Cytokinetics Inc. Morgan Stanley 24th Annual Global Healthcare Conference

MYQORZO aficamten was engineered with certain properties in mind and was developed very much to elaborate on those properties. I think those are playing well to what we hope ultimately proves competitive advantage in the marketplace. Ease of use, flexibility, convenience, these are things that we think matter, especially for a second to entry in a category of cardiovascular medicine. I do believe that, as we have projected, we are on track for some pretty ambitious goals. Goals like preferential share of new scripts by the end of the year. Goals like parity market access. That is all translating into very solid launch velocity and momentum. Andrew can elaborate, but we reported our full second quarter, and in that quarter, as you should expect, we saw a majority of new scripts coming from velocity accounts, those roughly 700 accounts that represent over 80% of the historical CMI business.

But what was also encouraging, and this is imperative to growing the category, is that there were at least half of prescription, I'm sorry, half of prescribers coming from either historically, physicians who had not prescribed a CMI or had not done so in a while. And that speaks to their comfort with MYQORZO, especially given a differentiated REMS risk mitigation, and also where we believe the data, strong data publications support its use. We're really optimistic and encouraged coming out of Q2. Q3 continues to look promising, and we're looking forward to sharing results at our next earnings call.

Some of that relates to market access, where those barriers are being chipped away, and we expect parity by the end of the year. But maybe I'll ask Andrew to elaborate on how we get to that goal.

Sure. From a new-to-brand share of 50%, as you mentioned, end of the second quarter, we were above 40% and still trending in that direction, over 50%. When we look at what it's going to take to get there, our strategy has always been to the higher we decile physicians every 10%, and the higher the decile means the most productive physicians we have the highest share, and it goes down from there. So it continues to get the centers of excellence on board and expand the market. As we expand the market below decile 10 and nine, they're the highest, spend more time with our field force, spend more time with those customers. And generally those, as you go down, those deciles are less familiar with the details of the data and the differentiation, so there's an education component as well.

But what we've learned, no surprise, is that differentiation matters, the REMS matters, the experience and the process of getting a patient on therapy and going through the REMS matters, and market access matters. So it's reinforcing those elements, as well as you go down. But we remain confident in that goal of greater than 50%, because when we focus resources, we're seeing the share difference.

So on average, those new to CMI prescribing or those that had not written a script for CAMZYOS in quite some time, on average, they are three prescriptions already. So it's not like it's one-off. We're seeing repeat prescribing. And this is a category where we're also very pleased to see a couple other things coming forward. One is very strong adherence and compliance on the part of patients. Patients, when they get a CMI prescription, and especially for MYQORZO, are staying on it, and I think that's essential to the kind of growth trajectory we're highlighting. The other thing that's really nice to see is that as physicians are prescribing, the time from prescribing to dispensing, the time from dispensing to revenue reimbursement is short.

At one time upon launch, I think analysts in general were assuming it might take at least 60 days to see that conversion from dispensing to reimbursement, where that on average is closer to three weeks today. So we're really pleased to see that. I think that speaks volumes to the kind of demand, the quality of the demand that we're seeing with MYQORZO.

I will ask Andrew to comment, but with any launch, there is going to be some friction points. What I am especially proud of is how our team is responding to those and knocking them down in order to accelerate the launch. Andrew, do you want to speak to that?