LENZ Therapeutics 2026年第3四半期決算説明会:VIZZの成長とOpExのリセット
LENZ Therapeuticsの2026年第3四半期決算は、製品売上高が前期比50%超増の260万ドル、有償処方箋数が51%増の38,000件超となった。全国テレビ広告と遠隔診療の導入が奏功し、受診サイクルが大幅に短縮され、処方増加分の50%以上を遠隔診療が占めた。
一方、同社は消費者主導モデルへの移行に伴う商業組織再編を発表し、従業員数を約40名に削減、2027年の営業費用目標を7,000万〜7,500万ドルへ引き下げる方針を示した。さらに、12月1日付でEvert Schimmelpennink CEOが退任し、Daniel Chevallard CFOが暫定CEOに就任する予定である。四半期末の現金等は1億9,730万ドルを確保している。
要点
- 2026年第3四半期の製品売上高は、第2四半期から51%増となる38,000件超の有償処方箋に支えられ、前期比50%以上増加して260万ドルとなりました。
- 遠隔診療(テレヘルス)は当四半期の増加処方箋数の50%以上を生み出しました。経営陣によると、全国テレビ広告と遠隔診療により、広告展開から受診に至るサイクルが従来の4〜6週間から数日以内に短縮されたとのことです。
- VIZZを処方した眼科医療従事者は15,000人を超え、その75%以上が複数回処方を行いました。眼科医療従事者における認知度は90%を超えました。
- LENZは、従業員数を約40名に削減し、年間営業費用を50%以上削減する消費者主導の商業組織再編を発表しました。
- 経営陣は2027年の営業費用目標を7,000万〜7,500万ドルとし、その70%以上を消費者主導の販売・マーケティングに配分する計画です。
- 社長兼最高経営責任者(CEO)のEvert Schimmelpennink氏は2026年12月1日付で退任します。取締役会が後任の選定を進める間、最高財務責任者(CFO)のDaniel Chevallard氏が暫定CEOを務めます。
主要財務データ
| 指標 | 2026年第3四半期実績 | 変動または背景 |
|---|---|---|
| 製品売上高 | 260万ドル | 前期比50%超の増加 |
| 有償処方箋数 | 38,000件超 | 第2四半期比51%増 |
| ライセンス売上高 | 80万ドル | Vertex Pharmaceuticalsからの契約一時金の一部計上 |
| Gross-to-Net比率 | 約93% | 同水準を維持 |
| 売上原価 | 50万ドル | 第3四半期の製品売上高に関連 |
| 販売管理費(SG&A費用) | 3,580万ドル | 前期比10%減 |
| 調整後販売管理費 | 約3,150万ドル | 株式報酬費用および30万ドルの一時的な非現金費用を除く |
| 研究開発費(R&D費用) | 0ドル | 直近の会計期間と同水準 |
| 純損失 | 3,100万ドル | 基本的および希薄化後1株当たり損失0.99ドルに相当 |
| 現金・現金同等物および有価証券 | 1億9,730万ドル | 四半期末残高 |
事業および業績ハイライト
VIZZの第3四半期の成長は、全国テレビ広告と7月に開設された遠隔診療チャネルの相乗効果によって牽引されました。同社によると、すべての流通チャネルで処方数が増加した一方、処方増加分の半分以上を遠隔診療が占めました。
VIZZは調剤薬局、オンライン薬局(e-pharmacy)、遠隔診療を通じて入手可能です。承認および発売開始から第3四半期までに、LENZはサンプル品および商用品を含め400万本以上のバイアルを配布し、約11万パックを販売しました。経営陣が引用した2026年のSymphony TRxデータに基づくと、VIZZは米国の老眼治療点眼薬市場で94%のシェアを占めています。
遠隔診療ルートでは、初期スクリーニングプロセスを経て、主に非同期型の医師による診察が行われます。初期の遠隔診療利用者は男女ほぼ半々で、45歳から55歳の患者にやや偏っていました。
オンライン薬局チャネルでは、患者の約60%が1か月分を超える量を購入しました。経営陣によると、この層は年間平均で5パック以上を購入しています。
国際展開において、LENZは販売パートナーを通じて11件の規制承認申請を行っており、審査が進められています。同社は、今後数か月および数四半期以内に、米国以外でのさらなる申請や承認取得の可能性があると見込んでいます。
経営陣の見通し(ガイダンス)
LENZは、2026年第4四半期中に組織再編活動の実質的にすべてを完了し、約500万ドルの一時的な純再編費用を計上する見込みです。
経営陣は年間営業費用が50%以上減少すると見込んでおり、2027年の営業費用目標を7,000万〜7,500万ドルとしています。予想される支出の70%以上は、同社の消費者主導の販売・マーケティング戦略を支えるために充てられます。支出削減の効果が全面的に表れるのは第1四半期になる見通しです。
同社は引き続き、製品売上総利益率が時間をかけて約90%に向けて推移すると予想しています。なお、LENZは売上高やキャッシュランウェイに関するガイダンスを示していません。
リスクおよび注視点
老眼治療点眼薬のカテゴリーは依然として初期段階にあり、LENZはリソースを医師に対する1対1のディテーリング(情報提供活動)から消費者需要の創出へとシフトさせています。実行力は、テレビ、デジタル広告、遠隔診療を通じて継続的に効率よく患者を獲得できるかにかかっています。
従業員数が約40名に削減され、営業およびメディカル部門が小規模化・特化されることから、組織再編に伴う実行リスクが生じます。
経営陣の体制変更も進められています。Schimmelpennink氏が初期の組織再編を指揮した後、Chevallard氏が暫定CEOに就任します。取締役会は後任CEOの選定作業を開始しており、Chevallard氏も候補に含まれていますが、具体的なスケジュールは示されていません。
経営陣はまた、Symphonyの処方データの精度が約70%にとどまっており、全体の処方活動に関する視界が限られていることも指摘しました。
アナリスト質疑応答の要点
- 遠隔診療の貢献:経営陣は、遠隔診療が今後も重要なチャネルであり続けると見込んでいます。ウェブサイトのトラフィックやその他の初期指標は第4四半期に向けて拡大を続けており、遠隔診療以外での処方数も増加しました。
- 広告効果のコンバージョン:遠隔診療の導入前は、テレビキャンペーンによって眼科医療機関経由で処方数が増加するまでに通常4〜6週間かかっていました。遠隔診療の導入により、経営陣は数日以内にその効果を確認できるようになりました。
- 営業人員の削減:LENZは、眼科医療従事者の認知度が90%を超えていること、処方者の75%以上が複数回処方を行っていること、ならびに担当者不在地域や非ターゲット医師においても同水準の処方が見られることを、営業カバレッジ削減の根拠として挙げました。
- マーケティング費用の配分:同社は、顧客獲得コストと測定されたリターンに基づき、テレビ、Instagram、Facebook、TikTokなどのチャネル間における支出を調整する方針です。
- 収益性:経営陣は黒字化のタイムラインを示さなかったものの、2027年の営業費用目標および四半期末時点における1億9,730万ドルの現金残高を改めて強調しました。
決算説明会トランスクリプト全文
決算説明会の完全なトランスクリプト
経営陣による説明
Operator
Good morning, ladies and gentlemen, and welcome to the LENZ Therapeutics Third Quarter 2026 Financial Results Conference Call. [Operator Instructions]
As a reminder, this call is being recorded. At this time, I would like to turn the call over to Dan Chevallard, Chief Financial Officer. Please go ahead.
Daniel Chevallard
Thank you, Tina. Good morning, and thank you for joining us today. My name is Dan Chevallard, Chief Financial Officer of LENZ Therapeutics. We are joined today by Eef Schimmelpennink, our President and Chief Executive Officer; Shawn Olsson, our Chief Commercial Officer; and Dr. Marc Bloomenstein, our Chief Medical Officer.
Before we begin, I would like to remind you that this call will contain forward-looking statements regarding LENZ's future expectations, plans, prospects, corporate strategy, regulatory and commercial plans and expectations, cash runway projections and performance. Actual results may differ materially from those indicated by these forward-looking statements as a result of various important factors and risks, including those discussed in our filings with the SEC and which can also be found on our website.
In addition, any forward-looking statement represents only our views as of the date of this webcast and should not be relied upon as representing our views as of any subsequent date. We specifically disclaim any obligation to update such statements. The company encourages you to consult the risk factors contained in our SEC filings for additional detail.
With that, I'll now turn the call over to Eef.
Evert Schimmelpennink
Thank you, Dan. Good morning, everyone. Today's results mark an important step forward for LENZ and VIZZ. In the third quarter, we saw more than 50% growth in both product revenue and total prescriptions, with strong momentum continuing into the fourth quarter. On October 1, we marked the 1-year anniversary of this launch.
Over the past year, we've built important foundations, gained valuable insights into what drives adoptions and, importantly, drove encouraging momentum from our consumer-focused initiatives. This last quarter, we continued to see that consumer demand generation is a key driver of growth. Expanding our pilot reading glasses campaign to national TV enabled us to reach a broader group of consumers with a clear message around an alternative to reading glasses.
Our newly established telehealth channel also gives interested consumers a convenient path to evaluation by an independent licensed eye care professional and, if appropriate, a prescription for home delivery. Together, these initiatives have helped to establish a more seamless path from awareness to evaluation, treatment and continued use. And as I mentioned, the results were more than 50% growth in product revenue and total prescriptions in the third quarter, with strong momentum carrying into the early weeks of Q4.
We have built a strong foundation with eye care professionals. This awareness now exceeds 90%, with more than 15,000 prescribing ECPs. At the same time, our launch experience has shown that physician awareness alone is not sufficient to drive adoption at the pace we want. The strongest growth response has come when consumer demand generation is paired with convenient access.
All of this is giving us great clarity on the commercial model best positioned to support durable growth in this category. Based on what we have learned, we announced a strategic reorganization designed to align LENZ with this consumer-led commercial model. Going forward, consumer marketing will be the emphasis of our U.S. commercial strategy, with a much smaller and more focused sales and medical team maintaining important KOL, ECP and trade relationships.
This is an evolution of our launch strategy, not a change in our commitment to LENZ. The reorganization concentrates our people and capital on the activities that are demonstrating the clearest connection to patient acquisition and sales growth. It also creates a more efficient structure for the business we are building.
As part of this transition, we expect our organization to move to approximately 40 employees, and we expect overall operating expense to decrease by more than 50%. We are targeting 2027 operating expenses of approximately $70 million to $75 million, with more than 70% of our projected spend allocated to our consumer-driven sales and marketing strategy. We strongly believe this focused model gives us the opportunity to reach more patients, expand this emerging category and build a durable business.
With that, I will hand it over to Shawn, who will provide more detail on our commercial execution.
Shawn Olsson
Thank you, Eef. As mentioned, we are 1 year into launch and have made measurable progress in 3 key areas: eye care professionals, consumers and access. With ECPs, we have driven awareness of VIZZ to above 90%, achieved more than 15,000 prescribing ECPs, and over 75% of them have prescribed more than once. With consumers, we've launched our national campaign and have continued to optimize ad placement to support VIZZ's continued growth.
On access, this is operating well and growing in all channels. VIZZ is now available through retail pharmacies, the e-pharmacy and [Finch Health] telehealth, giving patients several ways to access VIZZ. This broader campaign and the additional telehealth channel have been the key drivers of the 50% quarter-over-quarter TRx growth in Q3. And impressively, we have done that with Q3 working media spend broadly in line with Q2.
Looking at the performance of VIZZ, the presbyopia eye drop category is still in its infancy. We're focused on growing this market, and it's clear that VIZZ is the leader in this developing category. Since approval and launch through Q3, we have distributed more than 4 million vials, including samples and commercial products, and sold approximately 110,000 packs. This makes VIZZ the #1-selling presbyopia eye drop in the U.S. since its approval.
Furthermore, based on the 2026 TRx data from Symphony, VIZZ has a 94% market share in the U.S. Building a new category takes time and, therefore, a disciplined allocation of commercial resources. The more than 50% growth in Q3 shows what consumer campaigns can do, and that is where we will concentrate our efforts. Consumer marketing will take the lead in our commercial strategy and receive a larger share of our commercial investment, including continued national television and digital advertising on the channels that deliver the strongest return.
As we look towards our year 2 commercial focus, for ECPs, our foundational awareness of VIZZ is built, and we're moving from one-on-one detailing to broad ECP engagement through marketing, supported by a small team focused on key opinion leaders, speakers, national and state-level support. This keeps VIZZ top of mind in the community while allowing us to direct more resources towards consumer demand, which will be our primary focus. We believe this is the right commercial model for durable growth.
With that, I'll turn the call back over to Eef.
Evert Schimmelpennink
Thank you, Shawn. Before handing the call over to Dan to discuss our financial results and outlook, I also want to address the leadership transition we announced. After nearly 6 years leading LENZ and more than 25 years in biotech, I have decided to transition from my role as President and CEO, effective December 1, 2026, to be able to devote more time to our patients.
This is a deeply personal decision, and I've come to the point where I feel confident in the direction of the company. We have built an important foundation to this, and we have great clarity on the commercial model ahead, and we're aligning the organization around the opportunity in front of us. Dan and I will work closely together through December 1 to implement the reorganization, ensure continuity and position him for success as Interim Chief Executive Officer.
I have full confidence in Dan's ability to lead LENZ through its next phase. He knows the business inside out and has been closely involved in building the foundation for our commercial growth. Together with Shawn, Marc and the full leadership team, he is well prepared to lead LENZ through its next phase, and I look forward to continuing to support him, the team and the Board as a strategic adviser. I'm very grateful to the LENZ team, our past and present employees, and our Board of Directors for their support throughout this journey. I'm proud of what we have accomplished together, encouraged by the momentum we're seeing and confident in LENZ's future.
With that, I'd like to hand the call over to Dan.
Daniel Chevallard
Thank you, Eef. I'd like to start by saying thank you for all of your contributions to LENZ, and I look forward to your continued guidance as we work through your transition. Your leadership has left a lasting mark on LENZ, on me and the team we have built together. I'm humbled by the confidence placed in me by Eef and the Board of Directors to step into this role. I'm encouraged by our momentum.
Our priorities are clear, and we're focused on executing in this next phase at LENZ. As both Eef and Shawn have discussed, early results from the July launch of telehealth and our nationwide TV advertising campaign have been encouraging, as evidenced by a sequential increase of over 50% in product revenue in Q3 over Q2, with meaningful script growth observed across distribution channels.
Impressively, our telehealth channel contributed more than 50% of the incremental scripts this quarter. Reflecting on Q3, we reported total product revenues of $2.6 million, driven by over 38,000 paid scripts, representing a 50% and 51% sequential increase over Q2, respectively, and maintaining our consistently strong gross-to-net ratio of approximately 93%. In addition, we reported $800,000 in license revenue related to the recognition of a portion of the upfront payment received from our commercialization agreement with Vertex Pharmaceuticals signed in late Q2.
I will provide a further update on our global commercialization efforts for VIZZ in a moment. Turning now to operating expenses. Our cost of sales on third quarter product revenue totaled $0.5 million, and we continue to anticipate this to trend to approximately 90% product gross margin over time. Total SG&A decreased to $35.8 million in Q3, or approximately $31.5 million adjusted to exclude noncash stock-based compensation and an additional $0.3 million in one-time noncash charges.
This was a 10% quarter-over-quarter decline from Q2, which was in line with our expectations. Total research and development expenses remained $0 in the third quarter, consistent with recent periods. Our Q3 net loss per share, both basic and diluted, was $0.99 per share in the quarter on a net loss of $31 million, and we ended the third quarter with approximately $197.3 million in cash, cash equivalents and marketable securities.
As I discussed today, we announced a strategic consumer marketing-focused reorganization that is designed to concentrate our resources on the initiatives we believe have the greatest potential to drive durable patient growth, significantly lower our cost structure and increase capital efficiency. We anticipate completing substantially all activities related to the reorganization in the fourth quarter, with an estimated $5 million in one-time net restructuring charges.
As we look ahead, we expect our annual operating expenses will reduce by over 50% and are targeting 2027 operating expenses in the range of $70 million to $75 million, with over 70% of our forward spend allocated to our consumer-driven marketing strategy highlighted today. As I have in prior quarters, I wanted to take a moment to provide an update on our global licensing and commercialization efforts.
We continue to see VIZZ as a global product, and with a worldwide population of over 1.8 billion adults with presbyopia, we believe the opportunity to expand our commercial footprint is an important and promising one. In Q3, we continued to advance our regulatory efforts with our commercial partners and now have 11 regulatory submissions under review and anticipate multiple additional submissions and potential ex-U.S. regulatory approvals in the months and quarters ahead. We remain focused on further expanding our global network in additional strategic geographies. And as I mentioned, we'll maintain that effort as a strategic priority as we advance from here.
With that, I'll turn the call back over to Eef.
Evert Schimmelpennink
Thanks, Dan. To close, I want to thank the entire LENZ team for the commitment and dedication you've shown in bringing VIZZ from development through approval and onto the U.S. market. We're very encouraged by the momentum we're seeing. We have a clearer and more focused commercial strategy, and we're taking decisive steps to build a more efficient and durable business. I believe in the opportunity ahead for VIZZ and LENZ's ability to execute against it.
With that, we would like to open up the call for questions.
Operator
[Operator Instructions] Our first question comes from the line of Stacy Ku with TD Cowen.
質疑応答
Stacy Ku
Nice to see you step in. So just two. First, on telehealth, where do you see the contribution going for VIZZ prescriptions? With strategic changes, there can sometimes be some growing pains. Do you expect to see continued prescription growth in the next few months? And what gives you confidence in this trajectory looking further out over the next few years? And then second, if you look at the prescription trajectory, maybe through Symphony, can you talk about how closely aligned the prescriptions have been, correlating to your DTC strategy?
Shawn Olsson
Stacy, this is Shawn. Thanks for the question. So looking at the telehealth channel. So what we're seeing is, of the growth, telehealth is contributing the most to the recent growth in Q3. And so as we look forward, we continue to see that this will be a meaningful channel for us. What we are also very proud of is with our television campaigns and our advertising campaigns, we're seeing growth on all channels. So all channels remain meaningful to us, and all channels we saw growing in this quarter.
What gives us continued confidence is as we look at the early KPIs, visitors to the website, right, data going into this month, right, we continue to see that growth, and that gives us confidence in VIZZ's continued growth going forward. In terms of the Symphony data, we still believe the Symphony data is more accurate than the IQVIA data, and that's why we referenced the Symphony data in this call, continues to be a consistent amount off. It's hard for us to speculate if that will change going forward. But what we've seen so far is it continue to have about 70% accuracy.
Operator
Our next question comes from the line of Marc Goodman with Leerink Partners.
Alyssa Larios
This is Alyssa on for Marc. Now that the telehealth channel has been active for several months now, could you share what proportion of patients have required a live appointment versus completing the asynchronous ECP review? And secondly, could you provide any color on the characteristics or profile of these early adopters?
Shawn Olsson
This is Shawn. Thanks for your question. So when we look at the telehealth channel. So the way the telehealth channel is structured is, first of all, to get into the telehealth channel, it starts by going through a screener. The screener filters out any high-risk patients to make sure that only patients that are appropriate continue on to that doctor evaluation.
And that doctor evaluation, it can be, as you said, both asynchronous or synchronous, asynchronous being done at 2 separate times, synchronous being a call or a video face-to-face. The vast majority are done asynchronously. What we are happy to see is not only is telehealth working for providing new scripts, but it is also screening out patients appropriately. We do see people screened out both in the screener phase as well as after the screener phase when it moves on to the doctor evaluation. I think you had a second question. What was the second question?
Alyssa Larios
Just any detail on the demographics or patient characteristics from this early wave of adopters.
Shawn Olsson
Yes, great question. So what's nice about our e-pharmacy channel and our telehealth channel, we can see that demographic data of the patients. What we see is the telehealth patient is very similar to the other patients that are using the product. In the telehealth channel, the split is roughly 50-50 male, female. It does skew slightly more towards the younger end of presbyopia, right, in that 45 to 55 range. But ultimately, it is a very similar patient to what we're seeing in the other channels.
Operator
Your next question comes from the line of Yigal Nochomovitz with Citi.
Yigal Nochomovitz
This is Caroline on for Yigal. Can you tell us more about the sales cycle through telehealth? Specifically, do you have data that tracks when a consumer moves from seeing a digital or TV ad to engaging with the telehealth platform and ultimately filling a prescription? And how does that compare with the traditional in-office pathway?
Shawn Olsson
Thank you, and this is Shawn again. Thanks for the question. So what's great about the telehealth channel is we see a lot more data. What I can tell you is when we first ran our pilot TV campaign in select markets, when we first launched that, we didn't have the telehealth channel open yet. And typically, when we ran in those select markets, it was a 4- to 6-week cycle until we saw the lift from running the TV campaigns, so that patient went into the eye care office.
Here, now that we have the telehealth open, we can see when TV is on and when TV is off and a direct impact and correlation to scripts moving through the telehealth channel. So with the telehealth channel now open, that correlation from advertising and time to visit is within a couple of days compared to multiple weeks prior to the telehealth channel. So that's what we're seeing, and that gives us, again, positivity in our advertising. It also allows us to very easily monitor where advertising is working and where it's not to correlate advertising back to that patient.
Yigal Nochomovitz
Great. And then if I may, are your ex U.S. partners taking notes from the U.S. launch in terms of deploying a sales force or not and leveraging DTC campaigns?
Daniel Chevallard
Yes. Good question. This is Dan. I think we're definitely making sure that we're in constant communication with our commercial partners around the world. And to the extent that they can leverage our learnings for their commercial strategy, that's always going to be a positive. Important, though, also to remember that the U.S. market and ex U.S. markets are not the same. So we always characterize our learnings in the U.S. as U.S.-centric. And hopefully, the goal will be for them to leverage those for their specific markets.
Operator
Your next question comes from the line of Lachlan Hanbury-Brown with William Blair.
Lachlan Hanbury-Brown
I was wondering if you could talk more about the growth you're seeing outside the telehealth channel. I mean, is that sort of concentrated among certain prescribers? I know you don't have as much data there, but what kind of trends are you seeing there? And then secondly, can you just talk to your confidence level that you don't need as much of a field team anymore? I mean, I get that it looks like the telehealth and the advertising are really driving things, but what gives you confidence that taking the field team or the reps out of the field is not going to impact the growth trajectory moving forward?
Shawn Olsson
Hi, Lachlan, this is Shawn. Great question. I think I heard the first question correctly, but I just want to make sure. I think it was about the prescriber base in telehealth. Was that the first question?
Lachlan Hanbury-Brown
About outside of telehealth. We talked about the nice uptick you're seeing in telehealth, but wondering if that's accounting for about 15% of growth. Obviously, you're seeing growth outside of telehealth as well. So wondering if you can talk about what you're seeing there in terms of the breadth and depth of prescribers and where that growth is coming from.
Shawn Olsson
Got it. Thanks, Lachlan. So yes, we're very pleased that we now have over 15,000 prescribing ECPs. What we've seen since we've turned on our national TV campaign, one, we're seeing consistency in the prescribers, with 75% now prescribing multiple times. But what we're also seeing in growth outside of telehealth is the broad excitement for an eye drop for presbyopia. These new prescribers, a lot of them are not targets.
So what we're seeing is we're driving consumers into eye care professionals around the country that necessarily haven't been called upon. So we're seeing broad adoption and prescribing in the eye care community outside of telehealth, which is very good. And then what was your second question, Lachlan?
So on the impact of the sales force, what gives us confidence in this? So what we have seen is we have 90% awareness in the eye care community.
So they are fully aware that repeat prescribing behavior, what we're seeing is when a patient comes in and asks about VIZZ, it is prescribed. And therefore, the real success is getting more patients to come in and ask about VIZZ. What we are seeing is a lot in the doctor state to proactively bring up VIZZ, and our best focus and allocation of our dollars is to drive the patient in and ask about it. What we've also seen is in markets where we have an empty territory or non-target doctors, they are prescribing VIZZ as much as those targeted doctors. So that gives us confidence in the focus on the consumer campaign.
Operator
Your next question comes from the line of Jason Gerberry with Bank of America.
Jason Gerberry
This is Melanie on for Jason. Just one on the leadership transition. How are you guys thinking about the process for the permanent CEO search, both in terms of timing and profile you're looking for, especially given kind of the shift in commercial strategy?
Evert Schimmelpennink
Thanks for the question. This is Eef. So if you think about the transition, we want to make sure, and I'm making sure, that it's a very smooth one. Like I said, it was a personal decision on my end to transition out. I'll be leading the change that we just announced, making sure the organization is set up well for Dan to then step in as the interim CEO. As I've mentioned, Dan has a wealth of knowledge around the business.
He's been with me and us for a long time now and has been integral to everything that we do within LENZ. So he's extremely well positioned to lead the company. In parallel, the Board has started a search. And obviously, Dan is one of the key candidates in that as well. We're not making any commitments around timelines. Again, both me and the Board have full confidence in Dan to lead the organization into its next growth phase. So we don't expect any impact on our strategy and the execution of it with this transition.
Operator
Our next question comes from the line of Matthew Caufield with H.C. Wainwright.
Matthew Caufield
Apologies if this has been addressed previously. But in terms of marketing, in addition to the telehealth fulfillment channel, what possible factors would support ultimately turning on the DTC campaign in greater capacity following the strategic commercial reorg? Thanks for any added color there.
Shawn Olsson
Thanks. That's a great question. So again, this is Shawn. So what we continue to monitor on the DTC side is, as we're pulsing different channels, as we turn on TV, what's the response that we're seeing across not only telehealth, but all channels? We do the same thing across Instagram, across Facebook, across TikTok, as well as different ads. So what we continue to look at and measure is what's that consumer acquisition cost of our different ads. And as we drive that consumer acquisition cost down for the ones that we feel are a valuable ROI, that's our signal to turn up that spend or change how much we're allocating dollars to the different channels.
Operator
And our final question comes from the line of Biren Amin with Piper Sandler.
Biren Amin
This is Michael on for Biren. I was just wondering if you could give a little bit more color on the refill rate. And given the recent cost restructuring, could you share how you're thinking about timeline to profitability?
Shawn Olsson
Thanks, Michael. So this is Shawn. So I'll cover the refill rate. So what we are seeing is we have multiple channels, but the channel where we can see the best data is the e-pharmacy channel and the telehealth channel. Those channels represent the majority of our volume. Now the telehealth channel is still new. It's only about 3 months old. So we're early there. The e-pharmacy channel, we have data for over a year now.
And what we can see in our e-pharmacy channel is that about 60% of the patients purchase more than a 1-month supply. So we're encouraged by that number. For that same group, what we're seeing is over the course of the year, that group is buying more than 5 packs per year. So that's a little bit more color on the refill rate and the total product being consumed by our predominant channel.
Daniel Chevallard
And Michael, this is Dan. I'll take your second question as it relates to forward guidance. So ending Q3, $197.3 million in cash. I think what we highlighted today was, as you think about our forward spend, approximately a 50% reduction in our forward OpEx. So what we've guided is a $70 million to $75 million annual spend in 2027 and going forward, I think you should expect to see the full impact of that change in spend trajectory in Q1. We're not providing cash runway guidance or revenue guidance at this time, as we haven't previously. So I think we gave you those inputs for today based upon the disclosures we made here.
Operator
This concludes our question-and-answer session as I am now showing no further questions. Thank you for your participation, and we will now conclude today's conference call. You may now disconnect.
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