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Amarin Plc (AMRN 0.38%)
Q4 2022 Earnings Call
Mar 01, 2023, 8:00 a.m. ET


  • Prepared Remarks
  • Questions and Answers
  • Call Participants

Prepared Remarks:


Welcome to Amarin Corporation's conference call to discuss its fourth quarter and full year 2022 financial results and operational updates. I would like to turn the call over to Lisa DeFrancesco, senior vice president, investor relations and corporate affairs at Amarin.

Lisa DeFrancesco -- Senior Vice President, Investor Relations and Corporate Affairs

Thank you, Holly. Good morning, everyone. Thank you for joining us. Please be aware that this conference call will contain forward-looking statements that are intended to be covered under the safe harbor provided under the federal securities law.

We may not achieve our goals, carry out our plans or intentions, or meet the expectations disclosed in our forward-looking statements. Actual results or events could differ materially, so you should not place undue reliance on these statements. We assume no obligation to update these statements as circumstances change. Our forward-looking statements do not reflect the potential impact of significant transactions we may enter into, such as mergers, acquisitions, dispositions, joint ventures, or any material agreements that we may enter into, amend, or terminate.

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For additional information concerning the risk factors that could cause actual results to differ materially, please see the Risk Factors section of our annual report on Form 10-K for the year ended December 31, 2022, which has been filed with the SEC and is available through the Investor Relations section of our website at www.amarin.com. We encourage everyone to read this document. The call is intended for investors of Amarin and is not intended to promote the use of Vascepa and Vazkepa. An archive of the call will be posted on Amarin's website in the Investor Relations section.

Karim Mikhail, Amarin's president and chief executive officer, will lead our discussion; and Tom Reilly, Amarin's chief financial officer, will provide a more detailed review of our fourth-quarter 2022 financial results. After prepared remarks, we will open the call to your questions. I will now turn the call over to Karim Mikhail, president and chief executive officer of Amarin. Karim.

Karim Mikhail -- Senior Vice President and Head of Commercial

Thank you, Lisa. Good morning. And thank you all for joining us today. While 2022 was a challenging year for Amarin, it was also a year filled with significant accomplishments that we believe have created the foundation for our future and gives us confidence that 2023 will be a year of tremendous evolution for the company.

We're only beginning to see the results of the actions we took in 2022 and already in 2023. Throughout the remainder of this year, as each piece falls into place, we will be able to see more clearly the successful turnaround and the growing business that we have been building internationally. Amarin is in a unique position as we are building value for a product outside of the U.S. while facing increasing generic competition in the US market.

Our company is made up of people who come to work every day because they believe in our bold vision to stop cardiovascular disease from being a leading cause of death. This vision is what drives us. I'm proud of this team and what we have been able to accomplish together, and I'm excited for what we are able of accomplishing in the future as we continue to execute on our strategy. Today, I will briefly summarize the actions that we took in 2022 in the spirit of operational excellence to create value over the long term and bring Vascepa/Vazkepa with many eligible patients as possible across the globe.

I will also provide an update on our launch in the U.K. and where we stand with our plans for global expansion. I will provide an update on our results in the U.S. where the team's efforts to stabilize this business is providing the support for our global commercialization efforts.

I will then briefly discuss Amarin's presence at the upcoming ACC meeting, Tom will then discuss our financial results for the fourth quarter and our guidance for 2023, and I will conclude with a look ahead at the remainder of 2023. In 2022, we focused on three main areas: global commercialization, preserving our cash, and ensuring that we have the right talent to execute on our new global strategy. We began the year 2022 negotiating pricing in one market in Europe and ended the year with our product available in five European markets. Since the beginning of 2023, we have added a sixth country, with Switzerland, where we have received individual reimbursement in February.

We also have an additional five European markets in advanced stages of pricing and reimbursement negotiations. Our objective is to conclude the vast majority by the end of 2023 as we focus on building a diverse and sustainable revenue stream in Europe. In Spain, we remain active in the reimbursement process and are confident in our ability to secure pricing in this market. We have gone through two rounds of review and made solid progress.

We anticipate a potential third round of review imminently. In the Netherlands and Italy, we are in advanced stages of our price negotiations and are optimistic a decision could come around mid-year for these markets. We are also making good progress in France, which typically can take slightly longer than the other markets based on historical benchmarks. Other markets such as Norway, Portugal, Israel, and others are also progressing with potential decisions expected this year.

We focused on preserving our cash. In the first quarter of 2022, we saw almost $100 million in cash burn. With new members on our management team, we took swift action to renegotiate supply purchase arrangements. We also implemented a comprehensive cost-saving plan in June, and today, we are excited to announce that we are on track to exceed our $100 million cost-savings target, thanks to our continued fiscal discipline and cost-cutting efforts, which Tom will discuss in more detail later in the call.

These actions resulted in a cash flow positive fourth quarter and a year-end cash balance of more than $300 million. And lastly, we also built a strong European commercial organization with expertise in medical affairs, product launches, and with extensive cardiovascular product knowledge. Many of our team members come from companies where they successfully commercialize blockbuster drugs and have significant contacts, expertise, and knowledge of their respective markets. These professionals came to Amarin because of our leading product, our unmatched data, and our entrepreneurial culture, and they are utilizing their background and leveraging their experience to build the Amarin business and brand in Europe.

This European team also benefited from the valuable experience that our U.S. colleagues had, building the brand successfully over several years in the U.S. market. I'd like now to focus on providing an update on the U.K.

First, I think it's useful to provide a reminder of the key highlights. We completed our NICE application in July of 2021, spent the year focusing on securing final NICE approval, which came in July of 2022. Ninety days later, in October of 2022, the NHS funding was made available to begin adding Vazkepa to formularies. And in November of 2022, the national guidelines were published, and they included the Vazkepa's place in therapy for U.K.

patients. All of these steps and achievements were critical to help us establish a strong position for launch in this market. When we look at the pricing of Vazkepa compared to other oral analogs in the UK, we are extremely well-positioned, thanks in large part to the efforts of our local team. Given the volume of data available for Vazkepa and the efforts of our local team in conveying the value this product brings for patients, our pricing, from a daily treatment price perspective, far exceeds oral analogs across the cardiometabolic spectrum of products in the U.K.

When we look at the market access picture of Vazkepa in the U.K., initial market access is trending ahead of other recent comparable launches in the market. Our team has unlocked 19 out of the first 20 priority accounts, which collectively represents 50% of the eligible patient population for Vazkepa in the U.K. As a reminder, the U.K. is a market that is historically slower growing initially in terms of revenue.

Based on these trends and the price achieved, we believe there is a viable, strong, and long-term business opportunity for Vazkepa in the U.K. Moving now to our progress on global expansion outside of Europe. As a reminder, we set out to achieve more than 20 regulatory approvals between 2020 to 2024 in international markets. We achieved our 2022 objective of getting approvals in six markets, and already in 2023, we received an additional regulatory approval in New Zealand.

And yesterday, following this important approval, we announced an exclusive license and distribution agreement with CSL Seqirus in Australia and New Zealand. We are excited to announce this agreement with CSL Seqirus, a world-class pharmaceutical licensing and distribution partner. CSL Seqirus brings highly experienced market access and commercialization teams in Australia and New Zealand that are well positioned to support pricing and reimbursement efforts for Vazkepa, particularly with their strong record in successfully supporting pharmaceutical benefits listings and eventual marketing and promotion to help us to deliver this important medicine for patients in these countries. Importantly, both Australia and New Zealand contributed a significant number of patients to use it, so it is gratifying to know that we are moving in the direction of giving patients and physicians access to the product there.

We expect the next wave of approvals to include China through our partner, Eddingpharm. Regarding China, our partner, Eddingpharm, is in charge of the regulatory review process. In their latest update, Edding indicate that they expect an approval by midyear as a result of delays related to the shutdown of the regulatory process in China for a period of time due to COVID-19 restrictions. We are working very closely with Edding to ensure we have the latest update from our partner.

As of today, we have not received any indication that there are any open questions or concerns regarding the regulatory filing for our product. In Canada, HLS Therapeutics has obtained reimbursement from all major private and public payers, gaining access to a majority of eligible patients in Canada. HLS continues to be in the launch phase in the public sector, and they are seeing stronger growth for the product in provinces where public access was secured. We're also actively negotiating potential agreements in the Asia-Pacific and Central Eastern European regions, which would enable us to get this important product into the hands of clinicians and patients and ensure we can extract value from these important markets.

I'm pleased with the progress we've made advancing our international expansion plans. We remain focused on our core future objective, which is global growth and expansion for Vascepa/Vazkepa in Europe and internationally as, we believe, expansion is the key to creating value for shareholders. We remain confident in the multibillion-dollar market opportunity for Vascepa/Vazkepa in Europe and internationally. Moving to our U.S.

business and our plans for ACC 2023. In the fourth quarter of 2022, we recorded $90.2 million in total net revenue, including $88 million in U.S. product sales, in line with last quarter despite the continued pressure from generic competition. This is the fourth quarter -- or four consecutive quarters of revenue stabilization in the U.S.

in 2022. This unique achievement was only possible through the relentless dedication and efforts of our highly experienced U.S. team on the field and with the managed care organizations. We are continuing to maintain our share in the IPE market.

Our trends in January and February support continued stabilization of the business. In the first quarter, we are experiencing typical pharma seasonal trends that branded products like Vascepa can expect in the U.S. from fourth quarter to first quarter, driven by co-pays and deductibles resetting for patients and their healthcare plans with the new calendar year. We also expect to see some continued price erosion this year as we continue to experience generic competition.

Tom will talk in more details about what we can expect shortly. One compelling fact is that our U.S. team has generated more than $1 billion in sales since generic launch in 2020, and we continue to have multiple levers we can consider to maintain our profitability. As I mentioned earlier, our cost savings are ahead of plan, and we have the ability to launch either a brand generic or an authorized generic, as needed, at the right time.

While we are planning carefully for all potential scenarios, it is clear today that the strong and nimble infrastructure we retain in the U.S. provides us with the right team to continue to support business stabilization in the near term. Lastly, we continue to benefit from the strong data that we have generated with REDUCE-IT. Four abstracts were accepted and will be presented at the American College of Cardiology meeting taking place later this week in New Orleans.

We are excited to share new findings from the REDUCE-IT trial that add to the wealth of data that has consistently validated the utility of Vascepa in treating patient populations at high risk of cardiovascular disease. This important information, coupled with the analysis comparing the antioxidant effects of EPA, DHA, mineral oil, and corn oil, should help advance the medical community's understanding of the role and value of Vascepa and EPA to reduce cardiovascular events in at-risk patients globally. We remain committed to investing in our data and our medical presence with a global focus to support the medical education efforts for the launches of Vascepa/Vazkepa around the world. With that, I'll turn it over to Tom to talk more about our progress and strong results this quarter.


Tom Reilly -- Chief Financial Officer

Thank you, Karim. Good morning, everyone. I'm pleased to report additional details on our financial performance for the fourth-quarter and full-year 2022 following our pre-announcement in January. Let me begin by discussing our revenue performance.

For the fourth quarter of 2022, we reported total net revenue of 90.2 million, including net product revenue of 89.5 million, a decrease of 38% compared to the fourth quarter of 2021. U.S. product revenue was 88 million, in line with the third quarter of 2022, reflecting a relatively stable trend in volume. We remain pleased of the stable trends in spite of multiple competing generics on the market.

The U.S. business continues to generate a positive contribution margin, provides necessary financial support for expansion in Europe and other geographies around the world. Results included international product revenue of 1.5 million, which includes European product revenue of 0.3 million, beginning to reflect very early revenues from the U.K. Cost of goods sold for the three months ended December 31st, 2022 are 26.6 million, compared to 30.6 million in the corresponding period of 2021.

Gross margin was 70.3% for the three months ended December 31st, 2022, compared to 78.7% in Q4 2021, as a result of lower U.S. net selling price. Now, moving on to operating expenses. During the fourth quarter of 2022, we reported expenses of 73.2 million compared to 97.7 million in the fourth quarter of 2021, a decrease of 24.5 million, or 25%.

The decrease compared to last year includes the impact of the cost-saving initiative announced in June of 2022. These savings were partially offset by our investments in growth and expansion in Europe. Under U.S. GAAP, Amarin reported net income of 0.9 million for the fourth quarter of 2022, or basic and diluted loss per share of zero.

As of December 31st, 2022, Amarin reported aggregate cash and investments of 310.6 million and demonstrating the cash-positive fourth quarter of 2022. We continue to experience relatively stable trends in our U.S. business. Currently, we are not seeing any significant impact from Teva's listing of a one-gram generic version of Vascepa.

We do expect our U.S. revenues for the first quarter of 2023 to reflect the impact of typical branded seasonality, resulting in first-quarter revenues slightly lower than the fourth quarter. We do expect the year to reflect continued pressure on both prescriptions and also price as we work to retain key customers to the brand. We've continue to make progress against our cost reduction program announced in June of 2022, and we are on track to exceed the 100 million cost savings target we announced in mid-2022.

For the full-year 2023, we now expect operating expenses to be between 290 million to 305 million, compared with approximately the 350 million originally anticipated at the time of our June 2022 cost savings announcement. The lower-than-anticipated expenses are a result of additional initiatives taken across the organization to reduce costs, along with the timing of our European investments, where we committed to invest carefully in Europe ahead of reimbursement decisions. Since the cost savings announcement since June, we have taken significant steps this year to strengthen and streamline the company operationally. In addition, we have made significant progress in amending our supply agreements, and those negotiations are still ongoing.

With these initiatives and relatively stable trends in the U.S., we believe our current available cash resources, including U.S. profitability, are adequate to support continued operations, including European launch activities. Now, with that, I will turn the call back to Karim for closing remarks. Karim.

Karim Mikhail -- Senior Vice President and Head of Commercial

Thank you, Tom, for the financial overview and our results during the fourth quarter. We exited 2022 with a strong foundation to support our future growth plans as we focus on becoming a global, diversified cardiometabolic player. And we are off to a strong start in 2023. We have a very clear set of priorities.

Our first and main objective is to conclude reimbursement discussions successfully in the remaining European markets and launch. We will do this while remaining laser-focused on our cash preservation efforts. We're just beginning to see the results of our efforts over the last 18 months. Gaining pricing and reimbursement in Europe remains critical for a strong, sustainable future and shareholder value creation.

We would also like to take a moment to address Amarin's general meeting that was held yesterday, the results of which were disclosed after market closed. On behalf of the Amarin Board and management team, we would like to thank all of our shareholders for their engagement and feedback throughout this process. Continuing to enhance our shareholder engagement program across our broad investor base remains a key priority as we move through this year and beyond. 2023 is a critical year for Amarin as we continue pricing and reimbursement negotiations.

We are in the process of transitioning to a 15-member board, including the onboarding of all new members, to ensure that the company remains focused on progressing against our strategic objectives to deliver enhanced value for shareholders. I would like to take this opportunity to thank Per Wold-Olsen for his leadership, dedication, and counsel during his role as chairman of Amarin's board. The board expects to appoint a new chairman in due course. I would also like to commend our employees across the organization for their steadfast hard work, focus, and commitment to Amarin.

Finally, I hope we provided our shareholders with clear details of our fourth-quarter and full-year earnings results. And with that, operator, we're ready to take questions.

Questions & Answers:


Certainly. At this time, we will be conducting a question-and-answer session. [Operator instructions] Your first question for today is coming from Michael Yee at Jefferies.

Unknown speaker

Hi. Good morning. This is [Inaudible] on the line for Mike Yee. Thanks for taking my question.

I guess I have to -- first, on your U.K. launch, the access data you shared looks very promising. So, how do you see the access you have in the U.K. could translate to your product sales? And do you plan to break out European sales in your future reporting? And secondly, on Germany, I think you have mentioned that you plan to submit another dossier to Germany.

Maybe remind us what the process looks like and how we should think about the timeline. Thank you.

Karim Mikhail -- Senior Vice President and Head of Commercial

Thank you for the question. We'll start with the U.K. launch. So, as you've seen, you know, it is typical that any company, by the way, shares very specific metrics of a country launch.

We decided to do that since U.K. is one of our first big market launches, and we believe that there is value for shareholders to stay very close to these metrics. What we have presented today is data showing the formulary listing, which is really the most important step to opening the door for physicians to prescribe for the product. You know, it demonstrates that the product availability is real for a very large majority of patients.

Now, in terms of future results, we will try as much as possible to share more metrics, hopefully, also from a revenue perspective at the right moment. Having said that, you know, a breakdown of reporting between countries in Europe is not a very customary, you know, thing and I think would not help us, honestly, you know, in terms of negotiating prices and maintaining, you know, proper working relationship with the reimbursement agencies. But our intent is to share as much as possible, especially on the U.K., as the first country launch. For Germany resubmission, yes, this is the plan to go back to Germany because we believe that the German patients deserve to use Vascepa, but we believe the timing for this would have better chances of success after other large markets approving the product.

So, once we have, you know, Spain, Italy, France, it will probably be a better time to submit the file. And at that point in time, we will have a stronger dossier to submit. But thank you for the question. We are not giving up on Germany.

We will keep trying.

Unknown speaker

Thank you. That's very helpful. Thank you so much.

Karim Mikhail -- Senior Vice President and Head of Commercial

Thank you.


Thank you. Your next question is coming from Roanna Ruiz at SVB Securities.

Roanna Ruiz -- SVB Securities -- Analyst

Hi. Morning, everyone. So, wanted to check in about the U.S. a little bit.

So, what's your level of confidence in your exclusive contracts holding up this year? And do you expect revenue stabilization to continue through most of 2023?

Karim Mikhail -- Senior Vice President and Head of Commercial

Thank you, Roanna. So, on the U.S., you know, if you remember, the exclusive journey started really in July of 2021. So, this is not something that the team started working on this last quarter. Over the last 18 months, we were able to sustain our volume from the exclusive stable over, you know, six quarters.

So, there's definitely a very solid foundation. But we are in an open market where, you know, there is competition. Now, we have a fourth entrant which listed, but it's -- you know, it's not yet available on the market. So, we feel confident that the foundation that we have established is stable.

We already communicated in our, you know, comments that would have been -- see, you know, some erosion on the price. We're going to see, you know, a typical erosion on volume that we've seen quarter over quarter. And we're ready for multiple scenarios. You know, if we have, from the beginning, you know, assume that this market is going to act like the typical generic market and we're going to lose 90% of the business, by now, we would not have sold the $1 billion that we sold.

So, we continue to keep four fingers on the pulse. We stay very close. For the moment, the situation is stable. We have not lost any of these exclusive.

We are, you know, in a stable position. But if there are threats, we have a plan and we will act swiftly on this plan, if need be, to maintain U.S. profitability.

Roanna Ruiz -- SVB Securities -- Analyst

Got it. Thanks. Thanks for clarifying. So, I wanted to also ask about Europe at all.

So, I think on the call you mentioned Italy might have a reimbursement decision midyear, and France and Spain may possibly come online, too. So, I was curious, will you be ready to immediately launch in these regions after getting decisions? Or just curious what the rollout might look like for Vazkepa there.

Karim Mikhail -- Senior Vice President and Head of Commercial

Yeah. So, first of all, let me clarify. I mean, you mentioned three countries. Those three countries have very different processes and very different timelines.

So, in Spain, we try to be as clear as possible that we've had two rounds of negotiation. We are starting a third round of negotiation. So, this is imminent, as we described it, at least based on where we are in terms of negotiation. Italy, the process is less structured.

And, you know, the way it's progressing, current, you know, estimation is maybe by midyear. France usually takes longer time, right, in terms of, you know, arriving to an agreed-upon price. But in those three markets, the minute we're going to have reimbursement, we will be ready for a launch. And, you know, those markets differ.

In Spain, you have a lot of sort of regional market access, which, by the way, we have also made progress with just to ensure we are ready to launch, you know, when we have a Spanish price. In France, it's a very nationally driven system, so there are no regional access hurdles. So, the minute we're going to have a French price, we're going to be launching to really, you know, the major primary care population. And it's a significant market.

But France takes longer time based on benchmarks that we have. So, we're working on the three of them.

Roanna Ruiz -- SVB Securities -- Analyst

Understood. Thanks a lot.

Karim Mikhail -- Senior Vice President and Head of Commercial

Thank you.


Your next question for today is coming from Louise Chen at Cantor.

Louise Chen -- Cantor Fitzgerald -- Analyst

Hi. Thanks for taking my question. So, I want to ask you how committed you are to seeing cash flow break even. And how feasible is that given generics and also incremental burn with each new European approval?

Karim Mikhail -- Senior Vice President and Head of Commercial

Yeah, thank you, Louise. So, you know, 2022, we had a very clear vision to turn around the cash burn situation from the 100 million to the cash flow positive that you've seen. Now, we're entering a different phase, right? Because we have a number of milestones that we -- you know, we are going to have in 2023, especially with European launches. With those European launches, you know, there will be a necessity to invest.

So, the situation will change quarter to quarter. But there are also other variables that impact our cash flow, and I'll let Tom maybe talk more about that.

Tom Reilly -- Chief Financial Officer

Yeah. So, overall, cash flow, we overall -- our guidance is that we have enough cash and cash equivalents to get to the profitability to support the European launches. What we expect is -- for 2023, depending on the situation, what we expect is that we will have a decline in cash balance. There's going to be ebbs and flows between particular quarters.

So, we will not be coming in cash positive every quarter, but more of an ebbs and flows. As you recall, we took specific initiatives last year on the supply chain. We still have negotiations taking place and the cost savings initiatives as well.

Yeah. And, of course, you've heard us, you know, delivering above plan in terms of opex and the savings, right, which, you know, is a significant number, and big part will also depend on the stabilization of the U.S. So, we are very clear on what are the key drivers of maintaining our cash position, where it is the U.S. business, you know, our level of opex, which we are, you know, making far more additional efforts to try to save money.

But if we're going to spend a bit more, it will be good news because it means we have more European markets that are joining the launch -- the launches. It's important to note that a lot of our European expenses are already built in and baked with these numbers, right? So, you've seen on some of our slides, we talk about, you know, overall headcount in Europe today in the range of 200, which is basically saying we have recruited, you know, a significant number. In all those markets where we're launching, we are well equipped. So, hopefully, that will answer your question, Louise.

Louise Chen -- Cantor Fitzgerald -- Analyst

Yes. Thank you.


Your next question is coming from Cade Kruse at Goldman Sachs.

Cade Kruse -- Goldman Sachs -- Analyst

Hi, this is Cade Kruse on for Paul Choi. Our question is, how are you thinking about potential shifts in strategy? And has the new board provided any comments or directional guidance on a new strategy? Thank you so much.

Karim Mikhail -- Senior Vice President and Head of Commercial

Thank you. So, first of all, I mean, the new board members, it's still very fresh. I mean, the meeting was yesterday. Today is day one.

We're in very early stages of onboarding. But, I mean, for the moment, our strategy is very clear. Our shareholder value creation is about expanding and launching and succeeding in Europe while maintaining the profitability in the U.S. because that's necessary for us to make it there.

So, this is -- these are the key priorities. For the moment, you know, we have not had any shift in strategy. But, you know, as management, we have always been very open to reevaluate what's happening in the market and what we need to do. Because, you know, if you look at what's happened in the market over the last two to three years, things have developed and evolved significantly.

So, we stay very open to the market, to the situation, and to adapt our plans and our strategies accordingly. But for the moment, I believe we have a clear path to the future and moving ahead. Thank you. Thank you, Cade, for the question.

Thank you.


Your next question for today is coming from Naresh Chouhan at Intron Health.

Lisa DeFrancesco -- Senior Vice President, Investor Relations and Corporate Affairs

We can't hear a question.


Just one moment. Naresh, your line is live.

Naresh Chouhan -- Intron Health -- Analyst

Thank you. Can you hear me now?

Karim Mikhail -- Senior Vice President and Head of Commercial

Yes. Yes.

Naresh Chouhan -- Intron Health -- Analyst

OK. So, three questions, please. Firstly, on G&A, can you help us understand what's in here? So, 25, 30% of sales. I'm trying to get a sense of what's in there and where we should expect that to go over time.

On COGS, they were quite a bit higher than our estimates, about 300 basis points higher than consensus expected in Q4. Is there some underlying cost inflation here, or is this more one-off? And how should we view this for the rest of the year? And then in the U.K., the price agreed with NICE was a good, strong price. But obviously, each customer there requires further discount. So, given you've done such a good job now in terms of getting access at the local level, just trying to get a sense of whether or not those secondary discounts are material or should we consider those? Or you're pretty close to the prices set by NICE? Thank you.

Karim Mikhail -- Senior Vice President and Head of Commercial

So, thank you, Naresh for the questions. I'll let Tom handle the G&A sort of overview and the COGS, and I'm going to deal with sort of the price -- net price and potential discounts and so on. Tom.

Tom Reilly -- Chief Financial Officer

Sure. So, Naresh, thanks for the question. So, in general, in the G&A, within that line item, it's our corporate expenses to support the organization in there as well. We have legal base expenses.

We have insurance charges related to our overall programs from a program management, from a risk perspective. So, that's what's in our G&A. And your question related to cost of goods and on the increase in margin of approximately 0.3, it really comes down to sales mix. So, it comes down to U.S.

product sales versus mix of some of our product revenue that we have with some of our collaborative partners. So, overall, I think the root cause of your question was, was there any inflation impact? And the short answer to that is no, there was no inflation impact. And on the positive side, from the working capital perspective, we bring down quite a bit of inventory given the overall supply negotiations that we've taken and continued to onboard with. Karim, can you answer the last question, please?

Karim Mikhail -- Senior Vice President and Head of Commercial

Yeah. For the U.K. price, so you've seen from the slide that we put sort of, you know, the prices of the multiple cardiometabolic oral drugs in the U.K. on the list level.

And we're very conscious that some of these list prices for other benchmarks is not really the net, meaning that some of them are even discounting further to NHS to basically gain access. Where do we stand today? And based on our agreement, we are actually not discounting from this number that you see to NHS. So, this is, for us, a big part of the strategy of why we believe that the negotiation we've had was very successful because we convince NICE of the value of the product and that there was -- it was not necessary for us to be discounting this. So, all the formulary listings that you've seen there do not actually involve additional discounts, right? So, the list is the next, and we feel very proud of that performance.

And by the way, this is what's positioning us to strong negotiations in the other markets because the Spanish government and everybody else can see and visualize our price in the U.K. and they understand exactly what the British government is paying for Amarin -- for Vazkepa.

Naresh Chouhan -- Intron Health -- Analyst

That's great. Thank you.

Karim Mikhail -- Senior Vice President and Head of Commercial

Thank you.


We have reached the end of the question-and-answer session, and I will now turn the call over to Karim for closing remarks.

Karim Mikhail -- Senior Vice President and Head of Commercial

Well, I just want to thank you all, you know, for your presence today and for the engagement throughout 2022. As we said, it was a challenging year. We've had a very significant turnaround, and it's only the beginning of a true evolution of Amarin. We look forward to stay connected throughout the quarters and to very soon be sharing with you our results in the first quarter.

Thank you all for joining. Thank you.


[Operator signoff]

Duration: 0 minutes

Call participants:

Lisa DeFrancesco -- Senior Vice President, Investor Relations and Corporate Affairs

Karim Mikhail -- Senior Vice President and Head of Commercial

Tom Reilly -- Chief Financial Officer

Unknown speaker

Roanna Ruiz -- SVB Securities -- Analyst

Louise Chen -- Cantor Fitzgerald -- Analyst

Cade Kruse -- Goldman Sachs -- Analyst

Naresh Chouhan -- Intron Health -- Analyst

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