Earnings Call Transcript - TARS Q1 2025

Operator, Operator

Good day, ladies and gentlemen, and thank you for standing by. Welcome to Tarsus First Quarter 2025 Earnings Conference Call. At this time, all participants are in a listen-only mode. After the speakers’ presentation, there will be a question-and-answer session. As a reminder, this conference call is being recorded. At this time, I would like to turn the conference over to Mr. David Nakasone. Sir, please begin.

David Nakasone, Speaker

Thank you. Before we begin, I encourage everyone to go to the Investors section of the Tarsus website to view the earnings release and related materials we will be discussing today. Joining me on the call this afternoon are Bobby Azamian, our Chief Executive Officer and Chairman; Aziz Mottiwala, our Chief Commercial Officer; Jeff Farrow, our Chief Financial Officer and Chief Strategy Officer; and joining us for the question-and-answer session, Sesha Neervannan, our Chief Operating Officer. I’d like to draw your attention to Slide 3, which contains our forward-looking statements. During this call, we will be making forward-looking statements that are based on our current expectations and beliefs. These statements are subject to certain risks and uncertainties, and our actual results may differ materially. I encourage you to consult the risk factors contained in our SEC filings for additional detail. With that, I’ll turn the call over to Bobby.

Bobby Azamian, CEO

Thank you, Dave. Good afternoon, everyone, and thank you for joining us. 2025 is off to a tremendous start in terms of both patient impact and the exceptional sales growth of XDEMVY. I am pleased to share that in the first quarter, we generated more than $78 million in XDEMVY sales, a year-over-year increase of 217%, driven by approximately 72,000 bottles that were dispensed to patients. The results we have delivered to date demonstrate the impressive executional ability of our team to establish an entirely new market and foster its growth. They also highlight the difference and positive impact we can have on the millions of patients we aim to serve on our way to becoming an eye care leader. Aziz will provide more specifics on our commercial achievements this quarter, future plans for our innovative direct-to-consumer campaign, and the team’s ongoing efforts to build even more momentum. Having just come back from visiting doctors in Cincinnati, I wanted to share my personal perspective on how different it is to be in the field today versus a year ago or even a quarter ago. MDs and ODs are looking for more dry eye patients and beginning to prescribe XDEMVY across all patient segments, including MGD, dry eye, cataracts, and contact lenses. They are now fully empowered by the high-quality access we secured across all payer channels and our high-touch patient services that ensure patients can receive XDEMVY at a reasonable cost. Patients are beginning to ask about the product after seeing our unique and action-oriented direct-to-consumer campaign. I also heard from several of the eye care providers I visited that XDEMVY is one of the best advances they’ve seen in decades and has become their new standard of care. It is clear our growth drivers are having a significant impact, as our target physicians are rapidly moving from monthly to weekly to daily prescribing. We strongly believe we are just beginning to scratch the surface on the maximum prescribing potential for all our prescribers. While our immediate focus remains on the U.S. launch of XDEMVY, we are also continuing to explore the global potential of XDEMVY and pursuing our next category-creating opportunity, Ocular Rosacea. We recently presented meaningful new data at the American Society of Cataract and Refractive Surgery, which showed that the high prevalence and significant impact of Demodex blepharitis in Japan is on par with the U.S., meaning there are millions of people in Japan suffering from Demodex blepharitis and in need of XDEMVY. We are confident about the potential opportunity here and look forward to meeting with regulatory authorities in the second half of this year to determine our best path forward in this region. We are also making great progress in Europe. As a reminder, due to the stellar clinical data and product profile of XDEMVY, the European Medicines Agency has stated we do not need to conduct a Phase 3 study, and we remain on track for potential European regulatory approval in 2027. Turning to Ocular Rosacea, the more we learn about this pervasive and damaging eye disease, the more excited we are about its potential to be the next transformative category in eye care. We are consistently hearing from ECPs that they are seeing as much Ocular Rosacea in their practices as dry eye and that it may be even more impactful to their patients in terms of how they look, feel, and see. Like dry eye, Ocular Rosacea is a large and underserved market affecting approximately 15 million to 18 million Americans, with the majority of cases caused by an infestation of Demodex mites. It can also be quickly and simply diagnosed in any standard eye exam by looking for inflammation and redness. These are just a couple of the many parallels to Demodex blepharitis that give us great confidence in our ability to deliver another impactful therapeutic that targets the root cause of the disease. The potential medicine we are advancing is TP-04, a convenient sterile ophthalmic gel formulation of our best-in-class molecule, lotilaner. It is specifically designed to be used around the eye, and the ECPs we have spoken with are excited about this approach. We are accelerating this program as quickly as possible and remain on track to initiate a Phase 2 trial later this year. Finally, I’d like to highlight our recent equity financing, which secured approximately $135 million—no small feat in the current market environment. The significant support that our existing and new shareholders demonstrated through their participation in this upsized equity offering speaks to the confidence they have in the potential value of XDEMVY and our pipeline. These funds further strengthen our financial position and will enable us to continue to drive the growth of XDEMVY, potentially create another new category in Ocular Rosacea, and continue to advance our pipeline. There is clearly a lot to be excited about. We have a proven category-creating blueprint for success. We are advancing a pipeline of category-creating medicines that could potentially be the standard of care, and we believe that we are well positioned to achieve substantial and sustained revenue growth for years to come. With that, I will turn the call over to Aziz.

Aziz Mottiwala, Chief Commercial Officer

Thanks, Bobby. From the beginning, we have said that category creation provides great opportunity. It also requires a tailored, custom-built strategy that delivers consistent and increasing growth through a surround sound approach of education, ease of access, and flawless execution, all of which we are delivering. Our strong Q1 results exceeded our expectations even in the face of the typical headwinds like the annual resetting of deductibles and the impact of holidays and medical meetings. In the first quarter, approximately 72,000 bottles of XDEMVY were dispensed to patients, and we generated more than $78 million in net sales, a quarter-over-quarter growth of 18%. These results were principally driven by our recently expanded sales force, which is just beginning to demonstrate their ability to reach our target universe of prescribers more frequently and more effectively. Their efforts to drive awareness and change practice patterns have led to a profound shift from monthly to weekly prescribing. At the end of the first quarter, we saw an increase of approximately 110% in the number of ECPs, which is now in the thousands, writing more than one prescription per week compared to the end of Q3 of 2024. We saw very similar increases in daily prescribing as well. This increase in routine prescribing clearly underscores the value of this first-in-class therapeutic and the importance of an optimized sales force. What’s even more encouraging is knowing that while we made remarkable progress again this quarter, we still have millions more to serve. Our top prescribers say they haven’t even come close to reaching their limits, and there are thousands more of our target ECPs who have the capacity to prescribe XDEMVY every week and every day. Our success this quarter was also driven by broad commercial and Medicare coverage and the growing impact of our direct-to-consumer advertising campaign. We began the year with more than 90% of commercial and Medicare lives covered. This remarkable access has all but eliminated the most significant hurdle to physician adoption, and we are now seeing both an increase in ECP prescribing and patient access, particularly among Medicare patients. We are also well on our way to making XDEMVY a household name, thanks to the impact of our innovative DTC campaigns, coupled with our surround sound approach to physician and patient education. In the first quarter, we expanded our effort from streaming platforms into network television, which increased the average weekly website visits by 140% in March 2025 compared to December 2024. We’re also seeing thousands of patients taking the dry eye quiz every week. Given these strong results, we have a lot of optimism and confidence as we look to expand this effort even further through the end of the year. As Bobby mentioned, we just came back from the ASCRS and heard from several doctors that patients are starting to ask for XDEMVY by name. While this is really exciting, keep in mind that every patient journey is different. For the vast majority of patients, they typically need to see the ad multiple times, eventually make an appointment, and then fill the prescription. As we look at the second quarter and step into the next phase of the launch, we are confident we’ll begin to see even more benefits from the growth drivers we implemented last year. First, the sales force—after essentially two quarters under their belts, they are just beginning to hit their stride. Second, the benefits of broad access; with more than 90% of all lives covered, we have eliminated a major roadblock to access and expect to see an ongoing increase in patient volumes. Third, our action-oriented DTC campaign; frequent airing on streaming and network TV, supported by our digital and social efforts, is meaningfully increasing website traffic and patient engagement. Finally, our ongoing evidence generation, as illustrated by the new data highlighting the global prevalence and real-world patient burden of dry eye and the recently presented MGD data in dry eye patients, which is expected to further drive utilization across all patient segments. With these in place, we are confident that we will continue delivering consistent and increasing growth in one of the fastest-growing categories and firmly establish our position as the next leader in eye care. I’ll now turn it over to Jeff Farrow, our Chief Financial Officer and Chief Strategy Officer, to discuss our financial results. Jeff?

Jeff Farrow, CFO and Chief Strategy Officer

Thanks, Aziz, and good afternoon, everybody. Tarsus’ first quarter performance reflected both our executional strength and our team’s unwavering dedication and commitment to patients. XDEMVY net product sales were $78.3 million, driven by approximately 72,000 bottles dispensed to patients and a gross to net discount of approximately 47%. As a reminder, we recognize revenue when XDEMVY is shipped from our warehouse to the distributors, not based on the bottles dispensed to patients. Additionally, we ended the quarter with approximately 2.5 weeks of inventory in the channel, which is in line with previous quarters. The gross to net discount of approximately 47% reflects the excellent coverage we started the year with, as well as an adjustment to our estimate for the Medicare accrual for the fourth quarter of 2024. This adjustment made in the first quarter resulted in a reduction of the discount of approximately 1%, or approximately $1.5 million. Absent this adjustment, our gross to net discount for the first quarter would have been about 48%, which is in line with what we guided to on our previous earnings call. From a U.S. GAAP perspective, gross to net accruals in any given quarter are based upon estimates that are trued up upon subsequent invoices and data received. Continuing through the P&L, total operating expenses were approximately $104.6 million, an increase of $14 million compared to Q4 2024, driven primarily by XDEMVY direct-to-consumer advertising and other related commercial and marketing costs. Gross margins remained relatively flat and were approximately 93%. While uncertain and evolving, we also believe that even if tariffs were to be implemented as currently rumored, they would have an insignificant impact on our gross margins on other expenses. For background, we have approximately two years of API in the United States and several more years in Europe. Additionally, XDEMVY is currently being filled and finished by a well-known contract manufacturer in Europe, and we are well into the process of bringing on a second contract manufacturer located in the United States. Importantly, as I noted earlier, we have strong gross margins and like any other small molecule therapeutic or eye drop, XDEMVY manufacturing costs represent a very small part of our total cost of sales. Therefore, even if tariffs were imposed, we would not expect a material impact on the P&L given our low cost of goods. Moving to the balance sheet, we ended the first quarter with $407.9 million in cash and cash equivalents, which includes the $134.8 million from our recent equity raise. Echoing Bobby’s comments, this oversubscribed and upsized financing demonstrates continued shareholder appreciation for XDEMVY’s strong potential and, importantly, their support for Tarsus. Turning to our performance aspirations, we continue to anticipate strong annual growth of XDEMVY as our fully deployed sales force builds further momentum with eye care providers. Our DTC campaign encourages more and more patients to visit an eye care provider, with doctors moving from monthly to weekly, then daily prescribing. Looking specifically at the second quarter and factoring in historical second quarter headwinds of eye care provider conferences, holidays, and spring break, we remain confident XDEMVY will continue on its strong trajectory and expect the following: bottles dispensed to meaningfully increase compared to the first quarter and be in the range of 85,000 to 90,000, and the gross to net discount is expected in the range of 45% to 47%. We also reiterate our expectation that we will likely see more modest revenue growth in the third quarter due to typical sector summer dynamics, with stronger growth returning in the fourth quarter. Moving to operating expenses, given the early positive signals of our DTC advertising and surround sound campaigns, we have made the strategic decision to broaden our advertising efforts and increase our network spend even more. As a result, we now anticipate an increase in SG&A XDEMVY-related marketing costs of approximately $5 million to $10 million compared to the first quarter of 2025, as we amp up our DTC activities and spend with the goal of boosting this launch even further. We expect full year 2025 DTC costs to be in the range of $70 million to $80 million, with the potential to add even more in the second half of the year if we continue to see strong signals that the campaign is resonating with eye care providers and patients. Additionally, as we noted on last quarter’s call, in the second half of this year, we expect R&D expenses to increase with the planned initiation of the Phase 2 study of TP-04 in Ocular Rosacea. We continue to expect this study to cost between $7 million and $10 million, and the cost should be split between 2025 and 2026. In closing, we enter the second quarter of 2025 with a tremendous amount of momentum and strength, both operationally and financially. We look forward to sharing more updates with you in the coming quarters. I will now turn the call back to Bobby for final remark.

Bobby Azamian, CEO

Thank you, Jeff, and thank you all for making the time to join us today. As I said at the beginning, we have a lot to be excited about. We have a proven blueprint for success. XDEMVY is setting a new standard for product launches, and we have a strong financial position that enables us to continue driving the growth of XDEMVY and continue advancing a robust pipeline of other potential category-creating medicines. Operator, please open the line for questions.

Operator, Operator

Our first question or comment comes from the line of Lachlan Hanbury-Brown from William Blair. Your line is open.

Lachlan Hanbury-Brown, Analyst

Hey guys, thanks for the questions and congrats on the strong quarter. A couple of questions. I guess, first, you were talking about—you have spoken in the past about meeting with the FDA to align on study design for both pipeline products. I just wanted to check, have you seen any disruptions? Have you been able to have those meetings or schedule them as you expected? And then second, on XDEMVY in this past quarter, with Medicare coming online, can you give a sense of how much of the volume of the prescribing is going to commercial versus Medicare patients at the moment?

Aziz Mottiwala, Chief Commercial Officer

Thank you, Lachlan, for the question. I’ll take the first part of the first question regarding the pipeline. As you know, we are creating a new paradigm with our programs, especially with Ocular Rosacea with our blueprint of developing the new disease, new endpoints, and we are well on track to starting the trial in the second half of the year. We are proceeding with every sense of urgency, looking at the patient population and learning a lot from the physicians in the field regarding both the disease and the patients as well.

Bobby Azamian, CEO

I’ll just reiterate, Lachlan, to your question, we have not had any delays in our meeting schedule. So we have not seen an impact on our pipeline regarding your question.

Aziz Mottiwala, Chief Commercial Officer

For the second part of that question, when you think about our script volume in the first quarter, it’s a relatively equal split between Medicare and commercial prescriptions. The one thing to keep in mind is that the Medicare coverage—the bulk of that came online in the first quarter. So when you look at it versus, say, the fourth quarter, we definitely saw an increase in Medicare prescriptions. But as we look at the total volume of scripts, it’s about equally split. And that’s what we expected to see. The only other thing I’d add is that getting that coverage is a huge catalyst for us, and I think it’s been a tremendous growth driver. If you look back, that’s probably the one piece of feedback we receive from physicians that that was one of the key barriers. Now that that’s out of the way, I think we’d anticipate to see continued volume growth based on that great coverage.

Lachlan Hanbury-Brown, Analyst

Thanks for the questions.

Operator, Operator

Thank you. Our next question or comment comes from the line of Andrea Newkirk from Goldman Sachs. Ms. Newkirk, your line is open.

Andrea Newkirk, Analyst

Thank you, good afternoon and thanks for taking the questions. Aziz, I was just wondering if you could discuss the pushes and pulls that you’re seeing in repeat prescribing, more specifically around your comments regarding the prescribers who are writing daily versus weekly versus monthly scripts.

Aziz Mottiwala, Chief Commercial Officer

Absolutely. That’s been one of the great things to see as we’ve continued to accelerate this launch at the beginning of the year, the progression of doctors writing the product more frequently. When I look at the key drivers, there are a couple in the near term that have really impacted particularly in the first quarter. First would be the expanded sales force. Everyone recalls that we expanded the sales force late last year. They got off to a great start, and they’ve done a phenomenal job. With that said, having those repeat visits in front of those new customers for that expanded team is really starting to have that impact. Those repeat visits are resulting in further education, encouraging doctors to look across the different patient segments and expand their utilization. So that’s going very well. The second one, as I mentioned earlier, is the coverage. That was probably the biggest barrier we heard to deepening adoption when the doctor couldn’t differentiate who had coverage and who didn’t. Now with over 90% of lives covered, doctors can be a little bit more open in terms of who they’re thinking about treating. If you think about a particular segment, say, you’re a cataract patient, that’s a heavy Part B patient, and we’re able to address that segment more effectively now. This is a tangible example of how we’re hearing qualitatively from doctors that they are starting to utilize XDEMVY more and more. The key near-term drivers have been the sales force and coverage. That will continue to ramp, and on the back of that, we’ve got DTC and new data as well.

Bobby Azamian, CEO

Yes. Andrea, I’d just give you some color from my interactions with doctors. They can’t stress how amazed they are by the effect and overall profile of the medicine. That drives them to look more and more because they see how well it works, and every patient they prescribe it to is what they tell us, motivating them to look more. The evidence we’re generating will help them look even more, so we see only opportunity ahead regarding the progression that Aziz described.

Andrea Newkirk, Analyst

Got it. Bobby, maybe I could ask a follow-up there. Just given the efficacy that the physicians are recognizing and observing here, to what extent are you then seeing retreatments happening? Has that started coming in a more meaningful way than in previous quarters?

Bobby Azamian, CEO

Yes. We’re definitely hearing about it more and more. When I was in the field, I heard from many offices that they’re asking about when and how should I think about retreatment. Our sales force can talk them through the data that shows that by a year, about 40% of patients recur, as shown in the Phase 3 follow-up we had. They’re starting to see that themselves. I’ll pass to Aziz to talk a little about how we see that going forward. But I do believe it’s exactly as we suspected so far, and we expect that to be a meaningful long-term growth driver for us.

Aziz Mottiwala, Chief Commercial Officer

Yes, I can add more color. The first thing I always remind folks is that, with any product, even chronic medications, adherence is pretty low. To be successful, it’s all about driving new patients, and we’ve got 25 million patients out there that we want to continue diagnosing and treating for those patients. That’s really the core emphasis. To Bobby’s point, we do contemplate retreatments as a tailwind. When you look at the IQVIA data today, you’re seeing a high single-digit refill rate. If you start to do a bit of math and impute patients that were treated, say, a year ago relative to the volumes today, you can assume that the actual retreatment rate is probably leading that or even higher than what you’re seeing in the refill rate in IQVIA. So a very positive trend. This is what gives us confidence in reaffirming our estimate of about 20% annualized retreatment rates we discussed before. Again, it looks really good and is trending in the right direction.

Andrea Newkirk, Analyst

Okay. Thank you guys.

Operator, Operator

Thank you. Our next question or comment comes from the line of Pavan Patel from Bank of America. Your line is open.

Pavan Patel, Analyst

This is Pavan on for Jason Gerberry. First question is, how is the feedback from the Orion registry and the combined Ersa, Rhea, MGD data being received by eye care professionals? Are you seeing evidence that this new data is influencing prescribers’ behavior or expanding use into specific patient segments such as dry eye? And then the second question is regarding the upcoming Phase 2 trial for TP-04 in Ocular Rosacea. Can you share any details on the study design, primary endpoints, and patient population? Thank you.

Aziz Mottiwala, Chief Commercial Officer

Yes, thanks for the question. I’ll speak a little bit to the receptivity of the new data, and Sesha can speak to the pipeline developments here. Coming fresh off a conference, it’s really exciting to see how the doctors respond to the increasing base of evidence around the disease state and the product. When you look at the Orion registry, the real key takeaway there is that the vast majority—over 90% of patients are symptomatic. This is prompting doctors to want to look more, to examine the lids more closely and help identify more patients. When you look at the Ersa and Rhea data, we hear clearly that there’s evidence now showing that XDEMVY has an impact on the constellation of symptoms, as well as improving the oil secretions that are really important for eye health. These two things combined do two things: they help the doctor want to diagnose more, but then they start thinking about the types of patients. They’re not just thinking about their traditional dry eye patients; they’re considering dry eye patients, the impact of fluctuating vision on cataract patients or contact lens intolerant patients. They’re also thinking about how they can incorporate this in their daily routine. The data is being received very well; it’s still early, and data dissemination takes time. They have to see it and hear it multiple times, but the initial response is really positive. In particular, with the doctors that have really increased their frequency of prescribing, they do look back and say, 'Hey, I’m having multiple repeat visits with the rep.' I’m hearing more and more about this great data. Sesha, you want to talk about the pipeline?

Sesha Neervannan, Chief Operating Officer

Yes, thanks, Aziz. Great question, Pavan. In terms of Ocular Rosacea, as Bobby alluded to earlier, Ocular Rosacea is a highly prevalent disease, and more than 50% of those patients are caused by Demodex mites. This is a great opportunity for us to create another category, and we have the potential to pioneer a standard of care for Ocular Rosacea. The key features of Ocular Rosacea are prominent blood vessels on the eye, on the lid, and areas surrounding the eye, as well as erythema surrounding the eye. Those are the two features of Ocular Rosacea that physicians use to diagnose the disease. These are the objective measures that we are planning to look at in our trial. The size of the trial and how we’re going to be looking at everything, with all the details coming later this year as we get closer to starting the trial. The endpoints and the measures that we are contemplating align with what the FDA is in agreement with, so we are on a good track here.

Bobby Azamian, CEO

Yes. I’d just highlight two points on Ocular Rosacea from some of the interactions we’ve had in recent weeks with doctors. First, this is new. There’s never been a medicine developed or trialed for Ocular Rosacea. So under Sesha’s leadership, our team is diligently translating some of those important clinical findings into a robust clinical plan. The other thing I’m encouraged about is that doctors, both MDs and ODs, are so enthusiastic about Ocular Rosacea. They are seeing it more and more now that they’re examining eyelids. My assessment is that they’re even more familiarized with Ocular Rosacea than they were with dry eye when we were at a similar stage. This is an opportunity that we think is compelling. It’s hard to assess how big that is until we gather more data. As Sesha said, this looks and feels a lot like Demodex blepharitis, and it’s another example of how Tarsus can pioneer a new category of medicine.

Operator, Operator

Thank you. Our next question or comment comes from the line of Eddie Hickman from Guggenheim. Your line is open.

Eddie Hickman, Analyst

Thanks for the questions and congrats on the quarter. When you think about providing guidance going forward, what are the potential factors, beyond the summer bumpiness, that might prevent you from accurately extrapolating volumes and price going forward? Maybe I missed this, but you noted previously that you had already reached the target 15,000 doctors, and they are increasing their frequency of prescribing. How many more ECPs beyond that target have been reached? Thanks.

Jeff Farrow, CFO and Chief Strategy Officer

Hey, Eddie, it’s Jeff. I’ll take the first part of that question and then pass it over to Aziz. We look at the potential to provide guidance on a quarter-by-quarter basis. I think the two factors that are really causing us pause and preventing us to provide long-range guidance are, one, some of the impact of the DTC campaign, particularly the expanded network campaign. We want to ensure we understand that fully and what its impact will be in the back half of this year. Secondly, many macro events are going on as we speak, and we’re keeping an eye on those and want to be thoughtful as we consider moving forward on that front. We evaluate on a quarterly basis whether to move forward with revenue guidance.

Aziz Mottiwala, Chief Commercial Officer

Yes. When it comes to the target prescribing base, it has certainly grown beyond 15,000 in terms of the number of doctors that have utilized the product. However, we know that the vast majority of prescriptions—over 85%—are likely going to come from that core 15,000. Therefore, we focus our efforts on deepening prescribing. If it continues to grow, we have other mechanisms we can use to address that broader base. Our strategic efforts primarily focus on that core 15,000 audience to really move the needle from monthly to weekly, then weekly to daily prescribing.

Eddie Hickman, Analyst

Great. As that increases, do you expect the level of stocking that you have in the channel to change at all?

Jeff Farrow, CFO and Chief Strategy Officer

We don’t anticipate that, Eddie. It’s been hovering around two to 2.5 weeks consistently over the last five quarters. The pharmacies and distributors prefer not to hold a large amount of inventory to manage their balance sheet effectively. Hence, we don’t anticipate that evolving much beyond the 2.5 weeks.

Eddie Hickman, Analyst

Great. Thanks, guys.

Operator, Operator

Thank you. Our next question or comment comes from the line of Cory Jubinville from LifeSci Capital. Your line is open.

Cory Jubinville, Analyst

Thanks for taking our questions. Congrats on these numbers. Quick question from us. Based on the Q1 numbers we’re seeing today, we’re now looking at a run rate of over $300 million and growing for XDEMVY, which is greater than 2024 OpEx. Obviously, spend will increase in 2025 as you ramp marketing spend and advance some of these additional clinical programs. But could you comment on total projected 2025 spend beyond the DTC campaign? Could you also add some color about the potential to bridge to cash flow positivity following the recent equity raise? Can you achieve profitability with the current balance sheet?

Jeff Farrow, CFO and Chief Strategy Officer

Yes, Cory, this is Jeff. We are anticipating operating expenses to continue to grow, as we discussed regarding the DTC investment. Also, certain variable costs will rise as revenues increase, including the cost of goods sold. We haven’t provided long-range guidance on when we might reach cash flow positive status. I’d like to highlight that we are not opposed to being cash flow positive, but we are also considering investments in the pipeline, such as those in Ocular Rosacea. Until we’re in a position to provide top line revenue guidance, we’re probably not going to provide any cash flow positive guidance either.

Cory Jubinville, Analyst

Got it. One for Aziz. Regarding the targeted streaming service DTC campaign that you had last year, you mentioned the potential for some analytics regarding conversion rates on certain patient profiles, but it still seemed a bit early at the time to see those impacts. Today, you mentioned that the DTC campaign is driving that 140% increase in site traffic. At this point, do you have a solid understanding of who the most responsive patients are to DTC campaigns? If so, what does that patient profile look like?

Aziz Mottiwala, Chief Commercial Officer

Yes, it's a great question, Cory. When we did the streaming, we received a lot of valuable insights. For instance, we learned what demographic profiles engage with our content, the types of programs they respond well to, and the ideal times to air our ads. We also learned which of the activities really lead to eventual prescriptions. We previously highlighted the increase in the number of website visits and quizzes, which correlate well with prescription volumes. This has informed our programming choices specifically to those demographics. Typically, the patients will resemble the profile of those who have commercial coverage. For instance, there’s the mid-40s patient who is actively pursuing quality vision. They want to make an appointment and enjoy clear vision daily without the hindrance of conditions like blepharitis. The other demographic that has opened up with Medicare coverage is the 60-plus individual likely seeking cataract surgery and aiming for high-quality vision and an enhanced quality of life. Demodex blepharitis prevalence increases with age, so those are the two patient types we consider. With these insights, we’ve refined our deployment for DTC spending.

Bobby Azamian, CEO

Yes, Cory, this is Bobby. Just one more point, beyond the analytics. Our team remains very data-driven and is seeking a high return on investment. Additionally, I heard from numerous doctors that as they discuss XDEMVY and dry eye with patients, they say, 'I’ve heard of this.' This represents a substantial educational shift we’re beginning to see over the last few months following the launch of our ad campaign. We're effectively creating a new category, and patient education is crucial to our growth driver as we mentioned earlier.

Cory Jubinville, Analyst

Excellent. That’s helpful. Thanks, and congrats again.

Operator, Operator

Thank you. I’m showing no additional questions in the queue at this time. Ladies and gentlemen, this concludes the program. Thank you for your participation. You may now disconnect. Everyone, have a wonderful day.