Supernus Pharmaceuticals, Inc. (NASDAQ:SUPN) Q1 2021 Earnings Conference Call May 5, 2021 4:30 PM ET
Peter Vozzo - Westwicke Partners
Jack Khattar - Founder, President, CEO, Secretary & Director
James Kelly - EVP & CFO
Conference Call Participants
Kenneth Cacciatore - Cowen and Company
David Amsellem - Piper Sandler & Co.
Nicholas Rubino - Stifel, Nicolaus & Company
David Steinberg - Jefferies
Good afternoon, and welcome to Supernus Pharmaceuticals' First Quarter 2021 Financial Results Conference Call. [Operator Instructions].
I would now like to turn the conference over to Peter Vozzo of Westwicke, Investor Relations representative for Supernus Pharmaceuticals. You may begin.
Thank you, Jurgen. Good afternoon, everyone, and thank you for joining us today for Supernus Pharmaceuticals First Quarter 2021 Financial Results Conference Call. Today, after the close of the market, the company issued a press release announcing these results.
On the call with me today are Supernus' Chief Executive Officer, Jack Khattar; and Jim Kelly, Chief Financial Officer. Today's call is being made available via the Investor Relations section of the company's website at ir.supernus.com. Following remarks by management, we will open the call to questions. During the course of this call, management may make certain forward-looking statements regarding future events and the company's future performance. These forward-looking statements reflect Supernus' current perspective on existing trends and information.
Any such forward-looking statements are not guarantees of future performance and involve risks and uncertainties, including those noted in the Risk Factors section of the company's latest SEC filings. Actual results may differ materially from those projected in these forward-looking statements. For the benefit of those who may be listening to the replay, this call is being held and recorded on May 5, 2021, at approximately 4:30 p.m. Eastern Time.
Since then, the company may have made additional announcements related to the topics discussed. Please reference the company's most recent press releases and current filings with the SEC. Supernus declines any obligation to update these forward-looking statements, except as required by applicable securities laws.
I will now turn the call over to Jack.
Thank you, Peter. Good afternoon, everyone, and thanks for taking the time to join us as we discuss our 2021 first quarter results. Since the beginning of 2021, we have made significant regulatory, operational and commercial progress on a number of fronts. First, in April, we received FDA approval for Qelbree for the treatment of ADHD in pediatric patients, 6 to 17 years of age. We are actively preparing for the launch of the product in the U.S. starting later in the second quarter and are excited by the opportunity to provide this treatment as an important option for patients.
Our commercial launch activities are ongoing and include engagement with both physicians and patient groups who have expressed great interest in this unique new alternative for the treatment of ADHD. We will be launching Qelbree with more than 175 sales representatives who have strong expertise in CNS. We are leveraging our heritage in the ADHD space, having created more ADHD products than any other company in the world over the past 2 decades.
Supernus scientists created 4 different ADHD products using our technologies and expertise in the field. Our leadership in ADHD product development and commitment to the ADHD community is second to none. We are excited about the considerable level of attention Qelbree has received since its approval from physicians, patient advocacy groups, and the media because of its unique profile as the first novel noncontrolled substance to be approved in over a decade.
We will conduct post-marketing commitment studies, including a new study of Qelbree in preschool aged children with ADHD, 4 to 5 years of age. The completion of these studies is in response to a written request by the FDA and should, therefore, result in the FDA granting an additional 6 months of market exclusivity. Regarding the adult population, we are on track to submit a supplemental NDA to the FDA for Qelbree for the treatment of ADHD and adult patients in the third quarter of this year. The adult indication is important to help expand the use of Qelbree as adults represent approximately half of the total ADHD market in the U.S.
Turning now to the NDA for the apomorphine infusion pump, or SPN-830. We recently met with the FDA to discuss the contents of the November 2020 refusal to file letter and the requirements for resubmission. Based on those discussions, we now plan to resubmit the SPN-830 NDA in the second half of 2021. Since the last update we gave, we have made good progress on the additional device testing that the FDA has asked for, and we are now focused on completing all the remaining activities to have a complete file for resubmission later this year.
Regarding SPN-820, our first-in-class orally active mTORC1 activator, we have advanced it towards a Phase II clinical program and treatment-resistant depression following the successful completion of a multiple ascending dose study in healthy volunteers. In the MAD study, SPN-820 exhibited a favorable safety and tolerability profile across a broad range of potentially therapeutic doses. We remain on track to initiate a randomized Phase II clinical study in treatment-resistant depression by the end of 2021.
Moving on to the commercial products. We saw familiar first quarter dynamics such as insurance pressure that impacted our brand's performance compared to the fourth quarter of 2020. For APOKYN, net sales were also impacted by competitive headwinds for the brand that were initially seen in the fourth quarter of last year.
While still early in the second quarter, we believe we are starting to see stabilization in the business and look forward to improving the trend for the remainder of the year. Compared to last year, net sales of Trokendi XR increased 5% in the first quarter of 2021, while net sales of Oxtellar XR grew by 14%. These products continue to report healthy net sales gains despite the continued challenges from the pandemic, the typical first quarter market dynamics and the fact that they have now been on the market for nearly 8 years.
First quarter 2021 prescriptions as reported by IQVIA, and on an extended unit basis were flat for Oxtellar XR as compared to the first quarter of 2020, while Trokendi XR first quarter extended unit prescriptions were down 13% as compared to the first quarter of 2020.
Finally, regarding corporate development, we continue to be active in looking for strategic opportunities to further strengthen our future growth and leadership position in CNS.
With that, I will now turn the call over to Jim.
Thank you, Jack, and good afternoon. As I review our first quarter results, please refer to today's press release. I'll begin with our revenue earnings and a discussion of some unique items in the period and then turn to discuss operating expenses.
In summary, our results keep us on track with our 2021 plans, our team is well prepared for the launch of Qelbree as an important new treatment option for ADHD in pediatric patients, and our cash balance of $808 million maintains our strategic flexibility to in-license or acquire new products.
Total revenue for the first quarter of 2021 was $130.9 million, an increase of 38%, over $95 million in the same quarter last year. Total revenue was comprised of net product sales of $128.4 million and royalty revenue of $2.6 million. Net product sales for the first quarter of 2021 included $99.2 million from Trokendi XR and Oxtellar XR, reflecting 7% growth versus the first quarter of 2020 and $29.2 million from APOKYN, XADAGO and MYOBLOC.
Of note, the continued strength of Trokendi XR and Oxtellar XR was offset by APOKYN, which saw declines in demand linked to market and payer pressures. Regarding inventory levels, we saw some moderate destocking across the portfolio, equal to approximately $1 million compared to the fourth quarter of 2020.
Operating earnings were $13.2 million for the first quarter of 2021 as compared to $29 million in the same period the prior year. Of note in the first quarter of 2021, we recorded a number of noncash items that were the primary driver of this decline. We recorded a noncash in-process R&D expense of $15 million related to the equity investment in Navitor and noncash contingent consideration expense of $1 million associated with the 2020 US WorldMeds acquisition. The Navitor-related $15 million noncash expense is the result of the accounting impact of the March 2021 Navitor corporate restructuring, whereby we expensed our investment as an acquired in-process R&D asset in the period.
In addition, amortization expense for intangible assets was $6 million for the first quarter of 2021, a $4.7 million increase compared to the same period the prior year. Net earnings were $5.7 million for the first quarter of 2021, or $0.11 per diluted share, compared to $21.5 million, or $0.40 per diluted share, in the same period the previous year. Given the magnitude and growing number of the product acquisition-related items, we're considering adding non-GAAP financial measures to future company earnings press releases as we believe they provide greater transparency and can assist investors in understanding and assessing ongoing economics of Supernus' business and reflect how we manage the business internally and set operational goals. More to come on that topic on our future earnings calls.
As of March 31, 2021, the company had $807.7 million in cash, cash equivalent, marketable securities and long-term marketable securities compared to $772.9 million as of December 31, 2020. I will now provide some more detail related to operating expenses.
For SG&A, first quarter of 2021 expenses were $61.5 million compared to $41.6 million in the same period last year. This increase was primarily due to expenses associated with commercialization efforts for APOKYN, XADAGO and MYOBLOC as well as sales, marketing and launch activities related to Qelbree.
With the launch of Qelbree in the second quarter of 2021, we expect a step-up of at least $15 million in our quarterly SG&A run rate when compared to the first quarter of 2021. Research and development expenses were $34.3 million for the first quarter of 2021 compared to $18.9 million in the same period last year. Excluding the impact of the previously mentioned $15 million noncash item associated with our Navitor investment, R&D expenses in the period were approximately flat year-over-year.
Turning now to financial guidance for the full year 2021. We continue to expect revenues to range from $550 million to $580 million, comprised of net product sales and royalty revenue and including approximately $10 million of net product sales of Qelbree based on the launch in the second quarter of 2021.
For full year 2021, we continue to expect combined R&D and SG&A expenses in the range of $380 million to $410 million and operating earnings between $65 million and $90 million. In addition, we expect full year 2021 amortization of intangible assets of approximately $24 million. New this quarter to our guidance is the full year 2021 effective tax rate of 28% to 31%. This range is above our normally expected effective tax range for this period of 26% to 28% due to a number of discrete tax items in the year.
With that, I now turn the call back over to our operator for Q&A.
[Operator Instructions]. Our first question in queue comes from the line of Ken Cacciatore from Cowen and Co.
Jack, surprised on the really positive guidance here around the apomorphine pump. Can you provide any additional context? I know you've indicated device testing, just trying to better understand what you need to do. And it sounds like you don't need to address any additional clinical data.
And then on the Qelbree launch, a little bit, managed care has changed even the environment has changed even since you launched Trokendi and Oxtellar XR. So just any thoughts around progress there? Are we going to be subject to the automatic blocks? Or could we see some maybe initial wins, maybe any update on progress you're making?
Yes, sure. Regarding the pump, we have -- while we were discussing with the FDA and trying to clarify some of these requirements, in parallel, we were trying to complete some of the environmental testing that we had referred to in previous earnings calls. So those tests have been really progressing very well. So we are happy with the timing of those tests because with COVID and so forth, there were a lot of unknowns as to the timing and whether the suppliers will be able to complete the testing on time and so forth. So we feel a little bit better about the time line overall right now as to where we stand.
And the meeting in March helped us tremendously in clarifying with the FDA exactly the specific items they were looking for and therefore, we feel very good about the timing. We said the second half of this year, we're working pretty hard to do it as soon as we can in the second half. So as we get closer, hopefully, we can give people a little bit more clarity within that second half as we get closer to filing. But we feel good about it at this point as to where we stand. And yes, I mean, as we mentioned earlier, there were no requirements for any new clinical data behind the product.
Regarding managed care, we continue to talk to managed care. I mean this is an ongoing discussion, as everyone knows. Sometimes, it's all the way until the last minute for things to materialize one way or the other. We are clearly trying to avoid any new market block type of policies, as we all have seen in a lot of the new market launches. But we're not going to let that stop us. This is a product that is so unique and the excitement behind it, the requests we're getting from the field, from parents, from physicians about the product. When can you come and talk to me about it, I mean, the energy, the momentum we're seeing in the marketplace is incredible.
And we're going to let people try this product. We're going to sample it. We're going to give it to them. We're going to let utilization and demand really drive the success of this product. And we hope everyone will partner with us eventually in a reasonable manner as far as managed care is concerned to help everybody get access to this really great option treatment.
Your next question comes from the line of David Steinberg from Jefferies.
Okay. I have a few questions on the Qelbree launch. Jack, you indicated you're going to be sampling aggressively. So just curious, I assume that the actual scripts will be understated for some period of time because the samples will not be included in the paid scripts. What do you think is a reasonable time frame after the sampling, so that the actual scripts would correspond to what you're seeing in the marketplace?
Secondly, in terms of target physicians, I guess, how many calls do you think you'd make to the high decile docs before the action really starts for the back-to-school season?
And then are you targeting -- is there a difference in the decile between docs that write the most scripts in ADHD and also the docs that write the most scripts, specifically for nonstimulants?
And then the final question is, we get asked this a lot because there are a lot of different analogs ranging from the neos reformulation of methylphenidate to Vyvanse, which does over $2 billion in sales. What do you think is the best analog to look at for your launch of Qelbree?
Okay. I'll see, and I'll make sure I'll cover everything. Starting with the first question about sampling and when would you expect to really start reading real prescriptions and so forth. I mean for the obvious reasons, we're not going to divulge and disclose completely the full details of our sampling program and for how long and so forth. So -- but clearly, as far as prescriptions, you're right, samples are not picked up by IMS as prescriptions. So when you start seeing IMS prescriptions, these will be real demand, real prescriptions behind the product.
Hopefully, during that period, when there isn't enough data that people would like to see, we will try to provide folks with some other metrics, at least, to give people a good feel as to how the launch is going, the adoption in the marketplace, physicians coming on board or not coming on board and so forth. So we'll try to introduce other metrics that hopefully could give people at least a good feel as to how the launch is coming up in the first, at least 2, 3 months and so forth until things become much clearer.
As far as targeting physicians, I mean, as you know, and you've known us in this space, I mean, that's really one of the things we do extremely well, and we execute on extremely well. So you can bet on the fact that we will definitely be targeting physicians very precisely, as precisely as possible using really good data sources here and go after the physicians who are high prescribers on both ends. This is not a product that is just suited for people who use stimulants or people who use nonstimulants. This is a product that is suited for every patient out there.
So we're going to go after physicians who are high-volume prescribers and those physicians are across a wide span of different physician type, starting with pediatricians, child psychiatry and so forth as far as ADHD. And of course, back-to-school, as we all know, that's really the big season for a lot of patient initiations. Somewhere around the 40% of prescriptions are initiated during that back-to-school season. So we're going to be there. We're going to be part of the conversation between the physician and the parent and make sure Qelbree is one of the options that will be presented to the patients and to parents.
And again, back to the profile of Qelbree and really the exciting clinical profile we have with this product, you have a product that is so easy to use. You may not even need titration or very minimal titration, and it's not dependent on weight or no weight or any of that. It has a sprinkle option. It can work as early as the first week. It works in both attention and -- in attention and hyperactivity, beautiful safety and tolerability profile.
I don't know, this is just my opinion, why in the world, any parent will put their child on a stimulant or any other product. So -- and we're going to give them a sample to try it and try it for free initially. So the downside, we believe, is extremely low, obviously. So that's why we feel pretty good about being part of that conversation when it occurs during the back-to-school season and, then we have a good chat that most parents will probably give us a shot at trying the product.
And then the last question, if I remember, was more, is there a difference between those who prescribed stimulants or nonstimulants. The only really -- the overall general rule of thumb, and this is overgeneralizing here, not really. But as far as kids, if you look at the market, about 23% is nonstimulants. In adult, the usage of nonstimulant is much lower as a percent of the marketplace. So you would expect within the kids' usage, physicians who are treating kids, they are more likely to use nonstimulants versus physicians who treat adults.
Jack, actually there's one other question I asked. I know I asked a lot of them, which is what do you think is the correct analog. There are a lot -- there have been lots of different launches in ADHD ranging from highly successful ones to duds. What you -- what would you point to as the #1 or #2 analog that you would use for us to look at?
There is really no good analog because this is the first real new chemical entity to be introduced in over a decade. So if you're looking for an analog that is a recent analog, there is really no such thing in the current environment because most of the products introduced in the last 10 years or so are all reformulations of the same thing, methylphenidate and amphetamine and viloxazine is truly unique on its own as far as its place in the therapy and also the gap, it really fell here, a gap that we've been waiting for, for years and years.
And as you know, we've been in this market for 25-plus years in the ADHD market. We know it extremely well. So there is really no one I can point you to. Of course, Strattera at that time also was a new chemical entity, but it was a long time ago and it also was the first nonstimulant ever.
Now if you can take that as an analog, and if you're looking for a surrogate as to what the pent-up demand can be for a real nonstimulant that actually works -- works quickly within a reasonable time frame, has a good safety and tolerability, you probably should look at the first 6 months of Strattera when they first launched. And as you know, in those days, we were back at trial defending against Strattera with Adderall XR and so forth. And we saw the penetration, and it went up very, very quickly. And I believe, if I'm not mistaken, it reached a market share of 19% of the total ADHD market. So that should give you at least probably a good measure as to how deep and strong that demand could be for a real good nonstimulant.
Unfortunately, for a lot of patients at that time, the product started disappointing a little bit and had other issues on the label and so forth. But that 19% maybe is a good measure as to the pent-up demand. But also, again, I'll qualify all that by saying that was the first nonstimulant ever to be introduced at that time. Hopefully, that's helpful.
Your next question comes from the line of David Amsellem from Piper Sandler.
Just a couple. So first on business development. You have this fairly large commercial infrastructure focused on the psychiatry setting. I know you are focused on Qelbree and getting that launched right. But how big of a priority is it for you to bring in an asset where you can leverage your psychiatry-focused commercial infrastructure? So that's number one. And that's also bearing in mind that you're going to be focused on the adult setting in ADHD in due course. So again, that's number one.
And then secondly, and I apologize if you already have addressed this. Can you just talk about how you're thinking about steady state gross-to-nets for Qelbree? Obviously, there's some things like sampling and co-pay assistance and you're fairly aggressive on that early in the launch. But with contracting in place, looking out, say, 2 to 3 years, what does that look like?
Yes. Sure. Regarding the first question, as far as a priority. I mean, in BD, as we all know, availability is always half the battle. And we are looking on for a commercial asset in both areas, neurology, psychiatry, and we will figure out a way if it is in psychiatry, and it all depends on the timing, of course, as to when that asset comes on board. We will figure out a way of how to give it the right attention and also not to take away from the Qelbree launch.
Clearly, the Qelbree launch, no question, by far, is our top, top priority as a company at this time and then followed later on by the pump, which is extremely important for us as well. So anything we bring in depending on the timing of that acquisition, if we are lucky and fortunate to be able to land a really good asset, then we'll figure it out and we'll staff it and give it the right resources to do a good job with the new asset as well.
So I wouldn't limit ourselves by saying now we're very busy, and we don't have the time for something else, absolutely not. We're fully engaged on the BD side, and it will continue to be a priority for us to employ the balance sheet and put it in the right place to give us future growth for the company.
As far as the question on gross to net and steady state, I mean, we've all seen all the horrible gross-to-net levels and a lot of products have been launching with and so forth. I should hope and we will be trying to work pretty hard to be much lower than the 60s and the 70s percent gross to net. I don't think that's a very viable long-term strategy for a lot of products to continue with that kind of trend. So we should hope to be much lower than that but it's really hard for us to make -- give you a specific number, given that we haven't finished all our contracts or the contracts and so forth. So we will need few -- a year or so in the marketplace, obviously, to get a good feel as the word, long-term-wise, steady state-wise, we may able to settle at what level.
Your next question comes from the line of Annabel Samimy from Stifel.
This is Nick Rubino on for Annabel. A few from us. First, are you guys currently engaging with physicians in kind of this, I guess, soft launch that you're currently in? And then how are things going to change once you have the product in hand? I know you mentioned kind of sampling programs as being a large part of that and kind of how are you integrating that with physicians? And how should we see physicians kind of utilizing that program?
Then second, on pricing, you guys are at kind of the low end of the range of options. How is that facilitating payer conversations? And lastly, can you just remind us quickly about viloxazine IP in the U.S.? We know it's an NCE, but kind of what's the broad patent portfolio strength like?
Yes, sure. I mean the first question as far as to how the conversation and what kind of conversation you have with physicians initially when you have a soft launch, so to speak, or when actually the product becomes available. Clearly, at the beginning, we don't want to jump the gun because we don't want to disappoint physicians, they start writing prescription and the product is not available. So the timing is very delicate to make sure that those conversations are happening at the right time with the physicians. Those conversations, meaning detailed conversations about the benefits of the product, the unique profile of the product, the type of patient that the product can help and so forth.
Those conversations will be more closer to when we know for sure that the product is going to be at the shelf available. So that when the patient walks out of the physician's office with a prescription, they can actually fulfill and get that prescription. So clearly, that's always the delicate part of the initial launch between getting the supply, getting the product in the pipeline and the distribution channel, making it available and then our sales force at the same time, doing -- building the awareness around the product, building the excitement around the product. And when we get closer to having the product available, have the real, real conversation in selling the product to physicians and showing them the benefits of Qelbree.
As far as the pricing, I mean, I can't really make any specific comments other than what everybody know. Our pricing, we always said we are going to be reasonable in pricing our product. It is priced to make sure we have access and give access to people for the product. One question came up a couple of times. I mean we don't know where the total daily dose is going to end up landing. It could be much higher than 100 or 200 milligrams. So that remains to be seen, obviously, as physicians start using the product on a mass scale and trying it to see where the total daily dose will end up being on an average.
And then finally, regarding viloxazine and the IP. In the U.S., we have several families of patents here, surrounding the API synthesis, surrounding the formulation as well as surrounding the novel use of viloxazine in ADHD, and the patents are in the 2029 to 2033 time frame as far as expiration.
[Operator Instructions]. You have a follow-up question from the line of David Steinberg from Jefferies.
Okay. I've two follow-ups. My first is on Qelbree, and the pricing came out, and I think you just alluded to this with a WAC price for the 100, 150, 200 milligram. Given that like half the scripts now in ADHD are almost -- are adult, and if you look at the 299 to sort of 600 ranging from the 100 mg up to more than 200 mg. Where do you think the average sort of blended WAC price might be? Would it be over $400, if you assume -- or well over $400, if you assume that 50% of the users are going to be adult?
And then, Jim, you called out -- I just wanted some clarification. This APOKYN came in quite a bit lower or a decent amount lower than you thought in the first quarter and you called out market and payer pressures. Could you give us a little more clarification on what those pressures are? And why you think you're going to get under control? And I think Jack said get to sort of a normalized situation.
Yes. Yes, regarding the Qelbree pricing, again, the point I was trying to make is, clearly, we will need some time to see where physicians end up in the experience. They see themselves in the marketplace as far as where the total daily dose will land. In our clinical studies, as everybody knows, we started with 100 milligram for the young children as a starting dose and then for adolescent with 200 milligram, and they could go all the way up to 400 milligrams.
Of course, with adults, we did the study, and we started with 200 going all the way up to 600 milligrams. So clearly, as the actual usage in adult gets in the 4 to 6 milligram, so clearly, that's going to bring your weighted average WAC into the higher range from a pricing point of view. And similarly, even in adolescent, because the adolescent study went up from 200 to 400 milligrams. So clearly, the 400 milligram is going to carry a much higher price point for that prescription.
So all in all, that's why we said the total daily dose, we see it probably trending upward as time goes on. For these reasons as people get more experience with the product and as we get also the adult indication on board as well. Could it be north of $400? Probably. I mean if you run the math pretty quickly, assume a certain mix, you probably will end up somewhere, yes, in that range, higher than the $400 for a 30-day prescription.
On APOKYN, I can jump in very quickly, and then Jim can add. I mean the market pressures we talked about, it's really the same that I mentioned in my comments, which is really the market dynamics with a competitor like KYNMOBI and breech and other products in that sector, on-demand therapies that we've seen some competitive dynamics there.
COVID continue -- to a certain extent, continues to hurt that specific patient population because it is Parkinson's initiation. This is an injection that requires a nurse visit. So there is more to it than just prescribing a pill, obviously. So that continues. However, as I mentioned in my remarks, we're starting to see and easing of that, and we start seeing that more a little bit at the end of the first quarter into the second quarter. So we're encouraged a little bit with the improvement on patient initiations and so forth.
And then regarding payer pressures, it's really -- the comment is more related -- and Jim can jump in, but it's really more related to the insurance issues that you typically see in the first quarter.
And that's exactly right. You see it across all products. And with a specialty product like APOKYN, potentially a little more than others, just based on the price point, reset of insurance and co-pays.
Got it. Okay. So multiplying the first quarter by 4 would be on the low side for the year then, right?
Hopefully, yes. Yes. Yes. I mean we expect improvement through the year. And hopefully, COVID even gets better and better as time goes on, which, I think, that will be the case. So we're encouraged with what we are starting to see across different states, reopening and so forth. So we're very encouraged with that.
[Operator Instructions]. A follow-up question from the line of Annabel Samimy from Stifel.
We did get an extra question on our end. So with the Trokendi, UTRx is down 13% year-over-year, we're seeing a big jump in revenue, and we're seeing the same dynamic in Oxtellar as well with flat UTRxs and increases in the revenues. But with pricing kind of flat to down, where is that delta? And how should we think about that kind of discrepancy?
So why don't I start, and if Jack, you don't mind, I'll jump in here. On -- when you look at Oxtellar, and you look at, for example, the prior year, some of the ups and downs that we saw in 2020 from, for example, Q1, 2 and 3, you'll see that the Q3 number of about $28.4 million is in line with where we are now, but it's shouldered by numbers of about $23 million, $24 million. And so, what we are witnessing is we definitely noticed that there was some ups and downs, and I'll call it, the retail channel holdings of inventory as COVID was happening last year.
We think that's evening out just based on what we're seeing in the data we use to do our accruals. And so, it is creating some year-over-year comparison issues, primarily from Q4 into Q1. That said, when you look at the year-over-year on Oxtellar itself, we're looking at about 9% year-over-year, and we took price of about 8%. So don't get me wrong. Sequentially, the journey from Q1 last year to now has some ups and downs. But when you look at just the pricing we've taken and a fairly stable gross to net, it falls in line with the expectation.
When you look at Trokendi, you get a year-over-year -- let me get my numbers correct here, excuse me. It's about 14% year-over-year on Oxtellar with the pricing and then a slight improvement in our gross to net in Q1. When you look at the Trokendi year-over-year of about 5%, you compare that to the extended units being down about 12. And so, we are certainly making up some benefit there on gross to net as well.
There are no further questions in queue. I will now turn the call over back to Jack.
Thank you. We remain focused on the launch of Qelbree, a treatment option that is like no other ADHD product on the market. I would like to thank all our employees who have been committed for years to develop Qelbree and to make it available to the millions of patients who can benefit from its unique clinical profile. In addition, we continue to advance SPN-830 along its regulatory path towards potential approval. Qelbree and SPN-830 represent important growth drivers for our company, and we are committed to progressing them towards commercialization and market success. Thanks again for joining us today, and we look forward to updating you on our progress throughout the year.
Thank you, presenters. This concludes today's conference call. Thank you for participating. You may now disconnect.