Industry Insights on the Glaucoma Market, From OIS Glaucoma Innovation Showcase

Click here to watch the video version of this podcast.

Adrienne Graves, PhD, former CEO of Santen, opened this panel discussion by reiterating a sentiment expressed by surgeons, innovators, and investors: we’re in the middle of a glaucoma renaissance. The release of new devices, instruments, and pharmaceuticals has led to improvements in surgical procedures and other treatment options that promise to improve the lives of glaucoma patients.

For this OIS Podcast, originally recorded for the OIS Glaucoma Innovation Showcase, Dr. Graves corralled four ophthalmology leaders to discuss what’s new and what’s next in glaucoma innovation, how their companies stay resilient through the COVID-19 pandemic, and more.

A glimpse: Jay Katz, MD, CMO of Glaukos, shared the latest news on the iDose TR sustained-release travoprost implant and the iStent Infinite, an investigational device designed to reduce intraocular pressure (IOP) in open-angle glaucoma patients.

New World Medical, which focuses on glaucoma surgical devices, has three products launched and two in the pipeline. Santen, developer of options from drops to surgical solutions, is exploring new mechanisms of action and preparing for Phase III clinical trials for PRESERFLO, a microshunt currently available in Europe and under Food and Drug Administration review.

Allergan/AbbVie has put its DURYSTA, its biodegradable implant, into the hands of 2,000 physicians to date according to Ramin Valian, VP, international glaucoma, surgical, retina, and eye care portfolio.

Listen to the full episode to hear the panel address:

• What they would like their companies to focus on for glaucoma.
• How COVID-19 has affected product development, marketing, and physician interactions.
• How their companies are part of the glaucoma solution.

Other podcast participants include:

• Bilal Khan, CEO of New World Medical.
• Omar Sadruddin, MD, global medical director of Santen.

Click “Play” to listen.

Transcript:

Adrienne Graves: Greetings, I’m Adrienne Graves. And I’d like to thank OIS for highlighting and helping advance innovation in the glaucoma space. We have a stellar panel of industry leaders today from Glaukos, New World Medical, Santen, and Allergan, so we’ll get there, we’ll get their insights. And we’ll the things they want to highlight. And I’d like them to each introduce themselves. Tell us a little bit about their role. And then tell us what glaucoma innovation looks like, at their company, what their organization is doing to address unmet needs, innovation, and what they’re currently working on, and maybe even what they’d like to be working on. So we’ll start with Jay Katz, Dr. J. Katz from Glaukos. Hey, Jay. So what’s up big cloud cars? Take it away, Jay.

Jay Katz: Well, thanks, Adrianne, and thanks for including me in this panel. As the Chief Medical Officer for Glaukos, I’m really very fortunate to work with a number of different talented teams within Glaukos. My role has been to work with the development of new products. So taking novel ideas and making them into some type of commercial reality. That involves working with designing and implementing various clinical trials. Right, kind of going through the regulatory process with the FDA, and also being involved in post market activities, such as medical affairs and looking at philanthropic kind of grants as well as putting together phase four trials as well. So it’s really been a pleasure for me to kind of work with various different teams in kind of working on a path forward for glucose and do you want me to talk about some of the kind of the progress that’s been made a glaucoma to just delve into what that. So I kinda like to talk about two different areas. As a clinician there, there were kind of two needs that were glaring for us, in glaucoma, and the surgical side and also on the medical side. So on the surgical side, we had some difficulties with kind of transitioning from fairly safe medical therapy and laser therapy. And then the big leap forward to doing kind of incisional filtering surgery was just a huge, huge step there, because of the risk profile with those operations. So there was always this reluctance to kind of jumping into that kind of next step. And it was really important for a lot of these patients, because we’re worried about them getting worse and we often waited for definite progression, even though we’re pretty sure they’re gonna progress before moving to something that potentially could change their lives. You know whether it’s intra operative complications or post operative complications. So Glaukos is kind of pioneered the whole minimally invasive glaucoma surgery arena. They’ve been great and kind of developing an idea of bypassing the trabecular meshwork by developing a stent that they released in 2012. That stent is undergone modifications from my standardized and jacked I stent. Inject w. So it’s been a kind of a transition through various modifications towards creating a surgery that really can help kind of bridge that gap between conservative easy therapy that’s relatively safe to something that involves a filtering operation creating a filtering bleb with its attendant risks. So having that kind of minimally invasive glaucoma surgery as an option for patients without creating a filtering blip gives us something that’s relatively safe and effective and lowering intraocular pressure. So that’s been a great journey. On the second front, on the medical side, you know, it’s been kind of a ignored problem, but we know that compliance has been a huge issue for our patients with taking topical medications. And there are so many reasons why there’s a kind of a problem with people taking medication on a regular basis and I won’t list all the reasons but there, there’s a huge number of reasons why that exists. So how do you get around that? So to get around that issue has been the development of kind of sustained release drug therapy, preferably inside the eye, which has also had the added benefit of minimizing many of the side effects that we have, especially with the topical side effects that we incur with using medications. And we also have ignored the fact that quality of life is can be really terribly impacted by the use of topical medications which can exacerbate dry eye event, which is a big issue for our patients with glaucoma. So, glaucoma has developed one avenue of giving sustained drug delivery, which is the development of the iDose, which delivers Trevor post over a sustained period of time, best measured and not just months, or even years now, which is device that’s anchored within the angle of the eye placed inside the eye, and delivers drug therapy which lowers intraocular pressure, equivalent to our best class of drugs out there prostaglandins, or beta blockers and lowering intraocular pressure, a fair amount. So that really is kind of a wonderful kind of new approach to possibly treating patients with medical therapy, aside from topical medications, which we’ve done for over 100 years with kind of marginal success, so I think those two areas have been a fun, fun ride for me and watching the development within Glaukos.

Adrienne Graves: Yeah, pretty exciting. What is there something that you wish Glaukos were working on?

Jay Katz: Yeah, I think that, you know, right now, we’re kind of, there are a couple things that are in transition. And looking far ahead if we want to talk about that. Now, I’d be happy to. On the surgical side, we’re looking at the FDA approval for the ice and infinite as a standalone placement of three stents for the treatment of uncontrolled glaucoma. So this is without cataract surgery, which is where many of the mixed devices were initially launched. So we’re waiting for the FDA to kind of look at that and hopefully give a green light in the not-too-distant future. In addition, we’re looking forward to having the opportunity of using present flow, which is another way of creating a filtering bleb. And patients that do require filtering blebs and, and glaucoma, I think we need all the tools at our disposal. So that there are some patients who fail all the conservative measures who need a filtering bleb. And that’s another way of hopefully, having an easier and perhaps safer way of creating a filtering bleb and lowering intraocular pressure. So that’s on the surgical side, on the medical side, I think we’re already looking at ways of extending the sustainable delivery of drugs. So again, measuring duration of effect, not in terms of months, but in terms of years now, really extending out for a up to six years with various ways of delivery with this canister. So that’s pretty exciting for us as well. And then, of course, we know that there are many drugs that we’ve delivered topically that are very effective, lowering intraocular pressure, but they carry a significant burden of side effects. So is there some way to package those into sustained delivery within the eye. So there’s a whole new kind of array of drugs that we could kind of look at, some of which never even got to market because they weren’t really tenable for use topically because of the side effect profile. So then, that is kind of an exciting area. Also, you know there’s obviously a kind of a marriage between mixed devices and sustained delivery that looks very promising. So we often need a significant pressure reduction and in the marriage of those two modalities might give us a nice pressure reduction to put people in a safe category. But ultimately, all these things that we’re looking at is, is obviously to lower pressure. That’s the immediate goal, but also to preserve the vision of our patients, and also maintain the quality of life. That’s really what we’re all about. And in terms of looking way into the future, you know, that we’re really expanding the horizon of understanding outflow with the physiological outflow pathway of the eye. So beyond trabecular meshwork we’re also looking at how do you modify slumps canal, the collector channels that be scrolled venous circulation to further lower interact under pressure, so even beyond trabecular meshwork bypass. So that’s really kind of a whole new area that is kind of uncharted territory in my view, that’s not well understood that a lot of people, including Glaukos are looking at very carefully now. It’s another way of lowering intraocular pressure. So I think Glaucoma is just a fantastic field right now with the unlimited opportunities to really improve not just medical and surgical care, but in a variety ways. Also, diagnostically. This is kind of a unique period for us and glaucoma. In my career, this is probably the high point in terms of innovation.

Adrienne Graves: I call my Renaissance. Yeah, it really is. Well, thanks. Thanks, Jay. Thanks. Thanks for all those insights will now turn to Bilal Khan, CEO of New World Medical. So I think you’re in a great position since your CEO to tell us everything that’s new at New World.

Bilal Khan: Thank you so much. Yeah, so I have the privilege for the last 11 years of serving as CEO of New World Medical, and just, that does give me a broad purview to responsibilities. And it’s evolved as we’ve grown as an organization. But I’ve been it’s always humbling to speak in front of folks like Dr. Katz, because he was one of the first people to facilitate or visit for me when I started in this in this journey. So it’s been, so I’m gonna now speak about glaucoma in front of him, which is a little bit, you know, a little bit daunting, but I’ll give some thoughts about it. You know, it, I really, it’s a privilege to serve the first and foremost the surgeons in this space. And then also, indirectly, the patients that they sort of treat and, and as an organization, we sort of think deeply about where we fit in, where we can contribute in that treatment, in the course of care for these patients. And, and for us, it’s glaucoma surgical, we think about that, daily, it’s where our focus is, as an organization, it starts and stops with that. And the reason being is multifold. One is you as an organization, you have to see what differentiates you and what your unique contribution is. And for us, we’ve developed like Glaukos, we’ve developed multiple glaucoma surgical devices, and we’ve been focused across the disease spectrum. And as I’ll say, you know, glaucoma manifests in a lot of different ways. And there’s a benefit for us being a partner with a surgeon, if we can have a comprehensive portfolio of solutions, so that you go in there, and you can have an intelligent conversation across the disease state. So we are slowly bringing that portfolio to fruition. You know, I think this will be the third year where we launched another product. And then we have two more products in the pipeline. And we’re building beyond that as well. We usually talk about committed products, once they’re out of feasibility, and we’ve been committed to that. But the goal eventually as these come to fruition, is to treat surgically within the OR, because that’s our focus, from the mildest manifestation of disease to the most severe and we already with our refractory offerings, you know, I think we’re pretty comprehensive in that as well. But that’s the general goal is, for us as an organization. We’re also based in Southern California, as I think most of the folks on this call are, and we’re continue to grow as an organization. So thanks again for the opportunity to contribute today.

Adrienne Graves: Thank you very much. I now I’d like to bring on Omar Sadruddin from Santen. I hope you can tell us what’s going on now at Santen.

Omar Sadruddin: How you doing? Thank you so much. And thank you also to the esteemed panelists here that I get the opportunity to share some time with. And I’ll just build on really what Dr. Katz and Bilal just mentioned. But, you know, at Santen. When we think of glaucoma, we think of it comprehensively. And we’re aiming to have solutions along the entire treatment journey of the patient, which really includes the diagnostics, drops, lasers, Meigs and innovative filtering surgery solutions. But beyond that, we’re also looking at methods to capture 24-hour pressures, smart dispensers, and drug delivery systems. So now in terms of what we’re currently working on, we’re really focused on exploring new amylase from what is currently in the market. And we’ve got a couple of programs that are rather late stage one of them coming out of phase three, the other one is entering phase three, but one of them is the EP2 Receptor Agonist which is already commercially available in many countries in Asia. This is known as Omidenepag, abbreviated as OMDI. And then the other program that we currently have ongoing is our EP3 FP Receptor Dual Agonist known as Sepetaprost, and we’ve completed some studies and published on that other recent and are continuing full blown ahead into our phase threes. So that kind of highlights what we’re working on. In terms of new amylase from that surgically, we’re also working on present flows that you’ve heard Dr. Katz mentioned about a minute ago. And that is currently available in Europe and many different markets. And we’ve got, we recently hit a milestone hitting, being able to treat 10,000 patients, which is a huge milestone given where this program started and where we are today. And as far as the United States goes, it’s currently under FDA review. And we’re hoping to have it be on the other side of that very soon and hopefully, into the market through our partners with Glaukos. So aside from that, how we’re addressing the needs of the patients, one of the things that we started doing recently is directly engaging with patients to hear from them, as well as glaucoma patient organizations. And the goal here is to really understand first and foremost, the needs curve directly from the patient, but also to raise more awareness and people’s understanding of glaucoma, as well as the various therapies that are commercially available in the United States and the world. And then aside from that, I would add that we continue to find opportunities. And a moment ago, I mentioned that this couldn’t be more true than the example of the acquisition of Infocus. And ultimately, the subsequent partnership with Glaukos to introduce the present flow micro shunt, which is as most would know as sips material-based subcontinent tablet shunt. And this is available, like I said, in many markets, and with the help of Glaukos will be available in a lot more markets in the coming months in the year. And most recently, we also structured a deal with Aerie to roll out repressor Rocklatan and several markets in Asia. And that really complements our portfolio. Well. And, you know, speaking to the concept of innovation, we obviously know Aerie offerings here, Rhopressa and Rocklatan have been significant, especially when it comes to a new mechanism of action. So we’re hoping to now have this complement our established portfolio in Asia and other parts of the world and continue building on that. So that’s kind of in a nutshell what’s happening here at Santen.

Adrienne Graves: Thank you so much. That was great. I’d now like to introduce Ramin Valian of Allergan. Hello Ramin, great to see you. Really, I’m really excited to get an update on what’s going on at Allergan, you can touch on innovation. Plus it would be it’d be really nice to know if a focus on glaucoma or innovation has changed in any way. Since being part of that be sure so take it away.

Ramin Valian: Well, first of all, Adrianne, thanks so much for including me it’s always a pleasure to be with a panel with this group here. I think you said it really well at the end of Jays discussion by innovation. I mean when I’ve been in this business now almost 16 years. And certainly when I look at this the glaucoma space today, I think you said the perfect word glaucoma Renaissance, right because when you look at the space in Rancho glaucoma, as you heard from Bilal, and Jay and Omar, there’s a lot of innovation coming into the space and our again, as being part of Abbvie is a big player in that innovation. And it’s been a really exciting time to not only be as part of that, but also to give back certainly to the community because obviously, you know, being safe being the most precious sensor we have as human beings is incredible to have an opportunity to innovate in this space where we actually preserving vision, and really giving vision back to patients. From Allergan perspective or faster posing or one year with Abbvie, Allergan, I can be part of the Abbvie organization. And it’s been a very incredible journey. I think from an investment standpoint, what I’ve seen in organizations has been a much more renewed and much more vocal emphasis on IQ and innovation, with dollars going through investment, both r&d, but also in business development. I think most of you may have seen most recently, a few weeks back, we just announced a collaboration with Regenxbio, or Vietnam in a glaucoma space by the retinas face one time gene therapy for wet AMD diabetic retinopathy and other retinal conditions. And that’s pending on review by the regulatory bodies. But having said that, though, that kind of exemplify the organization’s commitment to innovation to be able to invest in one time gene therapy in red has really good signal in terms of AbbVie’s commitment, in terms of our presence in the organization and glaucoma particularly, I mean, look at a couple of ways. First of all, Allergan still remains to be the number one producer of branded drops in the world. So with our branded product, we still are committed to lowering IOP with our blend of prostaglandins combination products and alpha agonist. But also last year, we successfully launched the first biodegradable implant in the space to Durysta. Jay, I think touched on it from a language perspective by innovation in drug delivery. And we think about it as a biodegradable implant that was launched last year. If you look at the acceptance of these kind of sustained delivery technologies, I’m very pleased with our success, over 2000 physicians have actually adopted Durysta into practice, and over 10,000 patients have had a dress that implant kind of signifies that when you have a transformational innovation, like a biodegradable implant, which actually takes it drops away, there’s a good amount of energy but also enthusiasm by the community to offer a control for a patient. And then in reality, really take that control for a patient and get back to the physician. And the launch of duress was a really good example of that kind of innovation. Now, we’re certainly working forward to get multiple administration’s for Durysta. Those clinical trials are ongoing. But certainly from an innovation standpoint, I’m really proud of that launch, because that was the very first party product that was launched in the glide commerce space. So we had to really focus on changing practice patterns. That’s a whole different innovation when it comes to practice pattern, but also introducing technologies like Durysta, which is another innovation on the surgical front, we continue to be very much focused on Zen, and that’s our surgical intervention for refractory glaucoma. We continue to innovate Zen by having new indications, potentially unsurprising with Zen, but also from a pipeline perspective. We’re continuing to look at other polymer type devices, that as Jay pointed out, from Glaukos perspective, Glaukos doing great job of taking technologies and redirecting them with new modalities. And the same with our technology. So if you think about it, Durysta was actually a derivative of Ozurdex we launched Ozurdex 10 years ago, with an applicator. That Durysta applicator is similar to an Ozurdex applicator. So we had the technology, but we really ended up doing is taking the polymer technology from Ozurdex and adopting that to the light coma. And we continue to do that in the glaucoma space. And actually, we’re on our will our way of adopting or really evaluating our next generation processor might polymers, which I think will be a really important benefit to the patient population. Certainly as we kind of go into future, when you look at our long-term perspective of glaucoma, there’s a couple ways of looking at it. Our strategy is very much focused on drug delivery. Certainly Durysta is important for us, but also surgical innovation, as pointed out by both Bilal and Jay, that glaucoma patient journey is a long journey, right? And we want part of that journey, not only with drop, but also other interventions. And just going back to what you said earlier, This Glaucoma Renaissance, when you think about Meigs coming into the market almost 10 years ago, I think we’re about to go on the next generation of innovation being drug delivery or other innovations on the surgical front. But I think cumulatively all the companies you represent really what a perspective is, which is to continue to innovate in the space of a progressive disease like glaucoma.

Adrienne Graves: Really exciting stuff. And for Durysta. Can you tell us a little bit about the reception from the patient perspective, physician perspective as well?

Ramin Valian: So it’s interesting, right? It’s, you know, we talk about innovation. And when you look at innovation in glaucoma space, people like innovation of introducing three examples, drug delivery, right, what we’ve seen address actually is patient adoption has been very favorable. So if you give the patient the option of getting all their meds, and having endorsed the implant, more time, nine out of 10 times our patient actually likes that intervention. It’s really getting the physicians comfortable with offering a different intervention for that patient. I think for a patient acceptance standpoint, it’s been very well received, from a physician perspective, also has been able to see that city about 2000 or more physicians have adopted Durysta. So I think we see that innovation. Keep in mind, we launched risk up probably, as a marketer, worst nightmare during a pandemic, when we were shut down across the country. Right. So considering all the challenges, you know, I have to say it was very successful launch but very good doctors of the technology.

Adrienne Graves: Well, that, you know, it’s interesting that you mentioned launching a product during the COVID environment, and also even starting clinical trials or completing trials and environment. So the next question I’ll ask all of you is, you know, how has the COVID environment affected your business, whether it’s product development or marketing Doctor interactions. I’ll start again with you Jay.

Jay Katz: Well, obviously, co COVID is impacted every facet of exists across the world. So it certainly is impacted on clinical trials. Fortunately, in, you know, there’s been kind of a lot of give and take on the part of the FDA, they really bend over backwards to help with clinical trials and windows have in terms of seeing patients. But fortunately, I think that for whatever reason, many of the physicians and patients in the clinical trials really made an incredible effort. I was really surprised, pleasantly surprised, and how they really took participating in these programs very seriously. So there was not a huge kind of dent in the clinical trials, which was a little bit of a surprise for me, because people really did make an effort to come in the doctor’s offices bent over backwards in terms of keeping it safe for patients to be examined. And we didn’t have to resort to kind of remote monitoring, which was plan B, for many of us. So we really didn’t, did find what the clinical trials in terms of the real world, you know, when you’re talking about, especially elective procedures, where there’s no emergent situation, and a lot of facilities are closed down, except for emergent procedures, it certainly had an impact there in terms of the number of cases being done in these procedures being done. But on the other hand, Ophthalmology is especially because bounce back very quickly, and a lot of time and effort on the part of clinical practices, whether it’s private practice, or academic based practices, they really kind of rewired their system to allow for safe care of patients, even for elective care and elective procedures. So there certainly was a dip for a while there at the height of COVID When everything was shut down, but practices have bounced back to near 100% rather quickly. So again, very bright people. And patients certainly take glaucoma very seriously for the most part. And they want to take care of themselves. So it really has not had an extended negative effect. So yeah, I think that’s good news.

Adrienne Graves: That is good news. And as you say, glaucoma patients care about keeping their vision, and that’s why they, you know, they are compliant in terms of visits, but also want there to be more innovation. So glaucoma patients, you know, very actively care about that.

Jay Katz: Yeah, absolutely. And I think Ramin you know, is really, right on, you know, in talking about patient acceptance and Doctor acceptance, I mean, there’s kind of a palpable kind of thirst for innovation and alternative treatments. And Allergan deserves a lot of credit for kind of launching Durysta and giving an alternative medical therapy for our patients. I think that’s going to be very well received, as Ramin said.

Adrienne Graves: I agree. Bilal, what’s going on at New World in the COVID environment and what things have you had to adapt to? And give us some insights there?

Bilal Khan: Yeah, so we’ve had similar experiences to especially like the resilience of providers and patients has been pretty impressive. I think that’s stabilized, especially in the US, where it tends to be most mostly ASC based procedures. And internationally, I think there’s still a slowdown, especially in areas, it’s regionalized, even within the US, but also internationally is regionalized based on how severe the case loads are in different regions, and then how reliant surgeons are on doing procedures within hospital settings, which are, you know, have capacity constraints with COVID cases? So that’s been a little bit restrictive. I think, as far as clinical trials in the US, actually, I think we’ve hit sort of a new normal, where I think people are sort of in a cadence of dealing with these, these headwinds and, and there’s a little bit more stability we still see, I think, as case counts, go up and down. We still see a little bit of variability across the country. But it’s, it’s not as dramatic, especially when we had lockdowns early on, which I think was a shock to the system for everyone. Internationally, it’s been interesting. I think the regulatory bodies aren’t always as sophisticated as the FDA or don’t have as many resources, the FDA. So some of them have been prioritizing COVID trials. So some approvals and things, some paperwork and things of that sort have slowed down studies and also recruitment in certain regions have been challenging at times with lockdowns in different ways different countries are dealing with a situation. And then to top it off, now we’re in a new phase that we’re like, there’s a new business normal, it’s more broad, from the patient care setting to just what we’re dealing as organizations where our engineers have to be very resilient in dealing with suppliers prototyping, as we do tech transfer into production, because, you know, we’re all trying to make an impact, and that involves scaling all of our products, so we can deliver them to surgeons. You know, that’s the challenge, too. So sourcing is an issue. I think those suppliers and even some of the testing groups that we work with, they have capacity constraints with their staff being out, or just raw materials not being available. So the challenges are a period like, but we you know, I think all of us have really special people in our organization that are very determined to meet their obligations to surgeons and patients. And I think that that, you know, they go above and beyond, you know, every day I think it’s more than a job in our field. And I think it’s a credit to the people that work in this industry.

Adrienne Graves: That is a cool thing. Thank you, Omar, what have things been like it at Santen and what’s been affected in the cover environment?

Omar Sadruddin: Yeah, so I think our experience has been very similar to what Jay and Bilal have already mentioned. I think, on the contrary to what Jay mentioned, that actually we did see some slowdown on the development front, right, specifically for enrollment. And some of the ongoing studies that we have occurring here at Santen, it wasn’t as much as follow up as much as it was, you know, new patient enrollment. And I think there’s a there’s a process that comes with, you know, consenting a new patient of being able to talk to them about alternatives to current treatments that are out there, and what have you. And I think that process, it’s rather intimate, and not being able to do that in person, I think has had an effect on what we’ve seen in our new patient enrollment for the studies that we have currently ongoing. But we’ve also seen, you know, in regard to follow up, I guess the reason we haven’t taken much of a hit there is because we’ve seen some very unique ways of some of our clinical sites, coming up with different approaches and establishing outdoor clinics, or drive thru clinics to be able to do IoT checks and what have you. And that’s really allowed us to be able to continue that collection of meaningful data that becomes very important for these trials and FDA approval, as well as regulatory approvals around the world. Now, what’s interesting is that, as COVID was unfolding, last year around the world, our organization was already in the midst of finalizing some of our near mid long-term plans, and which we’ve already called out and rather incorporated the need for more digital solutions and our clinical trials. So as we were to see, in the later months after the COVID shutdown, and the pandemic really started arriving last year, we did see, you know, some of those plans that we have rather be accelerated. So in a sense, you know, COVID, was a catalyst for us to be able to push forward on plans that we already had in the making. And we’re trying to transform the way we do r&d Here at Santen over the next several years, and that kind of brought it up to the forefront. And now we’re trying to really manage multiple initiatives, aside from just clinical trials to see if we can incorporate more digital solutions and tools within the context of these trials. So it’s been interesting, I think, you know, from the commercial side, of course, in the initial stages, there was a slowdown because we weren’t able to where we do have the present flow available. And in ORs, we weren’t able to really support the surgeon there with their either their training cases and or future cases where they have or the appreciate the presence of a phantom proctor. And then aside from that, and certain markets where we were able to come up with some innovative solutions, we’re able to get our medications to patients and 30, 60, 90 days supplies. So I think COVID has really been a theme that allowed us to come up with innovative solutions and really implement them and continue business as we know it. But to the point that was made earlier, I think we’re still starting to figure out or continuing to figure out what the new norm should be. But I think with technology as advanced as it is digitalization is just inevitable and imminent. And I think, you know, considering the fact that we’re all doing this panel virtually as well, it’s very telling of that new normal in a sense, right. So, yeah, so I think as time goes on, we’re definitely excited to see how things could change more in the favor of the patients, as well as the physicians treating them. And I think it’s probably a good way to be able to use every trick in the book to continue business as usual. But yeah, that’s kind of what’s been happening at Santen over the last course of my 18 months or so.

Adrienne Graves: Now, Ramin. Tell us about what’s been going on in Allergan, how you’re how you’re affected, how you’re dealing with things and what’s going on.

Ramin Valian: I think the one thing I want to kind of point out is what’s really interesting, though, is the resilience of industry with the ophthalmology community actually emerge in this thing, right? Because when you look at it is a couple of things came into top of mind for me is, as we went through this whole shutdown, and all these environmental changes, there’s this perspective, for example, that the role of industry is going to be minimized. You don’t need wraps; you don’t need that kind of collaboration. But I’ve seen though, it’s been actually the opposite. But I’ve seen is bigger and better collaboration with industry and the society, for example, right, glaucoma society or Asperger’s. During these times, I think we came closer in terms of how to make this work, not only from an industry perspective, but also from an ophthalmology IQ experience. For continued education, for example, through these key societies, the role of a representative was even much more profound in the sense that there is a desire to have cervical reps in the OR, with the physicians that are certainly constraints would have also seen as we’ve adapted to those constraints. But more importantly, I think this this collaboration between industry and community actually been much more solidified. But I think fundamentally, what we realize is we continue to have to shape the same goals of education, patient care, but also bring innovation to the market. So I think long term, I think, you know, when you look back at it, a couple of key things emerge. But more importantly than anything else, I think this collaboration, just continued collaboration, stronger collaboration, was a key highlight, post, all these things we went through in the past eight months, 24 months.

Adrienne Graves: Now, well, one other thing I’d like to ask you, and this is sort of a rapid fire wrap up question. But tell us one thing that you would like the audience to know about your company that we haven’t addressed yet. So, Jay?

Jay Katz: Just rapid fire, I guess I would point out that Glaukos has really expanded its role in glaucoma, beyond being a medical device company to being also a pharmaceutical company. Now, but even beyond that, they’ve really embraced its role in the ophthalmology community and expansion to corneal health with crosslinking and also into the retinal area and dry eye. So it’s really trying to help on multiple fronts. And so this is Glaukos saying, you know, I’m here to save, you tried to help patients in a variety of ways.

Adrienne Graves: Perfect. Bilal.

Bilal Khan: So, you know, we’re different organizations, I think we talked like Glaukos is was the founding member or the foundation of the MIGS market. And I think now, Ramin and his team and Allergan have led on drug delivery in the glaucoma space. So we haven’t been that. But I think our founding story and our ownership structure has been, you know, very uniquely positioned us to be focused on our mission, and also to be disciplined in what we can contribute to the market. And I think that’s something that we always try to stress to all of our Surgeon partners is that, you know, while we are very focused on being are part of the solution, and that’s something that will continue to be as we as we move forward.

Adrienne Graves: Terrific. Omar, tell us about Santen.

Omar Sadruddin: So I think what I can say is for Santen. You know, we’ve recent, the magnified at this initiative that we call in service of patients, which is really focused on engaging with patients in general. I mentioned this briefly earlier, but one of the main goals here that we’re trying to accomplish is to gain patient input earlier in the art development process, especially in our glaucoma pipeline, which we’re hoping will allow us to understand and incorporate patient needs into the clinical studies. As you guys will know, the programs that we have to run for pharmaceutical development could yield several different studies and there’s opportunities along the way to be able to understand measures that have an impact on patient quality of life. and hopefully be able to find improvement in these measures. So I’m sure you’ll be hearing about this more in due course. And hopefully this initiative can truly help patients beyond just providing them with innovative therapies. But thank you, lastly, for having me on this panel, and this has been great.

Adrienne Graves: And Ramin what would you like us to know about Allergan?

Ramin Valian: Sure, you know, we’ve been in this space now for over 70 years. And we plan to be here for next 70 years. I think that one thing I want to emphasize it audiences that Allergan remains committed to this space and an Abbvie the patient’s our North Star. So we will continue to innovate and bring new technologies to the forefront and we’re here for next 70 years. Neither.

Adrienne Graves: Terrific. Well, I want to thank all of you for being here today and for the terrific discussion. Thank you. Being said, each panelists, you guys were just wonderful, and we really appreciate that you shared such insights with us today. So thank you very much.

Jay Katz, Bilal Khan, Ramin Valian, and Omar Sadruddin: Thank you.

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