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Mineralys Therapeutics (MLYS) 2026年第三季度业绩电话会:Lorundrostat临近FDA决议

2026年11月5日 08:08
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Mineralys Therapeutics核心产品lorundrostat针对难治性高血压的上市申请正在接受FDA审评,PDUFA目标审评日期为2026年12月22日。III期Launch-HTN分析显示受试者收缩压显著下降。截至2026年9月30日,现金及投资总计6.247亿美元,可支持运营至2028年。一线销售团队已到位,并正与支付方积极推进商业覆盖。

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核心要点

  • Mineralys Therapeutics 即将迎来 lorundrostat 于 2026 年 12 月 22 日的 PDUFA 目标审评日期。管理层表示,FDA 的审评工作正按正常程序推进,同时商业化上市筹备已进入最后阶段。
  • 在 III 期 Launch-HTN 分析中,接受 50 mg lorundrostat 治疗的受试者中有 46% 诊室收缩压降至 130 mmHg 以下,超过三分之二的受试者收缩压降幅达到至少 10 mmHg。
  • 截至 2026 年 9 月 30 日,现金、现金等价物及投资总计 6.247 亿美元。管理层预计这些资金储备足以支持计划中的运营至 2028 年,包括 lorundrostat 的潜在商业化上市。
  • 2026 年第三季度净亏损从上年同期的 3690 万美元扩大至 5730 万美元,主要反映了商业化相关的一般及行政开支增加。
  • 一线销售团队现已到位,销售代表平均拥有约 15 年的行业经验。目前与支付方的沟通已覆盖美国绝大多数参保人群。
  • 管理层估计,约有 2000 万名正在服用至少两种降压药的美国成年人血压仍未达标,这构成了 lorundrostat 的主要商业化机遇。

关键财务数据

指标2026 年第三季度2025 年第三季度 / 上年同期主要驱动因素
现金、现金等价物及投资6.247 亿美元截至 2025 年 12 月 31 日为 6.566 亿美元计划中的运营及上市筹备开支
研发费用2270 万美元3150 万美元关键临床项目完成后,临床前及临床成本下降
一般及行政费用3740 万美元970 万美元商业化投入、专业服务费及人员成本增加
其他收入净额总计280 万美元420 万美元2026 年 6 月高级有担保定期贷款的利息支出增加,部分被投资收益抵消
净亏损5730 万美元3690 万美元主要系商业化筹备相关的一般及行政费用增加

研发费用下降,部分原因是随着 lorundrostat 的关键项目于 2025 年第二季度结束,临床前及临床成本减少了 850 万美元。此外,临床供应、生产、监管及其他成本减少了 30 万美元。

一般及行政费用增加,主要由于专业服务费增加了 1540 万美元,人员相关开支增加了 1140 万美元,其他行政开支亦增加了 90 万美元。

业务与经营业绩

Lorundrostat 仍是 Mineralys 的核心价值驱动因素。该在研疗法针对难治性或未控制高血压的上市申请正在接受审评,FDA 预计将于 2026 年 12 月 22 日前作出决定。

在为期 12 周的 Launch-HTN 分析中,受试者在接受两至五种降压药物治疗的情况下仍患有未控制或难治性高血压。Lorundrostat 50 mg 使 46% 的受试者诊室收缩压降至 130 mmHg 以下,超过三分之二的受试者收缩压降幅达到至少 10 mmHg。

Mineralys 还公布了针对伴有高血压的中重度阻塞性睡眠呼吸暂停超重或肥胖成年人的 II 期 Explore-OSA 最终试验结果。在第四周,晚间服用 50 mg lorundrostat 使晨间收缩压降低了 11.1 mmHg,而安慰剂组仅降低 1.0 mmHg。该试验未显示出呼吸暂停低通气指数出现可衡量的变化。管理层表示,药物的安全性和耐受性良好,未发生包括高钾血症在内的严重安全事件。

来自 Transform-HTN 开放标签扩展研究的长期疗效与安全性数据定于 2026 年 11 月 8 日在美国心脏协会科学年会(AHA)上公布。

商业化筹备工作已接近完成。Mineralys 已组建一线销售团队,扩充了医学事务与医学科学联络官团队能力,并与覆盖美国绝大多数参保人群的支付方展开了对接。该公司还正在敲定面向医生、诊所工作人员和患者的患者支持计划。

管理层指引

管理层预计,公司持有的 6.247 亿美元现金、现金等价物及投资足以支持其计划中的运营至 2028 年,包括 lorundrostat 的潜在商业化上市。

若 lorundrostat 获得批准,Mineralys 打算尽快推动其上市供应,但管理层未明确潜在获批与正式上市之间的时间间隔。定价、总收入至净收入折算假设以及上市表现指标预计将在获批后或临近商业化时予以说明。

管理层预计商业保险将率先纳入覆盖。Medicare 的准入可能最初通过特批例外流程展开,并随着更广泛的药品目录覆盖逐步扩大。

风险与关注重点

  • Lorundrostat 仍处于 FDA 审评阶段,PDUFA 目标审评日期为 2026 年 12 月 22 日。管理层称监管沟通正按正常程序推进。
  • 预计初期的准入推进在商业保险领域更为强劲,而在纳入更广泛的用药目录之前,Medicare 的报销可能需要逐案处理特批例外申请。
  • 定价、返利策略以及总收入至净收入变动动态仍是影响上市经济效益的重要变量。
  • Explore-OSA 试验显示出了降压效果,但未使呼吸暂停低通气指数产生可衡量的改善。
  • 随着 Mineralys 搭建商业化基础设施,一般及行政费用大幅增加,导致季度净亏损扩大。
  • Lorundrostat 在高血压之外的适应症拓展计划以及任何潜在合作仍处于评估阶段。

分析师问答亮点

竞争定位:管理层认为 baxdrostat 的早期应用印证了未控制和难治性高血压对醛固酮合成酶抑制剂的市场需求。管理层列举了 12,000 名新起始用药患者,以及初级保健医生和专科医生的处方情况,同时强调了 lorundrostat 的降压幅度、选择性、半衰期和安全性特征。

支付方准入:Mineralys 已开始与支付方展开磋商,并预计在潜在获批后迅速推进对接。管理层表示,患者支持计划将协助医生、诊所工作人员及患者应对商业保险报销和 Medicare 特批例外申请。

指南纳入:管理层预计醛固酮合成酶抑制剂最初可能作为难治性高血压的四线用药被纳入临床指南。管理层认为,指南将为支付方的决策提供参考,但并非报销准入的唯一决定因素。

GLP-1 竞争:管理层表示,lorundrostat 在正常体重、超重及肥胖患者中均取得了稳定的降压效果,并将减重疗法与 lorundrostat 视为潜在的互补关系而非相互排斥。

其他适应症与合作:Mineralys 仍在评估 lorundrostat 在高血压以外领域的研发拓展,并对有助于扩大患者可及性的合作持开放态度,但管理层未透露具体计划或时间表。

财报电话会议完整实录


完整财报电话会议逐字稿

管理层陈述

Operator

Greetings. Welcome to the Mineralys Therapeutics Third Quarter 2026 Conference Call. [Operator Instructions] Please note, this conference is being recorded.

It is now my pleasure to introduce your host, Dan Ferry of Lifesci Advisors. Please go ahead, sir.

Daniel Ferry

Thank you. I would like to welcome everyone joining us today for our third quarter 2026 conference call.

This afternoon, after the close of market trading, we issued a press release providing our third quarter 2026 financial results and business updates. A replay of today's call will be available on the Investors section of our website approximately 1 hour after its completion. After our prepared remarks, we will open the call for Q&A.

Before we begin, I would like to remind everyone that this conference call and webcast will contain forward-looking statements about the company. Actual results could differ materially from those stated or implied by these forward-looking statements due to risks and uncertainties associated with the company's business. These forward-looking statements are qualified by the cautionary statements contained in today's press release and our SEC filings, including our annual report on Form 10-K and subsequent filings. Please note that these forward-looking statements reflect our opinions only as of today, November 4, 2026. Except as required by law, we specifically disclaim any obligation to update or revise these forward-looking statements in light of new information or future events.

I would now like to turn the call over to Jon Congleton, Chief Executive Officer of Mineralys Therapeutics.

Jon Congleton

Thank you, Dan. Good afternoon, everyone, and welcome to our third quarter 2026 financial results and corporate update conference call.

We've had an exciting and productive quarter, and I look forward to sharing our update. Today, I'm joined by Adam Levy, our Chief Financial Officer; and Eric Warren, our Chief Commercial Officer. I'll begin with an overview of the business and our recent clinical progress. Eric will then provide a commercial update, and Adam will review our third quarter financial results before we open the call for your questions.

We are now just weeks away from our PDUFA target date of December 22. While the FDA continues its review of the NDA, our focus is on completing our launch preparations so that we are ready to reach patients soon after the potential approval of lorundrostat. Approximately 20 million adults with hypertension treated with 2 or more drugs fail to achieve their blood pressure goal. The implications are clear. If people with hypertension can achieve their blood pressure goals, they are less likely to have poor outcomes that impact their quality of life and longevity. Providing innovations to help people achieve their blood pressure goals is what drives our work every day. A critical part of that work is the publication and presentation of lorundrostat data for the medical community to build awareness, understanding and enthusiasm for its clinical profile.

The major medical meetings this fall are giving us a series of opportunities to present data on lorundrostat that highlight its differentiated profile. We recently presented new data at the AHA Hypertension Scientific Sessions and at ASN Kidney Week, and we have an important late-breaking presentation coming this Sunday at the American Heart Association Scientific Sessions. We believe the data we have presented to date add to the strength of the data from our clinical program and suggest the potential of lorundrostat to help patients with difficult-to-treat hypertension reach their guideline recommended systolic blood pressure goals. These data include a new analysis of our pivotal Phase III Launch-HTN trial.

Participants in Launch-HTN had uncontrolled or treatment-resistant hypertension despite being treated with 2 to 5 antihypertensive therapies. In this 12-week analysis, 46% of participants treated with lorundrostat 50 milligrams achieved the AHA/ACC guideline-recommended office systolic blood pressure target of less than 130 millimeters of mercury and more than 2/3 achieved a systolic blood pressure reduction of at least 10 millimeters of mercury. We believe these are compelling data in a population that had previously not been able to reach their goal with existing therapies.

We also presented the final results from our Phase II Explore-OSA trial in overweight or obese adults with moderate to severe obstructive sleep apnea and hypertension. As many as 70% to 80% of adults with resistant hypertension have OSA. Their nighttime blood pressure is often elevated and is considered a significant driver of cardiovascular risk. In Explore-OSA, lorundrostat 50 milligrams taken once daily in the evening, reduced morning systolic blood pressure by 11.1 millimeters of mercury at week 4 compared with a 1.0 millimeter mercury reduction with placebo. Although we did not observe a measurable change in the Apnea-Hypopnea Index, the blood pressure reduction was consistent with what we saw in our pivotal trials and the safety and tolerability profile was favorable with no evidence of serious safety events, including hyperkalemia. We believe these results further emphasize the potential of lorundrostat in a high-risk subpopulation in whom blood pressure is particularly difficult to control.

New long-term efficacy and safety data from our ongoing Transform-HTN open-label extension trial will be featured in a late-breaking scientific presentation at the American Heart Association Scientific Sessions 2026 on November 8 in Chicago. Durable blood pressure control and a well-characterized long-term safety profile are important considerations for physicians managing a chronic condition like hypertension. We look forward to sharing these data with the medical community. As we have discussed, aldosterone plays a central role in hypertension as well as other cardiorenal and metabolic disorders. We remain committed to advancing our work in aldosterone-driven disease states and are evaluating the next steps in the clinical development of lorundrostat. Once we have finalized those plans, we will share them with you.

We're also excited to have 2 new Board members join Mineralys as we prepare for the launch of lorundrostat. Kris Peterson and Lonnel Coats are 2 experienced executives that bring a wealth of commercial expertise to Mineralys at this juncture of our corporate life. They will be providing their insights, perspective and experience to our management team as we prepare the market, the asset and the company for commercialization. As a part of this transition, Derek DiRocco, who joined the Board while we were a private company, will be concluding his tenure at the end of this year. I want to thank Derek for his support and guidance over the past several years during our development stage.

With that, I'll turn the call over to Eric to provide a commercial update.

Eric Warren

Thank you, Jon.

Our commercial organization continues to execute against our launch preparation plans, and we are advancing through the final stages of launch readiness. We believe we are well positioned to support awareness, drive adoption and create favorable access soon after potential approval.

Let me begin with the opportunity. As Jon noted, approximately 20 million adults in the U.S. are living with uncontrolled or resistant hypertension, representing a large and underserved population with meaningful clinical need. Our commercial focus is on clearly communicating the potential value of lorundrostat for appropriate patients relative to existing treatment options including its potential to improve blood pressure control, help more patients reach treatment goals and to do so with a safety profile supported by our clinical data package.

From an execution standpoint, I am pleased to report that our field sales team is now in place. In addition to our seasoned commercial leadership team, we have hired sales representatives with an average industry tenure of approximately 15 years. We have also continued to strengthen our medical affairs and medical science liaison capabilities. As Jon mentioned, our engagement with leading hypertension experts remains active with a focus on education around the unmet need in uncontrolled or resistant hypertension.

On the market access front, our engagement with payers now extends to the majority of U.S. covered lives. Our discussions continue to center on the clinical and economic burden of uncontrolled hypertension and the value proposition supported by lorundrostat's clinical data package. These conversations continue to reinforce our view that payers recognize the unmet need in this patient population. In parallel, we are finalizing a full-service patient support program designed to help physicians, their office staff and patients navigate access efficiently.

Our brand marketing efforts are also well underway, building the launch campaign we described last quarter, which is designed to educate both health care providers and patients. Taken together, we believe these efforts reflect launch readiness across the organization. We have built the team, advanced payer and provider engagement, expanded our educational infrastructure and put the core launch capabilities in place to support the introduction of lorundrostat if approved. We remain encouraged by feedback we are receiving from physicians, payers and patients, and we believe Mineralys is well positioned for launch.

With that, I'll turn the call over to Adam to review our third quarter financial results.

Adam Levy

Thank you, Eric. Good afternoon, everyone.

Today, I will discuss select portions of our third quarter 2026 financial results. Additional details can be found in our Form 10-Q, which will be filed with the SEC today. We ended the quarter with cash, cash equivalents and investments of $624.7 million as of September 30, 2026, compared to $656.6 million as of December 31, 2025. We believe that our current cash, cash equivalents and investments will be sufficient to fund our planned operations, including the commercial launch of lorundrostat into 2028.

R&D expenses for the quarter ended September 30, 2026, were $22.7 million compared to $31.5 million for the quarter ended September 30, 2025. The decrease in R&D expenses was primarily due to $8.5 million of lower preclinical and clinical costs resulting from the conclusion of the lorundrostat pivotal program in the second quarter of 2025 and $0.3 million of decreased clinical supply, manufacturing, regulatory and other costs.

G&A expenses were $37.4 million for the quarter ended September 30, 2026, compared to $9.7 million for the quarter ended September 30, 2025. The increase in G&A expenses was primarily due to investments to expand our operations in preparation for commercialization, including $15.4 million of higher professional fees, $11.4 million of increased personnel-related expenses resulting from headcount growth and increased compensation and $0.9 million of increased other administrative expenses.

Total other income net was $2.8 million for the quarter ended September 30, 2026, compared to $4.2 million for the quarter ended September 30, 2025. The decrease was primarily due to $3.2 million of increased interest expense related to the senior secured term loan entered into in June 2026, partially offset by $1.8 million of increased interest earned on investments as a result of higher average cash balances.

Net loss was $57.3 million for the quarter ended September 30, 2026, compared to $36.9 million for the quarter ended September 30, 2025. The increase was primarily attributable to the factors impacting our expenses that I described earlier.

With that, I will ask the operator to open the call for questions. Operator?

Operator

[Operator Instructions] Our first question is from Richard Law with Goldman Sachs.

分析师问答

Jin Law

Congrats on the progress. A couple of questions for me. The first is, how do you think about BAXFENDY's launch results so far with that $9 million revenues in Q3? And then the comment about payer coverage and not expecting Medicare coverage until 2028. Did anything stood out to you? And anything that you can see can be done differently and improved on as a second to market player? And I have a couple more follow-ups.

Jon Congleton

Yes, Rich. Thanks for the question. I appreciate it. I think at a high level, and I'll have Eric give you some more color, but at a high level, I think we're reviewing the baxdrostat launch is a validation of what we've been talking about that the demand is out there for ASIs to address this uncontrolled and resistant hypertension population and that access or coverage is out there as well. So I think it's validating those assumptions, but I'll have Eric add some additional color.

Eric Warren

Yes. Thanks, Rich. So as you know, Q3 was the first full quarter for them. So it is still really early. And we don't have any visibility into their rebates and buydowns. So it's difficult to form any kind of GTN correlations. But the initial prescription trends look favorable. 12,000 new patient starts is encouraging. I was also encouraged to see both primary care as well as specialists prescribing and the use in both resistant as well as uncontrolled hypertension. And as you mentioned, most of the business is coming from commercial, but they are getting some Medicare reimbursement now through that exception process that we've talked about. And that's why we deployed our account management team in the first quarter of this year to get an early jump on that payer engagement. We've been completing PI discussions with the vast majority of payers and lives. And we also have that patient support program that I commented on during my opening remarks that are going to make a big difference for us, Rich.

Jin Law

Okay. Got it. And then what are the development plans for lorundrostat beyond hypertension? Like which indication is the top priority that will potentially be the next Phase III in development?

Jon Congleton

Yes, Rich, thanks for that. We're obviously very enthusiastic about lorundrostat. We feel that aldosterone plays a significant role in driving not only hypertension, but frankly, comorbidities related to hypertension. We haven't provided clarity on that yet. We're continuing to evaluate it. And once we've locked in on a plan, we'll be sure to share that with the marketplace.

Jin Law

I got it. And just one last question to squeeze it in. I know we've been talking about partnership for some time. Is some form of partnership deal still on the table ahead of the upcoming launch?

Jon Congleton

Yes. Rich, we're always interested in getting lorundrostat to as many patients as we can. Partnering may be an aspect of that. And so we're routinely evaluating that. We're really not in a position to expand on specific activities at this time, though.

Operator

The next question is from Michael DiFiore with Evercore ISI.

Michael DiFiore

Congrats on the progress. Just 2 for me. If you give any initial thoughts you could share on the pricing versus access trade-off that you're optimizing for? In other words, would you accept a meaningfully lower net price in order to secure broad nonexclusive access? And my second question is regarding the launch. I mean, will you allow the reporting of prescription data at launch? And if not, which metrics will be provided to inform progress?

Jon Congleton

Yes. Mike, I appreciate the call. As we've stated in the past, pricing is something that we'll communicate as well as our thoughts on access and gross to net sometime post approval, post launch. Our goal is really to ensure that when physicians and patients decide that lorundrostat is the right choice for them that they have access to that. Part of that is price, part of that is the rebate strategy and part of it is what Eric described as the patient support program. As it relates to metrics that we'll provide at launch, presuming approval, I think it's premature to speak to that at this point. We'll certainly provide that. I would suggest post approval and likely subsequent to launch, but we'll try to provide visibility. We've tried to be transparent in the past as appropriate. I just don't think this is the time right now.

Operator

The next question is from Jason Gerberry with Bank of America.

Dina Ramadane

This is Dina on for Jason. Congrats on the progress this quarter. Just 2 quick ones from us. If BaxPA is positive next year and then you get first mover evidence in the primary aldosteronism, do you see that primarily expanding awareness of the aldosterone biology and benefiting the entire ASI class? Or is there a point where molecule-specific evidence begins to create a competitive advantage for BAXFENDY? And what would lorundrostat need to do to prevent that? And then just a quick question on kind of the label discussions you're having with FDA. We're now in 5, 7 weeks of the PDUFA and without getting ahead of the agency, have your label and post-marketing conversations progressed in line with your expectations? And has anything changed in your view of the likely breadth of the label or post-marketing requirements?

Jon Congleton

Thanks, Dina. We're obviously very much focused right now on the NDA review with the agency. I would say the dialogues are proceeding at normal course. I would say we continue to anticipate FDA feedback on December 22 on the PDUFA. As it relates to primary aldosteronism, I think there's a lot of thinking that's evolved over the 6 years I've been involved with Mineralys that dysregulated aldosterone is really more of a spectrum as opposed to defined disease states. Obviously, it will be interesting to see that data.

I think we've built out a very broad and diverse data set with lorundrostat, beginning with the proof-of-concept trial through our 2 pivotal studies in both apparent and confirmed hypertension as well as in our Explore programs looking at comorbid conditions such as CKD and OSA. So we feel very comfortable with the profile that's emerged with lorundrostat. How physicians view accumulating data and what is viewed as class effect and what is viewed as specific. I think it's a fair question. I think part of that will evolve over time, but we're obviously very focused on the 20 million patients right now that are struggling to get to goal. We know the implications if they do not. And we think that's where the imminent near-term opportunity is presuming approval of lorundrostat.

Operator

Our next question is from Evan Wang with Guggenheim Securities.

Boran Wang

This is Evan Wang. I'm here for Seamus Fernandez at Guggenheim. Just one from us. Curious, just given the feedback from AstraZeneca on Medicare, curious how you're thinking about how important Medicare is? And do you see this as an opportunity to really level the playing field with AstraZeneca in terms of time lines? And are there any other considerations from the AstraZeneca side that could impact lorundrostat's opportunity to compete?

Jon Congleton

Evan, do me a favor. Can you repeat the second half of your question? I got the first part.

Boran Wang

I was curious if there's anything like bundling wise, AstraZeneca could do that could negatively impact lorundrostat's ability to compete.

Jon Congleton

Yes. Evan, thanks for the question. As Eric indicated, we've been obviously watching the baxdrostat uptake. We think it does reflect demand from a physician standpoint to address those patients that are uncontrolled and resistant as well as access. We've gotten questions in the past about missing the bid cycle as AstraZeneca did. Presuming we get approved, we won't hit that bid cycle as well, whether or not patients on Medicare will get access. They clearly will. We know hypertension affects a significant amount of patients that are Medicare eligible as far as their coverage. And so we'll be looking forward to expanding that as soon as it's accepted on the formulary, but it doesn't preclude patients getting access to it. And so that's part of where we'll continue to focus, presuming approval at launch.

If I heard the last part of your question as far as just competitive dynamics, I think one of the points I'd like to make is that, yes, there's some natural competitive dynamics between lorundrostat and baxdrostat and some distinct differences within the data sets. But I think fundamentally, our focus is on the 20 million patients, less so on baxdrostat. I think if we got distracted and just thought about comparisons across ASIs, we're missing the broader opportunity. The market, I think, is primed at this point for an aldosterone-directed therapy that physicians can utilize with really robust clinically meaningful blood pressure reduction and doing so with a nice safety and tolerability profile. And so that's where our focus is really on as we're building out our commercial readiness presuming approval.

Operator

Our next question is from Mohit Bansal with Wells Fargo.

Mohit Bansal

Congrats on all the progress as well from my side. So Jon, I want to divert it to -- I want to talk a little bit about the segmentation of the market a little bit here. Trying to understand in the resistance as well as uncontrolled hypertension, what proportion of the patients are overweight or obese? And I think the related question is that we'll probably see Foundayo data next year for hypertension. And I think they are going after 25 and higher BMI. So it does look like GLP-1s actually lower the blood pressure as well. So like how do you see the market evolving with your drug and also GLP-1s going in there for the segment of the patients who are overweight and obese?

Jon Congleton

Yes, Mohit. Thank you for your question. And look, at the end of the day, it's really exciting times, I think, for patients dealing with cardiorenal metabolic disorders. We're seeing innovations just in the last several years that are making meaningful impact on their lives. We have clearly studied the benefit of lorundrostat in patients, whether they're normal BMI, overweight or obese, we've seen across that spectrum, very consistent reductions in their blood pressure. Clearly, you're seeing blood pressure reductions with weight loss, whether it's GLP-1 or some other means.

Typically, it's been about 5 millimeters of mercury, which is beneficial to patients, but certainly not in the realm of what we've seen both in absolute figures of 15 to 19 millimeters of mercury between advance and launch or even the placebo-adjusted figures of 8 to 11.7 -- 11.6, sorry. I don't know that one precludes the other. Clearly, there will be some patients that may be super responders on a GLP-1, but I think the vast majority of patients will likely need the continued benefits of therapeutic like lorundrostat. And as you know, Mohit, we believe there is a tight correlation between that visceral adiposity and dysregulated aldosterone. And so for those patients, hopefully, they see good weight loss, but they likely will still have some level of visceral adiposity as well as elevated systolic BP. So we think there's actually some synergy there.

Operator

Our next question is from Rami Katkhuda with LifeSci Capital.

Rami Katkhuda

I guess building off a few previous questions, how quickly do you anticipate achieving broad payer coverage post launch? And how should we think about the payer mix across resistant and uncontrolled hypertension patients? And then secondly, are there any historical CV drug launches that you view as relevant comps for lorundrostat, particularly about the time it could take to reach peak sales?

Jon Congleton

Rami, let me have Eric address the first part, and I'll grab the second part of your question.

Eric Warren

Yes. So from a payer coverage perspective, Rami, so definitely commercial will lead the way in terms of providing that access or that coverage initially. But we will, and we do anticipate Medicare coverage through the exception process, as I mentioned on a prior response. The Medicare exception process typically looks at the label, but it does require some navigation of that in which the PSP that we put forward is designed to support that. So commercial will lead the way, but don't discount Medicare from the beginning because we will get that through the exception process. We'll see progressive increases in that Medicare and expect a pretty equal contribution as we get to steady state.

Jon Congleton

And Rami, as far as analogs, I think we're living it right now. I think the baxdrostat launch, again, we've characterized that as very encouraging, encouraging on the validation of the demand and the access. So we're comforted by that. And I think there's even some signals of that with the oral PCSK9 that was reported recently by Merck. So there's clearly a need within cardiorenal metabolic disorders for the kind of innovations that have come forward in the last several years, and we're excited to be a part of that.

Operator

Our next question is from Tara Bancroft with TD Cowen.

Tara Bancroft

I have a similar kind of question, but I'm curious then, I didn't hear in that response anything about guidelines. So maybe you could talk about how you think guideline inclusion will play out, both for lorundrostat and in terms of the competitive dynamics of baxdrostat too. Like how soon do you think you could get the guideline inclusion? And how important are guidelines for payer coverage and formulary inclusion?

Jon Congleton

Yes. Thank you, Tara. We have been obviously focused on appropriately conveying the information about lorundrostat its data set across the spectrum of patients that we've studied, both the parent confirmed from Advance-HTN and our Explore programs. There are, at this stage, multiple guidelines. Our expectation is that certainly at the beginning, it will likely be in that fourth line resistant hypertension. How the guideline committees reflect the ASIs relative to the MRA, some of that is yet to play out, but I think there's obviously compelling clinical evidence to put them on parity. I would say that's where our focus has been with the various guideline committee members.

From a payer standpoint, I think it's informative, but it's not absolute. The payers and the discussions that we've had and even the market research we've done going back several years, the payers acknowledge they've got a real issue in uncontrolled and certainly in resistant hypertension. They understand the implications for the patients on their health care systems and the cost, and that's why I think you're seeing the kind of uptick we anticipated. What you're seeing now with baxdrostat is an acknowledgment of that unmet need. And so again, I think the guidelines will be informative, but not absolute in how the payers make their reimbursement decisions.

Tara Bancroft

Okay. Great. And I just want to clarify one thing just on timing. When you're doing contract negotiations with payers, can you start this during pricing labeling discussions? Or does it solely have to be after approval?

Eric Warren

Yes. We've already started the engagement. We have a pretty good expectation of what payers are looking forward, both from a clinical as well as a contracting perspective. Obviously, we haven't finalized the price yet, so that hasn't been revealed to the payer, but anticipate once we have approval, a relatively quick engagement and to start turning over some of that access in very short term.

Operator

Our next question is from Matthew Caufield with H.C. Wainwright.

Matthew Caufield

What do you view as the top key points to lorundrostat differentiation to help drive the real-world preference at the prospective launch? And separately, can you speak more to the described patient support program? Should that program be fully implemented by the possible launch timing?

Jon Congleton

Yes. Matt, thanks for the questions. I'll address the first one and have Eric address the second. I think the differentiation, I would begin somewhat broadly, and that is we know from meta-analysis with the existing genericized treatments that when you add a third or fourth agent, you typically see a 5- to 6-millimeter mercury reduction in systolic blood pressure. That's why I think our data set is very informative, both in launch and in advance when we look at patients, whether they're on 2 meds or 3 or more, we're seeing very robust reductions, 15 to 19-millimeter absolute reductions in BP, which I think just highlights the fact that when patients get to that third or fourth line and still cannot get to goal, aldosterone is likely the culprit that is still keeping them from their goal. And so I think that's, to me, the big opportunity, again, to really target those 20 million patients.

We've spoken in the past when we think about how does lorundrostat compared to baxdrostat. I think the selectivity in half-life has yielded what we believe to be a very compelling clinical profile, both on systolic blood pressure reduction as well as modest impact on on-target AEs, specifically hyperkalemia, hyponatremia and eGFR change. So we feel that we've got not only compelling data, but breadth of data, again, across apparent confirmed hypertension based on rates that we efforted with intent to have great diversity in the trial with 28% black or African-American in launch and 53% in advanced HTN. And so I think we've got a very compelling argument for physicians somewhat independent of who their patients may be that they're dealing with.

Regarding the patient support program.

Eric Warren

Yes, Matt. In terms of timing, so shortly after launch, you can anticipate that patient support program. And for competitive reasons, I won't get into all the details, but as I did say in the predefined remarks that it's important that it addresses both the HCP as well as their staff and the patients. So as you see the elements of our PSP unfold, don't be surprised to see all 3 of those addressed.

Operator

Our next question is from Alice Nettleton with UBS.

Alice Nettleton

So just assuming FDA approval, how quickly do you expect to launch lorundrostat after the PDUFA date? And then I have a follow-up.

Jon Congleton

Yes. Thanks, Alice. Presuming approval, our goal is to get lorundrostat into the hands of patients and access for physicians as soon as possible. We haven't guided specifically to what that kind of timing would look like. That's something we may provide post PDUFA date, but we haven't guided to that yet.

Alice Nettleton

And then again, on the AstraZeneca 3Q number, I think that's the main focus of investors. It kind of implies a low net price in 3Q if you look at the IQVIA data. And assuming this is relating to payer access still developing and the high patient support burden with the access program. I guess lorundrostat will be launching into probably a stronger ASI coverage in 2027. So should we assume you will have a more favorable gross to net at launch? Or will early 2027 still be challenging?

Eric Warren

Yes, Alice, it's Eric. So still really early. And as you mentioned, a combination of rebates and then some of those buydowns that they're doing make it pretty difficult to truly discern where that GTN will land. And then in terms of providing comments about our GTN, probably a little premature to do that. But as I said, that payer engagement has been a priority to us. So making sure that we have that rapid commercial and then obviously are pulling through that Medicare exception process. So not going to speculate on our GTN, but we'll start to reveal those details as we get closer into launch.

Operator

We have reached the end of the question-and-answer session. I would like to turn the floor back over to Jon Congleton for closing comments.

Jon Congleton

Thank you, operator, and thank you all for joining us today.

We are now just weeks away from our December 22 PDUFA target date. Our focus is squarely on being ready to reach patients soon after potential approval. The new data we shared at AHA-HTN and ASN Kidney Week add to the data supporting lorundrostat in uncontrolled or resistant hypertension, and we look forward to presenting long-term data from Transform-HTN open-label extension trial at the American Heart Association Scientific Sessions this coming Sunday. Our commercialization plans are on track. Our engagement with physicians and payers continues, and we look forward to the potential to bring lorundrostat to millions of patients in need.

On behalf of the entire Mineralys team, thank you for your continued interest and support, and we look forward to updating you on our progress.

Operator

This concludes today's teleconference. You may disconnect your lines at this time. Thank you for your participation.

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