Milestone Pharmaceuticals Inc. · NASDAQ:MIST
Milestone Pharmaceuticals — Investor Day (December 2022)
34 slides from Milestone Pharmaceuticals's investor day presentation, Dec 6, 2022
Slide 1: Commercial Opportunity Deep Dive for Milestone Pharmaceuticals
December 6, 2022Commercial Opportunity Deep Dive for Milestone PharmaceuticalsJoe OlivetoLorenz MullerChief Executive OfficerChief Commercial Officer
Slide 2: Forward Looking Statement
Forward Looking Statement2Milestone Commercial Deep-Dive December 6, 2022 ThePresentationcontainsforward-lookingstatementswithinthemeaningofthesafeharborprovisionsofthePrivateSecuritiesLitigationReformActof1995,asamend ed.Wordssuchas‘‘aim,’’‘‘anticipate,’’‘‘assume,’’‘‘believe,’’‘‘contemplate,’’‘‘con
Slide 3: Commercial Deep-Dive Agenda
Commercial Deep-Dive Agenda•Introduction and Overview of Milestone Pharmaceuticals•PSVT Disease Burden –The Problem•Etripamil –Value Proposition•Where Do We Play –Market Size•How Do We Engage –Commercial Strategy3Milestone Commercial Deep-Dive December 6, 2022
Slide 4: Commercial Deep-Dive Agenda: Introduction and Overview
Commercial Deep-Dive Agenda•Introduction and Overview of Milestone Pharmaceuticals•PSVT Disease Burden –The Problem•Etripamil –Value Proposition•Where Do We Play –Market Size•How Do We Engage –Commercial Strategy4Milestone Commercial Deep-Dive December 6, 2022
Slide 5: Management Team
Joseph OlivetoChief Executive OfficerAmit HasijaChief Financial Officer David Bharucha, MD, PhDChief Medical Officer Francis Plat, MD Chief Scientific OfficerLorenz MullerChief Commercial OfficerJeff NelsonChief Operating OfficerManagement Team5 Milestone Commercial Deep-Dive December 6, 2022
Slide 6: Investment Highlights
Investment Highlights1.Etripamilpotentially offers patients with PVST control over their condition through rapid resolution of episodes when and wherever they occur2.PSVT is a large untapped market with high unmet need for Patients and Health Care Providers 3.Experienced team with deep understanding
Slide 7: Atrial Arrhythmias with a Common Patient Burden
Atrial Arrhythmias with a Common Patient BurdenSources: adapted from https://en.ecgpedia.org/index.php?title=Supraventricular_Rhythms , accessed 2/20217Milestone Commercial Deep-Dive December 6, 2022 PSVT(AVNRT and AVRT)AFib-RVR (a subset of AFib)Regular rapid heart rateIrregular rapid heart rateCom
Slide 8: Current Standard of Care for PSVT
Current Standard of Care for PSVTSources: Internal estimates based on market research and longitudinal analysis of Truven/Marketscanand Medicare claims data; Page RL et al, 2015 ACC/AHA/HRS guideline for the management of adult patients with supraventricular tachycardia: executive summary: a report
Slide 9: Potential Paradigm-Changing Treatment to Empower Patient Control of their Condition
Potential Paradigm-Changing Treatment to Empower Patient Control of their Condition•Time consuming•Anxiety provoking •Costly•Unpleasant experience with adenosine 9Milestone Commercial Deep-Dive December 6, 2022 Drawbacks with the current standard of care in the Emergency Department•Often results in
Slide 10: Etripamil: Potential New Treatment for PSVT
Etripamil: PotentialNew Treatment for PSVTSources: Stambler BS, et al., J Am Coll Cardiol. 2018; Wight D,et al.J Am Coll Cardiol.2022 Mar, 79 (9_Supplement); Ip IpJE, et al. manuscript in preparation.; NODE-PK-101, -103, data on file.10Milestone Commercial Deep-Dive December 6, 2022•Developed to rap
Slide 11: Commercial Deep-Dive Agenda: PSVT Disease Burden
Commercial Deep-Dive Agenda•Introduction and Overview of Milestone Pharmaceuticals•PSVT Disease Burden –The Problem•Etripamil –Value Proposition•Where Do We Play –Market Size•How Do We Engage –Commercial Strategy11Milestone Commercial Deep-Dive December 6, 2022
Slide 12: Milestone Thought Leadership in PSVT
Initial Claims Analyses Qualitative HCP/Payer/Patient Market Research Updated Claims Analyses Qualitative and Quantitative Market Research (G7) Phase 2 Preparation for Phase 3 Phase 3 Phase 1 Robust market and customer understanding shown in interviews with 2,000+ stakeholders2018-2019 Quantitative
Slide 13: Longitudinal Study Enhances Understanding of Burden of PSVT
Longitudinal Study Enhances Understanding of Burden of PSVT Analysis of Prospective Patient Reported Outcomes (PRO) Longitudinal Data•Phase 1: Baseline Survey (medical and SVT episode history)•Phase 2: Longitudinal Weekly Surveys (episode survey if experienced an episode, QoL survey if not)5,277surv
Slide 14: Key Characteristics of PSVT for Patients that Define TAM
Key Characteristics of PSVT for Patients that Define TAM.Source: 2019 market research with patients conducted by BluePrintResearch Group (n=247) 14 Milestone Commercial Deep-Dive December 6, 2022~60%~45%with multiple 10+ minute moderate/severe* episodes per yearexperience an average duration ≥30 min
Slide 15: PRO Study Episode Burden: Symptoms Correlate with Episode Severity
Palpitations / rapidheart rateDifficulty breathingDizzinessChest pain 89%18%15%8% 87%43%34%19% 96%80%58%45%PRO Study Episode Burden –# Symptoms Correlate with Episode Severity 15Mild Episodes Moderate EpisodesSevere Episodes n=1113 (44%)n=1182 (47%)n=223 (9%)Symptoms by Episode Severity* % of Episod
Slide 16: The Emotional Burdens of PSVT, During and Between Episodes
The Emotional Burdens of PSVT, During andBetween Episodes Source: K Wood, Supraventricular Tachycardia and the Struggle to be Believed, EurJ Cardiovasc Nurs., 2007 December Will everyone know?To Appear Normal, Sustain Employment, Concealment, Social Stigma What is causing this?Frustration, Randomnes
Slide 17: Commercial Deep-Dive Agenda: Etripamil Value Proposition
Commercial Deep-Dive Agenda•Introduction and Overview of Milestone Pharmaceuticals•PSVT Disease Burden –The Problem•Etripamil –Value Proposition•Where Do We Play –Market Size•How Do We Engage –Commercial Strategy17Milestone Commercial Deep-Dive December 6, 2022
Slide 18: RAPID-Enabled Target Product Profile for Etripamil
RAPID-Enabled Target Product Profile for Etripamil18 EtripamilPlaceboConversion to Sinus Rhythm at 30 Minutes64% 31%Conversion to Sinus Rhythm at 60 Minutes73%55%Median Time to Conversion17 minutes54 minutesHealthcare Resource Utilization•Use of Etripamil resulted in a cumulative ~40% difference in
Slide 19: Etripamil Has Distinct Value Propositions For Patients
Etripamil Has Distinct Value Propositions For PatientsSource: Patient Advisory Boards and Focus Groups with Patient Ambassadors, HRW HCP and Patient Behavioral and Attitudinal Research 202219Milestone Commercial Deep-Dive December 6, 2022Patients Rapid & Reliable Relief Patient Empowerment Quiet Min
Slide 20: Etripamil Has Distinct Value Propositions for Patients and Physicians
Etripamil Has Distinct Value Propositions for Patients and PhysiciansSource: Patient Advisory Boards and Focus Groups with Patient Ambassadors; HRW HCP and Patient Behavioral and Attitudinal Research 2022 ;Triangle Insights Group (Node 301 and Rapid Qual and Quant HCP Demand Research 2020)20Mileston
Slide 21: Etripamil Has Distinct Value Propositions for All Stakeholder Groups
Etripamil Has Distinct Value Propositions for All Stakeholder GroupsSource: Patient Advisory Boards and Focus Groups with Patient Ambassadors; HRW HCP and Patient Behavioral and Attitudinal Research 2022 ;Triangle Insights Group (Node 301 and Rapid Qual and Quant HCP Demand Research 2020); Trinity L
Slide 22: Market Access Strategy Considerations
Market Access Strategy Considerations•Most US payers are expected to understand the burden of PSVT and the value prop for etripamil•Not expected to be “budget-impacting” enough to warrant active management•Minimal market competition less likely to drive large rebate pressure•Tier placement and utili
Slide 23: Commercial Deep-Dive Agenda: Market Size
Commercial Deep-Dive Agenda•Introduction and Overview of Milestone Pharmaceuticals•PSVT Disease Burden –The Problem•Etripamil –Value Proposition•Where Do We Play –Market Size•How Do We Engage –Commercial Strategy23Milestone Commercial Deep-Dive December 6, 2022
Slide 24: Core PSVT Market is Addressable Now, with Large Potential for Expansion
Core PSVT Market is Addressable Now*, with Large Potential for ExpansionSources: 1) assumes annual incidence rate for PSVT of ~300k from longitudinal claims analysis and the average time to diagnosis (currently 2-3 years) can be reduced to <6 months 2) Calculated as the difference between PSVT preva
Slide 25: Understanding Epidemiology of PSVT Using Longitudinal Claims Data
Understanding Epidemiology of PSVT Using Longitudinal Claims Data Source: Data on file from IBM Marketscan® Commercial Research Database (<65y) and the Medicare Limited Dataset (≥65y), with demographic, enrollment and claims data for commercially insured (Truven) and Medicare covered patients using
Slide 26: New Publication Addresses Under-reporting of Prevalence of PSVT
New Publication Addresses Under-reporting of Prevalence of PSVT•MESA/PREEMPT identify only patients presenting to healthcare settings acutely, with the episode confirmed on ECG during the encounter•Less than 25% of patients in RAPID on placebo sought medical intervention•Less than 40% of incident ca
Slide 27: Core PSVT Market is Addressable Now, with Large Potential for Expansion
Core PSVT Market is Addressable Now*, with Large Potential for ExpansionSources: 1) assumes annual incidence rate for PSVT of ~300k from longitudinal claims analysis and the average time to diagnosis (currently 2-3 years) can be reduced to <6 months 2) Calculated as the difference between PSVT preva
Slide 28: Commercial Deep-Dive Agenda: Commercial Strategy
Commercial Deep-Dive Agenda•Introduction and Overview of Milestone Pharmaceuticals•PSVT Disease Burden –The Problem•Etripamil –Value Proposition•Where Do We Play –Market Size•How Do We Engage –Commercial Strategy28Milestone Commercial Deep-Dive December 6, 2022
Slide 29: Core PSVT Market is Addressable Now, with Large Potential for Expansion
Core PSVT Market is Addressable Now*, with Large Potential for ExpansionSource: 1) assumes annual incidence rate for PSVT of ~300k from longitudinal claims analysis and the average time to diagnosis (currently 2-3 years) can be reduced to <6 months 2) Calculated as the difference between PSVT preval
Slide 30: Management of Patients with PSVT and Call Point Targeting
Management of Patients with PSVT and Call Point Targeting•Targeted sales force to reach majority of available opportunity•Significant overlap with most common CV portfolio call points (e.g., heart failure, OACs, lipidemia, diabetes)Source: Milestone Market Research on file30 Clinical CardiologistsPr
Slide 31: Cardiologists Report >50% Stated Adoption of Etripamil
Cardiologists Report >50% Stated Adoption of Etripamil when Shown RAPID Study Product ProfileSource: Quantitative market research conducted by Triangle Insights Group (n=250 cardiologists), June-September 2020 19%6%20%8%42%24%20%9%29%25%0%20%40% 60% 80%100%Current TreatmentTreatment with Etripamil A
Slide 32: Peak US Market Opportunity for Etripamil in PSVT
Peak US Market Opportunity for Etripamilin PSVTPatients with PSVT*Patient stated severity of SVT episode (mild, moderate, or severe) Peak US net revenue estimates assume a net price of $500-$1,000/Rx at launch and that patients prescribed etripamil use the product on average to treat 4 episodes per
Slide 33: Commercial Deep-Dive: Key Takeaways
Commercial Deep-Dive: Key Takeaways•PSVT represents a large and actionable population in the US with significant potential for expansion•Most patients with PSVT experience episodes that could benefit from etripamil•RAPID study results enable a target product profile that appeals to physicians and pa
Slide 34: Thank you
He: Milestone Thank you
Milestone Pharmaceuticals — Investor Day (December 2022) on 6ix