Contradictions Unveiled: scPharmaceuticals' Q1 2025 Insights on CKD Launch, Medicare Impact, and Fill Rate Challenges

CKD launch traction and expectations, Medicare redesign impact on FUROSCIX adoption, fill rate improvement and expectations, fill rate improvement, and class IV heart failure patient and doses per prescription are the key contradictions discussed in scPharmaceuticals' latest 2025Q1 earnings call.



FUROSCIX Doses and Revenue Growth:
- scPharmaceuticals filled approximately 13,800 FUROSCIX doses in Q1 2025, with net revenue of $11.8 million.
- Despite seasonal headwinds, doses filled increased quarter-over-quarter, driven by a rise in Medicare patients reaching their out-of-pocket caps or enrolling in smoothing programs.

Gross to Net Discount and Medicare Part D Impact:
- The gross to net discount for FUROSCIX in Q1 2025 was approximately 23%, with an anticipated blended GTN of 30% for the rest of 2025.
- This increase is mainly due to the Medicare Part D redesign, which is expected to increase FUROSCIX fill rates and prescribing for Part D enrollees with $0 copays post-catastrophic coverage.

CKD Indication Expansion and Autoinjector Progress:
- Formal launch of FUROSCIX in chronic kidney disease (CKD) began in April 2025, with nephrology prescriptions being filled since then.
- The Autoinjector development is progressing as planned, with an estimated 70%-75% reduction in COGS compared to the current on-body infuser, anticipated to be filed in the next quarter.

IDN Distribution Strategy and Sales Expansion:
- scPharmaceuticals is seeing significant growth in sales to integrated delivery networks (IDNs), with Q2 2025 expected to be larger than Q1.
- This expansion is driven by the ease of ordering FUROSCIX through IDN EMRs and facilitating discharges, contributing to the overall promotional efforts and sales increase.

Medicare Part D Copay Smoothing and Improved Fill Rates:
- scPharmaceuticals observed an increase in fill rates, with 55% in April compared to 46% in Q1, due to patients reaching their out-of-pocket maximums or electing for copay smoothing.
- This trend is expected to continue as more Medicare patients move into catastrophic coverage, reducing out-of-pocket expenses and increasing FUROSCIX dispenses.