ED Alternative to Oral Tablets

Shannon Battle (00:05):

Production if you’re not already familiar with us, my name is Shannon Battle. I’m the pharmacy services manager and primary point of contact for all things Vendor Advantage Network with IPC. And I’m here with my colleague Samantha Roy, director of Pharmacy Services and Specialty Programs, and Kelly Sall, our vice President of clinical programs and pharmacy services. We also have our special guest, Hayden Goldman from Olympia Pharmaceuticals. So welcome all of you. I’m glad to have us all here today.

Hayden Goldman (00:33):

Yes ma’am. Thank you for having me.

Shannon Battle (00:36):

Absolutely. Well, we want to welcome all of our IPC viewers. Any of you have been here before or new to the videos. We really want to encourage you to ask questions throughout both clinical and otherwise all of us will be looking at the Q and as, be able to answer them throughout the presentation today and then at the end as well, we’ll catch any that we hadn’t before. If you did miss the last webinar, we went over some really great discounts that we had on compounded products for IPC offered by Olympia Pharmaceuticals and how you can grow this cash based opportunity. So today will be much of the same, just expanding on some different specialties. Pam and Kelly, thank you guys for being here. As always, what are you guys hearing from our members currently on how they’re incorporating cash opportunities, these compounding opportunities are there but maybe they don’t know how to get started or what great areas, just any information you already have and that would help students out.

Samantha Pomeroy (01:36):

Sure. So similarly to our last call with Olympia, every time I consult with a pharmacy, they’re asking me, Sam, what’s a opportunity that I can get involved in with not a huge cash advancement upfront that will help my patients, my community? And this is just a great option. We’ve partnered with Olympia for our pharmacies to be able to source these 5 0 3 B products and general wellness, erectile dysfunction, weight loss, and all of these categories are really on the rise. And so our last webinar, Hayden gave us some really great pointers with wellness and longevity and weight loss, where to market those, what physicians offices to look to. So I’m really looking forward to focusing today on erectile dysfunction and some men’s health options for our pharmacies to be able to source from Olympia. And this is just a really great option for not that much of an investment upfront and this is a great opportunity for our stores to be able to see if this is going to work in their pharmacy and their community and what interests they’re going to have in their area from their patients and physicians. So excited to be here to listen in.

Kelli Stovall (03:04):

Dan. That’s well said. I think the other exciting thing about a product like this is these patients are already walking in your door and this allows you to help them in a further way because we know that with chronic conditions, ED does increase men with diabetes have a 50% higher risk of ed. So this is just another opportunity for you to increase that type of care for the patients that you have now as well.

Shannon Battle (03:31):

Yeah, absolutely. Well, Hayden, let’s jump right in. I’ll let you get started on the slides and really let us know. All you have to know about the men’s health and these products.

Hayden Goldman (03:39):

Oh yeah, absolutely. Absolutely. So really Ed, this is kind of the progression we see with most patients, right? First line of treatment, maybe something over the counter that who in the world knows what it’s going to do. We have seen some success with L-arginine. It is a vasodilator really allows, I would say those maybe with super mild early stages of ED might see some results just with L-arginine alone. Something interesting that we’re seeing throughout I would say the industry are these telemedicine practices, the blue shoes, the row HIMSS and hers rolling out easy accessible sildenafil todalofil, whether that is a gummy, it’s might be a tablet, but what this is allowing for are younger and younger patients to get their hands on sildenafil and fil early. So over time what we are seeing are more and more patients at a younger age struggling with the ED because they might have built some sort of a tolerance to sildenafil and tadalafil much earlier than we’ve ever seen previously or in the past.

(05:00):

So the last line of treatment and those that have been struggling with ED for quite some time, maybe the sildenafil and tadalafil just aren’t doing quite the trick any longer. That’s where we can go ahead and start utilizing some form of trimix, whether that’s a Bix just to get them started. We have some really popular lower concentrated or strength trimix formulas and then we also have quad mix. So what that also allows with SKUs and I think later on in the PowerPoint we’ll take a look at all the SKUs that we have to offer. It allows for patients to start again with a bix in early stages and you will retain patients through the various BIM mixes that we have. We have a ton of trimix formulas and then into quad mix. We see patients coming back time and time again over the span of 30 years obtaining, once you start all that patient’s going to do is work their way through that formulary and now you have phenomenal patient retention, right, because they’re going to continue coming back and it allows you to steadily increase or pivot that formula as needed just based on the results that they are seeing.

(06:21):

So what is trimix? So trimix is a combination of papin, phentolamine and atropine. These products work phenomenal together. It really works as vasodilators locking in the blood vessels in the penis ptn. It does a really great job, relaxes the muscles in the penis to allow for erections to begin much easier and retained as well. We could go ahead and go to the next slide. So why there are multiple studies out there. I would say the main issue that we see is PRI prism. Keep in mind we do have Rine. Rine is phenomenal reversal agent. We always provide olein free whenever a patient is first getting into trimix and it might be their first time utilizing it, we’ll go ahead, throw in a free papin or I’m sorry, a free fin tilt mean holy macro, I’m going all over the place.

(07:30):

Rine, the peas are killing me today. We’ll throw in a free and that’s just there just in case maybe if they inject just a little too much on their first try, they always have that reversal. So that’s always a good selling point. Kind of ease the mind of the patient if they do have hesitancy, which trust me, I totally understand why they would be hesitant, but having that reversal always available is great. Another great thing about trimix, we have stability to show that it is good and has a beyond use state for 360 days. We don’t run stability for 360 days on hardly any of our products. We’ve been doing trimix for a very long time. It’s pretty much what we were kind of built on or our foundation and of course our sterile skews have just grown from there, but Trimix is like our bread and butter, no doubt.

(08:32):

So you’ll see there are studies here. So prior Prism, extremely low and for those that do have prior prisms, you can offer the reversal. I would definitely consider if you are purchasing, it’s just okay, I need to order the olein as well. But yeah, great success there. This is a really interesting stat. So 92 to 100% response rate of those who did not respond to monotherapy. So those that were just taking a sildenafil tadalafil, you throw in apro ail, which is one of the ingredients that is utilized in Trimix and boom, all of a sudden they are seeing results. So people do become very much stagnant I would say in the space of ED where they just either don’t want to go to the doctor to talk about it and seek alternatives or they might be just hesitant to talk about it in general. And I think we see that across all lines of men’s health, but it is a phenomenal way to kind of break through that barrier.

Shannon Battle (09:46):

The support that you guys have for the pharmacies is amazing. I think it’ll make it a lot easier to break some of those barriers.

Hayden Goldman (09:53):

Oh yeah, 100%. I mean our pharmacists have borderline mastered everything when it comes to ED speaking to these patients, re-dosing of trimix, things of that nature. But you’ll see the onset of action is quicker than what you see with the oral products. I believe one thing that is very interesting, so we can kind of put two and two together, alcohol and sex, there are no contraindications there, which is phenomenal. I think that is something you see across ED patients. But yeah, this is a fantastic product and this is just comparing the two

Samantha Pomeroy (10:41):

Hayden you said that, and this was my experience too before coming to IPC, we offered trimix and it was one of our best sellers in our men’s health category and there was always at least three refills on a trimix because like you said, they generally stay on this treatment because it is so successful when a patient is starting out or for any of our pharmacists that might be joining or listening to the recording of this kind of just getting into this space, the patient starting out on this, do you recommend that the pharmacist order, the formulation that was prescribed plus the additional refills to have that in soccer? Do you see after the first initial formulation is given to the patient that there are adjustments and to what kind of weight to order those second to third vials until maybe adjustments need to be made?

Hayden Goldman (11:38):

That is a really great question. I would say it’s safe to say always have your providers prescribed with refills. Maybe let’s say that formula was not quite the fit. Don’t refill that script, right? Hopefully go back to the urologist and figure out or find a dose that works out well. What we usually say is to start anywhere between five and 10 units. The really sweet spot for a dose that does work and somebody that’s been taking trimix is around 25 units. As you continue taking trimix, once you get over that 25 unit mark is when we might need to consider a different dose. We want to keep the volume of the product being injected relatively low. So if a patient upfront is not getting the results having to inject well over 25 units, of course that would be a telltale sign. Let’s get back with the urologist and let’s figure out a dose that does fit the need for this patient. And we have some really good, I would say formulas that most go with upfront or first. And I think you’ll see that on the next slide as well. Does that answer your question, Samantha?

Samantha Pomeroy (13:02):

Yes. Yeah, I just was wanting to point out that I think that’s a great option with Olympia that you can just order one vial. So if you are just now getting into this space or just now offering this or sourcing this from Olympia, perhaps on that first prescription order the one vial to make sure that that’s the dose that your patient’s going to need before you order those additional refills in.

Hayden Goldman (13:23):

Absolutely. And you know what Shannon, now that I’m looking at this slide, I know what the next slide is. Let’s go to the next slide and then let’s go back to this slide. So as you can see at Olympia we have 20 plus formulas. This is a lot to kind of take in. What are all these numbers meaning the different formula names? Trust me, I have no idea who in the world came up with these names for these formulas. So be it. So we do have a lot, which is it’s I think a pro and I do think it is a to a degree, there are pharmacies out there that are offering two to five formulas of trimix. That is not going to work. It’s not going to work because your patient retention rates aren’t going to be great. You are only offering limited options and transparently every patient’s different and I think it can be addressed in various ways.

(14:20):

Right now up top you see our Bix BM three. That is a great option for somebody with super, I would say mild ed, the T 1 0 1, 1 0 5 and 1 0 6, that is usually where we start. Majority of our TRIMIX patients, those are no if ands or buts are best sellers. And then you make your way down, you’ll see the various formulas do change in strength, but that is exactly how it’s designed. Sure, we’ll start a patient on T 1 0 5 and they’ll be on that for quite a few years potentially. Before we might have to consider something like a SB four or S SP five. The SBS are really great as well. So with that in mind, yes, it can be a lot. And if you were to take this and I would say from a marketing aspect and shopping this within your community at various urologist offices, they are going to know what TRIMIX is.

(15:22):

We have not met a urologist that is like, oh, haven’t tried that line of treatment. That is false. They very well know what trimix is and they should be somewhat oriented to it. So being able to go to a urologist office and have this sort of offering available to them is very, very much intriguing. Now in terms of it, a pharmacy getting into it, well where in the world do I start? Holy mackerel. There are 20 formulas here and that is where I would go to the slide previous that we were just on. So with that in mind, what we have done and we’ve actually partnered with a telemedicine practice and I’ll drop the name Henry Meds. They’re phenomenal. They were really the first movers when it came to GLP ones and lo and behold, they’re the first movers when it has come to Trimix as well.

(16:20):

What we did was really pair down our formulary to just a few different SKUs, right? And I think this can very much easily be replicated at the level of each independent pharmacy rather than having 20 plus SKUs that you have to keep up with and maybe you might have, let’s say it’s very successful for you rather than keeping inventory of all of these, right? 20, let’s narrow it down and let’s just maybe shelf the few that you are seeing prescribe more frequently. Right now, the phenomenal thing is yeah, we are only going to shelf, let’s say BM three, T 1 0 5 and SB four. Those are our three go-tos. But if you have patients with needs that are outside of that, just know we have next business day turnaround time and you are going to get it by the next business day, just order those one-offs as needed. I think that is a big benefit. The other big benefit, being able to actually shelve these, the 360 day beyond view state from data compound, that is a huge plus as well. It doesn’t necessarily have to fly off your shelves, but if you have a urologist that is interested, it only makes sense to keep these products at your pharmacy and have ’em readily available for their patients same day pickup. I think that is definitely intriguing.

Samantha Pomeroy (17:45):

Hayden, we have a question from Rod. Will you customize formulations to one urologist according to what that urologist writes?

Hayden Goldman (17:54):

That is a very great question. So it was something that we did do in the past. We were tiny pharmacy when we were doing that, but no, at this point we wouldn’t. Again, these are 5 0 3 B products, so products produced out of the B to get any sterile product through R and D, MDMV and stability testing, that’s about a six to eight month process. But with that in mind, understanding what dose is needed, that’s also a plus. Whatever dose is being written for or certain formula, we will have comparable or comparable formulas to that within our 20. So there are alternatives. I know some urologists are just dead set on a wicked crazy dose that lo and behold is not within R 20. You can always, I would say consult with the urologist, right? See what would fit the mold.

Shannon Battle (18:57):

You have these certain ones that of course pharmacies are going to be using more often. They’re probably the ones that they’re going to want to talk to their urologist about. Do you guys have marketing kind of already put together they could present local offices?

Hayden Goldman (19:11):

We do. If we want to go to the, not next slide, but the slide after, we can go to the patient resources. So we have a ton of resources available for patients. We have a dosing guide as well. That’s phenomenal. I mean in all honesty, I think the biggest marketing push here and the biggest benefit would be the number of SKUs that we have available. So I mean simply going to a urologist office and being able to show them all the various formulas you can offer, I believe markets itself to a degree because a urologist, they know the benefit there. So that’s my take on it. You don’t have to know it that well. Again, having that many formulas at your disposal that you can have at your facility by the very next business day is a huge feather in the hat per se. And that’s why I believe it really does market itself.

(20:12):

Now, there are folks out there and clinicians that are or kind of shy away from the educational piece of it. That’s why we have seen pretty much all other product lines flourish in telemedicine practice, right? Trimix is going to be the last one to be taken, but once folks do start offering it virtually or via virtual health, it is going to take off because their patient retention is going to be so much better than any other product line or service line that you’re offering. It’s going to be the patient education barrier I think when it comes to telemedicine and we have a ton of resources to help with that. But that is my take in all honesty. Shannon, to your question there, I think it is a big educational piece.

Shannon Battle (21:08):

Yeah, it’s definitely helpful to have that support from you guys as well.

Hayden Goldman (21:13):

No doubt. No doubt. And our pharmacists, they’re available. They are the ones that make up like the Trimix injection guide there that you see. We’ll send that and every patient prescription we send out, I’m pretty sure we provide at least one copy of that when sending it as an office use order or out of the 5 0 3 B without a patient prescription. But yeah, phenomenal resources put together by them. They are always on the phone. So if there are any questions about dosing or maybe re-dosing that they are a phenomenal resource. And in all honesty, majority of the calls we get in, it’s not necessarily the dose or the formula, it’s truly how the patient is injecting as well. So being able to provide your patient with a URL or a QR code, whatever you might want, you’d be able to easily plug in that trimix injection tutorial and that should be very beneficial for patients as well. And last but not least marketing plug this in, but I am really excited about it. This does not help with ed, but it is a phenomenal product, one that we’re going to see have great success liquid, some morelin coming what I would call late fall of 2025 around November. Again, it’s one that we talked about in the last webinar, another product that we expect to do very well towards the end of this year, beginning of next.

Samantha Pomeroy (22:46):

So you’ll let us know as soon as this is available, Hayden, for our members because we’ve gotten several questions about this. I think this is going to be an amazing offer within independent pharmacy

Hayden Goldman (22:58):

100% because I’m like scratching and clawed liquid, some Moreland was actually a suggestion that I made probably towards the tail end of last year, beginning of this year and seeing it actually come to life is pretty exciting.

Samantha Pomeroy (23:16):

What’s the beyond you state of the liquid some Moreland? Do you have that yet?

Hayden Goldman (23:21):

No, we have not sent it off for stability testing transparently. We are going to want to get this out to market as soon as possible. So it’s likely that it’ll launch with a slightly shorter beyond use state because stability, that just takes time, right? We will end up running it through 360 days. I mean we won’t get there until the end of next year I believe, but I think it’ll likely launch with 90 is what we’re hoping. I think we are pretty eager for it, so it might even launch with 60, but we traditionally don’t launch with anything less than 90. And why Olympia? So the discrete packaging, I believe that might be one they put it on there. Not every day. I see our packaging transparently overnight shipping. I think that is overnight shipping, same day processing has got to be one thing that sets Olympia apart.

(24:22):

No if ands or buts about it. I mean anytime you get an order in with us prior to 12:00 PM Eastern standard time, I’d say Monday through Thursday, now that GLP ones are gone and Mondays aren’t such a bear, we are getting product out same day. So that is huge. And then pharmacists, our team of pharmacists are phenomenal. Again, that is something not a whole lot of 5 0 3 Bs have at their disposal. We have a team of five or six clinical pharmacists that man the phones ready to answer questions, concerns that you might give from your clinicians that you might be working with or patients alike. Marketing materials. We have added an individual on our marketing team and they actually have an email and field request for any such marketing material that you might want specifically or potentially altered. They’re more than happy to work with you.

(25:17):

And then last but not least, our quality department. I think the last webinar we were mid FDA audit. We are done with the FDA audit and the 4 83 we just got or did get was phenomenal and full transparency, it was our best FDA audit that we’ve had in quite some time, even though the previous ones weren’t terrible. This one is stellar. I think they were three little minor items that they picked up on. So we’re really excited and it’s a true testament to our quality team. We just became a new P certified out of our 5 0 3 B as of yesterday. So really excited about that. That was a long process. So between next day shipping, I would say clinical pharmacist or customer service. I know my team, they are responsive because they report to me and if they aren’t, we’re going to have a conversation. So between that and our quality, I mean it is a true testament to how phenomenal this organization is.

Shannon Battle (26:25):

Well, thank you again, Hayden. It’s great every time you guys have so much information that our stores are really looking for. As a viewer, if you haven’t already signed up with Olympia, there is a QR code there on the screen. It’ll take you right to their landing page on our website. Alternatively, if you go to ABC’s website, you can go to the vendor section and they’re all listed in alphabetical order. There’s a short contact form there that you can submit not just to order but to get set up so you can view pricing and everything that they have and really just get started and look around. Even if you’re not quite ready to order, excuse me, the team is really responsible and ready to reach out to you guys. There’s full catalog. You can explore all of the things they have, educational materials included. So Hayden, again, if we haven’t mentioned it to you guys, the discount for IPC members is anywhere from 25 to 35%. There are a few items. I think Hayden, I think you said last time on our call that there’s a few that may be even a little bit lower than what we started or a better discount now. So that’s better.

Hayden Goldman (27:26):

Yeah, I believe so. Got to be honest. I don’t have my master spreadsheet up right now, but yes, that is true.

Shannon Battle (27:34):

Yeah, well Olympia is one of the 45 vendors that our department has brought on to help all of our stores increase profits and bottom line. So one of the best that we’ve had recently and we really love this partnership. So again, I appreciate you being on here, Kelly and Sam, anything to add there?

Samantha Pomeroy (27:50):

No, I was just going to say, Hayden, thank you to you and your team for being so responsive to all of our members that have reached out to you. I mean, they get an immediate response. It’s easy for them to get set up, you answer questions. And so this is a really clinical space and we appreciate the information from your clinical pharmacist on staff answering questions that our pharmacist might have in their independent pharmacy to get started in this area if they are not. So thank you for your time.

Hayden Goldman (28:18):

Absolutely.

Shannon Battle (28:20):

Thank you again everyone, this will be a recording and it’ll be sent out via email. Reach out to us anytime with the further questions. You guys have a great rest of your week.

Hayden Goldman (28:28):

Thank you. Thank you all.

Shannon Battle (28:29):

Thank you.