UTHR
#We have been very opportunistic in the way that we look at expanding the Company.
Our core mantra is to identify corridors of indifference and run like (expletive) on them.
That's what we did in the first case with pulmonary hypertension, nobody was interested in the field, all the patients dying.
We ran like (expletive) down that corridor and are now generating $1.5 billion a year in revenue from that field, up from $750 million in revenues just five years ago.
And as we've mentioned that previous call, we expect these revenues to be able to double again in five years through the growth from Remodulin, Tyvaso and both in the implantable, disposable and combination versions as well as Orenitram reaching its blockbuster potential of $1 billion.
So that's the heart and soul of the Company's business development and core expansion.
Beyond that, when we saw another corridor of indifference, pediatric oncology, and specifically, neuroblastoma with no approved therapy for it, we ran like (expletive) down that corridor.
As a result, I think that we have brought a great gift to the patients, families and physicians caring for neuroblastoma patients with the first-ever FDA approval for drug to treat that indication.
And it looks like it will be a gift that keeps giving, as people begin to explore the potential of that platform for other oncology indications.
And that's pretty much our mantra, is just to keep to the ---+ find the corridor of indifference, where there are no or no effective therapy and then charge down that corridor to become first and dominant in that field.
Thanks.
Brian, next question.
Dr.
<UNK>.
Yes, sure.
Thanks <UNK>.
So I think we've stated previously that the rate of loss for every 100 patients we start, we lose approximately 15.
The reasons that we lose them are basically from intolerance.
Again, these are ---+ treprostinil is a very powerful agent.
It does a lot of good things; it also causes a lot of vasodilator-type side effects: headache, nausea, GI distress, and some other things, as does Uptravi.
If you look at their package insert, the profile and type of adverse events is similar and it's similar to epoprostenol as well.
So that's the main reason.
We haven't seen any competitive loss and again, it's very early in Uptravi's launch.
I don't think switching patients from Orenitram to selexipag would necessarily be a wise thing to do.
There's no idea about those comparability.
As I stated, the receptor diversity is quite different.
There's a unidimensional IP1 selective agent.
We find multiple receptors.
Our drug is titratable so patients that achieve higher dose may not actually be able to switch to selexipag.
So we don't see that happening and we don't expect that to happen.
The attrition, we've look carefully at the rate of loss and trying to minimize the attrition.
Again, it gets into that artful practice of making sure new physicians, in particular, change the dose appropriately; that they don't become too aggressive or go too easy because you want to make sure you get some therapeutic effect so that the side effects are not bothersome.
And then on the other hand, you don't want to go too hard so that you generate too many side effects and the patient wants to come off therapy.
So that's a lot of what we do, both with our sales team in terms of educating about how the drug was dosed in the clinical trials and then also with our support specialist, both from the specialty pharmacies and through our medical affairs department, educating new physicians, in particular, about the historical and artful practice of prostacyclin dosing.
Great.
Excellent answer.
Thanks, Dr.
<UNK>.
Brian, you've been wonderful.
We have time for just one more question.
Yes, very ---+ a little bit different question there.
So the way we are organized within the United Therapeutics, the function called strategic operations, which includes all of the direct relationships with the major payers, both in the US and abroad as well as Medicare, is managed by <UNK> <UNK>, the Chief Financial Officer.
And <UNK> is on the call.
<UNK>, can you provide some color on that.
Yes.
Thanks <UNK>.
Thank you for the question.
So in terms of going forward, in terms of reimbursement, we have not seen any significant changes in terms of reimbursement patterns with any of our therapies going forward.
And in terms of outcomes-based reimbursement discussions, there's again, we haven't been able to ---+ or haven't had those discussions on a going-forward basis as well.
And this operation has a very broad team underneath it in terms of Jay Watson, who are in constant contact in terms of the market and the reimbursement aspects of our therapies.
And we've been very successful at this point in getting the therapies reimbursed for our patients.
And if we're not able to, we actually provide those therapies free to the patients to make sure they're getting the proper treatment.
Excellent.
Well, everybody, thank you very much for joining the conference call and Brian, thank you for organizing it.
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Operator, you can now conclude the call.
