TG Therapeutics Inc

NASDAQ:TGTX

Earnings Call Analysis

Strong Revenue Growth and Margin Expansion Highlighted in Earnings Call

During the earnings call, the company reported a 15% increase in revenue, reaching $500 million in the last quarter. Gross margins improved by 3%, driven by cost-saving initiatives. Guidance was provided for a further 10% revenue growth next year, with a focus on expanding international markets and launching new products to drive profitability.

TJ's Transformational Leap with BRIUMVI in 2023

2023 marked a pivotal year for TJ, beginning with the successful launch of BRIUMVI, their innovative drug for multiple sclerosis (MS). As the year unfolded, BRIUMVI generated substantial momentum, yielding approximately $90 million in U.S. net revenue. Such a remarkable debut suggests not only significant early interest but also a solid demand foundation poised to bolster the company's 2024 projections, aiming for U.S. revenue between $220 to $260 million.

BRIUMVI's Unique Position in the Market

BRIUMVI stands out as the only anti-CD20 monoclonal antibody administered as a convenient 1-hour infusion every 6 months post-initial dose, a unique selling point for both patients and healthcare providers. The drug's glycoengineering for enhanced B-cell depletion and immune engagement, alongside robust Phase III trial outcomes, underscores its potential. Furthermore, recent patent extensions secure BRIUMVI's exclusivity until 2042, offering a lengthy horizon for exploration and market presence.

TJ's Strategic Focus on Product and Market Expansion

TJ's strategy hinges on four fronts: enhancing BRIUMVI's convenience, developing a subcutaneous (subcu) version, exploring uses beyond MS, and advancing new drug development. These initiatives, such as the ENHANCE Phase IIIb trial and partnership for the azer-cel CAR T cell therapy, highlight the company's commitment to innovation and potential future growth, backed by a projected $250 million operating budget for 2024.

Robust CD20 Market Growth and BRIUMVI's Prospect

The thriving CD20 therapy market, constituting about half the share of new MS treatments years, bodes well for BRIUMVI. With a current CD20 therapy market uptake of roughly 10% in the fourth quarter and strong demand, TJ is poised to capture a greater market share, potentially positioning BRIUMVI as the preferred IV therapy for relapsing MS.

Financial Stamina Backed by a Solid Cash Position

TJ closed the year with a healthy cash reserve of $217.5 million, bolstering confidence in its ability to self-fund operations until achieving cash flow positivity. This financial resilience enables continued investment in BRIUMVI and upcoming development projects without incurring additional capital strains.

Patient Persistence and Financial Forecasting

TJ anticipates positive persistence rates for BRIUMVI, equivalent to other IV CD20 therapies. While precise gross-to-net guidance for 2024 has not been provided, the expectation is for typical quarter-to-quarter variability. Additionally, no immediate patient segmentation updates from prior communications have been imparted.

International Market Penetration and Milestone Expectations

Launching BRIUMVI in Germany—a critical European market—stands as a key achievement, setting the stage for subsequent launches in other major countries. However, TJ does not anticipate any further milestone payments in the present year, projecting an international presence with steady growth rather than immediate financial windfalls.

Earnings Call Transcript 2023-Q4

[Operator]

Greetings, and welcome to the TG Therapeutics Fourth Quarter and Year-End 2023 Financial Results and Business Update Call. [Operator Instructions] As a reminder, this conference is being recorded. It is now my pleasure to introduce your host, Jenna Bosco. Thank you. Please go ahead.

[Jenna Bosco, executive]

Thank you. Welcome, everyone, and thanks for joining us this morning. I'm Jenna Bosco, and with me today to discuss the fourth quarter and year-end 2023 financial results are Michael Weiss, our Chairman and Chief Executive Officer; Adam Waldman, our Chief Commercialization Officer; and Sean Power, our Chief Financial Officer. Following our safe harbor statement, Mike will provide an overview of our recent corporate development Adam will share an update on our commercialization efforts and Sean will give an overview of our financial results before turning the call over to the operator to begin the Q&A session.

Before we begin, I'd like to remind everyone that we will be making forward-looking statements within the meaning of the Private Securities Litigation Reform Act of 1995. These forward-looking statements include statements about our anticipated future operating and financial performance, including sales performance, projected regulatory milestones, revenue guidance, development plans and expectations for our marketed products. TG [indiscernible] that these forward-looking statements are subject to risks that may cause our actual results to differ materially from those indicated. Factors that may affect TG Therapeutics operations include various risk factors that can be found in our SEC filings.

In addition, any forward-looking statements made on this call represent our views only as of today and should not be relied upon as representing our views as of any later date. We specifically disclaim any obligation to update or revise any forward-looking statements. This conference call is being recorded for audio rebroadcast on TG's website, www.tgtherapeutics.com, where will be available for the next 30 days. Now I'd like to turn the call over to Mike Weiss, our CEO.

[Michael Weiss, executive]

Thanks, Jenna, and good morning, everyone. Thanks for joining us on today's call. 2023 was a transformational year for TJ. We kicked off the year with the launch of BRIUMVI for relapsing forms of multiple sclerosis toward the end of January and saw a nice sales momentum carried throughout the year, resulting in approximately $90 million in U.S. BRIUMVI net revenue for our first partial year of sales. We believe these first year revenues speak to the high level of early interest and strong underlying demand for BRIUMVI, and we look forward to continued carry-through in 2024 and where we are targeting $220 million to $260 million in U.S. sales revenue.

The feedback from physicians, patients, nurses and infusion centers continues to be very positive and drives our confidence in both the short-term revenue ramp as well as the long-term blockbuster potential of BRIUMVI. Our team remains focused on our ultimate goal of becoming the #1 prescribed CD20 dynamic market share perspective and the early uptake supports our belief that, that is possible. Having said that, this is a competitive market, and BRIUMVI is the newest entry. So differentiation matters. .

One obvious difference is that BRIUMVI is the only anti-CD20 monoclonal antibody that can be given as a 1-hour fusion every 6 months after the starting dose, which may be an attractive profile for both patients want to get back to their daily lives and for health care practices seeking to increase the efficiency within their infusion suites. Beyond the 1-hour fusion, we are excited to continue to explore biological-based differences that may not be as readily apparent, but are perhaps clinically relevant. As a reminder, BRIUMVI is differentiated by design. -- having been glycoengineered for enhanced immune effector cell engagement and efficient B-cell depletion.

Preclinical data demonstrates that compared to the other anti-CD20s approved or used to treat MS, BRIUMVI has the highest binding affinity to CD20, the target for these types of drugs informed on B cells. And through its glycoengineering has the ability to induce the highest level of antibody-dependent cellular cytotoxicity regardless of patient-specific polymorphisms. Whether or not these biological attributes of BRIUMVI have clinical relevance in patients with MS has not yet been determined, as no head-to-head trials have been conducted for BRIUMVI versus the other anti-CD20s.

However, what has been well established is that BRIUMVI is the only anti-CD20 motocolonal antibody to achieve an annualized relapse rate of less than 0.1 in Phase III trials. Also in clinical trials, BRIUMVI rapidly depleted B cells with a median of 96% reduction within 24 hours and 95% on-time infusion completion rate, which we believe speaks to the tolerability profile of BRIUMVI. As we move forward, we are eager to explore to what degree the design attributes of BRIUMVI may be contributing to the robust activity seen. We plan to do more work to evaluate some of these unique attributes and to understand whether the molecular and nonclinical differentiation translates into clinical differences.

And we look forward to sharing more on that when available. I also wanted to highlight another recent exciting development. We were pleased to share yesterday that in addition to our current BRIUMVI patent and U.S. biologics exclusivity, the U.S. Patent and Trademark Office recently issued 3 additional patents for BRIUMVI, including a composition of matter patent related to the glycoengineered attributes of BRIUMVI. With these additional patents, our patent protection now extends through 2042, providing us a nice long runway to continue to explore the full potential of Roambi, including expanding the potential reach of BRIUMVI into MS as well as into other autoimmune diseases, which is a good segue to discuss what is next for BRIUMVI and TG.

First, let me say that the U.S. BRIUMVI by launch and commercialization is and will remain our highest priority. That said, our drug development team is poised and ready to potentially drive additional value through BRIUMVI life cycle management activities as well as new drug development. More specifically, we are focused in 4 key areas: first, in making IV BRIUMVI even more convenient. Last year, we presented the first data from the ENHANCE Phase IIIb trial, of which the goal is to evaluate the safety and efficacy of eliminating the 4-hour BRIUMVI 150 milligrams starting dose, for patients who are switching from a prior CD20 and have a prespecified low level of B cells.

Early safety data from this study is encouraging, and we look forward to presenting additional safety and efficacy data this year, including at the Acton conference, which is happening later this week. A second key area for us is developing subcu BRIUMVI. We have completed our preliminary subcu formulation and are preparing to enter human bioequivalent studies this year. We believe the subcu market could represent a significant new market opportunity for us as the IV and subcu CD20 markets within RMS are rather distinct, given the known profile of the currently available subcu and the profile of the other one under development, we believe there is plenty of room to strive to develop a potentially best-in-class subcu CD20 product.

Third, we are looking forward to expanding BRIUMVI beyond MS. There are multiple other disease indications where CD20 have proven to have utility. We look forward to launching our first autoimmune trial outside of MS this year. And fourth and finally, we are focused on new drug development and are extremely excited by our recent portfolio expansion. Last month, we entered into a partnership with Precision Biosciences to acquire a worldwide license to Precision's azer-cel allogeneic CAR T cell therapy program for autoimmune diseases and all other non-oncology indications. We believe azer-cel has the potential to be a first-in-class, best-in-class treatment for certain autoimmune diseases. As an allogeneic off-the-shelf product, we think azer-cel may offer benefits over autologous CAR T treatments.

Overall, we believe azer-cel is a great fit for us and an important addition to our current pipeline. Azer-cel has been used to treat over 80 cancer patients, and we look forward to hopefully treating the first autoimmune patients with azer-cel as soon as possible with an IND filing targeted for midyear. As you can see, we have put together a thoughtful and exciting development plan for 2024 and beyond that we believe can add significant value to our shareholders. We have been and will continue to be measured and our approach to R&D and from a capital allocation perspective, included in our approximately $250 million in projected 2024 operating budget are the dollars required to expand our BRIUMVI field teams to increase our marketing spend as well as moving forward, all of the current development plans we've just discussed.

With that, as I bring my prepared remarks to a close, I'd like to say how incredibly proud I am of the team and the progress we've made in 2023. We built a top-notch MS-focused commercial team that enabled us to rapidly integrate TG and BRIUMVI into the MS ecosystem. And we will continue to build upon this foundation with TG as a trusted partner to the MS community as we strive to serve the patients we treat to the best of our ability.

Finally, I also want to congratulate our ex-U.S. partner, Neuraxpharm on the official launch of Ryobi in Europe, which took place this week in Germany. We look forward to hearing more about their progress as they endeavor to commercialize ground being Europe and the rest of the world. With that, let me hand the call over to Adam Waldman, our Chief Commercialization Officer, to provide a detailed update of the Baram U.S. commercial launch. Adam?

[Adam Waldman, executive]

Yes. Thank you, Mike, and good morning, everyone. I'm pleased to share with you the results from the fourth quarter and cover the highlights from our BRIUMVI commercial launch performance in 2023. We Launching BRIUMVI last year was a transformational event for our company. We've built a strong commercial infrastructure that delivered exceptional results, exceeded expectations on the launch and now provides a solid platform for which to build potential blockbuster products in MS and capitalize on other autoimmune disease opportunities going forward.

And more importantly, we made a positive difference in the lives of thousands of people living with MS. As reported at the JPMorgan conference last month, fourth quarter net sales for BRIUMVI were $39.9 million, representing 60% growth quarter-over-quarter and bringing our full year 2023 revenues in at $89 million. The fourth quarter number exceeded our guidance and reflects the growing demand we are seeing for BRIUMVI. We saw an increasing number of repeat prescribers and incremental gains in new prescribers and new centers adopting BRIUMVI.

We also started seeing increasing prescribing from major academic centers in the fourth quarter. as the logistical barriers at these centers continue to decrease. In fact, in the fourth quarter quarter was the first time we saw more scripts from academic centers than within the private practice setting, which we view as positive progress given that 60% to 65% of patients are being seen by MS specialists in the academic setting, and this has been a focus for our team as we headed into the end of the year.

Overall, in 2023, we saw approximately 3,200 new patient prescriptions come through our hub, which we believe translates into about 3,500 total new patient scripts as not all new prescriptions will come into our hub. We're also pleased to see a wide distribution of use with new prescriptions coming from over 400 centers and 640 unique prescribers. Encouragingly, we also saw a diverse mix of patient types including those that were naive to all treatments and those that were previously treated and switched from both non-CD20 and CD20 agents. This mix of patient types remain fairly consistent throughout the year with the largest group consisting of patients that were previously treated, but naive to anti-CD20 therapy.

We were also highly encouraged by the persistence of returning patients, which so far appears to be consistent with our assumptions, which was based on what had been seen with the other anti IV anti-CD20 in the market. From an execution perspective, our teams did an exceptional job delivering on our launch plan in 2023. We had a well-designed and targeted launch strategy, efficiently focusing our resources on driving adoption at high-volume targeted accounts where we saw the vast majority of our business.

At this point, approximately 90% of the top 100 centers in the U.S. have utilized BRIUMVI. And with the lowest price of any branded medicine for MS, we prioritize gaining early access and coverage, and we're able to achieve coverage for 95% of commercial and Medicare lives within the first 9 months of launch. We built a best-in-class patient support team and our highly experienced and well-networked field teams have done an incredible job establishing TG as a respected partner in the MS community. We are very proud of our teams and believe their outstanding efforts are contributing to the positive experience with BRIUMVI and continue to build confidence in our organization.

The cumulative facts of what we've accomplished certainly helped to drive momentum that we saw in 2023, and we expect to see that momentum carry forward this year. Looking forward, we see the CD20 market continuing to grow. This class of drugs has transformed the way that MS is treated over the last 5 years with the CD20 share continuing to grow and now capturing approximately 50% to 55% share of new patients every year.

And we would expect that, that will expand even further going forward. We believe this is a continued tailwind for our business. We also expect that most patients and centers will continue to prefer an every 6-month IV dosing schedule. where patients don't have to think about their disease every day or every month and providers have the confidence that their patients are being compliant receiving their medication. We estimate there are approximately 40,000 patients going on a CD20 therapy each year or about 10,000 patients per quarter.

And in the fourth quarter of 2023, we had approximately 1,000 prescriptions coming to the TG Hub, which would reflect approximately a 10% market share if all these patients were infused. Since not all these patients prescribed BRIUMVI will actually be infused these prescriptions through the hub will not translate precisely in the market share. But nevertheless, we do believe this is an indicator of strong early demand for BRIUMVI, especially in our first year of launch. We also believe we have significant room to grow in what is a large and growing and expanding market.

Based on our market research and extensive interaction with neurologists, we continue to believe BRIUMVI's profile remains very compelling and will eventually be the IV therapy of choice in the relapsing MS market. This will, of course, take us time to achieve, but that's very much what we're focused on doing. In 2024, we'll expand our targets and continue to work on educating our customers on the BRIUMVI difference. We'll also continue to ramp up our efforts to increase patient awareness, which we believe can be an important driver in this market.

So far, this year is off to a really strong start, where we have seen record enrollments into our hub in January, and we believe we are tracking towards the upper end of our first quarter guidance range of $41 million to $46 million. And potentially higher if demand trends persist over the next month. We also feel very good about our full year guidance of $220 million to $260 million, which we provided at JPMorgan. We certainly have work to do, but we are focused and extremely motivated to continue to work every day to bring BRIUMVI to those people living with MS and their families. With that, I'll turn the call over to Sean Power, our CFO.

[Sean Power, executive]

Thank you, Adam, and thanks again to everyone for joining us. Earlier this morning, we reported our detailed fourth quarter and full year 2023 financial results. which can be viewed on the Investors & Media section of our website. This morning, I'll start with a discussion of our revenue for the fourth quarter and full year of 2023. As previously mentioned, we are pleased to report U.S. BRIUMVI net product revenue of $39.9 million during the fourth quarter. Also included in our total net product revenue for the fourth quarter is approximately $3.2 million of revenue for products sold to Neuraxpharm in support of the ex U.S. commercial launch and $800,000 of other revenue, taking total revenue for the fourth quarter to approximately $44 million as reported.

For the full year, we reported total revenue of approximately $234 million which is predominantly comprised of $88.8 million in U.S. BRIUMVI net product sales, $140 million in license revenue stemming from the upfront payment for our ex U.S. commercialization agreement with Neuraxpharm and $3.2 million in product revenue for products sold to Neuraxpharm as Delica mentioned. Our OpEx during the fourth quarter and full year has remained well controlled and in line with previously discussed ranges. For the fourth quarter and full year 2023, our operating expenses were $56 million and $213 million, respectively, which includes COGS of $7.8 million and $14.1 million in the respective period.

When excluding noncash compensation, our cash operating expenditures during the fourth quarter and full year 2023 were approximately $47 million and $175 million, respectively. On the back of the reported revenues and well-controlled OpEx, we were able to report net income of $12.7 million or $0.09 per diluted share during the full year of 2023. For the fourth quarter of 2023, we reported a net loss of $14.4 million or $0.09 per diluted share.

And finally, from a cash standpoint, we ended the year with approximately $217.5 million in cash, cash equivalents and investment securities, and we believe our current cash position coupled with our previously guided revenue and expense guidance provides us with sufficient capital to fund our operations to cash flow positivity.

With that, I will now turn the call over to the conference operator to begin the Q&A.

[Operator]

Thank you. The floor is now open for questions. [Operator Instructions] Today's first question is coming from Michael DiFiore of Evercore.

[Unknown Analyst]

This is Jessica on for Mike. My first question is, in the past, you guys have said that you've heard anecdotal reports of patients not petering out in the days and weeks leading up to their subsequent BMV dose, which is not always the case with competitor anti-CD20s. So what's been the feedback on this front? And how much do you see Brumby's consistent treatment duration as a key differentiating factor? And then also if I can sneak in another question. what can we expect on gross to net cadence for the balance of the year?

[Michael Weiss, executive]

Got it. Adam, you want to fill the first one and then I have Sean take the second.

[Adam Waldman, executive]

Persistence, I assume you mean the discontinuation rate for patients going from first or second and season to third infusion. As you know, it's still it's still early, but what I said in my remarks is true so far the trends seem positive and around what we expected based on what we saw with the other IV CD20.

So it's right in that range. I don't have any information right now to say that it's better. I certainly don't have any information to say that it's worse, but it's right where we expected. And we'll continue to look at it. Certainly, if it's more positive than we think, certainly, that will be an accelerator going forward.

[Sean Power, executive]

And on the gross to net front, we have not provided going forward and -- forward guidance on what to expect -- there will be some variability quarter-to-quarter, but again, we haven't provided precise guidance on what 2024 will look like. .

[Operator]

The next question is coming from Ed White of H.C. Wainwright. .

[Edward White, analyst]

So just wondering if you any numbers on the switches from prior therapies and how that's impacting your sales growth? .

[Michael Weiss, executive]

Yes. So I'll start there, and Adam can jump in. We haven't provided anything new. I mean what we've said previously, and it still holds true is that in terms of distribution of patients, we see about -- we have 3 buckets. Just to be clear, there's patients that are naive to all treatment. There's patients that switch from non-CD20 products to CD20.

So there's the nonCD20 to CD20 switches. What we said is that the largest group coming on to BRIUMVI are those that were naive to to CD20, but were pretreated with something else. And then the other 2 buckets, while they're not equal to each other, are relatively similar, and they're they're reasonably close to the first bucket. So usually is that nice distribution across all the buckets.

[Edward White, analyst]

Okay. And Europe, congratulations on getting the launch in Germany. Can you give us your thoughts on the launch in Germany and in other countries and perhaps the cadence of future milestone payments.

[Michael Weiss, executive]

Yes. Adam, you've been [indiscernible] want to take a crack? .

[Adam Waldman, executive]

Sure. So yes, as you know and as we've spoken about before, getting BRIUMVI launch in Germany was really important. It's the biggest market by far in Europe. So getting that going out of the start was important, and we're right on track with that, which is great. The other countries will start to come in the later part of this year into next year, including the U.K., France, Spain, Italy, and they're continuing to work with the reimbursement authorities and getting through the process they need to and making sure the drug can be accessed. They're working diligently on that. They have a lot of experience doing it, and we'll continue to work through the process. But Germany is by far the largest opportunity and the one that we prioritized first. .

[Michael Weiss, executive]

Yes. And then just on the cadence of future milestones. We're not expecting any additional milestones this year. there's a chance we would see a milestone toward the end of next year, an additional milestones, but we'll give more on that later. But I wouldn't expect any additional milestones this year. And as we reported, JPMorgan, obviously, it's a launch year for [indiscernible] phones, and we're not expecting a whole lot of royalty revenues as well.

[Edward White, analyst]

Okay. And just lastly, Adam had mentioned adding to the sales force and expanding your reach. How should we be thinking about that as far as the growth or the ramp of SG&A expenses. Are you currently adding? Is this something that we should see in the second half of the year? Just any guidance that you can give us on how you're expanding your sales force? .

[Michael Weiss, executive]

Yes. So I'll chime in, and Adam and Sean could jump in afterwards. So yes, so as it stands today, even in the fourth quarter, some of that expansion -- actually, most of that expansion is already included of the current expansion process.

So it's already probably built in most of it into the fourth quarter. There'll probably be a little bit more that trickles into the first quarter. And then it's possible over the course of the year, there'll be a slow additional build, but most of it is already incorporated.

And for sure, it's incorporated in our OpEx estimate of approximately $250 million for the year. So that's all built in to what we're guiding already.

[Operator]

the next question is coming from Roger Song of Jefferies.

[Unknown Analyst]

This is [indiscernible] for Roger. What time frame do you think is possible to achieve the #1 prescribed IBC 20 for BB by Dynamic share? And as a second question, -- are there any remaining gating factors for you to enter the human bioequivalent studies for subdue formulations of reinverts .

[Michael Weiss, executive]

Yes. You broke up a little bit at the end there, but I think I got it. In terms of time frame to be #1, we haven't set a time frame yet, so I can't share one. It's a goal that we have, and we're going to keep working toward the -- but certainly, as we get further along, I mean I don't anticipate '24 will be the year that we do that. So I think that's pretty sure about that.

But we are working towards that, and we'll keep it posted. In terms of the subcu development, we do have our preliminary subcu formulation that we want to take into the clinic. We don't think that there's anything in our way to do that. We've got some filings to do, but should be pretty straightforward. And we're hoping to have patients on hopefully by midyear.

[Unknown Analyst]

Excellent. And then maybe as a couple of follow-up questions. Are there -- is there any preparatory work required to enter BRIUMVI into studies outside of -- and as the last question, we've noticed there's still a small number of scripts and third-party trackers. Some investors are still curious about the trends -- maybe we could put this topic to bed for once and all. Do you see any value in the third-party script factor?

[Michael Weiss, executive]

Yes, I would certainly love that. Adam, do you want to hit that one on the third party.

[Adam Waldman, executive]

Sorry. So what I understand is the data you're seeing is SP data which is a very small portion of our business, less than 10%. So yes, to put it to bed, I would say it is absolutely not something that I would look at.

[Michael Weiss, executive]

And then your last question about moving outside of MS. I don't think there's any prework that we need to do. I think it's just logistics of getting it done within the context of all the other things that we have on our plate for this year. So that's probably later in the year event than an earlier year. I think we've got the higher priority projects will be the stuff I talked about, we're trying to make IV BRIUMVI more convenient, the subcu and the azer-cel stuff is probably on a higher priority setting to the earlier part of the year. But yes, I don't see any barriers to go outside of MS. .

[Operator]

The next question is coming from Matt Kaplan of Ladenburg Thalmann

[Matthew Kaplan, analyst]

Congrats on the progress. Just to stay on the enhanced Yes. Just to stay on the ENHANCE Phase IIb switching trial. Can you provide a little bit more information in terms of what we should be looking for from that data as it's released I guess, [indiscernible] and at greater conferences this year. .

[Michael Weiss, executive]

Matt, it's like a day or 2 away really you want to give it all the way Yes. I mean, look, so what are we trying to accomplish? I think it's a fair question. So we want to make it as easy as possible for folks to be able to switch seamlessly from another CD20 on to BRIUMVI. It's no secret doing an extra 4-hour infusion is not the ideal situation for that patient population who are already or B-cell depleted.

So the goal is step 1 is, can you safely take a patient who's on another drug they're B cell depleted and put them on another CD20 without sort of this initial conditioning regimen that we have for the starting dose. So that's step one. So safety is the utmost importance, and that's what we wanted to do. Partly, we wanted to get that done too because we had heard in the field that people were just switching people straight through to 1-hour BRIUMVI. So we wanted to make sure we have safety. .

The next part is, look, I think we would love to get it into the label. We are eliminating 150 milligrams of drug. So there will be an efficacy question. I don't think it's material efficacy question, but it has to be answered. So I think as we move forward, one, what we're looking for, make sure it's safe and well tolerated to switch people directly to a 1-hour BRIUMVI from another CD20.

And there's any signal that we've somehow been losing some activity by eliminating the 150 milligrams. So I think we're still probably in the safety phase of this trial. So I think in a [indiscernible], we'll be looking for more safety information probably by the time we get to [indiscernible], we should be able to have some additional efficacy again, single arm. So the efficacy information will be pretty straightforward, looking at MRIs and just making sure that there's nothing going on that would be surprising.

[Matthew Kaplan, analyst]

Okay. That's really helpful. And then in terms of your plans for BRIUMVI outside of the MS opportunity, can you help us think about how you prioritize the different indications that you're potentially looking at?

[Michael Weiss, executive]

Yes. I mean I think, look, we want to get started probably somewhere in the lupus arena with it. I can't promise that that's what's going to happen. But we do think that there's an interesting opportunity. It also will dovetail nicely as we look to get azer-cel in some of those indications as well. There's a nice synergy of clinical resources. So that's an angle that we're looking at, but I can't promise as the year goes on, we may have additional thoughts, and we may start someplace else.

But we do believe that that BRIUMVI is designed well for large market indications and right behind the azer-cel is designed for the more smaller, sicker kind of patient populations potentially within the same indications.

[Matthew Kaplan, analyst]

Okay. Great. Great. And then lastly, in terms of the recent patents that you announced, can you provide us some more detail in terms of what they cover and providing the protection out to 2042.

[Michael Weiss, executive]

Yes. I mean there's a lot of detail on those patents, but I think there's some substance is that in addition to a new composition of matter patents that covers the glycosylation profile of Bambi plus some use patents within that. We feel good about the 2042 a protection. So we feel that we've got a really nice runway here. But the bonds are issued, they're out there. People can read them, but the overriding concept is that it's a composition of matter plus and used patents and 2042 is a nice move [indiscernible]. .

[Operator]

Next is From Eric Joseph of JPMorgan.

[Unknown Analyst]

This is Noah on for Eric. My question is regard to subcu Brionte how important to drive uptake? Would it be to demonstrate efficacy via relapse rate compared to demonstrating comparability on bioequivalents?

[Michael Weiss, executive]

So the current competitor that's moving from their IV to subcu did a bioequivalence study. We're hoping that we'll be able to follow a similar pathway. So I don't think we're going to need to do a full efficacy study to bring the subcu forward. But that will be definitely subject to more conversations with the FDA. But as of now, the competitor subcu that's moving from IV conducted a bioglobal setting. We think that's an appropriate pathway.

[Operator]

. The next question is coming from Prakhar Agrawal of Cantor Fitzerld.

[Prakhar Agrawal, analyst]

Adam, you said 1Q is tracking at the top end of the guidance range. So maybe if you can give some more details on the January and February trends. Where is the demand growth coming from in terms of patient segments as well as physician segments, Academic versus community?

[Adam Waldman, executive]

Thanks for the question. I'm not going to get into too many details beyond what I said in the prepared remarks. We got off to a really strong start to the quarter. And as I said, we're feeling really good about our guidance to the higher end of that range. And then any other details we'll discuss on the next quarter call.

[Prakhar Agrawal, analyst]

Got it. And do you have a sense of what's the split of Academy versus community patient segments for BRIUMVI? And how do you expect that to trend over time?

[Adam Waldman, executive]

Sure. So in the beginning of the year, as I mentioned, it's probably 60-40 private practice to Academics. In the most recent quarters, it's more 50-50 Academic to private practice. And we are seeing, as I mentioned in the remarks, growth coming from academic centers in the latter half of the year and especially in the fourth quarter. .

[Prakhar Agrawal, analyst]

Got it. And lastly, what percentage of patients who are getting a prescription actually end up getting the infusion? Do you have any additional details on the trend there? And what's the time lag between getting a prescription to getting an infusion right now? And how does it track relative to OCREVUS.

[Adam Waldman, executive]

Yes. So the conversion rate we have it's still pretty early, and we have not given a number on that. It's it's encouraging, but we haven't given a specific number and perhaps in future calls, we'll look at it, but we still think it's very early to be giving that number. And then Prakash, can you repeat the second part of that question?

[Prakhar Agrawal, analyst]

Right. So what's the time lag between prescription and getting the infusion? And how does that trend versus OCREVUS.

[Adam Waldman, executive]

Yes. So I think what I've said in the past, it's about a 6-week time frame from enrollment into the hub into the first infusion. -- approximately. And from what we understand and from what we -- it's very similar to what you see with OCREVUS. There are a lot of things you can control in that process and there's things that are outside your control. We continue to see a trend in the direction we continue to shorten it over time. And so we'd like to see that trend, and we think it's very much in line with what's the competitor product. .

[Operator]

Our final question today is coming from Mayank Mamtani of B. Riley Securities.

[Unknown Analyst]

This is actually a William Wood on for Mayank. Congratulations on the past year and -- in terms of the cash and burn for 2024, how should we be thinking about the spend allocation between your trials? And what's been factored so far into the subcu trial? And then additionally, on the subcu trial, -- do you have any view or frequency of administration or the kind of device that you'll be using for the formulation? And then 1 follow-up.

[Michael Weiss, executive]

Yes. So on the subcu, we don't know yet in terms of the frequency of dosing. I think part of that is just going to be, but let's look at what the conversion is between the 2 from IV to subcu. And from there, we'll be able to design the appropriate dosing interval. Our goal, obviously, we know what the goal course are. We've got once a month from 1 of the subcu products and the other is once every 6 months with a pretty clunky product as far as we could tell. So somewhere in between, we think we'd be very successful. So we're going to try to get there. We won't know if we can until we put the material into people and see how it does and see how they react to it.

[Sean Power, executive]

And on the OpEx guidance, obviously, we've guided $250 million in OpEx for '24. We haven't provided detailed breakdown of how that shakes out. But everything that Mike and the team discussed today is obviously included in that $250 million guidance number. .

[Unknown Analyst]

Appreciate that. And then just 1 last question. You obviously, you've reported multiple new patents, providing protection into 2042, including calm as you just noted, as well as the recent launch in the EU. How should we be thinking about this in terms of potential external parties viewing these events and maybe spurring additional interest in TG.

[Michael Weiss, executive]

Yes, our goal is to build our business. We're not too worried about external parties. I think if you're referring to external parties being investors, I would hope they'd be updating their models to understand the significance of patent protection through 2042 and what that means to the overall NPV of the SAP, other outside parties I'm much too worried about.

[Operator]

At this time, I'd like to turn the floor back over to Mr. Weiss for closing comments. .

[Michael Weiss, executive]

Great. And thank you. And again, thanks to everyone for joining us this morning. As reported, we had a great launch year and year 2, while early is taking shape, and we're excited about our target guidance for this year of $220 million to $260 million in U.S. net sales revenue. Our pipeline and life cycle management activities are in full swing and believe these activities could translate into significant future value for TG. And our recent patent issuance will ensure a long runway to explore the full potential of BRIUMVI.

Finally, I want to thank again the whole TG team for their dedication to serving the MS community and for their incredible efforts on behalf of TG Hope everyone has a very nice day.

[Operator]

Ladies and gentlemen, thank you for your participation. This concludes today's event. You may disconnect your lines at this time or log off the webcast, and enjoy the rest of your day.