At the same time, we want to deep risk on the debt side of our Company. We've also restructured insulin purchase commitment and reduced our near-term cash outlay by $50 million. The EBU will be the foundation for our future launches and currently makes up about 37% of our revenue in 2023. As I presented at JPMorgan in January, our ability to grow double-digits for the foreseeable future looks bright when you see, in 2023, our total revenue approached $200 million, almost 100% growth year-over-year. I'm going to spend a few minutes on Afrezza and the EBU because we are at a pivotal inflection point with our future. Innovation takes time and disruption is even harder. When you think about the weight loss craze today GLPs were 20 years in the making to what you see today.

The pods in Type 1 diabetes 10 years in the making and pens took a huge time to convert from vials back in the early 2000. I believe we can make this business a core pillar of our growth story. When you look at the Endocrine business, it grew 32% year-over-year, or $70 million in '23, and created $20 million in Q4, the second quarter in a row of profit contribution as well as on a run rate of $80 million. We've made a lot of changes in 2023 and delivered despite those changes to set us up for a transformation once we see the new data from INHALE-1 and INHALE-3 this year. As I look at the revenue, Afrezza net revenue grew $12 million, or 27% year-over-year. This is our largest jump in seven years and is the most we've seen driven by volume alone as opposed to price balance by historical standards.

Several clinical readouts in 2024 may expand our market potential, and I'll talk about those in a minute. One of the questions I get is what is different this year than prior years? Our focus this year is incredibly different. We've been waiting for this moment, where we have people, money, and data, many times we had two out of three, but not all three. The number one, we got to maintain our persistence in Medicare and Commercial to grow this base business and leverage the $35 insulin copay that currently exists for Medicare and Commercial insured. So coverage we know is the number one objection. Number two, we optimized our sales force footprint here in January to build capabilities for the future growth. And what that means is, we were able to reallocate some headcount to create key account managers, reimbursement specialists, as well as virtual and in-person training across the country.

We also have new insights from market research, which I'll share with you shortly that suggest by executing effectively we can increase prescriber adoption. And finally, is around data and education. We want to focus on KOL development, education at conferences and publications to elevate the support and awareness, especially among academic centers. Here's some new market research as we go forward, called the Emotional Engagement Mindset model, which is done by a Company we've leveraged for market research. This shows a significant shift in perception by the various groups we tested with our new data. And you can see at baseline, just unaided awareness of a present, what people's perceptions were in terms of unattracted, apathetic, attracted or passionate.

And by exposing them to our core V-Go aid as well as some expectation of what INHALE-3 data could read out, you can see we shift almost two-thirds of our key target audiences are attracted or passionate about our future. This is really important because it's the first time we can see this big of a shift from where we started to where we end up with the new data coming. People don't want slow-acting insulin in a world that moves as fast as we do. When I look at the future here on our studies, INHALE-3 and INHALE-1, I'm going to talk a few minutes about these. We have 60 US sites in KOL sites like the Mayo Clinic, the Johnson Clinic, some of the foundations of diabetes treatment in this country. Irl Hirsch is our top-tier thought leader here on INHALE-3 as the Principal Investigator.

And he's done a great job ensuring this trial is dosing properly and enrolling quickly. We have over 300 patients in both of these trials and both of them are on track to read out this year. On the left side of the slide, Type 1 diabetes, INHALE-3, is the largest switch study away from AID pumps. There'll be about 120-some patients in this trial. Half of them will be on MDI, half of them will be likely on AID pumps, as we look at the data. The reason this data set is important is it's utilizing a new dosing conversion upfront to ensure proper efficacy is maintained or improved. We are also doing meal tolerance test at baseline in week 17, so we can see how people's dosing may have changed over this time frame. Another thing to remember about this trial, the first time we're enrolling, almost 25% of the patients are at level seven A1C when they entered.

So we're also showing you, hopefully, that tight control can remain by switching to Tresiba plus Afrezza or degludec as the generic name. So a lot of people asked me, what is the goal of INHALE-3? Our goal is equal efficacy to what perceived to be the standard of care, including an AID system. No mealtime insulin or AID system has ever beaten another system head to head. We think this is an important metric that is successful, and if we see a clinical advantage on highs or lows, that's upside to our expectation. We also plan to use this data to hopefully update conversion figure one in our Afrezza label. We've been in discussions with the FDA since the start of the PEDS program around how do we update that initial dose conversion. We hope that INHALE-3 will be part of that data set.

On the right side of the slide, you can see, sorry, on the bottom of the slide, the different data readouts. First dose will be ATTD in March, the 17-week data we expect to present at ADA in June, and the 30-week data will be complete in third quarter and will be presented at a future conference. On the right side of this slide is INHALE-1. This is a pediatric study and we think this is a watershed moment in order to transform the inflection of Afrezza will be through pediatrics. When we look at diabetes innovation today, whether it's CGM insulin pumps, has started with children and worked their way into adults because the patients are more on social media, the parents are more progressive, some doctors are more progressive. This will be the largest study done on Afrezza over ten years, and so far we don't have the data, but I can tell you the conversion dose has appeared to cause less dropouts relative to our original trial on Afrezza.

There's also a meal tolerance test at baseline using CGM and hope this study will be used to secure pediatric approval in 2025 and beyond. This is how we believe we will accelerate rapid growth of Afrezza and this will ultimately spill over into adults. The one hangover is still the lungs and we think it's time to move forward beyond this. When we look at the data today, we've been on the market 10 years, we've helped tens of thousands of patients. We are building up US KOL support and we have this new data coming out. We would not be going to the children if we were worried about the safety of our product. So when I look at the future and the growth opportunity, we look at four segments of our future. Number one, we're already approved for Type 1 and Type 2 adults.

INHALE-3 will be using a new dosing with CGM in an upfront conversion. We're super excited about this data set as it will also include the head-to-head data I just mentioned. GLPs will continue to be the bolster of the units there in Type 2 diabetes. However, those patients will still need a mealtime insulin, and will continue to promote Afrezza and V-Go in that segment as there are millions of people, who require mealtime insulin over the coming years. However, in order to be a leader in Type 1, we need the data from INHALE-3 to set us up for INHALE-1, which is the pediatric segment, because when we do finally get that data, we know insulin pumps will be the indirect competition of when it comes to a doctor, a patient or CDA making an educational decision for a patient.

They will want to know what Afrezza looks like against insulin pumps. So we started that study with INHALE-3. We're excited to hopefully wrap up INHALE-1 in a few months here. Once we see that data, we will have a one-two punch this year as we wrap up 2024. And now as people are starting to see the first dose data, we're getting questions on gestational diabetes. We think there's an unmet need there that we want to fulfill over time because there's only two drugs that can be used today, metformin, which crosses the placenta and slow-acting injectable insulin. And for anyone that knows anyone suffered from gestational diabetes, keeping your time and range really tight is critically important. I'm going to bridge over to the pipeline very quickly, NTM, nontuberculous mycobacteria with our clofazimine suspension.

So some of you may not be aware, but one of the competing products in Phase 3 had a pause last week in enrollment. And people ask me, why am I excited about our program? And why am I confident? Well, the reason we are excited is, one, when we purchased the product, there was preclinical data showing an improvement in bacterial recovery in the lung model that they used. Number two, there's worldwide data. The product is approved today indirectly through a market access program by the FDA and Novartis. We see worldwide data being generated from patients taking clofazimine here in the US, as well as Japan. Third, there's KOL support for this, along with guidelines, potentially. And finally, there's no near-term competition for trials now for patients.

So, as we look forward, we have 100 sites we're going to target across the world, and we see no other option, really, for these patients to enroll besides the current drug that's on the market Arikayce. So here is the design of our Phase 3 study called the ICON1 study, which was designed post our FDA feedback along with the quality of life group there at the FDA. We've taken their feedback, we've incorporated that into this design, and it's 120 patients on active arm and 60 on the placebo arm. We'll do an interim analysis at 50% and we'll continue to watch enrollment as we saw that competing program enrolled relatively quickly over the last six months of the year, last year, into this year, and that gave us even more excitement for the speed of enrollment that could happen with this trial.

We're excited to get this trial going and we expect to file the R&D here in March and kick off the trial in June as we've had a lot of dialogue with the FDA on the trial design and we expect quite quick approval on the Central IRB. It's exciting to us that this will be over a billion-dollar market with only two players in the next five to 10 years. We have the potential to be the second approved NTM product, and the market research indicate we will be a potentially preferred option for patients whether it's because of our favorable safety profile relative to oral clofazimine that's utilized or the toxicities and tolerability challenges that some people face with Arikayce. We also know that we have convenient dosing. What does that mean? 28 days of treatment followed by two months off, followed by 28 days of treatment.

So if you're doing well, you'll potentially be treated four cycles a year. That gives patients a large burden back from what they did every single day to where they are. We also know the current treatments are not highly efficacious and that patients need more options in order to keep this disease in control. It may be a disease that goes away and comes back over time, but it's one that they'll probably live with chronically for a long time. We have an opportunity to expand a brand within the brand as we think about clofazimine in the future. The next quick pipeline highlight I want to talk about is idiopathic pulmonary fibrosis-201. This is going to be known as nintedanib DPI as we go forward. The reason I'm excited about this program is our 28-day Tox data was very clean.

We know 80% of these patients die in five years. There's a huge unmet need in this disease state. And Ofev is the market leader marketed by Boehringer Ingelheim. And we have a decreased risk relative to the landscape that has failed in IPS development because we already know this molecule works in IPS. What we do also know is that there's severe GI toxicities, which limits patients acceptance and uptake and prescriber adoption. There's roughly 15,000 active patients in treatment in this country, and we believe bringing a more tolerable product that could potentially be dosed higher will be maximized in value for this population relative to what's out there today. Additionally, our rat neomycin study on 201 appeared to mitigate the inflammation of fibrosis comparable to oral nintedanib at substantially lower doses.

As we go forward and our IND will be filed, we'll be studying this in 201 in our next slide. We'll be studying this in our part one, a single ascending dose as well as our multiple ascending dose to show, can we tolerate higher doses over seven days? This will be an important study that gets done here in Q2 with data expected to read out in Q3. Our goal is to show lower GI side effects and safety in healthy volunteers. I want to acknowledge as we go forward the hard work that Steve has done in landing our royalty financing deal as we worked on this for over six months. We're in a great position because of Steve's vision and leadership over the last seven years. And before I turn it over, I just want to acknowledge all the hard work Steve has done for us and our shareholders and our employees.

With that said, I'll turn over to Steve to go over the financials for the quarter.

Steven Binder: Thank you, Mike, and good afternoon. I'm pleased to review select fourth quarter and full year 2023 financial results. Please supplement this call by reading the consolidated financial statements and MD&A contained in our 10-K. 2023 was a year of substantial revenue growth for the Company in terms of both percentage and dollar growth. Total revenues doubled versus 2022 and reached nearly $200 million. Let's break this down by starting with the fourth quarter total revenues at the bottom of the table. Our total revenues grew a robust 62% versus fourth quarter 2022, and 99% for the 2023 full-year period, primarily due to the growth in our Tyvaso DPI-related revenues. Going back to the top of the table, you will see that Tyvaso DPI royalty revenue for the fourth quarter was $21 million, which is 132% increase versus 2022, the result of continued growth in use of Tyvaso DPI for patients suffering from PAH and PH-ILD.

Please note that $2.1 million of the fourth quarter royalty revenue was sold to a third party and I will review the accounting for the royalty sale in a few slides. Collaborations and services fourth quarter revenue was $17 million, which was an 81% increase over 2022, was primarily representative of strong Tyvaso DPI production volumes in the fourth quarter. For the full year 2023, Tyvaso DPI royalty revenue was $72 million, an increase of 361% versus 2022, which was primarily due to the increase in patient demand for the product and the start of commercial sales by United Therapeutics late in the second quarter of 2022. Royalty revenue has now become our largest single source of revenue, which allows us to fund and progress our clinical development and product pipeline.

Collaborations and services revenue for the 2023 full-year period was $53 million, an increase of 90% versus 2022, which was primarily due to the start of commercial manufacturing in the second quarter of 2022, and the increase in production and sales of Tyvaso DPI semi-finished product to United Therapeutics in 2023. Moving down the table to our endocrine business. Total endocrine revenues were $20 million for the fourth quarter and $74 million for the full year. For the fourth quarter, Afrezza's net revenue of $15 million compared to $12 million in 2022. A growth rate of 29% which was mainly driven by higher patient demand with underlying paid TRx growth of 29% year-over-year, a lower gross-to-net deduction as a percentage of gross revenue and price.

Compared to the third quarter of 2023, there was a $2 million increase, which represents half patient demand and half increased channel inventory due to wholesalers purchasing an extra week of product in late December. This additional wholesaler purchase in late December would likely impact our net revenues for the first quarter of 2024. For the full year 2023 period, the 27% increase in Afrezza's net revenue was mainly related to increased volume from higher patient demand with underlying paid TRx growth of 25% price and a more favorable growth to net adjustment as a percentage of gross revenues. Net revenue for V-Go was $5 million for the fourth quarter of 2023. Revenues were 13% lower versus 2022, primarily due to lower patient demand and higher growth to nets as a percentage of gross revenues, partially offset by price.

V-Go net revenue improved versus the third quarter of 2023 by $0.2 million, mainly due to improved gross to nets. For the full year period, the 48% increase is primarily related to the purchase of V-Go on May 31st of 2022, reflecting a seven-month versus twelve-month comparative. The next slide shows our revenue growth by source and basic earnings per share on a quarter-by-quarter basis from the first quarter of 2022 through the fourth quarter of 2023. I'd like to show this graph because it highlights how dramatically our business has changed in two years, and how we're executing against expectations. For the fourth quarter 2023, total revenues increased 14% sequentially versus the third quarter of '23, and are up 62% versus the fourth quarter of 2022.

Fourth quarter 2023 total revenue of $58 million was almost 5x the total revenues recorded in the first quarter of 2022. Below the graph, where were our quarterly basic earnings and loss per share. The fourth quarter was the second straight quarter with net income and positive earnings per share. As I stated, during the third quarter earnings call, we are in a period where we expect to bounce back and forth between earnings and loss per share as our revenues increase, but we will also be increasing our spending on our pipeline as we move MNKD-101 into a Phase 3 Global Clinical Trial and MNKD-201 into a Phase 1 clinical trial. In addition, we will wait to see the results from the INHALE-3 and INHALE-1 clinical trials for Afrezza before deciding whether to increase promotional spend behind that product.

For now, we will continue to focus on growing the profitability of the endocrine business unit, which has had a positive contribution for two straight quarters. Moving on to our GAAP to non-GAAP reconciliation, I will first focus on the fourth quarter, which is on the left-hand side of the table. We had GAAP net income of $1 million, which when adjusted for select non-cash items for stock compensation, gain or loss on foreign currency transactions, which is related to our insulin purchase commitment, loss unavailable for sale securities, a sole portion of the royalty revenue, and the interest expense on the liability for sale of future revenues, which I'll discuss in more details in a minute, provide for a non-GAAP net income of $7 million versus a 2022 fourth quarter non-GAAP net loss of $11 million.

For the full year 2023 period, we ended with a net loss of $12 million, but when adjusted for the select non-cash items becomes a non-GAAP net income of $6 million, which is compared to a non-GAAP net loss of $78 million in 2022, an $84 million year-on-year positive change. Now I'd like to take some time to explain the accounting that resulted from the sale of our 1% of our Tyvaso DPI royalty. To set the stage, we sold 1% of our 10% royalty for $150 million plus up to $50 million more if certain net revenue numbers are attained within a period of time ending at September 2027. This puts a third-party valuation on the 10% royalty of approximately $1.5 billion to $2 billion. After we announced the royalty sale in early January, heard back from investors that we could have done a better job explaining how we recognized these transactions in our financial statements and how we got to our accounting conclusions.

So let me try again. First, we looked at all of the GAAP guidance, reviewed all similar relevant transactions we could find in the last five years, and then consulted with our auditors. The conclusion we arrived at, amongst other things, is that MannKind has a continuing involvement in the generation of Tyvaso DPI revenue through activities to protect the intellectual property of Tyvaso DPI, such as defending the patent estate, protecting the product, and the continuing involvement in the manufacturing of the product for United Therapeutics. Thus, the upfront proceeds recorded as a liability for future sales of royalties, not as revenue. The table on the slide reflects how the accounting works. We record the cash consideration received net of issuance costs and a related liability for the sale of future royalties on our balance sheet.

To recognize interest expense related to the liabilities, we forecast the future royalties to be received through 2042 and calculate the return that would be needed when receiving a $150 million upfront payment, 1% of the royalty over this time period. This rate came to just over 11%. In future period, we'll continue to estimate the future royalty stream based on royalty trends, commercial success of Tyvaso DPI, competition for the brand and other meaningful inputs. The outcome of these future estimates may adjust the prospective interest rate using determining interest expense and amortization of the liability. Each quarter, we will charge our P&L for non-cash interest expense based on the interest rate and credit the liability. We've also recognized 1% royalty as non-cash revenue and reduced the liability by this amount.

In addition to the non-cash attribute of this transaction, we also earn cash interest income of approximately $7.5 million annually. The slide shows how the accounting should work for 2024 if nothing changes in our forecast of expected royalty. The balance sheet would end 2024 with $153 million in cash and $153 million of a liability for the sale of future royalties. The liability balance will increase as long as the non-cash interest expense is greater than the non-cash royalty revenue, which is likely to occur over the next few years. Once the non-cash royalty revenue becomes greater than the non-cash interest expense assuming that sales of Tyvaso DPI continue to grow, then the liability balance will begin to decrease. Focusing on the 2024 income statement on the right side of the table, we will record non-cash revenue of $10 million and cash interest income of $7 million, offset by non-cash interest expense of $17 million.

As discussed on our previous slide, we expect to isolate the non-cash aspect of this transaction and our quarterly GAAP to non-GAAP reconciliation of net income and loss. With over $300 million in cash and investments on our balance sheet as of December 31st, 2023, we want to share our near-term priorities for using the cash to increase shareholder value. First, focusing on our development pipeline, we expect to fund much of MNKD-101 and MNKD-201 clinical trial expenses over the next few years through operating cash flow. As these assets advance through clinical trials, we will prioritize their funding. In addition to MNKD-101 and 201, we have two clinical trials for a present nearing data readouts. We will wait to see the results of these trials before deciding whether to invest more behind this asset to grow revenues.

In addition, we plan to do the following with our debt. Our midcap senior secured debt has a balance of approximately $33 million as of December 31st, 2023, and currently carries an interest rate of 8.25%. We expect to pay off this debt in the first half of 2024 to take advantage of the interest rate arbitrage between debt interest expense and cash investment return and release our assets from Midcap's security interest. MannKind convertible debt with a balance of approximately $9 million as of December 31st, 2023, is expected to be paid off early in cash or in a mix of cash and stock. By doing this, we would be reducing future shareholder dilution. Our senior convertible debt with a balance of $230 million as of December 31st, 2023, carries a low fixed interest rate of 2.5% and we do not expect to buy back bonds prior to maturity in March 2026.

When maturity arrives, we expect to reduce future dilution by paying off the debt with cash if our stock price is below the conversion price of $5.21. Additionally, we do not expect to access the ATM. To summarize, a very successful 2023, we doubled our total revenues to almost $200 million versus the prior year. Fourth quarter was the second successive quarter of positive contribution from our endocrine business unit. The fourth quarter was the second successive quarter of net income for the Company. We sold a 1% interest in our 10% Tyvaso DPI royalty, which value for the royalty stream alone at between $1.5 billion and $2 billion, and we ended 2023 with $302 million in cash and investments. 2024 should be another stellar year for MannKind, as we are financially prime to drive our commercial and clinical priorities and deliver increased shareholder value.

Thank you. And now I'll turn it back over to Mike.

Michael Castagna: Thank you, Steve. And I appreciate the explanation of all the accounting. I never wanted to know. Now they know why I appreciate you. Next slide. So MannKind has been around 33 years, and I want to give a special thank you to our Founder, who passed away eight years ago on February 25th. The reason that's important the day I decided to join MannKind, and I'll forever be grateful for Al Mann. He was a special human being, who cared about society, our patients, and making a difference. We have the foundation left us within 2016, and we built this into a major self-sustaining growth Company against all odds. When you look at the history from '16 forward, we announced our United Therapeutics collaboration. We acquired Qrum, which is now our Phase 3 asset with clofazimine or MNKD-101.

We purchased V-Go, which made our endocrine division more sustainable and brought us a couple thousand new prescribers, and Tyvaso DPI has been ahead of all the expectations since its approval. As I look forward, we are just getting started, expected 2024 milestones alone between Afrezza and the steady read-outs MNKD-101 -- MNKD-201. Not to mention that Tyvaso-DPI, which has two major trials going on in TETON 1 and TETON 2, which I heard this last week, were 70% enrolled. Once they finish up enrollment, they'll have 12 months there. We should expect to see data from United Therapeutics. Additionally, our team just this day completed the high-speed fill finish line in terms of qualification. I will now begin on the PPQ, hopefully producing much higher volumes of Tyvaso have that line as we exit Q1 going into Q2.

As I look at our future, we have several key value drivers. As you can see, our insiders picked up some stock in the next few weeks and hosted our Board Meeting because we believe we're undervalued and we're very confident in our future. Analysts have expenses in -- for our pipeline, but no revenue in the next five years. We think this is an unfair valuation of our Company given that we do expect to launch clofazimine in the next five years and move NTM -- I'm sorry, and move the IPF asset in terms of MNKD-201 into patients and then hopefully the Phase 3 by then. We go back and look at another successful company in time InterMune was similarly valued at $800 million at one point and 18 months later was $8 billion once they got a positive data readout.

Our job is to not react or overreact day to day to swings in the stock market but to lay out a firm foundation for future growth. And as we look out there whether it's the pipeline with MNKD-101, every 1,000 patients approximately $100 million in revenue. MNKD-201, we're going to start patients dosing there, as you think about IPF, every 1,000 patients is roughly $150 million in annual revenue. And then we get into Tyvaso DPI, which as you can see this past year, when you add up the collaboration services revenue and additions that have royalties, we know there's roughly 5,000 patients on Tyvaso DPI, and that's about half of the $250 million revenue that we experienced this past year. On the endocrine side, we have several major upcoming opportunities with INHALE-1 and INHALE-3, as well as Afrezza International.

V-Go is being managed for improved profitability as we continue to focus on improving our margins by producing COGS as well as improving gross to nets. As we take a step back, we have multiple shots on goal to create significant shareholder value across three commercial products when you think about Afrezza, Tyvaso DPI and V-Go, they're already FDA-approved, as well as two assets coming up quickly in the pipeline between MNKD-101 and MNKD-201. We have multiple shops on goal within these assets. We are completely focused on delivering shareholder value sustainably for years to come. We have several upcoming presentations and engagements at conferences. I'll be doing non-deal road shows with Steve over the coming months to get the word out as we feel like MannKind is at the best inflection point with the best team in the industry, cash on the balance sheet and multiple shots on goal in terms of data read-outs to drive future growth.

We're super excited about the future. And I will stop there, Valerie, to take questions. Thank you again.

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