1

Topic: Omidria

Two years ago this February I had eye surgery to remove a membrane growing over and distorting the shape of the retina in my right eye.  An ordinary thing due to aging.  A commonplace side effect of that surgery is a cataract in that eye.  Sure enough that eye now has a cataract (I thought my vision was getting worse and I was right!) which I will have removed.  My eye doctor is at Wilmer Eye Institute, part of Johns Hopkins of course, here in Baltimore.  My regular eye doctor told me there are many cataract specialists working at Wilmer.  I told her about Omidria and asked her to fix me up with an appointment to see a doctor with whom she thought I could talk to about Omidria.  I'm going to go into that appointment with Omidria literature - I'll look it up and print some out. 

Do you think it's possible to get an Omidria salesperson to call my cataract specialist surgeon to talk to her?  I would be happy to act as go-between to set it up, particularly to talk to my surgeon ahead of time so she has time to call Omeros and learn about Omidria if she is not yet aware of it.  If Omidria is not already used at Wilmer - a world-renowned eye institution - it would make for a great addition to Omeros' book in terms of sales.

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Re: Omidria

If the doctor/surgeon has not heard about Omidria, I'd think twice about using her/him.
But it may be that the doctor does not use Omdiria unless you pay for it, out of pocket or via private insurance, because medicare is not yet paying for it separately.

The doctor is unlikely to cost her practice, or the hospital, ~$430 for Omidria.
You might start off by emailing or calling the Dr. office and asking whether s/he routinely uses Omidria during lens replacement surgery.

There is an Omidria.com website where you can get information and perhaps they have things for patients there, too.

original content ©2020 to 2021 by Alan Robert Ross
Founder, Trust Intelligence
The foregoing is not investment advice.

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Re: Omidria

Been wondering about that myself, Alan, as to whether I should use this doctor is she hasn't heard of Omidria, or has heard of it but doesn't use it.  I'll ease my way into this situation and navigate through it.  If she's familiar with Omidria but doesn't pay for it, and I can't find another doctor who would pay for it (which I assume is doubtful), I'd pay for it myself if I thought the doctor would indeed use it and use it correctly.  $430 more or less isn't that much, I can afford that for this operation.  But I do want to use Omidria, not opioids including fentanyl.  If she flat out refuses, I will attempt to find someone else.

My regular eye doctor today - my first appointment with her because my previous doctor retired - has never heard of Omidria.  But she doesn't do surgery.

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Re: Omidria

Is Medicare paying for the operation, Avi?
If you don't have supplementary insurance (which may pay) and Medicare pays, they will not pay anything for Omidria.

No way the Surgeon will pay for it as the surgeon doesn't get much more for the operation than the price of Omidria.

Omidria is a liquid that is applied to the eye during surgery. It is a formulation of 2 drugs:

Ketorolac
Ketorolac is a non-steroidal anti-inflammatory that inhibits both COX-1 and COX-2, resulting in a decrease in tissue concentrations of prostaglandins to reduce pain due to surgical trauma.3

By inhibiting prostaglandin synthesis secondary to ocular surgical insult or direct mechanical stimulation of the iris, ketorolac also prevents surgically induced miosis.3

Phenylephrine
Phenylephrine is an α1-adrenergic receptor agonist and, in the eye, acts as a mydriatic agent by contracting the radial muscle of the iris.3

Refer your doctor to the website: https://omidria.com/

original content ©2020 to 2021 by Alan Robert Ross
Founder, Trust Intelligence
The foregoing is not investment advice.

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Re: Omidria

Yes, I expect Medicare will cover the cost of this operation.  I didn't pay anything at all, or some small amount (I can't remember) for my retina surgery 2 years ago.  I have Original Medicare and Part B I think it is, which theoretically covers what Original Medicare doesn't.

If it comes down to it I'll pay for Omidria myself.  I'm going to get right on this, instead of waiting for my pre-op appointment to introduce my thoughts to my surgeon.  If she isn't interested, I will gain almost 2 months time, as my pre-op appointment is January 4.  I'll get her e address and take it from there.

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Re: Omidria

I predict that you will be billed separately, but it will be interesting to see what the surgeon says if you request it to be used.

I presume the surgeon will tell you that it will lead to an extra charge, but who knows?
I will also be interested in
- finding out what that charge will be
- learning whether the surgeon tells you it is 'not necessary' or 'not needed' and why (probably because the surgeon is so skilled)

Remember, it reduces the occurrence of complications that may cause loss of vision in the eye, in addition to reducing pain and inflammation and the need for any pain relievers.

original content ©2020 to 2021 by Alan Robert Ross
Founder, Trust Intelligence
The foregoing is not investment advice.

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Re: Omidria

It also diminishes the need for clamps to hold the pupil open.  Lots of reasons to use Omidria.  I'll let you know how it goes.

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Re: Omidria

1 more cosponsor added to S 3067, Senate version of NO PAIN Act

original content ©2020 to 2021 by Alan Robert Ross
Founder, Trust Intelligence
The foregoing is not investment advice.

9 (edited by Alan Robert Ross 2020-11-24 20:48:03)

Re: Omidria

I just sent the image below to Greg with an email Subject: What's the answer?

I almost was going to ask him if you knew, or whether he could tell me the answer, but it hit me that any yes/no answer he gave to those questions would be equivocal.

Not that he will answer.

We all expect that the NOPAIN  ACT will not be passed separately. You can see a copy of it,here: https://sewell.house.gov/sites/sewell.h … %20Act.pdf

https://charts.stocktwits.com/production/original_259205183.png

Caitlin Emma @caitlinzemma
Covering the federal budget and spending bills for
@POLITICO
Author of @POLITICOPro’s Budget & Appropriations Brief. Tips: cemma@politico.com.
Washington, D.C.politico.com/staff/caitlin-…Joined March 2010
3,825 Following 16.2K Followers

Per usual, appropriators won’t be releasing the (b)s until the omnibus is finalized.
Happy Thanksgiving.

BREAKING: Top House and Senate appropriators have reached a bipartisan deal on funding allocations, or 302(b)s, that will inform an omnibus spending package to avert a government shutdown on Dec. 11, per a House Democratic aide.

original content ©2020 to 2021 by Alan Robert Ross
Founder, Trust Intelligence
The foregoing is not investment advice.

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Re: Omidria

That would be huge if they get it in.  I suppose we will not know until omnibus bill is passed

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Re: Omidria

I do not know when they give the details of the many provisions in the Bill. Surely the sponsors of a variety of Bills will be trying to get their favorites included. At some point after the Horse Trading in both Houses is over, the Bill will be published.

But the Sponsors of Bills to be incorporated may say whether or not their own Bills have been  included.  I don't know if they are sworn to secrecy, but I doubt it, and Greg may hear from the sponsors (or the Omeros lobbyists) before anything is public.

original content ©2020 to 2021 by Alan Robert Ross
Founder, Trust Intelligence
The foregoing is not investment advice.

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Re: Omidria

I'd suspect we would see it in the stock price before we actually hear anything

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Re: Omidria

Yeah all the Senators and Representatives and their friends and relatives will be buying and push the price up (not to mention the lawyers/lobbyists).

There is probably sporadically good opportunistic profits to be made just by studying legislation and having sources in DC who will keep you apprised about developments.

original content ©2020 to 2021 by Alan Robert Ross
Founder, Trust Intelligence
The foregoing is not investment advice.

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Re: Omidria

I have a friend whose company does just that.  They have a number of patent and regulatory lawyers who monitor certain cases, attending in person, and making risk assessments with respect to the outcomes, and the firm will trade based on that.

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Re: Omidria

Neat

original content ©2020 to 2021 by Alan Robert Ross
Founder, Trust Intelligence
The foregoing is not investment advice.

16 (edited by Alan Robert Ross 2020-12-02 18:29:35)

Re: Omidria

I have sent Greg a congratulatory note from me and my peeps to him and his... and got a thank-you within 5 minutes.

Consider yourselves thanked!

I slipped in a plug to tell him we exported MORE great things to come.

IMO Omidria is now worth about $1B in market cap. It probably will not be valued that high for a while, but peak sales would justify it in a few years.

In fact, it may lead to a sale of Omidria for between $750M to $1B at some point.

original content ©2020 to 2021 by Alan Robert Ross
Founder, Trust Intelligence
The foregoing is not investment advice.

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Re: Omidria

CMS wrote:https://charts.stocktwits.com/production/original_260997662.png

original content ©2020 to 2021 by Alan Robert Ross
Founder, Trust Intelligence
The foregoing is not investment advice.

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Re: Omidria

Now my faith in government has been restored.

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Re: Omidria

write them tongue

original content ©2020 to 2021 by Alan Robert Ross
Founder, Trust Intelligence
The foregoing is not investment advice.

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Re: Omidria

Thanks for thanking Greg:)  And I hope we can thank him a few more time in the next several months

I take it we can assume that they will continue this treatment past the 2021 date that is mentioned?

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Re: Omidria

The future is not perfectly predictable.
That's why we don't call it the past.

original content ©2020 to 2021 by Alan Robert Ross
Founder, Trust Intelligence
The foregoing is not investment advice.

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Re: Omidria

I see the question was addressed on the main thread.  Regardless of the noise the shorts might make regarding yearly re-approval, getting the revenues if 2021 should eliminate further chatter about financing, and also continue to solidly the clinical benefit of omidria.

The base case should be successful renewal every year.

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Re: Omidria

I also sent Greg a colorful and sincere congratulatory message moments ago.  Got a nice response a couple of minutes later.

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Re: Omidria

CMS Confirms Continued Separate Payment for Omeros’ FDA-Approved OMIDRIA ® in Ambulatory Surgery Centers Separate payment for OMIDRIA retroactively effective as of October 1, 2020 —
December 03, 2020 07:30 AM Eastern Standard Time
SEATTLE--( BUSINESS WIRE )--Omeros Corporation (Nasdaq: OMER) announced today that the Centers for Medicare & Medicaid Services (CMS) confirmed separate payment in ambulatory surgery centers (ASCs) for Omeros’ cataract surgery drug OMIDRIA ® (phenylephrine and ketorolac intraocular solution) 1%/0.3%. In its final rule directed to the Medicare outpatient prospective payment system (OPPS) and the ASC payment system for calendar year 2021, CMS confirmed that OMIDRIA qualifies for separate payment under CMS’ policy for non-opioid pain management surgical drugs when used in the ASC setting. This separate payment for OMIDRIA is effective retroactively beginning October 1, 2020.

“Omeros appreciates CMS’ decision to continue paying separately for our ophthalmic drug OMIDRIA,” said Gregory A. Demopulos, M.D., Omeros’ chairman and chief executive officer. “Having just come off its pass-through status, this is the first time that OMIDRIA qualifies under CMS’ payment policy for non-opioid pain-management surgical drugs in the ASC setting. In addition to reducing patient exposure to opioids, CMS’ decision continues to provide important access to OMIDRIA for Medicare beneficiaries and to allow ophthalmic surgeons to use their best medical judgment to treat those patients. This is a good outcome for surgical facilities, surgeons and their patients.”

OMIDRIA is the first and only FDA-approved product for use during cataract or lens replacement surgery that prevents pupil constriction during surgery and reduces postoperative ocular pain. In post-marketing studies, OMIDRIA has been shown to have a broad range of benefits, including the reduction of sight-threatening complications and mitigating the need for intra- and postoperative steroids. OMIDRIA is approved for use in both adults and children.

About OMIDRIA ®

Omeros’ OMIDRIA ® (phenylephrine and ketorolac intraocular solution) 1% / 0.3% is the first and only FDA-approved product of its kind and is marketed in the U.S. for use during cataract surgery or intraocular lens replacement to maintain pupil size by preventing intraoperative miosis (pupil constriction) and to reduce postoperative ocular pain. OMIDRIA also is the only NSAID-containing product FDA-approved for intraocular use. In post-launch studies across conventional and femtosecond laser-assisted cataract surgery, OMIDRIA has been shown to (1) prevent intraoperative floppy iris syndrome (IFIS) and iris prolapse, (2) significantly reduce complication rates (including sight-threatening cystoid macular edema and breakthrough iritis), use of pupil-expansion devices, and surgical times, (3) significantly reduce intraoperative use of the opioid fentanyl and postoperative prescription opioids, (4) enable performance of surgery and postoperative care without the use of steroids, and (5) significantly improve uncorrected visual acuity on the first day following cataract surgery. While OMIDRIA is broadly indicated for use in cataract surgery, the post-launch outcomes cited above are not in its currently approved labeling.

Important Safety Information for OMIDRIA ®

Systemic exposure of phenylephrine may cause elevations in blood pressure. In clinical trials, the most common reported ocular adverse reactions at two percent or greater are eye irritation, posterior capsule opacification, increased intraocular pressure, and anterior chamber inflammation; incidence of adverse events was similar between placebo-treated and OMIDRIA-treated patients. OMIDRIA must be added to irrigation solution prior to intraocular use.

About Omeros Corporation

Omeros is a commercial-stage biopharmaceutical company committed to discovering, developing and commercializing small-molecule and protein therapeutics for large-market and orphan indications targeting inflammation, complement-mediated diseases, disorders of the central nervous system and immune-related diseases, including cancers. Its commercial product OMIDRIA (phenylephrine and ketorolac intraocular solution) 1%/0.3% continues to gain market share in cataract surgery. Omeros’ lead MASP-2 inhibitor narsoplimab targets the lectin pathway of complement and is the subject of a rolling biologics license application under review by FDA for the treatment of hematopoietic stem cell transplant-associated thrombotic microangiopathy. Narsoplimab is also in multiple late-stage clinical development programs focused on other complement-mediated disorders, including IgA nephropathy, atypical hemolytic uremic syndrome and COVID-19. Omeros’ MASP-3 inhibitor OMS906, which targets the complement system’s alternative pathway, recently entered the clinic, and the company’s PDE7 inhibitor OMS527 has successfully completed its Phase 1 trial. Omeros’ pipeline holds a diverse group of preclinical programs including a novel antibody-generating technology and a proprietary GPCR platform through which it controls 54 new GPCR drug targets and their corresponding compounds. One of these novel targets, GPR174, modulates a new cancer immunity axis recently discovered by Omeros, and the company is advancing small-molecule GPR174 inhibitors.

original content ©2020 to 2021 by Alan Robert Ross
Founder, Trust Intelligence
The foregoing is not investment advice.

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Re: Omidria

"retroactively beginning October 1, 2020."

original content ©2020 to 2021 by Alan Robert Ross
Founder, Trust Intelligence
The foregoing is not investment advice.

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Re: Omidria

NOPAIN update. 
Senate 24, increase of 1. 
House 55, no change

original content ©2020 to 2021 by Alan Robert Ross
Founder, Trust Intelligence
The foregoing is not investment advice.

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Re: Omidria

I just something from the govt. about a related act... or a change in the title because of the CMS action?

Don't know, but here it is:

Summary: H.R.5057 — 116th Congress (2019-2020)
All Information (Except Text)
There is one summary for H.R.5057. Bill summaries are authored by CRS.

Shown Here:
Introduced in House (11/12/2019)
Pass-Through Technical Corrections Act

This bill specifically extends the duration of pass-through status (i.e., additional payment) for certain radiopharmaceuticals under the Medicare prospective payment system for hospital outpatient department services. In particular, the bill provides that a radiopharmaceutical with an indication for certain PET imaging that is covered in relation to clinical studies (i.e., coverage with evidence development) continues to receive pass-through status until the applicable coverage review is complete, even if such status initially expired on either December 31, 2017, or December 31, 2018.

original content ©2020 to 2021 by Alan Robert Ross
Founder, Trust Intelligence
The foregoing is not investment advice.

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Re: Omidria

But Omidria is not a radiopharmaceutical, right?

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Re: Omidria

Correcto!

original content ©2020 to 2021 by Alan Robert Ross
Founder, Trust Intelligence
The foregoing is not investment advice.

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Re: Omidria

Got this notice today, which appears to be that NOPAIN is alive and has been referred to a subCommittee, which I suppose, is progress.
====================
https://www.congress.gov/bill/116th-con … r=cga-bill

H.R.5172 - NOPAIN Act
116th Congress (2019-2020)
Sponsor:    Rep. Sewell, Terri A. [D-AL-7]
(Introduced 11/19/2019)

Committees:    House - Energy and Commerce; Ways and Means

Latest Action:    House - 11/20/2019 Referred to the Subcommittee on Health.  (All Actions)
Subject — Policy Area: Health

Summary (1)
Summary: H.R.5172 — 116th Congress (2019-2020)
All Information (Except Text)
There is one summary for H.R.5172. Bill summaries are authored by CRS.

Shown Here:
Introduced in House (11/19/2019)
Non-Opioids Prevent Addiction In the Nation Act or the NOPAIN Act

This bill temporarily establishes separate payments for certain non-opioid treatments under the Medicare prospective payment system for hospital outpatient department services and the payment system for ambulatory surgical center services. The bill applies to pain management treatments that are able to replace or reduce opioid consumption, as shown through clinical trials or data.

original content ©2020 to 2021 by Alan Robert Ross
Founder, Trust Intelligence
The foregoing is not investment advice.

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Re: Omidria

new front page of the Omidria site
https://charts.stocktwits.com/production/original_261875630.JPG

original content ©2020 to 2021 by Alan Robert Ross
Founder, Trust Intelligence
The foregoing is not investment advice.

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Re: Omidria

"a permanent J-code???"

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Re: Omidria

That is the billing code used, and it is especially useful for private insurers (more than Medicare).

original content ©2020 to 2021 by Alan Robert Ross
Founder, Trust Intelligence
The foregoing is not investment advice.

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Re: Omidria

Will NOPAIN be appended to the new Bill?
http://www.trustintelligence.com/viewto … 1087#p1087

original content ©2020 to 2021 by Alan Robert Ross
Founder, Trust Intelligence
The foregoing is not investment advice.

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Re: Omidria

I don't recall signing up for this bill, below, but it may be this is the successor of NOPAIN in the House after OMER got Pass Through... or perhaps I am getting alerts because it is similar.

Summary: H.R.5057 — 116th Congress (2019-2020)
All Information (Except Text)
There is one summary for H.R.5057. Bill summaries are authored by CRS.

Shown Here:
Introduced in House (11/12/2019)
Pass-Through Technical Corrections Act

This bill specifically extends the duration of pass-through status (i.e., additional payment) for certain radiopharmaceuticals under the Medicare prospective payment system for hospital outpatient department services. In particular, the bill provides that a radiopharmaceutical with an indication for certain PET imaging that is covered in relation to clinical studies (i.e., coverage with evidence development) continues to receive pass-through status until the applicable coverage review is complete, if such status initially expired on either December 31, 2017, or December 31, 2018.

https://www.congress.gov/bill/116th-con … r=cga-bill

original content ©2020 to 2021 by Alan Robert Ross
Founder, Trust Intelligence
The foregoing is not investment advice.

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Re: Omidria

Senator from WV mentions the Omnibus Bill has provisions to fight the increasing rate of addiction.

A little after the 5 minute mark:

https://twitter.com/WVMetroNews/status/ … 68897?s=19

original content ©2020 to 2021 by Alan Robert Ross
Founder, Trust Intelligence
The foregoing is not investment advice.

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Re: Omidria

I went through the document looking for Pass Through for Omidria but they were not named.

I went through all the mentions of opioid and while some were related but not close enough to get enthusiastic.

Feel free to look yourself:

https://rules.house.gov/sites/democrats … 116-68.pdf

original content ©2020 to 2021 by Alan Robert Ross
Founder, Trust Intelligence
The foregoing is not investment advice.

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Re: Omidria

I also went through the Bill for other key words, like 'Omidria' and 'reimbursement' and found nothing relevant. The lack of a PR from Omeros suggests NOPAIN is not in the bill, but it is possible that they are waiting until (if?) the bill is signed by POTUS.

original content ©2020 to 2021 by Alan Robert Ross
Founder, Trust Intelligence
The foregoing is not investment advice.

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Re: Omidria

Wouldn't the actual proposed no pain language need to be in the Bill?

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Re: Omidria

Some language would have to be there in the ~6000 pages. I doubt it is because I searched, but I don't know what they may have written to be sure of the results of the search.

I don't know if what UI searched is even the complete Bill, so I can't be definitive.

original content ©2020 to 2021 by Alan Robert Ross
Founder, Trust Intelligence
The foregoing is not investment advice.

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Re: Omidria

A poster on ST says he got this from his Senator. If that was today, it means the NOPAIN Bill did not make it into the Omnibus Bill.

In addition, if the Bill is in Committee when the session of Congress ends, I believe it dies and must be reintroduced in the next Congress. But I am no expert.
https://charts.stocktwits.com/production/original_266914014.png

original content ©2020 to 2021 by Alan Robert Ross
Founder, Trust Intelligence
The foregoing is not investment advice.

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Re: Omidria

The Omidria revenue estimates came out from Symphony, via Bloomberg and then from a investment manager to me to you. November sales were poor and a smidgeon less than October, which was the first month without reimbursement. 

I don't even need my spreadsheet to know that real sales in Q4 will be dismal. How dismal depends on the rebound in December.

If I were to make a moderately optimistic guess, I'd suggest $2M average in Oct. & Nov. and a possible 7 to 8 million in December, plus a recapture of the 8 million written off in Q3, so an optimistic view would be $20 million, or slightly less.

I will eventually use the spreadsheet, but it no longer really matters what Q4 was, except for one thing:

The progress in selling to the non-Medicare 55% of the market is almost non-existent AND at a minimal and unacceptable level.

In the first period without separate reimbursement, Omeros sold about $1M/month worth of Omidria during the bundle by Medicare. Now, without CMS coverage sales are twice as high, but still dismal.

$8M/month or $24M/Q is 20,000 vials/m.
$1M is 2,500 vials/mo and $2M is 5000.

Putting that into context, there are 316.7K procedures/mo in the USA alone. The non-Medicare portion is 174.2k/mo and the medicare portion, subject to non-reimbursement is the remaining  142.5K procedures/mo.

That means selling $2 million worth in a month is 2.87% penetration of the non-Medicare market. In a normal month with an additional $6M Omidria revenue ($400/vial), they sell 15,000 vials to Medicare patients even though there are 142.5K procedures. That is a weak 10.5% Medicare market share penetration.

The question I have been asking myself for years is what if the price was reduced to $100, from $400? The Gross Profit Margin would still be over 90% so the question would be whether they could sell more than 80,000 vials per month in the USA? That would be a 25.26% market penetration, as a whole.

If they sell anywhere near the price I suggest, the salespeople should have a much easier time selling AND they may finally be able to sell in Europe and the UK, Canada, Australia/NZ and elsewhere. Those ex-US market is substantially larger. a ~10% market penetration there would increase sales by about 50%.

A potential acquirer of Omidria, one who already has sales reps visiting lens replacement surgeons, could do this at reduced selling expenses.

Rounding off these very speculative, back-of-envelope, results, serving only the English-speaking markets and Europe could bring in $36M/Q instead of $24M, which comes to $432M revenue/year, with Gross profit of about $388.8M.

Gross revenue at $432M/yr would imply a buyout value of $1.296 BILLION, comfortably more than the current Market Cap of the whole company.

Of course, CMS would have to provide permanent separate reimbursement at $100/procedure for this to happen. This would seem to me to be a reasonable possibility.

I ask myself whether some smart major Pharma might see this and offer $800M to 900M for Omidria and then use the tactic I suggest, gambling that at only $100/vial, penetration of the US and foreign markets could be even greater than I estimated.

original content ©2020 to 2021 by Alan Robert Ross
Founder, Trust Intelligence
The foregoing is not investment advice.

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Re: Omidria

I get the data on a chart that is very small. I squinted and searched the chart to find the exact number and it was 1.16M, which is NOT al the sales...just the outlets they monitor. Every month I recalculate an adjustment factor I derive based upon the prior Q actual sales versus the Symphony-repeated sales.

Without loading the spreadsheet, I'd guess $1.16M does not translate to as much as $1.5M... not the $2M I estimated in my prior post.

original content ©2020 to 2021 by Alan Robert Ross
Founder, Trust Intelligence
The foregoing is not investment advice.

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If there were a smart pharma that would recognize the potential of a price reduction, then OMER should as well, although they may not want the distraction of growing the sales team, expanding internationally, etc

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There has to be a sweet spot re price of Omidria, number of sales, and maximizing income most efficiently.  A price higher than the sweet spot decreases total income due to lost sales.  A price lower than the sweet spot decreases total income due to lower price....

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It is a question WHETHER reducing the price 75% will lead to at least quadrupling revenue.

Regrettably not  certainty.
And it is a risk that would require hiring more sales people, as suggested.

IMO Greg would sell it. He has mentioned the possibility of selling, publicly, at least at one point, of $800M, I believe as a possible strategic alternative... at least I recall it (and can't provide a specific link, because I'd have to spend too much time searching for it).

There is obviously a price point at which the largest portion of the Market, non-medicare-covered surgeries, would lead to a gross revenue increase larger than the% decline. I don't know a reliable way to pick it, but you could do marketing research to get a hint.

original content ©2020 to 2021 by Alan Robert Ross
Founder, Trust Intelligence
The foregoing is not investment advice.

47

Re: Omidria

Alan, regarding the December Omidria numbers, I would imagine there could be an impact due to elective surgeries being put off again last month due to exploding COVID cases across the US.

I don't know how many centers heeded the call to do that (or were forced to), but it certainty could negatively impact December's numbers, unfortunately.

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I didn't know they were officially shut down, Ed... of that there were any Federal rules on it.

If Dec. is bad, so will be Jan. and likely Feb.
So the only thing positive in Q4 may be taking the $8M writeoff back onto the books.

original content ©2020 to 2021 by Alan Robert Ross
Founder, Trust Intelligence
The foregoing is not investment advice.

49

Re: Omidria

I saw my surgeon today re my pre-op examination for my cataract surgery.  We're talking Wilmer Eye Institute, Johns Hopkins Hospital here in Baltimore.  The world leader in eye care.  So we hear here in Baltimore.

Here's what is interesting.  My surgeon told me she has never heard of Omidria, but she was willing to talk about it.  She looked it up right there.  She told me that the drugs she uses are phenylephrine and ketoralac.  That's what Omidria is made of!  She looked at me and said that the only difference between Omidria and what she uses is that Omidria is pre-mixed, whereas she administers the drugs one after the other.  The first one, can't remember which it is, dilates, then she administers the other one.  She told me as far as she knows and can tell, there is no difference.  I am very open to reading here that she is correct, or not.

I have to say I was pleased that she is using the correct drugs in my view, but it's not the premixed Omidria label.  Any thoughts?

From start to finish, the operation takes about 10 minutes.

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Re: Omidria

She is a high volume surgeon from what she says.

Does she irrigate the eye DURING the procedure or give shots before?

Omidria irrigation has been shown to have beneficial effects and avoids "compounding", which can be dangerous.

I do not recall if Omidria was direct compared to the exact situation you mention. Bill or Ed or Jim or ???might know. I think they avoided it.

original content ©2020 to 2021 by Alan Robert Ross
Founder, Trust Intelligence
The foregoing is not investment advice.