51

Re: Omidria

She never mentioned anything at all about shots.  I would be getting a twilight anesthetic by IV.  She didn't mention anything about shots in the eye.  It sounded to me as if both drugs were administered prior to her commencing the actual operation of removing my cataract lens and replacing it.  That's all I can say.....

Can you tell me how I can find a facility relatively close by to me here in Baltimore that uses Omidria?  Does Omeros publish a list of doctors who use the drug?

52 (edited by Alan Robert Ross 2021-01-04 21:12:30)

Re: Omidria

I didn't mention shots to the eye either.

Omidria is dripped on the eye DURING the operation.

Her use of the 2 separate drugs is done SYSTEMICALLY and before the operation.

I have no idea about lists of users.
Why, would you change surgeon's?

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

53 (edited by alaskasalmonfisher 2021-01-04 23:39:53)

Re: Omidria

I'm not driven to change my surgeon or venue at this time.  I am happy to hear she uses the "right" drugs.  But I have a question for you - you're saying she uses the 2 drugs systemically.  Are you saying that that means the drugs are administered by IV?  Is that what "systemically" means?  It sounded to me like she drips the 2 drugs into the eye, then does the surgery.  The only thing administered by IV is the anesthesia, a twilight version.

And I'll be able to talk to the anesthesiologist beforehand, as to my desire NOT to have fentanyl mixed in with my anesthesia.  I will have some choices there, if I bring it up, she tells me.

As to fentanyl, or any anesthesia, I suppose it's the dose that is important.  Still, I've read too much about people dying from fentanyl, I just don't want any part of it.  I'm drug free - I don't need an opioid drug.  I have a friend who lost one of her sons, who was addicted to heroin, die from the fentanyl mixed in with his heroin.  I just don't want any part of fentanyl.  It rubs me the wrong way.  The whole point of Omidria, or at least a very important point of Omidria, is that it is opioid free.

54

Re: Omidria

alaskasalmonfisher wrote:

  It sounded to me like she drips the 2 drugs into the eye, then does the surgery.  The only thing administered by IV is the anesthesia, a twilight version.

That sounds accurate.  My eyes were done years before Omidria arrived on the scene. They're still fine. Just a trace of capsular haze according to my eye doc 1.5 years ago. No problem and no visit since.

55

Re: Omidria

I don't know how your surgeon uses those drugs. I believe at least some inject it systemically and not use it as eye irrigation.

I am also under the impression  that some surgeons don't use the drugs, use a combination compounded without FDA supervision or use 1, sometimes plus other drugs.

With Omidria, they normally find less fentanyl or any pain killer is needed...because there is little or no pain.

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

56

Re: Omidria

Omidria was/is a clever project by Omeros, not a breakthrough "new drug". OMER owns the combination and is the only FDA approved for the indication.

The components are generic drugs so it did not pay for a manufacturer of either to run expensive FDA trials to conclusively and scientifically show what the benefits were.

I believe the eye is irrigated throughout the lens replacement surgery, and therefore the Omidria is constantly administered, not like dilating the eye before the procedure.

Many high volume surgeon can do the procedure in 10 minutes and see no reason to fix/change their surgical system & routine (but they may also not be tracking patient outcomes, pain operatively or post-op).

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

57

Re: Omidria

Thank you.  I will double check with the surgeon what the source of her drugs are.  Because it's Wilmer, I suspect there will not be any issue.  I am told that they do umpteen of these cataract surgeries, that "everybody" gets a cataract operation.  They have a lot of surgeons working in the Institute doing these surgeries.  I asked for and was given a surgeon who was likely to not have any problem speaking with me about the drugs.  I felt comfortable with her.  All business, competent as far as I could tell.  I think her ancestry, as a point of interest, is Masai.  I've done a bit of reading about those people, particularly how they used to conduct lion hunts.  Won't get into that here, but my surgeon's name and physical stature brought to mind this guess of mine.

About the Texas incident where those 80 people went blind from compounded drugs - was that a compound of the same drugs used in Omidria, or different drugs?  I don't know if you know the answer to that.

But if I can't trust Wilmer Eye Institute, I can't trust anyone.....The surgeon said the operation is routine, is safe, but there is the tiny chance of blindness in the eye, which disclosure of course I understand.

What I found interesting was that there are different goals possible, in this operation.  IOW, they could operate with the goal of improving near vision.  They could operate with the goal of improving far vision.  I will guess that different lenses can provide different qualities of vision, depending on the curvature of the lens.  There is a checklist of specific goals for each individual operation.  In my case, since my vision is good at distance (no glasses while driving - but I do use reading glasses) the goal is simply to improve the general acuity of my right-eye vision such that it will go from the current 20/125 to 20/40 or the best that they can do.  Less than 24 hours after my operation 2 years ago to remove the membrane off of my retina, my right eye tested 20/40.  We are hoping that will come back as a result of getting rid of the cataract which is blurring my right-eye vision.  My right eye used to be 20/16 all my life.  My left eye still maintains it's 20/20 history.  The surgeon told me there is the possibility that I will need glasses of a small prescription. 

These outcomes are not 100% predictable, as we know.

58

Re: Omidria

Good luck with the procedure Avi whenever you choose to get it done.

59

Re: Omidria

Thank you, I appreciate it.  Wilmer is seeing fewer patients than before, of course due to Covid.  I have to wait 2-4 weeks just for the scheduler to call me.  And it'll be a couple or three weeks after that.  We may have the opportunity to stay at the Sanibel, FL house we stayed at last year, and if so we will then decide if we want to go, depending on the Covid situation.  I may not be operated on until April - even if we don't go to FL, I will be busy gearing up for the fishing season which means lifting boxes.  The barge deadline and the surgery may conflict in time - I will not be allowed to lift anything for one week after surgery.  A surgery in early April is fine.  I think that's what I'm looking at.

60

Re: Omidria

So I had my cataract operation today.  Ice storm in Baltimore had started perhaps 3 hours before we left home, but the roads were quite passable although covered by mushy slush and ice.  No problem at all if you were careful and drove appropriately slow.  In these conditions, I am way more afraid of other drivers than I am of having an accident myself.  I was doing 40 down the JFX and of course there were some people doing 50 and 50+.

The anesthesiologist came in to my cubicle, of course, along with her assistant.  We reviewed what was going to happen.  After that, I very politely advised them that I did not want any Fentanyl.  At that, the anesthesiologist and her assistant looked at each other with big eyes, and just about dropped their drawers.  I don't think anyone of their patients had ever said that before, to them.

We talked about it.  Here is what I surmise.  It is usual and customary behavior to use Fentanyl in their cataract operations.  They explained to me that Fentanyl was a pain reliever, not an anesthetic.  Remember, for a cataract surgery they're using a twilight anesthesia, not general.  Even if you're out in twilight, you might start blinking from the procedure even though you are not aware of it.  They put a drop or two of Fentanyl in your eye to stop the blinking, which blinking can totally screw up the surgeon.  Obviously, she can't operate on a blinking eye.

I told them I knew of someone who died from Fentanyl and just didn't want any part of it (heroin of course, cut with Fentanyl) and they respected that and told me that they would use an alternative if necessary.  That was satisfactory to me.

So we here Omidria investors have read quite a bit about opioid misuse and addiction in this country.  I don't know if the alternative to Fentanyl that they said they could use are opioid, or not.  I should have asked that, but didn't.  Actually, didn't think of that at the time.  And of course, it's all a question of dose, right?  I mean, you can die from drinking too much water.  But I just didn't want any Fentanyl or opioid on general principle.

The surgeon and staff seemed quite happy when I woke up.  I went right home.  Got home about noonish, I guess.  Took a 4 hour nap.  6:15 PM right now.  My eye now feels like it got poked.  Not too bad, though.  I may, or may not, take an Advil or something like that at bedtime, we'll see.  It's not too bad at all, but who likes a poke in the eye.

As I mentioned before, my surgeon typically uses the 2 drugs that Omidria is comprised of, dropped in separately one after the other.  I go in at 10:15 tomorrow morning for my postop, and we will see how successful, or not, this cataract operation has been.  The stated goal is to get back to 20/40 in my right eye, which is what my right eye vision was right after my retinal surgery 2 years ago, before the cataract appeared (which was expected as a result of the retinal operation).  I will be very satisfied with 20/40 in my right eye.  My left eye has always run at 20/20 and still maintains that level of performance.  My right eye used to be 20/16, but those days are gone.  I am hoping for 20/40.

So I want to state my opinion that the drug industry, in general, has got this country addicted.  The doctors and assistants always want to know, they ask, what drugs are you on, and when I tell them that I am on no drugs they pause for a moment because it's a change from the usual response of their patients.  They have to stop to take that in.  In fact, the anesthesiologist this morning, spent some time searching through my records, muttering frustration, and then remarked to me that everything seemed to be missing.  I told her that I had filled out and submitted all the preop forms that were presented to me - it's all nicely on computer of course, you do it at home before the date.  She checked and double checked for my information.  Which wasn't there.  And then all of a sudden she understood and told me that she sees what's going on - that I don't have anything wrong with me and I'm not on any drugs so there is no information to report.  Of course I am fortunate for sure to be in pretty good shape, but my point here is that it is a definite assumption of doctors performing a procedure or operation that a patient is on drugs, because of the overwhelming fact that practically EVERYONE is on some type of drugs these days.

I'm not saying that drugs are not necessary and very beneficial.  Of course they are.  Drugs save lives, they reduce pain.  They help.  But nothing in human life - very little anyway - is black and white.  As usual, it's a muddled and complicated situation.  THERE IS THE QUESTION OF MONEY re the pharmaceutical industry.  I'm just stating my opinion - too many people in this country are on or physically or mentally or emotionally addicted to drugs.

So TIPS has helped me out here, because I know about Omidria, the drugs that comprise it, I know a little bit about Fentanyl and its constructive and deconstructive uses - I went into this operation as a fairly well informed patient.  Hope it turns out good tomorrow!

61

Re: Omidria

Glad it's gone well Avi, and hope you wake up better than expected tomorrow.

62

Re: Omidria

interesting.
good luck.

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

63

Re: Omidria

Video: Improving Outcomes During and After Cataract Surgery

http://corporate.ewreplay.org/?v=6193481287001

About Omidria

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

64

Re: Omidria

The Jan revenue estimate from Symphony/Bloomberg is out at about $5 million. January is normally a low month and Dec. a high one but this Jan. number is crappy.

I normally report to you on numbers I have massaged based upon how far Symphony data has been off in the recent past. But with changes in reimbursement and such low numbers I hesitate to actually use math and imply my guess is based upon something reliable.

REAL revenue for January at $5M is only slightly worse than the total Q4'20 number at about $7M,,, which is why I expect the Q4 number to be between $14M and $18M depending on how much of the Q3 write-off is recaptured. If I had to pick 1 number I'd say $15.25M with the full write-off reversed.

With Jan'21 at $5M, Q1 could get to be $20M if we are lucky.
Omeros is seldom lucky (without some accompanying disaster)... but this company is not about Omidria.

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

65

Re: Omidria

We will see if the stock market now discounts a low January Omidria revenue report.  It could be another buying opportunity.  I could envision a short-lived opportunity.  A drop that doesn't last long, as people in the know take advantage of the low price and bid it back up.  But who knows.  Somehow I seem to have a bit more money right now than anticipated.  I'm going to put some cash inside my TDA account so I am ready to go if I see a good opportunity.

66

Re: Omidria

As I reported earlier the CONSENSUS EPS is $14.9M, which is likely to be close to reality (but includes recapture of prior write-off, not just actual Q4'20 sales revenue.

Not only do I see the consensus as close, but Omidria revenue is not all that important. Another $10 million cash is not important for narsoplimab revenue or approval(s) and continuing efficacy in what we believe is an ongoing CV19 trial.

We do not know if Greg has anything strikingly bullish that he can reveal and I do not think he will want to make a deal with the govt. for support until he has outstanding CV19 efficacy data from the ISPY trial, so he present the strongest possible position and requirements.

The company also has not control over FDA approval of narso for TA-TMA, so what can he say about that?

He can say that the company has been producing multiple batches of narsoplimab to use in the trials the CV19 CUP program and to ensure they have enough to sell when FDA gives marketing approval.

I think ISPY data may take another 2 to 4 weeks of treating patients before the sample size will be large enough, but that is a guess. based on how long Bergamo patients were treated, and how many patients Omeros was given to test by ISPY in February.

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

67

Re: Omidria

I understand.  I'm not sure that many or even most other people understand, as we have noted here before.  But there could be enough educated longs happy to pounce on an opportunity.  We'll see how it all plays out.

68

Re: Omidria

Omeros is still recovering from the plunge the other day.
It is undervalued...especially if it can successfully treat CV19 and similar conditions.

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

69

Re: Omidria

It just hit me why there is so few Omidria sales in late Dec and January. It is not that patients want to celebrate the holidays.... it is that the SURGEONs take extended holidays for week in January, in addition to working less from Christmas to New Year's. The ones that don't go somewhere warm in Jan., do it in Feb., which is also not a great month for Omidria sales.

This year, with crappy Omidria sales in January (but much better that Dec.), fewer people are traveling so maybe Feb. will be better than  the typical lull would make it.

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

70

Re: Omidria

from Stat
Who’s addressing America’s other health crisis?

(Spencer Platt/Getty Images)

What about the other epidemic? Drug overdoses are accelerating, and could for the first time claim 100,000 U.S. lives in a single year. While Washington treated the addiction crisis as a top priority just two years ago, the coronavirus pandemic has made it an afterthought. President Biden campaigned on an aggressive drug policy platform, pledging to spend $125 billion to curb the overdose crisis over 10 years. No such bill has been introduced in Congress and the Biden administration does not currently mention addiction on a list of its seven “immediate priorities.” It’s not clear when, or even if, a major push on addiction treatment will happen.

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

71 (edited by alaskasalmonfisher 2021-03-03 01:05:53)

Re: Omidria

I had my second postop exam the other day, and was talking to a lady who had her cataract operation about the same time as me.  Same surgeon.  For all I know, she had her operation the same day.  Anyway, like me, she needed no Advil or any pain relief whatsoever after her operation.  I asked the nurses taking care of me, and they said that over half of their cataract patients took some form of pain reliever after their cataract operation.  Over 50% took some type of pain reliever.  It would be interesting to know how many Hopkins cataract patients end up on an opioid pain relief drug, given that the drugs used for the operation are the same 2 drugs comprising Omidria (just separately instead of mixed together as in Omidria).  I would bet there are some number - after all, if over half of patients take some form of pain relief drug for the same operation as mine where I had absolutely no pain or discomfort at all (like the lady I met), I suppose some number end up on opioids.  As to my point in a prior post, perhaps some number of Americans are conditioned to want to take drugs for real and/or imagined pain and discomfort.  Who knows.  It's a point of interest.  Addiction is not good.

And I am very pleased to say that in my second postop the other day, my eye tested such that I could read half of the 20/25 line, which I couldn't do 10 days earlier at my first postop.  My surgeon told me she wouldn't be surprised if it gets better yet.  The original goal was 20/40 after the eye settled down.  Real good.  I can certainly tell the difference in my eyesight.....

72

Re: Omidria

Great to hear your eye surgery results Avi.  Have you noticed any color appearance changes?  Mine were dramatic ..... eliminating a sepia tone.

73

Re: Omidria

Glad the surgery went well, Avi.
Did they give you the Omidria components before the operation?

Omidria is dripped into the eye DURING the operation.

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

74

Re: Omidria

Hi Bill, all color distortions - which amounted to seeing rainbow rings around lights, stars, the moon - at night - are gone.  Color perception is completely normal.

Alan, no drugs were dripped into my eye prior to the surgery.  I was out before the surgeon dripped in the two drug components of Omidria.  And I've learned that to remove/install a lens (cataract surgery) - I just assumed they went straight into your eyeball which is what grossed me out.  But they go in way from the side - they stretch your skin way to the side and go in that way.  Apparently, our lens are held in place by a pouch.  The surgeon removes the old lens from your pouch, and inserts the new one.  But like I said, I had no pain and not even any discomfort.  Of course I have no comparables because this is my only cataract surgery, but if anyone here will have one, of course I recommend Omidria or using the 2 Omidria component drugs separately but concurrently, which is how my surgeon does it.  In fact, she had never heard of Omidria.  At my preop, I said to her I wanted to use Omidria and she didn't know what I was talking about.  But she looked it up right then and there, and then told me that she used the exact same drugs that Omidria was made of, but separately.  Interesting.  I decided I would be happy with that approach.  It worked for me.  I will never forget that story of the 60 or so people in TX who lost their sight due to contaminated compounded drugs.  It pays to do a little bit of research beforehand - by coincidence of course TIPS helped me out because we are concerned with Omidria.

I took an eyedrop drug to prevent infection for one week after.  Dropped it in 4 times/day, for one week.  Concurrently, I dropped in Prednisone, which of course is a steroid, also 4 times/day for the first week.  To keep down any inflammation.  Now I'm on Prednisone 3 drops/day for this week, then the next week 2 drops/day, then the last week 1 drop per day.  Steroids are powerful drugs of course so this is why you have to taper off gradually, it was explained to me.  If you just stop cold turkey, you might end up with an infection in any event.  So I'm following the directions, figuring that my surgeon knows what's going on (ha ha) even though of course I don't take any other drugs at all, ever, pretty much.  When it comes to something like this, I'm not against taking the drug(s).  It'll end, I seriously doubt I will have an infection (2 days ago at my second postop the surgeon looked in there and said I'm sure healing up very very well.  My eye feels pretty much completely normal.  I'll finish up with the Prednisone as instructed, and my body will cleanse itself and I'll be drug free again with way better sight.

I don't know anything about alternative drugs to the Omidria components, but based on my experience I think a person should go out of their way to have these drugs (or Omidria) used in their cataract operation.

So I'm thinking back 2 years to my retina operation.  I know that they go straight in to do that operation, to remove the membrane that had grown over my retina.  To get access, the surgeon dilates the pupil so she has a hole to get through to the retina.  Thinking about it, I am wondering if the lens is temporarily removed from the pouch, to provide access to the face of the retina, so she can remove the membrane.  Then the lens would be put back.  I am wondering if handling the lens in this manner is the reason why they told me at that time that I could expect a cataract to develop and would most likely want to have it removed.  I'm guessing here, trying to put 2+2 together, but it makes sense.

Our retinas are tricky equipment, very sensitive.  Talking to my eye doctor, he told me that there is a tremendous amount of research underway to try to manufacture an artificial retina, so people could see.  Absent a functional retina of course, we cannot see.  Of course I hope that someday a functional artificial retina will be developed, to save peoples' sight.

75

Re: Omidria

Manchin's clout with the Democrats and the GOP wooing him will almost surely get this Bill through Committee faster than otherwise... and to a vote.

Who will vote against deterring Opioid Addiction and Overdose Deaths?

https://www.register-herald.com/news/st … 95f73.html

Manchin, Capito reintroduce NOPAIN Act
The Register-Herald 18 hrs ago

   
A bipartisan group of U.S. senators, including Joe Manchin, D-W.Va., and Shelley Moore Capito, R-W.Va., have reintroduced the Non-Opioids Prevent Addiction in the Nation (NOPAIN) Act.

The legislation, co-authored by Sens. Jeanne Shaheen, D-N.H., and Rob Portman, R-Ohio, aims to address barriers to non-opioid pain management for those enrolled in Medicare.

Under current law, hospitals receive the same payment from Medicare regardless of whether a physician prescribes an opioid or a non-opioid. As a result, hospitals rely on opioids, which are typically dispensed by a pharmacy after discharge at little or no cost to the hospital. The NOPAIN Act would change this policy by directing CMS to provide separate Medicare reimbursement for non-opioid treatments used to manage pain in both the hospital outpatient department (HOPD) and the ambulatory surgery center (ASC) settings.

“An important part of this approach is ensuring that the Medicare program does not create a perverse incentive for doctors to continue to prescribe opioids to patients,” Capito said. "Instead, we should incentivize providers to utilize innovative non-opioid drugs and devices. The NOPAIN Act is an important step forward in preventing future addiction.”

“I am proud to reintroduce this bipartisan legislation to prioritize reimbursements for non-opioid treatments to ensure that non-opioid treatments are used whenever possible,” Manchin said. "We must address the drug epidemic so our communities can recover from the impacts of this terrible crisis, and I urge my colleagues on both sides of the aisle to support our commonsense legislation.”

U.S. Reps. Terri Sewell, D-Ala., and David McKinley, R-W.Va., plan to re-introduced companion legislation.

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

76

Re: Omidria

Good News. Even it the bill doesn’t materially impact omidria revenue it will certainly help sentiment with the market with respect to Omer

77

Re: Omidria

It would have some impact on revenue as reimbursement would not be limited to ASCs as it is now and could again include hospital settings.

78

Re: Omidria

You're turning me around here, because I thought one of the arguments for Omidria was that it cut down on the use of opioid drugs to combat pain post op, which saved a lot of money in treating those people who became addicted.

79

Re: Omidria

It does save money by reducing the need for pain meds and for treating addiction and the loss of value when an addict die.... but saving people's live is not just dollars and sense and calculating all the costs and all the benefits still may lead to more cost than benefits if you ignore the people who will be blind or dead because the system would not pay the cost.

It could be cheaper to let people die than to treat them.
It can be lots cheaper not to give people pain killers.
So does having a cost in lives and suffering mean insurers (govt. or private) should not pay it?

If I go for a lens replacement, if I have a choice for the insurance to pay for Omidria or not, why would I CHOOSE to have a higher change of being blinded or having more pain and inflammation?  I would choose to have Omidria.

Your premise is faulty IMO.

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

80

Re: Omidria

Not to belabor the point, but some number of people don't use Omidria.  They may have never heard of it, and don't do their pre op due diligence.  And their surgeon may not use Omidria, just to save money.  All depends on the numbers, I suppose, and we don't have those numbers.  We can let this go.

81

Re: Omidria

Omidria sales continue to suck. Before correction for the measurement errors Jan & Fed are about $10M, so maybe there is $11M, add maybe another 2 (MAX) on recaptured writeoff and then MARCH. March is usually a good month, but Feb. was down about 1/3 from last year and March during the early pandemic was a little better than last month (Feb 2021).

I believe consensus revenue for Q1 is in low 20s, like $23M. VERY unlikely Omeros will do that much. Could miss $20M.

People are probably still avoiding hospitals and surgical centers.

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

82

Re: Omidria

IMO (20:20 hinsight?) ..... and I believe we talked about  this at the time .... Omidria's initial gov't specified >$400 price was seriously too high and it's held Omidria back ever since.

83

Re: Omidria

Yes, I recall and I agreed at the time. The surgeons resent the price and that the Govt. pressures their fee and compounded Omidria ingredients cost more like 10% of the price of Omidria.

IMO the price at $100 would still have a 95% gross margin, but the question is whether it would sell more than 400% more product so that they revenue/profit will be greater than at the currently high price.

Seems to me, from the damage done to revenue by CMS refusal to reimburse, it reflects that there are little use by nonMedicare patients insured by private companies. Over 50% of lens replacements are for people less than 65,, yet Omidria revenue declines ~90% when Medicare bundles and refuses to reimburse.

And the high price ensures no European sales, as well.
Greg has said he's making progress with private insurers and I see no evidence. And he's gotten Omidria used in medical schools so that is a longterm benefit too.

The drug has about 10 years left of exclusivity and, if he can get NOPAIN passed, maybe he's be able to sell Omidria to a lens manufacturer who can sell Omidria using their regular sales force. That could bring in $1B (+/- $300M depending on whether revenue goes back to normal later this year). Using the money to advance more indications for narso sounds a much more lucrative opportunity.

If lightening strikes and narso gets a EUA for Covid and the stock soars (like a normal company would), there's be no significant need for selling Omidria if you can raise cash at $???/share (pick a number).

The ATM money raise seem to be an attempt to do that. There is no time limit. If Greg expects to get a EUA and a share price rise, or an early approval for narso in TA-TMA, possibly in the middle of next month, it seems obvious that he fantasizes that the share price will double or more. It deserves to, IMO, but being Omeros, I will only believe it when I see it.

Not 1 analyst gives Omeros any value for CV19 and few of them give any significant value for narso because of the usual LOW N excuse and that it is a new and obscure indication, with no approved drug, which Alexion apparently "stole" with off-label use. despite the Black Box Warning and no public data showing it works well.

We are soon to enter into a time for OMER with lots of promise if good things happen. Of course, the Biotech sector and the Market is hurting us so that we outperform, the stock can still decline because the sectors is doing worse.

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

84

Re: Omidria

Apparently the VA is buying 5 years of Omidria.
======================
6505--Omeros Corporation 65IB, 36F79721D0137 Performance Period: April 15, 2021 through April 14, 2026
ACTIVEContract Opportunity
Notice ID
36F79721D0137
Related Notice
Contract Line Item Number
1
Department/Ind. Agency
VETERANS AFFAIRS, DEPARTMENT OF
Sub-tier
VETERANS AFFAIRS, DEPARTMENT OF
Office
NAC FEDERAL SUPPLY SCHEDULE (36F797)
Award Details
Contract Award Date: Mar 31, 2021
Contract Award Number: 36F79721D0137
Task/Delivery Order Number:
Contractor Awarded Unique Entity ID (DUNS): 033364923
Contractor Awarded Name: OMEROS CORPORATION
Contractor Awarded Address: SEATTLE, WA 98119
Base and All Options Value (Total Contract Value): $18,910,340.

General Information
Contract Opportunity Type: Award Notice (Original)
All Dates/Times are: (UTC-04:00) EASTERN STANDARD TIME, NEW YORK, USA
Original Published Date: Apr 01, 2021 08:08 am EDT

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

85

Re: Omidria

Given the 170 VA Hospital and an average price of $300 per eye, the new contract is about 6.25 eyes per month at each hospital (for 5 years).

VA prescribes Omidria in special cases, not for the normal-risk lens replacements.

The VA gets a 20% or 25% discount on the price of Omidria, by statute, as does Medicaid (below CMS IOW).

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

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EyeMD87 Bullish 09:17 AM $OMER

I’m a VA ophthalmologist.  Most important thing this contract shows is that use of omidria is ramping up significantly everywhere including the VA. They wouldn’t have done this unless there is utilization across a significant percentage of VA hospitals

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

87

Re: Omidria

More Senators signed onto NOPAIN
https://www.congress.gov/bill/117th-con … 6/all-info

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

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Re: Omidria

Almost all the folks who are candidates for cataract surgery should be fully vaccinated by now, as well as the health care workers in the facilities.  I'd expect that procedures, and Omidria sales, should resume the trend when pass-through was in place before the pandemic.  We'll hopefully get a good update on the earnings call, not since it is so strategically important, as much as a valuable funding stream for the company.

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Re: Omidria

Perhaps you are right and guidance for Q2 will be given to counter the weak Q1 results....
I hope they have the data for April and are able to show a large increase over March.

I am assuming Omidria results will be negative and that even the analyst expectation consensus is too high.

I have a Reuters report from last week that is mostly useless by they note that over the past 90 days the EPS estimate has improved from -55 cents to -52 cents (with not rationale...just an average of analyst estimates).

IMO any good news is not going to come from actual business metrics.

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

90

Re: Omidria

All revenue estimates for the 1st 3 months (Q1'21) are now available to Bloomberg subscribers.

Jan. was about $4.3M.
Feb. was about $4.4M
March was $6M
Total therefore was $14.7

The correction factors I have been using were based upon somewhat stable past data on these numbers of the actually reported data.

I think the recent past was so mixed up with reimbursement changes, trying to estimate with match would be self-delusion.

I could be incorrect but I expect less than $20 M in Omidria to be reported.

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

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Re: Omidria

OMIDRIA mentioned prominently
https://capitolweekly.net/deadly-opioid … -covid-19/

Deadly opioid overdose epidemic overshadowed by COVID-19
BY RANDAL PHAM POSTED 05.04.2021

As if the deadly pandemic wasn’t bad enough, California continues to fight a battle against the opioid overdose epidemic.

A record 3,200 Californians lost their lives to opioids in 2019—well before the stress and disruption caused by COVID-19 caused overdose deaths to spike to new highs nationwide. By May 2020, powerful synthetic opioids such as fentanyl caused California’s 12-month all-drug overdose death rate to spike nearly 27%, significantly faster than the national average. In San Francisco alone, three times as many people lost their lives due to drug overdose than from COVID-19.

This crisis didn’t just come out of nowhere. It snowballed over time, fueled by an overprescription of opioid-based painkillers.

One major underlying contributor is the over‑prescription of opioid-based painkillers both during and after surgery.

Studies have found that patients who receive opioids after short-stay surgeries face a 44% increased risk for long-term opioid use than those who didn’t receive the potentially addictive drugs. As a surgeon, I’ve seen firsthand the effects persistent pain can have on a person, and I understand how hard it can be for many people to stop opioids once they’ve started.

That is why I strongly believe change is necessary to ensure that these powerful painkillers are prescribed only when appropriate and that all patients can confidently access non-opioid alternatives to manage pain.

While opioid addiction has many causes, one major underlying contributor is the over‑prescription of opioid-based painkillers both during and after surgery. According to an analysis on the impact of overprescribing in America, roughly 3 million people each year become frequent opioid users following a surgical procedure. Additional research shows that patients receiving an opioid prescription after a hospital short-stay or outpatient surgery are 44 percent more likely to become long-term opioid users afterwards.

Through my work as an ophthalmologist, I’ve seen how one of the greatest risks of opioid exposure can occur both during and after cataract surgery. Although this is generally a low-risk procedure – with thousands performed in the United States each day — as many as 35 percent of cataract surgery patients experience moderate-to-severe post-operative pain, many of whom received an opioid such as fentanyl during surgery.

Furthermore, an examination of the risk of long-term opioid use found that cataract surgery patients who received an opioid prescription post-surgery were 1.6 times more likely to use opioids long-term compared with patients who were not prescribed an opioid. Because nearly 4 million cataract procedures are performed each year, it only takes a small percentage of patients becoming addicted to represent a substantial number of new opioid users.

Given the severity of our nation’s opioid crisis, this failure to adequately cover alternatives to opioids is mindboggling.

Fortunately, the medical community has begun to take this issue seriously in recent years. In addition to the development of new prescriber guidelines meant to ensure opioids are prescribed in a manner that reduces the risk of addiction, many providers have turned to alternative pain management techniques that are often just as effective.

For cataract surgery patients — particularly those with small pupils – innovative and FDA-approved therapies such as Omidria (phenylephrine and ketorolac intraocular solution, 1%/0.3%) have been demonstrated to be effective at maintaining pupil size by preventing intraoperative miosis, reducing postoperative ocular pain, decreasing the need for postoperative drops and protecting against sight-threatening complications.

Studies have also found that the drug could effectively reduce the need for fentanyl during surgery by nearly 80 percent and decrease the amount of postoperative opioids prescribed by 56 percent.

Unfortunately, the Medicare program does little to support practices that use non-addictive alternatives. In fact, current reimbursement policy ensures that it’s more economical for practices to prescribe patients opioids — which are often covered by patients’ Medicare Part D prescription drug plans — than a non-opioid treatment.

Given the severity of our nation’s opioid crisis, this failure to adequately cover alternatives to opioids is mindboggling.

COVID-19 and its social ramifications have accelerated our local and national problem of opioid addiction.

Thankfully, a growing number of leaders in Congress have recognized the problem with this perverse incentive structure and have introduced legislation to fix it.

he Non-Opioids Prevent Addiction in the Nation (NOPAIN) Act would help reduce the current disparity and expand patient choice for non-opioid alternatives. Importantly, the NOPAIN Act does not restrict the appropriate use of opioids for patients who need them. Instead, this bipartisan legislation requires that Medicare provide separate reimbursement for non-opioid treatments in hospital outpatient departments and ambulatory surgery centers — the same policies that exist for many private insurers, the VA, and even Medi-Cal.

This relatively small change would help to correct the disincentives and enable physicians to prescribe non-opioid pain management therapies when appropriate, thereby reducing the overall risk of patients becoming exposed to and addicted to opioids. Last Congress, the NOPAIN Act was cosponsored by California’s own Reps. Ami Bera, Harley Rouda, Josh Harder, Luis Correa, and Zoe Lofgren. Now that the bill has been reintroduced in the House and Senate, I urge Speaker Nancy Pelosi and the rest of our state’s congressional delegation to support this commonsense solution.

COVID-19 and its social ramifications have accelerated our local and national problem of opioid addiction. It’s time to pass the NOPAIN Act, which rightly aims to give providers more flexibility to provide Medicare beneficiaries – a population at increased risk – with effective and non-addictive pain management therapies following surgery.

It is my hope that passage of this commonsense legislation will allow California to see a rapid decline in the number of opioid addictions, deaths, and suffering that plague our communities.

Editor’s Note: Dr. Randal Pham is an award-winning, board-certified eye surgeon in San Jose with a special interest in the prevention and treatment of world blindness.

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 wonder if any/how much money has changed hands between those with a vested interest in selling opioid drugs, and those who have no vested interest in passing the NOPAIN Act.

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Re: Omidria

The opioid producers have paid $Billions in fines already, despite years of political contributions.

The ongoing crime is that this is making the culturally puritanical USA even more hard on doctors and their patients who are in horrible, often intolerable, pain and need opiods or something even stronger.

Drug companies have been deterred in finding new pain-killers by the Govt. and many doctors with compassion have been harrassed and threatened by the DEA who has effectively made pain reduction more difficult to give (and get).

People in extreme pain should not have to suffer because some others abuse the drugs in question.
In around 2005 I was in horrible pain, much worse than kidney stone pain and ended up on 24/7 Morphine, which was the only thing that could control it. Before it was controlled it was the only time I understood people contemplating suicide.

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, in general terms, this country has a difficult time negating or stopping a bad course of action (too many opioid addictions) and promoting a good course of action (providing pain relief when really needed).

Your statement about your pain, and understanding people contemplating suicide, struck a chord with me.  When I had my diverticulitis 20 years ago, I thought about whether I wanted to die to escape the pain, or not.  I never have and never will tell anyone what my decision was.  Pain hurts, it can be a terrible thing.  What an understatement.

95

Re: Omidria

Conference Call wrote:

Net revenues from the sale of OMIDRIA in the first quarter were $21.1 million, a doubling over the previous quarter. Sales of OMIDRIA have continued to grow through the first part of the current quarter and are quickly approaching revenue levels in the ASCs present before OMIDRIA's pass-through status expired on September 30 of last year.

From this I estimate Q2 revenue from Omidria to be roughly $30M.

This is from a rough calculation I've done in my head taking into consideration that the Jan+Feb total reported by Symphony was slightly ore than $8M and the March total was slightly more than $7M. So a total of $15.5M Symphony for the Q translated to $21.1M in total sales ($5.5M or ~35% higher). Being conservative and increasing monthly revenue a bit, given guidance (which would be  a Symphony report of ~$8M,+8.5M+9M=~$25.5M) add another $5.5M and you get $31M... if Symphony misses  sales channel (like VA+Medicaid). Round down to $30M. If Symphony doesn't miss a channel per se, but misses a % of overall revenue because of how it does its sampling, than we could see something like $34M or $35M, but I would not make the more optimistic prediction by making an optimistic assumption about the Symphony data, without an supporting evidence.

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

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Re: Omidria

OMER tweeted that the House has re-introduce the NOPAIN Bill that was cancelled when the session ended.
==================================
The Non-Opioids Prevent Addiction in the Nation (NOPAIN) Act has just been introduced in the House by
@RepTerriSewell , @RepMcKinley , @RepAnnieKuster , and @RepBrianFitz.

The bipartisan bill will increase access to safe, effective alternatives to opioids for surgical pain.

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

97

Re: Omidria

Just got the April Symphony revenue numbers.

The fellow who provides them repeatedly fails to provide the number (although I have asked and he has them) but he provides the chart. I put the chart on my 49 inch monitor and estimate the number.

I estimate April's sales to have been between $7.85 million and $8.85 million.
I June and July are unchanged, which means the market efforts are ineffective, we will have between $23.5 and $26.5 million for Q2.
Mean is $25 million (yearly run rate of $100M).

I they increase revenue by $1M/month the prediction is between $23.5M and $29.5M
An improvement of $2M/month takes us up to between $26.5M and $32.5M.

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

98

Re: Omidria

NOPAIN added 13  more co-sponsors in the House

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

99

Re: Omidria

Looks like May Omidria sales are up about t13.5% from April, which was almost as high as March.
It is a nice increase really a much higher % increase than the typical monthly increase than typical in the early days 2015-2017.

Looks like the 3rd highest monthly total ever.
The two other highest months were 2 and 3 months before the loss of separate reimbursement.

I the June revenue continues to ramp higher at this rate we could have a 30% increase over Q1, potentially a little higher or lower because the data are not derived from a perfectly representative sample of Omidria customers.

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

100

Re: Omidria

If June sales is the same as the average of April and May my guess is that the total for Q2 will be $27M.

If June's revenue increases the same % as May over April, the Q2 total should be around $29 Million.

It will hit $30M in Q2, only if growth is accelerating.

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