Trellus Health (LSE:TRLS) — Investor Presentation

0:02 Afternoon, ladies and gentlemen, and welcome to the TRLS Health PLC Investor Presentation. Throughout this recorded presentation, investors will be in listen only mode. Questions are encouraged and can be submitted at any time using the Q and A tab situated on the right hand corner of your screen. Just please simply type in your questions at any time and press send. The company may not be in a position to answer every question it receives during today's meeting. However, the company will review all questions submitted today, and we'll publish those responses on the Investor Meet company platform. Before we begin, we would like to submit the following poll. And if you give that your kind attention, I'm sure the company would

0:34 be most grateful. And I'd now like to hand over to CEO, Monique Fayad. Good afternoon. Good afternoon. Good afternoon, everyone. Pleased to meet Fayad. I'm the CEO of TRLS Health, and we're delighted to be presenting our inaugural annual results this, this afternoon as a publicly traded company on the AIM exchange. Presenting today with me, I have cofounder doctor who is a also a director at the Mount Sinai IBD Center, and we also have CFO Richard Evans. So if we can continue to get started, we can go right into the presentation. Thank you. And I'll advance the slides. Wonderful. So just, as a quick overview for those who may be new to the company, TRELLUS HEALTH is a resilience driven, digital health solution for chronic conditions starting with inflammatory bowel diseases, which is the, which covers the two diseases of ulcerative colitis and Crohn's disease.

1:31 We have licensed, we have the proprietary license to a methodology from the Mount Sinai IBD Center, which is has been proven to have a tremendous, tremendous outcomes in terms of improved quality of care and and health as well as reductions in unplanned care, expensive unplanned care, and hospitalizations. We have, built out our proprietary TRELLUS Elevate platform that enables us to coordinate care with our patients as well as their GI providers, which we'll we'll speak about in a in a moment. And we are servicing both the b to b as well as the direct to consumer markets with our connected health solution. Our our license from Mount Sinai actually includes IBD as well as seven other chronic condition categories.

2:18 So we are evaluating expansion beyond IBD into other chronic conditions, specifically, irritable bowel syndrome, which I'll speak about in a moment, which is very similar in terms of its, symptoms as well as emotional burden. So a little bit more about TRELLUS, and how we're different from other, solutions or, say, apps that are out in the market right now. TRELLUS is a comprehensive solution that combines it combines both team, tech, and touch to address the needs of our our chronic disease patients. And and we actually, what's different from TRLS and all of these other apps that are just addressing reactively things like stress, anxiety, depression, is that we look we we look at the disease in context, and we approach, the patient holistically to address, what their challenges are and and assess resilience and then build resilience using proven methodology.

3:12 So how we do this is through a combination of an integrated resilience team, which consists of a resilience coach, a dietitian, and a nurse patient educator who utilize our TRELLUS Elevate platform and app to deliver, a number of digital tools and, and care coordination with the, with the patient's GI doctor. So the goal of this is to, again,

3:35 coordinate first first assess resilience and then coordinate care so that the patient stays health healthy and stays out of the hospital. I'd like to turn it over for a moment to doctor Marla Dubinsky, who is a cofounder of of, TRLSS to talk a little bit about the data behind, behind TRLSS. And, actually, this data was just newly published last year in November and shows actually increased, improved outcomes beyond what was originally published in 2020. So, Marla, why don't you, why don't you take it away? Sure. Good evening, everybody. As Monique noted, we TRLS Health is a connected health solution that really sees patients through the lens of resilience. Now a lot of people don't have not associated resilience per se with chronic condition. It's typically related to your employee resilience or maybe patients who have some sort of post traumatic stress disorder. But what we've been able to do is myself with my, cofounder who is the inventor of the method that uses resilience and positive psychology principles to actually implement behavior change in patients with chronic condition.

4:44 When you're 18, 19, or 20 and diagnosed with a lifelong condition, it's difficult. It's hard to overcome adversity. There's enough adversity going on in the world, let alone adding a chronic incurable condition. So what is resilience in the face of having a chronic health condition? There are five core targets that the TRLS method actually, focuses on because all five of these must be and fall into the resilient domain in order for patients to actually have the outcomes we see every day at the Mount Sinai IBD Center. This is an approach we're using analog day to day using our team at the Mount Sinai IBD Center. It's very unscalable, and we don't have the ability to actually bring it to patients at a more democratized or, all access to patients in the country and beyond who have IBD.

5:33 So what we showed here, and we published as Monique noted in in November, is that when you target these five areas of behavioral or emotional or brain health in someone who has a chronic condition like IBD, not only do you get them to graduate and actually improve their resilience, but as you improve someone's resilience, you actually have the result of lowering the amount of unnecessary or unplanned health care utilization, which comes to a large reduction, obviously, in the cost of care. So what we showed is that when we took the same patient and we compared them to the year before they enter the resilience program compared to a year after they enter the resilience program, we were able to see a significant drop in emergency room visits unplanned of seventy one percent, hospitalizations by over ninety percent, almost ninety five percent of patients. We had opioid reduction. Almost fifty percent of patients had opioid reduction and, of course, corticosteroids, steroids, which has a lot of side effects and actually, impacts long term prognosis of patients. That was reduced by over seventy percent.

6:41 And this happened in the same patients before they entered the program, built their resilience, and then went on to maintain their resilience, and they were able to change their health care behavior. So what we do is, you know, as I noted, every day, we still, manage our patients at the IBD center with this methodology. But as I noted, very unscalable, hard to democratize. So what the story was is that TRLS, by licensing the method, is able to use their digital technology and their tools and the platform that Monique alluded to where we are able to quantify one's resilience on a scale of zero to a 100, make the designation that someone is low or high resilient, create these resilience playbooks such as a curriculum that takes place over about six to eight months. This isn't something you go to one of those apps that Monique was showing, a single app. You're stressed. Here, use this, and your stress is gonna be reduced. No. What we're actually doing is we're preventing anxiety and depression because we're giving people the toolkit, the tools, the skills to actually learn resilience. Resilience is one of the few behavioral health things that you can actually learn and be taught.

7:54 So after we've decided you are low resilient, we deploy these, modules that are all digital and interactive. And in your back pocket, you have a team, a resilience coach, an IBD dietitian, or GI dietitian, and also a nurse educator who's there to reinforce the care plan because there's no way someone who has low resilience is going to be able to do this without the team. We all know we need someone to hold our hand as we go through in the face of chronic condition, and then we maintain them and track them and monitor them very closely to make sure they are sticking to their plan and they stay well. What what is also interesting and when you go get into sort of how we're gonna be able to expand pretty quickly using our new sort of delivery of our solution, shall I say, and Monique will get more into that. But what's very important is that there are two very large gastroenterology conditions that most gastroenterologists deal with. Maybe up to seventy percent of their patients walk in with either IBD, which is about one percent prevalence here in The UK as well as any westernized country.

9:04 And then you also have the other remaining percentage of our practice, which is about ten percent of The US population, similar westernized population, is irritable bowel syndrome. Often, they get confused, There is a letter difference. One is an actual disease that is a genetic disease. It's similar to psoriasis, diabetes, thyroid disease. These are chronic incurable, autoinflammatory or autoimmune conditions, lupus, the list goes on, diabetes. However, irritable bowel syndrome is there is no genetic cause. It isn't inheritable. It is not something that is incurable. What you need to do is work on that mind and body sort of what we call these disorders of brain gut interaction. There is a disconnect. There is an inability to separate your worry, your stress, your emotional health from your gut health. And so the same principles of resilience and behavioral health, resiliency, skills building applies to both IBD and IBS. And that's why also Monique noted there's other conditions we can apply this to. We are starting in

10:08 in gastroenterology. That's what I do. And our cofounder, Lori Kiefert, she is a expert psychogastroenterologist in the behavioral health space of these two diseases. So I'll turn it back over to Monique who's gonna walk us through how we go out. We automate and scale this process. Wonderful. Thank you, Marla. And just one thing to to reemphasize here. When we're addressing these two markets together, we're talking about a total US population of 33,000,000 and a combined, combined annual, health expense of around 80 you know, over $80,000,000,000. So very, very large populations here, helping us to expand beyond the three million IBD population quickly based on a disease that is very similar and can be, can be our our current platform and business can be leveraged to address this population very easily.

10:54 So just to, just refresh everyone's memories in terms of our our business model, we have two primary revenue streams. Our business to business side of the business focuses focuses on selling into health plans and employers. And the value proposition here is that we utilize the resilience method, to to predict those patients who will be at highest risk of of unplanned care utilization. That's the the tool has been quantified to be able to do that. And then we, we manage the patients, and we track them, using our platform and and through our care coordination to keep them out of the hospital with a goal of saving at least 20% per year on the health care costs of these very high cost, high need patients. So we're only charging the payers based on pay patients who actually do a resilience assessment, the resilience screening fee, or who enroll in active care coordination with us. We don't charge based on every member in their population, only those members that we either evaluate or, enroll in our active, care coordination.

11:56 In terms of direct to consumer, we're we're targeting, again, either a patient directly who can pay out of pocket a monthly membership fee, or we have alternative sources of paying for the patients in terms of a patient advocacy groups and, and pharma or industry. And all of these these groups have expressed interest in offering these type of services to patients who desperately need them because they don't have the type of, emotional and psychosocial support outside of the you know, they're just traditional episodic care visits with their GI doctor. So the value proposition to a patient is clearly that they're gonna feel better. Their symptoms are gonna be controlled. They're gonna be in more control of their disease overall, reduced stress and anxiety and depression, and also, as we saw on the slide previously about the data, decreased opioid use and hospitalizations.

12:47 But, really, the goal here is for them to feel better and more in control and in power of their of their disease and their life. So, you know, from an operational highlights perspective, we had a really, really strong year, our first year coming out, having successfully raised our our AIM, you know, AIM IPO proceeds of over $40,000,000. And what we what we did, basically, delivering on what we had, said we were going to do with the proceeds, we built out our TRLSS Elevate platform, our business, our clinical operation, which was, our our and our original care team, which was a licensed clinical care team in, New York, New Jersey, and Connecticut. We also established our first b to b contract with the Mount Sinai employee health system for a demonstration program with their employees with IBD.

13:34 And we also, con continued and started to expand into irritable bowel syndrome by, by appointing an SAB member who is an expert in in functional GI diseases to help assess how we could quickly quickly scale our platform into IBS. That's not to say we didn't run into our fair, fair number of challenges, which is not surprising for a for a start up, especially during a pandemic. So, what I wanted to outline here is that we're there were a few challenges that we ran into in terms of the contracting process, which is we knew would already be long for working with insurers and employer and employers. Typically, these, contracting timelines take anywhere between twelve to twenty four months, and we had we had built that into our our business plan that we were going to be contracting with them as we got started.

14:27 Of course, everyone's focus, during the last two years has been on the pandemic, and that clearly, you know, detracted from some attention in terms of pushing these contracts through. But as I mentioned, we did secure our b to b our first b to b contract with Mount Sinai, and we got very far in the contracting process with the New York State, health plan for their for demonstration program with their IBD population. One of the key challenges we ran into, dealt with the use of a licensed clinical, care team on the front end. So our care triad, again, we believe we we utilize a high touch approach because it's it's you know, what we're offering is is behavior change support, which needs intervention by humans, to help patients follow their plan and answer any questions they might have and off also offer dietary nutrition support is that we are utilizing a licensed triad of a a licensed clinical social worker, a registered dietitian, and a nurse practitioner.

15:23 In in employing those, and utilizing those licensed professionals, there are a number of regulatory challenges at a statewide level. You have to have them licensed in every state where they're delivering care, and you also need to have them credentialed with payers. So either a payer or health system has to do a very thorough review of a provider's, you know, qualifications, their status, the current status, their their insurance status. So effectively, takes a long time for that to happen anywhere from ninety to a hundred and twenty days if that's happening, normally. But, with, with Medicare and Medicaid and government, payers, that process could take up to six months. So we really were were finding that there were delays in the timing that we that we wanted to, be able to circumvent by evaluating potentially new delivery model that could enable us to move much much faster and much more profitably, which we'll talk about in a moment. The other, another constraint we had in utilizing a licensed care team has to do with pricing, controls on pricing and incentivization and referrals.

16:25 So, there are government regulations around your ability to charge less than fair market value for services that are being offered by a licensed clinical professional. So, therefore, we you know, offering a new service such as TRLS, we couldn't really offer introductory rates or special trial offers or any type of creative pricing or promotion that deviated from the, you know, the Medicare, or Medicaid fee schedules. So, therefore, you know, we reassessed kind of what we what we wanted to deliver. What was our initial vision and mission with TRLS was to, you know, digitize it and scale and deliver the resilience method at scale, you know, beyond the Mount Sinai IBD Center and really democratize access to the method by using a, you know, an integrated team to help the you know, help us deliver that.

17:10 And we realized we didn't need to deliver the method utilizing licensed clinical professionals.

17:15 We could actually utilize a resilience coach, a trained resilience coach, and a nurse patient educator who could deliver the method as effectively as, you know, using these licensed professionals and ensure that the method, you know, basically preserve the integrity of the method and evaluate the patients and then manage them through their behavioral change. And if by doing this effectively, we're no longer offering a licensed clinical service because we're not providing licensed clinicians in terms of offering any type of clinical care, whether that be diagnosis, treatment, or prescription. We're offering a resilience assessment, a personalized care plan, and coordinating care with the patient to work with their doctor and also ensure that they stay out of the hospital. So that doesn't fall under the any of the regulatory issues around licensing and credentialing or, referrals and price incentivization.

18:07 Therefore, we can, we can basically roll out our our service to all 50 states immediately, and we have a lot of freedom in terms of, pricing as well as promotion, for, you know, for any type of introductory rates for our direct to consumer. It also enables what we'll be doing is it enables us to move more quickly as we can now reach all 50 states. We are enhancing our digitization to enable us to more quickly onboard patients. Whereas previously, we would require all new patients to come in and have a resilience assessment first with a live human. We're gonna be working to digitize that process and bring people in, directly, do the resilience assessment, assign a care plan. And then after they have their care plan assigned, they can meet with their coach or their dietitian. Or if they have questions, they can speak with the nurse about any type of patient education issues.

18:57 This also enabled us much more rapid expansion into IBS, in order to, to get the to address the patient populations, the much larger patient population that is more frequently seen by GI doctors than IBD. So with these two conditions with IBD and IBS, we'll effectively be addressing, you know, eighty percent of the patients that are walking into a doctor's a GI doctor's office on any given day. So how we how we plan to, roll this out over the next, eighteen months, as you can see here in this slide, in q one, we were, you know, in the four states that we were licensed and just focusing on IBD. Now that we've, we've modified, and evolved our service delivery model, we can quickly roll out to the 50 states through the remainder of this year and also employ automation, as I mentioned on the front end to quickly more quickly onboard and evaluate patients.

19:50 So that enables our our throughput to be you know, from being able to intake several 100 patients per month to several thousand patients per month. And what's important about this as well is using this new care delivery model, the the cost of that care team actually goes down because we're no longer dependent on licensed clinical social workers on the front end who are expensive and who are also hard to hard to hire and recruit because they're in high demand due to a lot of the challenges regarding mental health professional services associated with the pandemic. So we still utilize, you know, licensed clinical social workers as you know, for training and quality control to make sure that our our coaches, our resilience coaches are trained accurately on the method and that they know how to contextualize a patient case to to apply the method and and do the resilience assessment.

20:39 But they're they will be used for quality control purposes and training and will not be interacting directly with our patients. So that also helps ensure the quality and preserve the quality of the of the method. And then as we get into, next year, in the first half of the year, we will have the, the ability to start to begin servicing IBS patients. So we expect we're gonna see significant ramp up beginning in in the first half of next year, to enable us to begin to onboard several thousand patients. Both you know, we'll be onboarding for both b to b and DTC, but many thousands of patients in DTC at a much more rapid rate through the, the enhanced automation that we'll be utilizing.

21:22 So in in terms of financial highlights, I don't know if I wanna turn it over to, Richard, our CFO, and he can speak to the Yeah. The delivery of what we we're what we were able to achieve in terms of financial highlights for 2021. Thanks, Monique. So not many words on this page, but there are a couple of sentences that are very, very important. So we've managed to make 4.3 cap, million dollars capital investment in the technology platform. That's what Monique mentioned earlier on, the Elevate platform. And that sets us up with a core IT platform in order to do the business in the future. We have one or two adjustments to make through the movement to d c DTC, but that should be finished by the end of August.

22:09 And we will have a very, very good and very sound IT platform. Despite the lack of revenue last year, we still managed to finish the year with net cash of $32,000,000. And I can tell you just because I'm sure you're interested anyway, the question hasn't come up yet, but I think we'll be probably about $19,000,000 at the end of this year and about $14,000,000 at the end of next year. And we will actually get into profitability in q four of next year. And therefore, I don't expect us to be coming back to the market to look for more cash. How are we gonna do all that? Obviously, is, encapsulated in the last sentence.

22:59 We're going to have effective cash flow management, which is in line with our business progression. What does that mean? What it means is we're gonna put certain, hires on hold until later in the year when we actually need the people. So we won't have people on board who whom we don't need at the moment. We will also postpone some tech developments until next year until we really need them. And so we're we're just being very careful about the way we manage cash. We're not stopping spending money. We're spending money on what we need to what we need to spend in order to achieve our goals, but we're being careful. And I think that's the solution to running a good business.

23:47 Great. Thank you, Richard. Thanks. So in terms of our outlook for you know, post post year end and our outlook for the remainder of the year, as you saw, we are going to continue to focus very closely on on our continued discussions on the b to b side with health plans and employers. The good news is now that we have, you know, have the ability to reach 50 states, we can really, meet the needs of jumbo employers, who have who have employees all across the the country, to meet their their chronic GI, diseases, and and address those using our method. We also have, we'll we'll roll out as as we showed in the slide about, you know, the phasing of our the evolution of our delivery model, to both b b to b and DTC in IBD and IBS. And we are in advanced discussions with pharma and other patient advocacy organizations about sponsoring access to TRELLUS, for their patients. And and we've had advanced discussions with these entities for over a year now. They're very pleased to hear that we have a new delivery model that enables us to to service patients nationwide and not be restricted by a state specific or a geographic region.

24:55 The automation that we'll be we'll be implementing will enable us to much more quickly, onboard and, and engage with patients, so we can increase the volumes, the intake volumes of patients that come onto the system through DTC. And, as Richard mentioned, we will continue to implement cost containment measures to keep our expenses in line with our commercial progress. We will likely be investing more in digital you know, targeted digital marketing to address the, the direct to consumer opportunity. And as well as as we bring more patients on, we'll be bringing more, of the, the resilience team members who are, you know, directly supporting our patients in line with that that growth of of patient volume. So with that, that pretty much concludes the presentation.

25:42 What I'd like to do now is address some of the questions. It looks like we've gotten a lot of questions, a lot of great questions from our audience. That's great. Let me just jump in, Monique, just to give you a chance to to take a look at some of those questions. And I'll if I may just bring back up the camera as well. So thank you very much indeed to you all for your presentation this afternoon. Ladies and gentlemen, please do continue to submit your questions using the Q and A tab on the right hand corner of your screen. I just want the team to take a few moments to review those questions submitted already. I'd like to remind you that recording of this presentation along with a copy of the slides and the published Q and A can be accessed via your Investor Meet company dashboard. Monique, you're quite right to say you've had a few questions come in. So perhaps if I may, if I could just hand back to you just to read out those questions and where appropriate to give a response, and then I'll pick up from you at the end. Certainly. Thank you. So, yeah, a lot lot of questions here. So let me just go through, and I'll I'll I mean, all very good questions. And thank you everyone for your attention and for your interest in in TRELLUS HEALTH and and our progress to date. So one question is when would you expect revenue in the DTC business to start to build sharply?

26:45 So, as I mentioned, as we build the automation, of our DTC, through the remainder of this year, we're gonna start seeing that taking off more, in q four of this year and then into next year as we're able to address IBS. So really that, you know, the IBS market being tenfold the size of the IBD market gives us a lot of, capability to expand. And by the end of next year, we will be expecting to see, you know, tens of thousands of DTC patients on board, whereas this year, we'll see a few thousand, by the end of this year. And that will clearly drive, you know, drive revenues in line with, with the number of patients.

27:21 Hold on. One good question. What should we look out for news wise in the near term? So, clearly, we've been having many discussions both on the b to b side and, on the DTC from a sponsorship side with, with health plans and with our, you know, potential sponsors in pharma. So we do expect that we'll be announcing a few of those in very short order, based on this new delivery model and our ability to service patients nationwide. We have been, as I mentioned, in in negotiations with the health New York State health plan that we're very close to signing another demonstration program contract with. We just need to go back to them with this new delivery model, which actually makes the contract contracting process much easier and quicker because we're not utilizing, licensed health care professionals, therefore, we you know, the the contracts are not as complex, and we don't have to wait for the credentialing process to slow us down.

28:16 Let's see here. When do you expect the results from the Mount Sinai test? So it's Mount Sinai is not actually a test. It's a demonstration program, by which we are, enrolling and engaging about 20 up to 25 patients who are our employees at the Mount Sinai Health System who have IBD. And so that that the demonstration program actually started in q one of this year, and we have begun enrolling patients in active care management. It typically will take, six months as as Marla mentioned. It's a process. This is you know, behavior change is not something that happens overnight, and it doesn't just happen by doing some, you know, some meditation. So, really, it it really we we target what the patient needs to work on, and we work with them over a period of six to eight months. So we do expect that we'll start to see, we will see data immediately in terms of how the patients are engaging with the system, and we can do, patient satisfaction surveys.

29:08 But in terms of the outcomes from the utilization of our of our method with you know, through TRLS, it's gonna take us about six months to see to start seeing the the actual data on those patients.

29:22 Let's see. In institutional markets, are there any indications that there is no more need for proof of efficacy? Certainly, one of the things we've heard consistently from, from the the payers, the health plans and employers is while they're incredibly impressed with the, you know, the science and the results that have come out of the IBD center that were published, they would really, you know, love to see more data coming from us as TRLS in terms of, patient engagement, patient interaction, as well as the actual health outcomes, and, health economic outcomes that we're expecting. So that was one of the reasons we accelerated our DTC, program is that we could just instead of waiting to have b to b contracts signed and bring patients in, we wanted to get patients on the platform, start engaging with patients, get the data because that in turn will drive, advanced, adoption through b to b by by demonstrating our own results.

30:19 What are the difference in pricing and returns in the retail market relative to institutional market? So I'm I'm assuming the difference is what is what are the difference in pricing and returns between the b to b and the DTC? So the pricing model in b to b remains the same in terms that we charge a a screening, fee as well as a monthly active, you know, care coordination fee. And then in the DTC, we're charging the monthly the monthly price. So we're starting out in terms of our monthly pricing for DTC at a rate of $79 per month, which we will be discounting for the first six months down to $49 per month as a special introductory offer to build awareness and to bring on as many IBD patients as we can, you know, in the in the first six months of, you know, of go live. And we're literally just rolling out this program as we've changed our service delivery model so that, you know, we're reaching out to patients and GI providers now to begin referring their DTC patients in using that pricing model.

31:20 The b to b model, had always been a certain, price, which we had included in our admission document. We will be lowering the b to b pricing model slightly to reflect the fact that we're no longer using licensed clinical social workers on the front end. Therefore, we can offer the, the screening fee and the care management fee at a slightly lower rate, which actually is beneficial to our payers, the health plans, the employers because they therefore, if we're still incurring or or resulting in a 20% savings, they're gonna get a better ROI on their program costs from from utilizing this new service delivery model. The payers, what they really care about is, again, that we're able to predict the patients who will be high utilizers and keep those patients out of the hospital, which we'll still be able to do consistently with this new service delivery model. So those are the differences.

32:09 And in terms of profitability, you know, both of these models, the profitability increases significantly with the with the greater number of patients that we get on board, especially DTC, which is a very highly automated proposition. So, I believe that I believe that addresses that question. I don't know if, Richard, you have any other comments on pricing and returns between the the b two b and the DTC markets? Well, just to to give a little indication, I mean, you can expect the margin a blended margin next year of about sixty sixty to 70%. And the margins will rise in 2024 over a 100%. So I think it's a very, very healthy outlook for the company. Great. Thank you.

32:57 Next question is when do you feel one or more large pharmaceuticals will sponsor patient access to TRELLUS? Well, we're hoping that that will happen sometime this year, and we have been in discussions with all the major pharmaceutical companies in the IBD space. I mean, and that's primarily attributed to the fact that our cofounders have, you know, their reputation, the reputation of Mount Sinai and the science behind what we're doing, the relationships that that they have, with those companies. They've been able to introduce us. We've had preliminary discussions. Actually, we've had several discussions in advanced stages about being able to offer these very important behavioral support services to their patients to enable the patients to stay compliant with their treatment plans and offer them support beyond what a a typical pharma support, service can provide, which is primarily just kind of questions around how to questions associated with how to take a medication or administer a medication or any side effects. So our service goes way beyond that in terms of the many more questions and issues that patients struggle with around, complying with the medication regime.

34:03 Lastly, let's see. I believe that is it. Yeah. If there are any other questions that we have, we are at the I think you've addressed everything that's come through. I think that final question, I think Miles took back. I think you had answered that as well. So thank you, firstly, to everybody that's submitted questions this afternoon. And thank you, Monique, to you and the team for taking the time to give your responses. Monique, I'm shortly to redirect investors to give you their feedback, which I know is particularly important to the company. You'll get their views and their expectations. Perhaps before doing so, I could just ask you for a few closing comments just to conclude with. Yes. Thank you very much. Well, I wanna thank everyone for watching today and for all of your thoughtful questions and for all of your support, over the over this first year as we've, gone public, and we've we've built and launched our platform and rolled out two patients.

34:56 We have a very exciting year ahead as you can see with, with the automation and the expansion across 50 states and into irritable bowel syndrome. And we're really looking forward to, you know, announcing many, many important, announcements regarding contracts, both b to b and, DTC to bring many more patients onto our platform. So thank you again for your time, and have a very good afternoon. That's great, Monique. Thank you very much indeed and to the team for updating investors this afternoon. Could I please ask investors not to close this session as we'll now automatically redirect you for the opportunity to provide your feedback in order the management team can better understand your views and expectations. So it'll take a few moments to complete, but I'm sure be very grateful gratefully received by the company. On behalf of the management team of TRLS Health PLC, I'd like to thank you for attending today's presentation.

35:42 That now concludes today's session and early good evening, should I say to you all. Thank you.