Evoke Pharma Inc (EVOK) 2023 Q4 法說會逐字稿

Good afternoon and welcome to the Evoke Pharma fourth-quarter and full-year 2023 earnings conference call. (Operator Instructions) I will now turn the call over to Daniel Kontoh-Boateng. Please go ahead, sir.

下午好，歡迎參加 Evoke Pharma 第四季和 2023 年全年財報電話會議。（接線員指示）我現在將把電話轉給 Daniel Kontoh-Boateng。請繼續，先生。

Good afternoon and thank you for participating in the Evoke Pharma's conference call and webcast today. With me today are Dave Gonyer, Evoke's Chief Executive Officer, Chris Quesenberry, GIMOTI's Chief Commercial Officer from Eversana; and Matt D’Onofrio, Evoke's President and Chief Operating Officer.

下午好，感謝您今天參加 Evoke Pharma 的電話會議和網路廣播。今天與我在一起的有 Evoke 執行長 Dave Gonyer、Eversana GIMOTI 首席商務長 Chris Quesenberry；以及 Evoke 總裁兼營運長 Matt DâOnofrio。

By now, you should have a copy of the press release we issued earlier. If not, it is available on the Investor Relations page of our website at evokepharma.com. We encourage everyone to read today's press release, as well as in both annual report on Form 10-K, which is now filed with the SEC. The company's Form 10-K and earnings release are also available on the Evoke's website.

現在，您應該已經收到了我們之前發布的新聞稿的副本。如果沒有，可以在我們網站 evokepharma.com 的投資者關係頁面上找到。我們鼓勵大家閱讀今天的新聞稿以及現已向 SEC 提交的 10-K 表格年度報告。該公司的 10-K 表格和收益報告也可在 Evoke 網站上取得。

Please note that certain information discussed on the call today is covered under the Safe Harbor provisions of the Private Securities Litigation Reform Act. We caution listeners that during this call, management will be making forward-looking statements. Actual results could differ materially from those stated or implied by these forward-looking statements due to risks and uncertainties associated with the company's business.

請注意，今天電話會議中討論的某些資訊受《私人證券訴訟改革法案》的安全港條款管轄。我們提醒聽眾，在這次電話會議中，管理階層將做出前瞻性聲明。由於與公司業務相關的風險和不確定性，實際結果可能與這些前瞻性陳述中明示或暗示的結果有重大差異。

These forward-looking statements are qualified by the cautionary statements contained in Evoke's press releases and SEC filings, including its annual report on Form 10-K and subsequent filings. This conference call contains time-sensitive information that is accurate only as of the date of this live broadcast. Evoke undertakes no obligation to revise or update any forward-looking statements to reflect events or circumstances after the date of this conference call and webcast.

這些前瞻性陳述受到 Evoke 新聞稿和 SEC 文件（包括其 10-K 表格年度報告和後續文件）中包含的警示性聲明的限制。本次電話會議包含時間敏感訊息，僅截至本次直播之日準確。Evoke 不承擔修改或更新任何前瞻性陳述以反映本次電話會議和網路直播之後發生的事件或情況的義務。

With that, I would now like to turn the call over to David Gonyer. Dave?

現在，我想將電話轉給 David Gonyer。戴夫？

Thank you, Daniel, and thanks, everyone, for joining the call this afternoon. As was described in today's press release, 2023 marked a milestone in Evoke's journey, not just commercially, but also in fulfilling our core mission, which is ensuring GIMOTI is within reach for every patient who needs it.

謝謝丹尼爾，也謝謝大家參加今天下午的電話會議。正如今天的新聞稿中所述，2023 年標誌著 Evoke 歷程中的一個里程碑，不僅在商業上，而且在履行我們的核心使命方面，即確保每位需要 GIMOTI 的患者都能獲得 GIMOTI。

Let me tell you why this core mission is so important. It's because it's about the patient and their experiences that can and will fuel the progress -- to help us fuel the progress as an organization. A testament to our efforts comes from the countless positive stories we've been told from health care providers, patients, and our own sales representatives who hear and tell us some amazing patient success stories on a daily basis.

讓我告訴你為什麼這個核心使命如此重要。這是因為患者和他們的經驗能夠並且將會推動進步——幫助我們推動組織的進步。我們從醫療保健提供者、患者和我們自己的銷售代表那裡聽到的無數積極的故事證明了我們的努力，他們每天都會聽到並告訴我們一些令人驚嘆的患者成功故事。

While gastroparesis impacts predominantly women, today, I'd like to share just a brief very inspiring story that was just shared to us this week, about a 30-year-old male who battled both type 1 diabetes and severe gastroparesis. This man who, was in and out of the hospital just about every month because of his gastroparesis, shared with this health care provider that, since starting on GIMOTI, he hasn't had a single hospital visit, not one.

雖然胃輕癱主要影響女性，但今天，我想分享一個簡短的、非常鼓舞人心的故事，這個故事本週剛分享給我們，講述的是一名30 歲的男性，他與1 型糖尿病和嚴重胃輕癱作鬥爭。由於胃輕癱，這名男子幾乎每個月都會進出醫院，他與這位醫療保健提供者分享說，自從他開始使用 GIMOTI 以來，他沒有去過一次醫院，一次也沒有。

And to his admission, it's been life-changing for him. It's stories like these that will push payers and providers and advocates to fight for patients who suffer from this insidious disease so they can receive the best care possible.

他承認，這改變了他的生活。正是這樣的故事將推動付款人、提供者和倡導者為患有這種隱匿疾病的患者而奮鬥，以便他們能夠得到最好的護理。

Now this is just one of many affirmations we have heard that continues to energize our commitment. Now while we're humbled to receive these stories of success, we also want to encourage providers to do more to diagnose and treat these patients with gastroparesis. But unfortunately, the norm for patients is to wait years before they're diagnosed. And then often told there's not much they can do -- can be done for them. When treatment is prescribed, all too often, payers are pushing the cost to the patient, or outright denying coverage. Payers can do better, and patients get their better treatment.

現在，這只是我們聽到的眾多肯定之一，這些肯定繼續激勵我們的承諾。現在，雖然我們很榮幸收到這些成功案例，但我們也希望鼓勵醫療服務提供者採取更多措施來診斷和治療這些胃輕癱患者。但不幸的是，患者通常要等待數年才能被診斷出來。然後經常被告知他們無能為力——能為他們做的事情不多。當規定治療時，付款人常將費用推給患者，或直接拒絕承保。付款人可以做得更好，患者也可以得到更好的治療。

The compelling evidence for GIMOTI goes beyond anecdotes. The scientific groundwork, the publication of our Phase 3 clinical data, and the peer-reviewed and plenary presentations of our real-world health resource utilization studies at leading gastroenterology congresses, demonstrating a reduction in emergency room and hospital visits, and the significant total health care cost savings compared to oral metoclopramide underscores the value of GIMOTI versus the current gold standard.

GIMOTI 的令人信服的證據不僅僅是軼事。科學基礎、我們的3 期臨床數據的發布，以及我們在領先的胃腸病學大會上對現實世界衛生資源利用研究的同行評審和全體會議演示，表明急診室和醫院就診次數減少，總體健康狀況顯著提高與口服甲氧氯普胺相比節省的護理成本凸顯了 GIMOTI 相對於當前黃金標準的價值。

Our story is really simple and straightforward, and it's shaping up to be very compelling as well. GIMOTI achieves rapid and direct absorption in the bloodstream. GIMOTI provides documented symptomatic relief as early as one week. And now GIMOTI shows improved outcomes versus oral metoclopramide.

我們的故事非常簡單明了，而且也非常引人注目。GIMOTI 在血液中達到快速、直接的吸收。GIMOTI 最快一周即可提供有記錄的症狀緩解。現在，與口服甲氧氯普胺相比，GIMOTI 顯示出更好的結果。

The drug delivery through the nose avoids the problem of the disease, which is an inability to predictively deliver pills into the small intestine to be absorbed. Importantly, many patients previously on oral metoclopramide in the HRU study or the health resource utilization study, who were switched to GIMOTI, likely because they were not doing well, experienced the same reduction in ER visits and hospitalizations while taking GIMOTI, confirming its place as a transformative medicine in gastroparesis treatment.

透過鼻子輸送藥物避免了這種疾病的問題，即無法預測地將藥丸輸送到小腸中吸收。重要的是，許多先前在HRU 研究或衛生資源利用研究中口服甲氧氯普胺的患者可能因為病情不佳而轉用GIMOTI，但在服用GIMOTI 期間，急診就診和住院治療也出現了同樣的減少，這證實了GIMOTI 的地位胃輕癱治療的變革性藥物。

Now let me switch gears a bit and turn to some highlights for 2023. I'm happy to report that we doubled our net revenue for GIMOTI over the last year. The number of new prescriptions grew by a notable 86% and total prescriptions dispensed increased by 101% year over year, clearly demonstrating the growing demand for GIMOTI. We also augmented our prescriber base by 72% while amplifying the depth of their prescribing by 36%.

現在讓我稍微轉換一下話題，談談 2023 年的一些亮點。我很高興地向大家報告，去年我們 GIMOTI 的淨收入翻了一番。新處方數量較去年顯著增加 86%，處方總量年增 101%，清楚顯示 GIMOTI 的需求不斷增長。我們也將處方者基礎擴大了 72%，同時將處方深度擴大了 36%。

Our commercial team's relentless focus propelled our targeting and outreach to health care providers, driving our financial achievements above our expectations. At important gastroenterology gatherings such as Digestive Disease Week and the American College of Gastroenterology Conferences, our data was selected by the respective governing boards for plenary presentations at both meetings.

我們的商業團隊不懈的專注推動了我們對醫療保健提供者的定位和推廣，使我們的財務表現超出了我們的預期。在消化疾病週和美國胃腸病學會議等重要的胃腸病學聚會上，我們的數據被各自的理事會選擇用於兩次會議的全體會議。

This is a testament to the strength and the importance of the health resource utilization study we perform, as data highlighted GIMOTI's role in significantly reducing ER visits and hospitalizations, outperforming oral metoclopramide and delivering care at a reduced price. This evidence not only resonated with GI professionals but also underscores our commitment to patient care and economic efficiency for payers.

這證明了我們進行的衛生資源利用研究的實力和重要性，因為數據強調了 GIMOTI 在顯著減少急診就診和住院、優於口服甲氧氯普胺以及以更低的價格提供護理方面的作用。這項證據不僅引起了胃腸道專業人士的共鳴，而且強調了我們對病患照護和付款人經濟效率的承諾。

Furthering our strategic initiatives, we transitioned our pharmacy services to ASPN. The strategic alignment with ASPN's robust platform positions us to better meet our distribution needs, enhance patient access, and streamline our services. And Chris will elaborate a little bit more on this in a moment.

為了進一步推進我們的策略性舉措，我們將藥局服務轉移到了 ASPN。與 ASPN 強大平台的策略聯盟使我們能夠更好地滿足我們的分銷需求、增強患者訪問並簡化我們的服務。克里斯稍後會詳細闡述這一點。

Looking back on a year of dynamic growth, our strategic investments have paid dividends. We've not only strengthened the belief in GIMOTI but doubled the patient count on therapy. As we lean into 2024, we're aiming high with a projected net revenue of approximately $14 million, nearly tripling our 2023 performance.

回顧這一年的蓬勃發展，我們的策略投資已初見成效。我們不僅增強了對 GIMOTI 的信心，而且使接受治療的患者數量增加了一倍。隨著 2024 年的到來，我們的目標很高，預計淨收入約為 1,400 萬美元，幾乎是 2023 年業績的三倍。

And with that, let me turn it over to Chris to talk about our current commercialization activities and plans moving forward for this year.

接下來，讓我把它交給克里斯來談談我們目前的商業化活動和今年的計劃。

Thanks, Dave. To confirm the uptake and acceptance that Dave just spoke about and revalidate last year's commercial strategy, we also took a look at providers consecutively prescribing GIMOTI after their initial script. This slide denotes that close to 30% of our cumulative prescribers, which totaled 1,748 physicians, have prescribed GIMOTI five or more times. The writers that have written prescriptions continue to write more and more over time.

謝謝，戴夫。為了確認 Dave 剛才談到的吸收和接受度並重新驗證去年的商業策略，我們還研究了在初始腳本後連續開出 GIMOTI 處方的提供者。這張投影片表明，我們累計開處方的醫生（總共 1,748 名醫生）中，有近 30% 開過 GIMOTI 處方五次或以上。隨著時間的推移，已經寫出處方的作家繼續寫得越來越多。

From our standpoint, this is highly encouraging and a strong testament to the drug's efficacy and prescriber and user-friendly profile. The unabated adding of new prescribers or so-called breadth of prescribing in 2023, while simultaneously continuing to grow the depth of prescribing, is difficult to do and is also an indication that there is still significant potential for growth for GIMOTI. We have not reached any ceiling of use for GIMOTI. Quite the opposite is true.

從我們的角度來看，這是非常令人鼓舞的，有力地證明了該藥物的功效、處方者和用戶友好性。2023年不斷增加新處方者或所謂的處方廣度，同時繼續增加處方深度，這是很難做到的，也表明 GIMOTI 仍有巨大的成長潛力。我們尚未達到 GIMOTI 的使用上限。事實恰恰相反。

While not shown on the slide, our market share of metoclopramide -- of the metoclopramide market showed similar gains throughout 2023. Encouragingly, as you look across important prescriber audiences, the share of GIMOTI compared to oral metoclopramide grew throughout 2023, and it's progressively stronger as you move from all potential prescribers of GIMOTI to those that are not call time target list, and further improves as you look specifically at call time targeted gastroenterologists.

雖然幻燈片中未顯示，但我們的甲氧氯普胺市佔率在 2023 年表現出類似的成長。令人鼓舞的是，當您查看重要的處方者受眾時，與口服甲氧氯普胺相比，GIMOTI 的份額在整個2023 年都在增長，並且當您從GIMOTI 的所有潛在處方者轉移到那些不在呼叫時間目標清單中的人時，該比例逐漸增強，並且隨著您的關注而進一步提高特別關注針對胃腸病專家的呼叫時間。

Importantly, our highest share for GIMOTI is with nurse practitioners and physician assistants, who provide a significant portion of the medical care for patients with gastroparesis as many gastroenterologists spend less time in clinic, deciding instead to perform procedures or scopes.

重要的是，我們GIMOTI 的最高份額是執業護理師和醫師助理，他們為胃輕癱患者提供很大一部分醫療護理，因為許多胃腸病學家在診所花費的時間較少，而是決定執行手術或檢查。

As mentioned, our objective is to nearly triple our performance in 2023 -- or excuse me, in 2024. In 2023, we built a solid foundation and believe we have earned the right to challenge our provider and payer colleagues to offer GIMOTI to a broader base of patients within diabetic gastroparesis. Throughout 2024 and beyond, our focus remains steadfast, reinforce the belief in GIMOTI amongst providers.

如前所述，我們的目標是在 2023 年（或對不起，在 2024 年）將我們的業績提高近兩倍。2023 年，我們奠定了堅實的基礎，並相信我們已經贏得了挑戰我們的提供者和付款方同事的權利，向更廣泛的糖尿病胃輕癱患者提供 GIMOTI。2024 年及以後，我們的重點仍然堅定，增強了供應商對 GIMOTI 的信心。

Importantly, we will make clear that oral metoclopramide did not have the same health care resource utilization reduction that GIMOTI provided and underscore that the nasal route of administration matters. For appropriate patients, we will ask providers to switch to GIMOTI, thereby broadening and deepening prescribing. We have addressed improving the fill rate for GIMOTI and will continue this imperative throughout 2024.

重要的是，我們將明確指出，口服甲氧氯普胺不會像 GIMOTI 那樣減少醫療資源利用率，並強調鼻腔給藥途徑很重要。對於合適的患者，我們將要求提供者改用 GIMOTI，從而擴大和深化處方。我們已經解決了提高 GIMOTI 的填充率的問題，並將在 2024 年繼續這項任務。

We earned a significant amount of prescribing of GIMOTI in 2023 and much of it was unable to be filled because providers sent the prescription to a local retail pharmacy. We will use tools and partners to mitigate this and guide scripts to a pharmacy in our network to capture scripts appropriately.

2023 年，我們獲得了大量 GIMOTI 處方，但其中大部分無法配藥，因為供應商將處方送到當地零售藥局。我們將使用工具和合作夥伴來緩解這種情況，並將腳本引導至我們網路中的藥房，以適當地捕獲腳本。

Lastly, we will increase our communication and education for tardive dyskinesia and leverage latent concerns to clarify risks and encourage appropriate benefit risk discussions. Here again, there is tremendous untapped potential to clarify appropriate use. We will be clear about who is inappropriate for GIMOTI and request those who are appropriate to be offered GIMOTI.

最後，我們將加強對遲發性運動障礙的溝通和教育，利用潛在的擔憂來澄清風險並鼓勵適當的利益風險討論。在這裡，澄清適當的使用還有巨大的未開發潛力。我們將明確誰不適合 GIMOTI，並要求那些適合的人提供 GIMOTI。

Tactically, here's how we plan to build on these initiatives. We will continue to promote and advocate for GIMOTI as the optimal choice for gastroparesis treatment due to its optimized nasal administration. We will support this with our quantitative and qualitative health care utilization data. And currently, we are partnering with pharmacy organizations to leverage their systems and services to mitigate prescriptions that fall outside our distribution lines and never reach patients.

從戰術上講，我們計劃如何以這些舉措為基礎。我們將繼續推廣和倡導 GIMOTI 因其優化的鼻腔給藥而成為胃輕癱治療的最佳選擇。我們將透過我們的定量和定性醫療保健利用數據來支持這一點。目前，我們正在與製藥組織合作，利用他們的系統和服務來減少不在我們的分銷範圍內且永遠無法到達患者手中的處方。

Additionally, with ASPN Pharmacy joining our network, we will gain access to their extensive pharmacy distribution network, including specialty drug pharmacies, improving GIMOTI's fill rates and ensuring our patients to receive the treatment they need without delay.

此外，隨著 ASPN Pharmacy 加入我們的網絡，我們將能夠進入他們廣泛的藥房分銷網絡，包括特殊藥物藥房，提高 GIMOTI 的填充率並確保我們的患者立即接受他們需要的治療。

Through appropriate channels, we'll also persist to demystify the risks associated with tardive dyskinesia or TD, through education and transparency. For background, tardive dyskinesia is the side effect of select medications more commonly seen with older antiseptic medication that causes involuntary movements to one's face and body that can't be controlled. The recent ACG guidelines indicate the risk of this side effect due to exposure to metoclopramide is lower than previously thought. In fact, it's likely less than 1%.

透過適當的管道，我們還將堅持透過教育和透明度來揭開與遲發性運動障礙或 TD 相關的風險的神秘面紗。作為背景，遲發性運動障礙是某些藥物的副作用，更常見的是較舊的抗菌藥物，會導致臉部和身體出現無法控制的不自主運動。最近的 ACG 指南表明，由於接觸甲氧氯普胺而產生這種副作用的風險比以前認為的要低。事實上，這個比例可能不到 1%。

And our only claims analysis presented at DDW in 2022 confirmed ACG's conclusion. By presenting clear data, including the low incidence, and which at-risk patients to avoid, we are shifting the narrative from fear to informed prescribing and monitoring. We believe this will reset perceptions and encourage physicians to prescribe GIMOTI to appropriate patients with confidence backed by a comprehensive understanding of a safety profile.

我們在 2022 年 DDW 上提交的唯一索賠分析證實了 ACG 的結論。透過提供清晰的數據，包括低發病率以及應避免哪些高風險患者，我們正在將敘述從恐懼轉向知情處方和監測。我們相信，這將重塑人們的看法，並鼓勵醫生在對安全性的全面了解的支持下充滿信心地向適當的患者開出 GIMOTI 處方。

As we build demand and utilization of GIMOTI, we've taken deliberate strides to enhance the accessibility of GIMOTI by evolving our distribution and pharmacy capabilities. Our journey began with EvokeAssist or Eversana Pharmacy, which allowed us to implement the system swiftly though it relied on manual processes and had longer fulfillment times. As we progress to vitaCare, we significantly upgraded our capabilities, integrating seamlessly with medical workflows, enabling electronic prescribing, facilitating automatic refills -- excuse me, automated refills to expedite the filling process.

當我們建立 GIMOTI 的需求和利用時，我們有意透過發展我們的分銷和藥房能力來提高 GIMOTI 的可及性。我們的旅程始於 EvokeAssist 或 Eversana Pharmacy，它們使我們能夠快速實施該系統，儘管它依賴手動流程且執行時間較長。隨著我們向 vitaCare 邁進，我們顯著提升了我們的能力，與醫療工作流程無縫集成，實現電子處方，促進自動補充——對不起，自動補充以加快填充過程。

Now with Asembia, we've taken our distribution to the next level. Building on our previous advancements, Asembia offers real-time patient communication via text, complete end-to-end automation, including prior authorizations, and transparent prescription status through accessible portals to physicians and patients.

現在，有了 Asembia，我們將我們的分銷提升到了一個新的水平。在我們先前的進步的基礎上，Asembia 透過文字、完整的端到端自動化（包括事先授權）以及透過醫生和患者可存取的入口網站提供透明的處方狀態來提供即時患者通訊。

This not only streamlines the prescription process for health care providers, but also ensures the patients receive their medication promptly. Most importantly, Asembia's robust infrastructure and expansive pharmacy network position us to further (technical difficulty). These strategic enhancements embody our commitment to optimizing the GIMOTI access and signify our unwavering dedication to patient care.

這不僅簡化了醫療保健提供者的處方流程，還確保患者及時收到藥物。最重要的是，Asembia 強大的基礎設施和廣泛的藥房網絡使我們能夠進一步（技術難度）。這些策略增強體現了我們對優化 GIMOTI 訪問的承諾，並表明我們對患者護理的堅定不移的奉獻精神。

Although we've only just initiated our partnership with Asembia, also known as ASPN Pharmacies, in November of 2023, it's clear we've identified a critical lever for enhancing our (inaudible). Through refined strategy and communication and process optimization within the ASPN platform, we've seen a tangible uptick in our conversion rates.

儘管我們剛剛在 2023 年 11 月啟動了與 Asembia（也稱為 ASPN Pharmacies）的合作夥伴關係，但很明顯，我們已經找到了增強我們的服務的關鍵槓桿。（聽不清楚）。透過 ASPN 平台內的精細化策略、溝通和流程優化，我們的轉換率有了明顯的提升。

Specifically, there's been a 2% overall increase in the number of new prescriptions filled, even more impressive when we exclude and process prescriptions, and improvement jumps to 22%. Moreover, we're seeing a significant shift towards greater efficiency with a 6% increase in sales that are reimbursed without the need for our patient affordability programs, a testament to streamline process, an inherent value proposition on GIMOTI.

具體來說，新配藥的數量總體增加了 2%，當我們排除和處理處方時，效果更令人印象深刻，改善幅度躍升至 22%。此外，我們看到了向更高效率的重大轉變，銷售額增加了 6%，無需我們的患者負擔能力計劃即可報銷，這是簡化流程的證明，也是 GIMOTI 的固有價值主張。

Additionally, ASPN's focus on rapid and transparent patient communication is yielding results. With ASPN, there's been a 12% reduction in patient-initiated abandonment of prescriptions, underscoring our commitment to ensuring that patients not only start to continue their treatment with GIMOTI as appropriate.

此外，ASPN 對快速、透明的患者溝通的關注正在取得成果。透過 ASPN，患者主動放棄處方的情況減少了 12%，這突顯了我們對確保患者不僅開始酌情繼續接受 GIMOTI 治療的承諾。

These metrics are not just numbers. They represent real improvements in patient access and adherence, which are vital to our mission of providing GIMOTI to all who can benefit from it. These benefits will also fall to the bottom line.

這些指標不僅僅是數字。它們代表了患者獲取和依從性的真正改善，這對於我們向所有能夠從中受益的人提供 GIMOTI 的使命至關重要。這些好處也將落入底線。

As we fortify our commitment to ensuring GIMOTI reaches those in need, leveraging technology remains critical. By actively reminding health care professionals to write prescriptions directly to ASPN, pharmacies at the point of prescription within electronic medical records, we are addressing retail leakage effectively. Using this approach, we successfully made headway in intercepting scripts that initially intended to be prescribed to a retail pharmacy, and successfully redirected over 1,500 of them to our pharmacy, including ASPN.

當我們堅定承諾確保 GIMOTI 惠及有需要的人時，利用科技仍然至關重要。透過積極提醒醫療保健專業人員在電子病歷中的處方點直接向 ASPN、藥房開處方，我們正在有效解決零售洩漏問題。使用這種方法，我們成功地在攔截最初打算向零售藥房開處方的腳本方面取得了進展，並成功將其中 1,500 多個腳本重定向到我們的藥房，包括 ASPN。

We believe that strategic communication effort with prescribers, pharmacists and patients alike is critical cementing GIMOTI's presence in the market and improving patient outcomes. Based on this success, we have recently expanded our coverage in partnership with other EMR partners.

我們相信，與處方者、藥劑師和患者等的策略溝通工作對於鞏固 GIMOTI 在市場上的地位和改善患者的治療效果至關重要。基於這項成功，我們最近與其他 EMR 合作夥伴合作擴大了我們的覆蓋範圍。

Our messaging is now enabled in nearly half of all electronic health record systems, and we have added new partners in Dr. First and ConnectiveRx at the beginning of this month, ensuring that GIMOTI prescription pathway is even more clear and direct.

我們的訊息傳遞現已在近一半的電子健康記錄系統中啟用，並且我們在本月初增加了 Dr. First 和 ConnectiveRx 等新合作夥伴，確保 GIMOTI 處方途徑更加清晰和直接。

Now last year, we unveiled two real-world evidence studies that demonstrated the qualitative and quantitative value of GIMOTI in addressing health care resource utilization of patients with diabetic gastroparesis. Image on the left-hand side of the slide shows the inpatient hospitalizations were reduced by 68% in patients using GIMOTI compared to oral metoclopramide. And it also showed emergency department visits were similarly reduced significantly by 60% in those taking GIMOTI versus oral metoclopramide.

去年，我們公佈了兩項真實世界證據研究，證明 GIMOTI 在解決糖尿病胃輕癱患者醫療保健資源利用方面的定性和定量價值。幻燈片左側的影像顯示，與口服甲氧氯普胺相比，使用 GIMOTI 的患者住院率減少了 68%。研究還表明，與口服甲氧氯普胺相比，服用 GIMOTI 的患者在急診就診次數同樣顯著減少了 60%。

The 257 patients taking GIMOTI experienced 34 fewer hospitalizations and 84 fewer ER visits over a six-month period. That is a significant win for patients who can spend more time at home with their families or doing simple things that we all take for granted. The reductions will also be a significant win for patients.

服用 GIMOTI 的 257 名患者在六個月內住院次數減少了 34 次，急診就診次數減少了 84 次。對於患者來說，這是一個重大的勝利，他們可以花更多的時間與家人在一起或做一些我們都認為理所當然的簡單事情。這些減少對患者來說也將是重大勝利。

Amazingly, looking to the right-hand side of the slide, despite numerically larger prescription costs in the GIMOTI arm, total health care costs, which is the sum of all medical costs and pharmacy costs encounters, were significantly lower. In fact, over $15,000 lower for patients taking GIMOTI, than those taking generic oral metoclopramide over a six-month period of time.

令人驚訝的是，看看幻燈片的右側，儘管 GIMOTI 部門的處方成本在數字上較大，但總醫療保健成本（所有醫療成本和藥品成本的總和）卻明顯較低。事實上，服用 GIMOTI 的患者比六個月內服用普通口服甲氧氯普胺的患者便宜超過 15,000 美元。

These data sets reinforce GIMOTI's clinical benefits and illustrates its profound potential economic impact. The substantial reduction in hospitalization and emergency department visits speaks volumes about its role in enhancing patient daily life and reducing the burden on our health care system. Moreover, the significant cost savings highlight GIMOTI's value proposition, marking it not only is a superior treatment option, but also financially responsible choice for health care providers and patients -- payers.

這些數據集強化了 GIMOTI 的臨床效益，並說明了其深遠的潛在經濟影響。住院和急診就診人數的大幅減少充分說明了其在改善患者日常生活和減輕醫療保健系統負擔方面的作用。此外，顯著的成本節省凸顯了 GIMOTI 的價值主張，標誌著它不僅是優越的治療選擇，而且對醫療保健提供者和患者（付款人）來說也是經濟上負責任的選擇。

I would argue that this is more than a win-win. It's a new standard in the treatment of gastroparesis, setting a precedent for how we evaluate treatment, efficacy, and cost effectiveness for patients with this debilitating disease and progressive disease. No other agent, in fact, no other modality used for gastroparesis has these types of breakthrough data demonstrating outcomes.

我認為這不僅僅是雙贏。這是胃輕癱治療的新標準，為我們如何評估患有這種使人衰弱的疾病和進行性疾病的患者的治療、療效和成本效益奠定了先例。事實上，沒有其他藥物，沒有其他用於治療胃輕癱的方法具有這些類型的突破性數據來證明結果。

And so we're going to test these data with payers. In fact, we're doing that right now with insurers, PBMs, and IBMs alike through market research, and asking them how these data might impact coverage decisions. We're in the midst of wrapping up this research, but what we are hearing from payers is that our health care resource utilization data has enough provocative elements to potentially impact the coverage decisions for GIMOTI based on the same HRU data that I showed you on the previous slide.

因此，我們將與付款人一起測試這些數據。事實上，我們現在正在透過市場研究與保險公司、PBM 和 IBM 等公司合作，詢問他們這些數據可能如何影響核保決策。我們正在完成這項研究，但我們從付款人那裡聽到的是，我們的醫療保健資源利用數據有足夠的挑釁性元素，可能會影響基於我向您展示的相同 HRU 數據的 GIMOTI 承保決策上一張幻燈片。

A significant portion of payers who are not currently covering GIMOTI indicated that data presented would make them reconsider coverage decision, with 40% of them affirming outright and another 40% expressing willingness to reconsider with additional evidence of costs and savings.

目前未承保GIMOTI 的很大一部分付款人表示，所提供的數據將使他們重新考慮承保決定，其中40% 的人直接確認，另外40% 的人表示願意重新考慮，並提供額外的成本和節省證據。

Additionally, of the payers who currently do provide coverage for GIMOTI, nearly half of it would further ease the process documentation requirements for obtaining for GIMOTI. This preliminary feedback bolsters our conviction that providing robust evidence can shift perspectives. Payers are looking for more detailed analysis of cost saving drivers and peer reviewed data to underpin credibility.

此外，在目前提供 GIMOTI 保險的付款人中，近一半將進一步放寬取得 GIMOTI 的流程文件要求。這項初步回饋增強了我們的信念，即提供強有力的證據可以改變觀點。付款人正在尋求對成本節約驅動因素和同儕審查數據進行更詳細的分析，以鞏固可信度。

We recognize this need for continued evidence generation, focusing on key factors such as reduced hospitalization lengths, lower readmission rates, and the overall reduction of the prescription burden. Additionally, the reduction of burden of illness, the avoidance of unnecessary medical procedures, and assurance of safety are pivotal components that would enhance the value story in GIMOTI.

我們認識到需要持續產生證據，重點關注縮短住院時間、降低再入院率以及整體減輕處方負擔等關鍵因素。此外，減輕疾病負擔、避免不必要的醫療程序和保證安全是增強 GIMOTI 價值故事的關鍵組成部分。

Now one of the main reasons for hesitancy among providers to prescribe GIMOTI is the fact that GIMOTI carries a box warning for tardive dyskinesia, similar to what oral metoclopramide might have in their label. TD is a movement disorder that causes involuntary movements to the face or body. Certainly, it can occur with metoclopramide, but TD is more commonly associated with antipsychotic medicines.

現在，供應商對開立 GIMOTI 處方猶豫不決的主要原因之一是 GIMOTI 帶有遲發性運動障礙的框架警告，類似於口服甲氧氯普胺在其標籤中可能有的警告。TD 是一種運動障礙，會導致臉部或身體不自主運動。當然，它可能與甲氧氯普胺一起發生，但 TD 更常見於抗精神病藥物。

We've come to appreciate that TD is a mystery for gastroenterologists. We don't deal with it on a regular basis, and there is a significant gap in their understanding of TD and how often it occurs. Their apprehension is leading many to avoid using metoclopramide or reserve it for the more refractory patients.

我們逐漸認識到 TD 對於胃腸病學家來說是一個謎。我們不會定期處理它，而且他們對 TD 及其發生頻率的理解存在很大差距。他們的憂慮導致許多人避免使用甲氧氯普胺或將其保留給更難治的患者。

We need to shift this narrative from being afraid and avoiding to one of educated and monitor. We will leverage our label and the excellent information within it to help providers see that the box warning is a road map, and the label information are guardrails to help the provider avoid prescribing to patients at risk and, thereby, develop a clear understanding of the many appropriate patients who can benefit from GIMOTI.

我們需要將這種敘述從恐懼和迴避轉變為教育和監控。我們將利用我們的標籤及其中的優秀信息，幫助提供者認識到方框警告是路線圖，標籤信息是護欄，幫助提供者避免向有風險的患者開處方，從而清楚地了解許多合適的患者可以從GIMOTI 中受益。

We will update HCPs with the most recent data and guidance around the risk of TD with metoclopramide, which again, it is likely less than 1%. We will educate on which patients to avoid, and we will clarify that, to date, no TD has been reported in the clinical development program or since the launch of GIMOTI in October of 2020.

我們將向 HCP 更新有關甲氧氯普胺 TD 風險的最新數據和指南，該風險可能低於 1%。我們將教育應避免哪些患者，並將澄清，迄今為止，臨床開發計劃中或自 2020 年 10 月推出 GIMOTI 以來，尚未報告任何 TD。

We will intensify our educational efforts moving forward to ensure that providers can make informed benefit/risk assessments when considering GIMOTI for their patients. Our multipronged approach includes educating our sales team with the latest insights on tardive dyskinesia, empowering motility specialists through symposia, providing -- and providing our sales force and targeted resources. And lastly, engaging patients through their providers with education so they can make informed choices.

我們將加強我們的教育工作，以確保提供者在為患者考慮 GIMOTI 時能夠做出明智的益處/風險評估。我們的多管齊下方法包括向我們的銷售團隊提供有關遲發性運動障礙的最新見解、透過研討會為運動專家提供支援、提供我們的銷售團隊和有針對性的資源。最後，透過醫療服務提供者讓患者接受教育，以便他們能夠做出明智的選擇。

We continue to engage KOLs within gastroenterology, but importantly, have expanded to educate and inform ourselves with KOLs within psychiatry and neurology specialties, like Peter MacAllister of the New England Institute of Neurology and Headache. And this is to inform our own education efforts.

我們繼續與胃腸病學領域的KOL 合作，但重要的是，我們已經擴大到與精神病學和神經病學專業領域的KOL 一起教育和了解我們自己，例如新英格蘭神經病學和頭痛研究所的Peter MacAllister 。這是為了告知我們自己的教育工作。

Our commitment is to ensure that every stakeholder, from health care providers to patients, is fully informed about GIMOTI, thereby supporting its appropriate use and reinforcing our dedication to patient safety and well-being.

我們的承諾是確保從醫療保健提供者到患者的每個利益相關者充分了解 GIMOTI，從而支持其適當使用並加強我們對患者安全和福祉的奉獻。

With that, I'll turn the call over to Matt to review the financials and closing remarks.

這樣，我會將電話轉給馬特，以審查財務狀況和結束語。

Thanks, Chris. Once again, thanks again for everyone joining us today. I'll get right into the books of financials for the fourth-quarter and full-year and 2023 results.

謝謝，克里斯。再次感謝大家今天加入我們。我將直接查看第四季度、全年和 2023 年的財務數據。

As Dave mentioned, for the fourth quarter, net product sales were approximately $1.7 million, compared with $796,000 during the fourth quarter of 2022. And the net loss was approximately $2 million or $0.59 per share, compared with $1.8 million or $0.54 per share for the fourth quarter of 2022.

正如戴夫所提到的，第四季的產品淨銷售額約為 170 萬美元，而 2022 年第四季的淨銷售額為 79.6 萬美元。淨虧損約為 200 萬美元，即每股 0.59 美元，而 2022 年第四季的淨虧損為 180 萬美元，即每股 0.54 美元。

For the year ended December 31, 2023, net product sales were approximately $5.2 million, compared with approximately $2.5 million for the year ended December 31, 2022. And the net loss was approximately $7.8 million or $2.33 per share, as compared with a net loss of $8.2 million or $2.62 per share for the year ended December 31, 2022.

截至2023年12月31日止年度，產品淨銷售額約為520萬美元，截至2022年12月31日止年度約為250萬美元。淨虧損約為 780 萬美元，即每股 2.33 美元，而截至 2022 年 12 月 31 日止年度的淨虧損為 820 萬美元，即每股 2.62 美元。

The year-over-year increase in revenue was due to higher net product sales in 2023 resulting from prescription sales through pharmacy service partnerships with ASPN Pharmacy, as Dave and Chris elaborated earlier, we captured prescriptions sent to retail pharmacies that previously didn't have the ability to order product, and sharing with providers in the GI community the exceptional head-to-head real-world data comparing GIMOTI to oral metoclopramide showing improvements in fewer hospitalizations and ER visits with GIMOTI compared to oral.

收入同比增長是由於2023 年產品淨銷售額增加，這是透過與ASPN Pharmacy 的藥房服務合作夥伴關係進行的處方銷售所致，正如Dave 和Chris 之前闡述的那樣，我們捕獲了發送到以前沒有的零售藥房的處方。次數。

Research and development expenses totaled $23,000 for the fourth quarter of 2022, compared to $27,000 for the fourth quarter of 2023. For the full year 2022, research and development expenses were approximately $0.2 million, compared with approximately $0.3 million for the prior year.

2022 年第四季的研發費用總計為 23,000 美元，而 2023 年第四季為 27,000 美元。2022 年全年，研發費用約 20 萬美元，而前一年約 30 萬美元。

For the fourth quarter of 2023, selling, general, and administrative expenses were approximately $3.5 million, compared with $2.3 million for the fourth quarter of 2022. For the year ended December 31, 2023, selling, general and administrative expenses were approximately $12.2 million, versus approximately $9.6 million for the year ended December 31, 2022.

2023 年第四季的銷售、一般和管理費用約為 350 萬美元，而 2022 年第四季為 230 萬美元。截至2023年12月31日止年度，銷售、一般及管理費用約為1,220萬美元，而截至2022年12月31日止年度約為960萬美元。

The increase in SG&A costs year over year resulted primarily from higher marketing royalty and Eversana profit sharing costs. We expect that selling, general and administrative expenses will increase in the future as we continue to progress with the commercialization of GIMOTI and we reimburse Eversana from the net profit obtained from the sales of GIMOTI.

SG&A 成本逐年增加主要是因為行銷特許權使用費和 Eversana 利潤分享成本增加。我們預計，隨著 GIMOTI 商業化的不斷進展，未來銷售、一般和管理費用將會增加，並且我們將從銷售 GIMOTI 獲得的淨利潤中償還 Eversana。

Total operating expenses for the fourth quarter of 2023 were approximately $3.6 million, compared with $2.3 million for the same period of 2022. And for the year ended December 31, 2023, total operating expenses were approximately $12.6 million, compared with approximately $10.3 million for the full year of 2022.

2023 年第四季的總營運費用約為 360 萬美元，而 2022 年同期為 230 萬美元。截至 2023 年 12 月 31 日的年度，總營運費用約為 1,260 萬美元，而 2022 年全年約為 1,030 萬美元。

As of December 31, 2023, cash and cash equivalents were approximately $4.7 million. We believe, based on our current operating plan with the existing cash, cash equivalents, including the proceeds from the recent public offering that we executed in February of 2024, as well as future cash flows from net product sales at GIMOTI, that that will be sufficient to fund our operations into the fourth quarter of 2024.

截至2023年12月31日，現金及現金等價物約470萬美元。我們相信，根據我們現有現金、現金等價物的當前營運計劃，包括我們於 2024 年 2 月執行的最近公開發行的收益，以及 GIMOTI 淨產品銷售的未來現金流量，這將是足以為我們2024 年第第四季的營運提供資金。

While we are seeing new prescription trends increasing through February, beginning of the year typically has higher co-pay expenses for the company to cover and other discounting because of the changing coverage for patients, and patients needing to meet their deductibles and the renewals of prior authorizations.

雖然我們看到新的處方趨勢在二月份不斷增加，但由於患者承保範圍的變化，以及患者需要滿足其免賠額以及之前的續訂，年初通常需要公司承擔更高的自付費用和其他折扣。

Recently, we've also been watching the situation with Change Healthcare closely to see what impact this may have on our business. It is clear that all health care entities were impacted by this, not just pharmaceutical companies or Evoke. Although Evoke and Eversana were able to put a solution in place within a week of the change health care outage, we are hearing from our partners and other industry experts that providers' inability to check patient eligibility benefits or submit claims has started to impact new prescribing across the brands they support.

最近，我們也密切關注 Change Healthcare 的情況，看看這可能對我們的業務產生什麼影響。顯然，所有醫療保健實體都受到了影響，而不僅僅是製藥公司或 Evoke。儘管 Evoke 和 Eversana 能夠在醫療保健服務中斷發生後一周內製定解決方案，但我們從合作夥伴和其他行業專家那裡得知，提供者無法檢查患者的福利資格或提交索賠，這已開始影響新的處方他們支持的品牌。

And lastly, a new opportunity that has gained some attention over the last several months was the ongoing interest in GLP-1 agonist or our glucagon peptide agonist. Currently on the market is the association with gastroenterology side effects attributed to those products, particularly gastroparesis. We believe the increased use of GLP-1 agonist could increase the number of people suffering from gastroparesis.

最後，過去幾個月引起一些關注的新機會是人們對 GLP-1 激動劑或我們的胰高血糖素勝肽激動劑的持續興趣。目前市面上的這些產品與胃腸道副作用有關，特別是胃輕癱。我們相信增加 GLP-1 激動劑的使用可能會增加胃輕癱患者的數量。

GLP-1 receptor agonists affect glucose control through several mechanisms, including enhancement of glucose-dependent insulin secretion, slowed gastric emptying, and reduction of postprandial glucagon and food intake. Slow gastric emptying may potentially lead to symptoms similar to gastroparesis. Although definitive evidence attributing GLP-1 agonist specifically causing gastroparesis is limited, a recent study published in the Journal of American Medical Association found that the use of GLP-1s for weight loss compared with the use of bupropion/naltrexone was associated with increased risk of pancreatitis, bowel obstruction and gastroparesis.

GLP-1 受體激動劑透過多種機制影響血糖控制，包括增強葡萄糖依賴性胰島素分泌、減慢胃排空以及減少餐後升糖素和食物攝取。胃排空緩慢可能會導致類似胃輕癱的症狀。儘管GLP-1 激動劑專門導致胃輕癱的明確證據有限，但《美國醫學會雜誌》最近發表的一項研究發現，與使用安非他酮/納曲酮相比，使用GLP-1 來減肥會增加胃輕癱的風險。

While these adverse events from GLP-1s have been relatively rare, even a 1% incidence rate could have an impact on the gastroparesis market considering the gigantic population, very large population expected to be treated with GLP-1s in the future.

雖然 GLP-1 引起的這些不良事件相對罕見，但考慮到未來預計將有大量人口接受 GLP-1 治療，即使 1% 的發生率也可能對胃輕癱市場產生影響。

And with that, operator, we've completed our formal remarks, and I'll turn it over for questions.

至此，接線員，我們已經完成了正式發言，我將把它轉交給大家提問。

(Operator Instructions) Yale Jen, Laidlaw & Company.

（操作員說明）Yale Jen，Laidlaw & Company。

Hello. Good afternoon and thanks for taking the question and congrats on the performance this year. I've got two or three questions here. The first one is, as you mentioned about the ASPN Pharmacy service that has improved your distribution, you have elaborated some, but could you give a little bit more color in terms of how that will impact on 2024 versus 2023 based on your evidence?

你好。下午好，感謝您提出問題，並祝賀今年的表現。我這裡有兩三個問題。第一個是，正如您提到的 ASPN 藥房服務改善了您的分銷，您已經詳細闡述了一些內容，但是您能否根據您的證據進一步說明這將如何影響 2024 年和 2023 年？

Chris, you want to take that?

克里斯，你想接受這個嗎？

Sure. And thanks, Yale, for the question. So ASPN delivers a couple of different aspects of their platform that help us. One is through efficient communication with patients. They get more patients to return phone calls and result in fewer abandonment of prescriptions. So that is a key to -- in fact, that's the largest reason for leakage in our prescription funnel, is patients not calling us back. So they will significantly reduce that.

當然。謝謝耶魯提出的問題。因此，ASPN 提供了其平台的幾個不同方面來幫助我們。一是透過與患者的有效溝通。他們讓更多的患者回電，並減少放棄處方的情況。因此，事實上，這也是我們處方管道洩漏的最大原因，患者不會回電給我們。所以他們會大大減少這種情況。

The second thing is, is that they have strong relationships with payers and are integrated into those payer systems. So their efficiency in processing prescriptions and electronic prior authorizations is yielding a higher percentage of prescriptions that gain approval for those prior authorizations. And again, those approval prior authorizations mean increased reimbursed scripts, which certainly will help us from a revenue perspective.

第二件事是，他們與付款人有牢固的關係，並已整合到這些付款人系統中。因此，他們在處理處方和電子事先授權方面的效率提高了獲得這些預先授權批准的處方比例。再說一遍，這些事先批准意味著增加了可報銷的腳本，從收入的角度來看，這肯定會對我們有所幫助。

And the last piece, and one that we're excited about, too, is the fact that we are going to be adding pharmacies to our network through the ASPN network of pharmacies, which will give us access to pharmacies that have strong contract with payers, including Medicaid. And Medicaid is an important aspect for our growth in 2024.

最後一點，也是我們感到興奮的一點是，我們將透過 ASPN 藥房網路將藥房添加到我們的網路中，這將使我們能夠訪問與付款人簽訂了牢固合約的藥房，包括醫療補助。醫療補助是我們 2024 年成長的重要面向。

And maybe just a tack on this question, to answer here, in terms of the pharmacy, what kind of a distribution -- geographic distribution in the United States, more local or regional or more nationally?

也許只是解決這個問題，在這裡回答一下，就藥房而言，是什麼樣的分佈——美國的地理分佈，更多是本地或區域性的，還是更多是全國性的？

Our current pharmacies have coverage in all contiguous 50 states. So we have a good coverage from that perspective. As you can imagine, some states in terms of Medicaid, require you to have a local pharmacy in order to distribute the product. So that's why adding pharmacies are going to be important to us. In certain of those states, we can't deliver a prescription, even though we might have approval to do so.

我們目前的藥局涵蓋所有鄰近的 50 個州。因此，從這個角度來看，我們有很好的報導。正如您可以想像的那樣，一些州在醫療補助方面要求您擁有當地藥房才能分發產品。這就是為什麼增加藥局對我們來說很重要。在某些州，我們無法提供處方，即使我們可能已獲得這樣做的批准。

So we're strategically adding pharmacies that will augment our coverage, especially in Medicare and Medicaid.

因此，我們正在策略性地增加藥房，以擴大我們的覆蓋範圍，特別是在醫療保險和醫療補助方面。

Okay. Great. And then maybe the last question here is in terms of (inaudible) sales guidance for 2024, should we consider that as a little bit conservative? Or how should we overall think about this guidance? Thanks.

好的。偉大的。也許最後一個問題是關於 2024 年（聽不清楚）的銷售指導，我們是否應該認為這有點保守？或者我們應該如何整體考慮這個指導？謝謝。

Yeah, this is Matt. Yeah, I guess we're not going to comment further on any further guidance. We're putting that out there in terms of what we believe is doable, what we've seen in terms of growth in the past. We believe that there's -- as Chris said earlier, unlimited opportunity at this point. We haven't seen any curtailing of physicians' interest. We're in no way reaching some sort of significant market share yet with any of the targets that we're currently meeting with.

是的，這是馬特。是的，我想我們不會對任何進一步的指導發表進一步評論。我們以我們認為可行的方式以及我們過去所看到的成長方式來實現這一目標。正如克里斯之前所說，我們相信目前存在著無限的機會。我們沒有看到醫生的興趣有任何減弱。對於我們目前正在實現的任何目標，我們都還沒有達到某種重要的市場佔有率。

So we think this is appropriate and very doable, and that's what we're providing guidance at this time.

所以我們認為這是合適的並且非常可行，這就是我們目前提供的指導。

Okay. Maybe just one more question here. As you mentioned about GLP-1, gastroparesis is one of expected side effects. Just curious, up to now, have you ever treated patients that actually also taking the prescription of any of the GLP-1 whether that be subcu or oral drug? Thanks.

好的。也許這裡還有一個問題。正如您所提到的 GLP-1，胃輕癱是預期的副作用之一。只是好奇，到目前為止，您是否曾經治療過實際上也服用任何 GLP-1 處方的患者，無論是皮下藥物還是口服藥物？謝謝。

Yeah. So, Yale, it's a great question. I really appreciate you opening this up. I think it's really important for people to understand that GLP-1s, one of the key mechanisms of action -- they do several different things related to satiety curtailing, sort of the cravings and other things. But it does also clearly slow down the GI track. And by definition, delayed gastric emptying. That is what gastroparesis is.

是的。所以，耶魯大學，這是一個很好的問題。我真的很感謝你打開這個。我認為人們了解 GLP-1 非常重要，GLP-1 是關鍵的作用機制之一，它們會做一些與減少飽足感、食慾等相關的不同事情。但它也明顯減慢了胃腸道的進程。根據定義，胃排空延遲。這就是胃輕癱。

So whether or not patients who are mostly diabetic, and that's what the original indication was for, had gastroparesis beforehand, very mild perhaps. And then this addition of the GLP-1 sort of unmasked or exacerbated those issues, we're not certain exactly. And then -- or is it completely de novo new patients coming on with this. We have read stories online of some persons claiming that it's totally de novo, they had no problems beforehand. I still think it's just early days around that.

因此，大多數糖尿病患者（這就是最初的適應症）是否事先患有胃輕癱，可能非常輕微。然後，GLP-1 的添加有點暴露或加劇了這些問題，我們不確定。然後——或者說這完全是新的患者出現的。我們在網路上讀到一些人聲稱這完全是從頭開始的，他們之前沒有任何問題。我仍然認為現在還處於早期階段。

And then in terms of whether or not GIMOTI has been used with any of these patients, of course, we're not promoting for anything in that nature. We do receive prescriptions from physicians and will pursue authorization for whatever reason they so choose to write it for I myself happen to have met a nurse practitioner who did have significant symptoms associated with her own treatment of herself with Wegovy and used GIMOTI to treat herself and her symptoms with that. That was her decision, we found out after the fact.

然後，就 GIMOTI 是否已用於這些患者而言，當然，我們並不是在宣傳任何此類性質的東西。我們確實收到醫生的處方，並且無論出於何種原因都會尋求授權，他們之所以選擇寫下處方，是因為我自己碰巧遇到了一位執業護士，她確實有與她自己使用Wegovy 治療相關的明顯症狀，並使用GIMOTI 來治療自己，她的症狀與此有關。這是她的決定，我們事後才知道。

And we also are hearing from physicians at the conferences, they're asking questions about utilizing GIMOTI to help patients with these problems. Because they do -- either do have gastroparesis or mimics it very keenly. So I think physicians are starting to find their own ways to deal with these problems which may, in fact, again, be gastroparesis.

我們也在會議上聽到了醫生的意見，他們詢問有關利用 GIMOTI 來幫助患者解決這些問題的問題。因為他們確實患有胃輕癱，或非常敏銳地模仿它。所以我認為醫生開始尋找自己的方法來處理這些問題，事實上，這些問題可能又是胃輕癱。

And Yale, this is Dave. Just one thing I would point out, so this was not in our forecast assumptions for 2024, it doesn't just be upside. So I want to make sure that's clear as well.

耶魯大學，這是戴夫。我只想指出一件事，所以這並不在我們對 2024 年的預測假設中，它不僅僅是上行空間。所以我想確保這一點也清楚。

Okay. That's great. And again, congrats on quite a nice performance so far.

好的。那太棒了。再次恭喜迄今為止的出色表現。

Thank you.

謝謝。

Thank you.

謝謝。

This concludes the Q&A portion of today's call. I would now like to turn the call back over to Matt D'Onofrio for any additional or closing remarks.

今天電話會議的問答部分到此結束。我現在想將電話轉回給馬特·多諾費奧，請他發表補充或結束語。

Yeah. Thank you. Well, building on the momentum from 2023, our guidance for net revenue again is that $14 million target for 2024. And that represents nearly a threefold increase from last year. This forecast in support of our strategy, the investments, and has been central to strengthening health care providers' belief in the value of GIMOTI.

是的。謝謝。嗯，在 2023 年的勢頭基礎上，我們對 2024 年淨收入的指導再次是 1,400 萬美元的目標。比去年增加了近三倍。這項預測支持我們的策略和投資，並且對於增強醫療保健提供者對 GIMOTI 價值的信念至關重要。

Again, we continue to strive for improved execution and the breadth of depth of prescription rates while continuing to invest in the evidence that supports GIMOTI's outstanding brand. We look forward to sharing our progress over the course of the year and really appreciate you all for your continued support.

同樣，我們繼續努力提高執行力和處方率的廣度和深度，同時繼續投資於支持 GIMOTI 卓越品牌的證據。我們期待分享我們在這一年中取得的進展，並非常感謝大家的持續支持。

Thank you very much, and we'll close at this time, operator.

非常感謝您，我們將在此時關閉，接線員。

Thank you, sir. This concludes the -- I'm sorry. This concludes today's Evoke Pharma's fourth-quarter and full-year 2033 earnings call and webcast. You may disconnect your lines at this time and have a wonderful day.

謝謝你，先生。至此結束——對不起。今天 Evoke Pharma 的第四季和 2033 年全年財報電話會議和網路廣播到此結束。此時您可以斷開線路並度過美好的一天。