ADMA Biologics (NASDAQ:ADMA) Q2 2026 Earnings Call

0:00 Good afternoon, and welcome to the ADMA Biologics Second Quarter twenty twenty six Financial Results and Business Update Conference Call on Wednesday, 08/05/2026. At this time, all participants are in a listen only mode. There will be a question and answer session to follow. Please be advised that this call is being recorded at the company's request and will be available on the company's website approximately two hours following the end of the call. At this time, I would like to introduce the company. Please go ahead. Welcome, everyone, and thank you for joining us this afternoon to discuss ADMA Biologics' financial results for the second quarter of twenty twenty six and recent corporate updates.

0:51 I'm joined today by Adam Grossman, our president and chief executive officer Terry Kohler, our chief financial officer and treasurer. During today's call, Adam will provide some introductory comments and provide an update on corporate progress, and Terry will provide an overview of the company's second quarter twenty twenty six financial results. Finally, Adam will then provide some brief summary remarks before opening up the call for questions. Earlier today, we issued a press release detailing the second quarter twenty twenty six financial results and summarized certain achievements and recent corporate updates. The release is available on our website at www.abnobiologics.com.

1:35 Before we begin our formal comments, I'll remind you that we will be making forward looking statements during today's call that represent the company's intentions, expectations, or beliefs concerning future events, which constitute forward looking statements for the purposes of the safe harbor provisions under the Private Securities Litigation Reform Act of 1995. All forward looking statements are subject to factors, risks and uncertainties such as those detailed in today's press release announcing this call and in our filings with the SEC, which may cause actual results to differ materially from the results expressed or implied by such statements. In addition, any forward looking statements represent our views only as of the date of this call and should not be relied upon as representing our views as of any subsequent date.

2:27 We specifically disclaim any obligations to update any such statements except as required by the federal securities laws. We refer you to the disclosure notice section in our earnings release we issued today and the risk factors section of our quarterly report on Form 10 Q for the quarter ended 06/30/2026, for a discussion of important factors that could cause actual results to differ materially from those forward looking statements. Please note that the discussion on today's call includes certain non GAAP financial measures, including adjusted EBITDA and adjusted net income. A reconciliation of these non GAAP financial measures to the most directly comparable GAAP metric is available in our earnings release, which is available on our website at www.adenomyologics.com.

3:18 With that, I would like to now turn the call over to Adam Grossman. Adam? Good afternoon, everyone, and thank you for joining us. Our second quarter results reflect strong execution across the business and demonstrate the power of Ascentive's long term growth trajectory. During the quarter, we delivered continued financial progress, strong cash generation and improving commercial momentum, while incentive utilization strengthened throughout the period. Ascentive demand accelerated during the second quarter and June delivered the strongest sequential utilization growth we have experienced since the first half of twenty twenty four. This momentum was driven by increasing physician adoption, broader provider engagement, new patient starts and higher patient utilization.

4:11 As we have discussed previously, distributor reported end user utilization remains our leading indicator of continued revenue growth. Based on the end market utilization data we continuously review, we believe current Ascentive inventory levels remain appropriate and are consistent with underlying demand. Importantly, Ascentive utilization strengthened progressively throughout the quarter across our commercial network, reinforcing our view that Ascendant remains early in its penetration of the later line refractory primary immunodeficiency market. While we continue to see competitive pressures in The U. S. Immunoglobulin market, BIVIGAM demand stabilized during the quarter, resulting in sequential improvements in both utilization and revenue.

5:01 Increased supply and competitive pricing pressures remain within The US standard immunoglobulin market, And we continue to maintain our disciplined approach that prioritizes durable profitable growth over unsustainable discounting and other incentives. Importantly, despite this evolving standard IG backdrop, Ascentive continued to outperform and utilization expanded. Increasing physician adoption, new patient starts, and record utilization further demonstrate the relative insulation provided by Ascentive's differentiated product profile and its positioning among later line refractory and medically complex primary immunodeficiency patients. One of the most important developments during the quarter was the continued expansion of Ascentive's real world evidence base.

5:56 We submitted an abstract for presentation at the twenty twenty six American College of Allergy, Asthma and Immunology Annual Scientific Meeting, highlighting results from a large real world health outcomes and health resource utilization analysis of one hundred and twenty seven medically complex primary immunodeficiency patients, the majority of whom had previously received other immunoglobulin replacement therapies prior to switching to Ascentiv. The analysis compared patient outcomes and healthcare resource utilization during the twelve months before incentive initiation with the twelve months following administration. Following initiation of incentive treatment, patients experienced statistically significant reductions in infection related hospitalizations, outpatient healthcare utilization, oral antibiotic use, and corticosteroid use, the proportion of patients experiencing infection related emergency room visits also declined.

7:01 We believe these results are especially meaningful because they were observed in a medically complex population with significant baseline disease burden and healthcare resource utilization. The study's cohort included patients with chronic pulmonary and respiratory comorbidities, prolonged use of antibiotics or corticosteroids, and prior infection related hospitalizations or emergency room utilization. We believe these findings further support Ascentive's differentiated clinical profile and growing body of real world evidence. These findings also reinforce our view of Ascentive's positioning as a later line therapy for PI patients whose disease remains inadequately controlled and provides additional support for continued physician adoption, patient access and payer engagement.

7:54 We believe these findings complement Ascentiv's existing broad commercial payer coverage and could further strengthen commercial payer access. More broadly, we feel payer willingness to engage in these discussions reflects growing recognition of Ascentiv's differentiated value proposition and the significant clinical and financial burden associated with recurrent infections, hospitalizations, and other healthcare utilization among medically complex patients.

8:24 Operationally, we believe we are well positioned to support the continued revenue growth. Our yield enhanced manufacturing process remains embedded in commercial production and continues to support product availability, manufacturing efficiency and margin performance. Our diversified plasma sourcing strategy provides reliable access to high titer plasma, and we believe our current supply infrastructure is sufficient to support anticipated demand. We are confident our financial position also remains a significant strategic advantage. Strong profitability and cash generation provide us with substantial flexibility to invest in commercial expansion, manufacturing initiatives and our capital efficient pipeline, while continuing to execute on our capital allocation priorities.

9:18 During the quarter, we repurchased approximately 7,100,000 shares of common stock under our previously authorized share repurchase program. These repurchases were funded through internally generated cash flow, and we continue to believe that returning capital to stockholders at attractive values represents an effective use of capital while preserving meaningful financial flexibility. We remain on track to complete our previously stated $200,000,000 or more 2026 share repurchase target. Looking ahead, we continue to see multiple expected durable drivers of incentive growth. These include increasing patient utilization, expanding physician adoption, new patient starts, broader prescriber engagement, growing payer access, and an expanding body of clinical and real world evidence.

10:15 Accordingly, we are reiterating our full year 2026 financial guidance and remain confident in our ability to meet or exceed those expectations. Beyond the SENIV, we continue to advance SG-one through a capital efficient development pathway. We are progressing with plasma collection optimization, potency assay development, and additional preclinical activities supporting planned cGMP conformance log production during the second half of twenty twenty six. It is well documented in the published literature that a significant unmet medical need exists despite current strep pneumonia prevention recommendations. Immunocompromised patients remain at a disproportionately high risk for severe pneumococcal disease.

11:05 Underlying impairments in functional immunity limit vaccine mediated protection, leaving a persistent need for alternative targeted preventive strategies in the patients at greatest risk. We believe SG-one has the potential to mitigate the disease burden and are encouraged by the preclinical studies conducted to date. These activities are intended to support the anticipated submission of our pre IND meeting package to the FDA by year end. Encouraging preclinical findings generated to date continue to support our belief that SG-one could address a meaningful unmet medical need and represent a substantial long term growth opportunity for ADMA. If approved, we believe SG-one represents a 300,000,000 to 500,000,000 annual revenue opportunity, leveraging ADMA's existing manufacturing capabilities, and commercial infrastructure could support an efficient development program and potentially expeditious commercial launch.

12:09 Overall, we believe ADMA enters the second half of twenty twenty six from a position of increasing strength. Ascentive demand is accelerating and differentiated value proposition is becoming increasingly well supported. Civigand demand is stabilizing in the face of increased competitive pressures, and we believe our manufacturing and plasma sourcing platforms are positioned to support sustained growth and ensure the continuity of care for patients. Our business is performing across all facets. We are making progress with our stated corporate goals and objectives, and we continue to generate significant cash. Before I turn the call over to Teri, I would like to recognize and thank the entire ADMA team for their continued dedication, efforts and execution.

12:57 Our commitment to patients, operational discipline and focus on excellence remain central to our performance and position the company for sustained long term success. Terry? Thank you, Adam. I'll begin with our second quarter financial results before discussing our balance sheet, cash generation, capital allocation priorities and outlook for the remainder of 2026. Total revenue for the second quarter was $124,400,000 compared to $122,000,000 in the prior year period, representing 2% year over year growth. Ascentive revenue was $102,900,000 increasing 24% year over year, while BIVIGAM revenue was $19,400,000 reflecting sequential improvement from the first quarter as market conditions stabilized.

13:50 Gross profit for the quarter was $86,300,000 resulting in gross margin of 69% compared to 55% in the prior year period. Margin expansion primarily reflected continued incentive mix expansion together with the ongoing benefits of our yield enhanced manufacturing process. Adjusted EBITDA was $61,800,000 increasing 22% year over year, while adjusted net income totaled $39,000,000 increasing 8% year over year. GAAP net income for the second quarter was $37,800,000 increasing 11% year over year.

14:29 It is important to note that ADMA's effective tax rate for the quarter was 24.7%, an increase of approximately 10 percentage points compared to the prior year period. The increase was primarily driven by discrete tax benefits recognized in the prior year quarter. The company continues to anticipate its normalized effective tax rate to be approximately 24% going forward.

14:55 Taken collectively, the second quarter financial results demonstrate the continued earnings leverage of our business model as Ascentive becomes an increasingly larger component of our product mix and our manufacturing platform continues to deliver operating efficiencies. Turning to the balance sheet, we ended the quarter with approximately $136,000,000 in cash and cash equivalents. Net leverage remains less than a half a turn and we maintain approximately $100,000,000 of additional borrowing capacity under our existing revolving credit facility. We believe our balance sheet continues to provide significant strategic flexibility to invest in commercial expansion, manufacturing initiatives and pipeline development, while continuing to execute a disciplined capital allocation strategy.

15:44 As the company continues to remain actively repurchasing its own shares, we repurchased approximately 7,100,000 shares during the quarter under our authorized share repurchase program using internally generated cash flow, bringing the year to date total repurchases to approximately 13,800,000 shares and representing approximately 5.3% of ADMA's common stock outstanding as of 06/30/2026.

16:12 We believe repurchasing shares at attractive valuations represents an effective allocation of capital while maintaining substantial financial flexibility to support long term growth initiatives. Cash from operations totaled approximately $30,000,000 during the quarter, reflecting continued earnings growth and disciplined working capital management.

16:34 Accounts receivable totaled $138,200,000 at quarter end and days sales outstanding or DSOs of approximately one hundred and one days, improving from approximately one hundred and seven days at the end of the first quarter. As we discussed previously, DSOs have stabilized over the first half of twenty twenty six, and we will continue to target DSOs between ninety one hundred and five days in the second half of the year. Importantly, the quality of our receivables remains excellent. All of our receivables from Q1 twenty twenty six have been collected, and we continue to expect collection in full of all of our outstanding receivables. Inventory at the quarter end was $239,300,000 Inventory levels remain consistent with our commercial planning assumptions and are intended to support continued growth in Ascentive and ensure the continuity of care of all patients.

17:29 Turning to our outlook, we are reiterating our full year 2026 financial guidance. We continue to expect total revenue of $530,000,000 to $560,000,000 adjusted EBITDA of $265,000,000 to $300,000,000 and adjusted net income of $170,000,000 to $200,000,000 Our outlook continues to assume sustained competitive dynamics and pricing pressure within the standard immune globulin market through the balance of the year. At the same time, it reflects our expectation that Ascendant will remain the company's principal driver of revenue growth, profitability and cash generation. Our guidance also incorporates planned investments supporting commercial expansion, manufacturing initiatives and continued advancement of SG-one, while preserving the financial flexibility to continue returning capital to stockholders.

18:22 Importantly, our outlook continues to reflect what we believe are prudent planning assumptions despite the improving commercial indicators discussed today. Based on our second quarter performance, continued strong cash generation and the commercial indicators Adam discussed earlier, we remain confident in our ability to meet or exceed our full year expectations. Overall, we believe ADMA remains exceptionally well positioned. We believe our differentiated commercial portfolio, expanding profitability, strong cash generation, disciplined capital allocation strategy and flexible balance sheet provide a solid foundation to continue investing in the business while creating meaningful long term value for stockholders. With that, I'll turn the call back to Adam. Thank you, Teri.

19:08 As we conclude, we believe the second quarter further validated the strength and durability of ADMA's business. In the face of ongoing competitive immunoglobulin market pressures, Ascentive demand strengthened throughout the quarter, with June delivering the strongest sequential month over month end user growth we have experienced since the first half of twenty twenty four.

19:31 At the same time, BIVIGAM demand is stabilizing, resulting in sequential improvement in both utilization and revenue. Together, these trends for our IG product portfolio reinforce our confidence that Ascentive remains well positioned to drive continued growth through the balance of 2026 and beyond, and BIVIGAN will maintain its present positioning. Equally important, we believe Ascentive's differentiated value proposition continues to strengthen. This view is supported by the expanded base of real world evidence that has been published, as well as through a new abstract submitted to the twenty twenty six American College of Allergy, Asthma and Immunology Annual Scientific Meeting, which documents significant improvements in health outcomes and reductions in healthcare resource utilization among medically complex primary immunodeficiency patients.

20:26 We believe these findings further support increasing physician adoption, payer engagement and long term commercial expansion for Ascentiv. Operationally and financially, we believe ADMA remains exceptionally well positioned to execute on our long term strategy. Our yield enhanced manufacturing platform, diversified plasma sourcing strategy, strong balance sheet and significant cash generation are expected to provide the flexibility to invest in commercial growth, advance our pipeline and continue returning capital to stockholders through disciplined share repurchases. Beyond incentive, we continue to execute against our development strategy and remain on track to submit our pre IND meeting package for SG-one to the FDA by year end and produce conformance batches in the second half of twenty twenty six.

21:21 We continue to believe SG-one represents a compelling long term opportunity that leverages ADMA's existing manufacturing platform, commercial infrastructure, and decades of expertise in the specialty plasma derived biologics in an area of medicine where significant unmet medical needs persist. To sum up, commercial momentum continues to build. Our differentiated evidence base continues to expand, and our financial profile continues to strengthen. Collectively, these strengths reinforce our confidence in ADMA's long term growth trajectory and are expected to position the company to execute against its core mission.

22:03 To continue creating meaningful benefits for patients and healthcare providers, which translates into value creation for our stockholders in the years ahead. Before opening the call for questions, I would once again like to thank our employees for their extraordinary efforts working for the patients counting on us. At ADMA, we are operating on the forefront of science, rapidly implementing innovative technologies and tackling challenges to address unmet medical needs. Without your efforts, dedication, and unwavering commitment to operational excellence, we would not be achieving all that we have and what is yet to come. We also extend our gratitude to our stockholders for their continued support of our company and its important mission.

22:51 Thank you for your continued support and interest in ADMA. Operator, we can now open the call for questions. Thank you. Today's question and answer session will be conducted electronically. To ask a question, you will need to press 11 on your telephone and wait for your name to be announced. To withdraw your question, please press 11 again. We'll pause just a moment to assemble the roster. Our first question will be from Ryan Deschner with Raymond James. Ryan, your line is open. Hi. Good afternoon, and thanks for the question.

23:37 Curious on what your current thinking is on how quickly orders associated with McKesson deal might develop over the next several quarters. How much overlap on call points with existing customers is there or do think there will be? If you give us an idea of how payment terms compare between McKesson and your other customers? Thanks. Thanks, Ryan. Thanks for the question. So McKesson is an important part of our go forward strategy to continue penetrating with Ascentiv. As we've discussed previously, some of the GPO buying groups that are associated that buy through McKesson are primarily focused on secondary immune deficiency, And that does not overlap with the current call points that we have been calling on for Ascentive through our legacy distribution partners. So I can say that we are seeing some very good utilization.

24:36 We're having great conversations with a lot of the decision makers at a number of these parties that buy exclusively through McKesson through these GPO buying group contracts. And it is certainly part of our go forward growth strategy. With respect to payment terms, their payment terms are a little faster than some of the others who we sell to, But we're very happy with the partnership thus far, and we expect it to continue throughout the back half of this year into 2027. Thanks so much. Thank you, Ryan. Next, our question will be from Kristen Kluska with Cantor Fitzgerald. Kristen, your line is open.

25:22 Hi, everyone. Thank you so much for taking my questions. Can you provide us with any new statistics or color just thinking around the reimbursement dynamics that are going on with Asenov and with some of the market dislocation that is temporary, have you noticed any shifts or signals in how those dynamics are going? Thanks, Kristen. With respect to reimbursement dynamics, I mean, Ascentiv and Bibigan for that matter both see broad access throughout the commercial reimbursement landscape. We're not seeing any significant negative changes in the market. We are continuing to see increased utilization through the commercial channel. And I think that that's mostly driven by the body of real world data and evidence that we've published to date.

26:17 And we think that that's going to continue to grow going forward, especially in light of the new data that we talked about in the prepared remarks, and that's included in the press release. With respect to some of the market dislocation challenges, we still certainly see large amounts of standard IG throughout The U. S. Marketplace. We play in the outpatient setting, which I know that you're quite familiar with. Almost 100% of the product that ADMA sells is in the ambulatory infusion, home infusion type setting. And we still are seeing some pretty competitive pressures in that market from a supply standpoint as well as from discounting and rebating.

27:06 We did see stabilization in the quarter from the first quarter troughs. As we mentioned in the prepared remarks also, BIVIGAM recovered a bit. We are seeing a stronger utilization of BIVIGAM. But again, it still is substantially down year over year. Ascentive continues to grow in the face of all of these competitive pressures. We are extremely encouraged by Ascetic's 24% year over year growth. And again, represented the largest month over month growth in end user utilization that we've seen since the first half of twenty twenty four. So we're excited, we're encouraged, payer access continues to be open and broad. And again, this is all predicated on the fact that the product is being used in the refractive comorbid immune compromised patient that is not doing well on standard products.

28:12 Thank you, Adam. And then sorry, may I ask one more?

28:16 Go Yes. Okay. Thanks. I was just going to ask how we should be thinking about R and D for the next few quarters here as SG-one continues to advance. Thanks again. Hi, Kristen, it's Terry. So as you noted, R and D stepped up this quarter as we're preparing for potential future state clinical trial for SG-one. The $6,000,000 you saw in the quarter is something that we think will carry throughout the rest of the year. There will probably be a step up again, although not as large obviously in Q4 as we start to manufacture conformance locks. Appreciate all the color. Thanks everyone. Thanks for your questions, Next, we have Anthony Petrone with Mizuho Financial Group. Anthony, your line is open.

29:08 Thanks. Good afternoon, everyone. Maybe, Adam, going back to the traditional IG market BIVIGAM, some of the PPTA data out there still kind of showing kind of an erratic pattern with distributor stocking and you referred to some competitors out there that perhaps are still putting excess inventory into the channel and discounting. So maybe what's the visibility as to when all of this normalizes? And as we get into 2027, do you think we could be back modest growth for BIVIGAM? And I'll have a couple of follow ups. Thanks, Anthony. We're seeing some stability with BIVIGAM in our market arena.

29:54 Certainly, are competitive dynamics that we've touched on. Those continue to persist, but we are seeing stabilization there. Are guidance is unchanged. And I remember saying during the last quarter call that we've taken a pretty conservative approach to the new guidance framework. We still anticipate BIVIGAM being down, call it, 40% to 50% from 2025. And Ascentive should be in the upper 20s, low 30% range year over year growth. So we feel very good about Ascentive's go forward utilization growth. It's plugging the hole from the BIVIGAM downturn as well as some of the other intermediate fractions and normal source plasma that we no longer are generating revenues from.

30:48 But could there be some upside, if that's what you're asking from BIVIGAM? I guess there's always a chance and an opportunity, but that's not currently something that we are contemplating. We've been working very hard with BIVIGAM, with some of our distribution partners, with some of these new GPOs. BIVIGAM's been awarded some preferred status across some of these different programs. And we're optimistic that the drug is going to continue to be used. Again, it's a safe, efficacious, good product made by us. We think it has stabilized. So we think that this is a run rate that could be anticipated go forward.

31:33 Could there be a little bit of upside? Sure. But that's not something that we're guiding to right now. I think if there is upside, I think that could only benefit the business. Thanks. And then follow-up would be just your comment, Adam, on commercial payer access could potentially further strengthen here. I know that CVS Caremark has a dedicated policy in place for Asenov. I think claims do get through via prior authorization with United and Cigna. But do you think we actually get another dedicated policy decision? Or where do you think that commercial payer access can potentially expand? Is there any milestones we should be looking for? Thanks. So, to the best of my understanding from our market access team, Ascentiv and Bivigand for that matter are pretty much in parity with a number of the other IG brands out there. We are starting to see additional access and increases throughout different geographic regions and different commercial payers.

32:40 I know that our team has been engaged in robust discussions with a number of payers trying to secure improved access for ASCENIV as we go forward and continue to publish this data. But again, in the appropriate use case patient population, we are continuing to see more patients get approved through prior authorization process. And again, that's not unique to us. That's across the entire IG landscape, about 70 plus percent or so of IG scripts do require prior auth. So we feel good about payer access. We think that we're in a great position for this to continue to grow, and we are seeing commercial payer book of business continue to increase quarter over quarter.

33:31 Thank you for your questions, Anthony. Our next and final individual with a question is going to be Gary Nachman with Canaccord Genuity. Gary, your line is open. Great. Thanks, and good afternoon. Adam, on the increasing demand for incentives, you previously talked about growth of 2% to 4% month on month. Do you expect it to continue at that rate, or could it possibly be even better than that? It sounded like it accelerated nicely in June. Was it actually that range? And maybe just some more on what drove that acceleration? Then I have a follow-up. Sure. Yes, June certainly month over month was outsized.

34:19 Again, as we are contemplating guidance for the full year, Gary, we are forecasting in this 2% to 4% month over month growth if you smooth it out throughout the course of the year, but we are seeing an acceleration with respect to Ascentive end user utilization and end user pull through from our distribution partners. Again, this is data that they report to us, so it's only as good as the data that they're reporting to us, but we feel very good about this utilization. And what I really think is happening out there, Gary, is we've been shouting from the rooftops at all the medical conferences. Medical education, we've talked about our grassroots medical education efforts, regional speaker programs, speaker programs at a number of the regional and national meetings.

35:12 And when you say enough times, people start to pay attention. When you publish enough papers, people start to believe, okay, there are number of different institutions in different geographies publishing data that shows improved outcomes, reduction in health care resource utilization. We think all of this is what's changing some of the clinician mindset, or at least bolstering confidence of the clinicians that maybe have one or two patients on Ascentive that they're willing to now put more patients on Ascentive. But I can tell you that it's a combination of all of the above. I think that it's been quite a journey for us since we launched the product in the back half of twenty nineteen. But I think we're really at a turning point here where we've got real world data in the public domain that supports the fact that this is a differentiated product with a unique antibody profile that's demonstrating differentiated clinical benefits from patients who are just not thriving on standard IG therapy.

36:21 So we think this is going to continue to grow. We think it's going to continue to provide more access to clinicians who want to learn about ASCENIV and want to understand it. And I can tell you that our field reimbursement team and medical affairs teams, coupled with national accounts and sales, they're all working together well, and we're doing everything we can to grow the business as absolutely fast as possible. Thank you, Gary. Okay. Great. Wait, just a follow-up if I Of course. You know, you'll yeah, I mean, just mentioned the data you'll be presenting, that new data that looks very good in primary immunodeficiency. Are you working on anything in secondary immunodeficiency that would help uptake in that segment of the market?

37:09 And I'm curious how you're thinking about how important that's going to be for the overall growth of ASCENIV moving forward? Thanks. Sure. So, I know that I previously mentioned on some calls that we do have some investigator initiated studies ongoing in certain organ transplant patients, I think mainly lung. That work is still ongoing. I expect it hopefully sometime this year. And I do know that there are a couple of other investigator initiated studies that are either kicking off or will kick off in the oncology setting. With respect to Ascentive's growth outlook, for the foreseeable future, we are just scratching the surface in our total addressable market from a penetration perspective.

37:56 So we feel extremely confident in our ability to garner more patients that are refractive to standard IG and that are continuing to experience chronic persistent infections and have the comorbidities that I've spoken about. So we certainly think that there is a lot of white space in front of us with respect to growing our on label market, if you will. You can't see my quote marks on my fingers, but the on label market. But certainly, as we continue to progress into 2027 and beyond, IG is widely used in secondary immune deficient patient populations. That is the fastest growing area of IG growth currently in The United States, the oncology, the organ transplant setting, and the autoimmune disease setting. So while it may not be the most important thing today with respect to what we're focusing on from a growth perspective, I think over time, as we flip the calendar into the next decade, certainly, we've got big hopes and dreams that we're to penetrate that market as well. And we are starting to see utilization in that market, again, through the McKesson specialty relationships, through some of the community oncology practices.

39:11 There is some utilization of BIVIGAM and Asenov in that market. But truly, what's driving utilization today just has to do with the fact that there are patients with primary immune deficiency diagnoses that are just not thriving on standard IG. And when they reach the end of their rope and the doctors are throwing their hands up, patients are trying Asenov, and they're doing better. Good outcomes will correlate into continued growth for Asenov and our company. Great. That's helpful. Thank you. Thank you again, Thanks, Gary. This will conclude our question and answer portion of the call. I'd like to turn it back over to Adam now for additional closing remarks.

39:59 Thank you, everybody, for your time this afternoon. We appreciate it. Donate plasma helps save a life, and, we look forward to speaking with you soon. Thanks for your support. Thank you, Adam. This concludes the conference call for today. We appreciate your participation, and you may now disconnect.