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Earnings call · FY2023 Q3
Executive readout · one minute
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Good afternoon. And welcome everyone to the Beyond Air Financial Results Call for the Third Fiscal Quarter ended December 31, 2022. At this time, participants are in a listen-only mode. A question-and-answer session will follow the formal presentation. And now, I would like to turn the conference over to Edward Barger, Head of Investor Relations at Beyond Air. Please go ahead.
Thank you, Operator. Good afternoon, everyone, and thank you for joining us. Today, after market close, we issued a press release announcing the third quarter of fiscal year 2023 operational highlights and financial results. A copy of this press release can be found on our website under the News and Events section. Before we begin, I would like to remind everyone that we will be making comments and various remarks about future expectations, plans, and prospects, which constitute forward-looking statements for purposes of the Safe Harbor provisions under the Private Securities Litigation Reform Act of 1995. Beyond Air cautions that these forward-looking statements are subject to risks and uncertainties that could cause actual results to differ materially from those indicated. We encourage everyone to review the company’s filings with the Securities and Exchange Commission including, without limitation, the company’s most recent Form 10-K and Form 10-Q, which identifies specific factors that may cause actual results or events to differ materially from those described in the forward-looking statements. Additionally, this conference call is being recorded and will be available for audio rebroadcast on our website, www.beyondair.net. Furthermore, the content of this conference call contains time-sensitive information that is accurate only as of the date of the live broadcast, February 9, 2023. Beyond Air undertakes no obligation to revise or update any statements to reflect events or circumstances after the date of this call. Joining me on today’s call are Steve Lisi, Chairman and Chief Executive Officer; Duncan Fatkin, Chief Commercial Officer; and Douglas Larson, Chief Financial Officer. And with that, I will turn the call over to Steve Lisi.
Thanks, Ed, and good afternoon to everyone joining us. Today, I will be providing an update across our portfolio, including Beyond Cancer. This will be followed by an overview of our financial results for the quarter by our Chief Financial Officer, Doug Larson, and then as usual, we will open the call up for questions. Before discussing our pipeline of financials, I would like to turn it over to our Chief Commercial Officer, Duncan Fatkin, for an update on the LungFit PH commercial launch.
Thanks, Steve, and good afternoon to our investors. During the last quarter, we have continued to make tremendous progress with the initial phase of our commercial launch of LungFit PH. As a reminder, our go-to-market strategy is a multi-phase commercial approach. The initial phase represents a measured release of LungFit PH to a select group of hospitals that have Level 3 or Level 4 NICUs and staff experienced with inhaled nitric oxide. I am very pleased to report that our team has completed evaluations of LungFit PH at a variety of different hospitals in line with our strategy to gain feedback on our logistics, customer service, and of course, the clinical performance of the device. The feedback has been in line with our expectations and we have moved into the contracting phase with a number of hospitals as a result of their experience and awareness of our technology. In addition, our team has demonstrated the LungFit PH system in person at over 150 hospitals and at state and national conferences in our target regions, a tremendous achievement given continued restrictions in hospitals as a result of the triple threat of COVID, RSV, and flu during the winter period so far. As anticipated, respiratory therapists and neonatologists are highly motivated to eliminate cylinders and are impressed with how simple and easy the LungFit PH system is to use. Hospital administrators are reacting very positively to the flexible and transparent business models presented, and we believe, in some cases, they will revisit some of the restrictions placed on the use of nitric oxide due to cost and logistical challenges. We have been able to test our logistics infrastructure, as well as our clinical and sales operations support through our 24x7 LungFlex service. Based on the feedback received in the first seven months since launch, we are planning to move into an accelerated phase of promotion in the spring. We will use the experience from this first phase of our launch to refine our business model, geographical focus, and clinical training to ensure that we optimize the next phase of our launch. As I have previously mentioned, during the second phase, we will be expanding our commercial team, both field sales and clinical specialists, and building a network of reference hospitals and key opinion leaders. We are very excited about the progress made over the last quarter and look forward to building a coalition of hospitals, supporting this amazing new technology and accelerating awareness of a new way of delivering nitric oxide across the U.S. and Beyond. With that, I will turn the call back to Steve for the pipeline review.
Thanks, Duncan. I will start with LungFit PH, where we have faced regulatory delays. Our quest for CE Mark is going well, but we must postpone our anticipated approval until the first half of our fiscal year 2024. In the U.S., we have faced similar issues of delays beyond our control, and thus, we have not yet submitted our PMA supplement for cardiac label expansion, but expect to do so before the end of the first half of this calendar year. We remain confident in achieving both of these goals. With respect to our VCAP program, we continue to work closely with the FDA to agree upon the protocol for our study, which we intend to start in the fourth quarter of calendar year 2023. We began this discussion over the summer and we believe that the FDA should allow this study to be conducted given our efficacy and safety profile in an adult pneumonia study, three bronchiolitis studies, two NTM studies, along with several other studies. These studies have resulted in excess of 5,000 NO administrations at 150 parts per million to 250 parts per million nitric oxide in over 170 patients. Not to mention the Squeaky Clean safety data in animals that we have mentioned many times in the past. As a reminder, this proposed study is extremely similar in design to what we reported from our Israeli viral pneumonia study. We expect to treat patients hospitalized with pneumonia who test positive for any virus, including any and all variants of SARS-CoV-2. We have seen no serious adverse events related to 150 parts per million to 160 parts per million NO in three bronchiolitis studies and one adult pneumonia study. Plus, we filed with infants long-term, some out more than five years, and saw no long-term effects from the acute NO treatment. Our studies and long-term data reflect our continuing ability to manage concerns of methemoglobinemia and nitrogen dioxide exposure associated with high concentration NO treatment. We are confident that we will be able to build on these results. Moving to 250 parts per million NO, which was delivered in our study multiple times per day at home by patients with no medical professional present for more than 11 weeks. You can see these data as they were presented at the 2022 Chest Annual Meeting by visiting our website. Just a reminder, no methemoglobinemia and no nitrogen dioxide issues were reported. We believe that these data support moving forward with a pivotal study for NTM patients and we will move as fast as possible. At this time, we do not see the study beginning until the second half of our fiscal year 2025. We look forward to working with the FDA to meet or shorten this timeline. Our pilot study in patients with underlying COPD will not be conducted this coming winter. We will look to begin to start in the fourth quarter of calendar 2024. LungFit PH and VCAP are our immediate priorities and we will continue to work with the FDA in addressing the varied applications of nitric oxide. Moving on to Beyond Cancer. Progress over the last 15 months since the money raised has been very strong. The Phase 1a human clinical study is ongoing with our current belief that we will be releasing topline data later this calendar year. Our first publication is out with another expected later this year. Our preclinical team is quite active with data expected at several medical conferences this year and we have already shown a doubling of survival in animals when we added our UNO therapy to anti-PD-1 therapy compared to anti-PD-1 alone. The team has also been expanded with the recent hiring of Gavin Choy as COO and the additions of Dr. Fred Dirbas and Dr. Mark Pegram, both world-renowned oncologists at Stanford to our Beyond Cancer SAB. In addition, the first patent for our technology was issued. Please visit beyondcancer.com for details on all of these accomplishments and stay tuned for more later this year. I will now turn the call over to Doug Larson, our Chief Financial Officer, to provide an overview of our financial results for the fiscal quarter ended December 31, 2022.
Thanks, Steve, and good afternoon, everyone. Our financial results for the third quarter of fiscal year 2023, which ended on December 31, 2022, are as follows. On a GAAP basis, research and development expenses for the fiscal quarter ended December 31, 2022, were $5 million, compared with $2.5 million for the fiscal quarter ended December 31, 2021. This increase was driven mainly by compensation costs from scaling up operations in Beyond Cancer, as well as from increased investments in preclinical work being done across the group in our targeted therapeutic areas. General and administrative expenses for the fiscal quarter ended December 31, 2022, increased to $8.9 million, compared with $4.9 million for the fiscal quarter ended December 31, 2021. $3 million of the increase was due to the planned structural investments in Beyond Cancer, with the remaining $1 million attributable to continued investments in people and systems necessary to support the commercial launch of LungFit PH in the U.S. Other income and expense for the fiscal quarter ended December 31, 2022, was a $0.2 million gain, compared with a $0.5 million loss for the fiscal quarter ended December 31, 2021. The two main drivers in this year-over-year improvement were the gains we made from our investments in marketable securities, as well as favorable foreign exchange movements. For the fiscal quarter ended December 31, 2022, the company had a GAAP net loss of $13.8 million, of which $12.7 million or $0.43 per share was attributable to the shareholders of Beyond Air, Inc. compared with a net loss of $7.7 million or $0.29 per share for the fiscal quarter ended December 31, 2021. Net cash used by the company, including Beyond Cancer, was $9.3 million for the quarter ended December 31, 2022. Through the first nine months of this fiscal year, net cash burn has been $27 million. As of December 31, 2022, the company reported cash and cash equivalents, marketable securities and restricted cash of $63.2 million. We still forecast that our average quarterly cash burn for fiscal 2023 to be within a range of $8 million to $10 million per quarter. And with that, I will hand the call back to Steve.
Thanks, Doug. Hope everyone is as pleased as I am with the execution and progress at Beyond Air. Operator, let’s go to Q&A.
Our first question comes from Matt Kaplan with Ladenburg Thalmann. Please go ahead.
Hi. Good afternoon and thanks for taking the question. Just wanted to follow up on how the LungFit PH launch initial early launches going Phase 1. I guess, is there anything that you learned about, I guess, the competitive marketplace in the hospital, which is new or unexpected, which could potentially help to expedite the launch or would potentially slow it down in terms of marketplace penetration?
Thanks, Matt. And I will turn this over to Duncan to answer this question. But the one thing I will say before that is that hospitals move very slowly. I think COVID just made things a little bit more difficult to get things through in the hospital space, lots of new procedures in terms of getting new teams into the hospital to get work done. But that’s just from my bird’s eye view, but I will let Duncan comment on this further.
Yeah. Thanks for the question, Matt. No, we are really pleased with the way it’s going. Essentially, there’s no change to the plan. We are executing as per our previous conversations, our first six months to nine months up to a dozen hospitals and that’s all we have been doing. We have had really excellent feedback during that period. And as we have said before, we have been focusing on the logistics, the service. And from a clinical point of view, things have gone as absolutely well as we could expect. We are very pleased with the feedback that we have been getting. We have trained hundreds of respiratory therapists in a number of different hospitals and now we are in the contracting process. And as I mentioned in my remarks, I am very impressed with the access we have got considering the triple threat that we are all familiar with and now we go through the contract process with these various hospitals and the ones that we are now moving forward with in the early phase of that broader expansion. And each hospital is different, there are different stages and they have different processes and some of those have become more onerous, some of them haven’t changed. So it depends from hospital to hospital. So nothing that we have learned has surprised us and we are pleased with the progress.
Great. And then, specifically, how should we think about Phase 2 as you are moving into this accelerated sales in the spring?
Yeah. I think that we said that the first six months to nine months would be that sort of Phase 1. So we are coming to the end of that. So in the next fiscal year is when we start to ramp up, and as I said, it depends on the mix of hospitals that we end up with from a contractual point of view, we can’t know for sure exactly when they are all going to hit, partly for the reasons that Steve commented on and partly just the luck of the draw in terms of where they are in their contracting process. So, unfortunately, we can’t control that to a significant extent, but as we get more scale, we will obviously have more confidence in that.
Our next question comes from Greg Fraser with Truist Securities. Please go ahead.
Good afternoon, folks. Thanks for taking the questions. So the hospitals that have done an evaluation and decided to not move forward with contract discussions, have there been any common reasons why?
So, I mean, the initial - I think it all comes down to contracting. If they are in a phase where we have done an evaluation and they are looking at, for example, dual source. In some cases, they can do that. In some cases, it takes a little bit longer. So that’s part of the reason is around contracting. And the other might be to do with the scale of the hospital in terms of it might be part of a group, and that group might have, in some cases, we have done work with a hospital that was acquired by a group and that slows things down. So typically it’s around the timing of the contracting process. That’s the most common. But we have been selective and we are still working with most of those hospitals.
And Greg, just to follow up on that. I think you're asking whether there is something consistently wrong with our system that leads people to sign up with us. I believe that's incorrect with regard to the reality of the situation. The process is slow. If you review all the conference call transcripts from the past two years, I've mentioned that this is typically a six-month to nine-month process to get things underway, and we just finished six months at the end of December, including July and August, which is usually a challenging time for launches. We anticipated it would take a while to get things moving, and this isn't just about quickly supplying products; it requires time for education and training with hospitals. We haven’t encountered any issues with our system that concern us or the hospitals that have interacted with it. There may be minor adjustments needed, as is normal during a launch, and we will likely be refining our system for the next decade, similar to our competitors. For instance, the INOmax DSIR has evolved significantly since its initial approval, and they continue to release new versions. There is always room for enhancement. However, we have not identified anything that prevents hospitals from utilizing our system. This does not reflect our current position. In fact, we are basically where we expected to be at this point. Would I prefer it to progress faster? Absolutely, everyone wishes for that. But the reality is that six months to nine months is our estimate, and that's how long it will take. We will need the full nine months to achieve the momentum we aspire to. I believe that addresses your question, but please feel free to clarify if that's not what you were asking.
Yeah. No. That’s what I was asking. That’s a very helpful answer. Thank you. On the contracting discussions, I believe your objective is to supply NO at a price similar to what the hospitals are already paying. Are hospitals receptive to that or are some looking for discounts? Any color there would be helpful.
It really varies; every hospital is unique. We have explored different business models as we have grown and adapted. Our approach depends on the specific needs and clinical environments of each hospital. In some situations, we anticipate aligning with current pricing expectations, while in others, we might be priced at a premium. It largely depends on the advantages of removing cylinders from the hospital and the value of simplifying logistics. Therefore, I can’t provide a straightforward answer since the circumstances differ so much. However, we haven’t encountered significant challenges in this area, and we will continue to be flexible and responsive to their requirements.
Got it. That’s very helpful. And then can you just comment a bit more about the CE Mark process and what contributed to the later timing versus your prior expectation?
They changed things in the EU a few years ago, the new MDR, I guess, they call it, and that resulted in a significant decline in the number of notified bodies in Europe, plus a lot of the capacity of these remaining notified bodies was being used up by companies with products that were already on the market. A lot of these things, these products were subject to the new rules and could have been pulled off the market. So there wasn’t a lot of capacity. We were in. We had a timeline with our notified body. We communicated guidance to you based on that timeline communicated to us. They just couldn’t get it done. They are overworked, overwhelmed and these things happen. We are working with them. They are doing a good job. We don’t see any reason why we won’t be getting CE Mark, but we still have to work through the process with them. And things are just taking longer than expected. And we went through these things with them and got timelines and thought we all could hit them. I send them together, thought they could hit these timelines. It just didn’t happen. There seem to be delays with regulatory stuff in the U.S. and Europe. I think the regulatory agencies are recovering from what happened during COVID and what happened in Europe anyway from the change in regulations. But some companies are getting luckier than others in their timelines. But it’s really been nothing of concern for us in terms of we are insufficient to get approval. That’s not the issue. The issue is just working through it and trying to meet the timeline. So it’s unfortunate, but it is what it is and we will just get it in a couple of months. That’s all we can do.
Got it. Okay. I will ask one more and then I will hop back in the queue. On the cardiac filing. I think you had a meeting with the FDA. Did anything come up in that meeting that was unexpected to potentially be a hurdle to approval? Thanks so much.
Yeah. Our meeting on the cardiac label expansion was pushed back by the FDA, so it was scheduling conflicts. So that meeting has not yet occurred, which is why we haven’t submitted the PMA supplement. So I really can’t comment. I am sorry.
The next question comes from Yale Jen with Laidlaw & Company. Please go ahead.
Good afternoon and thanks for taking the questions and congrats on all the progress. In terms of LungFit PH, you mentioned that in the second phase, you are going to expand the sales force. Could you give us a little bit of color how that pace might be and how that size might be? And then I have a follow-up.
Yeah. So, yeah, thanks. The pace at which we expand the commercial team is going to be dictated by what we see coming in the next six months to 12 months in terms of expected contracts. So, Duncan is going to be building up that team starting very soon and we are going to be focusing on our clinical team build-up first. Those are the guys who educate, train the hospital employees and that’s really the hurdle in the beginning as you get rolling since it is relatively new for these hospitals. And then we will focus more on the actual sales reps once we have gotten our clinical people up to the number that we need. So this will be ongoing. The expansion of the team will be ongoing probably for the next 18 months to 24 months. We don’t just snap our fingers and bring everybody in, right? So they will come in waves. So that’s the Phase 2 of our launch. Like I said, mostly we will get going in the next few months and it will last probably 18 months to 24 months as we build that team. I hope that answers the question; if it didn’t, please let me know.
That’s very helpful. I appreciate that. Maybe one more question in the FDA meetings for the LungFit PRO on VCAP. Any color of the meetings you can talk about?
Yeah. I mean we don’t like to talk about what we said between us and the FDA. Our communications are private with them. But again, what I will say is that we are certainly enthusiastic about getting this study started up in the fourth quarter of this calendar year. So we are looking forward to it; that’s for sure.
Okay. Great. And maybe just talking one more, which is that we noticed that the LungFit PRO trials, both in the MTN as well as in COPD, have been pushed out quite a bit compared to your earlier guidance, including your recent slide deck. Was there any strategic reason for taking that move? Thanks.
COPD is not a strategic focus for us right now. The FDA timelines have been extended, and we need sufficient time to properly organize the study. Even though it may not seem seasonal, it truly is, as we are monitoring exacerbations in patients that often lead to hospitalizations. We expect to see a higher volume of these exacerbations during the winter months compared to summer, so we don’t want to conduct this study outside of the winter season. Given the current timelines from the FDA, we won’t be able to complete it in the upcoming winter. This reflects our situation today. Regarding NTM, we have aimed for late 2024 and have shifted our guidance to the latter half of our fiscal year. While this sounds like a delay, we are just being cautious as the FDA is facing a heavier workload. We want to allow ourselves some leeway in case of any further delays. If everything goes smoothly, we may be able to expedite the process a bit, but we will have to wait and see. This is not solely about protocol discussions with the FDA; it also involves our final home system that is under development. We need to get both the device and the study approved. In contrast, for pneumonia, the focus is solely on the study, not the device.
Okay. Great. Very helpful. Appreciate it, and again, congrats on all the progress.
Thanks, Yale.
Our next question comes from Suraj Kalia with Oppenheimer & Company. Please go ahead.
Good afternoon, everyone. So two questions. Duncan, one for you and one for Steve. Let me start out with you, Duncan. So, Duncan, you all have been consistent in terms of the phase launch of PH. I was wondering if I could push you a little bit in terms of quantifying the sites that have gone through evaluations and are now in the contracting phase. And specifically, when you see a site has finished evaluation, what does the typical NICU that may or may not already be contracted with Alancarta do from an evaluation perspective to push it to the next stage?
Hey, Suraj. We are not going to comment on those numbers, but Duncan can comment on the other question.
Yeah. So from an evaluation point of view, again, it varies from hospital to hospital, depending on the protocol and the quality assurance process they have in place. In some cases, in fact, they do what they call a bench test. So that requires them to go through a protocol without actually connecting it to a patient. But in a typical evaluation where they do have clinical experience, they will go through that process in a matter of somewhere between a week and three to four weeks and it’s usually lined up with a period before their contract is due. And again, some hospitals begin their contracting process six months, nine months, in some cases, 12 months ahead based on the protocol and the various stakeholders in a value access committee or something of that nature that they need to go through. So, unfortunately, there’s no one size fits all again. But from our perspective, it’s a pretty straightforward process, because our system is so fast and simple. They just have to use our system instead of the one they are currently using as per their protocol. I hope I have answered your question.
Fair enough, Duncan. Steve, one question for you, and I know you guys at this stage are somewhat diverse to giving specifics on numbers. But picking up with the commentary in terms of some of the things getting delayed, the process is taking longer. Maybe if I could just position it this way, Steve. Fiscal fourth quarter numbers are about $3 million in revenues. Fiscal 2024, if I am looking at it correctly, it’s almost $40 million. So maybe you can help thread the needle here in terms of what you are seeing in terms of the phase launch and how would you guide us based on what the consensus numbers are out there? Gentlemen, thank you for taking my questions.
Thanks, Suraj. And let’s be clear, those numbers are from you and the other analysts that’s consensus. We have given no guidance whatsoever, so that’s just your interpretation and we are not going to be giving guidance at this point. I think I have been very clear about that and we are going to wait and see how things play out and gather more information before doing that, and that will probably happen when we announce our fiscal year, which obviously ends March 31st. So you can look forward to us discussing in more detail what kind of guidance we would be giving at that time. I think it’s still a little bit too early to discuss those things.
At this time, we are showing no further questions in the queue and this concludes our question-and-answer session. I would now like to turn the conference over to Steve Lisi for any closing remarks.
Thanks. Thank everyone for joining us today. Very much appreciate the interest. Look forward to speaking to you very shortly in a couple of upcoming industry conferences. Thanks very much.
The conference has now concluded. Thank you for attending today’s presentation. You may now disconnect.
SEC filing · Item 2.02
Filed Feb 13, 2023 · complete as-filed document
SEC periodic report
Filed Feb 10, 2023 · complete as-filed document