{"documentId":"1A2WeeklyLaunchTrackerWK19_abc456DefGhIjKlMnOpQ","title":"Weekly Launch Tracker — WK19","revisionId":"rev-1A2WeeklyLau","body":{"content":[{"sectionBreak":{"sectionStyle":{"columnSeparatorStyle":"NONE","contentDirection":"LEFT_TO_RIGHT"}}},{"paragraph":{"elements":[{"startIndex":1,"endIndex":64,"textRun":{"content":"Weekly Launch Tracker — Week 19, 2026 (week ending 2026-05-08)\n","textStyle":{"bold":true}}}],"paragraphStyle":{"namedStyleType":"TITLE","direction":"LEFT_TO_RIGHT"}}},{"paragraph":{"elements":[{"startIndex":1,"endIndex":160,"textRun":{"content":"Prepared by Marco Reyes, Launch Lead. Distribution: CCO, VP Commercial, Regional Sales Directors, Market Access Director, MSL Lead, CI Analyst, HEOR Director.\n","textStyle":{}}}],"paragraphStyle":{"namedStyleType":"NORMAL_TEXT","direction":"LEFT_TO_RIGHT"}}},{"paragraph":{"elements":[{"startIndex":1,"endIndex":10,"textRun":{"content":"Headline\n","textStyle":{"bold":true}}}],"paragraphStyle":{"namedStyleType":"HEADING_2","direction":"LEFT_TO_RIGHT"}}},{"paragraph":{"elements":[{"startIndex":1,"endIndex":328,"textRun":{"content":"Zenvara national TRx for the week ending May 8 came in at 763 against a plan of 944, a variance of -19.2%. New-to-brand prescriptions (NBRx) in the Northeast came in at 354 against a plan of 412, a variance of -14.1%. The four-week trailing variance is now -16% and widening, with the gap concentrated in the Northeast region.\n","textStyle":{}}}],"paragraphStyle":{"namedStyleType":"NORMAL_TEXT","direction":"LEFT_TO_RIGHT"}}},{"paragraph":{"elements":[{"startIndex":1,"endIndex":413,"textRun":{"content":"The proximate cause appears to be operational: UnitedHealthcare prior-authorization turnaround in the Northeast has slipped from a four-day average in Q1 to a nine-day average over the last three weeks. Field reports from four reps in Boston, NYC, and Philadelphia corroborate the data signal. We have not yet been able to triangulate the operational change at UHC; conversations are open through Aisha and Ben.\n","textStyle":{}}}],"paragraphStyle":{"namedStyleType":"NORMAL_TEXT","direction":"LEFT_TO_RIGHT"}}},{"paragraph":{"elements":[{"startIndex":1,"endIndex":184,"textRun":{"content":"This is the largest single-week variance since the launch and the first time the four-week trailing variance has exceeded the -10% deviation threshold established in the launch plan.\n","textStyle":{}}}],"paragraphStyle":{"namedStyleType":"NORMAL_TEXT","direction":"LEFT_TO_RIGHT"}}},{"paragraph":{"elements":[{"startIndex":1,"endIndex":11,"textRun":{"content":"By region\n","textStyle":{"bold":true}}}],"paragraphStyle":{"namedStyleType":"HEADING_2","direction":"LEFT_TO_RIGHT"}}},{"paragraph":{"elements":[{"startIndex":1,"endIndex":256,"textRun":{"content":"Northeast: TRx 198 vs plan 247 (-19.8%); NBRx 354 vs plan 412 (-14.1%). The miss is concentrated in Massachusetts, New York, and eastern Pennsylvania. Megan (Boston), Tony (NYC), and Priya (Chicago — adjacent territory) are all flagging the same pattern.\n","textStyle":{}}}],"paragraphStyle":{"namedStyleType":"NORMAL_TEXT","direction":"LEFT_TO_RIGHT"}}},{"paragraph":{"elements":[{"startIndex":1,"endIndex":128,"textRun":{"content":"Southeast: TRx 178 vs plan 188 (-5.3%); NBRx 142 vs plan 152 (-6.6%). Tracking essentially to plan. No payer concerns flagged.\n","textStyle":{}}}],"paragraphStyle":{"namedStyleType":"NORMAL_TEXT","direction":"LEFT_TO_RIGHT"}}},{"paragraph":{"elements":[{"startIndex":1,"endIndex":91,"textRun":{"content":"Midwest: TRx 156 vs plan 159 (-1.9%); NBRx 120 vs plan 124 (-3.2%). On plan within noise.\n","textStyle":{}}}],"paragraphStyle":{"namedStyleType":"NORMAL_TEXT","direction":"LEFT_TO_RIGHT"}}},{"paragraph":{"elements":[{"startIndex":1,"endIndex":223,"textRun":{"content":"West: TRx 231 vs plan 213 (+8.5%); NBRx 178 vs plan 165 (+7.9%). Outperforming. Sofia (LA) closed three IDN accounts in WK17-WK18; pull-through is materializing as expected. Lila is tracking 124% to plan for the district.\n","textStyle":{}}}],"paragraphStyle":{"namedStyleType":"NORMAL_TEXT","direction":"LEFT_TO_RIGHT"}}},{"paragraph":{"elements":[{"startIndex":1,"endIndex":18,"textRun":{"content":"By payer (top 5)\n","textStyle":{"bold":true}}}],"paragraphStyle":{"namedStyleType":"HEADING_2","direction":"LEFT_TO_RIGHT"}}},{"paragraph":{"elements":[{"startIndex":1,"endIndex":231,"textRun":{"content":"UnitedHealthcare (commercial): NBRx -22% vs plan WK19. PA approval rate dropped from 84% in Q1 to 71% in the last four weeks. Average turnaround now 9.1 days vs Q1 baseline of 4.2 days. This is the dominant signal in the dataset.\n","textStyle":{}}}],"paragraphStyle":{"namedStyleType":"NORMAL_TEXT","direction":"LEFT_TO_RIGHT"}}},{"paragraph":{"elements":[{"startIndex":1,"endIndex":119,"textRun":{"content":"Anthem/Elevance (commercial): NBRx -3% vs plan. PA approval rate stable at 79%. Turnaround 5.8 days, in normal range.\n","textStyle":{}}}],"paragraphStyle":{"namedStyleType":"NORMAL_TEXT","direction":"LEFT_TO_RIGHT"}}},{"paragraph":{"elements":[{"startIndex":1,"endIndex":119,"textRun":{"content":"Aetna/CVS (commercial): NBRx +2% vs plan. Step-edit through comparator effective Jan 1, 2026, performing as forecast.\n","textStyle":{}}}],"paragraphStyle":{"namedStyleType":"NORMAL_TEXT","direction":"LEFT_TO_RIGHT"}}},{"paragraph":{"elements":[{"startIndex":1,"endIndex":117,"textRun":{"content":"Cigna/Evernorth (commercial): NBRx -1% vs plan. Tier 3 preferred placement effective Jan 1, 2026, ramping smoothly.\n","textStyle":{}}}],"paragraphStyle":{"namedStyleType":"NORMAL_TEXT","direction":"LEFT_TO_RIGHT"}}},{"paragraph":{"elements":[{"startIndex":1,"endIndex":148,"textRun":{"content":"Humana (Medicare Part D): NBRx -8% vs plan. Documented in last week's tracker; relates to the Gold Plus exclusion (off formulary, exception only).\n","textStyle":{}}}],"paragraphStyle":{"namedStyleType":"NORMAL_TEXT","direction":"LEFT_TO_RIGHT"}}},{"paragraph":{"elements":[{"startIndex":1,"endIndex":16,"textRun":{"content":"Field activity\n","textStyle":{"bold":true}}}],"paragraphStyle":{"namedStyleType":"HEADING_2","direction":"LEFT_TO_RIGHT"}}},{"paragraph":{"elements":[{"startIndex":1,"endIndex":216,"textRun":{"content":"Total calls logged in Veeva for WK19: 1,148 (target: 1,160). Reach against Tier 1 targets at 91% (target: 95%) — slightly behind, partly due to two territory vacancies in Atlanta and Philadelphia that close June 1.\n","textStyle":{}}}],"paragraphStyle":{"namedStyleType":"NORMAL_TEXT","direction":"LEFT_TO_RIGHT"}}},{"paragraph":{"elements":[{"startIndex":1,"endIndex":218,"textRun":{"content":"Sample drops: 184 logged for WK19 (Q1 weekly average: 202). Specialty pharmacy fill rate on samples 71% vs 80% target — confirms the operational story; reps are dropping samples but PA bottleneck is preventing fills.\n","textStyle":{}}}],"paragraphStyle":{"namedStyleType":"NORMAL_TEXT","direction":"LEFT_TO_RIGHT"}}},{"paragraph":{"elements":[{"startIndex":1,"endIndex":276,"textRun":{"content":"Notable field reports this week: Priya (Chicago) flagged that three patient starts at Northwestern Medicine were abandoned after PA decisions exceeded 10 days. Tony (NYC) confirmed similar pattern at MSK and NYU. Ben (DM East) raised in the Friday district meeting on May 8.\n","textStyle":{}}}],"paragraphStyle":{"namedStyleType":"NORMAL_TEXT","direction":"LEFT_TO_RIGHT"}}},{"paragraph":{"elements":[{"startIndex":1,"endIndex":22,"textRun":{"content":"Competitive activity\n","textStyle":{"bold":true}}}],"paragraphStyle":{"namedStyleType":"HEADING_2","direction":"LEFT_TO_RIGHT"}}},{"paragraph":{"elements":[{"startIndex":1,"endIndex":334,"textRun":{"content":"Jordan flagged on Tuesday May 12 that a competitor (BMS CheckMate program) abstract appears in the ASCO 2026 supplement table of contents with Kaplan-Meier reported at 18.2 months. Our last cut on ZENITH-1 is 17.6 months. Embargo lifts at ASCO opening Plenary, three weeks out. CI brief in preparation, target delivery Thursday EOD.\n","textStyle":{}}}],"paragraphStyle":{"namedStyleType":"NORMAL_TEXT","direction":"LEFT_TO_RIGHT"}}},{"paragraph":{"elements":[{"startIndex":1,"endIndex":213,"textRun":{"content":"No other notable competitive activity this week. The CheckMate competitor data, if confirmed by Plenary, would represent the first competitor MOH to approach our ZENITH-1 numbers in the 1L PD-L1-high population.\n","textStyle":{}}}],"paragraphStyle":{"namedStyleType":"NORMAL_TEXT","direction":"LEFT_TO_RIGHT"}}},{"paragraph":{"elements":[{"startIndex":1,"endIndex":14,"textRun":{"content":"Action items\n","textStyle":{"bold":true}}}],"paragraphStyle":{"namedStyleType":"HEADING_2","direction":"LEFT_TO_RIGHT"}}},{"paragraph":{"elements":[{"startIndex":1,"endIndex":223,"textRun":{"content":"1. UHC payer escalation call scheduled for Wednesday May 13 at 11am ET. Aisha leading; Marco joining. Objective: identify cause of PA latency drift and request operational remediation. Pre-read circulated Tuesday morning.\n","textStyle":{}}}],"paragraphStyle":{"namedStyleType":"NORMAL_TEXT","direction":"LEFT_TO_RIGHT"}}},{"paragraph":{"elements":[{"startIndex":1,"endIndex":188,"textRun":{"content":"2. Field east meeting Thursday May 15 at 8am ET. Ben to circulate top-3 PA blockers per rep in advance. Objective: codify pattern, identify HCPs to target with bridge program enrollment.\n","textStyle":{}}}],"paragraphStyle":{"namedStyleType":"NORMAL_TEXT","direction":"LEFT_TO_RIGHT"}}},{"paragraph":{"elements":[{"startIndex":1,"endIndex":87,"textRun":{"content":"3. Jordan to deliver ASCO competitor CI one-pager by Thursday EOD per Dana's request.\n","textStyle":{}}}],"paragraphStyle":{"namedStyleType":"NORMAL_TEXT","direction":"LEFT_TO_RIGHT"}}},{"paragraph":{"elements":[{"startIndex":1,"endIndex":128,"textRun":{"content":"4. Cigna formulary win to be logged in win/loss tracker on confirmation (Marco expects email confirmation Thursday afternoon).\n","textStyle":{}}}],"paragraphStyle":{"namedStyleType":"NORMAL_TEXT","direction":"LEFT_TO_RIGHT"}}},{"paragraph":{"elements":[{"startIndex":1,"endIndex":165,"textRun":{"content":"5. Aisha to prepare a forward-looking gap-to-forecast scenario for the May 18 executive review, incorporating the WK19 variance and the UHC operational trajectory.\n","textStyle":{}}}],"paragraphStyle":{"namedStyleType":"NORMAL_TEXT","direction":"LEFT_TO_RIGHT"}}},{"paragraph":{"elements":[{"startIndex":1,"endIndex":23,"textRun":{"content":"Risks and watch items\n","textStyle":{"bold":true}}}],"paragraphStyle":{"namedStyleType":"HEADING_2","direction":"LEFT_TO_RIGHT"}}},{"paragraph":{"elements":[{"startIndex":1,"endIndex":315,"textRun":{"content":"If UHC PA latency does not normalize by end of May, the cumulative year-to-date variance could reach -10% by mid-June, which would meaningfully impact the year-one revenue total. A conservative scenario assumes a four-week recovery starting June 1, recovering approximately half of the WK17-WK21 gap by end of Q3.\n","textStyle":{}}}],"paragraphStyle":{"namedStyleType":"NORMAL_TEXT","direction":"LEFT_TO_RIGHT"}}},{"paragraph":{"elements":[{"startIndex":1,"endIndex":235,"textRun":{"content":"Florida Medicaid Preferred Drug List refresh is scheduled to land Sunday May 11. Internal monitoring confirmed that historical refreshes have surprised us with same-day effective dates. Aisha to scan the published PDL Monday morning.\n","textStyle":{}}}],"paragraphStyle":{"namedStyleType":"NORMAL_TEXT","direction":"LEFT_TO_RIGHT"}}},{"paragraph":{"elements":[{"startIndex":1,"endIndex":245,"textRun":{"content":"The CheckMate competitor abstract, if it confirms a positive OS readout at ASCO, would materially shift the 2L competitive landscape. Defensive messaging is preloaded; field talk track update is queued in the MAR pipeline pending confirmation.\n","textStyle":{}}}],"paragraphStyle":{"namedStyleType":"NORMAL_TEXT","direction":"LEFT_TO_RIGHT"}}},{"paragraph":{"elements":[{"startIndex":1,"endIndex":18,"textRun":{"content":"Cross-references\n","textStyle":{"bold":true}}}],"paragraphStyle":{"namedStyleType":"HEADING_2","direction":"LEFT_TO_RIGHT"}}},{"paragraph":{"elements":[{"startIndex":1,"endIndex":90,"textRun":{"content":"Underlying NPA data: /api/iqvia/rx-velocity?product=ZENVARA&weeks=4&territory=northeast.\n","textStyle":{}}}],"paragraphStyle":{"namedStyleType":"NORMAL_TEXT","direction":"LEFT_TO_RIGHT"}}},{"paragraph":{"elements":[{"startIndex":1,"endIndex":56,"textRun":{"content":"Formulary status: /api/mmit/formulary?product=ZENVARA.\n","textStyle":{}}}],"paragraphStyle":{"namedStyleType":"NORMAL_TEXT","direction":"LEFT_TO_RIGHT"}}},{"paragraph":{"elements":[{"startIndex":1,"endIndex":59,"textRun":{"content":"Slack thread: #payer-escalations (Aisha 09:15 ET Friday).\n","textStyle":{}}}],"paragraphStyle":{"namedStyleType":"NORMAL_TEXT","direction":"LEFT_TO_RIGHT"}}},{"paragraph":{"elements":[{"startIndex":1,"endIndex":99,"textRun":{"content":"Field activity summary: /api/veeva/calls/summary?product=ZENVARA&start=2026-05-04&end=2026-05-15.\n","textStyle":{}}}],"paragraphStyle":{"namedStyleType":"NORMAL_TEXT","direction":"LEFT_TO_RIGHT"}}},{"paragraph":{"elements":[{"startIndex":1,"endIndex":116,"textRun":{"content":"Next tracker (WK20): scheduled for circulation Monday May 18 at 11am ET, in conjunction with the executive review.\n","textStyle":{}}}],"paragraphStyle":{"namedStyleType":"NORMAL_TEXT","direction":"LEFT_TO_RIGHT"}}}]},"documentStyle":{"pageNumberStart":1,"marginTop":{"magnitude":72,"unit":"PT"},"marginBottom":{"magnitude":72,"unit":"PT"},"marginLeft":{"magnitude":72,"unit":"PT"},"marginRight":{"magnitude":72,"unit":"PT"},"pageSize":{"height":{"magnitude":792,"unit":"PT"},"width":{"magnitude":612,"unit":"PT"}}},"namedStyles":{"styles":[{"namedStyleType":"NORMAL_TEXT","textStyle":{"fontSize":{"magnitude":11,"unit":"PT"}}},{"namedStyleType":"TITLE","textStyle":{"fontSize":{"magnitude":26,"unit":"PT"},"bold":true}},{"namedStyleType":"HEADING_1","textStyle":{"fontSize":{"magnitude":20,"unit":"PT"},"bold":true}},{"namedStyleType":"HEADING_2","textStyle":{"fontSize":{"magnitude":16,"unit":"PT"},"bold":true}}]},"lists":{},"inlineObjects":{},"headers":{},"footers":{},"footnotes":{},"suggestionsViewMode":"DEFAULT_FOR_CURRENT_ACCESS"}