KalVista Pharmaceuticals (KALV) TD Cowen 46th Annual Health Care Conference summary

Commercial launch and market adoption

• Ekterly, the first and only oral therapy for hereditary angioedema (HAE), launched in July last year and has seen strong adoption in both initial and subsequent territories.

• Early success attributed to years of physician and community education, robust clinical data, and a dedicated medical and commercial team.

• Patient and physician satisfaction rates are near 90%, with high comfort and willingness to prescribe among clinicians.

• Most patients are switching from other on-demand therapies, with a notable share coming from Ruconest users.

• High-burden patients (≥2 attacks/month) represent about 20% of the population but account for 35–40% of on-demand usage; about a quarter have transitioned to Ekterly.

Patient experience and support services

• The QuickStart program streamlines patient onboarding, providing immediate access to therapy while commercial coverage is processed, typically within 40 days.

• Refills are seamless, with prescriptions usually valid for a year and patients averaging 2 cartons per refill, more frequently than initially expected.

• Patient support services are highly praised by both physicians and payers, contributing to a positive access experience.

• Early adopters were often drawn from a pre-launch database, but new patient growth is increasingly driven by referrals and community advocacy.

Revenue dynamics and market outlook

• Refill revenue now exceeds new patient start revenue, reflecting attack-driven usage rather than patient count.

• Consensus revenue estimates for the year are around $180–185 million, with linear patient growth expected to continue.

• Gross-to-net discounts are expected in the high teens to low 20s percent, in line with industry norms, with minimal pressure for aggressive contracting.

• The total addressable market is estimated at $1.5 billion, based on current dose volumes and pricing, with potential upside if treatment rates increase.