Endo International PLC (ENDP) 2022 Q1 法說會逐字稿

Good day, and welcome to the First Quarter 2022 Endo International plc Earnings Conference Call. (Operator Instructions)

大家好，歡迎參加遠藤國際有限公司2022年第一季業績電話會議。 （操作員指示）

As a reminder, this call is being recorded. I would now like to turn the call over to Laure Park, Senior Vice President, Investor Relations and Corporate Affairs. You may begin.

提醒一下，本次電話會議正在錄音。現在我想將電話轉給投資者關係和公司事務高級副總裁Laure Park。您可以開始發言了。

Thank you. Good morning, and thank you all for joining us to discuss our first quarter 2022 financial results. Joining me on today's call are Blaise Coleman, Endo's President and CEO; Mark Bradley, Executive Vice President and CFO; and Patrick Barry, our President, Global Commercial Operations.

謝謝。早安，感謝大家加入我們，討論我們2022年第一季的財務表現。今天參加電話會議的嘉賓包括Endo公司總裁兼執行長Blaise Coleman、執行副總裁兼財務長Mark Bradley以及全球商業營運總裁Patrick Barry。

We have prepared a slide presentation to accompany today's webcast, and that presentation, as well as other materials, are posted online in the Investors section at endo.com.

我們準備了一份幻燈片演示來配合今天的網路廣播，並且該演示以及其他材料都發佈在 endo.com 的投資者部分。

Additionally, later this morning, a copy of our prepared comments will also be posted online in the Investors section at endo.com.

此外，今天上午晚些時候，我們準備好的評論的副本也將在 endo.com 的投資者部分在線發布。

I would like to remind you that any forward-looking statements made by management are covered under the U.S. Private Securities Litigation Reform Act of 1995 and the applicable Canadian securities laws, and are subject to the changes, risks and uncertainties described in the press release and in our U.S. and Canadian securities filings.

我想提醒您，管理層所做的任何前瞻性陳述均受 1995 年美國私人證券訴訟改革法案和適用的加拿大證券法的約束，並受新聞稿和我們在美國和加拿大證券文件中描述的變化、風險和不確定性的影響。

In addition, during the course of this call, we may refer to non-GAAP financial measures that are not prepared in accordance with accounting principles generally accepted in the United States, and that may be different from non-GAAP financial measures used by other companies. Investors are encouraged to review Endo's current report on Form 8-K furnished with the SEC for Endo's reasons for including those non-GAAP financial measures in its earnings release and presentation. The reconciliations of non-GAAP financial measures to the most directly comparable GAAP financial measures are contained in our earnings press release issued yesterday, unless otherwise noted therein.

此外，在本次電話會議中，我們可能會提及一些非公認會計準則 (non-GAAP) 財務指標，這些指標並非按照美國公認會計準則 (GAAP) 編制，且可能與其他公司使用的非公認會計準則 (non-GAAP) 財務指標有所不同。請投資人查閱 Endo 提交給美國證券交易委員會 (SEC) 的 8-K 表格最新報告，以了解 Endo 在其收益報告和簡報中包含這些非公認會計準則 (non-GAAP) 財務指標的原因。除非另有說明，否則非公認會計準則 (non-GAAP) 財務指標與最直接可比較的公認會計準則 (GAAP) 財務指標的對帳表已包含在我們昨日發布的收益新聞稿中。

I would now like to turn the call over to Blaise. Blaise?

現在我想把電話轉給 Blaise。 Blaise？

Thank you, Laure. Good morning, everyone, and thank you for joining us.

謝謝你，Laure。大家早安，感謝你們的收看。

Turning to Slide 3. As we've previously discussed, our strategic priorities guide all that we do as we work to transform our company. Our first strategic priority, to expand and enhance our portfolio, is essential to fueling our company's future growth and will be achieved through a combination of internal and external investments. This week, we announced advancements for our Sterile Injectables and Medical Aesthetics portfolios. Starting with sterile injectables. On Monday, we announced the acquisition of a portfolio of 6 product candidates from Nevakar. These products are in various stages of development, with the first launch expected in 2025. Endo will control all remaining development, regulatory, manufacturing, commercialization activities for these assets.

翻到第三張幻燈片。正如我們之前所討論的，我們的策略重點指導著我們在公司轉型過程中所做的一切工作。我們的首要策略重點是擴大和增強我們的產品組合，這對於推動公司未來的成長至關重要，並將透過內部和外部投資相結合來實現。本週，我們宣布了無菌注射和醫學美容產品組合的進展。首先是無菌注射劑。週一，我們宣布從Nevakar收購了6個候選產品組合。這些產品處於不同的開發階段，預計2025年首次上市。 Endo將負責這些資產所有剩餘的開發、監管、製造和商業化活動。

This acquisition further bolsters and expands our pipeline of differentiated ready-to-use sterile injectables.

此次收購進一步增強並擴大了我們差異化的即用型無菌注射劑產品線。

Additionally, yesterday, we announced that later this quarter, we plan to launch a new multi-cohort open-label study referred to as APHRODITE-1 focused on reducing bruising associated with the utilization of QWO. The study will test different interventions to assess their potential impact on the reduction of bruising and is part of our investment to achieve QWO's full potential.

此外，我們昨天宣布，計劃在本季度晚些時候啟動一項名為 APHRODITE-1 的新的、多隊列開放標籤研究，重點關注減少使用 QWO 相關的瘀傷。該研究將測試不同的干預措施，以評估其對減少瘀傷的潛在影響，這也是我們為充分發揮 QWO 的潛力而進行的投資的一部分。

Our second strategic priority, to reinvent how we work, permeates our entire organization and everything we do. A key element of this priority is to optimize our manufacturing network, invest in new capabilities in support of our future portfolio and maximize supply chain flexibility and resiliency. Last month, the U.S. FDA completed its first inspection of our new manufacturing facility in Indore, India, resulting in no major Form-483 inspection observations.

我們的第二大策略重點是重塑工作方式，這貫穿我們整個組織以及我們所做的每一件事。這一重點的關鍵在於優化我們的生產網絡，投資新的能力以支持我們未來的產品組合，並最大限度地提高供應鏈的靈活性和韌性。上個月，美國食品藥物管理局（FDA）對我們位於印度印多爾的新生產工廠進行了首次檢查，結果未發現任何重大的483表格檢查發現問題。

We've already received FDA approvals for several solid oral-dosed products that will be manufactured at the new site.

我們已經獲得 FDA 批准在新工廠生產幾種固體口服產品。

Additionally, we continue to identify actions to simplify our ways of working across our business. We expect these actions to generate cost savings in the second half of 2022, with a portion of the savings expected to be utilized to fund certain high-priority new initiatives such as our new QWO clinical study.

此外，我們將繼續探索簡化整個業務工作方式的措施。我們預計這些措施將在2022年下半年帶來成本節約，其中一部分預計將用於資助某些高優先級的新項目，例如我們新的QWO臨床研究。

Our third strategic priority, to be a force for good, embodies our commitment to create sustainable value that benefits all of our stakeholders. It also drives our environmental, social and governance strategy. Last week, we published our 2021 Corporate Responsibility Report, which serves as an annual accounting of our performance and our progress to integrate ESG into our company. I'm pleased with our progress, which includes the measurement of Scope 1 and Scope 2 greenhouse gas emissions data.

我們的第三大策略重點是成為向善的力量，這反映了我們致力於創造永續價值，造福所有利害關係人的承諾。它也推動著我們的環境、社會和治理策略。上週，我們發布了2021年企業責任報告，該報告每年回顧我們的業績以及將ESG融入公司營運的進展。我對我們的進展感到滿意，其中包括範圍一和範圍二溫室氣體排放數據的測量。

I want to thank all of our team members for their continued commitment to our vision and for their efforts to advance our strategic priorities.

我要感謝我們團隊的所有成員對我們願景的持續承諾以及為推進我們的策略重點所做的努力。

Moving to Slide 4. This is a snapshot of our segment and consolidated revenues and our adjusted EBITDA for the quarter. First quarter enterprise revenues of $652 million were better than expected due to slightly higher revenues across each of our business segments. Compared to prior year, revenues decreased by approximately 9%, primarily due to decreased revenues from our Sterile Injectables segment, partially offset by increased revenues from our Generic Pharmaceuticals segment.

轉到幻燈片4。這是本季我們各部門、合併收入以及調整後EBITDA的概覽。第一季企業營收為6.52億美元，優於預期，這得益於我們各業務部門的營收均略有成長。與去年同期相比，收入下降了約9%，主要原因是無菌注射部門收入下降，但部分被仿製藥部門收入成長所抵消。

First quarter of 2022 adjusted EBITDA of $311 million was better than expected due to higher revenue, favorable product mix and lower adjusted operating expenses. Compared to prior year, adjusted EBITDA decreased by approximately 15%, primarily due to lower total VASOSTRICT revenues, lower adjusted gross margin and higher adjusted operating expenses due to increased commercial investments.

2022年第一季調整後EBITDA為3.11億美元，優於預期，這得益於營收成長、產品組合優化以及調整後營運費用下降。與去年同期相比，調整後EBITDA下降了約15%，主要原因是VASOSTRICT總收入下降、調整後毛利率下降，以及商業投資增加導致調整後營運費用上升。

Turning to Slide 5. First quarter revenues from our Branded Pharmaceuticals segment were better than expected, primarily driven by higher growth in XIAFLEX and other office-administered products. Compared to prior year, segment revenues decreased by approximately 1%. This reflects a 12% decrease in our established products portfolio and a 4% increase from our specialty products portfolio.

翻到第5張投影片。第一季度，我們品牌藥品部門的營收優於預期，主要得益於XIAFLEX和其他門診管理產品的更高成長。與去年同期相比，該部門收入下降了約1%。這反映了我們成熟產品組合下降了12%，而特色產品組合則成長了4%。

Although XIAFLEX's performance in January and February was unfavorably impacted by ongoing medical and administrative staff shortages in physician offices and lower numbers of in-person patient office visits, we saw improving market conditions and a recovery in demand starting in March. We remain optimistic that market conditions will continue to steadily improve throughout the rest of the second quarter and the second half of the year.

儘管 XIAFLEX 在 1 月和 2 月的業績受到醫生診所持續的醫務和行政人員短缺以及患者就診次數減少的不利影響，但我們看到市場狀況從 3 月份開始有所改善，需求也開始復蘇。我們仍然樂觀地認為，市場狀況將在第二季剩餘時間和今年下半年繼續穩定改善。

First quarter revenues from our Sterile Injectables segment were consistent with our expectations. Compared to prior year, segment revenues decreased by approximately 22% due to decreased VASOSTRICT revenues, primarily related to generic competition as well as lower overall market demand as COVID-19-related hospitalization utilization declined.

我們無菌注射劑部門第一季的營收符合我們的預期。與去年同期相比，該部門收入下降了約22%，原因是VASOSTRICT收入下降，主要歸因於仿製藥競爭以及新冠疫情相關住院率下降導致的整體市場需求下降。

Turning to Slide 6. The vasopressin market is currently very dynamic and evolving. First, beginning late last year and continuing early into the first quarter of this year, hospital purchasing of VASOSTRICT vials continued to be elevated, driven by COVID-19-related hospitalization utilization and projected future needs. This was followed by the entry of multiple generic vasopressin vial competitors, triggered by Eagle's January launch at risk, which substantially reduced the market pricing in our VASOSTRICT vial market share.

翻到第6張投影片。目前，血管加壓素市場充滿活力，並不斷發展變化。首先，從去年底到今年第一季初，受新冠疫情相關住院病例利用率和未來需求預測的推動，醫院對血管加壓素瓶裝藥物的採購量持續上升。隨後，由於Eagle公司1月上市存在風險，多家仿製血管加壓素瓶裝藥物競爭對手進入市場，這大幅降低了我們血管加壓素瓶裝藥物的市場份額。

As we moved through the first quarter and COVID-19-related hospital utilization began to decline, overall vasopressin market volumes also began to significantly decline. The convergence of aggressive competition and overall declining market volumes on VASOSTRICT vial demand has resulted in a current high level of VASOSTRICT vial channel inventory in terms of week on hand.

隨著第一季的推進，與新冠疫情相關的醫院用藥量開始下降，血管加壓素市場的整體銷售也開始大幅下降。激烈的競爭加上 VASOSTRICT 藥瓶需求整體下滑，導致目前 VASOSTRICT 藥瓶通路庫存（以周庫存計算）處於高位。

Based on this, we anticipate experiencing a prolonged period of VASOSTRICT vial destocking through the remainder of the second quarter. Accordingly, we expect to see a material unfavorable impact on revenues from VASOSTRICT in the second quarter, inclusive of a onetime negative destocking impact of approximately $25 million. Additionally, as we approach the end of Eagle's 180-day exclusivity period in mid-July, we are preparing for potential additional market entrants.

基於此，我們預計在第二季剩餘時間內，VASOSTRICT 藥瓶庫存將持續下降。因此，我們預計第二季 VASOSTRICT 的營收將受到重大不利影響，其中包括約 2,500 萬美元的一次性負面庫存下降影響。此外，隨著 Eagle 180 天的獨佔期將於 7 月中旬結束，我們正在為潛在的其他市場進入者做準備。

With regards to our VASOSTRICT ready-to-use bottle, while early in the launch, we are encouraged by the market conversion to the bottle and the positive feedback we have received from our customers to date. Many of our customers have noted the potential for efficiency and convenience, particularly as it relates to room temperature storage of the bottle as well as the flexibility of having the bottle at the site of care.

關於我們的 VASOSTRICT 即用型瓶裝產品，雖然上市尚處於初期階段，但市場對瓶裝產品的接受度以及迄今為止客戶的積極反饋令我們倍受鼓舞。許多客戶都注意到了其高效便捷的潛力，尤其是在瓶裝產品可在室溫下儲存以及在護理現場攜帶瓶裝產品的靈活性方面。

Moving to Slide 7. First quarter revenues from our Generic Pharmaceutical segment exceeded expectations due to better-than-planned varenicline revenues. Compared to prior year, first quarter segment revenues increased by 3%, mainly due to revenues from varenicline, partially offset by competitive pressure on certain other generic products. I'll share more about the varenicline opportunity on the next slide.

轉到第7張投影片。由於伐尼克蘭的銷售收入優於預期，我們仿製藥部門第一季的營收超出預期。與去年同期相比，第一季部門收入成長了3%，這主要得益於伐尼克蘭的收入，但部分成長被其他某些仿製藥的競爭壓力所抵消。我將在下一張幻燈片中分享更多關於伐尼克蘭銷售機會的資訊。

Finally, International segment revenues for the first quarter were in line with expectations, and essentially flat compared to prior year.

最後，第一季國際部門的營收符合預期，與去年同期基本持平。

Moving to our Varenicline product opportunity on Slide 8. We're extremely proud of our team members' efforts to successfully expand our capacity during the quarter, which now is fully equipped to supply the market pre-Chantix withdrawal levels. This is critical to our ability to fulfill the current unmet product demand. Based on recent IQVIA data, we have approximately 85% share of the current market for the molecule. We believe Varenicline has the potential to be a significant opportunity for us this year. However, we currently have no visibility into when competition might materialize for this product. Therefore, it's difficult to estimate the full year outlook at this time.

轉到幻燈片8上的伐尼克蘭產品機會。我們非常自豪團隊成員在本季成功擴大了產能，目前產能已完全能夠滿足市場在Chantix停產前的水平。這對於我們滿足當前未滿足的產品需求至關重要。根據IQVIA的最新數據，我們目前佔據該分子約85%的市場。我們相信伐尼克蘭有潛力成為我們今年的一個重要機會。然而，我們目前尚不清楚該產品何時會出現競爭。因此，目前很難預測全年前景。

What we can say with confidence is that we are working to fully capitalize on the opportunity. This includes investments in omnichannel marketing to create awareness of generic Varenicline availability in support of increasing overall Varenicline market volumes.

我們可以自信地說，我們正在努力充分利用這一機會。這包括投資全通路行銷，提高人們對伐尼克蘭仿製藥的認知度，從而支持擴大伐尼克蘭的整體市場規模。

Moving to Slide 9. Maximizing XIAFLEX for long-term growth is a critical element of our strategic priority to expand and enhance our portfolio. We believe that XIAFLEX has the potential to satisfy the large unmet needs that continue to exist for nonsurgical options to treat both Peyronie's disease and Dupuytren's contracture. We're encouraged by the strong interest by patients seeking treatment, which is fueling underlying demand across both indications as measured by consumer traffic to our website and physician locator sites. It's a good early indicator of patient interest and initial consumer activation.

移至幻燈片9。最大化XIAFLEX的長期成長是我們擴大和增強產品組合策略重點的關鍵要素。我們相信，XIAFLEX有潛力滿足佩羅尼氏症和杜普伊特倫攣縮治療中持續存在的大量未滿足的非手術治療需求。患者對治療的濃厚興趣令我們備受鼓舞，這推動了兩種適應症的潛在需求，這一點從我們網站和醫生定位網站的消費者流量中可以看出。這很好地體現了患者興趣和初始消費者活躍度。

To realize the potential of these indications and drive meaningful adoption and sustainable long-term growth, we are committed to consistent investment in condition awareness and consumer activation.

為了實現這些適應症的潛力並推動有意義的採用和可持續的長期成長，我們致力於持續投資於狀況意識和消費者活化。

For Peyronie's Disease, our branded campaign is intended to motivate men to visit a specially trained urologist and to request XIAFLEX. To help assist with diagnosis, we are also developing a digital app to give men who have a curvature, the ability to screen themselves for Peyronie's disease and securely share that information with a urologic professional, all from the privacy of their own homes. We plan to launch this app later this year.

針對佩羅尼氏症，我們的品牌宣傳活動旨在鼓勵男性就診於經過專業培訓的泌尿科醫生，並申請 XIAFLEX 治療。為了協助診斷，我們也正在開發數位應用程序，幫助患有陰莖彎曲的男性自行篩檢佩羅尼氏症，並安全地將資訊分享給泌尿科醫生，所有這一切都可以在他們自己家中私密的環境下完成。我們計劃於今年稍後推出這款應用程式。

For Dupuytren's Contracture, we're very encouraged by the consumer response from our new condition-awareness campaign, featuring real patients. Our Watching Education Unfold commercials are driving strong digital traffic from patients searching for information regarding their condition.

對於杜普伊特倫攣縮症，我們新的疾病認知宣傳活動以真實患者為主角，消費者的反應令我們深受鼓舞。我們的「觀察教育進展」廣告吸引了大量正在搜尋自身病情資訊的患者，為他們帶來了強勁的數位流量。

In addition to optimizing our on-market indications, our XIAFLEX maximization plan also includes continued investment in the development of potential future new indications. The current XIAFLEX indications in clinical development include plantar fibromytosis and adhesive capsulitis. We believe these potential orthopedic-focused indications represent the opportunity to potentially bring an innovative treatment option to address a large unmet need for patients who are seeking a nonsurgical approach.

除了優化我們現有的上市適應症外，我們的 XIAFLEX 最大化計劃還包括持續投資開發未來潛在的新適應症。目前，XIAFLEX 處於臨床開發階段的適應症包括足底纖維肌痛和沾黏性關節囊炎。我們相信，這些潛在的骨科適應症代表著一種潛在的創新治療方案，有望為尋求非手術治療的患者帶來大量未滿足的醫療需求。

In addition, these potential indications represent attractive market opportunities, are highly synergistic with our current orthopedic selling footprint and commercial capabilities, and represent highly efficient adjacencies for our XIAFLEX franchise.

此外，這些潛在適應症代表著極具吸引力的市場機會，與我們目前的骨科銷售足跡和商業能力具有高度的協同作用，並且代表著我們 XIAFLEX 特許經營權的高效鄰接。

From a time line perspective, we anticipate last patient to be enrolled in the Phase II study for plantar fibromatosis by the end of the year. For adhesive capsulitis study, we expect final Phase II results early in the third quarter of this year.

從時間軸來看，我們預期足底纖維瘤病的II期臨床試驗將於今年底前完成最後一名患者的入組。對於沾黏性關節囊炎的II期臨床試驗，我們預計最終結果將於今年第三季初公佈。

Turning to Slide 10. As we indicated last quarter, as a company, we are very focused on listening and learning from the medical aesthetics community and becoming a trusted and enduring partner in this space. In response to their feedback, we are committed to identifying potential solutions that prevent and/or mitigate bruising and potential subsequent skin discoloration following the use of QWO. Accordingly, we are advancing a multi-cohort, open-label, self-controlled study referred to as APHRODITE-1 later this quarter. Taking into account real-world learnings, observations and historical clinical study findings, APHRODITE-1 will test different interventions to assess the potential impact on the reduction of bruising following the treatment with QWO, as we believe bruising is the likely precursor to the occasional incidence of skin discoloration.

翻到第10張投影片。正如我們上個季度所指出的，作為一家公司，我們非常注重傾聽和學習醫學美容界的意見，並致力於成為該領域值得信賴的持久合作夥伴。為了回應他們的回饋，我們致力於尋找潛在的解決方案，以預防和/或減輕使用QWO後出現的瘀傷以及可能出現的後續皮膚變色。因此，我們將在本季稍後推進一項名為APHRODITE-1的多隊列、開放標籤、自身對照研究。 APHRODITE-1將結合現實世界的學習、觀察和歷史臨床研究結果，測試不同的干預措施，以評估QWO治療後對減少瘀傷的潛在影響，因為我們認為瘀傷可能是偶爾發生的皮膚變色的前兆。

Additionally, the study is being created with the flexibility to add cohorts in order to test additional interventions over time, if desired. Next week, we will be presenting a poster on the study design at the Symposium for Cosmetic Advances and Laser Education in Nashville, Tennessee.

此外，本研究還具有靈活性，可以根據需要添加隊列，以便隨著時間的推移測試其他幹預措施。下週，我們將在田納西州納許維爾舉行的美容進步與雷射教育研討會上展示關於本研究設計的海報。

Currently, we are estimating completion of the study in mid-2023.

目前，我們預計這項研究將於 2023 年中期完成。

On the commercial side, we have adjusted our commercial resource levels and we'll have a focused approach on HCP outreach, successful practice integration and our targeted consumer activation. We believe this approach continues to give us a meaningful commercial presence in the medical aesthetics space and better meets today's needs. It also enables us to redeploy funding to the QWO APHRODITE study.

在商業方面，我們調整了商業資源水平，並將重點放在拓展醫療保健專業人士 (HCP) 、成功整合實踐以及激活目標消費者方面。我們相信，這種策略將使我們在醫學美容領域繼續保持重要的商業影響力，並更好地滿足當今的需求。這也使我們能夠將資金重新部署到 QWO APHRODITE 研究中。

Turning to Slide 11. We continue to evolve our R&D pipeline and manufacturing capabilities to support the introduction of an increasing number of sterile products that focus on our customers' evolving needs. With the recent acquisition of the 6 ready-to-use development stage product candidates from Nevakar, we have approximately 40 projects in our pipeline, with sterile injectable products now representing approximately 90%.

翻到第11張幻燈片。我們持續改善研發管線和生產能力，以支援推出更多滿足客戶不斷變化的需求的無菌產品。隨著近期從Nevakar收購6個處於開發階段的即用型候選產品，我們的管線專案已達約40個，其中無菌注射劑產品約佔90%。

Year-to-date, across our Sterile Injectables and Generics segments, we've launched 5 products and expect to launch approximately 10 new products during 2022.

年初至今，我們在無菌注射劑和仿製藥領域已推出了 5 種產品，預計 2022 年將推出約 10 種新產品。

In addition to our organic efforts to expand and enhance our portfolio, we intend to remain active on the business development front. We continue to be focused on opportunities such as the recent Nevakar acquisition, which are in our core areas of growth and which we believe will enable us to further leverage our existing capabilities. We've taken and will continue to take a disciplined approach to deploying capital on business development opportunities that align with our strategy.

除了透過內部擴張和增強投資組合，我們還計劃繼續積極開展業務拓展。我們將繼續關注諸如近期收購Nevakar等機遇，這些機會是我們的核心成長領域，我們相信這將使我們能夠進一步提升現有實力。我們一直以來都採取並將繼續採取嚴謹的策略，將資本投入符合我們策略的業務拓展機會。

With that, let me now turn the call over to Mark to further discuss the company's financial results and our financial guidance. Mark?

說完這些，現在讓我把電話轉給馬克，進一步討論公司的財務表現和我們的財務指導。馬克？

Thank you, Blaise, and good morning, everyone. On Slide 12, you will see a snapshot of our first quarter GAAP and non-GAAP financial results. On a GAAP basis, loss from continuing operations was approximately $65 million or $0.28 per share on a diluted basis in the first quarter of 2022, compared to income from continuing operations of approximately $47 million or $0.20 per share on a diluted basis in the first quarter of 2021. This decrease was primarily due to decreased revenues and increased operating expenses, primarily related to our investment in consumer marketing efforts to support XIAFLEX, as well as higher litigation-related costs and asset impairment charges.

謝謝布萊斯，大家早安。在第12張投影片上，您將看到我們第一季GAAP和非GAAP財務表現的快照。以GAAP計算，2022年第一季持續經營虧損約6,500萬美元，即攤薄後每股0.28美元，而2021年第一季持續經營利潤約4,700萬美元，即攤薄後每股0.20美元。這一下降主要是由於收入減少和營運費用增加，這主要與我們為支持XIAFLEX而對消費者行銷工作的投資有關，以及訴訟相關成本和資產減損費用的增加。

On an adjusted basis, income from continuing operations was approximately $156 million or $0.66 per share on a diluted basis in the first quarter of 2022, compared to income from continuing operations of approximately $175 million or $0.73 per share on a diluted basis in the first quarter of 2021. This was primarily attributable to a decrease in revenues that was partially offset by a decrease in adjusted taxes due to lower pretax income and a lower adjusted effective tax rate.

經調整後，2022 年第一季持續經營收入約為 1.56 億美元，即攤薄後每股 0.66 美元，而 2021 年第一季持續經營收入約為 1.75 億美元，即攤薄後每股 0.73 美元。這主要歸因於收入減少，但由於稅前收入減少和調整後有效稅率降低導致調整後稅收減少，部分抵消了收入減少的影響。

As a result of the actions intended to simplify our ways of working that Blaise mentioned earlier, we expect to realize between $55 million and $65 million of annualized pretax cash savings by the end of the second quarter of 2023. While we expect to begin realizing some of these savings in the second half of 2022, we also expect to reinvest a portion of the savings back into the business, including to fund the QWO APHRODITE-1 study. In connection with these actions, we expect to incur between $40 million and $55 million in total pretax restructuring-related expenses, which includes approximately $25 million to $35 million of cash charges.

正如Blaise先前提到的，為了簡化我們的工作方式，我們預計到2023年第二季末，年度稅前現金節省將達到5500萬至6500萬美元。我們預計部分節省將在2022年下半年開始實現，同時我們也計劃將部分節省的資金重新投資於業務，包括資助QWO APHRODITE-1研究。與這些行動相關的稅前重組相關費用預計將達到4,000萬至5,500萬美元，其中包括約2,500萬至3,500萬美元的現金支出。

In the first quarter of 2022, we recorded a pretax charge of approximately $30 million, which included approximately $20 million of cash charges.

2022 年第一季度，我們記錄了約 3,000 萬美元的稅前費用，其中包括約 2,000 萬美元的現金費用。

Turning to Slide 13. Consistent with our approach for the first quarter, we are only providing financial guidance for the second quarter of 2022 at this time, due to continued uncertainties in certain key assumptions that are expected to impact the full year. For the second quarter of 2022, we expect total revenues to be between $500 million and $525 million, adjusted EBITDA to be between $110 million and $125 million and adjusted loss from continuing operations to be between $0.15 and $0.17 per share on a diluted basis.

翻到第13張幻燈片。與第一季的策略一致，由於某些關鍵假設的不確定性持續存在，預計會影響全年業績，因此我們目前僅提供2022年第二季的財務指引。我們預計2022年第二季的總營收將在5億美元至5.25億美元之間，調整後EBITDA將在1.1億美元至1.25億美元之間，調整後持續經營業務虧損將在攤薄後每股0.15美元至0.17美元之間。

As we previously disclosed, beginning with the first quarter of 2022, we no longer exclude acquired in-process R&D from the non-GAAP performance measures we use in connection with our quarterly financial reporting and forward-looking guidance. This change was made in response to views expressed by the SEC, and is consistent with broad adoption by others in the industry.

正如我們先前所揭露的，從2022年第一季開始，我們將不再將收購的在研研發成果排除在我們用於季度財務報告和前瞻性指引的非公認會計準則 (non-GAAP) 績效指標之外。此項變更是為了回應美國證券交易委員會 (SEC) 的意見，並與業內其他公司普遍採用的做法一致。

Accordingly, our second quarter adjusted EBITDA and adjusted earnings per share guidance includes the nonrecurring $35 million payment related to the previously announced Nevakar portfolio acquisition that will be expensed as acquired in-process R&D in the second quarter. However, it is important to note that our credit agreement and bond indentures continue to permit acquired in-process R&D which includes upfront and milestone payments expensed as R&D, to be added back for purposes of calculating certain leverage ratios and other metrics within those agreements.

因此，我們第二季調整後EBITDA和調整後每股盈餘預期包含與先前宣布的Nevakar投資組合收購相關的3,500萬美元非經常性付款，該款項將在第二季作為收購的在研費用列支。然而，值得注意的是，我們的信貸協議和債券契約仍然允許將收購的在研費用（包括作為研發費用的預付款和里程碑付款）加回，以計算這些協議中的某些槓桿率和其他指標。

With respect to second quarter 2022 total revenues, compared to the first quarter of 2022, our guidance range primarily reflects significant erosion in both VASOSTRICT vial price and underlying demand due to competition, lower overall vasopressin market volumes and the estimated onetime destocking impact of approximately $25 million. It also reflects slightly improving market conditions for XIAFLEX and the continued impact of competitive events in our Generics business.

就2022年第二季總收入而言，與2022年第一季相比，我們的預期範圍主要反映了競爭導致VASOSTRICT瓶裝價格和潛在需求大幅下降、血管加壓素市場整體銷售下降以及預計約2500萬美元的一次性去庫存影響。這也反映了XIAFLEX市場狀況略有改善，以及競爭事件對我們仿製藥業務的持續影響。

Our second quarter 2022 guidance assumes an adjusted gross margin of approximately 67%, which is lower than the first quarter of 2022 due to product mix.

我們對 2022 年第二季的預期是調整後的毛利率約為 67%，由於產品組合原因，該利率低於 2022 年第一季。

We further assume that second quarter 2022 adjusted operating expenses as a percentage of revenue will be approximately 46.5%. This assumption reflects our continued commitment to invest in our core areas of growth. This includes investing in both on-market and potential future new XIAFLEX indications, funding the QWO APHRODITE-1 clinical study and investing in the development of new sterile injectable products. It also includes the nonrecurring $35 million investment related to the Nevakar portfolio acquisition.

我們進一步假設2022年第二季調整後營運費用佔營收的百分比約為46.5%。這個假設反映了我們持續致力於投資核心成長領域。這包括投資XIAFLEX已上市及未來潛在的新適應症、資助QWO APHRODITE-1臨床研究以及投資新型無菌注射劑產品的開發。此外，這還包括與收購Nevakar投資組合相關的3,500萬美元非經常性投資。

We believe these strategic investments in our portfolio will generate long-term value for Endo.

我們相信，我們投資組合中的這些策略投資將為 Endo 創造長期價值。

Relative to the second quarter, we expect operating expenses to decline in the second half of the year as a result of the cost efficiency actions intended to simplify our ways of working that we've previously mentioned.

相對於第二季度，我們預計下半年的營運費用將會下降，這得益於我們先前提到的旨在簡化工作方式的成本效率措施。

Finally, for the second quarter of 2022, we are assuming interest expense of approximately $143 million and an adjusted effective tax rate of approximately 1%. Please keep in mind that neither our first quarter actual results nor our second quarter guidance ranges may be indicative of future period results. As I mentioned earlier, we are not providing full year 2022 guidance, as there continues to be significant near-term uncertainties associated with certain key assumptions that are expected to impact our full year adjusted results.

最後，對於2022年第二季度，我們假設利息支出約為1.43億美元，調整後有效稅率約為1%。請注意，我們第一季的實際業績和第二季的業績指引範圍均不代表未來期間的業績。正如我之前提到的，我們不提供2022年全年業績指引，因為某些關鍵假設仍有重大的短期不確定性，預計這些假設將影響我們全年調整後業績。

The assumptions with the highest degree of near-term uncertainty relate to VASOSTRICT, varenicline and our specialty-office-administered products, particularly XIAFLEX. These key near-term uncertainties could serve as either a considerable headwind or tailwind in the second half of 2022 relative to our projected second quarter guidance ranges, depending on how actual events materialize throughout the remainder of the year.

近期不確定性最高的假設與 VASOSTRICT、伐尼克蘭以及我們專科診室管理的產品（尤其是 XIAFLEX）有關。這些關鍵的近期不確定性可能會在 2022 年下半年成為我們第二季預期範圍的顯著阻力或順風，具體取決於今年剩餘時間實際事件的進展。

For VASOSTRICT, the key uncertainties primarily include the level and rate of VASOSTRICT vial erosion, including the impact of future vial competition following the 180-day period of exclusivity and the level and rate of vasopressin vial conversion to the ready-to-use VASOSTRICT bottle. A potential resurgence in COVID-19-related hospitalizations also creates some uncertainty for overall vasopressin demand.

對於 VASOSTRICT，主要不確定因素包括 VASOSTRICT 藥瓶的腐蝕程度和速率，包括 180 天獨佔期結束後未來藥瓶競爭的影響，以及加壓素藥瓶向即用型 VASOSTRICT 藥瓶的轉換程度和速率。新冠相關住院人數可能再次激增，也為加壓素的整體需求帶來了一些不確定性。

For varenicline, the key uncertainties include the timing and number of future competitive entrants as well as the rate and extent of the recovery in the total varenicline market volume to pre-Chantix withdrawal levels.

對於伐尼克蘭而言，主要的不確定因素包括未來競爭者的進入時間和數量，以及伐尼克蘭市場總量恢復到 Chantix 停產前水平的速度和程度。

For our specialty-office-administered products, the key uncertainties relate to the ongoing medical and administrative staff shortages in physician offices and the corresponding impact on the number of in-person patient office visits. Although we have recently seen improving market conditions for our specialty-office-administered products, the rate and extent of the recovery will have a material impact on the performance of this portfolio of products, particularly XIAFLEX, over the remainder of the year.

對於我們專科門診管理的產品，主要的不確定因素在於醫師診所持續存在的醫事和行政人員短缺，以及由此對病患就診次數的影響。儘管我們近期看到專科門診管理產品的市場狀況有所改善，但復甦的速度和程度將在今年剩餘時間內對該產品組合（尤其是 XIAFLEX）的業績產生重大影響。

Switching to Slide 14. This is a summary of second quarter 2022 segment revenue assumptions, as well as product-specific assumptions for XIAFLEX and VASOSTRICT.

切換到投影片 14。這是 2022 年第二季分部收入假設的摘要，以及 XIAFLEX 和 VASOSTRICT 的產品特定假設。

Advancing to Slide 15 and wrapping up the financial discussion. Unrestricted cash flow prior to debt payments was $91 million for first quarter 2022 compared to $250 million in the prior year. This decrease was primarily due to lower adjusted EBITDA, coupled with higher opioid-related legal expenses and settlements.

跳到第15張投影片，結束財務討論。 2022年第一季，償還債務前的無限現金流為9,100萬美元，去年同期為2.5億美元。下降的主要原因是調整後息稅折舊攤提前利潤（EBITDA）下降，以及阿片類藥物相關法律費用和和解金增加。

We ended the first quarter of 2022 with approximately $1.4 billion of unrestricted cash and a net debt-to-adjusted EBITDA ratio of approximately 4.7x. These amounts reflect the repayment of approximately $180 million of maturing debt that we made in January.

截至2022年第一季度，我們擁有約14億美元的非限制性現金，淨債務與調整後EBITDA比率約為4.7倍。這些金額反映了我們1月償還的約1.8億美元到期債務。

We expect second quarter 2022 unrestricted cash outflow prior to debt payment to be between $280 million and $295 million. This range reflects expected payments of approximately $165 million for opioid-related legal expenses and accrued liabilities. It also includes the $35 million payment that has been made for the acquisition of the Nevakar portfolio.

我們預計2022年第二季償還債務前的無限制現金流出將在2.8億美元至2.95億美元之間。這一範圍反映了預計約1.65億美元的阿片類藥物相關法律費用和應計負債。此外，還包括為收購Nevakar投資組合而支付的3,500萬美元。

Let me now turn the call back over to Blaise. Blaise?

現在我把電話轉回給 Blaise。 Blaise？

Thank you, Mark. Prior to turning the call over to Laure to manage our question-and-answer period, I want to provide a brief update regarding the opioid litigation. With respect to the opioid litigation as a whole, we continue to be focused on our primary goal of achieving a broad-based resolution of the remaining opioid claims. At the same time, we'll continue to actively defend the company in court when necessary, and we will pursue individual settlements when we believe they are in the best interest of the company.

謝謝，馬克。在將電話轉給勞雷主持問答環節之前，我想先簡單介紹一下阿片類藥物訴訟的最新進展。就整個鴉片類藥物訴訟而言，我們將繼續專注於我們的首要目標，即廣泛解決剩餘的鴉片類藥物索賠。同時，我們將在必要時繼續積極地在法庭上為公司辯護，並在我們認為符合公司最佳利益的情況下，尋求個別和解。

Additionally, we are actively exploring other strategic alternatives, both in support of achieving a broad-based resolution, and the event we're unable to achieve such resolution. As with any thorough analysis of a complex situation, the path to resolution will continue to take time and we cannot speculate on the likelihood, nature or timing of any outcome.

此外，我們正在積極探索其他策略替代方案，以支援達成廣泛的解決方案，以及應對我們無法達成解決方案的情況。與任何對複雜局勢的全面分析一樣，解決問題的道路仍將需要時間，我們無法推測任何結果的可能性、性質或時間。

More importantly, while we continue to address the opioid litigation, our Endo team members remain highly focused on our day-to-day business execution, advancing our strategic priorities and delivering our portfolio of life-enhancing products to our customers and the patients they serve.

更重要的是，在我們繼續處理阿片類藥物訴訟的同時，我們的 Endo 團隊成員仍然高度關注我們的日常業務執行，推進我們的戰略重點，並向我們的客戶及其服務的患者提供改善生活的產品組合。

I want to thank each of our team members for their strong execution during the first quarter and continued commitment as we move forward in 2022 to helping us to continue to transform the company for the long term.

我要感謝我們團隊的每一位成員在第一季的出色表現，以及在 2022 年繼續致力於幫助我們繼續實現公司長期轉型的承諾。

Let me now turn the call back over to Laure. Laure?

現在我把電話轉回給勞雷。勞雷？

Thank you, Blaise. Michelle, can we have our first question, please?

謝謝，布萊斯。米歇爾，我們可以問第一個問題嗎？

Our first question comes from Chris Schott with JPMorgan.

我們的第一個問題來自摩根大通的克里斯·肖特。

Just the first one is, I was trying to get a little bit more color on VASOSTRICT and how to think about the go-forward business as we look beyond 2Q, I know it's a volatile environment. But I guess if I take the 85 to upper 80s erosion this quarter and adjust for the destock, it seems like it implies the underlying business is around $60 million in the quarter. I guess is that a reasonable run rate?

首先，我想進一步了解 VASOSTRICT，以及展望第二季度之後，如何看待未來的業務發展。我知道現在市場環境動盪。但如果我把本季 85% 到 85% 以上的銷售額損失考慮進去，並根據去庫存的情況進行調整，似乎意味著本季的基礎業務收入約為 6000 萬美元。我想，這是一個合理的營運率嗎？

And then as we look out to 3Q and beyond, should we expect further erosion of that, let's call it, $60 million business as additional competition comes in? Or is it too early to call on that? And I just had a follow-up after that.

那麼，展望第三季及以後，隨著競爭加劇，我們是否應該預期這筆6,000萬美元的業務會進一步受到侵蝕？還是現在下結論還太早？我剛剛對此進行了跟進。

Sure. Thanks, Chris, for that question. Now as we've stated here, we're not providing guidance beyond Q2, but in terms of the math that you just did in terms of the impact of the destocking in Q1 as we size it is about $25 million. So absent that, your math is correct.

當然。克里斯，謝謝你的提問。正如我們之前所說，我們不會提供第二季度之後的業績指引，但根據你剛才的計算，我們認為第一季去庫存的影響約為2500萬美元。所以，撇開這些因素不談，你的計算是正確的。

As we move forward into Q3, as we mentioned, there is the day-181 loss of exclusivity period for Eagle will happen at that time. And so it's uncertain what that will look like in terms of additional competition. And if there is additional competition, what that will mean in terms of impact to our VASOSTRICT business.

正如我們之前提到的，隨著我們進入第三季度，Eagle 的獨家經營期將在第 181 天到期。因此，就額外競爭而言，目前尚不確定這將帶來什麼影響。如果出現額外競爭，這將對我們的 VASOSTRICT 業務產生什麼影響？

Okay. And then just a kind of bigger picture question. I guess, just given the step down in revenues, just elaborate a little bit more about how you're thinking about OpEx? I know you've done a lot to optimize the P&L over the last few years. But if we're in a situation where VASOSTRICT remains depressed, do you need to think about, I guess, deeper cost cuts in the business? I'm just trying to get my hands around when I look at kind of the 2Q EBITDA numbers and just kind of think about the go-forward business. Just help me understand a little bit about how you're thinking about expense management.

好的。接下來是一個更宏觀的問題。考慮到收入的下降，您能否更詳細地闡述您對營運支出（OpEx）的看法？我知道過去幾年您在優化損益表方面做了很多工作。但如果 VASOSTRICT 的表現持續低迷，您是否需要考慮進一步削減成本？我只是想了解第二季的 EBITDA 數據，以及未來的業務發展。請您幫我理解您對費用管理的看法。

Yes. Sure. Thanks, Chris. A couple of things. One, as we think about the business longer term, clearly, our first priority is about expanding and enhancing our portfolio. So we are going to remain committed to investing in our growth drivers going forward.

是的，當然。謝謝，克里斯。有幾件事。首先，當我們考慮長期業務時，顯然我們的首要任務是擴大和增強我們的產品組合。因此，我們將繼續致力於投資未來的成長動力。

Our second strategic priority is to reinvent how we work. And that is all about us driving efficiencies and productivity across the business. It's just part of our DNA.

我們的第二個策略重點是重塑我們的工作方式。這是為了提高整個企業的效率和生產力。這已經融入我們的DNA中了。

And so as we move forward, we will continue to look for opportunities to meaningfully drive efficiencies and productivity. Over the long term, though, our path back to EBITDA growth and getting to levels that we want to be at is going to be through the portfolio. So we are committed to making sure we're going to continue to invest behind our growth drivers appropriately.

因此，在我們前進的過程中，我們將繼續尋找機會，實際提高效率和生產力。但從長遠來看，我們重回EBITDA成長並達到預期水準的途徑將是透過投資組合。因此，我們致力於確保繼續對成長動力進行適當的投資。

Our next question comes from David Amsellem with Piper Sandler.

我們的下一個問題來自 Piper Sandler 的 David Amsellem。

So I had a couple. Just first, just elaborating more on the cost structure. Given that QWO is obviously promotion-intensive and given that you're essentially trying to build the brand, can you talk about your ability to really invest in that product given the pressure on the top line and all the dynamics associated with vasopressin?

我有幾個問題。首先，我想詳細談談成本結構。鑑於QWO顯然需要大量的推廣，而且你們主要在努力打造品牌，能否談談，考慮到營收壓力以及與血管加壓素相關的所有動態因素，你們是否有能力真正投資該產品？

I mean in other words, is that an area where you think significant further investment makes sense? Certainly, your remarks are not lost on me regarding investment QWO. But how do you think about its role going forward, given the realities of the business? So that's number one.

換句話說，您認為在這個領域進行進一步的大規模投資是否合理？當然，您關於投資QWO的評論我並沒有忽視。但考慮到業務的現實情況，您如何看待它在未來的角色？所以這是第一個問題。

And then number two is, can you talk about the potential for asset divestitures and how that could potentially free up some capital or address the cost structure to the extent that the cash flow from VASOSTRICT -- or a lot of the cash flow from VASOSTRICT is going away? How do you think about that?

第二個問題是，您能否談談資產剝離的可能性，以及這如何能夠釋放一些資本，或者在 VASOSTRICT 的現金流（或者說，VASOSTRICT 的大部分現金流）消失的背景下，解決成本結構問題？您對此有何看法？

Yes. Thanks, David, for those 2 questions. I'll comment on both and then also let Patrick comment on the QWO question. Maybe on the second one in terms of divestitures, our focus right now is driving EBITDA and EBITDA growth. And in terms of divestitures, the way we think about that and have always thought about it is, hey, does this product -- does this part of our business make sense to us going forward from a strategic perspective. And that's how we take those decisions.

是的。謝謝David回答這兩個問題。我會對這兩個問題發表評論，然後讓Patrick評論QWO的問題。關於第二個問題，就資產剝離而言，我們目前的重點是推動EBITDA和EBITDA成長。至於資產剝離，我們一直以來的思考方式是：從策略角度來看，這個產品－這部分業務對我們未來發展是否有意義？這就是我們做出這些決策的方式。

But right now, we're not going to be selling assets from a liquidity standpoint that's at the expense of EBITDA, because our focus again is on driving long-term EBITDA growth.

但目前，從流動性的角度來看，我們不會以犧牲 EBITDA 為代價來出售資產，因為我們的重點再次放在推動長期 EBITDA 成長。

In terms of QWO, yes, as you heard in the prepared comments, we did make some adjustments to our commercial operating model given where we are with QWO and the opportunity we have currently around that. We are absolutely investing for the long-term success of QWO and that was why later this quarter we'll be initiating the APHRODITE-1 study, which is really focused in on identifying potential prevention and/or mitigation of bruising, which ultimately, we believe, is the precursor to the occasional incidence of skin discoloration that's happening in the market today.

關於QWO，是的，正如您在準備好的評論中聽到的，考慮到QWO的現狀以及我們目前面臨的機遇，我們確實對我們的商業運營模式做了一些調整。我們絕對會為QWO的長期成功進行投資，因此我們將在本季稍後啟動APHRODITE-1研究，該研究的重點是尋找潛在的預防和/或緩解瘀傷的方法。我們認為，瘀傷最終是目前市場上偶爾出現的皮膚變色現象的前兆。

In terms of investment levels, we think the model we have in place right now with the changes we made is the right model for us and is a sustainable model as we move forward. And if and when we have success with APHRODITE, we'll be in a very good position to drive the type of growth around QWO that we believe is appropriate for that opportunity.

就投資水準而言，我們認為我們目前的模式以及我們所做的調整對我們來說是正確的，並且是我們未來永續發展的模式。如果我們在 APHRODITE 上取得成功，我們將處於非常有利的位置，能夠推動我們認為適合這一機會的 QWO 成長。

Our next question comes from Gary Nachman with BMO Capital Markets.

我們的下一個問題來自 BMO 資本市場的 Gary Nachman。

First, just a follow-up on the APHRODITE study for QWO. So that won't be completed until mid next year. Do you expect physicians will be comfortable using the product really at all until you have that data, if there are such concerns of bruising and discoloration? So how do you see the use of the product over the next year, at least until you have the data?

首先，我想跟進一下 APHRODITE 對 QWO 的研究。這項研究要到明年年中才能完成。如果有瘀傷和變色等問題，您認為在獲得這些數據之前，醫生真的會放心使用該產品嗎？那麼，至少在獲得數據之前，您如何看待該產品在未來一年的使用情況？

And then with the new additions to the Sterile Injectable pipeline from Nevakar, how big are those opportunities? And are there a lot of these types of assets out there that you're looking at? And how much flexibility do you have on the balance sheet to actually bring those types of assets in to bolster the pipeline further?

那麼，隨著Nevakar無菌注射產品線的新增，這些機會有多大？你們正在考慮的這類資產有很多嗎？你們在資產負債表上有多少彈性，可以實際引入這些類型的資產來進一步增強產品線？

Great. Thanks, Gary, for those questions. I'll let Patrick comment on our approach currently with QWO and then I'll take your second question on the Sterile Injectables.

太好了。 Gary，謝謝你的提問。我先讓Patrick談談我們目前與QWO合作的方式，然後再回答你關於無菌注射劑的第二個問題。

Yes, Blaise, thanks for the question. Yes, we definitely do believe there is a market today. What we've learned thus far in the early stages of launches is that, that QWO works. It is effective in the right patient. That moderate cellulite patient without skin laxity, we're seeing a good result. And so importantly, though, it is -- what we also have learned, importantly, it is very strategic and relevant to set the proper expectation for the experience of bruising. And as Blaise talked about, in a small percentage of patients, the risk of discoloration. And so it's about expectation setting in the practice so that the patient expectation can be set. But there is a core of physicians that understand QWO and understand the opportunity to address cellulite. And I think we've demonstrated that there is a market there based on our ability to be able to onboard 2,000 accounts.

是的，Blaise，謝謝你的提問。是的，我們確實相信現在有市場。到目前為止，在產品發布的早期階段，我們了解到QWO是有效的。它對合適的患者有效。對於沒有皮膚鬆弛的中度橘皮組織患者，我們看到了良好的效果。然而，重要的是，我們也了解到，重要的是，設定適當的瘀傷預期是非常策略性的，也是相關的。正如Blaise所說，一小部分患者有變色的風險。所以，關鍵在於在實務上設定預期，以便設定患者的預期。但有一群核心醫生了解QWO，也了解解決橘皮組織問題的機會。我認為，基於我們能夠獲得2000個帳戶的能力，我們已經證明了QWO市場是存在的。

Those accounts -- those are accounts that were willing to trial QWO. And so job 1 in 2022, while the APHRODITE work is being done to improve the patient experience and the account experience with QWO, we still have this market, an opportunity to move towards adoption. So we're going to continue to focus in on those accounts that want to engage with us, that want to offer QWO in their practice and integrate QWO into their practice. So we'll be focused on education around patient selection, product education, setting expectations and having a very focused approach around creating noise in the marketplace from a consumer perspective, mainly through social channels and digital platforms.

那些帳號－那些願意試用 QWO 的帳號。因此，2022 年的首要任務是，在 APHRODITE 工作正在進行的同時，我們仍在努力改善 QWO 的患者體驗和帳戶體驗，同時我們仍然擁有這個市場，有機會推動 QWO 的普及。因此，我們將繼續專注於那些希望與我們合作、希望在其實踐中提供 QWO 並將其融入實踐的客戶。因此，我們將專注於圍繞患者選擇、產品教育、設定預期，並採取非常有針對性的方法，從消費者的角度在市場上製造轟動，主要透過社交管道和數位平台。

Thanks, Gary. And in terms of your question on the Nevakar opportunities, the different products that we acquired are in various stages of development. I'm not going to comment on any specific opportunity other than to say that they're ready-to-use products and they target opportunities that currently range from modest to large addressable markets.

謝謝，加里。關於你提到的Nevakar專案機會，我們收購的不同產品處於不同的開發階段。我不會對任何特定的機會發表評論，我只想說，這些產品都是現成可用的產品，而且它們瞄準的目標市場範圍從中等規模到大型。

In terms of the question on future opportunities, what I would tell you is that both internally and externally, there are opportunities that we're very excited about to be able to bring the type of products we want that are really going to meet the evolving needs of our customers going forward.

關於未來機會的問題，我想告訴你的是，無論是內部還是外部，我們都有機會推出我們想要的產品，這些產品能夠真正滿足未來客戶不斷變化的需求。

In terms of flexibility to invest, we obviously have financial constraints. However, between our internal capabilities and then maybe bring in opportunities that are going to probably admittedly be a little bit earlier in stage of development, we can really take those opportunities and use our capabilities to develop those and really bring value to the market through the value add we'll have in terms of the products we'll be able to launch in the future.

在投資靈活性方面，我們顯然存在財務限制。然而，憑藉我們內部的能力，以及可能帶來的、雖然可能處於開發早期階段的機會，我們可以真正抓住這些機會，運用我們的能力去開發它們，並透過我們未來能夠推出的產品所帶來的附加價值，真正為市場帶來價值。

Our next question comes from Nathan Rich with Goldman Sachs.

我們的下一個問題來自高盛的 Nathan Rich。

Maybe following up on VASOSTRICT and looking at the guidance for 2Q and trying to adjust for the COVID impact and inventory destocking. I guess, like, looking at that, it seems to -- the guidance seems to imply a more significant sales erosion than I think what we would typically expect when seeing a couple of competitors on the market. I guess, Blaise, any thoughts on why that might be the case?

也許會跟進 VASOSTRICT 的後續工作，並查看第二季度的業績指引，嘗試根據新冠疫情的影響和庫存去化進行調整。我想，從這個角度來看，業績指引似乎暗示銷售額下滑幅度比我們通常預期的要大，尤其是在市場上出現幾個競爭對手的情況下。 Blaise，您覺得這可能是為什麼呢？

And then any initial progress or thoughts on the ready-to-use formulation and the uptake that might see in the market?

那麼，對於即用型配方以及市場上可能出現的吸收，您有什麼初步進展或想法嗎？

Sure. I'm going to get Patrick, he can comment on what we're seeing in the marketplace for ready-to-use. On the first question, in terms of what we saw in the -- from a decline perspective and what we're expecting in Q2, Nathan. What I would say is a couple of things and it's in our script, we talked about the convergence of a number of events. So we did have, obviously, the impact of competition and we have multiple generics coming to market at one time. So we are seeing an impact on share and price.

當然。我去聯絡帕特里克，他可以評論我們在即用型藥物市場上看到的情況。關於第一個問題，就我們看到的——從下滑的角度來看，以及我們對第二季的預期，內森。我想說的是幾件事，在我們的腳本中，我們討論了一系列事件的融合。因此，我們顯然受到了競爭的影響，而且我們同時有多個仿製藥上市。因此，我們看到了對市場份額和價格的影響。

The other thing that's happening, though, is overall market volumes, right? We had a pretty significant spike in market volumes, particularly in the first part of the first quarter due to elevated COVID-19-related hospitalizations and ultimately VASOSTRICT utilization. So you have that element of where market volumes are coming down pretty significantly in our guidance from Q1 to Q2 from an overall market standpoint.

不過，另一件正在發生的事情是整體市場交易量，對吧？我們的市場交易量出現了相當顯著的成長，尤其是在第一季上半場，這主要是因為新冠疫情相關的住院人數增加，最終導致VASOSTRICT的使用率上升。所以，從整體市場的角度來看，從第一季到第二季度，我們的預期中已經反映出市場交易量大幅下降的因素。

The other element that we mentioned was, for us, just given where the product was early on in the first quarter in terms of the purchasing by the wholesalers. Because of COVID-19, we're now also seeing a period of significant destocking. So the convergence of all of those factors are really [what] leading to the guidance number you see for Q2.

我們提到的另一個因素是，就我們而言，這只是考慮到第一季初期批發商的採購情況。由於新冠疫情的影響，我們現在也經歷了一段大幅去庫存的時期。所以，所有這些因素的共同作用，才是您看到的第二季業績指引的真正原因。

I'll let Patrick take the RTU question.

我請派崔克回答 RTU 問題。

Thanks. Yes. As it relates to the RTU for VASO, we're very encouraged by the level of interest and excited about the receptivity that we've seen. Obviously, in Q1, it was very early in the launch. And so the data, it's early days. You can certainly take a look at the April IQVIA data to see how we're doing.

謝謝。是的。關於VASO的RTU，我們對大家的興趣程度感到非常鼓舞，也對我們看到的接受度感到興奮。顯然，在第一季度，產品發布仍處於初期階段。所以數據也還處於初期階段。當然可以查看4月份的IQVIA數據，了解我們的進度。

But overall, we're very pleased by the uptake, the trends in terms of market share. We've seen positive feedback overall from the accounts that we've introduced, the VASO ready-to-use presentation. Hospitals are recognizing that ready-to-use product provides a lot of -- I think, a lot of benefits to them. Hospitals are under pretty extreme labor pressure. So a ready-to-use product that takes the pressure off pharmacy, particularly those who have to offer 24-hour pharmacy services, takes a lot of pressure off pharmacy mixing rooms. And having a ready-to-use at site of care, I think everyone is recognizing that, that's a benefit.

但總體而言，我們對市場份額的成長趨勢感到非常滿意。我們推出的VASO即用型產品的客戶整體回饋正面。醫院逐漸意識到即用型產品能為他們帶來許多好處。醫院的勞動力壓力非常大。因此，一款即用型產品可以減輕藥局的壓力，尤其是需要提供24小時藥局服務的藥房，從而大大減輕藥局調配室的壓力。我認為，在醫療機構配備即用型產品，每個人都意識到了這一點，這是一個好處。

And just the cold-chain flexibility, having that at site of care without some of the limitations around cold chain, are some of the early reasons why we're seeing a lot of interest, and we're seeing conversion. So we anticipate that we're going to continue to convert. I think we feel like the conversion opportunity is a good one for us, and we're very excited about what we're seeing early on.

冷鏈的靈活性，以及在護理現場不受冷鏈限制的優勢，是我們早期看到大量客戶關注並實現轉換的原因之一。因此，我們預期轉換率還會持續上升。我認為轉化機會對我們來說是一個利好，我們對早期的進展感到非常興奮。

This concludes the question-and-answer session. I'd like to turn the call over to Blaise Coleman for closing remarks.

問答環節到此結束。接下來，請布萊斯·科爾曼致閉幕。

Thank you, operator, and thank you, everyone, for joining us this morning, and we look forward to providing you with updates as we move forward. And we hope everyone has a great weekend.

謝謝接線員，也謝謝大家今天早上的參與。我們期待在未來的工作中為您提供最新進展。祝大家週末愉快。

This concludes the program. You may now disconnect. Everyone, have a great day.

節目到此結束。現在可以斷開連線了。祝大家擁有美好的一天。