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# ЕЛН Message Board

• dar200 dar200 Jan 31, 2005 2:25 PM Flag

## Count infusions, not patients

There are a lot of estimated 2005 revenue numbers being posted here which multiply "x" number of patients by \$23,500 per patient.

\$23,500 is for 13 infusions spaced 4 weeks apart. The only patients who will receive 13 infusions in 2005 are those who had their first infusion in the first two weeks of December '04 (essentially just over none) and the first two weeks of Jan '05. Patients who got their first infusion in the last half of January will get their 13th infusion in Jan '06.

To average it out, we can come close by saying a patient who gets a first infusion in January will get 12.5 infusions in calendar 2005. February first infusion (new) patients will receive 11.5 infusions during the year, March new patients, 10.5, and so on.

The above assumes no dropouts, which, of course there will be. There will be the 1% who have a severe reaction to the infusion or Tysabri who will drop out almost immediately, say after the second infusion with severe adverse events. Then there will be a larger percentage, those with persistent antibodies at six months, where maybe half of the estimated 6% will drop out.

To illustrate, assume 5,000 patients get their first infusion in January. 1%, 50 drop out after two infusions, and 150 drop out after 7 infusions. From this group we end the year with 4,800 getting 12.5 infusions = 60,000 infusions, 150 got 7 infusions = 1,050 infusions and 50 got 2 infusions =100. Thus, the January "starters" will result in approximately 61,150 infusions. To get "annualized patients", divide estimated infusions by 13 = 4,704 patients accounting for \$23,500 of revenue each.

To say, for example, that 30,000 patients were infused in the first quarter of 2005 X \$23,500 of revenue each = \$705 million of 2005 Tysabri revenue is just plain wrong. 30,000 different patients on Tysabri, minus a 4% dropout rate will result in ANNUAL revenue of about \$677 million, but it won't all be 2005 revenue.

On the other hand eln/biib record revenue when they ship product to the wholesaler, doctor, or infusion center. So, 2005 revenues will be significantly impacted by product shipped which has not been dripped (filling the channel).

Once the channel is full and growing very slowly, sell-through rate and annualized revenue per patient will be driver of revenue estimates....like 2007 and beyond.

But for 2005 and 2006, filling the channel and "new start counting of infusions" is the precise way to go.

We'll have to see what kind of patient data is released. I hope it is total infusions and "new starts" as well as non-started scripts written.
Regardless of how it is done, I think we are in for some exciting news on 2/8.

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• Thanks for the Ty estimation framework. Clear and useful.

pharmd

• The post was directed to me Rock.

Nemo

• " I did not suggest stuffing. If you think Ty shipments to the infusers will not exceed the drips to patients in 2005, you are too stupid to participate here."

________________________________________________________

Please don't put words in my mouth. Although the post was in reaction to the thread, I was not implying that YOU stated anything.

Otherwise, I guess I'm just stupid.................yeah, right.

Perhaps you should look before you leap. Do an Author search on my ID, and then make your attempt at stardom. To make a blanket statement like you did is folly.

Nemo

• Listen to some of the intelligent posters here. There is a rate of increase in patients day after day, month after month. Trying to figure out the revenue of 2005 is a moving target. But if someone tells you on Feb 1 that number of patients are already on T, then you can take that number times 23,500 to get a current 'run rate'. It is easy for people to relate to and understand. And it is real. And it is the future. Get a grip and let go of your continued ranting of someone else is wrong.

• Just trying to sort out which poster you are calling stupid.
the haint

• I did not suggest stuffing. If you think Ty shipments to the infusers will not exceed the drips to patients in 2005, you are too stupid to participate here.

• Agreed. In my opinion, Feb 8th will be the last time for people to buy shares of ELAN at a "great" price. I couldn't resist buying more last week.

MARVELRULESALL

• You neither agreed nor disagreed, as far as I can tell.

It's a damn good thing too because if you disagreed I'd have to try and give you a good kicking like Peatie is trying to do to Jeanie right now ...

• There will be NO "channel stuffing" with Tysabri. BIIB will need to know EXACTLY how many patients are on the infusion cycle, and if there are any drop outs. Tysabri will not be stocked in a traditional sense. It will be bulk ordered by Neurological Practices, and those bulk orders will be allotted for every 4 weeks.

The supply will be scrutinized until BIIB is sure of a surplus of supply, and after the unprecedented uptake post launch, that won't be for a while.

Nemo

• Both numbers are surely good guages; but; if you're looking at what is actually bought by the channel, which is assumed to be based on need (I'm sure the channels have sophisticated and reliable methods for forecasting demand), then, surely the channel alone is a good enough indicator.

I would expect wholesale to purchase sufficiently to satisfy the required infusions plus some growth rate plus some contingency.

Bit like TA, the one figure is presumed to be representative of the other.

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