Seeking Alpha
We cover over 5K calls/quarter
Profile| Send Message|
( followers)  

NPS Pharmaceuticals, Inc. (NASDAQ:NPSP)

Special Call

October 17, 2012 8:30 a.m. ET

Executives

Susan Mesco - Senior Director, IR and Corporate Communications

Francois Nader - President and Chief Executive Officer

Analysts

Salveen Richter - Canaccord Genuity

Eun Yang - Jefferies

Joseph Schwartz - Leerink Swann

David Friedman - Morgan Stanley

Alan Carr - Needham & Company

Carol Werther - Summer Street Research Partners

David Nierengarten - Wedbush Securities

Ed Arce - MLV & Co.

Operator

Good day, ladies and gentlemen, and welcome to the NPS Pharmaceuticals Inc. Conference Call to discuss Gattex update. My name is Diana and I’ll be the operator for today. At this time all participants are in a listen-only mode. Later we will conduct a question-and-answer session. (Operator instructions)

As a reminder this conference is being recorded for replay purposes. I’d now like to turn the conference over to your, Susan Mesco, Senior Director, Investor Relations and Corporate Communications. Please proceed.

Susan Mesco

Thank you. Welcome to our conference call to discuss yesterday’s advisory committee meeting for Gattex. Before we start, let me remind you that today’s call may include forward-looking statements based on current expectations. Such statements represent our judgment as of today and may involve risks and uncertainties. Please refer to our filings with the SEC which are available from the SEC or our website for information concerning the risk factors that could affect the company.

I will now turn the call over to Dr. Francois Nader, our President and Chief Executive Officer.

Francois Nader

Thank you, Susan. Good morning and welcome to those joining us. Yesterday, the FDA’s Gastrointestinal Drugs Advisory Committee met to review and discuss our data for Gattex in adult short bowel syndrome. We were very very pleased that the committee unanimously affirmed our long standing belief in the favorable benefit risk profile for Gattex for adult short bowel syndrome.

As discussed during the meeting, patients with short bowel syndrome desperately need new treatment options, specifically a long-term therapy that can help them improve absorption of nutrients and fluid and reduce or even eliminate their reliance on parenteral nutrition. We are confident that the panel’s endorsement will lead to having Gattex become the first and only FDA approved long-term therapy for short bowel syndrome.

We are also very excited to report at yesterday’s meeting that five additional patients achieved independence from parenteral nutrition while on Gattex in STEPS 2, as you recall our 24 month open label study. We now have a total of 12 patients or at least one of every seven patients in STEPS 2 who were able to completely discontinue parenteral nutrition. We also had three patients that were successful weaned off parenteral nutrition support while on 0.5 milligram per kilo per day of Gattex during our earlier Phase 3 study.

It is truly remarkable that these patients recovered their independence from parenteral nutrition after being hooked to central line for up to 25 years. What we find particularly encouraging is that ten of the 15 patients were able to discontinue PN after a year or more on Gattex, reinforcing the positive effect of the long-term use of the drug.

With these new exciting data and unanimous review by the Ad Com, we are confident that Gattex will be approved by year-end. In addition, we continue to believe that Gattex represents a compelling market opportunity given the strength of the data and the significant unmet medical need. Our commercial build out is taking place in a gated fashion. Yesterday’s successful vote will trigger the hiring of several key additional positions, including regional leadership positions for the field force, key account managers and NPS Care coordinators who will offer personalized services to each Gattex patient. We will also begin recruiting talent for the NPS field force with offers contingent upon approval of Gattex.

I would like to take a moment to thank the patients, their families and the investigators who participated in our clinical trials. We certainly appreciate their ongoing support. I would also like to thank the FDA’s staff and the members of the Ad Com for the opportunity to present our Gattex clinical program and discuss its potential use as a long-term treatment for SBS. In addition, we are grateful to the physician experts, patient advocacy groups, patients and caregivers, who spoke yesterday and underscored the unmet need in short bowel syndrome.

And importantly, I would like to recognize the hard work of the NPS clinical and regulatory teams in preparing for the panel. Our success is a testament to their relentless commitment to bringing Gattex to the patients who need it. Our PDUFA date for the Gattex NDA is December 13, and we look forward to continuing our interactions with the FDA over the coming weeks as we move forward discussing our proposed risk management program which includes, as you heard yesterday, our label, the REMS, the educational program and SBS registry.

With that we will now open the call to your questions.

Question-and-Answer Session

Operator

(Operator Instructions) Your first question will come from the line of Salveen Richter, Canaccord Genuity.

Salveen Richter - Canaccord Genuity

Congrats on panel yesterday. Just wanted to get a sense of when you are able to launch post-approval and where you stand with identifying new patients into the launch and partnering with home-infusion groups.

Francois Nader

Yeah, this is an ongoing process. We will continue identifying patients until the D-day when we launch, and certainly for many days thereafter. It’s an interesting challenge and we are in the process of continuing our discussions, negotiations with the home infusion companies, so we will be updating. The launch, frankly, the launch date will very much depend on the labeling and the REMS. And the type of (inaudible) issuer requirements that the REMS will impose on us. So stay tuned, this is something that we will update you on -- probably on our earnings call coming up early November.

Operator

Your next question comes from the line of Eun Yang, Jefferies.

Eun Yang - Jefferies

Congratulations too, it’s a great news. So the question is, identifying patient is one thing but I think, it seems to me that getting patients to reimbursed is not that hard. So once you identify patients and getting them reimbursed through your patient assist process, how long do you think they would take?

Francois Nader

That’s a very good question because frankly we believe that the reimbursement is one of the very very interesting challenges that the rare disease business has. And we are looking at this challenge from two different perspective. You have the perspective of the payer and you have the perspective of the patient. So I will address the payer’s first.

As I have said it now for over a year, we are taking the payer’s aspect of reimbursement very seriously. We have engaged the payers in an ongoing conversation and we are in the process of finalizing our value proposition to the payers. The market continues to show that the price is inelastic. There is certainly a willingness to reimburse Gattex. But we are also cognizant of the challenges and the hurdles that the payers might put in place.

The other aspect of the payers has to do with time. Not all payers have a quick turnaround time when it comes to listing -- I mean listing products on their formulary. And therefore it will take a number of months to get the top payers enrolled, involved in the process of reimbursing Gattex. The other aspect has to do also with Medicare. 40% of our patients, or an estimated 40% could be Medicare patients. And therefore this follows another track. All this to say that we will be ready. We have a top notch professional team in place at NPS dedicated to reimbursement. And this is something that I am very confident that we will achieve sometime in time.

The other aspect though that is probably as important if not more, is the patient’s aspect. In our studies of other rare diseases, at times patients are challenged by insurance companies and frankly do not have the courage or the strength to go through the motion and through the process of securing reimbursement. And this is where our NPS care coordinators kick in and they would assist and support the patients one on one during this process of reimbursement. So it’s a dual approach which will take a little bit of time as you know. But we are ready and we will be ready to make sure that these patients have access to Gattex in a very systematic fashion.

Eun Yang - Jefferies

Now the (inaudible) when you mentioned that you are continuously identifying patients eligible for Gattex. It’s estimated there are 10,000 to 15,000 patients in the U.S. During the process, do you see that that’s the right number or right prevalence in the United States or could it be smaller or larger?

Francois Nader

We believe that the 10,000 to 15,000 which we triangulated in three or four different market research is the right prevalence number. And this is a number that the FDA used yesterday in their interactions. We however draw a distinction between prevalence and addressable population. Based on experience we have with orphan diseases it appears that in virtually all cases there is a difference between the prevalence and the addressable population. So additionally, the addressable population is much smaller than the prevalence. And the addressable population is really defined as a bottom-up approach where your (inaudible) your [MSL] and the other options that we have start with identifying one patient at a time.

And this is what we are focusing on now because the prevalence give us, if you will, an overall number. But the work that the team has been doing now for many months is the bottom-up approach and identifying prescribers and patients really one at a time.

Eun Yang - Jefferies

Any estimate as to what the addressable patient population might be?

Francois Nader

We don’t have an estimate now. This is work in progress and we don’t have a final number.

Operator

Your next question comes from the line of Joseph Schwartz, Leerink Swann.

Joseph Schwartz - Leerink Swann

I was wondering how long do you think patients have to be on PN in the real world before they are candidates for Gattex. I think your studies, it was around a year or at least but there was some discussion at the panel about whether that needs to be observed. And it would seem to me that if you were able to get patients on Gattex closer to their last event, they might be the most motivated and most able to benefit from the drug.

Francois Nader

Joe, that’s a very good question. So there are probably at least two, maybe three answers to your question. So in our clinical studies, you are absolutely right, patients should have been on parenteral nutrition for at least a year. Okay. Now in clinical practice what we are hearing from surgeons and gastroenterologists, they consider in general that [chronicity] began after six months. And I think Dr. (inaudible) said yesterday that when one of his patient has been on parenteral nutrition for six months the probability of being weaned of course went down pretty dramatically. So we have already two numbers.

I would say that the third number will really come from the labeling that we will negotiate with the agency, and the limitation that the agency might or might not put on defining the patients. Because this will have a direct impact and correlation to reimbursement and payers. Usually payers tend to follow the label pretty strictly and therefore we need to make sure that -- I mean the patients are reimbursed for Gattex. So this is one of the many elements that we will be negotiating with the agency between now and December 30.

As you have seen it from the slides that the FDA projected yesterday. They tend to refer to the indication as adult short bowel syndrome. And we will see how this definition will evolve. Would it evolve to chronically dependent on parenteral nutrition or not, and if it evolves to chronically dependent on parenteral nutrition whether the label will specify a number of months where patients should be on parenteral nutrition before initiating Gattex.

Now again, as a bridge the European label, the European label states that the patient should be stable on parenteral nutrition before starting Gattex. And this is something that I don’t know if the FDA will take into consideration or not.

Operator

Your next question come from the line of David Friedman, Morgan Stanley.

David Friedman - Morgan Stanley

Just in term of the registry that was discussed yesterday. I was wondering if you could just talk about when that is expected to start. How you expect to use that in terms of data collection and will you ever disseminate data as updates from that overtime?

Francois Nader

So the registry is something that we internally believe at NPS will be a very very beneficial tool for the patients, for the physicians, and for the agency. I mean there is no reliable short bowel syndrome registry in the U.S. Currently there are couple of attempts here and there but our objective is to have a very comprehensive registry. The question that was debated yesterday was whether or not the registry should be mandatory. And this is something that will be hit again, negotiated with the FDA between now and approval.

The reason this is important is, is the registry will be made obligatory. Then this will -- that will be the news, bad news. The good news is it will be highly, highly reliable because every patient on Gattex will be in the registry. The bad news is as the patients said it yesterday, it will add a burden on the patient and therefore might restrict access to Gattex. And this is what the balance should be, should be [tracked] if you want.

Now the other aspect, and I don’t know if it was clear in the deliberations yesterday, we are proposing a registry for short bowel syndrome with patients that are not on Gattex and patients who are on Gattex. Because one of the challenges we have in any orphan indications and short bowel syndrome is no exception, is the weakness of the base line. In other words, we don’t know exactly what type of event happened in these patient population as a base line. And therefore at times it’s very difficult to compare events that appear with patients on Gattex because we don’t have any comparator to refer to.

So it’s very important for us to work with the advocacy groups and with the physicians and any network home infusions and other to have as many patients in the registry as possible. And specifically patients who are not on Gattex. Just to built this base line and therefore when we have any adverse events be able to reassess very quickly the meaningfulness of this adverse event.

As to your last question, we consider the registry as being a very important study. So we are taking it very seriously and I think this will trigger eventually in the future possibly a publication. But the numbers have to be meaningful before we even attempt to do that.

David Friedman - Morgan Stanley

Okay. Thanks. And then just one last question. The patients that have been in the extension studies, do you plan on following them, short of for as long as they stay on drug as part of a trial or is the goal at some point to have them migrate on to commercial paying drugs if and when approved.

Francois Nader

You know there is a third alternative, it’s to migrate them to the registries so they can have access to the drugs commercially if you will but they will be enrolled in the registry which might be the third option.

David Friedman - Morgan Stanley

Okay. So in that case they would be on commercial paying drug?

Francois Nader

Correct. I mean the reason being that STEPS 2 will be completed by year-end and we will results of the, officially if you will, STEPS 2 as the study will close. And then we have STEPS 3 that is ongoing and the duration is a year. And there is no need for us to extend it any further. So the option will then be to switch all patients to commercial products when they are available and monitor them through the registry.

Operator

Your next question comes from the line of Alan Carr with Needham & Company.

Alan Carr - Needham & Company

You brought up five more patients yesterday and again this morning and that were weaned off the drug. I am wondering if you can give us a better sense of timing of when these patients are coming off. You mentioned that some of them -- several of them happened after one year. Is this a steady rate hear over time or is there a particular time period where it looks it’s strongest and then it’s coming down or going up as time goes forward?

Francois Nader

Unfortunately I don’t have the slide that we projected yesterday in front of me that shows the time when these patients came off. But what we have seen, Alan, which was quite exciting is, Gattex seem to work more and more overtime. And here again, I mean it goes back to the individual patient. So we could not find based now on all these patients that were weaned off, any significant criteria or variable that could play as a predictor. What we were so very interested in is we have patients who were weaned off after being on Gattex for over two years, which is frankly remarkable.

So this pleads in favor of the long-term use of Gattex and this is a discussion that also occurred yesterday at the ad com. And the discussion has to do with the long-term benefit of Gattex. And just having patients who were able to wean off after two years on Gattex is really, absolutely exceptional. So we will certainly encourage all patients to continue being on Gattex for the long-term and hope that they will continue to reduce their reliance on parenteral nutrition and eventually come off.

Alan Carr - Needham & Company

I wanted to slip-in a quick unrelated question on NATPARA. Is there any update there on manufacturing issue? Has that been resolved and if not is it still not going to be a limiting factor for the BLA next year?

Francois Nader

The manufacturing is not a limiting factor anymore. That’s the probably the best way to answer your question. The process now has been engaged to complete the user study and engage the FDA in a conversation related to the protocol and the execution and the interpretation of the study. But manufacturing is no more a gating factor in the filing of NATPARA.

Operator

Next question comes from the line of Carol Werther, Summer Street Research Partners.

Carol Werther - Summer Street Research Partners

I was wondering if you could tell us where you are with the manufacturing and if the FDA has inspected the plants?

Francois Nader

The manufacturing is pretty much in place. We have the commercial products that we will need to successfully launch Gattex. The FDA completed, to our best knowledge, our pre-approval inspection. I am not aware of any ongoing plans for additional PAI. They did a pretty thorough job, frankly, looking at a number of our manufacturing or contractors, or CMOs. I don’t believe that there is anything else or more in the works at this stage. So from a commercial supply chain perspective, we are ready. And again no PAI that I know of that is ongoing or planned.

Carol Werther - Summer Street Research Partners

And could you comment a little about pricing and where you are with pricing? And do we know any of the prices that have been set in Europe?

Francois Nader

Not that I am aware of. The pricing in Europe has not been set publicly at least. And as for us, frankly, this is the work that we are engaged into and pricing will very much depend on the final labeling that we will get from the agency. It will depend very much on the REMS. And it will depend very much on the ongoing active market research that we have with the payers. And I don’t think you can expect us to release any indication on pricing before the product is approved. So this will be discussed probably on the call announcing the approval of Gattex, not before.

Carol Werther - Summer Street Research Partners

Okay. And I was a little bit confused yesterday about the REMS and what decision was really made. From your perspective, did they want to add to what you have suggested?

Francois Nader

Yeah, I agree with you, Carol. I was sitting in the room and the conversation was confusing. I am not surprised that...

Carol Werther - Summer Street Research Partners

I didn’t know what to write to (inaudible)

Francois Nader

Nor did I, actually. So basically here’s how it goes. We proposed a comprehensive risk management program. The good news is the FDA was very much aligned with our proposal. The questions yesterday were to the committee as to whether or not the committee would advise the FDA to do anything more differently. The reason you and I could not come up to a conclusion is the fact that the FDA will take or has taken all these comments under consideration. They have an internal meeting usually to digest all of the above and come up with an internal FDA recommendation that in turn will be discussed with MPS. So until that point, frankly we will not know what the FDA will decide as being the appropriate risk management plan.

This being said, I should say that this has been an ongoing and very positive interaction between the company and FDA. We proposed a very comprehensive program. They were very complimentary about our program. And the discussions that we had were very very positive. So this is an area that I believe very strongly that what the FDA will come up with would be something that as a company we can live with, but also will not inadvertently limit access to Gattex. But yesterday was not a decision point. It was more an input if you will process.

Carol Werther - Summer Street Research Partners

My last question is that it seems to come up during the panels that they thought they would use Gattex off-label in pediatric patients. Are you planning to do any studies or do we have any dosing information about pediatric patients.

Francois Nader

Now you hit it right on the head. I mean one of the challenges with a pediatric program is dosing. And you know pediatric could be interpreted in a wide, wide range of ages. Pediatric starts in pre-term babies and ends at 17 years, I don’t know, 11 months and 29 days. Just shy of 18 years old. We believe, the experts believe that the physiology, the anatomy and all the different pharmacological impact of teduglutide might vary with ages which is the case for virtually any other drug.

So when it comes to, for example dosing, which is a very good question. There is probably a high likelihood that teenagers and young adults will have the same dose of 0.5 milligram per kilo per day. We have to make a little bit more to design and implement probably couple of more studies to better understand the dosing and the dosing regimen for kids who are much younger than that.

Now all that being said, it’s interesting what we heard yesterday, which was very very consistent with everything we have heard from other experts that there is a huge unmet medical need in the pediatric population. I mean these patients die or these patients now become chronically dependent on parenteral nutrition for the rest of their lives as was discussed yesterday by the mother who really told a wrenching study about her son and her son’s life. I mean it’s horrible. So there is certainly an unmet medical need and this will be our first clinical development priority once Gattex is approved. So stay tuned.

Carol Werther - Summer Street Research Partners

I just want to commend you all for really fabulous presentation yesterday at the FDA. Great job. Thanks for answering my questions.

Operator

The next question comes from the line of David Nierengarten, Wedbush Securities.

David Nierengarten - Wedbush Securities

I have a quick question about patient dynamics. There was commentary yesterday at the panel about how long might a physician treat a patient before determining if that patient had responded to Gattex. And I was wondering about your thoughts on that. Would we expect a physician to treat over 9 months, a year, 15 months, especially given how patients seem to continue to benefit over extended periods of time.

Francois Nader

Only data that we can rely on at this stage is our data coming from STEPS and STEPS 2. We have a number of patients who did not respond during STEPS and responded during STEPS 2, more specifically in the first six months after STEPS. So if we add these data, we have a finding that says that most patients respond within 12 months. Now let me contradict myself very quickly here by saying that two patients who did not respond during the first year ended up being weaned off, which is really -- I mean it’s kind of crazy but this is what it is.

So all this to say that in the world of biological, frankly, the predictability of the response is extremely difficult. So in the absence of tangible, solid data that will give us an indication as to when to stop because of non-response, we will really rely on the patient physician relationship and the decision will be made individually based on the benefit, risks of Gattex in the individual patient. So I will be surprised if we see any clearer or more defined indications in the label. Because at the end of the day it is a patient-physician decision.

Anecdotally, we had dinner yesterday with one of our experts who actually presented at the panel. And he told us that he has a patient who did not respond in the criteria of 20%, but when he came to stop Gattex the patients absolutely refused because the patient saw a difference in his well being before and after Gattex. And the patients refused actually to stop Gattex. And even though he did not meet the 20% threshold, the patient was very happy being on Gattex. So in the study these patients would have been a failure, in real life the patient is a success. So go figure.

Operator

And the last question comes from the line of Ed Arce, MLV. Please go ahead.

Ed Arce - MLV & Co.

So first question is, I found it very curious that amongst the panelists yesterday, one of the two oncologists after hearing the safety data, wondered out loud whether the data presented regarding the malignancies really raised or rose to the level of requiring a contraindication on the label. And I am wondering given that reaction if this is something that might still be on the table in the discussions that are ongoing with the FDA?

Francois Nader

Everything that was discussed yesterday is on the table. Just as a point of reference, if you take (inaudible) which is a very well known agent. I mean it’s as you know a non-specific growth hormone with very specific cancer risk. Their label reads that (inaudible) is contraindicated with active cancer only which is strange in today's world, but this is the label. And if you look at some of the GLP-1s, and GLP-1s are indicated in diabetes. And in the label there is a clear indication of a risk of cancer at doses that are within therapeutic range. So we are now talking serious stuff but yet they are not contraindicated when there is an ongoing cancer.

So it’s interesting because the label at the end of the day is a negotiation between the company and the agency. And it very much depends on the agency’s stand at that particular moment with this particular product indicated for this particular population. So we will do what is right for the patient and what we believe is right based on the data that we you know, cannot comment more than that at this stage. Stay tuned.

Ed Arce - MLV & Co.

Right. I just thought that, that was interesting given that there is short of a balance has to be struck between the precedence, previous therapies as you mentioned and the current data.

Francois Nader

That’s correct. And this is, frankly this is why probably we were not surprised because throughout this process we had (inaudible) ad com. And on each one of them we had oncologists that played the role of the two gentlemen who were here yesterday. And I can tell you throughout the (inaudible) ad com cancer was not raised as a critical issue. So it was in a way very consistent when you talk to oncologists.

Ed Arce - MLV & Co.

Right. And one other question is, given that the effect of the absorptive capacity has been shown to really reverse quickly upon withdrawal. I think you touched upon this earlier, what effect could that data have on ultimately the duration that’s listed on the label?

Francois Nader

So short bowel syndrome is a chronic condition and GLP-2 is a product that, as you just said, increases absorption and builds overtime as we just said. The one element that was not discussed yesterday but the underlying -- now it’s a anatomical component of your question, is the fact that Gattex increases the number of [anthrocytes], increases the mass but does not increase the number of the neuroendocrine cells that actually secrete GLP-2. So even though there is an increase in the mass of the gut, it does not increase the number of cells that secrete GLP-2 and therefore it doesn’t increase the level of GLP-2.

So when we stop Gattex, those [anthrocytes] having a turnover time of about nine days, just turn over and without the presence of a GLP-2 tend to revert to the baseline status. Now, how long would it take, it depends because in our Phase 2 study it was a matter of weeks. In our Phase 3 follow-up it was a matter of months and for some patients they did not revert. So maybe there is a tipping point where patients do not revert. All this to say that we don’t really know. And the importance of the registry will kick in exactly to answer these kind of questions that we would not be able to answer given the relative small size of our clinical development program.

So we hope that if we have let's say 100, 200, 500 short bowel syndrome patients, we will stop Gattex. We can follow them longitudinally and asses how quickly or not they revert to their base line. So for the moment we recommend that Gattex should be used on the long run, in the long run with the same dose given every day.

Operator

This concludes today's question-and-answer portion for today's conference. I would now like to turn the call back to Dr. Nader for closing remarks.

Francois Nader

Thank you. And thank you for your questions today. Always very interesting and for your time. We look forward to updating you further on our commercial plans on future quarterly calls. With that have a great day. Thank you.

Operator

Thank you, again, ladies and gentlemen for your participation. This concludes today's conference. You may now disconnect and have a great day.

Copyright policy: All transcripts on this site are the copyright of Seeking Alpha. However, we view them as an important resource for bloggers and journalists, and are excited to contribute to the democratization of financial information on the Internet. (Until now investors have had to pay thousands of dollars in subscription fees for transcripts.) So our reproduction policy is as follows: You may quote up to 400 words of any transcript on the condition that you attribute the transcript to Seeking Alpha and either link to the original transcript or to www.SeekingAlpha.com. All other use is prohibited.

THE INFORMATION CONTAINED HERE IS A TEXTUAL REPRESENTATION OF THE APPLICABLE COMPANY'S CONFERENCE CALL, CONFERENCE PRESENTATION OR OTHER AUDIO PRESENTATION, AND WHILE EFFORTS ARE MADE TO PROVIDE AN ACCURATE TRANSCRIPTION, THERE MAY BE MATERIAL ERRORS, OMISSIONS, OR INACCURACIES IN THE REPORTING OF THE SUBSTANCE OF THE AUDIO PRESENTATIONS. IN NO WAY DOES SEEKING ALPHA ASSUME ANY RESPONSIBILITY FOR ANY INVESTMENT OR OTHER DECISIONS MADE BASED UPON THE INFORMATION PROVIDED ON THIS WEB SITE OR IN ANY TRANSCRIPT. USERS ARE ADVISED TO REVIEW THE APPLICABLE COMPANY'S AUDIO PRESENTATION ITSELF AND THE APPLICABLE COMPANY'S SEC FILINGS BEFORE MAKING ANY INVESTMENT OR OTHER DECISIONS.

If you have any additional questions about our online transcripts, please contact us at: transcripts@seekingalpha.com. Thank you!

Source: NPS Pharmaceuticals' CEO Discusses Gattex Update (Transcript)
This Transcript
All Transcripts