Earnings Call
Mannkind Corp (MNKD)
Earnings Call Transcript - MNKD Q1 2020
Operator, Operator
Please standby, we are about to begin. Welcome to the MannKind Corporation First Quarter 2020 Earnings Call. As a reminder, this call is being recorded on May 6, 2020, and will be made available for playback on the MannKind Corporation website shortly after the conclusion of this call until May 20, 2020. This call will contain forward-looking statements. Such forward-looking statements are subject to risks and uncertainty, which could cause actual results to differ materially from these stated expectations. For further information on the company's risk factors, please see their 10-Q report filed with the Securities and Exchange Commission this afternoon, the earnings release and the slides prepared for this presentation. Joining us today from MannKind are Chief Executive Officer, Michael Castagna; and Chief Financial Officer, Steven Binder. I would now like to turn the conference over to your host Mr. Castagna. Please go ahead, sir.
Michael Castagna, CEO
Hello, and thank you, everyone. Good evening. Last we spoke, 17 million people had filed for unemployment and unfortunately that number is probably going to double by tomorrow. I’m optimistic as the country lives up; people can adjust to normal, and we can expect a gradual recovery as things go forward. The one plus for us with COVID is the discussion around A1c control and diabetes, as we've seen a significantly higher death rate of people who go into the hospital with diabetes than those without. This discussion has been elevated as we go forward with our customers considering that the 5 million people on injectable insulin are not reaching their goal and need to do everything they can to achieve that now more than ever. Hence, our mission is to help people control their health and have the freedom to live their life. This has been our focus over the last six weeks more than ever as we continue to talk about control and the dozen webinars that we've done with our commercial sales and marketing team and medical team over the last several weeks. Really quickly, I want to touch on the key things that we've achieved in Q1 despite the impact of COVID happening in early March. AFREZZA U.S. quarterly revenue of $8 million was 58% higher than the first quarter of 2019 and represented the highest quarter of sales we've had to date. There was some stocking of wholesalers, and patient stock-up increased net revenue by approximately $0.5 million to $700,000 as we could see prescriptions accelerating during March. However, research analysts ranged from $6.5 million to $7.7 million with a consensus of $7.1 million. And you can see we certainly beat consensus estimates here in Q1. Our gross margin achieved a record high of 48%, and it has continued to grow more positive each quarter over the last five quarters, up from a negative gross margin historically. Additionally, Brazil unfortunately launched at the wrong time with COVID launching there in Brazil, forcing them to shut down their markets and slowing their progress. We anticipate a second shipment in June at a reduced cost to ensure that we can continue to supply the product that we ship, not only in September, but also get the prices down and sales moving in their market. They, too, are under lockdown. We come out of this surely week to week to understand what's going on and how we can help them succeed. Fortunately, United Therapeutics had their earnings call last week, and we are on track to receive our third milestone of $12.5 million in Q2. And COVID-19, while it has delayed the brief study slightly, we don't expect any submission impact to the FDA on our timeline or additional trials we have to do now and at the end of the year. They were not on the critical path, and they don't appear to be on the critical path as we open up the markets again. UT has done a great job ensuring that when the markets open, we can enroll patients again with ample space and that the protocols are ready to go. I believe that we will finish up the BREEZE study and the other two remaining trials, which are the PK study and the human factor study, as quickly as possible over the summer. On the cash flow front, more good news as we've continued to reduce the cash burn quarter-over-quarter; Steve will share with you shortly, at $11.1 million this year versus $24.1 million in 2019. Overall, I am happy with our continued growth over the past few quarters and excited to see our team move forward. We continue to manage our cash tightly in the new environment we are operating in. I'm going to switch slightly to talk about what we're doing regarding COVID-19 as everyone is asking, what is our response to COVID? Number one, two and three is to keep our employees safe and our patients safe. We've implemented work from home, and we've had travel restrictions since early March. I'm amazed at how smoothly it has been to move an entire company to a virtual work environment. The team has done an incredible job and communication has enhanced significantly. I think everyone is working more hours as they wake up to a Zoom call at 8 o'clock and shut down at 6 or 7 o'clock at night before they can start to read their emails. Number two, we maintain the supply of our life-saving product, Afrezza. The Danbury manufacturing facility is limited to essential personnel only, with the remaining staff working from home. We need to maintain our supply chain. We are in the process of producing finished goods that will carry us for the remainder of 2020 to ensure no supply disruption occurs in the marketplace. Additionally, we want to reduce the strain on the medical system by minimizing in-person healthcare provider visits. We've made a donation of masks to Danbury Hospital. We continue to find opportunities to support our local communities where we operate. In terms of developing treatments for COVID-19, we evaluated four opportunities that I talked about recently. At this point, we've decided not to pursue two of them: one because it likely addresses an OTC product and we won't be able to move forward in our current capacity or under FDA regulations; and the second because it would require approximately 10 to 15 cartridges of inhalation powder, three to four times a day, which is just not a feasible solution. There are two other products that we remain under investigation. I'll continue to watch the marketplace as this evolves to determine if we move these forward. As we've said previously, we're not going to invest a lot of shareholder money on COVID-19, but we will seek outside partners and opportunities to fund these projects while being happy to dedicate our personnel and infrastructure around these endeavors. I'm hopeful that as the vaccine becomes available, we could be one of the partners to develop an inhalable vaccine, similar to what we've seen with the flu. However, we must first find the vaccine before becoming too optimistic. Most importantly, it is crucial that we sustain our business by reducing activities and spend here in Q2 and throughout the year. Many of our vendors have helped us reduce our cost structure in Q2 by taking cuts in their own fees either in this quarter or for the remainder of the year. We reduced the majority of our employees' pay by 20% for Q2, and we were fortunate to receive the Paycheck Protection Program, which helped us preserve jobs as we commenced Q2. Let me share with you some insights as we went into April when we received these funds. Number one, you can see the NRx that we tracked off in February through the first week of March, with the blue line peaking in the first week of March, followed by a downward trend over the last seven weeks. As always, there is usually a lag between new patient starts and TRx entering the marketplace. However, we see TRx starting to be impacted due to the lack of product build-up in demand that we observed in Q1 not happening in Q2. It seems to imply that things are hopefully stabilizing as we move into May and start getting our sales force back into action. Patient retention has held up remarkably well, considering that our NBRx, which are true new brand treatments, have decreased almost 35% through early April. We just opened up seven territories this week and are getting feedback from our reps on what’s happening and how they're being received in the marketplace. We are using these insights to train our sales force going out again next week. We expect to release waves of our employees back into the marketplace weekly as locations open up. Anecdotal feedback has been positive, indicating that our customers welcome our representatives back to the offices. We're using customary protective equipment, checking temperatures, and following good housekeeping guidelines to prevent cross-contamination for our employees who have been exposed to COVID-19. We expect 20 more representatives to go out next week, assuming everything goes well this week and there are no changes in the states that are opening up. This will help us start to drive new access moving forward in the coming weeks and we hope to see stabilization, and ultimately, growth as we enter June and close out Q2. We are continually gathering feedback from the reps. The good news so far is that the small private practice doctors, where we have a disproportionate amount of sales with Afrezza, are limited in welcoming our team, while academic centers and larger health practices remain comparatively more closed off. That is something we will continue to monitor. For those who may not have seen it, the acuity report out there is freely downloadable. I want to discuss some of the market trends we've observed. Overall, COVID-19 had a disruptive market impact across many parts of the healthcare industry. NBRx and new starts are significantly down, and some of the new launches have also been negatively impacted. Patient interactions are down 30% to 70%, depending on the specialty. Telehealth is up considerably, but generally not for new patient starts or changing treatment regimens, at least not in the current environment we are facing. As telehealth continues to gain traction, I see this larger opportunity to help manage people living with diabetes, especially as they might be hesitant to go outside. Regarding NRx timing, we mentioned a pull forward in March. We've seen softness in April, but hopefully we can flatten things out here in May. The 90-day fills have slightly increased, but not significantly compared to other disease states regarding Afrezza. To mitigate these impacts, we have implemented a virtual care model that allows us to have effective interactions with HCPs via Zoom. We have something called Mchats that allow us to conduct one-on-one discussions with doctors and thought leaders. We continue to engage thought leaders and host webinars every week. We had one today, another one on one day last week, and a few last week. We're getting 50 to 100 customers at a time listening to different topics that we're sharing regarding COVID-19, Afrezza, and telemedicine. Our customer experience center is continuing to assist our patients wherever possible. We're also focused on moving our free bridge claims into paid claims, as we believe that 60% to 70% of them can be converted moving forward. We're seeing early signs of this continuing to increase every four weeks. Additionally, we aim to ensure patients experience continuity of care despite job losses. We have a startup program that can provide free medication for up to four months, alongside a copay system ensuring that any commercial patient doesn’t pay more than $15. We launched the specialty pharmacy network in Q1, which now constitutes almost 10% of our sales. We don't expect this to show significant impact on our weekly scripts, as all these pharmacies report to Symphony. Additionally, one of the significant efforts to initiate Afrezza involves ensuring patients receive an ACV1 device, and we've implemented a program to ship these directly to patients to minimize disruption in new patient starts. Although our overall commercial efforts have been disrupted, we expect an unfavorable impact in Q2. We can't predict the ultimate impact of pandemic events on our near-term business. That said, we are planning for success, investing in a new reimbursement support hub that will launch in Q3. We filled the 12 roles that we planned for in Q1 and are finalizing our pediatric protocol with the medical and FDA later this year. So while we can't predict the future, we are attempting to control our destiny as best we can. I'm going to turn it over to Steve.
Steven Binder, CFO
Thanks, Mike, and good afternoon. I’m very pleased to review our first quarter 2020 financial results, which show another quarter of accelerating Afrezza net revenue, increasing Afrezza gross margin, and improving operating cash burn. I'll be discussing select financial highlights and urge you to read the condensed consolidated financial statements and MD&A contained in our 10-Q, which is filed with the SEC this afternoon. Let's start by looking at revenues for the first quarter of 2020. Afrezza net revenue was a record $8 million compared to $5.1 million for the corresponding first quarter of 2019. The 58% increase was generated by volume growth from underlying Afrezza prescription demand, which was up 27%, a favorable mix of cartridges, which I'll explain in the next slide, and approximately $0.5 to $0.7 million from increased buying patterns and patient prescription trends as patients stocked up on Afrezza during the pandemic stay-at-home orders in March. There was no Afrezza international revenue in the first quarter. Gross margins were 43% for the quarter, which fell into our expected range of 42% to 44%, as communicated during our 2019 year-end earnings call. This increase from 38% a year earlier was primarily due to a revised estimate of product returns and an increase in the utilization of our patient copay assistance program. Revenue from collaboration and services was $8.2 million for Q1 2020 versus $12.4 million for the same quarter in 2019. The reduction in revenue was mainly due to the recognition of the $10 million United Therapeutics research agreement over the period from the fourth quarter of 2018 to the second quarter of 2019, as our performance obligations were substantially completed. To date, we have recognized $45.6 million from the United Therapeutics license agreement and $9.8 million from the United Therapeutics research agreement, totaling $55.4 million recognized overall. The next slide shows how our favorable product mix impacted our Q1 revenue growth. When comparing cartridges, our 12-unit cartridge is priced three times higher than the 4-unit cartridge and the 8-unit cartridge is priced two times higher than the 4-unit cartridge. In this slide, we use 4-unit equivalent cartridges for easy comparisons of growth rates and to show the favorable impact on Afrezza revenues from cartridge mix. The bars on the right show that the most expensive 12-unit cartridge had the fastest growth at 73% versus Q1 2019, followed by the 8U at 60% and the 4U at 42%. The faster growth of the higher unit cartridges reflects a higher growth rate of Afrezza revenue. On the Afrezza gross profit and gross margin, this slide shows gross profits steadily increasing from $1.1 million in Q1 2019 to $3.8 million in Q1 2020. In the green box below the gross profit, the gross margin for Q1 2020 was 48%, which has also been steadily growing since the beginning of 2019. The primary reason for rising gross profit and gross margin is attributed to increased Afrezza revenue. As you’ve seen more on Afrezza, the cost of goods sold has remained relatively flat, given the production volumes being lower than our production capacity. We don’t see significant variations in the cost of goods sold by quarter since a majority of manufacturing expenses are recognized as cost of goods sold in the quarter incurred. This slide shows how we utilize cash and operate activities in Q1 2020 and throughout all four quarters of 2019. The lighter magenta bars represent Afrezza net revenue from Q1 2019 to Q1 2020. The bottom bars represent the non-GAAP net cash used in operating activities. You’ll see a steady reduction in net cash outflows quarter-over-quarter, demonstrating our careful management of spending while benefiting from increasing Afrezza net revenues. Non-GAAP net cash used in operating activities was $11.1 million in Q1 2020 compared to $24.1 million in Q1 2019, marking a 54% reduction in net cash used, primarily due to a $9.3 million expenditure in Q1 last year on direct-to-consumer TV advertising, which was not repeated in 2020. We also reduced spending on a range of promotional and marketing activities, along with personnel and employee-related costs, which contributed to the lower cash burn in Q1 2020. I’m proud of our employees' awareness regarding the importance of cash management. In conclusion, we have had a solid start to 2020, despite the headwinds from the COVID-19 pandemic. As Mike just described, we have mitigated the impact of the pandemic on the company by pulling back on spending, receiving fee reductions from vendors, implementing a pay reduction for most of our employees, and obtaining the PPP loan. We will remain proactive in navigating the company through the uncertainty presented by the pandemic and will take appropriate actions to ensure MannKind continues moving in the right direction for all of our stakeholders. Thank you, and I'll turn it back over to Mike for additional comments.
Michael Castagna, CEO
Thank you, Steve. On the next slide, you can see that our TRx has continued to grow, supporting our sales force infrastructure from Q1 2017 to Q1 2020. We typically see a slight dip in Q1 versus Q4. This year was no different, albeit much less than last year. However, we expect this to recover as we progress throughout the year. Here, we may see a flattening in Q2 followed by a pickup as we move to Q3 and Q4. We've done everything we can to ensure success coming out of COVID, leading to a growth trajectory where you see a 3x growth from prescriptions and a doubled revenue based on that growth. For instance, we saw quarterly net revenue jump from $1.2 million in 2017 to over $8 million here in 2020—a 7x growth in revenue. We don’t foresee any drastic shifts in this trajectory; we are focused on pushing forward beyond 2020 to overcome the COVID-19 bumps we are facing. A lot is happening, and we are progressing; we are ensuring our resources align efficiently, while reducing costs wherever necessary to maintain demand and advance this company. Our virtual shareholder meeting is set for May 21st. I want to remind everyone to vote their shares and to sign in 10-15 minutes before the start with their control number to ask questions. It will be crucial for attendees who want to interact. There are five proposals on the agenda. The collection of our new directors utilizes live updates. We've recently added two new directors, while one of our older directors has chosen not to face reelection. We are also seeking to increase our authorized common shares; we are down to about 20 million shares in our authorized capital, which was less than three years ago. We said those shares would last approximately three years. We are looking to amend the 2018 equity incentive plan that allows compensation for non-executive officers and is up for ratification. I want to thank all our shareholders for your patience during this trying time. I believe the company is moving in the right direction, taking appropriate actions. Q1 reflects a strong indication of what is to come as we continue to build this company and help more patients with Afrezza while advancing TrepT and our international expansion. I want to thank our employees, especially in the commercial, finance, and HR teams, as they moved rapidly to secure the PPP loan, which helped preserve jobs. Our employees are operating under extremely challenging conditions, maintaining Afrezza production to support TrepT's progress and preparation for FDA filing later this year. The R&D team is simultaneously working on TrepT and addressing COVID-19 as well as pipeline opportunities. Our sales and medical teams are communicating and collaborating like never before. More than ever, I’m excited about the teamwork we are witnessing. Here is just a thumbs-up from our two team members who were out in the field yesterday, Scott and AJ. Thank you for all your hard work, and thank you to our employees who are beginning to return to normal operations. Thank you, everyone. I think we will move to questions.
Operator, Operator
Thank you. We'll take our first question from Brandon Folkes with Cantor Fitzgerald. Please go ahead.
Brandon Folkes, Analyst
Hi. Thanks for taking my questions and congratulations on all the progress during the quarter. Firstly, can you just talk about the impact of COVID-19 on your ability to onboard and potentially train new patients? You've talked about the sales force going back to work, but maybe in April, how should we think about that as the sales force ramps back up? Secondly, could you elaborate further on what drives growth in the high unit cartridges? Thank you.
Michael Castagna, CEO
Great. Great question, Brandon. I think we definitely saw a drop of about 35% in new to brand starts due to fewer patients being seen by doctors, with even fewer undergoing in-office visits. Many have turned to telemedicine, primarily to maintain care. I wouldn't say people are actively looking to change their care. However, we have started conversations with providers and have implemented the ability to ship ACV1 directly to patients, complete with instructional videos showing them the ACV1 result to ensure compliant new patient enrolments. This program launched just last week, and we are already shipping devices days later. I believe we can continue onboarding new patients and getting doctors to start them. Regarding training new patients, maintaining proper initial usage is vital. We've developed a virtual training program allowing patients and doctors to receive real-time support from the company. We are leveraging new technologies while seeking new opportunities, and we'll continue to evaluate these as markets reopen. Right now, our team is fully equipped to onboard new patients, which is crucial for our future growth. We expect the process to be slower than in Q1, but we are currently witnessing around 100 to 150 new patients weekly, which is essential as we move through May and June. The growth in higher unit cartridges derives from two primary aspects: the drug's initial struggles were primarily due to under-dosing as doctors could not align the four unit cartridge with a four unit injectable. The goal of the medical and commercial teams has been to push for higher strengths of 8s and 12s rather than only 4s and 8s. This effort reflects our commercial strategy and the medical team's success in providing accurate dosage information to providers, resulting in this upward trend over the years. This growth reflects our effective execution in the growing demand.
Brandon Folkes, Analyst
Great. Thank you very much.
Operator, Operator
Thank you. We'll now take our next question from Steven Lichtman with Oppenheimer and Company. Please go ahead.
Steven Lichtman, Analyst
Hey. Thanks. Hi guys. Mike, regarding the seven territories that you will be opening this week, could you explain that a little further? Are these areas that are opening to in-person patient visits, or does it mean that your sales reps can go in, or perhaps both? And was this the first group of territories to open up?
Michael Castagna, CEO
Steve, you’re coming in very unclear; maybe it’s the mask. I think your question was whether it's the first week we are opening up and how feedback from the seven reps looks. Is that right?
Steven Lichtman, Analyst
Yeah, just trying to understand what the seven territories opening up means. Are those locations now open for in-person patient visits, or can your sales reps enter, or is it both? I want to clarify what that means.
Michael Castagna, CEO
Absolutely. Our definition of 'open up' refers to states compliant with their various stay-at-home orders that are beginning to allow individuals back to a sense of normalcy, and we are initiating this as a pilot week where we had seven reps cross over four states. In some of these states, we lack representatives, so they aren’t relevant, but in two states, we had seven reps. Establishing contact and attempts to set up lunches is being evaluated on its appropriateness and whether doctors are allowing reps and if their offices will even open. One example, even though Atlanta is reopening, doctors are not planning to see patients until late May or early June. While our reps could be distributed, there aren't many accessible locations since doctor offices remain closed. In the South Carolina market, we did find opportunities that allowed our sales force to meet customers, who were very happy to see our team again. This feedback has been encouraging. In some areas, we received feedback that integral academic centers and larger healthcare networks are still relatively closed off, which is an area we will monitor. This feedback is beneficial since the majority of our business is conducted with private practice doctors; those practices are the first to open, as they also have to operate. This is only 72 hours into the pilot, so there isn’t too much additional data, but the preliminary responses seems promising. Our reps have been following appropriate protection protocols to avoid exposure to other patients in the doctor’s offices. Additionally, we expect another 20 reps to go out next week, assuming all goes well this week and there are no further changes in the states opening up, which will help establish access as we proceed into more weeks. This could lead us toward stabilizing and hopefully growing as we head into June and wrap up Q2.
Steven Lichtman, Analyst
Got it. Thanks, Mike, for the color. Now shifting to the expense side, your gross margin expansion continues to impress. Steve, at what revenue level should we expect absolute costs to start to rise? Also, I know you're not providing guidance, but do you have directional insight you could share on collaboration revenue in the coming quarters?
Steven Binder, CFO
We don't give forward-looking guidance. However, I will note that we’ll continue to see gross margins expand until we need to increase our manufacturing capacity, such as adding shifts or production lines for Afrezza. Regarding guidance on collaboration revenues, that is being amortized roughly on a straight line until the end of 2021. Thus, if you're modeling, you should expect relatively consistent amortization of that revenue on our revenue line through the end of that period.
Michael Castagna, CEO
Steve, I would generally say that for the next three to four quarters, you shouldn’t expect any shifts to occur within the manufacturing line, like adding additional shifts. The factory is structured for scale, and I believe we still have some expansion opportunities and productivity improvements available before needing to hire more shifts. While this may change regarding how we pace for TrepT production, we have time to think about where we need to adjust staffing and capacity planning. So I would assert that looking ahead over the next few quarters evidence reflects a consistent range per the information Steve provided.
Steven Lichtman, Analyst
Got it. And finally, you mentioned some steps have been taken to reduce SG&A costs, which have already decreased significantly in Q1. Based on the new actions you’ve implemented, should we expect further reductions in absolute costs for Q2?
Michael Castagna, CEO
Yes, our goal is to continue improvements this year. We are running the company very tightly. Occasionally, one-off events impact results; for instance, annual bonuses are paid in Q2, which makes year-over-year comparisons more relevant than quarter-to-quarter. Insurance renewals occur for directors and officers' insurance in August each year, meaning certain onetime events arise, creating challenges for quarter-to-quarter comparisons. However, you can see that we are aiming to manage costs closely. The team has done an incredible job keeping our operations lean; we conserve talent when employees leave without always rushing to fill those positions. Every dollar is being directed toward revenue-generating opportunities, and any further beneficial trends will help us to bolster our movement toward getting this product into patients' hands effectively.
Steven Lichtman, Analyst
Thank you, guys. I appreciate it.
Michael Castagna, CEO
Thank you.
Operator, Operator
Thank you. We’ll take our next question from Thomas Smith with SVB Leerink. Please go ahead.
Thomas Smith, Analyst
Hi, guys. Good afternoon. Thanks for taking my questions. I just had a couple. First, this is obviously a difficult operating environment out there. Can you provide more information on what you’re doing to stay engaged with existing Afrezza prescribers? Additionally, what actions are you implementing for patients facing unemployment, who have perhaps lost their insurance during this time, to retain them on Afrezza?
Michael Castagna, CEO
Sure. I actually have David Kendall here. David, would you like to share a few words about how we’re connecting with our support leaders to maintain engagement?
David Kendall, Medical Team
Thanks for the question, Thomas. It’s actually been a unique opportunity for us to connect with providers during their downtime as they have had a bit more breathing room in their schedules. For many, this isn't the situation they were looking for, given lower patient volumes, but both personally and our medical team have had opportunities to engage active prescribers and discuss how they can continue administering Afrezza safely. Many have questioned the utilization of Afrezza therapy alongside typical upper respiratory infections, and we are providing essential remote support to demonstrate properly. Therefore, we are facilitating pulmonary function testing and supporting virtual onboarding for patients continuously. We have been maintaining our medical engagement effectively and coordinating closely with our commercial team to help navigate these dynamics.
Michael Castagna, CEO
I can confirm I have been personally emailing a list of about 700 providers, sending updates every six to ten days. Feedback on the topics is positive—we recently conducted a telehealth webinar a couple of weeks ago; many people could not join, requesting another opportunity. We hosted a follow-up session this past Monday with over a hundred participants, involving many excellent questions and thought leaders. We conducted another successful session this morning with Steve Edelman and Dr. Nick Argento from Maryland, drawing around 60 to 70 providers' participation. We continue looking for ways to keep our customers engaged with Afrezza top of mind, providing valuable outreach as they contemplate their business model adjustments in reduced patient volumes or optimizing telehealth and in-person sessions. We strive to bring them quality information in these challenging circumstances. We've maintained strong engagement with prescribers and are thrilled that we are hearing from some who hadn’t reached out in a year, demonstrating their evolving perspectives regarding Afrezza and patient populations. I feel really encouraged by their attitude shifts. Our growth trajectory seems promising as we progress through this period. Regarding unemployment, our team is actively monitoring and preparing for some programs we will announce next week. Believe it or not, we have not received inquiries regarding job losses impacting access to Afrezza! That said, I will follow there are several options available if someone requires Afrezza—we have a startup program that we are willing to adapt to cover expenses immediately. There’s also a copay program ensuring any commercial patient pays no more than $15, so we aim to alleviate financial burdens. We’ve launched a program to ensure broader accessibility, and we will keep close tabs on any shifts in coverage as these trends develop.
Thomas Smith, Analyst
Thanks for the helpful color. Can you detail the Paycheck Protection Program funds? We've seen some companies in the space return loans that are inconsistent with the Treasury Department guidelines. Can you discuss how you view these funds and whether you believe you might need to repay based on updated guidance?
Michael Castagna, CEO
We’ve been following the news concerning the Paycheck Protection Program. As of now, over 340 public entities have received these funds, with about 42 returning them; the vast majority went to non-public entities due to public companies often failing to meet the various specifications outlined. However, we qualify as the sort of small business that this program was intended to protect; we have 233 employees, falling well within the 500-employee threshold established. The PPP loan has been critical in supporting our ongoing operations given the economic climate, particularly with roughly 50% of our costs tied to personnel. When we decided to apply for this loan, we’d seen NBRx's and NRx's decline and knew the economic landscape wouldn't look good for Q2, prompting crucial decisions. When the stay-at-home orders began to take effect, it spurred us into action, working through the complexities presented by accessing this funding for public companies. Ensuring proper funding to maintain our workforce became essential, and needing to offset declining revenue — particularly concerning potential layoffs — would have been detrimental. We were indeed excited to safeguard employees’ jobs, allowing us to continue forward with our business plans and even take on new hires as they arrived. We cautiously await any forthcoming guidance from the FDA and the government regarding the appropriate use of these funds moving forward. For now, we believe we made the right choice in taking advantage of these funds, thus protecting our workforce, and ensuring MannKind continues on a solid trajectory. We will keep monitoring as the situation unfolds.
Thomas Smith, Analyst
Great. Thanks, Mike. Appreciate the color.
Operator, Operator
Thank you. We'll take our next question from Bert Hazlett with BTIG. Please go ahead.
Bert Hazlett, Analyst
Thanks. I doubt it later. Maybe I missed this, but it seems as if United Therapeutics is increasingly bullish on the prospects for TrepT and its expansion beyond the current market they are focused on. Could you just remind us how TrepT specifically can participate in that and plans to do so in the expanded market?
Michael Castagna, CEO
Hey, Bert. When we entered our deal with United, we anticipated that the trial was set to yield positive results. The WHO three criteria shows that the market for Tyvaso is vast, and we believe our TrepT program has significant potential to penetrate that space as well, especially considering the easier delivery platform we offer and the minimal backup supplies required. We went into this partnership confident in the benefits of Treprostinil and pulmonary hypertension, but now additional benefits from market expansion are extremely positive for both parties. As we continue forward on this trajectory, we are closely considering the manufacturing and capacity needed to meet this new demand while ensuring we support current trials like BREEZE but also preparing for additional indications such as interstitial lung disease. We're thrilled about Tyvaso's possibilities; we think it will be a critical driver of the company’s future growth, ensuring consistent revenues as we continue to move forward.
Bert Hazlett, Analyst
Thanks.
Operator, Operator
Thank you, and that does conclude today's question and answer session. I would like to turn the conference back over to management for any closing remarks.
Michael Castagna, CEO
Thank you again, everyone. We have the ADA conference coming up, which has moved to a virtual format, as well as Endo 2020. Our team is organizing many one-on-one virtual sessions with all key stakeholders. We have datasets being released at these conferences alongside ongoing publications, all while preparing for the launch of BluHale's patient edition and the professional in-office editions. We're excited about these opportunities as they will aid in our training endeavors for patients. We remain optimistic about our trajectory as we manage through the pandemic, while tracking weekly scripts and anticipating their stabilization over the next three to four weeks as healthcare providers begin to reopen and patients start returning for treatment. Despite the challenging times, we’ve persevered remarkably against the escalation of situations we encountered four to six weeks ago. Hence, I am overall optimistic. Thank you, again, to our shareholders, our employees, and all the supporting staff who stood by us here. We expect to emerge from this even stronger than before. Thank you.
Steven Binder, CFO
Thank you.
Operator, Operator
Thank you, that does conclude today's conference. Thank you all for your participation. You may now disconnect.