Vyome Holdings Inc (HIND) 2023 Q3 法說會逐字稿

Good afternoon, and thank you for joining the ReShape Lifesciences third quarter 2023 conference call. I I'd now like to turn the call over to Michael Miller from Rx Communications.

下午好，感謝您參加 ReShape Lifesciences 2023 年第三季電話會議。我現在想將電話轉給 Rx Communications 的 Michael Miller。

Good afternoon, and thank you for joining the ReShape Lifesciences third quarter 2023 earnings call. I'm pleased to be joined today by Paul Hickey, President and Chief Executive Officer; and Thomas Stankovich, Chief Financial Officer.

下午好，感謝您參加 ReShape Lifesciences 2023 年第三季財報電話會議。我很高興今天與總裁兼執行長 Paul Hickey 一起出席會議。和首席財務官托馬斯·斯坦科維奇。

Paul will provide an overview and update on the company's activities, which will include a discussion with Dr. Caroline Apovian, a member of ReShape's Scientific Advisory Board. Then Thom will review the financial results for the period. I'll then turn the call back over to Paul for some closing remarks, after which we'll open the call to a question and answer session.

Paul 將提供公司活動的概述和最新信息，其中包括與 ReShape 科學顧問委員會成員 Caroline Apovian 博士的討論。然後湯姆將審查該期間的財務業績。然後，我會將電話轉回給保羅，讓他發表一些結束語，然後我們將開始電話問答環節。

As a reminder, this conference call as well as ReShape Lifesciences SEC filings and website, including the investor information section of the website contains forward-looking statements within the meaning of the Private Securities Litigation Reform Act of 1995.

謹此提醒，本次電話會議以及 ReShape Lifesciences 的 SEC 文件和網站（包括網站的投資者資訊部分）包含 1995 年《私人證券訴訟改革法案》含義內的前瞻性陳述。

Actual results could differ materially from those discussed due to known and unknown risks, uncertainties and other factors. These and additional risks and uncertainties are described more fully in the company's filings with the Securities and Exchange Commission, including those factors identified as risk factors in the company's most recent Annual Report on Form 10-K. As an additional reminder, ReShape's stock is listed on NASDAQ trading under the symbol RSLS.

由於已知和未知的風險、不確定性和其他因素，實際結果可能與討論的結果有重大差異。這些以及其他風險和不確定性在公司向美國證券交易委員會提交的文件中進行了更全面的描述，包括公司最新的 10-K 表年度報告中確定為風險因素的因素。額外提醒一下，ReShape 的股票在納斯達克上市，交易代號為 RSLS。

I'll now turn the call over to Paul Hickey, President and CEO of ReShape.

現在我將把電話轉給 ReShape 總裁兼執行長 Paul Hickey。

Paul?

保羅？

Thank you, Mike, and thanks to all of you for joining us this afternoon for our third quarter 2023 earnings call. After I provide an overview and update on ReShape's activities, will be joined by a member of our Scientific Advisory Board, Dr. Caroline Apovian, Co-Director at the Center for Weight Management and Wellness in the Division of Endocrinology, Diabetes and Hypertension at Brigham and Women's Hospital in Boston, and a Professor of Medicine at Harvard Medical School.

謝謝麥克，也謝謝大家今天下午參加我們的 2023 年第三季財報電話會議。在我對 ReShape 活動進行概述和更新後，我們的科學顧問委員會成員、布里格姆大學內分泌、糖尿病和高血壓科體重管理和健康中心聯合主任 Caroline Apovian 博士將加入我們的行列。波士頓婦女醫院和哈佛醫學院的醫學教授。

As an expert in key opinion leader in her field, I've asked Dr. Apovian to provide her clinical viewpoint related to GLP-1 and their impact on the care continuum for obesity.

作為該領域關鍵意見領袖的專家，我請 Apovian 博士提供她與 GLP-1 相關的臨床觀點及其對肥胖症護理連續性的影響。

So most important takeaway from this call is for all of our investors to understand that we remain dedicated to achieving profitability by executing our growth strategies and maintaining our emphasis on creating a shareholder value.

因此，這次電話會議最重要的收穫是讓我們所有的投資者明白，我們仍然致力於透過執行成長策略和保持對創造股東價值的重視來實現盈利。

Yesterday, I visited with surgeons from one of our centers of excellence in Louisville, Kentucky. Now then lap into Louisville, this site has implemented the Hive platform and also as part of our co-op marketing program. Despite the pressures from GLP-1 adoption, this center is on pace to have year-over-year, Lap-Band procedural growth in 2023. Validating that our marketing initiatives are working. There's much look forward to as we move towards 2024, and we are optimistic about the growth potential for the company.

昨天，我拜訪了肯塔基州路易斯維爾的一個卓越中心的外科醫生。現在進入路易斯維爾，該網站已經實施了 Hive 平台，也是我們合作行銷計劃的一部分。儘管面臨 GLP-1 採用的壓力，該中心仍有望在 2023 年實現 Lap-Band 程序的同比增長。驗證我們的行銷計劃正在發揮作用。邁向 2024 年，我們充滿期待，我們對公司的成長潛力感到樂觀。

Before I recap our third quarter and subsequent highlights, I'd like to comment on important events occurring within the obesity market today. As most of you already understand the global obesity market is growing at an alarming rates and carries with it.

在回顧第三季和後續亮點之前，我想對當今肥胖市場中發生的重要事件發表評論。正如你們大多數人已經了解的那樣，全球肥胖市場正在以驚人的速度成長，並隨之而來。

Significant medical repercussions and associated economic costs of obesity remains a complex lifelong disease that requires personalized treatment to ensure long-term weight loss goals are achieved. I'm sure you are also aware of the growing popularity of GLP-1 agonists that have brought significant benefits to those suffering from type 2 diabetes and help those who are obese.

肥胖帶來的重大醫療影響和相關的經濟成本仍然是一種複雜的終身疾病，需要個人化治療以確保長期減重目標。我相信您也知道 GLP-1 激動劑的日益普及，它為第 2 型糖尿病患者帶來了顯著的益處，並幫助了肥胖者。

We believe that GLP-1 adoption is expanding the medical weight loss market by vastly reducing the stigma that often occurs around obesity and medical intervention, including bariatric surgery. The GLP-1 related big pharma marketing efforts and resulting adoption has helped increase the numbers of people seeking medical attention for this disease, especially by those who have avoided surgery in the past.

我們相信，GLP-1 的採用正在擴大醫療減肥市場，大大減少了圍繞肥胖和醫療幹預（包括減肥手術）經常出現的恥辱感。 GLP-1 相關大型製藥公司的行銷努力和由此產生的採用幫助增加了因這種疾病尋求醫療護理的人數，特別是那些過去避免手術的人。

Given the increasing body of evidence pointing to the fact that weight loss through the GLP-1 usage has limitations related to comorbidities and accessibility. We believe that the market opportunity for the Lap-Band will increase.

鑑於越來越多的證據表明，透過使用 GLP-1 來減肥存在與合併症和可及性相關的限制。我們相信 Lap-Band 的市場機會將會增加。

From a continuum of care perspective, individuals with obesity and GLP-1 therapy are likely potential candidates for Lap-Band bariatric surgery as the next viable anatomy, preserving weight-loss treatment. Certainly, I will have Dr. Apovian speak to her personal experience, which is representing what we are hearing from physicians across the US that the GLP-1 adoption, while potentially delaying surgical consults in the short term is increasing the number of patients who would consider bariatric surgery.

從連續照護的角度來看，肥胖且接受 GLP-1 治療的個體可能是 Lap-Band 減重手術的潛在候選者，作為下一個可行的解剖結構，保留減重治療。當然，我會讓Apovian 博士談談她的個人經歷，這代表了我們從美國各地的醫生那裡聽到的情況，即GLP-1 的採用雖然可能會在短期內延遲手術諮詢，但會增加需要接受手術的患者數。考慮減重手術。

In other words, once GLP-1 agonists, patients get a taste of weight loss, yet have issues with the drug's accessibility, durability or tolerance. They will contemplate bariatric surgery, especially imminent ways surgery procedures like the Lap-Band.

換句話說，一旦使用 GLP-1 激動劑，患者就會嚐到減肥的滋味，但會遇到藥物的可及性、持久性或耐受性問題。他們會考慮減重手術，尤其是像膝帶式手術這樣迫在眉睫的手術方式。

Now before I introduce Dr. Apovian, let me take a few minutes to update you on our progress related to our three primary growth pillars. As I recall, our first pillar is to operate our business with a disciplined metrics-driven approach to drive predictable revenue expansion, through a sustainable and scalable business model.

現在，在介紹 Apovian 博士之前，請允許我花幾分鐘時間向您介紹我們在三個主要成長支柱方面取得的最新進展。我記得，我們​​的第一個支柱是採用嚴格的指標驅動方法來經營我們的業務，透過可持續和可擴展的業務模式推動可預測的收入擴張。

The second is to continue to expand our product portfolio and pipeline across the care continuum. And our last or third pillar is to continue to validate our evidence base weight loss solutions, leveraging our Scientific Advisory Board for key insights on strategic initiatives.

第二是繼續擴大我們的產品組合和管道，涵蓋整個護理領域。我們的最後一個或第三個支柱是繼續驗證我們的證據基礎減肥解決方案，利用我們的科學諮詢委員會獲得有關戰略舉措的關鍵見解。

Our first pillar remains paramount for reshape to deliver shareholder value and ultimately profitability. As we consider the impact of GLP-1 adoption for weight-loss treatment, which has put pressure on several markets, including bariatrics, it was necessary to take a hard look at our operations, make significant cost reductions while ensuring growth and that our company adheres to key P&L metrics.

我們的第一個支柱對於重塑以實現股東價值和最終獲利能力仍然至關重要。當我們考慮採用GLP-1 對減肥治療的影響時，這給包括減肥治療在內的多個市場帶來了壓力，因此有必要認真審視我們的運營，在確保增長的同時大幅降低成本，並且我們公司遵守關鍵損益指標。

Thom will later detail the expense savings we have identified, realized and are planning for. But in summary, we have identified and implemented effective November 1, cost reductions totaling approximately $8 million, representing more than a 40% reduction in operating expenses for 2024.

Thom 稍後將詳細介紹我們已確定、實現和計劃節省的費用。但總而言之，我們已確定並實施了自 11 月 1 日起生效的成本削減總額約為 800 萬美元，相當於 2024 年營運費用減少了 40% 以上。

We are optimizing our marketing spending while making additional reductions in consulting services, totaling approximately $2.4 million. We have also executed a reduction in force of approximately $1.2 million. We have decided to temporarily pause our reshape care program and achieve an estimated savings of $0.8 million, while we continued our efforts to secure a self-insured employer to provide ReShape care to their employees.

我們正在優化行銷支出，同時進一步削減諮詢服務費用，總計約 240 萬美元。我們也削減了約 120 萬美元的兵力。我們決定暫時暫停我們的 ReShape 護理計劃，預計節省 80 萬美元，同時我們繼續努力確保有自我保險的雇主為其員工提供 ReShape 護理。

We have also planned for a $0.9 million of reductions for incentive compensation and other payroll-related amounts. All part of streamlining our team significantly, but without affecting revenue. Our Board is aligned with our strategy and will also take a 50% reduction in their compensation.

我們還計劃削減 90 萬美元的激勵薪酬和其他與工資相關的金額。所有這些都顯著精簡了我們的團隊，但不影響收入。我們的董事會與我們的策略保持一致，也將減少 50% 的薪酬。

Taken together, these reductions will allow us to focus and invest in our growth drivers, while at the same time extending our cash runway. These changes are bold, necessary and indicative to our commitments to our first growth pillar, I established late in 2022. In point of fact, with these 2024 reductions, the company's core operating expense reductions between 2022 and 2024 are estimated at $22 million, or 70%.

總而言之，這些削減將使我們能夠專注並投資於我們的成長動力，同時擴大我們的現金跑道。這些變化是大膽的、必要的，並體現了我們對我在2022 年末建立的第一個成長支柱的承諾。事實上，透過2024 年的這些削減，公司在2022 年至2024 年間的核心營運費用預計將減少2200 萬美元，或70%。

In addition to the necessary cost reduction initiatives related to our first growth pillar, we made significant progress with our newly improved digital lead generation and patient engagement campaign. As I mentioned earlier, with Lap-Band Louisville, we have seen an increase in the quality of patient needs while successfully reducing costs in targeted markets for our surgeon advocates operate.

除了與我們的第一個成長支柱相關的必要的成本削減措施外，我們還透過新改進的數位潛在客戶開發和患者參與活動取得了重大進展。正如我之前提到的，透過 Lap-Band Louisville，我們看到患者需求品質的提高，同時成功降低了我們外科醫生倡議者在目標市場的成本。

In particular, our exclusive partnership with high medical allows us to advance lead optimization software that can enhance patient engagement and increase patient volume. This software utilizes AI, SMS, patient self-service technology, which in combination with our targeted direct-to-consumer marketing campaign, helps individuals effortlessly overcome new patient intake challenges. As a result patients can easily book appointments with medical professionals at any time.

特別是，我們與高醫療的獨家合作夥伴關係使我們能夠推進先導優化軟體，該軟體可以提高患者參與度並增加患者數量。該軟體利用人工智慧、簡訊、患者自助服務技術，與我們有針對性的直接面向消費者的行銷活動相結合，幫助個人輕鬆克服新的患者接收挑戰。因此，患者可以隨時輕鬆預約醫療專業人員。

Let's now discuss our progress executing our second growth pillar. We are well positioned with our current FDA approved Lap-Band system, which provides a minimal invasive long-term treatment for obesity and is safe for surgical alternative to more invasive weight loss surgeries.

現在讓我們討論一下我們執行第二個成長支柱的進展。我們目前已獲得 FDA 批准的 Lap-Band 系統處於有利位置，該系統為肥胖提供微創長期治療，並且可以安全地替代更具侵入性的減肥手術。

This past June, we filed a PMA supplement with the FDA for the next-generation Lap-Band 2.0 Flex. This product has been designed with physician feedback in order to improve the patient experience. Like the current Lap-Band, the Lap-Band 2.0 Flex can be adjusted post-operatively to increase or decrease the band opening depending on the patient's tolerance to ban therapy.

今年 6 月，我們向 FDA 提交了下一代 Lap-Band 2.0 Flex 的 PMA 補充文件。該產品的設計考慮了醫生的回饋，以改善患者體驗。與目前的 Lap-Band 一樣，Lap-Band 2.0 Flex 可以在術後進行調整，根據患者對禁止治療的耐受性來增加或減少帶子的開口。

Additionally, Lap-Band 2.0 Flex has a new feature called Flex technology, which acts as a relief valve, enabling larger pieces of food to pass through the narrow passage more easily. Specifically the Band momentarily relaxes before returning to its resting diameter while minimizing discomfort caused by swallowing large pieces of food.

此外，Lap-Band 2.0 Flex 還具有名為 Flex 技術的新功能，可充當安全閥，使較大的食物更容易通過狹窄的通道。具體來說，帶子會暫時放鬆，然後恢復到其靜止直徑，同時最大限度地減少吞嚥大塊食物引起的不適。

We anticipate approval from the FDA by year end or early 2024. We believe, based on surgeon feedback that our Lap-Band 2.0 Flex will be a growth catalyst for the company's Lap-Band franchise once approved. Also of note, in September, we signed an exclusive royalty-bearing license agreement with Biorad to manufacture, commercialize and distribute the Obalon Gastric Balloon System in India, Pakistan, Bangladesh, Nepal, Bhutan, Sri Lanka, and the Maldives.

我們預計將於年底或 2024 年初獲得 FDA 的批准。我們相信，根據外科醫生的反饋，一旦獲得批准，我們的 Lap-Band 2.0 Flex 將成為該公司 Lap-Band 特許經營權的成長催化劑。另外值得注意的是，9 月，我們與 Biorad 簽署了獨家特許權使用費許可協議，在印度、巴基斯坦、孟加拉、尼泊爾、不丹、斯里蘭卡和馬爾地夫製造、商業化和分銷 Obalon 胃氣球系統。

The license agreement provides for $200,000 in upfront payments from Biorad to ReShape and ongoing license payments of 4% on a gross sales of the Obalon Balloon System in the territories. The agreement is important as it represents the first step towards re-introducing our patented Obalon Balloon System.

該授權協議規定 Biorad 向 ReShape 支付 200,000 美元的預付款，並根據 Obalon 氣球系統在這些地區的總銷售額的 4% 進行持續許可付款。該協議非常重要，因為它代表了重新引入我們專利的 Obalon 氣球系統的第一步。

And we believe that Biorad, with decades of experience manufacturing, distributing medical devices in the vast [cell-data] the Asia market potentially reaching approximately 20% to 25% of the world's population as an ideal partner to expand the reach of our technology. We expect this agreement will lay the groundwork catalyzed the successful relaunch and commercialization of the Balloon System in markets worldwide.

我們相信，Biorad 擁有數十年的製造經驗，在亞洲廣闊的[細胞數據]市場中分銷醫療設備，有可能覆蓋全球約 20% 至 25% 的人口，是擴大我們技術覆蓋範圍的理想合作夥伴。我們預計該協議將為推動氣球系統在全球市場的成功重新推出和商業化奠定基礎。

By given the scope of our second growth pillar to expand our portfolio and global distribution, we have recently engaged the Maxim Group on an exclusive basis to identify strategic merger and acquisition opportunities that provide synergistic partnerships. Engaging Maxim and executing on this initiative is very high priority for me and the ReShape Lifesciences.

鑑於我們的第二個成長支柱的範圍是擴大我們的產品組合和全球分銷，我們最近與 Maxim 集團獨家合作，以確定提供協同合作夥伴關係的策略併購機會。對我和 ReShape Lifesciences 來說，讓 Maxim 參與並執行這項計畫是非常重要的。

As for our third growth pillar, we continue to work closely with our Scientific Advisory Board or SAB comprise an internationally recognized experts and surgeons in the obesity and metabolic disease fields. The SAB is fully engaged in helping us develop our launch strategy for our Lap-Band 2.0 Flex and marketing our suite of weight-loss solutions.

至於我們的第三個成長支柱，我們繼續與我們的科學顧問委員會（SAB）密切合作，該委員會由肥胖和代謝疾病領域的國際公認專家和外科醫生組成。 SAB 全力幫助我們制定 Lap-Band 2.0 Flex 的推出策略並行銷我們的減重解決方案套件。

At this time, I'd like to introduce Caroline Apovian from Brigham Women's Hospital and Harvard Medical School. As previously mentioned, Dr. Apovian is a member of our Scientific Advisory Board and has been a key opinion leader and an expert in the field of bariatric surgery for decades. She's also nationally recognized experts on nutrition, metabolism and obesity medicine.

這次我想介紹一下來自布萊根婦女醫院和哈佛醫學院的卡洛琳‧阿波維安（Caroline Apovian）。如前所述，Apovian 博士是我們科學顧問委員會的成員，數十年來一直是減重手術領域的關鍵意見領袖和專家。她也是全國公認的營養、新陳代謝和肥胖醫學專家。

Caroline, I'd like to ask you given to everyone your background and then discuss your view on the recent changes in the field of obesity treatment, including the adoption of GLP 1 and the overall impact you feel they will have on that surgical procedures available today.

卡羅琳，我想請您向大家介紹一下您的背景，然後討論您對肥胖治療領域最近變化的看法，包括 GLP 1 的採用以及您認為它們將對現有外科手術產生的總體影響今天。

But also like to hear about your experience with combination therapies comprising GLP 1 and other gastric surgeries, including Lap-Band to help those who plateaued with their weight loss. Dr. Apovian.

但也想聽聽您使用包括 GLP 1 和其他胃部手術在內的聯合療法的經驗，包括幫助那些體重減輕達到穩定水平的人的 Lap-Band 手術。阿波維安博士。

Thanks, Paul. Good afternoon. As Paul mentioned, I am the co-director of the Center for Weight Management and Wellness in the Division of Endocrinology, Diabetes and Hypertension is Brigham and Women's Hospital. And I'm a Professor of Medicine at Harvard Medical School.

謝謝，保羅。午安.正如保羅所提到的，我是布萊根婦女醫院內分泌、糖尿病和高血壓科體重管理和健康中心的共同主任。我是哈佛醫學院的醫學教授。

My interest in obesity began 35 years ago when I was a fellow in Nutrition & Metabolism at the New England Deaconess Hospital after completing my internal medicine residency there. I was lucky and honored to have studied under George Blackburn. So he's considered the father of nutrition and obesity medicine. And since that time, I have focused completely on obesity and nutrition.

我對肥胖的興趣始於 35 年前，當時我在新英格蘭女執事醫院完成內科住院醫師實習，擔任營養與代謝科的研究員。我很幸運也很榮幸能夠在喬治·布萊克本的指導下學習。因此他被認為是營養和肥胖醫學之父。從那時起，我就完全專注於肥胖和營養。

Obesity is a disease and its many serious complications exert a heavy toll in both human and economic terms. More than a third of adults in the United States have obesity back in 42% of the population, and they are subject to elevated rates of type 2 diabetes, Hypertension, Dyslipidemia and Cardiovascular disease.

肥胖是一種疾病，其許多嚴重併發症對人類和經濟造成沉重損失。在美國，超過三分之一的成年人患有肥胖症，佔總人口的 42%，他們患有第 2 型糖尿病、高血壓、血脂異常和心血管疾病的幾率也很高。

The 42% of Americans who suffer from obesity with a BMI over 30 will likely go on to develop type 2 diabetes and heart disease. The negative effect on quality of life is enormous. GLP-1 and other we call them news is nutrient simulated hormonal therapy are having a tremendous positive impact in that more people than ever are asking about treatment for their obesity.

42% 的 BMI 超過 30 的肥胖美國人可能會繼續患上第 2 型糖尿病和心臟病。對生活品質的負面影響是巨大的。 GLP-1 和其他我們稱為營養模擬荷爾蒙療法的新聞正在產生巨大的積極影響，因為比以往任何時候都有更多的人詢問肥胖治療。

We have learned almost all that we know about GLP-1 and other [gut] hormones from our experience with bariatric surgery. Which works by altering the secretion of gut hormone. In addition, we've learned from laparoscopic banding that the use of GLP-1 and other new initiatives would be complementary with the Lap-Band to facilitate long lasting weight loss.

我們從減肥手術的經驗中了解到了關於 GLP-1 和其他[腸道]激素的幾乎所有知識。它透過改變腸道激素的分泌來發揮作用。此外，我們從腹腔鏡束帶中了解到，GLP-1 和其他新措施的使用將與 Lap-Band 相輔相成，以促進持久的減肥。

We're utilizing as many of the GLP agonists as we can, is there analogs of naturally occurring gut hormone that can be helpful in reducing body weight by now up to 20%. And even more since today, approval by the FDA of [Zap] about.

我們正在盡可能地利用 GLP 激動劑，是否有天然腸道激素的類似物可以幫助減輕體重高達 20%。甚至從今天起，[Zap] 就獲得了 FDA 的批准。

Unfortunately, insurance companies and the government haven't kept up with the science and don't really embrace obesity as a disease. So these powerful drugs are not ubiquitously covered and they're certainly not covered by Medicare or Medicaid. In just the last year at our center for Weight Management Wellness at the Brigham, we've seen more than 10,000 unique patients just on the medical end. So not bariatric surgery, [embarrassing] endoscopy, but the medical weight management and saw 10,000 patients.

不幸的是，保險公司和政府沒有跟上科學的步伐，並沒有真正將肥胖視為一種疾病。因此，這些強效藥物並沒有普遍覆蓋，而且它們當然也不在醫療保險或醫療補助範圍內。就在去年，我們在布里格姆的體重管理健康中心就診了超過 10,000 名獨特的患者。所以不是減重手術，[尷尬的]內視鏡檢查，而是醫療體重管理，並看到了 10,000 名患者。

I believe that the utilization of GLP-1, the new shares will ultimately increase the number of patients who would consider surgery. In other words Well, first of all, we're the 10,000 patients are certainly coming and seeking medical treatments but I'm able to convince those patients with BMIs over 40 over 35, but more than I used to that surgery really is a better option for them. And I'm seeing this anecdotally over the past six months.

我相信，新股 GLP-1 的利用最終將增加考慮手術的患者數量。換句話說，首先，我們有 10,000 名患者肯定會來尋求治療，但我能夠說服那些 BMI 超過 40 超過 35 的患者，但比我以前認為手術確實更好他們的選擇。在過去的六個月裡，我看到了一些軼事。

And also once patients are new just yet, understand that they can lose weight by altering the gut hormone and they feel so much better. Again, yet have issues with accessibility, durability, tolerability thereof. They may contemplate bariatric surgery more often, and we are seeing this to be true. And that includes minimally invasive procedures like the lab there.

而且，一旦患者剛開始接觸，就知道他們可以透過改變腸道荷爾蒙來減肥，而且感覺好多了。再次，還存在其可訪問性、耐用性、耐受性的問題。他們可能會更頻繁地考慮減肥手術，我們認為這是事實。這包括像那裡的實驗室那樣的微創手術。

And we have been able to convince many patients with BMIs over 40 that surgery met remains their best option, and we're seeing this again in the last six months or so since certainly -- since the advent of Wegovy and Mounjaro.

我們已經能夠讓許多 BMI 超過 40 的患者相信手術仍然是他們的最佳選擇，而且自從 Wegovy 和 Mounjaro 出現以來，我們在過去六個月左右的時間裡再次看到了這一點。

Now, even though this is true, bariatric surgery is still underutilized in the United States, only 1% of patients eligible for the surgery, get the procedure done annually 250,000 procedures done annually. If the same thing happened with Cardiac surgery, we would say this was negligent, but the problem is overlooked with coping city. Bariatric surgery is like getting your gallbladder out, but patients feel they have the erroneous idea that this is aggressive surgery and that people regain their weight, which of course is not true.

現在，儘管事實如此，減肥手術在美國仍未充分利用，只有 1% 的患者符合手術資格，每年完成手術 25 萬例。如果同樣的事情發生在心臟手術上，我們會說這是疏忽，但應對城市卻忽略了這個問題。減重手術就像切除膽囊一樣，但患者認為他們有錯誤的想法，認為這是一種激進的手術，人們的體重會恢復，這當然不是事實。

Many patients, also don't see their obesity as a disease. The nurses are helping patients understand that they have a disease because they take the medication, they feel full for the first time in their lives. And if they want to continue feeling that way and losing more weight, they understand now -- that they are understanding more and more we consider bariatric surgery, including the Lap-Band.

許多患者也不認為肥胖是一種疾病。護士們正在幫助患者了解他們患有疾病，因為他們服用了藥物，他們有生以來第一次感到飽足。如果他們想繼續保持這種感覺並減輕更多體重，他們現在就明白了——他們越來越了解我們考慮的減肥手術，包括腹帶手術。

In order to effectively treat obesity it's imperative. The combination of interventions such as diet, exercise, medications like are nutritious, endoscopy and bariatric surgery, including the Lap-Band being employed at different stages of a patient's weight loss through.

為了有效治療肥胖，勢在必行。飲食、運動、營養藥物、內視鏡檢查和減重手術等介入措施的組合，包括在患者減重的不同階段使用的膝帶。

Combination therapy, including GLP 1 and uses for those who plateau with their weight loss from bariatric surgery will help individuals get back on track, that said to ensure patients receive the appropriate treatment it's crucial for medical and surgical societies to collaborate on the development of guidelines that stratify patients based on BMI and determine which medications and procedures can be used alone or in combination.

聯合療法，包括GLP 1 以及用於那些因減肥手術而體重減輕達到穩定水平的患者，將幫助個人回到正軌，也就是說，為了確保患者接受適當的治療，醫學界和外科界合作制定指南至關重要根據體重指數對患者進行分層，並確定哪些藥物和程序可以單獨使用或合併使用。

I certainly hope that these insights that I have got now from my 35 years of experience and most importantly, over the past few years, hope that these insights have been helpful and look forward to answering questions later during the call. I'll pass the call back to Paul.

我當然希望我現在從 35 年的經驗中獲得的這些見解，最重要的是，在過去幾年中，希望這些見解能夠有所幫助，並期待在稍後的電話會議中回答問題。我會把電話轉回給保羅。

Well, thank you, Caroline. That was -- I think it hit the spot and I think that was appreciated by the listeners, and I'm sure there'll be questions for you. But as a leader in your field, I truly appreciate your participation and hearing your opinions firsthand. So before I turn it over time, just a few more thoughts based on what you heard so far. We do remain very confident that with our Lap-Band and expected future offering in the Lap-Band 2.0 Flex.

好吧，謝謝你，卡洛琳。那是——我認為它擊中了要害，我認為聽眾對此表示讚賞，我相信你們會有問題。但作為您所在領域的領導者，我真誠地感謝您的參與並親自聽取您的意見。因此，在我將其轉述之前，請根據您到目前為止所聽到的內容再提出一些想法。我們對我們的 Lap-Band 和預期的 Lap-Band 2.0 Flex 未來產品仍然非常有信心。

That we, as a company are uniquely positioned with the least invasive safest and most durable weight option for those patients that have historically had an aversion to medically managed weight loss and surgery.

作為一家公司，我們擁有獨特的定位，為那些歷來厭惡藥物管理減重和手術的患者提供侵入性最小、最安全、最持久的減重選擇。

Given the growing body of evidence pointing to the fact that weight loss due to GLP-1 usage has limitations related co-morbidities and accessibility. We believe that the market opportunity for Lap-Band will increase. And from a continuum of care perspective, these patients are likely potential candidates for bariatric surgery as a next viable weight loss treatment.

鑑於越來越多的證據表明，使用 GLP-1 導致的體重減輕具有與併發症和可及性相關的限制。我們相信 Lap-Band 的市場機會將會增加。從連續護理的角度來看，這些患者可能是減重手術的潛在候選者，作為下一個可行的減重治療方法。

I'd now like to turn the call over to Thom Stankovic to provide a recap of our financial performance.

現在，我想將電話轉給湯姆·斯坦科維奇（Thom Stankovic），讓他回顧一下我們的財務表現。

Thom?

湯姆？

Thanks, Paul. And once again, thank you all for joining our webcast this afternoon. As a reminder, a full discussion of our financials is available in our press release and 10-Q. As Paul mentioned earlier in November and in response to continued pressure on the company's revenue caused by the adoption of GLP-1, we are reorganizing the company.

謝謝，保羅。再次感謝大家今天下午參加我們的網路廣播。謹此提醒，我們的新聞稿和 10-Q 中提供了有關我們財務狀況的完整討論。正如 Paul 在 11 月早些時候提到的，為了應對因採用 GLP-1 對公司收入造成的持續壓力，我們正在重組公司。

I've identified cost reductions of approximately $8 million or more than 40% just for 2024 alone. Specifically a reduction in force of approximately $1.2 million in November and December and $300,000 more budgeted cost phasing in early 2024, as well as $900,000 of reductions in incentive compensation and other payroll related amounts have been implemented across all expense categories.

我已確定僅 2024 年成本就減少了約 800 萬美元或超過 40%。具體而言，所有費用類別均已在 11 月和 12 月減少約 120 萬美元的人力，並在 2024 年初分階段預算成本增加 30 萬美元，並減少激勵薪酬和其他工資相關金額 90 萬美元。

Core operating costs in total have been reduced by approximately $5.4 million, which includes reductions in selling and marketing costs of $2.4 million without affecting our continued marketing spend optimization costs related to the pause of ReShape care about $800,000.

核心營運成本總共減少了約 540 萬美元，其中包括銷售和行銷成本減少了 240 萬美元，但不影響我們與暫停 ReShape 護理相關的持續行銷支出優化成本約 80 萬美元。

Expenses related to G&A totaled $1.3 million, primarily in professional consulting fees and insurance costs. R&D expense grew $900,000, which primarily includes consulting and reduced admin fees. Additionally, third quarter 2023 core operating expenses were 37% lower than the third quarter of 2022.

與 G&A 相關的費用總計 130 萬美元，主要是專業諮詢費和保險費。研發費用增加了 90 萬美元，其中主要包括諮詢費用和減少的管理費用。此外，2023 年第三季核心營運支出比 2022 年第三季低 37%。

Taken it all together with actions thus far, we've made significant progress reducing our core operating expenses, cutting approximately $22 million or 70% between 2022 and 2024. A full discussion of our actual financials is available in today's press release and 10-Q.

綜上所述，加上迄今為止採取的行動，我們在減少核心營運支出方面取得了重大進展，在2022 年至2024 年間削減了約2200 萬美元或70%。有關我們實際財務狀況的完整討論，請參閱今天的新聞稿和10-Q 。

So I will just take over a moment. I will just take a moment to review key financial metrics for the third quarter ended September 30, 2023. Our revenue totaled $2.2 million for the three months ended September 30, 2023, which represents a reduction of $600,000 compared to the same period in 2020. Growing popularity of GLP-1 prescription drugs for weight loss treatment is the primary reason for the decrease in sales volume in the US and internationally.

所以我只佔用一點時間。我將花點時間回顧截至2023 年9 月30 日的第三季的關鍵財務指標。截至2023 年9 月30 日的三個月，我們的收入總計220 萬美元，與2020 年同期相比減少了60 萬美元。用於減肥治療的 GLP-1 處方藥的日益普及是美國和國際銷售下降的主要原因。

We have focused our new marketing strategies through targeted and AI supported digital media campaigns near bariatric surgery centers while reducing cost and increasing efficiencies. We expect that these efforts will come to fruition during the fourth quarter of 2023 and beginning of 2024.

我們透過在減重手術中心附近進行有針對性的、人工智慧支援的數位媒體活動來集中我們的新行銷策略，同時降低成本並提高效率。我們預計這些努力將在 2023 年第四季和 2024 年初取得成果。

Our continued focus on increasing demand for the Lap-Band system and recently launched three new sizes of calibration tools will grow revenues. Additionally, we anticipate receiving FDA approval for the Lap-Band 2.0 Flex late this year or early in 2024, followed by a US product launch that should contribute to increased sales going forward.

我們繼續關注對 Lap-Band 系統日益增長的需求，並於最近推出了三種新尺寸的校準工具，這將增加收入。此外，我們預計 Lap-Band 2.0 Flex 將於今年底或 2024 年初獲得 FDA 批准，隨後在美國推出產品，這將有助於增加未來的銷售量。

Gross profit for the three months ended September 30, 2023 was $1.3 million compared to $2.1 million for the same period in 2022, a decrease of $800,000. Gross profit as a percentage of total revenue for the three months ended September 30, 2023 was 60% compared to 75% for the same period in 2022.

截至 2023 年 9 月 30 日止三個月的毛利為 130 萬美元，較 2022 年同期的 210 萬美元減少了 80 萬美元。截至2023年9月30日止三個月的毛利佔總營收的百分比為60%，而2022年同期為75%。

The decrease in gross profit percentage is due to the decrease in sales volume, primarily related to GLP-1 drugs coming to market. Nevertheless, it is the highest gross margin percentage in any quarter this year as some of our cost reductions have had a positive impact on gross margins during the third quarter.

毛利率下降是由於銷量下降，主要與GLP-1藥物上市有關。儘管如此，這是今年任何季度中最高的毛利率百分比，因為我們的一些成本削減對第三季的毛利率產生了積極影響。

Sales and marketing expenses for the three months ended September 30, 2023 decreased by $800,000 to $1.8 million compared to $2.6 million for the same period in 2022. The decrease of $800,000 is primarily due to a decrease in advertising and marketing expenses as we re-evaluated our marketing approach and have moved to a targeted digital marketing campaign.

截至2023 年9 月30 日止三個月的銷售和行銷費用減少80 萬美元，至180 萬美元，而2022 年同期為260 萬美元。減少80 萬美元主要是由於我們重新評估後廣告和行銷費用減少我們的行銷方法已轉向有針對性的數位行銷活動。

General and administrative expenses for the three months ended September 30, 2023 decreased by $1.7 million to approximately $2.1 million, compared to $3.8 million for the same period in 2022. The decrease is primarily due to a reduction in payroll-related expenses and personnel changes and reductions in professional services.

截至 2023 年 9 月 30 日止三個月的一般及行政費用減少 170 萬美元，至約 210 萬美元，而 2022 年同期為 380 萬美元。減少的主要原因是工資相關費用和人事變動的減少以及專業服務的減少。

Additionally, other reductions included intangible asset amortization as the company impaired its finite intangible assets during the fourth quarter of 2022, and a decrease in rent and insurance costs for the expired lease of our former Carlsbad, California location.

此外，其他減少包括無形資產攤銷，因為該公司在 2022 年第四季度損害了其有限的無形資產，以及我們前加州卡爾斯巴德地點的到期租約的租金和保險費用的減少。

Research and development costs for the three months ended September 30, 2023 remained consistent with the same period in 2022. Well, the -- and Professional Services. Non-GAAP adjusted EBITDA loss was $2.9 million for the three months ended September 30, 2023, compared to a loss of $4.2 million for the same period last year.

截至 2023 年 9 月 30 日的三個月的研發成本與 2022 年同期保持一致。嗯，還有專業服務。截至 2023 年 9 月 30 日的三個月，非 GAAP 調整後 EBITDA 虧損為 290 萬美元，而去年同期虧損為 420 萬美元。

We ended the quarter with $1.5 million of cash and cash equivalents and remain debt-free on our balance sheet with a $2.8 million in net proceeds from our recent public offering in October and the cost reductions detail during the call, we will preserve cash and extend the company's cash runway. As we finish 2023 and move into 2024, we anticipate our revenues increasing and a continued reduction in our operating expenses.

本季末，我們擁有150 萬美元的現金和現金等價物，資產負債表上保持無債務狀態，我們最近10 月份的公開發行獲得了280 萬美元的淨收益，電話會議期間我們還詳細介紹了成本削減細節，我們將保留現金並延長公司的現金跑道。隨著 2023 年結束並進入 2024 年，我們預計我們的收入將增加，營運費用將持續減少。

With that, I will now turn the call back over to Paul.

現在，我將把電話轉回給保羅。

Thank you, Thom. Before we open the call up for Q&A, it's important to reiterate as both Thom and I have detail that we have and will continue to significantly reduce operating expenses across all categories, so we can invest in our growth initiatives.

謝謝你，湯姆。在我們開始問答之前，有必要重申一下，因為 Thom 和我都了解我們已經並將繼續大幅減少所有類別的營運費用，以便我們可以投資於我們的成長計劃。

The bold steps we have taken to reorganize the company will help to ensure sustainability and scalability. We continue to prioritize investments, including marketing automation to support scalable lead acquisition segment and consumer centric messaging be an updated website for improved patient engagement and a frictionless booking system with qualified providers while further reducing lead generation costs. Taken together, we expected to increase Lap-Band procedures and ultimately revenue.

我們為重組公司所採取的大膽步驟將有助於確保永續性和可擴展性。我們繼續優先考慮投資，包括支援可擴展的潛在客戶獲取細分市場的營銷自動化，以及以消費者為中心的消息傳遞，更新的網站以提高患者參與度，以及與合格提供者的無摩擦預訂系統，同時進一步降低潛在客戶生成成本。總而言之，我們預計會增加 Lap-Band 程序並最終增加收入。

We will continue to develop and offer a portfolio that is differentiated from the competition with transformative technologies that consist of selection of patient friendly, non-anotomy changing lifestyle enhancing products, programs and services that provide alternatives to a more invasive bariatric surgeries to help patients achieve healthy, durable weight loss.

我們將繼續開發和提供一個在競爭中脫穎而出的變革性技術產品組合，其中包括選擇患者友好、非解剖性改變生活方式的增強產品、計劃和服務，為更具侵入性的減肥手術提供替代方案，幫助患者實現健康、持久的減重。

At the same time, we will continue to work with our world-class scientific advisory board to continue to execute on our plan for success in a global market that is changing in historic fashion to normalize safe and effective treatments for obesity.

同時，我們將繼續與世界一流的科學顧問委員會合作，繼續執行我們的計劃，以在全球市場中取得成功，這個市場正在以歷史性的方式發生變化，使安全有效的肥胖治療正常化。

This concludes our prepared remarks, so now we would like to open the call to your questions. Operator?

我們準備好的演講到此結束，現在我們想開始回答你們的問題。操作員？

Thank you. (Operator Instructions)

謝謝。 （操作員說明）

Anthony Vendetti, Maxim Group.

安東尼文代蒂，馬克西姆集團。

Thank you. Thanks for that overview, Paul, and for also Dr. Caroline Apovian. That was very helpful to hear your view. Maybe starting with Dr. Apovian, Obviously, there's a lot of news around the GLP-1 today, Lilly's was approved for weight loss or obesity.

謝謝。感謝 Paul 的概述，也感謝 Caroline Apovian 博士。聽到你的觀點非常有幫助。也許從 Apovian 博士開始，顯然，今天有很多關於 GLP-1 的消息，禮來公司被批准用於減肥或肥胖。

And there's also as you discussed, there's comorbidities, there is a potential adverse side effects we don't know at what level at this point, right? other than what the studies are showing. And we'll I guess we'll find out over the next 12 or 24 months as this rolls out. What is your expectation. It's obviously impacting sales for the Lap-Band from bariatric procedures as patients and consumers decide tried something new.

正如您所討論的，還有合併症，還有潛在的不良副作用，我們目前不知道其程度如何，對嗎？除了研究顯示的內容之外。我想我們會在接下來的 12 或 24 個月內隨著它的推出而找到答案。你的期望是什麼。隨著患者和消費者決定嘗試新的東西，這顯然會影響減肥手術的 Lap-Band 的銷售。

Do you think it's a 12 month process before they realize maybe a the cost or the side effects for some of them are not worth it, is it two to three years before some of that sort of data starts to set in or are some of the apathy for GLP 1? Maybe it starts to set in or the initial sort of shiny new toy starts to wear off it. What's your best guess on have certainly your guess is much better than mine, but what's your best estimate as to when all this sort of plays out? And then just trying to get a good understanding of that.

您是否認為這是一個 12 個月的過程，然後他們才意識到其中一些人的成本或副作用不值得？是兩到三年之後，某些此類數據開始出現，還是某些數據開始出現？對GLP 1 的冷漠？也許它開始生效，或者最初那種閃亮的新玩具開始磨損。你的最佳猜測是什麼？當然你的猜測比我的好得多，但是對於所有這些事情何時發生，你的最佳估計是什麼？然後只是試著很好地理解這一點。

Yeah. Well, what I'm seeing, we have five doctors, three nurse practitioners, two PAs and RD in our medical practice, obesity medicine. We saw 10,000 new patients last year. What's coming via the decrease in bariatric surgery, came from COVID, first of all. The COVID numbers went down, as you all know, are starting to recover, and but part of it is most, I don't see the decrease in bariatric surgery. I am seeing an increase.

是的。嗯，據我所知，我們的醫療實踐、肥胖醫學領域有五名醫生、三名執業護士、兩名 PA 和 RD。去年我們接待了 10,000 名新患者。減重手術減少所帶來的影響首先來自新冠疫情。眾所周知，新冠病毒感染人數有所下降，正在開始恢復，但其中大部分是，我沒有看到減肥手術的減少。我看到了成長。

Well, bariatric surgeons in my practice are telling me there's a decrease, but it takes a while for that 10,000 patients we saw last week just in the medical arm. We'll get through the program. We have 4,500 patients on our waiting list just for medical treatment. They're trying to get in and they have to wait eight months to one year. You see one of our medical practice providers.

嗯，我診所的減重外科醫生告訴我，人數有所減少，但對於我們上週在醫療部門看到的 10,000 名患者來說，這需要一段時間。我們會完成這個計劃。我們的等候名單上有 4,500 名患者只是等待治療。他們試圖進入，但必須等待八個月到一年。您會見我們的一位醫療實踐提供者。

Why is that? There aren't enough obesity medicines specialist in the United States to the quell this is demand. Therefore, all the great new newshes, that's fantastic but the primary care providers can't -- they don't have the resources in your practices to prescribe. Because of the prior authorization headache, which requires new FTE just to process the prior obligations.

這是為什麼？美國沒有足夠的肥胖藥物專家來滿足這種需求。因此，所有偉大的新消息都很棒，但初級保健提供者卻不能——他們在您的實踐中沒有資源來開處方。由於事先授權令人頭疼，因此需要新的 FTE 來處理事先的義務。

And then they don't know how to give the drug. They don't know how to provide diet and exercise. So it's a big -- the primary care is just don't have resource. So it's relegated to obesity medicine specialist. There only 6,500, 7,000 obesity medicine specialists in the United States.

然後他們不知道如何給藥。他們不知道如何提供飲食和運動。所以這是一個大問題——初級保健只是沒有資源。所以它被歸類為肥胖醫學專家。美國祇有6,500、7,000名肥胖醫學專家。

So what I'm trying to say here is that we all have a backlog. And once the patient gets in over the past six months, what I have seen and my colleagues have seen is that we are able to get them in as a new patient and we give them the patients with a BMI over 40 or over 35.

所以我想說的是我們都有積壓的事情。一旦患者在過去六個月內進入，我和我的同事所看到的是，我們能夠將他們作為新患者納入進來，並為他們提供 BMI 超過 40 或超過 35 的患者。

We're looking them in the face and saying, I know you want to go on Wegovy, I can't give you Wegovy. There's a shortage. Plus when the shortage is relieved. Yes, I can give you Wegovy, you realize you're going to have to be on it for the rest of your life and you're going to get a 16% weight loss.

我們看著他們說，我知道你想繼續使用 Wegovy，但我不能提供你 Wegovy。有短缺。再加上當短缺得到緩解時。是的，我可以給你 Wegovy，你意識到你將不得不終生服用它，並且你的體重將減輕 16%。

Or I guess I lost 15 pounds on Wegovy and I want to lose more. Your BMI 50, the way you're going to lose more is bariatric surgery until I'm able with all of these patients because of a shortage, because of the fact that they realize, that they need to be on an injection for the rest of their life or because of they got weight loss.

或者我想我在 Wegovy 上減掉了 15 磅，而且我想減掉更多。你的體重指數為 50，你會失去更多的方法是減肥手術，直到我能夠治療所有這些由於短缺而導致的患者，因為他們意識到，他們需要注射剩下的時間他們的生活或因為他們減肥了。

And they got the 16% weight loss that Wegovy can give, but not more. And in a patient needs to lose 100 to 150 pounds, that's not going to work. So I'm able now to convince the patient to get a consultation with one of our bariatric surgeons, and we have 10 of them and they have appointments next week, where is I have an 8 months to 12 months waiting list.

他們得到了 Wegovy 可以提供的 16% 的減肥效果，但也沒有更多。對於需要減重 100 到 150 磅的患者來說，這是行不通的。所以我現在可以說服病人去諮詢我們的一位減肥外科醫生，我們有 10 位減肥外科醫生，他們下週有預約，我有一個 8 個月到 12 個月的等待名單。

Okay.

好的。

All right. So what's happening, but it's good -- yes, you're right, it's going to take some time to get the patient through. On top of that, we have the laparoscopic adjustable gastric band. I have always wanted to combine the Lap-Band with a GLP-1 and now a news because now we have, [Zep bound] and we have double duals and triples coming down the pike.

好的。所以發生了什麼，但它是好的 - 是的，你是對的，需要一些時間才能讓病人度過難關。最重要的是，我們有腹腔鏡可調節胃束帶。我一直想將 Lap-Band 與 GLP-1 結合起來，現在這是一個新聞，因為現在我們有了，[Zep 綁定]，我們有雙雙和三雙。

Because then you get the restriction of the Lap-Band with the change in gut hormone [Millio] with the multitude of new shows that are coming down the pike. So this is going to provide a less, let's say, less aggressive form of surgery with a medication that can hopefully achieve weight losses of more than 20% or more than 25%.

因為隨著腸道激素[Millio]的變化以及大量即將推出的新節目，你會受到圈帶的限制。因此，這將提供一種較不激進的手術形式，並使用藥物有望實現體重減輕超過 20% 或超過 25%。

(multiple speakers) That's very helpful. So in the situations where they want to lose the patient's goal is to lose more than 16% or 20%, do you how often do you recommend bariatric surgery versus the Lap-Band with the GLP-1? And are there instances right now where you're just recommending the Lap-Band without the GLP and then you can do the GLP-1 later. I'm just wondering how are you right now guiding or advising your patients.

（多名發言者）這非常有幫助。因此，在他們希望患者減重超過 16% 或 20% 的情況下，與使用 GLP-1 的 Lap-Band 相比，您建議減重手術的頻率是多少？現在是否有這樣的情況：您只是推薦 Lap-Band 而沒有 GLP，然後您可以稍後再執行 GLP-1。我只是想知道您現在如何指導或建議您的患者。

But it runs the gamut. Because what you need to understand about our center is we have bariatric surgery, but we also have bariatric endoscopy with Chris Thompson, the world leader in endoscopic devices and procedures. So but within bariatric endoscopy, we are definitely and with bariatric surgery, it definitely adding GLP-1 to both of endoscopic and bariatric surgery procedures.

但它涵蓋了所有領域。因為您需要了解我們中心的一點是，我們有減肥手術，但我們也有克里斯·湯普森（Chris Thompson）的減肥內視鏡檢查，克里斯·湯普森是內視鏡設備和手術的世界領先者。因此，但在減重內視鏡檢查中，我們肯定會在內視鏡和減重手術中添加 GLP-1。

What we are, what -- and the Lap-Band, what I do recommend initially is? If you're going for bariatric surgery, uses a sleeve gastrectomy or the electrostatic adjustable band and certainly not -- , or even the endoscopic procedures.

我們是什麼，我最初推薦的 Lap-Band 是什麼？如果您打算進行減肥手術，請使用袖狀胃切除術或靜電可調帶，當然不使用，甚至內視鏡手術。

We don't add a [new] right away. We wanted because we don't want to get excessive weight loss because you're going to lose muscle and fat. Lose muscle and fat anyway, especially with the more aggressive bariatric surgery procedures like the bypass, even the sleeve. The sleeve, the bypass and the [biliopanic] to diversion, you're losing almost half muscle. Because you're losing it so fast.

我們不會立即新增[新]。我們想要這樣做是因為我們不想過度減肥，因為你會失去肌肉和脂肪。無論如何，都要減掉肌肉和脂肪，尤其是採用更積極的減重手術，例如搭橋手術，甚至是袖套手術。袖子、旁路和[膽怯]轉移，你幾乎失去了一半的肌肉。因為你失去它的速度太快了。

You don't want to do that, that causes sarcopenia and a lower resting energy expenditure and it's there. And those patients don't do well, what you want to do is get a good amount of weight loss with one procedure if you're going to use the procedure. And then when you place tau either [plateau] or you don't lose as much as you want it, which is often the case or you do great. But then a year later, you regain some weight, then you add the new.

你不想這樣做，這會導致肌肉減少症和較低的靜止能量消耗，它就在那裡。而那些患者的情況並不好，如果您打算使用該手術，那麼您想要做的是透過一次手術獲得大量的體重減輕。然後，當你將 tau 蛋白放置在[穩定期]時，或者你沒有失去你想要的那麼多時，這種情況經常發生，或者你做得很好。但一年後，你的體重又恢復了一些，然後你又增加了新的體重。

Okay. So you don't want to do anything at once.

好的。所以你不想立刻做任何事。

(multiple speakers)

（多個發言者）

This is Paul and Dr. Apovian, I thank you for that type of all the answers you provided. I wanted to add one more point. Maybe you can add to it as well. When in terms of the numbers of people that you're saying, just kind of reminding and I know we've talked about this before where there's as mentioned during the call, there's only 1% of the people that in prior years, decades, 1% that could have surgery are seeking out surgery.

我是 Paul 和 Apovian 博士，我感謝你們提供的所有此類答案。我想再補充一點。也許你也可以添加它。就你所說的人數而言，只是提醒一下，我知道我們之前已經討論過這個問題，正如電話中提到的那樣，只有 1% 的人在前幾年、幾十年裡， 1% 可以接受手術的人正在尋求手術。

And our belief is and I think that's what Dr. Apovian was a firming there's more people now beyond that 1% that are seeking care specific with the GLP 1 being as popular with the big marketing push from big pharma. And then it's the timing, I know that I love to have an answer to right, but the timing for nationwide on average centers that are unlike Brigham and Women's and the Center of Excellence that Dr. Apovian has formed over the years, I'm sure has ways of managing their timetable that are completely different across the board.

我們的信念是，我認為這就是 Apovian 博士所致力於的，現在有超過 1% 的人正在尋求特定護理，GLP 1 與大型製藥公司的大力行銷推廣一樣受歡迎。然後是時機，我知道我喜歡有一個正確的答案，但是全國平均中心的時機與布萊根婦女醫院和 Apovian 博士多年來建立的卓越中心不同，我是肯定有完全不同的管理時間表的方法。

As you look at smaller centers and centers that are less apt to have all the experience that you get out at the Brigham and our only counter to kind of the GLP-1 marketing push is our marketing efforts, which I think I noted briefly that the one center that was one of our three pilots, back in a Louisville.

當您看到較小的中心和中心時，它們不太可能擁有您在 Brigham 獲得的所有經驗，而我們對 GLP-1 營銷推動的唯一反擊是我們的營銷努力，我想我簡要地指出了一個中鋒是我們三名飛行員之一，坐在路易斯維爾的一架飛機上。

Actually coming in with more procedure growth this year than last year with Lap-Band, based on the fact that they are now doing the marketing are doing the things that we put in place and it's working. So that's exciting for us.

事實上，今年 Lap-Band 的程式成長比去年更多，因為他們現在正在做行銷，正在做我們所做的事情，而且效果很好。這對我們來說是令人興奮的。

But Caroline, would you agree that you would have more pent-up demand for people that are coming in to see you this year than versus previous years because of what's happened the last six months.

但是卡羅琳，你是否同意，由於過去六個月發生的事情，與往年相比，今年對來看你的人會有更多被壓抑的需求。

There's no doubt. There's really no doubt that we're seeing patients many more patients than we used to because of the media attention on obesity, not just the medications, but just the fact that the patients are finally realizing, doctors are. But it's the patients, who need to understand what they have is not shameful.

毫無疑問。毫無疑問，我們接診的患者比以前多得多，因為媒體對肥胖的關注，不僅僅是藥物，而是患者最終意識到，醫生也是如此。但患者需要明白，他們擁有的東西並不可恥。

That's what I said on 60 minutes, it's the shame that stops people from going to see the doctor about their obesity and this is finally ending because we're finally understanding that if there is a pill, or an injection that can help you lower your body weight set point, it can't be a matter of willpower, because it's not. And that's what's changed.

這就是我在 60 分鐘裡所說的，這是一種恥辱，阻止人們因肥胖而去看醫生，這一切終於結束了，因為我們終於明白，是否有一種藥片或註射劑可以幫助您降低體重設定點，這不可能是意志力的問題，因為它不是。這就是改變的地方。

And that's why we can get patients in because they're looking for medication, but suddenly they're amendable and open to the idea of bariatric surgery. I'm not hearing any more like I used to, oh doc, I don't want that surgery, I know I can do it on my own. I'm not hearing that any more.

這就是為什麼我們可以讓病人進來，因為他們正在尋找藥物，但突然間他們變得願意接受減肥手術的想法。我不再像以前那樣聽到，哦醫生，我不想做那個手術，我知道我可以自己做。我不再聽到這個了。

Okay. That's great.

好的。那太棒了。

And that's a godsent.

這是天賜之物。

Okay, great. That's very helpful. And obviously, it sounds like your center is a center of excellence and you have a line and a huge backlog of patients. And but shifting gears, Paul, maybe just on two other points here.

好的，太好了。這非常有幫助。顯然，聽起來您的中心是一個卓越的中心，並且您有一個隊列和大量積壓的患者。但保羅，換個角度，也許只是在其他兩點。

The agreement is signed the exclusive royalty bearing agreement with Bio-Rad metastasis, the private company for the overland gastric balloon system. Where is that in terms of being rolled out, is that something that's going to be rolled out before the end of the year, or are they going to start selling that in 2024 and maybe just any other expectations around that agreement?

該協議是與 Bio-Radmetastasis（生產陸路胃氣球系統的私人公司）簽署的獨家特許權使用費協議。就推出而言，它會在哪裡推出？是否會在今年年底之前推出，或者他們是否會在 2024 年開始銷售，也許只是圍繞協議的任何其他期望？

Yes, I think a Bio-Rad have aggressive as aggressive goals there. The project has kicked off in terms of we signed the agreement and we've got the two teams from Bio-Rad and from reshape engaging in, as you'd expect, sort of the weekly, the appropriate cadence of project meetings.

是的，我認為 Bio-Rad 在那裡有同樣激進的目標。該專案在我們簽署協議後就已啟動，來自 Bio-Rad 和 reshape 的兩個團隊如您所料，以每週一次的適當步調參與專案會議。

And they have aggressive time lines that they've stated. I think the knowledge transfer could take longer in terms of getting what we know over into their hands so they can execute the production. And then beyond the production, it's about verification, validation of their process. So that has the same level of global quality that is needed to pass metastasis with the regulatory bodies worldwide. So I'd expect that I think we're all pushing to do something this year and to have, I'm sorry, we're sitting here now in November it's we're pushing to get something done this year.

他們已經聲明了緊迫的時間表。我認為知識轉移可能需要更長的時間才能將我們所知道的知識交到他們手中以便他們能夠執行生產。除了生產之外，還涉及流程的驗證和確認。因此，它具有與全球監管機構通過轉移所需的相同水平的全球品質。所以我預計今年我們都在努力做一些事情，很抱歉，我們現在在 11 月坐在這裡，我們正在努力在今年完成一些事情。

I think we're now looking at something that has to be in the first part of next year. But yes, the both sides are eager to get. So initially, Bio-Rad get this product produced and get it done the right way. So we can start the next Phase of this. But I'll definitely keep you updated on progress and milestones as we define them and have some predictability to it. I'm going to be, I won't be shy about sharing those with you.

我認為我們現在正在考慮一些必須在明年上半年完成的事情。不過是的，雙方都渴望得到。因此，最初，Bio-Rad 生產了該產品並以正確的方式完成。所以我們可以開始下一階段。但我一定會及時向您通報進度和里程碑的最新情況，因為我們定義了它們並對其具有一定的可預測性。我會，我不會羞於與你分享這些。

Okay, excellent. And then on the cost cutting $8 million in 2024, is that going to are there going to be some one-time charges in the fourth quarter that we're in right now to account for that and if so, do you have, your time have a hand of what that might be?

好的，非常好。然後，關於 2024 年削減 800 萬美元的成本，我們現在正在處理的第四季度是否會產生一些一次性費用，如果是的話，您有時間嗎？有可能是什麼？

Thanks, Anthony.

謝謝，安東尼。

Yes, sure, absolutely. Yes, I we're not anticipating any big charges in Q4 as a result of all of this. And then if there were they would be one-time in nature. But as of as right now, I'm not expecting anything in the millions of dollars, if you will.

是的，當然，絕對是。是的，我們預期第四季不會因此而產生任何大額費用。如果存在的話，它們本質上也是一次性的。但就目前而言，如果你願意的話，我並不期待數百萬美元。

So the answer your question directly, no, I'm not expecting anything material. Will there be some? Yes, you can imagine that there, but there would be some costs related to new when you do a reduction in force, there's most likely going to be some severance costs and those types of things. So we'll accrue for all of that during Q4 for.

所以直接回答你的問題，不，我不期待任何實質的東西。會有一些嗎？是的，你可以想像，但是當你減少兵力時，會產生一些與新產品相關的成本，很可能會產生一些遣散費和此類費用。因此，我們將在第四季度累積所有這些費用。

Okay, great. Thank you for all that information. And I'll hop back in the queue greatly.

好的，太好了。感謝您提供所有這些資訊。我會大大地跳回到隊列中。

Thank you. And this concludes our question and answer session. I would now like to turn the conference back over Paul Hickey for any closing remarks.

謝謝。我們的問答環節到此結束。現在我想將會議轉回由保羅·希基發表閉幕詞。

Great. Thank you. I hope that you value our transparency and consistency of what we've expressed during this call. And that's you're able to appreciate are enhancing the efficiency and reliability of our company through the revamping of the organization to continue our quest to grow shareholder value as a sustainable and scalable company.

偉大的。謝謝。我希望您重視我們在這次電話會議中所表達的透明度和一致性。您可以體會到，我們透過組織重組來提高我們公司的效率和可靠性，以繼續追求作為一家可持續發展和可擴展的公司來增加股東價值。

We will continue to work diligently to build on our commitment to provide evidence-based personalized devices and therapeutic. As we remain optimistic about the long-term growth potential for the company.

我們將繼續努力工作，兌現我們提供基於證據的個人化設備和治療的承諾。我們對公司的長期成長潛力保持樂觀。

A special thanks to Dr. Apovian for participating in today's call. As always, I want to thank all of our current and past employees. Our Board members, customers, consultant advisers, suppliers, existing and new shareholders for your continued support of ReShape as we progress on our mission to become the premier physician-led weight loss company. I look forward to continuing to engage with our stakeholders, health care partners and shareholders.

特別感謝 Apovian 博士參加今天的電話會議。一如既往，我要感謝我們所有現任和過去的員工。我們的董事會成員、客戶、顧問顧問、供應商、現有和新股東，感謝您對 ReShape 的持續支持，幫助我們實現成為一流的醫生主導的減肥公司的使命。我期待繼續與我們的利害關係人、醫療保健合作夥伴和股東合作。

This conference has now concluded. Thank you for attending today's call, you may now disconnect. Everyone have a great day.

本次會議現已結束。感謝您參加今天的電話會議，您現在可以斷開連接。每個人都度過了愉快的一天。