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HLS Therapeutics Inc
TSX:HLS

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HLS Therapeutics Inc Logo
HLS Therapeutics Inc
TSX:HLS
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Price: 4.14 CAD 4.28% Market Closed
Updated: May 17, 2024

Earnings Call Transcript

Earnings Call Transcript
2023-Q3

from 0
Operator

Good morning, and welcome to the Q3 2023 Financial Results Conference Call for HLS Therapeutics. On this morning's call, we have Craig Millian, Chief Executive Officer; and Tim Hendrickson, Chief Financial Officer. [Operator Instructions] Earlier this morning, HLS issued a news release announcing its financial results for the 3 and 9 months ended September 30, 2023. This news release, along with the company's MD&A and financial statements, are available on HLS's website and on SEDAR+. Please note that slides accompanying today's call can be viewed via the webcast, a link to which is available in the company's earnings press release and at its website on the Events page. Certain matters discussed in today's conference call or answers that may be given to questions could constitute forward-looking statements. Actual results could differ materially from those anticipated. Risk factors that could affect results are detailed in the company's annual information form, which has been filed on SEDAR+ at www.sedarplus.ca. During this conference call, HLS will refer to adjusted EBITDA. Adjusted EBITDA does not have any standardized meaning prescribed by IFRS. Adjusted EBITDA is defined in the company's press release and annual filings that are available on SEDAR+ and on the company's website. Please note that all financial information provided is in U.S. dollars, unless otherwise specified. I would now like to turn the meeting over to Mr. Millian. Please go ahead, sir. Thank you, Chris.

C
Craig Millian
executive

Good morning, everyone, and thank you for joining us. On our call today, I'll review highlights for the quarter. Tim will follow up with a more detailed look at our financial results and then we'll hold the Q&A session. In Q3, HLS achieved an important milestone. For the first time, we achieved quarterly product sales in Canada exceeding $10 million and had our highest ever total product sales of $13.4 million. This performance was driven by strong growth in Vascepa total prescriptions and prescribers as well as another consistent quarter from Clozaril. In the third quarter, we made good progress executing against Vascepa key priorities such as aligning with Pfizer on changes to our 2024 go-to-market model as well as taking steps towards improving access and reimbursement. We believe the progress we're making has us well positioned for the remainder of the year and into 2024. Regarding Q3 results, on a consolidated basis, Q3 revenue was $16 million. Adjusted EBITDA was $5.1 million, and cash from operations was $5.4 million. Overall, our revenues grew 2% year-over-year, and our promoted product sales in Canada grew 9% in constant currency. Relying on positive cash from operations, we significantly increased the capital allocated to share buybacks in Q3, reflecting our belief that the current share price does not accurately reflect the underlying value of our business. Pfizer once again generated significant adjusted EBITDA and cash flow in Q3. In local currency, revenue grew sequentially by 3%. Was down by 3% or about CAD 300,000 year-over-year. Year-to-date, patient volume is up 1% as growth in Ontario and Western Canada continues to offset modest declines in Quebec. We continue to look at ways of growing Clozaril and are aligning our strategies to address the unique challenges and opportunities on a province-by-province basis. These efforts are being undertaken with 3 objectives in mind: one, expanding the number of patients being put on clozapine treatment in areas where we have leading market share; two, converting business from competitors where there is open access and three, defending market share in our key accounts. One key differentiator that we continue to leverage is our CSAN platform and associated technology with a goal of delivering a superior customer experience. We think our offering helps set us apart from the competition. And importantly, there's data to suggest it may help increase patient adherence. Real-world evidence presented earlier this year at a psychiatric pharmacy conference showed a 32% higher retention rate after 18 months for Clozaril CSAN patients versus those on the leading generic. This data is being submitted for publication and supports the argument for patients and physicians to have product choice. In addition, our own market research has found that nearly twice as many prescribers were very satisfied with CSAN versus generic platforms. Beyond product choice, we continue to believe that clozapine treatment, overall is greatly underutilized. Only about 1 in 4 treatment-resistant schizophrenia patients received clozapine treatment. Coming out of the pandemic, we're looking at ways to partner with psychiatrists and health systems to improve appropriate utilization for eligible patients. Achieving even modest growth in clozapine utilization would result in Clozaril receiving a substantial proportion of that road where we have leading market share, for example, in Ontario. Now let's switch gears and look at Vascepa's Q3 performance. Vascepa generated 44% year-over-year net sales growth in local currency, driven by 89% prescription growth. Q3 growth in scripts and net sales is consistent with our year-to-date growth trend. In the quarter, we saw both continued growth in new prescribers as well as more consistent prescribing from existing riders. In addition to the 86% increase in total prescriber’s year-over-year, we saw a 97% increase in the average number of consistent prescribers. As a reminder, we define consistent prescribers as those physicians who have written a Vascepa prescription in at least 4 out of the 5 prior weeks. This growth came despite seasonal effects where there tends to be a slowdown in prescribing during July and August. Importantly, we saw a strong uptick in Vascepa prescriptions in September, setting us up for what we believe will be a strong finish to the year. An important Vascepa milestone occurred in September as weekly prescriptions exceeded 2,000 for the first time. To add some context, it took 30 months from launch to exceed 1,000 weekly prescriptions but just 13 months to go from 1,000 to 2,000 weekly scripts. We've also seen pickup in new prescriptions starting in September. This NRX chart compares the average NRX or new prescription generated in July and August with the amount generated in September. The favorable trend shows strength coming out of the summer months with continued strong performance in Quebec, along with recent improvements in Ontario. Now I'd like to provide an update on 2 priorities to help drive Vascepa growth and profitability that I introduced on our Q2 call. First, we said we would work with our sales partner, Pfizer, to improve the Vascepa go-to-market model for 2024. I'm pleased to say that we have successfully amended our collaboration agreement with Pfizer with changes taking effect on January 1, 2024. Our partnership with Pfizer is a strong one, and they have shown a willingness to engage collaboratively with us since we began discussions on this issue last quarter. Vascepa is an important product for both partners, and we're excited about the prospect of moving forward together. We believe that with these changes, we will increase the productivity of our sales calls in primary care, while also reducing overall call capacity and realizing cost efficiencies. Our intent is to both improve profitability for Vascepa and invest some cost savings into reaching prescribers through other channels to augment the impact of our direct selling efforts. We look forward to continuing to strengthen our partnership with Pfizer in 2024, and I believe that the best is yet to come. Second, we spoke on our Q2 call about the opportunity to improve access and reimbursement at the provincial level. One area of focus is to improve the long delays being experienced by new patients eligible for treatment under Ontario's public plan. At the time of our Q2 call, the Ontario government lead time for processing new chronic drug requests was 44 business days. We have continued to engage with the province and express our concerns on behalf of patients. While the Ontario government is still reporting backlog, unlike when we reported earlier, we are now seeing a larger number of new Vascepa claims coming through. So progress has been made, but more work is needed to reduce those wait times further and clear the remaining backlog. The good news is that underlying demand is strong, and we continue to support physician offices wherever we can to pull those patients through. As I discussed previously, the goal is to move to a more appropriate and less restricted level of access, employing a limited use or LU code. The LU code vastly simplifies and accelerates the authorization process for a newly prescribed patient. We believe the ongoing delays in Ontario further support our already strong rationale to secure an LU code for Vascepa as the majority of other cardiovascular medicines are reversed this way. To be clear, authorities are under no obligation to provide this level of access. However, we believe it is a question of when, not if, in terms of receiving LU code, and we are actively engaging with provincial authorities at all levels to help make this happen sooner rather than later. We believe that liberating health care providers from the extreme administrative burden of preauthorization paperwork and eliminating excessively long wait times for patients to get on treatment will have a profound impact on Vascepa utilization in the future. One final positive note related to access and reimbursement is that we recently reentered discussions with British Columbia Pharmacare and are working towards finalizing a product listing agreement in that province. Not only is the public market in BC an important one, but there tends to be a strong correlation between private and public access in BC. So we believe there will also be a lift in private coverage once the PLA is in place. We are currently working through coverage implementation with the province and will provide an update on the timing once we get a specific date for product availability under Farman care. Before I turn the call over to Tim, I just wanted to take a moment to also highlight some of the exciting scientific work that's still being supported on behalf of Vascepa. I recently attended the Vascular 2023 Congress in Montreal held in late October. This is a special event that occurs every 10 years. It brings together under one roof, separate conferences sponsored by 6 leading Canadian professional associations in cardiovascular medicine and diabetes. It was a great opportunity for me and our leadership team to engage with many of our key opinion leaders throughout the conference. At the meeting, Dr. [Indiscernible] from Paris presented a poster from REDUCE-IT ACS. This data highlighted the benefits of Vascepa in patients who had a recent acute coronary syndrome prior to randomization into the REDUCE-IT study. Additionally, Professor [Indiscernible] who is internationally respected for his preclinical work establishing the mechanism of icosapent ethyl, which is the active ingredient in Vascepa, presented several posters with relevant new data. Looking forward, our partner, Amarin, recently announced new research from the REDUCE-IT trial was accepted for presentation at the American Heart Association scientific sessions taking place this week in Philadelphia. One of the accepted abstracts of note is an oral presentation on the reduction in first in total CV events following treatment with Vascepa in a unique high-risk patient subgroup with a history of metabolic syndrome at baseline but without diabetes. Over the last couple of weeks, first at the Vascular 2023 Conference and now at AHA, it's been exciting to see the quality of science reporting out and building on the already vast body of evidence supporting the clinical benefits of Vascepa. So to sum up on Vascepa, supported by solid Q3 results, strong trends in prescribing and progress on our top priorities, we are confident that we will achieve fiscal 2023 revenue guidance for Vascepa of CAD 18 million to CAD 20 million. In addition, we expect Vascepa to make a positive contribution to adjusted EBITDA starting in the second half of 2024. With that, I'll turn it over to Tim for a closer look at the numbers. Tim?

T
Tim Hendrickson
executive

Thank you, Craig, and good morning, everyone. Beginning with revenues. Total revenue for Q3 2023 were $16 million, up 2% from $15.7 million last year, bringing year-to-date revenues to $47.2 million, up 3% from $45.8 million a year ago. Within this, excluding royalties, total product sales generated by HLS were $13.4 million, also up 2% from a year ago and just ahead of the previous highest quarter. Canadian product sales for the quarter were $10.2 million, exceeding $10 million for the first time, an increase of 6% from a year ago despite a 3% negative currency headwind as the value of the Canadian dollar was lower than the year before. In constant currency terms, Canadian product sales were up 9% over last year, which is more reflective of the strong fundamentals of this growing business. Sales growth in Canada were led by Vascepa, which was up 44% from a year ago to CAD 4.7 million, a growth rate that is in line with year-to-date growth. Notably, within this quarter, after slower months during the summer in July and August, most of the growth in the quarter came in September after Labor Day. Earlier, we have commented that the growth in net sales would trail the growth in prescriptions as the business adjusted to the addition of public reimbursement, a process that began in the second half of last year. We are seeing that channel split starting to stabilize. Turning to Clozaril. We also reported our strongest clause results of the year in Q3 for both the Canadian and U.S. markets. Canadian Clozaril product sales were up 3% sequentially in local currency, though down 3% year-over-year. For the year-to-date period, Canadian closer sales are down 2%, while the number of patients continues to grow, up 1% over the year. Over time, we expect that net sales will follow the underlying patient fundamentals. Though there are some regional dynamics in gross to net adjustments and business concentration as well as quarter-to-quarter changes in channel inventories. U.S. Clozaril product sales were also up sequentially 3% but were down $300,000 year-over-year as year ago net sales included favorable adjustments for lower rates of returns, while this year included modest erosion in unit sales, partially offset by pricing taken earlier this year as well as an increase in other gross to net adjustments. Royalty revenues were $2.6 million for the quarter, a small increase year-over-year, but noticeably down from the $3.4 million in the last quarter, which included a large onetime milestone receipt tied to the initial sales of Xenpozyme. The long anticipated launch of this fourth product in the royalty portfolio last year was last year, and it is encouraging to see that worldwide sales of this product are growing with Sanofi, the global marketer of the product, reporting strong growth for the quarter in all regions. The royalty term for what is currently the largest royalty in the portfolio will be coming to an end in Q4 so that we expect that royalty revenues for next year in 2024 will be in a range of $3 million to $4 million for the year but forward growing again, driven by growth in Xenpozyme sales. Within operating expenses, cost of goods increased by 38% as a result of the strong growth year-over-year in Vascepa sales. Other operating expenses also increased by 8.5% or $700,000 for last year as a result of the increase in marketing and selling expense for Vascepa, particularly the expansion of primary care selling efforts. Both for the quarter and the year-to-date period, the medical, regulatory and general and administrative costs have remained largely flat year-over-year. With the changes recently agreed with Pfizer for our 2024 primary care selling efforts for Vascepa, we can expect both increased productivity of selling efforts as well as our revamped go-to-market plan. As Craig mentioned earlier, some of those cost savings will be reinvested in reaching target customers through other channels. But overall, we expect a net reduction of about 10% in Vascepa-related sales and marketing expenses, which will contribute towards improved Vascepa profitability in 2024. For the quarter, adjusted EBITDA was $5.1 million. Looking at the 9-month period ending September 30, 2023, the direct contribution to adjusted EBITDA from Clozaril was $21.7 million. For the same period, direct contribution loss to adjusted EBITDA from Vascepa was $7 million. As Craig mentioned, with the planned growth for Vascepa and other changes that we are making, such as the recent amendment to our agreement with Pfizer, we expect Vascepa to make a positive direct contribution to adjusted EBITDA in the second half of 2024. In Q3, we generated cash from operations of $5.4 million compared to $4.2 million for the same quarter last year. Year-to-date, we have generated $12.1 million in cash from operations. Cash and cash equivalents were $21.8 million at September 30, up from $20.7 million at December 31 last year. During the quarter, we amended our credit agreement, which is comprised of a senior secured term loan, a revolver facility and an expansion facility. The syndicate is led by JPMorgan and now includes 2 of our newest banking partners, TD Bank and Canadian Western Bank. Under the terms of the amended agreement, the maturity date has been extended to August 2026, and the balance on the revolver facility at the time of the amendment was combined with the principal amount in remaining on the existing senior term loan for a new senior secured term loan balance. In addition, there is a new revolving facility of $30 million that is currently undrawn and an expansion facility of up to $70 million to support attractive strategic growth opportunities. With solid fundamentals in place, we also continue to de-lever our balance sheet. And at September 30, 2023, the principal amount of the senior secured term loan outstanding was $91.7 million, down from $93.8 million in August when we amended the credit agreement. Purchases under the company's normal course issuer bid were up by more than 3x in Q3 compared to the first 2 quarters of this year as the company has increased its rate of share repurchases. In addition to the 143,000 shares purchased in the third quarter, a further 87,000 shares were repurchased in October since the end of the quarter. The current NCIB agreement expires next week on November 13. Yesterday, the TSX approved a renewal of this agreement that will come into effect for end of the year as of November 14, on largely the same terms. Of note, due to the increase in HLS trading volumes, the renewed NCIB has a 47% higher daily limit on share repurchases, which will be helpful and will support a further increase in share repurchases as there were many trading days in Q3, where we were unable to purchase more shares as we had reached the daily limit.As part of the NCIB, we are also able to participate in block trades that are separate from the daily limit. We see this activity as an important use of capital, particularly at current share price levels, but do not reflect the underlying value of the company. And with that, I'll pass it back to Craig for his closing comments.

C
Craig Millian
executive

Thanks, Tim. To sum up, Q3 was a solid quarter financially and we have made progress against key initiatives to drive Vascepa's growth while accelerating our time line to brand profitability. We also continue to stay focused on Clozaril, seeking incremental growth opportunities while maintaining our strong margins. Our near-term focus is operational excellence to drive the success of our existing product portfolio while seeking to improve the overall financial strength of the business. In parallel, we will remain vigilant in evaluating business development opportunities that meet our strategic and financial criteria, and that might expand our portfolio and scale our business over the longer term. That concludes my prepared remarks. At this point, I'll ask the operator to please provide instructions for asking questions.

Operator

[Operator Instructions] Your first question comes from Rahul Sarugaser, Raymond James.

R
Rahul Sarugaser
analyst

So heartening to see some key changes this quarter. I'm going to start with a big macro one because we can't turn a corner right now without being asked about GLP-1 drugs and given the potential impact around cardiovascular and I'm sure you've been asked about this all the time. So I'd like to get your view on the potential impact of GLP-1 drugs on Vascepa.

C
Craig Millian
executive

That's a great question, Rahul. So certainly, we are monitoring closely the adoption and impact of GLP-1s. Certainly, just coming back from the Vascular 2023 conference, there was a lot of understandable excitement about those treatments. I think regarding the role of Vascepa within secondary prevention, I think we obviously have a very strong data. And I think as we speak to key opinion leaders, they view Vascepa as potentially a foundational therapy for those eligible patients and they don't necessarily see the GLP-1 so much as a consideration or a threat there. I think in the diabetes side, obviously, they're viewed as foundational therapy and have been. And I think the question here is around kind of the value proposition to add a product like Vascepa on top of kind of these effective earlier line diabetes treatments. And there certainly is a compelling case to be made. These are patients that have multiple risk factors, and Vascepa obviously acts mechanistically in a different fashion to mitigate kind of persistent risk above and beyond these other treatments. So it really comes down to making the case to add Vascepa in that primary prevention patient. I think longer term, what's the -- kind of what's the impact from an epidemiology perspective in terms of rates of diabetes and heart disease down the road, it's difficult to predict. I don't think it's necessarily something that will have a dramatic impact in the near term. But I think if we look out many years from now, obviously, there could be a bending of the curve in terms of disease. And obviously, that's a good thing from a societal perspective. But I don't think those sort of macro impacts should affect our near to midterm trajectory for Vascepa, certainly not something in the next few years.

R
Rahul Sarugaser
analyst

That's very helpful. And then just a follow-up question. It's good to see that you've been revising and told them earlier about revising the agreement with Pfizer. Would you also give us a little more color in some of the mechanical changes in that agreement that should help boost productivity?

C
Craig Millian
executive

I think it comes down to basically focusing our selling efforts in primary care on kind of the highest value targets. I think earlier on, we cast a very wide net. And it was clear that a lot of the calls were being made were not necessarily having impact for a number of reasons. And frankly, some of the calls were being made on not very high. I would characterize as high potential prescribers or those that see a lot of Vascepa eligible patients, for example, patients who are already on statins with elevated triglycerides. So what we wanted to do now is really kind of narrow somewhat the size of the universe that we're calling on, but really concentrate that call activity on the highest value targets as well as those primary care physicians who've shown the greatest kind of interest or promotional responsiveness towards potentially writing Vascepa. So we think by doing that, we don't really pay much of a penalty by kind of rightsizing the overall kind of full capacity, if you will. And we actually think there's opportunity by kind of concentrating those calls even more on those high-value, high-potential targets that are most likely to write Vascepa. So that's kind of the philosophy kind of how we do that. There's a number of different parameters that we looked at and that we aligned with Pfizer on, and I won't get into those details, but it was quite robust, quite rational. And I think both parties felt really good about how things netted out and are excited about moving this model forward in 2024. I think the other thing this allows us to do, Rahul, is also obviously take some of those savings to the bottom line, but also reallocate a little bit of that towards other types of channel strategies that, frankly, we haven't been able to invest in. So we think there's an opportunity to even amplify the impact of our direct selling efforts moving forward.

R
Rahul Sarugaser
analyst

Good luck, certainly we'll be looking forward for productivity there.

Operator

Your next question comes from David Martin, Bloom Burton.

D
David Martin
analyst

The first one relates to what Raul just asked. As you're focusing or as Pfizer focuses its efforts, how many primary care physicians will they now be calling on versus what they were previously?

T
Tim Hendrickson
executive

So some of those details will be sorted as we go about it. I think it's a concentration in both the potential to prescriber, but we're also making sure that the focus is right geographically. And ensuring that we're getting, especially in the larger markets of Ontario and Quebec. We're making sure that we're getting that level of coverage. I would expect that the total number of physicians would be down fairly significantly, probably by 1/3.

C
Craig Millian
executive

It's about 25% to 33% in terms of reduction in overall call it, capacity, which will be largely driven by a smaller call universe. Bear in mind, we were calling on it, I believe, in a 4:1 ratio of primary care to specialists. So we'll still be calling on far more primary care physicians than cardiologists and endocnologists. But again, the tail of that, when you look at kind of that bottom 25% or 30%, we're actually very low decile right. And by that, I mean physicians who see a relatively small number of patients who fit the criteria for Vascepa in terms of being on statins, for example. So in terms of -- even though it's a smaller call universe of, say, 25% to 30%, in terms of potential, it's much smaller than that. It's a very small on the actual value of that aggregate group of positions we're calling on because we're just cleaning off again, those the lowest potential writers.

T
Tim Hendrickson
executive

And one thing to add that while there is kind of we're focusing on this group that's still a very large group, but that has higher potential, there's also room for there to be increased productivity, largely as a result of being able to concentrate higher frequency of calls on those higher potential physicians. And so it's not just simply a reduction in areas where I don't think there's any direct loss from that. But it also is concentrating that effort in a way that we should start to see a greater increase in productivity out of that effort.

D
David Martin
analyst

Second question, shifting to the royalties. Do you expect that Xenpozyme will eventually fully compensate for the loss of Emblem when might that occur? And can you say what your royalty is on Xen.

C
Craig Millian
executive

That's a very good question, David. I think we are looking forward to a very, very long path on Xenpozyme. If we look at analyst coverage, there's a very wide range on what the expected results could be. Our own research would probably suggest that it will be at the healthier end of that range. And so we expect that to play out over time. But it's a little soon at this point to get into whether it would reach that level or not. But we are expecting it to grow and to be quite healthy for many years to come.

D
David Martin
analyst

In that portfolio of royalties, are there any others that you're going to be using over the next 5 years?

C
Craig Millian
executive

So it's interesting. What I'll comment there is if you look at the intangible asset note, we comment on the expected useful life for amortization purposes. And obviously, right now, that's been a range that's included something falling off in the very near term. After that, I would think we're looking at useful lives that are in the 7 to 8 years range. So it's a very healthy runway going forward.

D
David Martin
analyst

Switching to Clozaril. You mentioned the modest declines in Quebec. How much is Quebec of Canadian Clozaril? What's the cause of the declines? Will they likely continue? Or can you reverse them?

T
Tim Hendrickson
executive

So I think some of the challenges in Quebec, and this is something that we've talked about a few times. Under Quebec's Bill 92, they've introduced some restrictions that frustrate our ability to secure new patients. The efforts of the team have been really quite astoundingly successful, very, very remarkable efforts that have been very effective at maintaining support for our existing patients in Quebec. We continue to have ongoing discussions with Quebec around seeking a way to reintroduce coverage for new patients. That is the most appropriate thing. Particularly new patients are probably most at risk and most would benefit from being able to be supported by CSAN, so that remains an objective of ours. But even in the interim, we've been doing really quite well. In terms of the size of the business, it's one that's probably directionally consistent with the importance of Quebec was in the country. Our Ontario business is larger, but Quebec would be right up there after that. And so it's where you would expect it. And so it's important. And we're doing really, frankly, very well, all things considered, and hope to restore the opportunity for growth going forward.

C
Craig Millian
executive

David, so the study that I referenced around the impact of CSAN on patient adherence versus leading generic program. This is a very compelling, we think, support for getting an exception to this legislation in Quebec, which we hope in the future will allow us to begin to grow the business in Quebec. For now, it's about maintaining the base that we have. And as Tim said, we pulled out all the stops to support the patients who are on treatment have done a remarkable job of retaining them.

Operator

[Operator Instructions] Your next question comes from Justin Keywood, Stifel Canada.

J
Justin Keywood
analyst

I was hoping just to clarify some early comments on the royalty portfolio. What are the expectations for 2024?

T
Tim Hendrickson
executive

So we're expecting royalty revenues for 2024 to be in a range of $3 million to $4 million.

J
Justin Keywood
analyst

So that would be down substantially from, I believe, it's around USD 11 million in the last 12 months. Is that correct?

T
Tim Hendrickson
executive

That's correct.

J
Justin Keywood
analyst

And what would be the expectation for that royalty portfolio to rebound to the current levels?

T
Tim Hendrickson
executive

That return would be driven by the growth in Xen design. That's a product that was approved and only launched kind of mid last year. Most recent quarter-on-quarter growth has been very positive and encouraging for it reaching potential. I think it's a little early to say whether it gets to be as big as the decline this year, but it certainly will be growing quite a bit over the next few years. And as pointed out earlier, we also expect a very long runway on that.

J
Justin Keywood
analyst

Are there any other initiatives being taken to offset that decline in EBITDA because it's quite substantial, I believe, at around 30% of the consolidated run rate.

C
Craig Millian
executive

So we're aware of that. And actually, our plans for next year called for the growth, both in the top line and kind of a combination of growth as well as some of the cost savings we've highlighted to offset that decline in royalty related to EBITDA. So more to come on that, but we certainly have -- are aware of it and we put plans in place to drive growth as well as move as quickly as we can, for example, with Vascepa to make it a positive contributor to EBITDA. So we're confident that we've got the tools within our current product portfolio to offset any of those declines.

Operator

Your next question comes from George Ulybyshev, Clarus Securities.

G
George Ulybyshev
analyst

Just a few here. On Vascepa, can you share with us a rough split between specialists and general practitioners when it comes to total prescriptions written in the quarter? And are you guys seeing any meaningful uptick in the number of GPs prescribed in the drug?

C
Craig Millian
executive

Yes. So the latest data is total prescriptions are about 2:1 specialists to general practitioners. However, the new prescriptions are about even 50-50. So suggested that the primary care of the general practitioners continue to become an increasingly important component of overall prescribing, albeit at probably a slower pace than I think what was originally projected. And so certainly, we think there's a significant opportunity and we think with the changes to the go-to-market model next year in primary care to really accelerate that rate of prescribing within primary care. And frankly, we see the opportunities to -- there's still a good percentage of cardiologists, for example, that aren't consistently writing Vascepa. So we see opportunity really across the board, but in particular, progress in primary care, but even more to come.

G
George Ulybyshev
analyst

And if Alberta or BC were to go through on the public reimbursement side, how much of a lift in revenue could we potentially see relative to your current peak sales guidance? Is this something you could quantify for us?

C
Craig Millian
executive

So for this year, we wouldn't see it having a material impact just based on the timing. And again, we don't know exactly when that product listing agreement with British Columbia will be finalized. We are in regular contact with them and trying to advance this as quickly as possible. But obviously, the government has whatever priorities they have. So obviously, the sooner we can get that in place, the more impact it will have, we do see it as a positive driver for 2024 and not just on the public side, but because of a very strong relationship with the largest private plan in British Columbia in terms of really tracking the formulary of the public plan, we really see this as kind of a 2 for 1 where getting on the public listing will also drive our performance or at least our ability to have access in the largest private plant as well in BC. So to answer your question, no impact in 2023. But depending on when the listing happens, we expect certainly some upside for 2024.

G
George Ulybyshev
analyst

And has anything changed in the last few months that you guys decided to restart the discussions with the province BC?

C
Craig Millian
executive

I don't think we ever gave up and I think on our last call, obviously, we were disappointed with that the talks installed and actually had stopped at that point. But we never give up. We are committed to making Vascepa available to as many patients as possible regardless of whether they're private or public pay patients. And so we had the opportunity to reengage and again, very encouraged by the progress we've made and looking forward to getting this one to the finish line.

Operator

Your next question comes from David Martin, Bloom Burton.

D
David Martin
analyst

I just want to confirm, I don't think BC in your negotiations can negotiate a lower price than the rest of the provinces. Is that correct? Those aren't the terms that you're discussing with them right now?

T
Tim Hendrickson
executive

So David, we're going to steer carefully here. Of course, the terms are confidential. But you're quite correct. The terms, I'll go back to the letter of intent that was signed with the PCPA, and it is common to all provinces. And so this is not in any way a deviation from that. We're pleased that the progress is being made, and we look forward to this coming about. But we can't really kind of get into the nature of the confidential terms.

D
David Martin
analyst

What is the status of negotiations with Alberta? And when do you expect a resolution there?

C
Craig Millian
executive

It’s ongoing. And I would say I don't anticipate anything imminently with Alberta. Each province, there was some -- even though, as Tim mentioned, there are some commonalities. -- there are some things that are unique. And again, without commenting on the specifics, we're still working through some things there. So I would say ongoing discussions, we don't expect any closure on that, certainly not by the end of this year.

D
David Martin
analyst

Is this like a normal time course for Alberta? Are they usually this slow or is this unusual?

C
Craig Millian
executive

I don't think it's -- each province, there's some unique aspects that without getting into the details are required a little bit more batching forward. And so that's -- again, what's encouraging is we continue to have a dialogue with them. We continue to look to find a solution that meets their needs, and that would be acceptable to us. But yes, I don't know that there's anything unique about Alberta. It's probably just specific to this particular negotiation.

D
David Martin
analyst

And I guess, going back to Justin's question about the EBITDA impact of the Emblem royalty. With all the initiatives you have in place aside from that, do you expect EBITDA margin to be relatively stable next year? Or is it going to take a hit?

T
Tim Hendrickson
executive

So as we're looking forward, we're looking to see growth and actually really quite significant growth on our product portfolio. And we're also looking to see EBITDA grow as well. And so how that plays out in terms of the EBITDA margin, that obviously will vary quarter-to-quarter, but it should be a very, very significant EBITDA contribution.

Operator

There are no further questions at this time. I will now turn it back to Mr. Millian for closing remarks.

C
Craig Millian
executive

Thank you, Chris, and thank you all for participating on today's call. We look forward to reporting to you on our progress in the coming quarters and is speaking with all of you again in the near future. Goodbye. Have a great morning.

Operator

Thank you. Ladies and gentlemen, this concludes your conference call for today. We thank you for participating and ask that you please disconnect your lines.