Milestone Pharmaceuticals Inc (MIST) 2026 Q1 法說會逐字稿

Ladies and gentlemen, good morning, and welcome to the Milestone Pharma first quarter 2026 earnings conference call. (Operator Instructions) As a reminder, this conference is being recorded.

各位女士、先生，早安，歡迎參加 Milestone Pharma 2026 年第一季財報電話會議。（接線員指示）提醒各位，本次會議將被錄音。

It is now my pleasure to introduce your host, Michael Wood of LifeSci Advisors. Please go ahead.

現在我很榮幸介紹本次會議主持人——LifeSci Advisors 的 Michael Wood。請開始。

Thank you, operator. Good morning, everyone, and welcome to the Milestone Pharmaceuticals first quarter 2026 financial results and business update conference call. Earlier this morning, the company issued a press release providing an overview of its financial results for the quarter ended March 31, 2026, and recent corporate highlights. The release can be accessed on the Investors and Media section of the company's website, milestonepharma.com.

謝謝，接線員。各位早安，歡迎參加 Milestone Pharmaceuticals 2026 年第一季財務結果與業務更新電話會議。今天稍早，公司已發布新聞稿，概述截至 2026 年 3 月 31 日止季度的財務結果與近期公司重點事項。該新聞稿可於公司網站 milestonepharma.com 的「投資人與媒體」專區查閱。

Before we begin, I'd like to remind you that some of the information presented on this conference call contains forward-looking statements under the securities laws. These forward-looking statements involve substantial risks and uncertainties that could cause actual clinical programs, future results, progress, timing, performances or achievements to differ materially from those expressed or implied by such forward-looking statements. These risks and uncertainties associated with Milestone's business and factors that could cause or contribute to such differences are described in detail in the company's filings with the SEC, including in the Risk Factors section of the annual report on Form 10-K for the year ended December 31, 2025, filed with the SEC on March 20, 2026.

在開始之前，我想提醒各位，本次電話會議中所呈現的部分資訊依證券法規屬於前瞻性陳述。這些前瞻性陳述涉及重大風險與不確定性，可能導致實際的臨床計畫、未來結果、進展、時程、表現或成就與該等前瞻性陳述所明示或暗示者存在重大差異。與 Milestone 業務相關的這些風險與不確定性，以及可能造成或促成此類差異的因素，已在公司向美國證券交易委員會（SEC）提交的文件中詳加說明，包括截至 2025 年 12 月 31 日止年度之 Form 10-K 年報「風險因素」章節；該年報已於 2026 年 3 月 20 日向 SEC 提交。

Speaking on the call today will be Joseph Oliveto, President and Chief Executive Officer of Milestone; Lorenz Muller, Chief Commercial Officer; and Amit Hasija, Chief Financial Officer and EVP of Corporate Development. In addition, Dr. David Bharucha, the company's Chief Medical Officer, will also be available on the call during the Q&A session. So with that, I'll turn the call over to Joseph Oliveto. Joe, please go ahead.

今天出席並發言的有：Milestone 總裁兼執行長 Joseph Oliveto；商務長 Lorenz Muller；以及財務長暨企業發展執行副總裁 Amit Hasija。此外，公司醫務長 David Bharucha 醫師也將在問答環節中在線。接下來我把電話交給 Joseph Oliveto。Joe，請開始。

Thank you, Michael. Good morning, everyone, and thank you for joining us today. This is an exciting day as it represents our first analyst call reporting on our first ever quarter or, more accurately, partial quarter of sales since the commercial launch of CARDAMYST for acute episodes of paroxysmal supraventricular tachycardia or PSVT.

謝謝你，Michael。各位早安，感謝今天加入我們。今天令人振奮，因為這是我們首次分析師電話會議，報告自 CARDAMYST 商業上市以來的首個季度——更精確地說，是首個季度中的部分期間——銷售表現；CARDAMYST 用於成人陣發性上心室性心動過速（PSVT）急性發作。

Today, our prepared remarks will highlight three advances or updates since our last quarterly call. First, we'll provide our thoughts on the launch of CARDAMYST. Second, we'll discuss the initiation of our Phase 3 pivotal trial for etripamil for patients with atrial fibrillation and rapid ventricular rate or AFib-RVR. And lastly, we'll provide an update on our financials from our CFO, Amit Hasija.

今天我們的事先準備發言將重點說明自上次季度電話會議以來的三項進展或更新。第一，我們將分享對 CARDAMYST 上市的看法。第二，我們將討論針對心房顫動合併快速心室率（AFib-RVR）患者之 etripamil 第 3 期關鍵性試驗的啟動。最後，我們的財務長 Amit Hasija 將提供財務更新。

Let's start with the launch. To recap, CARDAMYST, the brand name for etripamil, was approved by the FDA on December 12 as the first and only rapid-acting self-administered prescription therapy for acute PSVT episodes in adults. Following approval, we immediately mobilized our launch plan. We quickly engaged our distribution channels such that CARDAMYST became readily available through retail pharmacies by the end of January. We then began promotion of CARDAMYST in earnest in mid-February, including the deployment of our national sales force of approximately 60 sales representatives.

先從上市談起。回顧一下，CARDAMYST（etripamil 的品牌名）已於 12 月 12 日獲 FDA 核准，成為首個且唯一可快速起效、可自行給藥的處方療法，用於成人 PSVT 急性發作。核准後，我們立即啟動上市計畫。我們迅速與配送通路合作，使 CARDAMYST 在 1 月底前即可透過零售藥局廣泛取得。接著我們於 2 月中旬開始積極推廣 CARDAMYST，包括部署約 60 名業務代表的全國銷售團隊。

Launching within two months of the approval was an aggressive goal that we successfully met in Q1.

在核准後兩個月內完成上市是一個具挑戰性的目標，而我們已在第一季成功達成。

Now a little less than three months since the launch, we're excited to share the emerging themes we've observed so far. Cardiology health care providers across the board, including physicians, nurses, nurse practitioners and physicians' assistants are consistently responding positively to CARDAMYST. It seems clear to us that the HCP audience we've engaged so far quickly understands the value that CARDAMYST brings to the patients with SVT due to its safety profile and ease of effective self-administration. Insurers continue to collaborate with us on pathways to coverage with the goal of adding CARDAMYST to their formularies.

目前距離上市不到三個月，我們很高興分享迄今觀察到的初步主題。各類心臟科醫療照護提供者（HCP），包括醫師、護理師、護理師執業者以及醫師助理，對 CARDAMYST 的反應一貫正面。我們清楚看到，迄今接觸到的 HCP 族群能迅速理解 CARDAMYST 對 SVT 患者所帶來的價值，原因在於其安全性特徵以及可輕鬆且有效地自行給藥。保險業者也持續與我們合作，推動給付途徑，目標是將 CARDAMYST 納入其處方集。

A great example of this is our earliest major win, Express Scripts National Formulary coverage. Express Scripts is one of the three major pharmacy benefit managers, or PBMs, which when combined with the other two major PBMs account for more than 80% of commercially covered lives in the United States. Perhaps most gratifying for us is the positive initial feedback we are receiving from the patient community and specifically those patients who received CARDAMYST. We gain these insights of patient experiences through our ongoing patient engagement activities, our social media monitoring and through physicians and nurses feedback, much of which is in the form of unsolicited text, calls and e-mails.

一個很好的例子是我們最早取得的重要成果：Express Scripts 全國處方集給付。Express Scripts 是三大藥品福利管理機構（PBM）之一；三大 PBM 合計涵蓋美國超過 80% 的商業保險人口。對我們而言，最令人欣慰的或許是來自病友社群的正面初期回饋，特別是那些實際取得 CARDAMYST 的患者。我們透過持續的病友互動活動、社群媒體監測，以及醫師與護理師的回饋來獲得這些病患經驗洞察，其中許多是以非邀約的簡訊、電話與電子郵件形式提供。

The stories take the form of two flavors. The first being those patients who've used CARDAMYST and have had a positive experience during an event, but also interestingly, stories from some patients who relay excitement simply from having obtained CARDAMYST from their pharmacy and not even having used it yet. These patients describe having an increased sense of preparedness and security for when their next event will occur. All of these patient stories are a very valuable reminder of why we do what we do.

這些故事大致可分為兩種類型。第一類是患者在發作時使用 CARDAMYST 並獲得正面體驗；另一類同樣有趣，是一些患者僅僅因為已從藥局領到 CARDAMYST、甚至尚未使用，就表達了興奮之情。這些患者表示，對於下一次發作何時到來，他們感到更有準備、也更安心。所有這些病友故事都非常珍貴，提醒我們為何投入這項工作。

So I'll hand it over to Lorenz to provide some additional details on the launch.

接下來我把時間交給 Lorenz，請他提供更多上市相關細節。

Thank you, Joe, and thank you to everyone joining us this morning. Building on Joe's overview, I will provide more color on our commercial rollout and sales progress of CARDAMYST in the first part of the year. Given that it's so early in the launch, I'll break total scripts out by month, which demonstrates steady progress month-over-month.

謝謝你，Joe，也感謝今天早上加入我們的各位。延續 Joe 的概述，我將補充更多關於今年前段 CARDAMYST 商業推廣與銷售進展的細節。由於上市仍在非常早期，我會按月份拆分總處方量（scripts），以呈現逐月穩定進展。

Moving forward, we plan to report total prescriptions, unique health care practitioner writers and unique patients as quarterly figures. Through the end of April, we've captured approximately 600 total prescriptions. Specifically, February generated approximately 100 prescriptions and March was around 200, totaling approximately 300 prescriptions in our first partial quarter. In April, we're reporting around 300 scripts, or as many as the previous two months combined. Our data indicate that these prescriptions were written by over 400 unique health care professionals for approximately 560 unique patients.

展望未來，我們計畫以季度為單位報告總處方數、開立處方的獨立醫療專業人員數，以及獨立患者數。截至 4 月底，我們累計取得約 600 張總處方。具體而言，2 月約 100 張、3 月約 200 張，合計在首個部分季度約 300 張。4 月我們約報告 300 張處方，約等於前兩個月合計。我們的數據顯示，這些處方由超過 400 位獨立醫療專業人員開立，對象約為 560 位獨立患者。

Our last key metric that we are reporting today and we will continue to report quarterly is lives covered by commercial insurance. With our early Express Scripts win announced at the end of March, we conservatively estimate that 25% of all commercially insured patients have quality coverage for CARDAMYST.

我們今天報告的最後一項關鍵指標、且未來也將按季度持續揭露的是：商業保險涵蓋人數（lives covered）。隨著我們在 3 月底宣布取得 Express Scripts 的早期成果，我們保守估計約有 25% 的商業保險患者已獲得對 CARDAMYST 具品質的給付保障。

Now for some perspective on what these numbers mean and why they're important at this early stage. In terms of prescription volume, while it's too early to forecast trends definitively, we are pleased to see data showing steady month-over-month growth. As Joe mentioned, prescriber reception has been very positive, which we see as a validation of the core value proposition for CARDAMYST. With both a well-established calcium channel blocker mechanism and a safety profile supported by robust clinical data, we believe that these first scripts written by our target providers tell us that prescribers see CARDAMYST as an important and needed solution for their patients with PSVT.

接著提供一些觀點，說明這些數字在現階段的意義以及其重要性。就處方量而言，雖然現在仍太早無法對趨勢做出明確預測，但我們很高興看到數據呈現逐月穩定成長。如 Joe 所提，處方醫師的接受度非常正面，我們視之為對 CARDAMYST 核心價值主張的驗證。憑藉已被充分建立的鈣離子通道阻斷劑作用機轉，以及由扎實臨床數據支持的安全性特徵，我們相信，目標醫療提供者所開立的這些初期處方顯示，處方者將 CARDAMYST 視為其 PSVT 患者一項重要且迫切需要的解決方案。

As I said, through the end of April, over 400 unique prescribers have written approximately 600 total prescriptions for CARDAMYST. We view this breadth as a strong leading indicator of the appeal of CARDAMYST among providers. When a new therapy like this is adopted across a relatively wide physician base from the onset rather than just a narrow group of early adopters, we believe it signals that the value is clearly resonating broadly. Thus, we are building a strong, receptive foundation of prescribers who, as coverage expands and their familiarity with CARDAMYST increases, should increase their prescribing depth over time.

如我所說，截至 4 月底，已有超過 400 位獨立處方者為 CARDAMYST 開立約 600 張總處方。我們認為這樣的廣度是 CARDAMYST 在醫療提供者間吸引力的強勁領先指標。當這類新療法從一開始就能在相對廣泛的醫師群體中被採用，而非僅限於少數早期採用者時，我們相信這代表其價值主張已在更廣泛層面產生共鳴。因此，隨著給付範圍擴大、且醫師對 CARDAMYST 的熟悉度提升，我們正在建立一個強健且具高度接受度的處方者基礎，這些處方者應會隨時間增加其開立深度。

I will add that many of these prescriptions are coming from physicians who have met with one of our sales representatives only a few times. This is important as we believe in pharmaceutical launches, early trial after one or two interactions is a positive signal about the strength of the clinical story and a physician's interest in the product. This is something our commercial teams specifically aspire to from the onset, and we believe it reflects the compelling nature of the profile of CARDAMYST and its value proposition. As our reps build frequency and deepen their relationships through repeat visits, we have every expectation that this will be a driver of growing prescription patterns.

我還要補充的是，這些處方中有許多來自僅與我們業務代表會面過幾次的醫師。這點很重要，因為在藥品上市推廣中，我們認為在一到兩次互動後就出現早期試用，是臨床論述強度以及醫師對產品興趣的正向訊號。這也是我們商業團隊從一開始就特別追求的目標，我們相信這反映了 CARDAMYST 特徵輪廓與其價值主張的吸引力。隨著業務代表透過重複拜訪提高互動頻率並深化關係，我們完全預期這將成為處方成長趨勢的驅動因素。

Now to the third metric, coverage. On March 31, we announced that Express Scripts, one of the nation's largest pharmacy benefit managers, added CARDAMYST to its commercial national formularies. I want to highlight the importance of this earlier than predicted success. This is the first contracted formulary acceptance of CARDAMYST by a major payer.

接著談第三項指標：給付覆蓋。3 月 31 日，我們宣布全美最大的藥品福利管理機構之一 Express Scripts，已將 CARDAMYST 納入其商業全國處方集。我想強調這項早於預期的成功之重要性。這是 CARDAMYST 首次獲得主要支付方的合約式處方集納入。

In the landscape of commercial drug launches, getting a major PBM formulary placement within the first quarter of a launch is a significant achievement. We see this as clear validation of the clinical and economic value to payers, particularly in terms of our clinical data, illustrating the potential of this drug to reduce health care utilization, including emergency department visits and hospital admissions.

在商業藥品上市的版圖中，能在上市後第一季內取得大型PBM處方集（formulary）收載，是一項重大成就。我們認為這清楚驗證了該藥物對付款方的臨床與經濟價值，特別是就我們的臨床數據而言，顯示此藥物具備降低醫療資源使用的潛力，包括急診就醫與住院收治。

The Express Scripts coverage decision means that we now have approximately one in four commercially insured lives covered. We believe most of that coverage is quality coverage, meaning patients are more likely to be approved at the point of sale rather than navigating an overly onerous prior authorization process and we will be able to refill a prescription multiple times to treat subsequent episodes of PSVT.

Express Scripts 的給付決策意味著，我們目前約有四分之一的商業保險受保人群獲得保障。我們相信其中多數屬於高品質的保障，亦即患者更可能在銷售端點（point of sale）即獲核准，而非必須面對過度繁瑣的事前授權（prior authorization）流程；同時，我們也將能多次續配處方，以治療後續發生的 PSVT 發作。

We are actively negotiating with other major PBMs and health plans. And while I won't get ahead of any specific decisions, we are committed to continuing to expand contracted coverage, and we expect further announcements as those discussions progress.

我們正積極與其他主要PBM與健康保險計畫進行談判。雖然我不會搶先透露任何特定決策，但我們致力於持續擴大已簽約的保障範圍，並預期隨著討論推進，將有進一步公告。

So to summarize where we stand across our three key metrics, the breadth of new prescribers and early physician acceptance gives us confidence that we are gaining traction. We are building momentum, and we will continue to plan for an acceleration in prescription volume as our launch progresses. These measurements of growth will be driven by increased promotional frequency with our target physicians, continued pull-through from our first major coverage win and additional anticipated positive coverage decisions.

總結我們在三項關鍵指標上的現況，新處方醫師的廣度與早期醫師接受度讓我們有信心正在取得進展。我們正在累積動能，並將持續規劃隨著上市推進而加速處方量成長。這些成長衡量將由以下因素驅動：對目標醫師提高推廣頻率、我們首個重大給付勝利所帶來的持續拉動效應（pull-through），以及其他預期的正面給付決策。

I'll now turn the call back over to Joe to update on progress in our clinical development program.

接下來我把電話交回給 Joe，請他更新我們臨床開發計畫的進展。

Thank you, Lorenz. I'll turn now to the next major advancement for milestone and for etripamil. Namely that we have initiated our Phase 3 trial for atrial fibrillation with rapid ventricular rate or AFib-RVR named ReVeRa-301. This ReVeRa Phase 3 registration trial is based firmly on the successful performance of etripamil in our AFib Phase 2 study.

謝謝你，Lorenz。接下來我將談到另一項重要的里程碑進展，以及 etripamil 的進展。也就是我們已啟動針對「心房顫動合併快速心室率」（atrial fibrillation with rapid ventricular rate，AFib-RVR）的第三期試驗，名為 ReVeRa-301。這項 ReVeRa 第三期註冊性試驗，堅實建立在 etripamil 於我們 AFib 第二期研究中的成功表現之上。

In that trial, patients on etripamil demonstrated a statistically significant and clinically meaningful reduction in their ventricular rate compared to placebo and also showed symptomatic improvement. The design of our Phase 3 AFib study, ReVeRa, uses the same approach of patient self-administration of drug and operational study conduct as our successful Phase 3 trials in PSVT.

在該試驗中，使用 etripamil 的患者相較於安慰劑，在心室率方面呈現具統計顯著且具臨床意義的下降，並且也顯示症狀改善。我們第三期 AFib 研究 ReVeRa 的設計，採用與我們在 PSVT 成功第三期試驗相同的患者自我給藥方式與研究執行模式。

Specifically, the Phase 3 AFib ReVeRa study is a double-blind, placebo-controlled, event-driven trial in which the patient will self-administer the drug outside of the health care setting. The study employs the same 70-milligram dose and repeat dose regimen that is already approved for CARDAMYST for SVT and many of the operational conduct components are the same as those that were used in the SVT program.

具體而言，第三期 AFib ReVeRa 研究為雙盲、安慰劑對照、事件驅動（event-driven）試驗，患者將在醫療照護場域之外自行給藥。該研究採用與 CARDAMYST 已核准用於 SVT 相同的 70 毫克劑量與重複給藥方案，且多項營運執行要素與 SVT 計畫中所使用者相同。

Regarding status, we are labeling clinical study drug. We have begun contracting with key clinical research sites with whom we've had successful experience from our PSVT trials and have completed contracting with several. We're actively recruiting additional trial sites in several geographic regions with a focus on the US and the trial has been posted on clinicaltrials.gov. We expect to enroll our first patient into this trial in the second half of this year and look forward to providing further updates as the ReVeRa-301 study advances this year.

就目前狀態而言，我們正在進行臨床試驗用藥的標示作業。我們已開始與關鍵臨床研究中心簽約，這些中心是我們在 PSVT 試驗中曾有成功合作經驗者，且已完成與其中數家的簽約。我們也正積極在多個地理區域招募更多試驗中心，重點聚焦美國，並已將試驗登錄於 clinicaltrials.gov。我們預期將於今年下半年納入首位受試者，並期待在今年 ReVeRa-301 研究推進之際提供更多更新。

I will now turn the call over to Amit for a financial update.

我現在把電話交給 Amit，請他進行財務更新。

Thanks, Joe. We have a strong balance sheet, including approximately $184 million in cash, cash equivalents and short-term investments as of March 31, 2026. This compares with $106 million at December 31, 2025. We believe our cash balance provides sufficient runway to support both ongoing CARDAMYST launch activities and our operations into the second half of 2027, including the execution of the ReVeRa-301 study.

謝謝，Joe。我們的資產負債表相當穩健，截至 2026 年 3 月 31 日，現金、約當現金與短期投資約為 1.84 億美元；相較之下，2025 年 12 月 31 日為 1.06 億美元。我們認為目前的現金水位提供了充足的資金跑道（runway），可支持持續進行的 CARDAMYST 上市活動，以及公司營運至 2027 年下半年，包括執行 ReVeRa-301 研究。

The higher cash number is primarily the result of $75 million cash payment we received in January in connection with our royalty purchase agreement with RTW, as well as approximately $19 million in net proceeds from ATM sales and Series A warrant exercises that took place during Q1. Our operating cash burn during Q1 was approximately $23.7 million. Product revenues in the first quarter of 2026 were $0.2 million.

現金數字較高主要來自兩項因素：其一是我們於 1 月因與 RTW 的權利金購買協議而收到 7,500 萬美元現金款項；其二是第一季透過 ATM（at-the-market）發行與 A 系列認股權證行使所取得約 1,900 萬美元淨收益。我們第一季的營運現金消耗（operating cash burn）約為 2,370 萬美元。2026 年第一季產品營收為 20 萬美元。

R&D expense net of tax credits was $3.3 million in the first quarter of 2026 compared to $5 million in the first quarter of 2025. The decrease compared with the prior year was primarily due to a decrease in the outside service costs related to drug development and research. G&A expense was $4.8 million in the first quarter of 2026 compared to $5.2 million in the first quarter of 2025. The decrease was primarily due to lower professional costs, partially offset by an increase in personnel costs.

扣除稅額抵減後的研發費用（R&D expense net of tax credits）在 2026 年第一季為 330 萬美元，較 2025 年第一季的 500 萬美元下降。相較前一年下降主要是因與藥物開發與研究相關的外部服務成本降低。一般及行政費用（G&A expense）在 2026 年第一季為 480 萬美元，較 2025 年第一季的 520 萬美元下降；下降主要因專業服務成本降低，部分被人員成本上升所抵銷。

Commercial expense was $15.8 million in the first quarter of 2026 compared to $10.4 million in the first quarter of 2025. The higher commercial expense was primarily a result of additional personnel costs, professional costs and other operational costs related to the launch of CARDAMYST. Net loss for the first quarter of 2026 was approximately $26.1 million or $0.20 per share compared to $20.8 million or $0.31 per share in the first quarter of 2025.

商業化費用（Commercial expense）在 2026 年第一季為 1,580 萬美元，較 2025 年第一季的 1,040 萬美元增加。商業化費用較高主要是因與 CARDAMYST 上市相關的新增人員成本、專業服務成本及其他營運成本。2026 年第一季淨損約為 2,610 萬美元或每股 0.20 美元，相較之下，2025 年第一季淨損為 2,080 萬美元或每股 0.31 美元。

I will now turn the call over to Joe for some concluding statements.

我現在把電話交回給 Joe，請他做一些結語。

Thank you, Amit. As we reflect on the quarter, we are proud of the early execution of our launch and the progress we are making in establishing CARDAMYST as a novel treatment for PSVT. While we're still in the early stages, the initial indicators we are seeing give us confidence in the opportunities ahead with the PSVT launch and with our AFib-RVR Phase 3 clinical development program. Our focus remains clear: driving disciplined commercial launch execution, including expanding payer access, advancing our clinical development program and managing our resources responsibly. We believe these priorities position us well to continue our momentum over the course of 2026 and beyond. Thank you again to our team and our shareholders for your continued support.

謝謝你，Amit。回顧本季，我們為上市初期的執行成果以及在將 CARDAMYST 建立為 PSVT 創新治療方案方面所取得的進展感到自豪。雖然仍處於早期階段，但我們目前看到的初步指標，讓我們對 PSVT 上市機會以及 AFib-RVR 第三期臨床開發計畫的前景更具信心。我們的重點仍然明確：推動嚴謹的商業化上市執行（包括擴大付款方可近性）、推進臨床開發計畫，並負責任地管理資源。我們相信這些優先事項使我們在 2026 年及其後能持續延續動能。再次感謝我們的團隊與股東持續支持。

That concludes our remarks, and we will now open the call to questions.

以上為我們的說明，接下來我們將開放提問。

(Operator Instructions) Ritu Baral, Cowen.

（接線生指示）Ritu Baral，Cowen。

I wanted to ask about the 400 unique prescribers and sort of the first Rxs, NRxs that have come in. Can you talk about the mix of prescribers at this point and how you expect that sort of evolution of the mix, especially as you continue your commercial targeting? And how do you think that that will sort of reflect downstream on the percentage of patients -- I'm sorry, the mix of patients that you end up getting?

我想詢問關於 400 位不重複開立處方的醫師，以及目前進來的首批處方（Rxs、NRxs）。你們能談談目前處方醫師的組成嗎？以及在你們持續進行商業化目標鎖定的同時，你們預期這種組成會如何演變？另外，你們認為這將如何在後端反映到患者比例——抱歉，我是指你們最終獲得的患者組合（mix of patients）？

And then according to our calculations, while you have mentioned that you're giving away free drug, it doesn't look like you've given away that much free drug. Can you talk about sort of the receptivity of that program, and has sort of bridging programs been offered and will that continue to be a part of the 2026 effort?

另外，根據我們的計算，雖然你們提到有提供免費用藥，但看起來實際送出的免費藥量並不多。你們能談談該計畫的接受度嗎？以及是否有提供過渡（bridging）計畫，且這是否會持續作為 2026 年工作的一部分？

Yes. Great, Ritu. Great to hear your voice. Thanks for listening in on the call. And maybe I'll start a little bit, particularly with the prescriber mix and ask Lorenz to comment a little further on what that means for downstream as we're thinking about it now.

是的。很好，Ritu。很高興聽到你的聲音。謝謝你收聽這通電話。或許我先簡單回答一下，特別是關於處方醫師組成，然後請 Lorenz 再補充一些，說明我們目前如何思考這對後端的意涵。

And then also Lorenz to give a little bit more color on how much free drug we're giving away and how we think about that going forward. So we've always said that this is primarily driven by clinical cardiologists. That's where the majority of these patients live in terms of their management. We always thought that EPs, electrophysiologists, could be a bigger writer in the first year, primarily because we don't have or are not expecting a lot of refills in the first year. So that was our guidance before launch.

另外也請 Lorenz 再多補充一些我們提供了多少免費用藥，以及我們未來如何看待這件事。我們一直說，這主要由臨床心臟科醫師所驅動，因為就患者管理而言，多數患者都在這個族群中。我們也一直認為，心臟電生理醫師（EPs，electrophysiologists）在第一年可能會是較大的開立者，主要是因為第一年我們沒有、或不預期會有大量續配（refills）。這是我們上市前的指引。

And I would say we're largely seeing that. So far, we've seen approximately 50% of the scripts to date written by cardiology and about 25% written by electrophysiology. The other 25% is really a combination of nurse practitioners, physicians' assistants, a few PCPs, really not many at all and just another bucket that are not classified in our data.

我會說我們大致上確實看到這樣的情況。到目前為止，我們看到約 50% 的處方由心臟科開立，約 25% 由心臟電生理科開立。其餘 25% 則是護理師（nurse practitioners）、醫師助理（physicians' assistants）、少數基層照護醫師（PCPs，primary care physicians）——其實非常少——以及另一個在我們資料中未分類的類別所組成。

So it seems to be playing through with how we've thought about it prelaunch with the idea that while electrophysiologists are writing only 25%. Currently, that's a big number relative to where they'll be over the long haul, and they're influential, as you might be aware. So it's good to have that prescribing behavior because those are the folks that will be called by cardiologists asking about the drug. They're important to P&T committees, they're important guidelines, all those types of things.

因此看起來與我們上市前的預期一致：雖然心臟電生理醫師目前只開立 25%，但相對於長期而言，這已是很大的比例，而且他們具有影響力，如你所知。因此能看到這樣的開立行為是好事，因為心臟科醫師會致電詢問藥物的往往就是這些人。他們對藥事與治療（P&T）委員會很重要、對臨床指引也很重要，以及所有這類事情。

Lorenz, maybe if you want to comment a little further on how you see downstream going and then move over to the free drug program.

Lorenz，也許你可以再多評論一下你如何看待下游的進展，然後再談到免費用藥計畫。

Sure. Happy to do that. Ritu, thanks for the question. So Joe is exactly right in that we expected the majority of early scripts to come from cardiology and maybe favor electrophysiology somewhat as the thought leaders. Over time, we would expect to continue to see the majority of our prescriptions coming from cardiology, clinical and interventional cardiology. Electrophysiology will continue to use it, but their use case is more focused on bridging patients to an ablation. And so there wouldn't be as much reuse of the drug, assuming those ablations were successful.

當然，很樂意。Ritu，謝謝你的問題。Joe 說得完全正確：我們預期早期處方的大多數會來自心臟科，並且可能會稍微偏向心律電生理（electrophysiology），因為他們是意見領袖。隨著時間推進，我們預期仍會看到大多數處方來自心臟科，包括臨床心臟科與介入心臟科。心律電生理也會持續使用，但他們的使用情境更聚焦於將病人橋接到消融術。因此，假設消融成功，藥物的重複使用就不會那麼多。

So I think over time, we will see two dynamics. One is the percentage of cardiology scripts that is written by clinical cardiologists and interventionalists will increase relative to total, including EPs. And I do think the second dynamic over time is we will start to see more APPs, so nurse practitioners and physicians' assistants. As practices get comfortable that the cardiologists in that practice or cardiologists are comfortable prescribing the drug, which we are seeing evolve relatively quickly, APPs will become more the day-to-day managers of these patients and the prescribers.

所以我認為隨著時間推進，我們會看到兩個動態。第一，心臟科處方中，由臨床心臟科醫師與介入醫師開立的比例，會相對於總量（包含 EP）而提高。第二個動態是，隨著時間推進，我們會開始看到更多 APP，也就是專科護理師（nurse practitioners）與醫師助理（physicians' assistants）。當診所逐漸熟悉、且該診所的心臟科醫師或心臟科醫師更習慣開立這個藥物（我們看到這個演進相對快速），APP 會更成為這些病人的日常管理者與開立處方者。

I also think, finally, over time, so measured in years, not months, I do think primary care will start to adopt more, although they only represent roughly 1/3 or 1/4 or 1/3 of the prescribing population. What we're seeing is early on is primary care that look more like cardiologists than true primary care. And I do think over time, primary care will also start to write more because they're seeing some of the younger patients where they don't have -- they only have -- the only form of cardiovascular disease those younger patients have is PSVT.

最後我也認為，隨著時間推進——以年而非月來衡量——基層醫療也會開始更多採用，儘管他們大約只占處方族群的 1/3 或 1/4 或 1/3。我們早期看到的是，那些基層醫療醫師看起來更像心臟科醫師，而不是真正典型的基層醫療。我也確實認為，隨著時間推進，基層醫療也會開始開出更多處方，因為他們會看到一些較年輕的病人，而這些年輕病人沒有——他們只有——他們唯一的心血管疾病型態就是 PSVT。

To your second question on free drug quantities, our goal in the launch has always been to ensure that when a script comes in, that the payer is notified that there's demand there because that helps us ultimately convince payers that there is demand and therefore, that they want to cover the drug and make themselves -- avail themselves of those rebates.

至於你第二個關於免費用藥數量的問題，我們在上市推進中的目標一直是確保：當有處方進來時，付款方（payer）會被通知那裡存在需求，因為這最終有助於我們說服付款方確實有需求，因此他們會想要給付該藥，並讓自己——能夠享有那些回扣。

So we don't just provide free drug right out of the gate. We go through the process and then the pharmacist and/or the physician, the office have to fill out the paperwork for prior auths or medical exception, which is where most of the scripts come through ahead of coverage. And only where those prior auths or medical exceptions are not granted, do we then come in primarily with assistance.

所以我們不會一開始就直接提供免費用藥。我們會先走流程，然後藥師和／或醫師、診所必須填寫事前授權（prior auth）或醫療例外（medical exception）的文件；在獲得給付之前，多數處方都是透過這些途徑進來。只有在事前授權或醫療例外未獲核准的情況下，我們才會主要以協助方式介入。

So I would say I was pleased to see that we are week-over-week seeing growth in the number of scripts that are actually filled. And that is in part a sign of expanded coverage, meaning the ESI coverage decision win, but also somewhat our ability to now convert patients, meaning at the end of the chain, if they don't pass medical exception, we are there to catch that patient and allow them to use the drug.

所以我會說，我很高興看到我們每週（week-over-week）實際被配藥（filled）的處方數正在成長。這部分是擴大給付的跡象，也就是 ESI 給付決策的勝利；但也部分反映我們現在能夠轉換病人——也就是在流程鏈的最後端，如果他們未能通過醫療例外，我們會在那裡接住病人，讓他們仍能使用該藥。

So this is more sort of like true bridging rather than like a sampling effort. Is that correct?

所以這更像是真正的橋接，而不是像試用（sampling）活動。這樣理解正確嗎？

Yes, I think that's accurate, Ritu, yes.

是的，Ritu，我認為這樣說是正確的。

Ted Tenthoff, Piper Sandler.

Ted Tenthoff，Piper Sandler。

Congrats on the nice first quarter launch. Lorenz, always appreciate all the detail and color that you provide. My question has to do with the ReVeRa-301 and just a sense of -- I know you're just starting and just kicking it off, but walk us through a little bit more in terms of the patients that you're enrolling and maybe what our expectations should be in terms of how long it might take to enroll the study?

恭喜第一季上市表現不錯。Lorenz，一直很感謝你提供的所有細節與觀點。我的問題是關於 ReVeRa-301——想請你談談一些感受：我知道你們才剛開始、剛啟動，但能否帶我們更深入了解一下你們正在納入的病人類型，以及我們對於完成收案可能需要多久，應該抱持什麼樣的預期？

Sure. I'll handle this. Of course, if there's any further questions, David Bharucha is on the line. So very importantly, and just a reminder for the audience is atrial fibrillation is a huge market. Current estimates about 10 million patients with atrial fibrillation in the US alone and growing. Expectations are that this number will increase in the short term here.

當然。我來回答這題。當然，如果還有進一步問題，David Bharucha 也在線上。非常重要的是，也提醒各位聽眾：心房顫動是一個非常龐大的市場。目前估計僅在美國就約有 1,000 萬名心房顫動患者，而且仍在成長。預期這個數字在短期內還會增加。

And very important to realize that we are looking for patients that have AFib are characterized with AFib and importantly, are characterized with AFib and events of rapid ventricular rate. These are events above 100 beats per minute and commonly last for some time and are very importantly, symptomatic to the patient. The ultimate value prop for CARDAMYST, Ted, is really to help resolve that elevated rate, bring it down towards a more normal rate, doesn't have to get all the way to normal and reduce symptoms.

而且非常重要的是要理解：我們尋找的是有 AFib（心房顫動）病史、被診斷為 AFib 的病人，並且關鍵是同時具有快速心室率（rapid ventricular rate）的事件。這些事件是每分鐘超過 100 下的心跳，通常會持續一段時間，而且對病人而言非常重要的是會有症狀。Ted，CARDAMYST 的最終價值主張（value prop）是協助解決這種升高的心率，把它降到更接近正常的範圍，不一定要完全回到正常，並減輕症狀。

And by doing that, we should enable the patient to manage these episodes at home and not have to go to the emergency department for most commonly IV calcium channel blockers like IV diltiazem. That is the value prop. We want to follow that in this study. So very importantly, we're looking for patients that have a history of AFib with rapid ventricular rate, ideally more elevated rates and very importantly, symptomatic rates.

透過這樣做，我們應該能讓病人在家中管理這些發作，而不必為了最常見的靜脈注射鈣離子通道阻斷劑（例如靜脈注射 diltiazem）而前往急診室。這就是價值主張。我們希望在這項研究中驗證這點。因此非常重要的是，我們要找的是有 AFib 合併快速心室率病史的病人，理想上是心率更高、且非常重要的是有症狀的心率事件。

So that's what's really the driver for this study in the patient population we'd like to see. We believe that the study should -- well, it is powered at 90% to deliver 0.05 based on really the second endpoint, which is symptomatic improvement. We believe that powering it that way should deliver a successful results with a total size of somewhere in the range of 150 to 200 total events. And we believe that, that study should take around two years from start from our first patient enrolled to data.

所以這就是這項研究的驅動因素，以及我們希望看到的病人族群。我們相信這項研究應該——嗯，它的設計檢定力（power）為 90%，以 0.05 顯著水準，主要是基於第二個終點，也就是症狀改善。我們相信以這種方式設定檢定力，總事件數大約在 150 到 200 件的範圍內，就能帶來成功的結果。我們也相信，從第一位病人入組到取得數據，這項研究大約需要兩年。

That's our current estimate. There's a lot of variables in there, but it's driven primarily off of our experience with our PSVT program, our experience with our Phase 2 program in AFib and trying to triangulate around what we saw in both of those programs both with the AFib experience in the emergency department, but also operationally the PSVT program in the outpatient setting. So it will be -- also it will be sized similar to our PSVT programs in the sense of multi-country, multisites ranging up to 600 patients enrolled in the funnel, if you will, to deliver that 150 to 200 total AFib-RVR events.

這是我們目前的估計。裡面有很多變數，但主要是基於我們在 PSVT 計畫上的經驗、我們在 AFib 第二期計畫上的經驗，並嘗試綜合（triangulate）兩個計畫中看到的情況：包括在急診室的 AFib 經驗，以及門診環境下 PSVT 計畫的營運經驗。因此它也會——它的規模也會與我們的 PSVT 計畫相近，意即多國、多中心；如果你把它想成漏斗（funnel），最多可能需要納入多達 600 名病人，才能產出那 150 到 200 件 AFib-RVR 總事件。

Mohit Bansal, Wells Fargo.

Mohit Bansal，Wells Fargo。

Congrats on all the progress. I want to dive a little bit deeper in the Express Script formulary decision. Can you remind us what kind of prior auth is required to make it available for the patient? And then if I do the math on like number of prescriptions and then the sales you are reporting, it seems like pretty high, almost $800 per script number. So is that, Lorenz, like you said, that you are trying to make sure that payers do see it and you are not providing free drug just yet. Is that the reason why the gross to net seems to be really good here?

恭喜你們的所有進展。我想更深入探討 Express Scripts 的處方集（formulary）決策。你能提醒我們，為了讓病人可取得用藥，需要哪一類的事前授權（prior auth）嗎？另外，如果我用你們提供的處方數去對照你們報告的銷售額來算，似乎每張處方的金額很高，接近每張 800 美元。Lorenz，這是否如你所說，你們是想確保付款方確實看得到需求、而你們尚未提供免費用藥？這是否就是為什麼這裡的 gross-to-net 看起來非常好？

Yes. I think those maybe are questions for Lorenz to provide color. What I'm hearing, Mohit, is you really want to know about ESI coverage and what that looks like in terms of how quality is it and what's the prior auth process was the first question. And then the second question, let me just make sure I got it correctly. Are you calculating something like $800 per script? Is that what I heard?

是的。我想這些可能是請 Lorenz 補充說明的問題。我聽到的重點是，Mohit，你主要想了解 ESI 給付以及它在品質上看起來如何、以及事前授權流程是什麼樣子，這是第一個問題。第二個問題，我確認一下我是否理解正確：你是在計算類似每張處方 800 美元嗎？我聽到的是這個嗎？

Yes. So basically, like $238,000 divided by the 300-script number that you provided. So just trying to calculate it via that.

是的。基本上就是用你們提供的 30x 張處方數去除以 238,000 美元，所以想用這樣來估算。

Okay. Well, maybe I'll ask Lorenz or Amit to help out with that one as well. So Lorenz, maybe you could start with the ESI number.

好的。那我也許請 Lorenz 或 Amit 也協助回答這題。Lorenz，也許你可以先從 ESI 的部分開始。

Sure. Yes. So ESI is one of the three big pharmacy benefit managers, right? It rolls up under Ascent. And so by signing a contract with them and getting coverage, that allows, as I mentioned on the call, about one in four commercially insured patients to have coverage for the drug.

當然。是的。ESI 是三大藥局福利管理公司（pharmacy benefit managers, PBM）之一，對吧？它隸屬於 Ascent。透過與他們簽約並取得給付，如同我在電話會議中提到的，這讓大約每四位商業保險（commercially insured）病人中就有一位能獲得該藥的給付。

And that means all the plans that ESI administers a pharmacy benefit for will now have the ability to make a coverage decision and then fill the drug without all the different steps that I mentioned in the previous question from Ritu, which is an onerous prior auth process or medical exception, things that take time and requires a lot of work on the part of the physician or the pharmacy to populate.

這表示所有由 ESI 管理藥局福利的方案，現在都能做出給付決策，並且在不需要我在前一題回覆 Ritu 時提到的那些不同步驟下就能配藥——也就是繁瑣的事前授權流程或醫療例外等，這些都很耗時，且需要醫師或藥局投入大量工作去填寫。

With Express Scripts, I mentioned that we think the majority of that will be what we call quality coverage. I can't say all of it because there's a lot of different benefit designs under ESI and not everyone opts into the offer, but we have confidence that the majority will. And our definition of quality coverage is essentially that the -- it's not onerous to prescribe the drug and get it filled, meaning the physician's office doesn't have to do a ton of paperwork, in some cases, no paperwork in order for the product to be able to be filled at the pharmacy. And that there is the ability for the patient to refill the drug a number of times.

關於 Express Scripts，我先前提到，我們認為其中大多數將屬於我們所稱的「優質給付」。我不能說全部都是，因為在 ESI 之下有許多不同的給付設計，而且並非每個人都會選擇加入該方案，但我們有信心大多數會是。我們對「優質給付」的定義，基本上是——開立處方並完成領藥不會過於繁瑣，亦即醫師診所不需要做大量文書作業；在某些情況下，甚至不需要任何文件，產品就能在藥局完成配藥。此外，病患也能夠多次續領該藥品。

Most patients have more than one episode a year. And so they want -- if they have success with the drug, which we are hearing anecdotally from patients, they are, they'll want to go back and get a refill, and we don't want it to disproportionately limit the amount of product that a patient can get, but we also understand that payers in a launch here might be concerned about a patient using this 30 or 50 or 80 times a year, which we're not expecting to see.

多數病患一年會有不只一次的發作。因此他們會希望——如果該藥物對他們有效（我們也從病患端的口耳相傳聽到這點），他們就會想回來續領；我們不希望不成比例地限制病患可取得的產品數量。但我們也理解，在上市初期，支付方可能會擔心病患一年使用 30 次、50 次或 80 次，而我們並不預期會看到這種情況。

So again, quality coverage is limit the amount of prior auth paperwork to as little as possible. And ideally, anything that's required is adjudicated at the pharmacy and not requiring the doctor or the doctor's office to fill a lot of paperwork and also that the quantity limits aren't overly draconian. So we're happy if a patient can have up to 6 or 12 fills in a year. Although in a launch year, as we've said, we expect most patients to use this a couple of times.

所以再次強調，「優質給付」就是把事前授權（prior auth）的文書作業降到越少越好。理想狀況下，任何必要的要求都能在藥局端完成理賠審核，而不需要醫師或診所填寫大量文件；同時，數量限制也不應過於嚴苛。因此，如果病患一年最多可以領藥 6 次或 12 次，我們就會很滿意。雖然在上市第一年，如我們所說，我們預期多數病患只會使用幾次。

On the second part of the question, by the way, I was taking note. I think, Mohit, the confusion is we had announced on the earnings call that we have around about $200,000 in net sales and that that's coming from 600 prescriptions, not 300. So I think the math you did was a little bit off in terms of the dollars per prescription. It is, in fact, a little bit lower than the range we've often quoted of $500 to $1,000, but that's because we're in the first quarter of launch, and we are seeing a lot more use of denial conversion or where medical exceptions aren't going through, we do want those patients to have access to the drug.

順帶一提，關於問題的第二部分，我剛剛有做筆記。我想，Mohit，混淆點在於：我們在財報電話會議上宣布，我們約有 20 萬美元的淨銷售額，而那是來自 600 張處方，不是 300 張。所以你算的每張處方對應的金額在數學上有點偏差。實際上，確實比我們過去常引用的每張處方 500 到 1,000 美元區間略低，但那是因為我們正處於上市的第一季，而且我們看到更多「拒付轉換」（denial conversion）的使用，或是在醫療例外（medical exceptions）未能通過時，我們仍希望這些病患能取得藥物。

So we expect that number to increase steadily over the next few quarters to get into the range of what we've reported previously.

因此，我們預期接下來幾季這個數字會穩步上升，回到我們先前所報告的區間。

Tiago Fauth, Raymond James.

Tiago Fauth，Raymond James。

I just want to talk a little bit more about the acceleration in prescription volume, right? So you are seeing that steady pace of adds -- an increase in adds. I'm curious, and again, it hasn't been that long, but the Express Script agreement, can we expect to see some degree of acceleration relative to that? Does that quality coverage actually could increase the pace of net adds?

我想再多談一點處方量加速的部分，對吧？所以你們看到新增處方（adds）的步調穩定——新增量在增加。我很好奇，而且再次強調，時間還不算長，但就 Express Script 的協議而言，我們是否可以預期相對而言會看到某種程度的加速？所謂的優質給付是否真的可能提高淨新增（net adds）的速度？

And then I have a follow-up just in terms of the depth of prescribers and the patient journey. Question here is mostly about the ramp for the launch, right? So what are some of the key levers that will lead a physician to prescribe to more patients and for a patient to actually utilize this more than once a year. I know there's probably a cap there. But again, depth of prescribing and also the utilization per patient, what are some of the levers early in the launch? I understand, but just trying to think about this the longer term.

接著我有一個追問，關於開立醫師的深度以及病患旅程（patient journey）。這個問題主要是關於上市爬坡（ramp），對吧？也就是說，哪些關鍵槓桿會促使醫師對更多病患開立處方，以及讓病患一年實際使用超過一次。我知道可能會有上限。但再次回到開立深度，以及每位病患的使用頻率，在上市初期有哪些槓桿？我理解現況，只是想從更長期的角度思考。

Okay. So Tiago, great for jumping on here and for the questions. Again, I'll start, Lorenz. I don't know if I caught all those questions at the end. I might have to ask Tiago to come back to a few of them.

好的。Tiago，謝謝你加入並提出問題。再次說明，我先開始回答，Lorenz。我不確定我是否完全抓到你最後那幾個問題；我可能需要請 Tiago 再回來補充幾點。

But certainly, ESI -- and remember, Tiago, we got that right at the end of the quarter, so right at the start of April. So these first quarter numbers are really all without any coverage pretty much or very, very little coverage, whatever you get initially out of the gate.

但當然，ESI——而且 Tiago，請記得我們是在季度末才拿到那個結果，也就是 4 月初。所以第一季的數字基本上幾乎都是在沒有任何給付、或只有非常非常少的給付下產生的，也就是一開始剛上市時能拿到的那種初始給付。

So remember that is the first thing. We do see coverage in general and then ESI is a good early win is providing two things. One is obviously a little better pull-through once a script gets to the pharmacy and that paperwork, as Lorenz said explained, having to be a lot less, if any, to be able to actually see the script show up and actually get filled. So that's the first part. And then the subsequent kind of intangible that is just the reality these days is physicians will write if they know that there's less hassle factor.

所以請先記住這點。我們確實看到整體給付在推進，而 ESI 作為早期的一個好成果，帶來兩件事。第一，顯然是一旦處方送到藥局後，實際領藥的「拉動率」（pull-through）會更好；而且如 Lorenz 所解釋，為了讓處方真正出現在系統並完成配藥，所需的文書作業會少很多，甚至不需要。這是第一部分。第二個後續、較難量化但在當今確實存在的現實是：如果醫師知道麻煩會比較少，他們就更願意開立處方。

It's funny. I've been out in the field now too handfuls of times. And very consistently, you're ending the call with how do I get it? Is it covered? Is it in Epic? That type of stuff. What pharmacy has it? And is it covered and what have I got to do? And what does my staff have to do is a real question.

很有趣的是，我最近也多次到第一線拜訪。非常一致地，拜訪結尾大家都會問：我要怎麼拿到？有給付嗎？Epic 系統裡有嗎？諸如此類。哪一家藥局有？有給付嗎？我需要做什麼？我的行政人員需要做什麼？這些都是真實的問題。

So it's an intangible, but I can't help but believe that with coverage, and we are very cognizant of not wanting to put too much burden on these offices with the idea of turning them off. A doctor has to write two or three, four pieces of paperwork for a patient and then they don't get it, that can frustrate them. So we're very sensitive to not having that happen. And getting that coverage. And at the end of the day, we think that as we get coverage and less of that paperwork has to happen, it's going to result in more initial scripts.

所以這是個較難量化的因素，但我不禁相信：有了給付，而且我們非常清楚不希望讓這些診所承擔過多負擔、以免讓他們卻步。如果醫師必須為一位病患填兩三份、四份文件，結果病患還拿不到藥，這會讓他們很挫折。因此我們非常敏感，不希望發生這種情況。取得給付後，最終我們認為，隨著給付到位、需要處理的文書減少，將會帶來更多初始處方。

So it's just in the back of the physician's mind. So yes, to acceleration. However, remember, Express Scripts, while a big payer, it's one of three on the commercial side. And remember, about half of our population is commercial, about half of the population is Medicare. So think of it as like half of the 25% that we reported for the total target addressable market in terms of coverage so far. So a ways to go on that front. So that was a lot on that.

所以這會在醫師心中形成一種背景認知。因此，是的，會有加速。不過請記得，Express Scripts 雖然是大型支付方，但在商業保險端它只是三家之一。而且我們約有一半族群是商業保險，約一半是 Medicare。換個方式想，它大概相當於我們先前報告的、目前整體目標可觸及市場（total target addressable market）給付覆蓋率 25% 的其中一半的那 25% 的一半左右。所以在這方面還有一段路要走。這部分我講得有點多。

Lorenz, maybe you can move on to the second and third questions.

Lorenz，也許你可以接著回答第二和第三個問題。

Yes, I will. And I'll just add one other thing on the acceleration. You were focused a lot, Tiago, on the coverage part of acceleration. And we certainly think broader coverage will be for the reasons Joe mentioned, a driver of acceleration. But the other one is promotional response, right?

好的，我來回答。我也想在加速這點上再補充一件事。Tiago，你剛剛很聚焦在「給付」對加速的影響。我們當然認為，更廣泛的給付會基於 Joe 提到的原因，成為加速的驅動因素。但另一個因素是推廣回應（promotional response），對吧？

Our reps have been out there now for a couple, three months. They've seen a lot of their customers only once or maybe twice. And as they get more frequency on those customers and as they reach more of the customers in the rather large territories that they have, we do expect that to result in more prescription writing. And that's a little bit of answering to the second part of your question, which you were asking about two parts, as I heard. One was what are the tactics or the levers where target physicians will write more than they're currently doing. Most of our physicians based on the numbers we reported this morning, have written a script, although about 25% have written more than that.

我們的業務代表到市場上也才兩三個月。他們對許多客戶可能只拜訪過一次，或最多兩次。隨著他們對這些客戶的拜訪頻率提高，以及在他們相當大的負責區域內觸及更多客戶，我們確實預期這會帶來更多處方開立。這也部分回答你問題的第二部分——我聽到你問了兩個面向：第一是有哪些策略或槓桿，能讓目標醫師比目前開更多處方。根據我們今天早上公布的數據，多數醫師都已經開過一張處方，雖然約有 25% 的醫師開過不只一張。

And then the second part was how are we going to drive utilization of the patient where they fill more than one script. And both of those will happen over time. And they're related to both the physicians' awareness and willingness to trial, which we're seeing, but then translating the willingness to trial to usage where they use it on more patients and where patients actually come back after they've had a successfully treated episode or where they ask for a second script to be filled even before they have a first episode because they want to have access to the drug.

第二個面向是：我們要如何推動病患端的使用，讓他們不只領一次處方。這兩件事都會隨時間發生，而且彼此相關：一方面是醫師的認知提升與願意嘗試（我們正在看到），另一方面是把「願意嘗試」轉化為實際使用——也就是他們用在更多病患身上，以及病患在成功治療一次發作後會回來，或甚至在第一次發作前就要求再領第二張處方，因為他們希望能隨時取得藥物。

So with the payers being willing to give patients, say, more than one dose at a time, we do believe patients will go in and fill a second or a third script in order to be able to have the drug on them, in the office, at home, in close proximity. So when they have that unexpected episode, they can treat it quickly.

因此，如果支付方願意讓病患一次取得不只一劑，例如一次給超過一個劑量，我們確實相信病患會去領第二張或第三張處方，讓藥物能放在身邊、在辦公室、在家裡或近距離可取得。這樣當他們遇到突發的發作時，就能快速治療。

So I think all of that, the answer is time and effort for us to continue to drive promotional response, getting in front of HCPs, prescribers and making sure they're aware and trialing in appropriate patients. And then we do think over time, as patients have a successful experience with the drug, we've seen this already in some of the anecdotal social media listing we've been doing. They'll come back to the docs say, hey, that really works for me. Could you write me another script? I'd like to refills. That's sort of a dynamic. We will also accelerate our adoption.

所以我認為，總結來說，答案就是時間與投入：我們要持續推動推廣回應，接觸醫療照護專業人員（HCPs）與開立者，確保他們了解並在合適病患中進行試用。接著我們也認為，隨著時間推進，當病患對藥物有成功的使用經驗——我們已在一些我們做的社群媒體口碑蒐集裡看到——他們會回去跟醫師說：嘿，這對我真的有效。你能再幫我開一張處方嗎？我想要續領。這樣的動態也會加速我們的採用。

Brandon Folkes, H.C. Wainwright.

Brandon Folkes，H.C. Wainwright。

Congrats on all the progress so far. Maybe just two for me. Can you talk about how you're thinking about targeted DTC spend going forward here? And then last year at your Commercial Day, you provided a lot of really insightful detail on how you envisioned the launch. Can you just talk about if the launch is tracking sort of within all those expectations? Anything there that you see different today? Obviously, Express Scripts coming on very early on. But yes, just put in context how you see the launch today versus sort of how you framed it last Feb.

恭喜你們目前為止的所有進展。我這邊可能只有兩個問題。你們能談談接下來對於精準投放的 DTC（直接面向消費者）支出是怎麼思考的嗎？另外，去年在你們的 Commercial Day 上，你們提供了很多非常有洞見的細節，說明你們如何構想這次上市。你們能否談談目前上市進度是否大致符合當時的預期？今天有沒有看到任何不同之處？很明顯，Express Scripts 很早就加入了。不過，請把目前你們對上市的看法，放在去年 2 月你們當時的框架下做個對照。

Sure. Again, I think I'll just provide a high level. And then, Lorenz, these are really questions for your insights. I would say with regard to targeted DTC spend, hopefully, what came across in our plans before we got the approval, Brandon, was we're trying to be very thoughtful around how to use the dollars and use them in areas that are really going to drive the most bang for the buck.

當然。再次強調，我先提供一個高層次的說明。然後 Lorenz，這些問題更適合由你來補充見解。我會說，關於精準投放的 DTC 支出，希望在我們獲批之前所提出的計畫中，Brandon，你能感受到的是：我們正努力非常審慎地思考如何使用這些資金，並把錢花在真正能帶來最高投資報酬的領域。

And things like targeted DTC or what we call DTP, direct-to-patient as well as even things like nonpersonal promotions to physicians. Everyone is aware, we have about 10,000 targets. I'm pretty sure everyone is aware that we're not going to get to all those targets. There are no C physicians in our target call base. And that lends itself to nondirect promotion or what we call nonpersonal promotion. So these are ability to get the message and the information to these offices that we can't have our reps come in on, right?

像是精準 DTC，或我們稱之為 DTP（direct-to-patient，直接面向病患），以及甚至像是對醫師的非個人化推廣（nonpersonal promotions）。大家都知道，我們大約有 10,000 個目標。我很確定大家也都知道，我們不可能觸及所有這些目標。在我們的目標拜訪名單中沒有 C 類醫師。而這就更適合採用非直接推廣，或我們所說的非個人化推廣。也就是說，能把訊息與資訊傳遞到那些我們的業務代表無法進入拜訪的診所，對吧？

And it takes a little longer to get to those offices. But the thought is behind both of these tactics, if you will, is let's make sure we have enough coverage and enough general awareness through the more routine routes of our sales representatives and working through the coverage system before we really start driving patients into the office. So it's always been very tailored that way, and we still expect that to happen.

而觸及那些診所需要更長的時間。但這兩種策略背後的想法是：在我們真正開始把病患導入診間之前，先確保透過業務代表較常規的途徑，以及透過給付覆蓋（coverage）體系的推進，我們已經有足夠的覆蓋率與整體認知度。所以一直以來都是以這種方式做精準配置，我們也仍然預期會如此進行。

We are, though, having pilots in those areas such that when we are ready to turn on the spigot, if you will, and open up spends on those areas, we know where and how to spend it. So that's the general philosophy of how we're approaching these things. But Lorenz, maybe you can provide a little bit more color specifically to the DTC spends that Brandon is talking about.

不過，我們也在這些領域做試點（pilot），如此一來，當我們準備好「打開水龍頭」並在這些領域加大投入時，我們就知道該把錢花在哪裡、以及怎麼花。這就是我們處理這些事情的一般理念。但 Lorenz，也許你可以就 Brandon 所提到的 DTC 支出，提供更具體的補充。

Sure. So we've always said that this is a patient-driven market. And we still -- everything we're seeing in the launch so far suggests that that was a correct assessment. And so it's really a question of timing rather than -- so it's not if, but it's when. And what I mean by that is you don't want to drive patients, this is in any therapeutic area into the HCP office or into a prescriber office if the prescriber is not aware of the new drug, right? That always becomes problematic. It's one of the reasons why DTC ads are not allowed in the launch year, meaning television.

好的。我們一直都說這是一個由病患驅動的市場。而目前我們在上市過程中看到的一切，都顯示這個判斷是正確的。所以問題其實在於時點，而不是——也就是說，不是「要不要」，而是「何時」。我的意思是，在任何治療領域，你都不希望在處方醫師尚未了解新藥的情況下，就把病患導入 HCP（醫療照護專業人員）或處方醫師的診間，對吧？那通常會造成問題。這也是為什麼在上市第一年不允許做 DTC 廣告（指電視廣告）。

So what we're doing is to be compliant with that, which we believe, which we agree with, is we've done some pilots, as Joe alluded to, which are really primarily targeting tools that are already in doctors' offices, whether they're wallboards or whatever that is, to be able to generate some awareness amongst patients and see if we can actually raise awareness amongst patients through those tactics. So they're not expensive, but there are things that are very scalable.

因此，為了符合這項規範——我們相信這是合理的、也同意這樣的做法——我們如 Joe 所提到的，做了一些試點，主要是鎖定醫師診所內既有的工具，不論是牆面看板（wallboards）或其他形式，來在病患之間建立一些認知度，並觀察是否能透過這些策略提升病患的認知。這些做法成本不高，但具有很強的可擴展性。

So if we invest in that and we do it for a period of two or three months and we see a positive ROI, then we'll know we can do more of that later this year or starting next year to drive patient awareness because we're very confident that if a patient is aware of a new treatment for SVT since there's no competition out there, they will likely go into the doctor and ask for it. And where they do ask for it, more than likely it will be granted.

所以，如果我們投入這些做法，執行兩到三個月後看到正向的 ROI（投資報酬率），那我們就會知道今年稍晚或從明年開始可以做得更多，以提升病患認知度。因為我們非常有信心：若病患知道 SVT 有一個新的治療選項，且市場上沒有競品，他們很可能會去看醫師並主動詢問。而一旦他們提出詢問，多半也會獲得處方。

Then more broadly in terms of patient activation, so that was just awareness generation tactics. But in terms of actually doing kind of the customer relationship marketing, building educational resources and then capturing patients by advertising for them and then building a relationship with them and marketing to them. So the classic direct-to-patient type tactics.

再更廣泛一點談病患啟動（patient activation）：剛剛那只是提升認知的策略。但若談到真正去做類似 CRM（客戶關係行銷），建立教育資源，然後透過廣告吸引並蒐集病患，再與他們建立關係並對他們行銷——也就是典型的 direct-to-patient 類策略。

We are in the process of building those capabilities, and we expect to bring them online in a time frame, whether it's later this year or early next, where we have sufficient awareness and trial amongst cardiology that they're not going to be surprised that a patient is coming in to ask for the drug and certainly won't be irritated by that. So that's kind of how we think about the staged rollout of a very important and long-term tactic that I think will drive business, which is patient activation.

我們正在建立這些能力，並預期在某個時間點上線——可能是今年稍晚或明年初——屆時在心臟科領域已經有足夠的認知度與試用（trial），醫師不會因為病患進來詢問這個藥而感到意外，當然也不會因此覺得困擾。這就是我們對於分階段推出一項非常重要、且我認為能帶動業務的長期策略——病患啟動——的思考方式。

In terms of the second part of your question, Brandon, around what are some of the -- how is the launch tracking from our view? You kind of captured the three broad areas. So we think about payers, we do think we're a little bit ahead of what we were expecting with the early win from ESI.

至於你問題的第二部分，Brandon，關於從我們的角度看上市進度如何——你其實已經抓到三個主要面向。我們會看付款方（payers）；我們確實認為，因為 ESI（Express Scripts）的早期勝利，我們比原先預期稍微超前一些。

And we -- nobody asked about how we're doing with the other big payers, but we are in active discussions and are pleased with what we're seeing in terms of level of engagement, right? You can't get to a contract, you can't get to coverage if the payers don't want to talk to you. And I can confidently say we are talking to all the major payers, both the commercial ones, which is the big 3 PBMs as well as the Medicare payers where we're setting ourselves up to be within the consideration set for formulary decisions in 2027.

而且——雖然沒有人問我們與其他大型付款方的進展——但我們正積極洽談，並對目前看到的互動程度感到滿意，對吧？如果付款方不願意跟你談，你就不可能走到合約、不可能走到給付覆蓋。我可以很有信心地說，我們正在與所有主要付款方對話，包括商業端（也就是三大 PBM）以及 Medicare 付款方；我們也在為 2027 年的處方集（formulary）決策，讓自己進入其考量名單（consideration set）。

So there -- I'd say we're ahead of plan. In terms of cardiologists and HCP reception, we are hearing very positive feedback and Joe and I have seen it when we've been out in the field ourselves in terms of the profile of the drug. People seem very happy with the efficacy and the safety data. It doesn't take very long when you're in the field as a rep or as one of us going out to get the doctor to say, okay, I get it. This looks really interesting. Yes. And then you start talking about what kind of a patient and when am I going to be able to write this.

所以——我會說我們超前於計畫。就心臟科醫師與 HCP 的接受度而言，我們聽到非常正面的回饋；而且 Joe 和我在親自下到市場時，也看到了大家對這個藥物特性的反應。大家似乎對療效與安全性數據非常滿意。當你以業務代表身分、或像我們這樣出去拜訪時，通常不需要太久，醫師就會說：好，我懂了，這看起來很有意思，是的。接著就會開始討論：什麼樣的病患適合？我什麼時候能開這個藥？

I can say we've mentioned earlier in the pre-approval that we were targeting around 10,000 doctors. We currently have engaged with about 1/3 of those doctors, meaning a sales rep has been in there one or multiple times to actually get in and talk and make them aware of etripamil. And you heard me earlier, so that's -- think about it as around 3,000 or 4,000 doctors that have actually been engaged with a sales rep. And you heard earlier that we have around 400 writers. So we're seeing north of a 10% prescribing rate for the people that we've reached.

我可以說，我們在獲批前曾提到目標大約是 10,000 位醫師。我們目前已經與其中約 1/3 的醫師有互動，也就是業務代表已經進去一次或多次，實際與他們溝通並讓他們了解 etripamil。你剛剛也聽到我提到，所以——可以把它想成大約 3,000 到 4,000 位醫師已經由業務代表實際接觸。而你也聽到我們目前大約有 400 位開立處方者（writers）。因此，在我們已觸及的人群中，處方率超過 10%。

And this early in the launch, two to three months in, we're actually quite pleased with that metric. We expect it to obviously grow as we get more reach and as we get more frequency on these customers. But that's an early metric that I think is a sign of, that the launch is tracking as we hoped it would.

在上市初期、才兩到三個月的時間點，我們其實對這個指標相當滿意。隨著我們觸及更多醫師、以及對這些客戶的拜訪頻率提高，我們預期它當然會成長。但這是一個早期指標，我認為顯示上市進度正如我們所希望的那樣推進。

And then the patient response is the third area that's very important. All we've heard at this point is anecdotal from social media listening about how patients are responding to the drug. Not many patients have gotten a prescription and actually use the drug given the nature of the episodes, but some have. And so far, that response has been overwhelmingly positive. And so that's a very good sign that patients are having good experience. They're going to report that back to their doctor and then they're going to get refills.

第三個非常重要的面向是病患反應。目前我們聽到的多半是透過社群媒體聆聽（social media listening）所得到的軼事性回饋，關於病患對藥物的反應。由於發作型態的關係，真正拿到處方並實際使用藥物的病患還不多，但確實有一些。到目前為止，回饋幾乎是一面倒地正面。因此，這是非常好的訊號，代表病患有良好的使用體驗。他們會把這些回饋告訴醫師，接著就會續方。

Congrats on the launch progress to date.

恭喜目前為止的上市進展。

Dennis Ding, Jefferies.

Dennis Ding，Jefferies。

This is Georgia on the line for Dennis Ding. A quick question on the commercial strategy and launch. You mentioned many of the early prescriptions are coming from just one or two rep interactions. Can you provide more detail on just how many touch points you're seeing on average today and how you expect that to evolve as the launch matures to hit those 10,000 docs you just spoke about? And any plans for a sales force expansion to do that?

我是 Georgia，代 Dennis Ding 在線上提問。關於商業策略與上市，我有個簡短問題。你們提到許多早期處方只來自一到兩次的業務互動。你們能否更詳細說明目前平均看到的接觸點（touch points）大約是多少？以及隨著上市逐步成熟、要觸及你們剛提到的 10,000 位醫師時，你們預期這個數字會如何演變？另外，是否有擴編銷售團隊以達成這點的計畫？

And then relatedly, are you seeing differences across prescriber segments such as the EPs versus the cardios in terms of the number of interactions required to drive initial and repeat prescribing? And then finally, when would you expect your sales force to reach max productivity?

然後相關地，您是否看到在處方醫師族群分層上（例如心臟電生理醫師（EP）相較於心臟科醫師）在推動首次與重複開立處方所需互動次數方面存在差異？最後，您預期貴公司的銷售團隊何時能達到最高生產力？

Okay. Yes. I think some of these, Georgia, will be a little tough just given how early we are, especially when we want to talk about repeats. Really, we're just in the initial stages there. But Lorenz, a host of good questions for you to speculate on, I would say, some of these things.

好的。是的。我想其中一些問題，Georgia，可能會有點難回答，主要是因為我們目前仍處於非常早期的階段，尤其當我們想談重複處方時。實際上，我們才剛進入那部分的初期階段。不過 Lorenz，這是一系列很好的問題，讓你可以就其中一些事情做些推測。

Fair enough. Thanks, Georgia, for the questions. So in terms of the early prescriptions, yes, you're correct. We know many of our customers have seen a sales rep once or twice, although a number of them have seen them dozens of times. It really very much varies in terms of the access. So it is definitely too early to be able to calculate promotional response.

可以理解。謝謝你，Georgia，提出這些問題。就早期處方而言，是的，你說得沒錯。我們知道許多客戶只見過業務代表一到兩次，雖然也有不少客戶已經見過他們數十次。這在可及性方面差異很大。因此，現在確實還太早，無法計算促銷反應。

We can get an anecdotal feel for, wow, that doctor got one detail and they wrote a script, and we saw that a number of times, right? So that's very promising and suggests that it's not complicated to understand how to use this drug, and there don't appear to be any concerns about new mechanisms or safety concerns or any of that, that would limit a doctor based on an initial encounter or two with a sales rep to be willing to write the drug and actually follow through with getting it filled.

我們可以從軼事中感受到，例如：哇，那位醫師只聽了一次產品說明就開了處方，我們也多次看到這種情況，對吧？所以這非常令人鼓舞，並顯示這個藥物的使用方式不難理解，而且似乎沒有任何對新機轉或安全性的疑慮或其他問題，會讓醫師在與業務代表初次接觸一兩次後就不願意開立，或不願意實際完成處方並讓病人領藥。

So that feels pretty good early on. But you're right, we will, over time, want to get doctors not only to reach more customers than the ones we've already reached, so go beyond the roughly 1/3 of our targets that we've reached and get to a higher number and then also get more depth, which would result in it being more top of mind, which means that each doctor would end up writing for more than one patient over time.

所以在早期這樣的感覺相當不錯。但你說得對，隨著時間推進，我們會希望醫師不僅能觸及更多客戶、超越我們目前已觸及的大約三分之一目標名單、提升到更高的覆蓋數，同時也要加深互動深度，讓產品更常被想起；如此一來，每位醫師隨時間推移就會為不只一位病人開立處方。

In terms of sales force expansion, our strategy at launch is still valid, which we thought is we're going to go out with a sufficiently sized sales force, our 60 reps, where we can confidently demonstrate demand, but not get ahead of coverage. So what we don't want to do is make a number of -- a larger number of physicians frustrated by the fact that they can't get scripts filled and then decide they're not going to write until we have broader coverage. So we felt like that was the rightsized sales force to be able to go out with.

就銷售團隊擴編而言，我們在上市時的策略仍然有效：我們認為要以足夠規模的銷售團隊出擊——也就是我們的 60 位業務代表——讓我們能有信心證明需求存在，但又不會超前於保險給付覆蓋。因為我們不希望讓更多醫師因為處方無法順利領藥而感到挫折，進而決定在我們取得更廣泛的給付覆蓋之前都不再開立。因此我們覺得這是合適規模的銷售團隊。

And as we do gain coverage, this has always been the strategy, focused on commercial first, but over time, next year, we hope to get some Medicare coverage. That will be the time to consider expanding the sales force. But you also heard me say earlier that we're also going to be thinking about ramping up patient activation. And so it's going to have to be a responsible decision around what gets the biggest bang for the buck.

而隨著我們逐步取得給付覆蓋——這一直都是策略——先聚焦商業保險，但隨著時間推進，明年我們希望能取得部分 Medicare 覆蓋。那將是考慮擴編銷售團隊的時點。不過你也聽到我先前提到，我們也會思考加大病人啟動（patient activation）。因此必須負責任地做出決策，評估哪一項能帶來最大的投入產出效益。

So later this year, we'll have a better sense of the promotional response for our existing promotion. In other words, how much do we pay for a rep and how many scripts does that rep generate? And we'll also have a sense from some of the pilots about how effective patient activation is. If we market to a patient, we identify them and market to them, will they actually go in and get a script. And we can measure all that because they're largely digital tactics.

所以在今年稍晚，我們會更清楚現有推廣活動的促銷反應。換句話說，我們為一位業務代表付出多少成本，而該代表能帶來多少張處方。我們也會從一些試點計畫中了解病人啟動的效果：如果我們對病人行銷、辨識並觸及他們，他們是否真的會去就醫並取得處方。我們可以衡量這些，因為多半是數位策略。

And based on that, we'll make a decision probably later this year or early next year around where do we put the resource, which one gets the bigger bang for the buck. So it's going to be ROI driven in terms of how we expand the commercial effort, and it's not just focused on the sales force.

基於這些結果，我們可能在今年稍晚或明年初做出資源配置決策：資源要投向哪裡、哪一項能帶來更大的投入產出效益。因此，我們擴大商業化投入將以投資報酬率（ROI）為驅動，而不會只聚焦在銷售團隊。

You also asked about any differences in promotional response from cardiologists versus electrophysiologists. And again, it's too early to calculate that from data. But again, having been out in the field, Joe also alluded to the number of times he's been out. The use case and the discussion with an EP is a little different than with a cardiologist, and we've trained our reps to be able to accommodate that. But we're not necessarily seeing any incremental resistance to prescribing and/or any overly enthusiastic prescribing differences between cards and EPs.

你也問到心臟科醫師與心臟電生理醫師在促銷反應上是否有差異。同樣地，現在還太早，無法從數據計算出來。但就我們在第一線的觀察——Joe 也提到他外出拜訪的次數——與 EP 的使用情境與討論方式，確實與心臟科醫師略有不同，我們也已訓練業務代表能因應這些差異。不過我們並未看到在開立意願上，心臟科與 EP 之間有任何額外阻力，或是某一方特別過度熱衷開立的明顯差異。

It's just that how they think about using the drug is a little different. A cardiologist is more likely managing a newly diagnosed patient that doesn't want an ablation or an existing patient that is dissatisfied with existing therapies. And the EP is more thinking about how to use the drug potentially on a patient that they're queued up and waiting for an ablation.

差別主要在於他們思考如何使用該藥物的方式略有不同。心臟科醫師更可能在管理新近診斷、但不想做消融術（ablation）的病人，或是對既有治療不滿意的既有病人。而 EP 則更在思考，如何把該藥物用在那些已排程、正在等待消融術的病人身上。

And your last question is around -- on sales force productivity and maximizing that. And again, it's too early to calculate that, but conventional, let's call it, wisdom or experience would suggest that when you deploy a new sales force, you need at least three to six months before they can get out to all of their customers, to get to their reach targets and also get sufficient frequency on their customers to get them on whatever adoption path that particular customer is on.

你最後一個問題是關於——銷售團隊的生產力以及何時能達到最大化。同樣地，現在還太早無法計算，但一般所謂的常識或經驗會認為：當你部署一支新的銷售團隊，至少需要三到六個月，他們才能拜訪到所有客戶、達到觸及目標，並對客戶維持足夠的拜訪頻率，讓客戶沿著其各自的採用路徑前進。

So I'd suggest that second half of this year is what we'll have a better sense of that. And that's also when we feel like we can start to calculate promotional response, which would drive some of the investments that I mentioned earlier in this answer.

因此我會認為今年下半年我們會更有把握掌握這點。那也將是我們覺得可以開始計算促銷反應的時候，而這會驅動我先前在回答中提到的一些投資決策。

I think there's one thing to add, Georgia, is the difference, at least from my experience being in the field now, it's hard to get through a discussion with an electrophysiologist about CARDAMYST for PSVT with them not wanting to bring up atrial fibrillation and they, almost to a person, do.

Georgia，我想補充一點：至少就我目前在第一線的經驗來看，與心臟電生理醫師討論 CARDAMYST 用於 PSVT 時，幾乎很難在不提到心房顫動（atrial fibrillation）的情況下完成對話；幾乎每一位都會提到。

And we know that. We know that it's driven largely by the fact that their ablations in atrial fibrillation are not nearly as successful as they are in SVT. And it provides a nice bridge for us then to have that discussion with them with our medical team. We refer them over to the medical side of the house and the clinical side of the house to be able to engage them around what we're doing on the development and the Phase 3 program for AFib. So that's the other main difference between the two groups, cardiology and atrial fibrillation.

而我們也知道這點。我們知道這主要是因為他們在心房顫動的消融術成功率，遠不如在 SVT 的成功率。這也為我們提供了一個很好的銜接點，讓我們的醫學團隊能與他們進一步討論。我們會把他們轉介到公司內部的醫學端與臨床端，讓他們了解我們在 AFib 的研發工作與第三期（Phase 3）計畫。因此，這就是兩個族群之間的另一個主要差異：心臟科與（聚焦）心房顫動的差異。

We want to be super compliant and make sure we drive the message home that this drug is for PSVT. It's approved there. There's a high medical need there. To Lorenz's point, we do talk about the right patients. Maybe it's that patient getting a bridge to an ablation or that patient who's trying to decide on their ablation. That's the discussion. But it really is obvious that they're really looking forward to our development in AFib and that gets them excited and gets our clinical team excited.

我們希望高度遵循合規要求，並確保把訊息傳達清楚：這個藥物是用於 PSVT；它在該適應症上已獲核准；而且那裡有很高的醫療需求。呼應 Lorenz 的觀點，我們確實會談到合適的病人族群：也許是需要在消融術前作為過渡（bridge）的病人，或是正在考慮是否要做消融術的病人。討論重點在這裡。但很明顯的是，他們非常期待我們在 AFib 的研發進展，這也讓他們感到興奮，同時也讓我們的臨床團隊感到振奮。

Ladies and gentlemen, as there are no further questions from the participants, I would now hand the conference over to the management for their closing comments.

各位女士、先生，由於與會者已無進一步提問，我現在把電話會議交回管理層作結語。

Thank you, operator, and thank you all to the investors who called in today and those who listened in. And I appreciate all your interest in Milestone and look forward to updating you as the launch progresses. Have a great day.

謝謝主持人，也謝謝今天來電以及收聽的各位投資人。我很感謝大家對 Milestone 的關注，並期待在上市推進的過程中向各位更新進展。祝各位有美好的一天。

Thank you. Ladies and gentlemen, the conference of Milestone Pharma has now concluded. Thank you for your participation. You may now disconnect your lines.

謝謝。各位女士、先生，Milestone Pharma 的電話會議到此結束。感謝各位的參與。您現在可以掛斷電話。