan extremity of May 2023. And this is owed to nan three-month announcement play that Janssen would beryllium required to supply successful bid to terminate nan statement successful these markets.

We will proceed to exclude from our guidance immoderate imaginable royalty gross related to income of nan agelong acting INVEGA products successful nan U.S. arsenic arbitration proceedings pinch Janssen related to these royalty payments are ongoing.

I want to underscore that removing these Janssen rate flows from our guidance and profitability targets is for readying purposes only and does not successful immoderate measurement bespeak our belief successful nan spot of our ineligible position successful this matter. This attack besides has nan use of providing a clearer image of nan spot of nan underlying business, driven by our proprietary products successful VUMERITY and nan operating leverage that we've engineered into nan business.

I'll now locomotion done nan highlights of our 2023 financial expectations and nan afloat expectations were outlined successful nan property merchandise and nan 8-K issued this morning. So, for nan apical line, we expect full revenues to beryllium successful nan scope of $1.13 cardinal to $1.25 billion.

For our proprietary products, I'll commencement pinch LYBALVI. We presently expect LYBALVI nett income successful nan scope of $180 cardinal to $205 cardinal for 2023. This scope reflects our existent anticipation of continued request maturation and nan gross to nett adjustments will stay reasonably unchangeable during nan first half of nan year, and past could widen successful nan 2nd half if we participate into immoderate further commercialized contracts.

For VIVITROL, we expect nett income successful nan scope of $380 cardinal to $410 cardinal and for ARISTADA, we expect nett income successful nan scope $315 cardinal to $345 million. In position of our operating expenses for 2023, costs of equipment sold are expected to summation to a scope of $230 cardinal to $250 million, chiefly driven by accrued volumes of cardinal manufactured products.

R&D expenses are expected to beryllium successful nan scope of $370 cardinal to $400 million, driven by investments successful nan imaginable registration enabling studies for nemvaleukin, arsenic good arsenic nan early objective improvement for nan orexin program, which is expected to output first impervious of conception information successful patients by nan extremity of nan year.

SG&A expenses are expected to beryllium successful nan scope of $695 cardinal to $725 million. The year-over-year summation chiefly reflects strategical investments successful nan planned DTC run for LYBALVI and costs related to nan separation of nan oncology business. We expect GAAP nett nonaccomplishment to beryllium successful nan scope of $160 cardinal to $200 cardinal and we expect non-GAAP nett income to beryllium successful nan scope of $0 cardinal to $40 million.

As I mentioned, these financial expectations bespeak a full-year of nan mixed neuroscience and oncology business. Overall, astatine nan midpoints of nan provided ranges, our operating disbursal statement items see astir $190 cardinal of walk related to advancing nan oncology business and costs associated pinch nan planned separation transaction and building nan basal infrastructure to support nan oncology business arsenic a standalone publically traded company.

A much elaborate breakdown is disposable successful nan slides accompanying nan webcast. This estimate is intended to supply a wide schematic model for reasoning astir nan various components of nan business and whitethorn beryllium refined arsenic we advancement done nan year. The planned separation of nan oncology assets is expected to heighten nan profitability of nan remaining neuroscience business.

To bespeak this improved financial profile, coming we announced updated semipermanent profitability targets. The caller targets bespeak a one-year acceleration of our antecedently provided targets and specifically expanding our non-GAAP nett income separator targets to 25% successful 2024 and 30% successful 2025 and expanding our EBITDA separator targets to 20% successful 2024 and 25% successful 2025.

For clarity, these improved profitability targets proceed to presume nan removal of each worldwide royalty revenues related to income of nan agelong acting INVEGA products, arsenic good arsenic nan successful and timely completion of nan planned separation successful 2023.

So, taking a measurement back, we judge separating nan oncology business has galore operational virtues and will besides importantly heighten nan financial floor plan of nan resulting neuroscience company, which we expect will look pinch a increasing apical line, simplified superior allocation determination making, a streamlined costs structure, and expanding margins.

The updated and accelerated profitability targets provided coming are a reflection of our committedness to driving maturation and semipermanent profitability and we look guardant to updating you connected our advancement arsenic we forge ahead.

And pinch that, I'll manus nan telephone complete to Rich.

Richard Pops

That's great, Iain. Thank you. So, earlier talking astir what lies up successful 2023, I want to statement nan value of 2022 arsenic a turning constituent for nan execution of our strategy astatine Alkermes. With nan beardown motorboat of LYBALVI connected apical of double-digit gross maturation for VIVITROL and ARISTADA our neuroscience business is evolving arsenic we planned.

Our R&D investments are besides showing committedness pinch nemvaleukin enrolling successful registration enabling studies successful oncology and our orexin 2 receptor agonist entering and progressing successful nan clinic. And from a financial standpoint, we continued our crisp attraction connected operational efficiency, disciplined disbursal management, and driving profitability.

We managed nan business pinch these elements successful mind, commercialized execution, R&D productivity, financial discipline, each were evident successful 2022. 2023 is going to beryllium an important year, 1 successful which we build connected nan accomplishments of past twelvemonth and found a caller trajectory for nan company. We're focused connected 3 cardinal operational areas.

They are driving nan ongoing motorboat of LYBALVI, advancing our orexin programme successful narcolepsy and different slumber disorders, and executing connected nan planned separation of our oncology businesses. We judge each of these priorities tin thrust important worth for our shareholders. So, I'll walk a small clip connected each of them starting pinch LYBALVI.

The beardown traction of nan LYBALVI motorboat successful 2022 gives america assurance successful its potential. As nan first twelvemonth of motorboat progressed, healthcare providers person noted LYBALVI’s differentiated weight floor plan successful comparison to [olanzapine] [ph] successful their ain practices.

Looking ahead, we judge LYBALVI semipermanent imaginable successful this marketplace will beryllium grounded successful its proven objective efficacy, which is rooted successful nan established efficacy of olanzapine and demonstrated successful our pivotal objective trials, on pinch existent world diligent and healthcare supplier experiences.

So, arsenic you heard from Todd, we person a clear attraction successful 2023, driving nan breadth of prescriber base, further enhancing nan entree profile, and building consciousness among patients caregivers and healthcare providers. Major brands successful this class build steadily complete clip and we judge nan LYBALVI DTC run will play a important domiciled successful driving its maturation trajectory successful this illness area that is characterized by millions of patients and predominant changes successful medications.

We're excited astir nan opportunity that LYBALVI represents arsenic a caller curen action for patients, but besides for its imaginable to thrust maturation astatine Alkermes. The 2nd privilege is to beforehand ALKS 2680, our orexin 2 receptor agonist programme successful narcolepsy and different slumber disorders. This programme represents an breathtaking opportunity successful neuroscience fixed some nan beardown biologic relevance of nan orexin pathway to narcolepsy and nan important imaginable marketplace opportunity.

From a technological standpoint, there's a beardown linkage betwixt nan orexin pathway and nan disease. The situation is 1 of molecular design. We've leveraged our chemistry capabilities and pharmacokinetic expertise to create highly potent mini molecule orexin agonist designed to seizure nan capacity of nan endogenous earthy neuropeptide successful affecting wakefulness and cataplexy.

Potency is an basal constituent for efficacy and safety, but it is not capable connected its own. It must beryllium coupled pinch CNS penetration pinch a pharmacokinetic floor plan that promotes wakefulness during nan time and slumber astatine night. Based connected our preclinical and modeling work, we judge that ALKS 2680 tin embody these attributes successful a convenient erstwhile regular dose. We started nan first successful quality study for 2680 successful nan 4th fourth of past twelvemonth and we're moving quickly.

We've now dosed respective cohorts successful a azygous ascending dose study and we are good into dose levels that our modeling indicates should beryllium therapeutically applicable successful narcolepsy. Thus far, nan information and tolerability floor plan successful patient volunteers has been bully and accordant pinch what we observed successful preclinical studies.

We've been collecting EEG information pursuing azygous doses successful patient volunteers and are encouraged to person seen early signals of target engagement. We clear capable dose levels successful nan azygous ascending dose study to trigger nan initiation of nan aggregate ascending dose study and expect to statesman enrolling subjects successful nan coming weeks. This study designed involves regular dosing of ALKS 2680 for 10 days.

We besides scheme to initiate a Phase 1b impervious of conception study to measure accepted objective efficacy endpoints specified arsenic attraction of wakefulness successful narcolepsy type 1, narcolepsy type 2, and idiopathic hypersomnia. [Technical Difficulty]

Operator

Ladies and gentlemen, please standby. We are experiencing method difficulties. Your convention will resume momentarily. Once again, convey you for joining america today. Your teleconference will resume momentarily. Thank you. [Operator Instructions]

Ladies and gentlemen, convey you for opinionated by. Our teleconference will now resume.

Richard Pops

Okay. Apologies. We're having immoderate telecom issues today. So, I'll prime up wherever I near off. I was talking astir nan study that's underway successful our narcolepsy program. And I was making nan constituent that arsenic we launched nan Phase 1b impervious of conception study, that'll really statesman looking astatine nan accepted objective efficacy endpoints. And nan astir important was 1 is astir apt attraction of wakefulness, which we're going to trial successful patients pinch narcolepsy type 1, narcolepsy type 2, and idiopathic hypersomnia, arsenic good arsenic successful slumber deprived patient volunteers.

So, taken together, these studies are designed to make preliminary impervious of conception information by nan extremity of nan year. So pinch a beardown biologic rationale, and important aesculapian and economical potential, we judge that this programme offers an opportunity to create sizeable shareholder value. So, we'll proceed to attraction connected observant execution, while cautiously and expeditiously advancing nan programme and we look guardant to sharing our advancement pinch you passim nan year.

Finally, our 3rd privilege for nan twelvemonth is to complete nan separation of nan oncology business. We judge nan separation if we completed will unlock worth and position some nan oncology business and nan remaining neuroscience business for maturation and occurrence arsenic we simplify nan finance thesis and superior allocation determination making for each business.

The oncology broadside of nan business has a compelling standalone finance thesis. Anchored by nan imaginable of nemvaleukin, our caller investigational engineered IL-2 version that's a imaginable first-in-class crab immunotherapy. The IL-2 pathway offers important imaginable successful oncology. Nemvaleukin is nan astir precocious IL-2 version successful improvement and is distinguished by nan information generated successful nan session showing anti-tumor activity arsenic azygous supplier monotherapy and successful operation pinch checkpoint inhibitors.

Our existent improvement efforts are focused connected imaginable registration enabling studies successful 2 difficult to dainty tumor types. ARTISTRY-6 is evaluating nemvaleukin’s monotherapy successful mucosal melanoma and ARTISTRY-7 is evaluating nemvaleukin successful operation pinch pembrolizumab successful platinum-resistant ovarian cancer. These are ongoing blinded studies and will proceed enrolling some this year.

In addition, nan caller station separation oncology institution would person a pipeline of different preclinical immunotherapy programs. Our engineered tumor target IL-12 and engineered IL-18, some of which person been advancing preclinical improvement and correspond charismatic oncology targets. So, pinch nan precocious shape plus pinch nan imaginable to beryllium a first successful people medicine, preclinical pipeline assets and clear developmental milestones, we judge nan separation of nan oncology business represents a compelling imaginable opportunity for oncology focused investors.

So, I'll springiness you a speedy update connected nan position of nan planned separation. While we proceed to measure a scope of options for nan separation of nan oncology business, spinning nan oncology business into an independent publicly-traded institution is our readying scenario. We person a knowledgeable squad starring nan separation efforts, arsenic good arsenic an engaged committee providing oversight that has heavy acquisition and expertise successful separations and different transactions.

There's a tremendous magnitude of activity underway related to taxation planning, SEC and firm governance matters, nationalist institution listing requirements and organizational structure. In position of activity for nan station separation oncology company, nan recruiting process for nan CEO and different activity positions is good underway. And we're pleased pinch nan level of liking successful nan caliber of candidates coming done nan process.

Across nan activity streams, we're making advancement and expect to complete [pros separation] [ph] successful nan 2nd half of 2023, taxable to customary closing conditions, including last support from nan Board of Directors.

Following nan planned separation, we expect Alkermes to go a profitable axenic play neuroscience company. Alkermes will proceed to build connected our practice of invention and excellence successful this therapeutic abstraction pinch a attraction connected important unmet needs wrong neuroscience.

With a beardown apical statement growth, I'm sorry, driven by nan maturation of our proprietary products, a specialized commercialized infrastructure successful neuropsychiatry and addiction and proven supplier improvement capabilities, this stand-alone neuroscience business represents a important opportunity to seizure operating leverage, thrust maturation and profitability, and beforehand imaginable caller medicines for neurological disorders.

So, I will decorativeness location pinch a clear way guardant for each aspects of nan business. We participate 2023 pinch important operational momentum and we're well-positioned to create worth for our shareholders.

So, pinch that, I'll move it backmost to Sandy. Hope that we don't driblet nan statement again and we tin tally nan Q&A.

Sandra Coombs

All right. Thanks Rich. Rob will unfastened nan telephone for Q&A now.

Question-and-Answer Session

Operator

Thank you, Sandy. [Operator Instructions] Thank you. Our first mobility coming comes from nan statement of David Amsellem pinch Piper Sandler. Please proceed pinch your question.

David Amsellem

Hey, thanks. So, I conscionable wanted to drill down connected nan longer-term separator targets. Can you talk astir nan equilibrium betwixt SG&A and R&D walk connected nan neuropsych business? And I conjecture what I'm trying to amended understand is, really are you reasoning astir R&D successful nan discourse of what seems for illustration a beautiful thin infrastructure pinch conscionable nan orexin successful nan clinic? And should we presume that there's going to beryllium sizeable – considerably much promotional finance successful LYBALVI, not conscionable this year, but continued further finance and maturation successful SG&A arsenic a consequence successful nan product. Just thief america framework those puts and takes, if you will? Thank you.

Todd Nichols

So nan semipermanent separator targets, it's really a operation of 2 things. One, you've evidently sewage gross maturation connected nan apical line. And past we're looking to person arsenic overmuch of that incremental gross slowdown to nan bottommost statement successful bid for america to beryllium capable to deed nan targets. That said, LYBALVI is going to beryllium a large driver connected nan apical line. And to make judge we maximize nan opportunity for LYBALVI, we'll beryllium continuing to put successful nan DTC run complete nan adjacent mates of years.

I deliberation we've [learned] [ph] a batch successful this first twelvemonth arsenic we launched nan integer campaign. We person launched nan integer run and past we launched nan TV campaign. So, we'll beryllium capable to good tune, maximize nan effectiveness of that investment. And past from an R&D perspective, nan exemplary going guardant is to person a leaner R&D statement absent nan oncology assets. But we besides recognize we request to put for nan longer-term, truthful we'll beryllium doing immoderate activity from our early find motor and past besides looking astatine perchance insourcing immoderate programs into nan pipeline arsenic well. But that wide attraction connected profitability is simply a cardinal tenant for us. It has been for nan past fewer years and it will proceed to beryllium truthful into nan future.

David Amsellem

Okay. Thank you.

Operator

Our adjacent mobility is from nan statement of Akash Tiwari pinch Jeffries. Please proceed pinch your question.

Akash Tiwari

Hey, acknowledgment truthful much. Maybe conscionable a fewer if I can. On your semipermanent guide, moreover pinch nan spin, I wasn't getting to your guided nett income targets successful 2025 unless I put a LYBALVI number that's adjacent to 500 million, americium I missing thing present aliases is it adjacent to opportunity your soul expectations connected this merchandise person grown since past year? And past connected your orexin program, nan liver toxicity connected [Takeda's OX2] [ph] look to show up aft a period of dosing. With that successful mind, are you readying successful your [MAD patient trial] [ph] aliases successful immoderate of nan tests that you're going to person this twelvemonth to dose patients for an extended play of clip and really do you consciousness astir de-risking safety, peculiarly astir liver toxicity arsenic you participate into a Phase 2b trial? Thanks.

Todd Nichols

So, connected nan semipermanent profitability targets, what I will opportunity is, we haven't provided our semipermanent anticipation aliases our highest income anticipation and we will not do truthful today. As I mentioned that nan accomplishment of nan profitability targets is really going to get to beryllium driven by maturation of each 3 of our proprietary products and nan maturation of VUMERITY arsenic well, which will beryllium a cardinal travel done to nan bottommost statement for us.

And past obviously, arsenic I mentioned previously, that maturation successful gross flowing down to nan bottommost statement successful bid to beryllium capable to execute nan targets that we group retired today.

Richard Pops

And it's Rich, possibly I'll return nan orexin question. Our position is that nan toxicity seen from different compounds are mostly idiosyncratic those peculiar structures alternatively than orexin 2 agonism per se. But to nan question, nan nonsubjective successful this twelvemonth is to found that impervious of conception target engagement affecting nan architecture of nan slumber aftermath rhythm and establishing dose because nan champion measurement to interrogate longer-term toxicity imaginable is by interrogating astatine nan due dose.

Now, cognize that nan creation characteristic going into nan programme was to maximize aliases optimize astir potency. Potency successful and of itself being a really clear creation nonsubjective to minimize nan imaginable for off-target supplier induced liver injury. But you'll ne'er afloat reply to that mobility until you get longer exposures arsenic you bespeak astatine nan applicable doses successful nan diligent organization of interest.

Operator

Thank you. The adjacent mobility is from nan statement of Umer Raffat pinch Evercore ISI. Please proceed pinch your question.

Umer Raffat

Hi, guys. Thanks for taking my question. First, possibly possibly connected LYBALVI. I admit each nan colour connected nan motorboat metrics. Something I've been reasoning astir is nan number of prescriptions per prescriber appears to beryllium reasonably stable. And I would person thought that complete time, there's much prescriptions per prescriber conscionable fixed nan refills and caller ads. Just trying to understand if nan TRx maturation really is being driven much by nan caller prescribers signing on, would admit immoderate colour connected that?

And secondly, Rich, could you explain connected nan orexin trial, is it nan [SAD] [ph] cohorts that you've seen information connected aliases are you besides seeing nan Part 2 MAD? And besides if you could speak to really galore formulations are successful nan proceedings and if there's a notable quality betwixt these formulations for nan orexin? Thank you.

Todd Nichols

Yes, I'll commencement disconnected with, benignant of nan dynamics we're seeing pinch nan prescriber base. We're really encouraged by what we're seeing overall. It's accordant breadth of prescribing connected a month-over-month and quarter-over-quarter basis. Your mobility is right. Overall, nan breadth of prescribing correct now is – nan extent of prescribing is comparatively stable, but that's really an encouraging motion because our prescriber breadth continues to grow.

So, we really spot a batch of nan description correct now coming from caller prescribers arsenic we bring caller prescribers connected board. [Launch today] [ph], we're encouraged that astir 7,400 prescribers person written nan product. And our aspiration is that's going to proceed to turn consecutively complete nan adjacent mates of quarters arsenic we proceed to beforehand nan launch. And arsenic Iain said earlier, arsenic we ray disconnected nan DTC constituent of our run astatine mid-year this year.

Richard Pops

Umer, it's Rich. Just to echo what Todd was saying. Our acquisition is erstwhile physicians effort LYBALVI, they for illustration it. So, driving breadth is – successful our view, operationally successful nan [indiscernible] prerequisite driving depth. So, I deliberation we're excited astir nan measurement nan breadth is maturing. I had a hunch you’d inquire a mobility astir nan orexin. So, what I'd opportunity is that nan information we're seeing correct now is from nan SAD cohorts, truthful nan single-ascending dose, and this is an incredibly informative first shape of nan improvement programme because we're learning astir tolerability, obviously, an ascending doses.

We're seeing PK and really that PK tracks backmost to our modeling, which appears to beryllium rather precocious fidelity astatine this point. We're besides from a purely translational medicine constituent of view, looking astatine quantitative EEG successful patient volunteers, non-sleep deprived pursuing a azygous dose. And that's wherever we're conscionable opening now to spot grounds that is accordant pinch nan thought of target engagements. We're excited astir that.

The MAD cohorts will ray disconnected very soon now pinch morals support and operational spell connected nan MAD. So, that should start-up successful nan adjacent fewer weeks, followed by nan 1B, which we'll beryllium looking astatine successful patients.

Umer Raffat

Thank you.

Operator

Next mobility is comes from nan statement of Chris Shibutani pinch Goldman Sachs. Please proceed pinch your question.

Chris Shibutani

Great. Thank you very much. Two questions. One, you talked astir possibly enhancing nan entree floor plan for mid-year and really that mightiness effect nan gross to nett trajectory. Could you conscionable elaborate a small spot further astir what you'll guidelines that reasoning on? And past successful position of nan orexin agonist there, tin you, astatine this point, I cognize we're still very early successful objective development, talk astir what you spot arsenic perchance nan opportunity from a competitory positioning standpoint of really to differentiate? I've heard a batch of potency successful your vocabulary. Is that really nan emphasis? Ultimately, what benignant of floor plan do you, benignant of aspire it?

Todd Nichols

Yes. I'll commencement disconnected pinch nan marketplace entree question. As we said successful nan prepared remarks, our anticipation is that gross to nett is going to beryllium comparatively unchangeable complete nan first half of nan year, and it could germinate successful nan 2nd half of nan year. We're successful changeless interaction pinch commercialized payers correct now and discussions pinch them. And I deliberation really nan measurement to deliberation astir this is that marketplace entree sum successful nan class is not stagnant.

It will proceed to germinate complete time. And this is really – this is simply a marketplace that is really categorized by navigating step-throughs, PAs, aesculapian exceptions and each nan activity that we've done pinch HCPs and this class tells america that they are good versed successful this area, and they tin really negociate nan dynamic.

So, we talked a batch astir conscionable providing a pathway to access. That's going to beryllium a operation and a substance of contracting positive each nan programs we person to support diligent access. For LYBALVI correct now, we judge we're really good positioned. The immense mostly of patients person a pathway to access. We're seeing bully utilization crossed each of our marketplace entree programs, our PA programs, our co-pay programs, and we are having these ongoing discussions pinch payers.

So, correct now, if we find that we request to heighten nan position, we'll do so, and we'll look astatine that successful nan 2nd half of nan year, but that wouldn't hap without really a strategical finance aliases strategically looking to spot if we do request to heighten that position.

Richard Pops

And past Chris, connected nan orexin stuff, I'm gladsome you asked nan mobility because potency is simply a feature, but it's not needfully a benefit. So, what is nan use of potency? So, nan measurement we spot these different compounds evolving successful nan session is that there's a number of different optimization parameters successful this creation of this molecule. And my long-standing belief has been that these molecules are each going to beryllium rather different. I don't deliberation they're each going to beryllium nan same.

Even if it's stipulated if they prosecute nan receptor, they mightiness person nan aforesaid effect connected nan slumber aftermath cycle, they could beryllium very, very different on respective parameters. Number 1 is safety. We've already seen drug-induced liver wounded from 1 conception that whitethorn aliases whitethorn not beryllium successful [indiscernible] others. Number 2 is nan on-target toxicity aliases AE that you'd beryllium focused connected our cardiovascular stages, humor pressure, and bosom rate. And we deliberation these whitethorn beryllium different, not conscionable because of potency, but besides because of PK.

And PK is besides wholly applicable pinch respect to different constituent that these could differentiate, which is connected nan beingness aliases absence of insomnia. If your waveform is excessively extended and you don't let group to return backmost to baseline earlier it’s clip to spell to furniture aliases if it's excessively little and they don't person an extended play of wakefulness.

So, there's a number of different – and I must say, from nan very opening of this program, we've been seeking – utilizing nan animal activity and different modeling activity to effort to optimize 2680 to beryllium delicate to each of these different parameters.

Chris Shibutani

Thank you.

Operator

Our adjacent mobility is from nan statement of Paul Matteis pinch Stifel. Please proceed pinch your question.

Paul Matteis

Hey, acknowledgment truthful overmuch for taking my question. I wanted to inquire different conscionable mobility astir nan profitability targets. Congrats connected pulling those in. More specifically, really overmuch is that pull-in driven by nan oncology spin? And are location immoderate other, benignant of factors, either further costs subject or, again, alteration successful gross expectations that are embedded successful that? And past conscionable connected nan orexin POC information later this year, could you conscionable stock a small spot much granularity connected what we should expect? Like really galore patients connected drug, placebo, things had long of treatment, things for illustration that, that I deliberation will thief america understand really de-risking these information are? Thank you.

Iain Brown

Okay. Paul, I'll return nan profitability question. So, nan rotation of nan oncology assets, obviously, that brings down nan R&D walk rather importantly round-about – if you look astatine nan small array we provided wrong nan slides, it's astir $145 cardinal astatine nan midpoint of ongoing oncology costs that would travel retired of nan P&L. I deliberation astatine nan aforesaid time, arsenic you spot what we're doing successful 2023, investing successful nan continued motorboat of LYBALVI pinch nan DTC campaign. This year, we're going to person a full-year of integer and perchance half a twelvemonth of TV.

So, you could spot immoderate incremental investments wrong – for DTC location wrong nan income and trading line. But again, nan expertise to deed these revised targets is really going to beryllium predicated connected gross maturation connected nan apical statement pinch travel down to nan bottommost line. So that's really – that continued attraction connected costs guidance is really going to thief america successful achieving nan profitability targets 1 twelvemonth earlier than we antecedently anticipated.

Richard Pops

And Paul, it's Rich, nan sequencing of nan 2023 objective activity pinch orexin is very deliberate. And I mentioned Umer before, SAD progressing into nan MAD arsenic you clear doses, peculiarly arsenic you commencement getting into wherever we modeled to beryllium therapeutically applicable concentrations. MAD provides 10 days of vulnerability gives america PK connected a steady-state basis, arsenic good arsenic tolerability and information pinch further EG information.

You move into nan 1b. The 1b will beryllium circa 40 aliases 50 patients, I would say, pinch practice crossed NT1, NT2, idiopathic hypersomnia arsenic good arsenic slumber deprived individuals. So, you'll get a sampling crossed each of those different phenotypes aliases illness categories, which should beryllium capable to spot whether you're having effect connected nan architecture slumber – against nan superior extremity constituent that 1 cares astir for registration, which is this attraction of wakefulness test, which is simply a reasonably reliable marker for nan activity of these narcotics successful nan syndication.

Paul Matteis

Okay. Thanks. But what astir astatine year-end, Rich, conscionable for for illustration really overmuch information – not 150 [patients] [ph]?

Richard Pops

Well, nan only logic I'm going to beryllium a small spot soft connected that is because we clear morals support astatine each different stage. And truthful depending connected nan timing of nan morals support and past nan consequent enrollment, nan patient volunteers, we person a beautiful bully thought connected because they're patient volunteers successful Phase I sites. But arsenic we commencement moving into NT1, NT2, IH and that – truthful we'll springiness you a small spot much – but I expect, I mean, our readying lawsuit is to person accusation successful astatine slightest nan NT1s this year.

So, we'll spot – we'll update – we'll spell arsenic accelerated arsenic we can, obviously, but we'll spot arsenic we move done these various logistical hurdles.

Paul Matteis

Okay. Understood. Thanks truthful much.

Richard Pops

You’re welcome. I did reply a portion of Umer's question, which is astir formulations. And there's 1 formulation successful nan clinic. Different doses, 1 formulation.

Operator

The adjacent mobility is from nan statement of Uy Ear pinch Mizuho. Please proceed pinch your question.

Uy Ear

Hi, guys. Thanks for taking my question. I conjecture my first mobility is nan guidance, it is nan commencement of nan year, and it seems wide. Just wondering what would it return to benignant of constrictive it? And secondly, could you supply america pinch immoderate colour connected nan gross presumption for VIVITROL and ARISTADA successful nan guidance? I mightiness person missed it. Thanks.

Iain Brown

I'll return nan past 1 first. So, nan VIVITROL gross to net, we expect that – truthful fiscal twelvemonth 2022 ended pinch a 50% gross to net. We primitively thought it was going to beryllium astir 52%, but we did spot immoderate favorability connected nan Medicaid broadside of nan business arsenic we went done nan year.

So, we don't expect needfully seeing that favorability travel done successful 2023. So, I'd expect that you'd spot an summation successful nan gross to nett back-up towards that 52% level. And past nan gross to nett for ARISTADA has been remarkably stable, I would say, complete nan past mates of years. So you, would expect that benignant of level of gross to nett to proceed into nan future.

And past your wide mobility astir why guidance, arsenic you say, it's early successful nan year. So, there's tons of puts and takes arsenic we spell done nan twelvemonth that could effect nan business. And we've done our champion estimated trying to put those together. If you – I mean we could spell down line-by-line, I don't deliberation we person clip to do that. But looking astatine VIVITROL, for example, nan maturation successful intoxicant dependence and past spot what happens connected nan opioid broadside of nan business. ARISTADA is very overmuch limited upon marketplace growth, and we person definite assumptions built successful there. Market maturation could beryllium different to what we're anticipating.

LYBALVI is still successful nan motorboat phase. We've sewage a batch going connected pinch respect to LYBALVI and nan DTC campaign, for example. So, those are conscionable a fewer examples of immoderate of nan things, surely connected nan gross side. And obviously, arsenic we spell done nan year, what we typically do is we effort and constrictive those ranges down arsenic we, benignant of knowledgeable things passim nan year.

Uy Ear

Thank you.

Operator

Our adjacent mobility is from nan statement of Jason Gerberry pinch Bank of America. Please proceed pinch your question.

Jason Gerberry

Hi guys. Thanks for taking my questions. Just wanted to inquire a mobility astir nan LYBALVI payer operation and gross to nett specifically. It seems for illustration your gross to nets are beautiful low, and so, it seems for illustration you're not really contracted overmuch connected nan commercialized side, but yet you're not expecting, benignant of nan volatility we spot typically successful for illustration twelvemonth 1, 2 for narcotics that are heavy commercially insured. So, conscionable wondering if you can, benignant of speak to nan payer operation broadly betwixt nan 2 indications that you person there.

And past conscionable a speedy follow-up question. Just connected nan VIVITROL patent case, I deliberation it's 1 azygous patent successful dispute. So, wondering if you're expecting a beautiful speedy turnaround clip connected a ruling from nan [judge there] [ph]? Thanks.

Todd Nichols

Yes, I'll commencement disconnected pinch nan payer operation arsenic well. It's a bully observation. Right now, overall, what we're seeing pinch what we saw past year, we saw successful nan 4th fourth is, we didn't spot arsenic overmuch vulnerability pinch our wide gross to nett and nan rebates that we had to pay. We launched – erstwhile we launched nan product, we put a number of programs into place, our PA programme our co-pay program, and we're really seeing really bully utilization.

For example, northbound of astir 70% of each of our anterior authorizations are approved, which is very accordant pinch nan branded category. I deliberation besides what we're seeing is, we're seeing nan existent leverage successful nan dual indications, schizophrenia and bipolar. Schizophrenia, nan operation typically successful schizophrenia patients is simply a higher operation wrong Medicare and Medicaid. Within bipolar, you really spot a higher operation of commercialized and Medicaid. And we're getting a patient operation of some of those correct now.

Overall, arsenic clip settles out, we judge that LYBALVI will beryllium very accordant pinch nan category, which is fundamentally astir a 3rd for commercial, a 3rd for Medicaid and a 3rd for Medicare.

Richard Pops

And connected nan yearly litigation, while you're correct, there's a azygous patent. There's a bid of arguments underneath that patent that are reasonably nuanced and will beryllium discussed during nan trial. So, I won't estimate really accelerated aliases slow nan judge will work. Our presumption is that there'll beryllium immoderate type of determination successful nan Q2 clip frame.

Jason Gerberry

Got it. Thanks.

Operator

Our adjacent mobility comes from nan statement of Jessica Fye pinch J.P. Morgan. Please proceed pinch your question.

Jessica Fye

Hey guys. Good morning. Thanks for taking my question. When we deliberation astir nan guidance for 2023 SG&A up astir $100 cardinal astatine nan midpoint year-over-year. I ideate overmuch of this is PTC for LYBALVI, but tin you quantify that? And really should we deliberation astir nan annualized DTC costs for LEVALVI arsenic we deliberation up to 2024, for example? And past sticking pinch LYBALVI, but connected gross to net, I want to make judge I understand what's embedded arsenic it relates to your LYBALVI income guidance for 2023?

I deliberation you mentioned precocious 20s successful nan first half and that, that whitethorn widen depending connected if you do further contracting. So, what's baked into nan gross guideline successful position of widening successful nan backmost half, if thing aliases would that beryllium upside to income guidance if you opt to not spell that route?

Iain Brown

Okay, Jessica, acknowledgment for nan questions. I'll return a spell astatine those. So, for 2023, wrong SG&A, you'll spot there's astir $75 million, $80 cardinal of incremental income and trading walk and nan mostly of that is focused connected nan DTC campaign. So that would beryllium for a full-year of integer and half a twelvemonth of TV. So, if you deliberation astir nan further years retired to 2024 and 2025, if location was a full-year of some TV and digital, past location would beryllium an summation successful SG&A proportionately.

Also wrong nan G&A, I deliberation I did mention, and it's illustrated a small spot successful nan descent that we person successful nan tables. A batch of nan one-time type separation costs associated pinch separating retired nan oncology business are included wrong nan SG&A line. There's astir $45 cardinal of costs successful full betwixt building retired nan infrastructure for nan stand-alone entity and those one-time costs. So that looks for illustration G&A is expanding by much than it will.

Obviously, pinch nan neuroscience business connected stand-alone basis, those costs will nary longer beryllium portion of nan business. And past from a gross to nett position for LYBALVI, arsenic Todd mentioned, precocious 20s for nan first half of nan year. And past nan nett income scope we gave coming of [180 to 205] [ph] really encapsulates a scope of gross to nett possibilities that we could spot successful nan 2nd half. So, we're not being circumstantial today. That will go much into [light] [ph] arsenic we participate into immoderate imaginable negotiations and we'll beryllium capable to supply much item arsenic we spell done nan year.

Jessica Fye

Great. Thank you.

Operator

Our adjacent mobility is from nan statement of Marc Goodman pinch SVB. Please proceed pinch your question.

Marc Goodman

Good morning. Rich, could you talk astir what's going connected down nan scenes pinch trying to build a deeper pipeline connected nan CNS side? Do you deliberation successful a twelvemonth from now, location will beryllium much products there? I conjecture nan mobility is partially really fierce you're going to beryllium connected nan BD side? And past besides what's happening successful discovery. I cognize you don't want to disclose anything, but possibly you tin conscionable talk astir it if thing will beryllium disclosed complete nan adjacent twelvemonth aliases so? Thanks.

Richard Pops

Morning Marc, it's astir apt excessively early to make a telephone connected that different than erstwhile you deliberation astir nan neuroscience institution spun it's going to person orexin moving aggressively successful nan clinic. But nan pipeline down that, we've not fixed you guys immoderate visibility into, in-part because immoderate of it, arsenic you indicated, is not ready, but besides because we'll request to populate it pinch immoderate further candidates. So, nan R&D and profitability guidance that Iain has mentioned accommodates nan thought of expanding nan pipeline, but not successful a melodramatic fashion.

I mean, we're not going to spell connected a spending spree because we're managing business to deed those profitability targets. But arsenic nan gross statement grows, if we support connected a ratio basis, an R&D statement that's in-line pinch what our adjacent companies would do, it accommodates nan description of R&D. And of course, nan awesome toggle is what happens pinch nan orexin program. If that continues to rotation that's going to go a really important characteristic of nan pipeline.

Marc Goodman

Well, I conjecture what I'm getting astatine is that nan BD broadside is really up to you, right? I suppose, really fierce you want to be. So, I conjecture I'm conscionable funny really fierce – what does it look for illustration retired there? We cognize that's happened to nan biotech assemblage complete nan past mates of years. It conscionable seems for illustration a bully clip for you to beryllium building up nan pipeline, taking advantage of those opportunities.

Richard Pops

Yes, I deliberation that you're right. I deliberation that there's – we went done a play of clip location really wasn't overmuch retired location that we were attracted successful now. I deliberation nan group is progressive now, but that happens connected specified an episodic ground erstwhile nan stars align and you find thing that meets nan criteria from a technological market, arsenic good arsenic intelligence spot for perspective. So, it's difficult to springiness you guys immoderate guidance connected nan timing and sequencing of that different than to cognize that it's a priority.

Marc Goodman

Okay. Thanks.

Operator

Our adjacent mobility is from nan statement of Douglas Tsao pinch H.C. Wainwright. Please proceed pinch your question.

Douglas Tsao

Sorry astir that. Thanks for taking nan questions. Just arsenic a follow-up connected LYBALVI and nan comments successful position of nan gross to net. Just funny if you tin conscionable locomotion done really you're reasoning astir nan determination whether to statement much successful nan 2nd half of nan twelvemonth that would lead to an description connected nan gross to nett and what you would astir get for that from an entree standpoint?

Todd Nichols

Yes, absolutely. So, we're watching this very intimately overall. We look astatine it a mates of different ways. We're really looking astatine nan TRx’s and nan publication from each of nan channels. And we really spot a patient information of prescriptions. As I said earlier successful my prepared remarks connected bipolar and schizophrenia, but we besides spot a patient magnitude of prescriptions that are flowing done pinch commercial, pinch Medicaid and Medicare.

So, we're watching that really closely. And those are discussions that we besides past person pinch commercialized payers. And 1 of nan determination points that we're reasoning astir is our entree floor plan correct now support nan aspiration that we have. And if we request to heighten it successful immoderate way. And those are discussions that we had past year, and we'll proceed to person those this year. We deliberation that LYBALVI is very well-positioned correct now wrong marketplace access, because we are seeing nan prescriptions travel through.

We do a adjacent magnitude of marketplace investigation pinch providers arsenic well. And wide successful this category, they deliberation successful wide that astir of nan branded agents person a akin profile. There's ever measurement astatine its anterior authorizations, aesculapian exceptions. So that goes into our determination constituent arsenic well, too. But overall, correct now, we deliberation we're really well-positioned.

Douglas Tsao

Okay. Great. Thank you very much.

Operator

Thank you. Our last mobility is from nan statement of Brandon Folkes pinch Cantor Fitzgerald. Please proceed pinch your question.

Brandon Folkes

Hi, acknowledgment for taking my question. I conscionable want to travel backmost to nan neuroscience SG&A spend. On LYBALVI, conscionable fixed nan breadth of prescribing is driving maturation currently, really do you deliberation astir your headcount, infrastructure, and nan commercialized cognition successful 2023 and possibly embedded successful those 2024 and 2025 profitability targets? Thank you.

Iain Brown

Yes. I deliberation we've built nan infrastructure. Initially, we built it for VIVITROL, and we were capable to commencement leveraging it pinch ARISTADA. We now person 3 products that are supported by nan commercialized infrastructure. And I deliberation nan infrastructure that we person coming is going to support maturation for each 3 products into nan early without america needing to walk further money.

I deliberation nan incremental investments connected nan SG&A broadside aliases surely connected nan income and trading broadside are really going to beryllium astir this DTC campaign, some successful this twelvemonth and successful nan adjacent mates of years. But arsenic I said, nan thought betwixt nan DTC run is to turn aliases move that gross statement up. So, assuming we spot that, we will proceed to put successful DTC, but we're going to study a batch arsenic we get into nan program, and we'll beryllium capable to set that finance arsenic we deem appropriate.

Brandon Folkes

Great. Thank you very much.

Operator

Please spell ahead, Sandy.

Sandra Coombs

All right. Thanks, everyone, for joining america connected nan telephone today. Apologies for nan method difficulties and base pinch us. We'll beryllium disposable each time if you request us. Thank you.

Operator

This will reason today's conference. You whitethorn disconnect your lines astatine this time. Thank you for your participation.