<SEC-DOCUMENT>0001306923-19-000011.txt : 20190219
<SEC-HEADER>0001306923-19-000011.hdr.sgml : 20190219
<ACCEPTANCE-DATETIME>20190219160735
ACCESSION NUMBER:		0001306923-19-000011
CONFORMED SUBMISSION TYPE:	SC 13G/A
PUBLIC DOCUMENT COUNT:		1
FILED AS OF DATE:		20190219
DATE AS OF CHANGE:		20190219

SUBJECT COMPANY:	

	COMPANY DATA:	
		COMPANY CONFORMED NAME:			Vanda Pharmaceuticals Inc.
		CENTRAL INDEX KEY:			0001347178
		STANDARD INDUSTRIAL CLASSIFICATION:	PHARMACEUTICAL PREPARATIONS [2834]
		IRS NUMBER:				030491827
		STATE OF INCORPORATION:			DE
		FISCAL YEAR END:			1231

	FILING VALUES:
		FORM TYPE:		SC 13G/A
		SEC ACT:		1934 Act
		SEC FILE NUMBER:	005-82196
		FILM NUMBER:		19615026

	BUSINESS ADDRESS:	
		STREET 1:		2200 PENNSYLVANIA AVE NW
		STREET 2:		SUITE 300E
		CITY:			WASHINGTON
		STATE:			DC
		ZIP:			20037
		BUSINESS PHONE:		202-734-3400

	MAIL ADDRESS:	
		STREET 1:		2200 PENNSYLVANIA AVE NW
		STREET 2:		SUITE 300E
		CITY:			WASHINGTON
		STATE:			DC
		ZIP:			20037

FILED BY:		

	COMPANY DATA:	
		COMPANY CONFORMED NAME:			Palo Alto Investors LP
		CENTRAL INDEX KEY:			0001306923
		IRS NUMBER:				770558164
		STATE OF INCORPORATION:			CA
		FISCAL YEAR END:			1231

	FILING VALUES:
		FORM TYPE:		SC 13G/A

	BUSINESS ADDRESS:	
		STREET 1:		470 UNIVERSITY AVE
		CITY:			PALO ALTO
		STATE:			CA
		ZIP:			94301
		BUSINESS PHONE:		650-325-0772

	MAIL ADDRESS:	
		STREET 1:		470 UNIVERSITY AVE
		CITY:			PALO ALTO
		STATE:			CA
		ZIP:			94301

	FORMER COMPANY:	
		FORMER CONFORMED NAME:	Palo Alto Investors, LLC
		DATE OF NAME CHANGE:	20041025
</SEC-HEADER>
<DOCUMENT>
<TYPE>SC 13G/A
<SEQUENCE>1
<FILENAME>Vanda_13G_A7.htm
<DESCRIPTION>SC 13G/A
<TEXT>
<HTML>
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     <TITLE></TITLE>
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<P STYLE="margin: 0"></P>

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    <TD STYLE="width: 100%; padding-right: 5.4pt; padding-left: 5.4pt">
        <P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0; text-align: center"><B>UNITED STATES</B></P>
        <P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0; text-align: center"><B>SECURITIES AND EXCHANGE COMMISSION</B></P>
        <P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0; text-align: center"><B>Washington, D.C. 20549</B></P></TD></TR>
</TABLE>
<P STYLE="font: bold 11pt Times New Roman, Times, Serif; margin: 0 0 12pt; text-align: center">&nbsp;</P>

<P STYLE="font: bold 11pt Times New Roman, Times, Serif; margin: 0 0 12pt; text-align: center">SCHEDULE 13G<BR>
<BR>
Under the Securities Exchange Act of 1934<BR>
(Amendment No. 7)</P>

<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0">&nbsp;</P>

<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0">&nbsp;</P>

<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0; text-align: center"><B>Vanda Pharmaceuticals, Inc.</B></P>

<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0"><U>&#9;</U></P>

<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0; text-align: center">(Name of Issuer)</P>

<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0">&nbsp;</P>

<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0">&nbsp;</P>

<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0; text-align: center"><B>Common Stock</B></P>

<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0"><U>&#9;</U></P>

<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0; text-align: center">(Title of Class of Securities)</P>

<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0">&nbsp;</P>

<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0">&nbsp;</P>

<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0; text-align: center"><B>921659108</B></P>

<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0"><U>&#9;</U></P>

<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0; text-align: center">(CUSIP Number)</P>

<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0">&nbsp;</P>

<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0">&nbsp;</P>

<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0; text-align: center"><B>February 7, 2019</B></P>

<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0"><U>&#9;</U></P>

<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0; text-align: center">(Date of Event Which Requires Filing of this
Statement)</P>

<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0">&nbsp;</P>

<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0">Check the appropriate box to designate the rule pursuant to which
this Schedule is filed:</P>

<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0">&nbsp;</P>

<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0">[ <B>X </B>]&#9;Rule 13d-1(b)</P>

<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0">&nbsp;</P>

<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0">[ ]&#9;Rule 13d-1(c)</P>

<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0">&nbsp;</P>

<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0">[ ]&#9;Rule 13d-1(d)</P>

<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0">&nbsp;</P>

<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0; text-indent: 0.5in">The remainder of this cover page shall be filled
out for a reporting person's initial filing on this form with respect to the subject class of securities, and for any subsequent
amendment containing information which would alter the disclosures provided in a prior cover page.</P>

<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0">&nbsp;</P>

<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0">The information required in the remainder of this cover page shall
not be deemed to be &quot;filed&quot; for the purpose of Section 18 of the Securities Exchange Act of 1934 (&quot;Act&quot;) or
otherwise subject to the liabilities of that section of the Act but shall be subject to all other provisions of the Act (however,
see the Notes).</P>

<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0">&nbsp;</P>

<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0"><B>Potential persons who are to respond to the collection of information
contained in this form are not required to respond unless the form displays a currently valid OMB control number.</B></P>

<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0">&nbsp;</P>

<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0">&nbsp;</P>


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    <DIV STYLE="page-break-before: always; margin-top: 6pt"><TABLE CELLPADDING="0" CELLSPACING="0" STYLE="width: 100%"><TR><TD STYLE="text-align: left; width: 100%">CUSIP 921659108</TD></TR></TABLE></DIV>
    <!-- Field: /Page -->

<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0">&nbsp;</P>

<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0"><U>&#9;</U></P>

<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0">&nbsp;</P>

<TABLE CELLPADDING="0" CELLSPACING="0" WIDTH="100%" STYLE="font: 11pt Times New Roman, Times, Serif; margin-top: 0; margin-bottom: 0"><TR STYLE="vertical-align: top">
<TD STYLE="width: 0.5in"></TD><TD STYLE="width: 0.5in">1.</TD><TD>Names of Reporting Persons.<BR>
<BR>
<B>Patrick Lee, MD</B></TD></TR></TABLE>

<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0"><U>&#9;</U></P>

<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0">&nbsp;</P>

<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0 0 0 1in; text-indent: -0.5in">2.&#9;Check the Appropriate Box if
a Member of a Group (See Instructions)<BR>
<BR>
(a)&#9;<U>&#9;</U><BR>
<BR>
(b)&#9;___<U>X</U>___</P>

<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0"><U>&#9;</U></P>

<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0">&nbsp;</P>

<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0 0 0 1in; text-indent: -0.5in">3.&#9;SEC Use Only <U>&#9;&#9;</U></P>

<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0"><U>&#9;</U></P>

<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0 0 0 1in; text-indent: -0.5in">&nbsp;</P>

<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0 0 0 1in; text-indent: -0.5in">4.&#9;Citizenship or Place of Organization
&#9;<B>U.S.A.</B></P>

<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0 0 0 1in; text-indent: -0.5in">&nbsp;</P>

<TABLE CELLSPACING="0" CELLPADDING="0" STYLE="width: 100%; border-collapse: collapse">
<TR STYLE="vertical-align: top">
    <TD ROWSPAN="4" STYLE="width: 19%; border-top: windowtext 1pt solid; padding-right: 5.4pt; padding-left: 5.4pt">
        <P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0">Number of</P>
        <P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0">Shares</P>
        <P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0">Beneficially</P>
        <P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0">Owned by</P>
        <P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0">Each Reporting</P>
        <P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0">Person With:</P></TD>
    <TD STYLE="width: 81%; border-top: windowtext 1pt solid; border-bottom: windowtext 1pt solid; font: 11pt Times New Roman, Times, Serif; padding-right: 5.4pt; padding-left: 5.4pt">5.&#9;Sole Voting Power&#9;<B>0</B></TD></TR>
<TR STYLE="vertical-align: top">
    <TD STYLE="border-bottom: windowtext 1pt solid; font: 11pt Times New Roman, Times, Serif; padding-right: 5.4pt; padding-left: 5.4pt">6.&#9;Shared Voting Power&#9;<B>&nbsp;&nbsp;&#9;4,345,571</B></TD></TR>
<TR STYLE="vertical-align: top">
    <TD STYLE="border-bottom: windowtext 1pt solid; font: 11pt Times New Roman, Times, Serif; padding-right: 5.4pt; padding-left: 5.4pt">7.&#9;Sole Dispositive Power&#9;<B>0</B></TD></TR>
<TR STYLE="vertical-align: top">
    <TD STYLE="border-bottom: windowtext 1pt solid; font: 11pt Times New Roman, Times, Serif; padding-right: 5.4pt; padding-left: 5.4pt">8.&#9;Shared Dispositive Power&#9;<B>4,345,571</B></TD></TR>
</TABLE>
<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0 0 0 1in; text-indent: -0.5in">&nbsp;</P>

<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0 0 0 1in; text-indent: -0.5in">9.&#9;Aggregate Amount Beneficially
Owned by Each Reporting Person&#9;<B>4,345,571</B></P>

<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0"><U>&#9;</U></P>

<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0">&nbsp;</P>

<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0 0 0 1in; text-indent: -0.5in">10.&#9;Check if the Aggregate Amount
in Row (9) Excludes Certain Shares (See<BR>
Instructions)&#9;</P>

<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0"><U>&#9;</U></P>

<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0">&nbsp;</P>

<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0 0 0 1in; text-indent: -0.5in">11.&#9;Percent of Class Represented
by Amount in Row (9)&#9;<B>8.29%</B></P>

<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0"><U>&#9;</U></P>

<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0">&nbsp;</P>

<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0 0 0 1in; text-indent: -0.5in">12.&#9;Type of Reporting Person (See
Instructions)&#9;<B>IN, HC</B></P>

<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0"><U>&#9;</U></P>

<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0">&nbsp;</P>


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<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0"><U>&#9;</U></P>

<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0">&nbsp;</P>

<TABLE CELLPADDING="0" CELLSPACING="0" WIDTH="100%" STYLE="font: 11pt Times New Roman, Times, Serif; margin-top: 0; margin-bottom: 0"><TR STYLE="vertical-align: top">
<TD STYLE="width: 0.5in"></TD><TD STYLE="width: 0.5in">1.</TD><TD>Names of Reporting Persons.<BR>
<BR>
<B>Anthony Joonkyoo Yun, MD</B></TD></TR></TABLE>

<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0"><U>&#9;</U></P>

<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0">&nbsp;</P>

<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0 0 0 1in; text-indent: -0.5in">2.&#9;Check the Appropriate Box if
a Member of a Group (See Instructions)<BR>
<BR>
(a)&#9;<U>&#9;</U><BR>
<BR>
(b)&#9;___<U>X</U>__</P>

<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0"><U>&#9;</U></P>

<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0">&nbsp;</P>

<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0 0 0 1in; text-indent: -0.5in">3.&#9;SEC Use Only <U>&#9;&#9;</U></P>

<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0"><U>&#9;</U></P>

<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0 0 0 1in; text-indent: -0.5in">&nbsp;</P>

<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0 0 0 1in; text-indent: -0.5in">4.&#9;Citizenship or Place of Organization
&#9;<B>U.S.A. </B></P>

<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0 0 0 1in; text-indent: -0.5in">&nbsp;</P>

<TABLE CELLSPACING="0" CELLPADDING="0" STYLE="width: 100%; border-collapse: collapse">
<TR STYLE="vertical-align: top">
    <TD ROWSPAN="4" STYLE="width: 19%; border-top: windowtext 1pt solid; padding-right: 5.4pt; padding-left: 5.4pt">
        <P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0">Number of</P>
        <P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0">Shares</P>
        <P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0">Beneficially</P>
        <P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0">Owned by</P>
        <P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0">Each Reporting</P>
        <P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0">Person With:</P></TD>
    <TD STYLE="width: 81%; border-top: windowtext 1pt solid; border-bottom: windowtext 1pt solid; font: 11pt Times New Roman, Times, Serif; padding-right: 5.4pt; padding-left: 5.4pt">5.&#9;Sole Voting Power&#9;<B>0</B></TD></TR>
<TR STYLE="vertical-align: top">
    <TD STYLE="border-bottom: windowtext 1pt solid; font: 11pt Times New Roman, Times, Serif; padding-right: 5.4pt; padding-left: 5.4pt">6.&#9;Shared Voting Power&#9;<B>4,345,571</B></TD></TR>
<TR STYLE="vertical-align: top">
    <TD STYLE="border-bottom: windowtext 1pt solid; font: 11pt Times New Roman, Times, Serif; padding-right: 5.4pt; padding-left: 5.4pt">7.&#9;Sole Dispositive Power&#9;<B>0</B></TD></TR>
<TR STYLE="vertical-align: top">
    <TD STYLE="border-bottom: windowtext 1pt solid; font: 11pt Times New Roman, Times, Serif; padding-right: 5.4pt; padding-left: 5.4pt">8.&#9;Shared Dispositive Power&#9;<B>4,345,571</B></TD></TR>
</TABLE>
<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0 0 0 1in; text-indent: -0.5in">&nbsp;</P>

<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0 0 0 1in; text-indent: -0.5in">9.&#9;Aggregate Amount Beneficially
Owned by Each Reporting Person <B> &#9;4,345,571</B></P>

<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0"><U>&#9;</U></P>

<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0">&nbsp;</P>

<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0 0 0 1in; text-indent: -0.5in">10.&#9;Check if the Aggregate Amount
in Row (9) Excludes Certain Shares (See<BR>
Instructions)&#9;<B>______</B></P>

<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0"><U>&#9;</U></P>

<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0">&nbsp;</P>

<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0 0 0 1in; text-indent: -0.5in">11.&#9;Percent of Class Represented
by Amount in Row (9)&#9;<B>8.29%</B></P>

<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0"><U>&#9;</U></P>

<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0">&nbsp;</P>

<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0 0 0 1in; text-indent: -0.5in">12.&#9;Type of Reporting Person (See
Instructions)&#9;<B>IN, HC</B></P>

<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0"><U>&#9;</U></P>

<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0">&nbsp;</P>


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<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0">&nbsp;</P>

<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0"><U>&#9;</U></P>

<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0">&nbsp;</P>

<TABLE CELLPADDING="0" CELLSPACING="0" WIDTH="100%" STYLE="font: 11pt Times New Roman, Times, Serif; margin-top: 0; margin-bottom: 0"><TR STYLE="vertical-align: top">
<TD STYLE="width: 0.5in"></TD><TD STYLE="width: 0.5in">1.</TD><TD>Names of Reporting Persons.<BR>
<BR>
<B>Palo Alto Investors LP</B></TD></TR></TABLE>

<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0"><U>&#9;</U></P>

<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0">&nbsp;</P>

<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0 0 0 1in; text-indent: -0.5in">2.&#9;Check the Appropriate Box if
a Member of a Group (See Instructions)<BR>
<BR>
(a)&#9;<U>&#9;</U><BR>
<BR>
(b)&#9;___<U>X</U>__</P>

<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0"><U>&#9;</U></P>

<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0">&nbsp;</P>

<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0 0 0 1in; text-indent: -0.5in">3.&#9;SEC Use Only <U>&#9;&#9;</U></P>

<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0"><U>&#9;</U></P>

<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0 0 0 1in; text-indent: -0.5in">&nbsp;</P>

<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0 0 0 1in; text-indent: -0.5in">4.&#9;Citizenship or Place of Organization
&#9;<B>California</B></P>

<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0 0 0 1in; text-indent: -0.5in">&nbsp;</P>

<TABLE CELLSPACING="0" CELLPADDING="0" STYLE="width: 100%; border-collapse: collapse">
<TR STYLE="vertical-align: top">
    <TD ROWSPAN="4" STYLE="width: 19%; border-top: windowtext 1pt solid; padding-right: 5.4pt; padding-left: 5.4pt">
        <P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0">Number of</P>
        <P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0">Shares</P>
        <P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0">Beneficially</P>
        <P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0">Owned by</P>
        <P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0">Each Reporting</P>
        <P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0">Person With:</P></TD>
    <TD STYLE="width: 81%; border-top: windowtext 1pt solid; border-bottom: windowtext 1pt solid; font: 11pt Times New Roman, Times, Serif; padding-right: 5.4pt; padding-left: 5.4pt">5.&#9;Sole Voting Power&#9;<B>0</B></TD></TR>
<TR STYLE="vertical-align: top">
    <TD STYLE="border-bottom: windowtext 1pt solid; font: 11pt Times New Roman, Times, Serif; padding-right: 5.4pt; padding-left: 5.4pt">6.&#9;Shared Voting Power&#9;<B>4,345,571</B></TD></TR>
<TR STYLE="vertical-align: top">
    <TD STYLE="border-bottom: windowtext 1pt solid; font: 11pt Times New Roman, Times, Serif; padding-right: 5.4pt; padding-left: 5.4pt">7.&#9;Sole Dispositive Power&#9;<B>0</B></TD></TR>
<TR STYLE="vertical-align: top">
    <TD STYLE="border-bottom: windowtext 1pt solid; font: 11pt Times New Roman, Times, Serif; padding-right: 5.4pt; padding-left: 5.4pt">8.&#9;Shared Dispositive Power&#9;<B>4,345,571</B></TD></TR>
</TABLE>
<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0 0 0 1in; text-indent: -0.5in">&nbsp;</P>

<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0 0 0 1in; text-indent: -0.5in">9.&#9;Aggregate Amount Beneficially
Owned by Each Reporting Person&#9;<B>4,345,571</B></P>

<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0"><U>&#9;</U></P>

<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0">&nbsp;</P>

<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0 0 0 1in; text-indent: -0.5in">10.&#9;Check if the Aggregate Amount
in Row (9) Excludes Certain Shares (See<BR>
Instructions)&#9;<B>______</B></P>

<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0"><U>&#9;</U></P>

<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0">&nbsp;</P>

<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0 0 0 1in; text-indent: -0.5in">11.&#9;Percent of Class Represented
by Amount in Row (9)&#9;<B>8.29%</B></P>

<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0"><U>&#9;</U></P>

<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0">&nbsp;</P>

<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0 0 0 1in; text-indent: -0.5in">12.&#9;Type of Reporting Person (See
Instructions)&#9;<B>OO, IA</B></P>

<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0"><U>&#9;</U></P>

<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0">&nbsp;</P>

<DIV STYLE="margin-bottom: 6pt; text-align: center">4<TABLE CELLPADDING="0" CELLSPACING="0" STYLE="width: 100%"><TR><TD STYLE="text-align: center; width: 100%"><!-- Field: Sequence; Type: Arabic; Name: PageNo --><!-- Field: /Sequence --></TD></TR></TABLE></DIV>
    <DIV STYLE="page-break-before: always; margin-top: 6pt"><TABLE CELLPADDING="0" CELLSPACING="0" STYLE="width: 100%"><TR><TD STYLE="text-align: left; width: 100%">CUSIP 189464100</TD></TR></TABLE></DIV>
    <!-- Field: /Page -->

<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0">&nbsp;</P>


<TABLE CELLPADDING="0" CELLSPACING="0" WIDTH="100%" STYLE="font: 11pt Times New Roman, Times, Serif; margin-top: 0; margin-bottom: 0"><TR STYLE="vertical-align: top">
<TD STYLE="width: 0.5in"></TD><TD STYLE="width: 0.5in">1.</TD><TD>Names of Reporting Persons.<BR>
<BR>
<B>PAI LLC</B></TD></TR></TABLE>

<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0"><U>&#9;</U></P>

<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0">&nbsp;</P>

<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0 0 0 1in; text-indent: -0.5in">2.&#9;Check the Appropriate Box if
a Member of a Group (See Instructions)<BR>
<BR>
(a)&#9;<U>&#9;</U><BR>
<BR>
(b)&#9;___<U>X</U>__</P>

<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0"><U>&#9;</U></P>

<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0">&nbsp;</P>

<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0 0 0 1in; text-indent: -0.5in">3.&#9;SEC Use Only <U>&#9;&#9;</U></P>

<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0"><U>&#9;</U></P>

<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0 0 0 1in; text-indent: -0.5in">&nbsp;</P>

<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0 0 0 1in; text-indent: -0.5in">4.&#9;Citizenship or Place of Organization
&#9;<B>California</B></P>

<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0 0 0 1in; text-indent: -0.5in">&nbsp;</P>

<TABLE CELLSPACING="0" CELLPADDING="0" STYLE="width: 100%; border-collapse: collapse">
<TR STYLE="vertical-align: top">
    <TD ROWSPAN="4" STYLE="width: 19%; border-top: windowtext 1pt solid; padding-right: 5.4pt; padding-left: 5.4pt">
        <P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0">Number of</P>
        <P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0">Shares</P>
        <P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0">Beneficially</P>
        <P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0">Owned by</P>
        <P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0">Each Reporting</P>
        <P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0">Person With:</P></TD>
    <TD STYLE="width: 81%; border-top: windowtext 1pt solid; border-bottom: windowtext 1pt solid; font: 11pt Times New Roman, Times, Serif; padding-right: 5.4pt; padding-left: 5.4pt">5.&#9;Sole Voting Power&#9;<B>0</B></TD></TR>
<TR STYLE="vertical-align: top">
    <TD STYLE="border-bottom: windowtext 1pt solid; font: 11pt Times New Roman, Times, Serif; padding-right: 5.4pt; padding-left: 5.4pt">6.&#9;Shared Voting Power&#9;<B>4,345,571</B></TD></TR>
<TR STYLE="vertical-align: top">
    <TD STYLE="border-bottom: windowtext 1pt solid; font: 11pt Times New Roman, Times, Serif; padding-right: 5.4pt; padding-left: 5.4pt">7.&#9;Sole Dispositive Power&#9;<B>0</B></TD></TR>
<TR STYLE="vertical-align: top">
    <TD STYLE="border-bottom: windowtext 1pt solid; font: 11pt Times New Roman, Times, Serif; padding-right: 5.4pt; padding-left: 5.4pt">8.&#9;Shared Dispositive Power&#9;<B>4,345,571</B></TD></TR>
</TABLE>
<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0 0 0 1in; text-indent: -0.5in">&nbsp;</P>

<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0 0 0 1in; text-indent: -0.5in">9.&#9;Aggregate Amount Beneficially
Owned by Each Reporting Person&#9;<B>4,345,571</B></P>

<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0"><U>&#9;</U></P>

<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0">&nbsp;</P>

<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0 0 0 1in; text-indent: -0.5in">10.&#9;Check if the Aggregate Amount
in Row (9) Excludes Certain Shares (See<BR>
Instructions)&#9;<B>______</B></P>

<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0"><U>&#9;</U></P>

<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0">&nbsp;</P>

<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0 0 0 1in; text-indent: -0.5in">11.&#9;Percent of Class Represented
by Amount in Row (9)&#9;<B>8.29%</B></P>

<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0"><U>&#9;</U></P>

<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0">&nbsp;</P>

<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0 0 0 1in; text-indent: -0.5in">12.&#9;Type of Reporting Person (See
Instructions)&#9;<B>OO, IA</B></P>

<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0"><U>&#9;</U></P>

<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0">&nbsp;</P>

<DIV STYLE="margin-bottom: 6pt; text-align: center">5<TABLE CELLPADDING="0" CELLSPACING="0" STYLE="width: 100%"><TR><TD STYLE="text-align: center; width: 100%"><!-- Field: Sequence; Type: Arabic; Name: PageNo --><!-- Field: /Sequence --></TD></TR></TABLE></DIV>
    <DIV STYLE="page-break-before: always; margin-top: 6pt"><TABLE CELLPADDING="0" CELLSPACING="0" STYLE="width: 100%"><TR><TD STYLE="text-align: left; width: 100%">CUSIP 189464100</TD></TR></TABLE></DIV>
    <!-- Field: /Page -->

<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0">&nbsp;</P>

<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0"><U>&#9;</U></P>

<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0">&nbsp;</P>

<TABLE CELLPADDING="0" CELLSPACING="0" WIDTH="100%" STYLE="font: 11pt Times New Roman, Times, Serif; margin-top: 0; margin-bottom: 0"><TR STYLE="vertical-align: top">
<TD STYLE="width: 0.5in"></TD><TD STYLE="width: 0.5in">1.</TD><TD>Names of Reporting Persons.<BR>
<BR>
<B>Palo Alto Healthcare Master Fund II, L.P.</B></TD></TR></TABLE>

<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0"><U>&#9;</U></P>

<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0">&nbsp;</P>

<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0 0 0 1in; text-indent: -0.5in">2.&#9;Check the Appropriate Box if
a Member of a Group (See Instructions)<BR>
<BR>
(a)&#9;<U>&#9;</U><BR>
<BR>
(b)&#9;___<U>X</U>__</P>

<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0"><U>&#9;</U></P>

<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0">&nbsp;</P>

<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0 0 0 1in; text-indent: -0.5in">3.&#9;SEC Use Only <U>&#9;&#9;</U></P>

<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0"><U>&#9;</U></P>

<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0 0 0 1in; text-indent: -0.5in">&nbsp;</P>

<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0 0 0 1in; text-indent: -0.5in">4.&#9;Citizenship or Place of Organization
&#9;<B>Cayman Islands</B></P>

<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0 0 0 1in; text-indent: -0.5in">&nbsp;</P>

<TABLE CELLSPACING="0" CELLPADDING="0" STYLE="width: 100%; border-collapse: collapse">
<TR STYLE="vertical-align: top">
    <TD ROWSPAN="4" STYLE="width: 19%; border-top: windowtext 1pt solid; padding-right: 5.4pt; padding-left: 5.4pt">
        <P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0">Number of</P>
        <P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0">Shares</P>
        <P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0">Beneficially</P>
        <P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0">Owned by</P>
        <P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0">Each Reporting</P>
        <P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0">Person With:</P></TD>
    <TD STYLE="width: 81%; border-top: windowtext 1pt solid; border-bottom: windowtext 1pt solid; font: 11pt Times New Roman, Times, Serif; padding-right: 5.4pt; padding-left: 5.4pt">5.&#9;Sole Voting Power&#9;<B>0</B></TD></TR>
<TR STYLE="vertical-align: top">
    <TD STYLE="border-bottom: windowtext 1pt solid; font: 11pt Times New Roman, Times, Serif; padding-right: 5.4pt; padding-left: 5.4pt">6.&#9;Shared Voting Power&#9;<B>2,733,722</B></TD></TR>
<TR STYLE="vertical-align: top">
    <TD STYLE="border-bottom: windowtext 1pt solid; font: 11pt Times New Roman, Times, Serif; padding-right: 5.4pt; padding-left: 5.4pt">7.&#9;Sole Dispositive Power&#9;<B>0</B></TD></TR>
<TR STYLE="vertical-align: top">
    <TD STYLE="border-bottom: windowtext 1pt solid; font: 11pt Times New Roman, Times, Serif; padding-right: 5.4pt; padding-left: 5.4pt">8.&#9;Shared Dispositive Power&#9;<B>2,733,722</B></TD></TR>
</TABLE>
<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0 0 0 1in; text-indent: -0.5in">&nbsp;</P>

<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0 0 0 1in; text-indent: -0.5in">9.&#9;Aggregate Amount Beneficially
Owned by Each Reporting Person<B> &#9;2,733,722</B></P>

<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0"><U>&#9;</U></P>

<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0">&nbsp;</P>

<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0 0 0 1in; text-indent: -0.5in">10.&#9;Check if the Aggregate Amount
in Row (9) Excludes Certain Shares (See<BR>
Instructions)&#9;<B>______</B></P>

<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0"><U>&#9;</U></P>

<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0">&nbsp;</P>

<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0 0 0 1in; text-indent: -0.5in">11.&#9;Percent of Class Represented
by Amount in Row (9)&#9;<B>5.21%</B></P>

<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0"><U>&#9;</U></P>

<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0">&nbsp;</P>

<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0 0 0 1in; text-indent: -0.5in">12.&#9;Type of Reporting Person (See
Instructions)&#9;<B>PN</B></P>

<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0"><U>&#9;</U></P>


<!-- Field: Page; Sequence: 5 -->
    <DIV STYLE="margin-bottom: 6pt"><TABLE CELLPADDING="0" CELLSPACING="0" STYLE="width: 100%"><TR><TD STYLE="text-align: center; width: 100%"><!-- Field: Sequence; Type: Arabic; Name: PageNo -->5<!-- Field: /Sequence --></TD></TR></TABLE></DIV>
    <DIV STYLE="page-break-before: always; margin-top: 6pt"><TABLE CELLPADDING="0" CELLSPACING="0" STYLE="width: 100%"><TR><TD STYLE="text-align: left; width: 100%">CUSIP 921659108</TD></TR></TABLE></DIV>
    <!-- Field: /Page -->

<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0"><B>Item 1.</B></P>

<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0">&nbsp;</P>

<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0 0 0 1in; text-indent: -0.5in">(a)&#9;Name of Issuer<BR>
<BR>
<B>Vanda Pharmaceuticals, Inc.</B><BR>
<U>&#9;</U></P>

<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0 0 0 1in; text-indent: -0.5in">&nbsp;</P>

<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0 0 0 1in; text-indent: -0.5in">(b)&#9;Address of Issuer's Principal
Executive Offices<BR>
<BR>
<B>2200 Pennsylvania Avenue, N.W., Suite 300E, Washington, D.C. 20037</B><BR>
<U>&#9;</U></P>

<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0"><B>Item 2.</B></P>

<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0">&nbsp;</P>

<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0 0 0 1in; text-indent: -0.5in">(a)&#9;The names of the persons filing
this statement are:

<BR>
<B>Palo Alto Investors LP (&quot;PAI&quot;)</B>
<BR><B>PAI LLC (&ldquo;PAI
GP&rdquo;)&nbsp;</B>
<BR><B>Patrick Lee, MD</B><BR>
<B>Anthony Joonkyoo Yun, MD</B><BR>
<B>Palo Alto Healthcare Master Fund II, L.P. (&quot;Healthcare Master II&quot;)</B><BR>
<B><U>&#9;</U></B>
(collectively, the &quot;Filers&quot;).</TD></TR>

<BR>

<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0 0 0 1in; text-indent: -0.5in">&nbsp;</P>

<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0 0 0 1in; text-indent: -0.5in">(b)&#9;The principal business office
of the Filers except Healthcare Master II is located at:<BR>
<BR>
<B>470 University Avenue, Palo Alto, CA 94301</B><BR>
<BR>
The principal business office of Healthcare Master II is located at:<BR>
<BR>
<B>Cayman Corporate Centre, 27 Hospital Road</B><BR>
<B>George Town, Grand Cayman KY1-9008</B><BR>
<B>Cayman Islands</B><BR>
<B><U>&#9;</U></B></P>

<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0 0 0 1in; text-indent: -0.5in">&nbsp;</P>

<TABLE CELLPADDING="0" CELLSPACING="0" WIDTH="100%" STYLE="font: 11pt Times New Roman, Times, Serif; margin-top: 0; margin-bottom: 0"><TR STYLE="vertical-align: top">
<TD STYLE="width: 0.5in"></TD><TD STYLE="width: 0.5in">(c)</TD><TD>For citizenship of Filers, see Item 4 of the cover sheet for each Filer.</TD></TR></TABLE>

<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0 0 0 1in; text-indent: -0.5in">&nbsp;</P>

<TABLE CELLPADDING="0" CELLSPACING="0" WIDTH="100%" STYLE="font: 11pt Times New Roman, Times, Serif; margin-top: 0; margin-bottom: 0"><TR STYLE="vertical-align: top">
<TD STYLE="width: 0.5in"></TD><TD STYLE="width: 0.5in">(d)</TD><TD>This statement relates to shares of Common Stock of the Issuer (the &quot;Stock&quot;).</TD></TR></TABLE>

<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0 0 0 1in; text-indent: -0.5in">&nbsp;</P>

<TABLE CELLPADDING="0" CELLSPACING="0" WIDTH="100%" STYLE="font: 11pt Times New Roman, Times, Serif; margin-top: 0; margin-bottom: 0"><TR STYLE="vertical-align: top">
<TD STYLE="width: 0.5in"></TD><TD STYLE="width: 0.5in">(e)</TD><TD>The CUSIP number of the Issuer is: <B>921659108</B></TD></TR></TABLE>

<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0"><B>&nbsp;</B></P>


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    <DIV STYLE="page-break-before: always; margin-top: 6pt"><TABLE CELLPADDING="0" CELLSPACING="0" STYLE="width: 100%"><TR><TD STYLE="text-align: left; width: 100%">CUSIP 921659108</TD></TR></TABLE></DIV>
    <!-- Field: /Page -->

<P STYLE="font: bold 11pt Times New Roman, Times, Serif; margin: 0 0 0 1in; text-indent: -1in">Item 3.&#9;If this statement is
filed pursuant to rule 240.13d-1(b) or 240.13d-2(b) or (c), check whether the person filing is a:</P>

<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0 0 0 1in; text-indent: -0.5in">&nbsp;</P>

<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0 0 0 1.5in; text-indent: -1in">(a)&#9;[ ]&#9;Broker or dealer registered
under section 15 of the Act (15 U.S.C. 78o).</P>

<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0 0 0 1in; text-indent: -0.5in">&nbsp;</P>

<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0 0 0 1.5in; text-indent: -1in">(b)&#9;[ ]&#9;Bank as defined in section
3(a)(6) of the Act (15 U.S.C. 78c).</P>

<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0 0 0 1.5in; text-indent: -1in">&nbsp;</P>

<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0 0 0 1.5in; text-indent: -1in">(c)&#9;[ ]&#9;Insurance company as
defined in section 3(a)(19) of the Act (15 U.S.C. 78c).</P>

<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0 0 0 1.5in; text-indent: -1in">&nbsp;</P>

<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0 0 0 1.5in; text-indent: -1in">(d)&#9;[ ]&#9;Investment company registered
under section 8 of the Investment Company Act of 1940 (15 U.S.C. 80a-8).</P>

<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0 0 0 1.5in; text-indent: -1in">&nbsp;</P>

<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0 0 0 1.5in; text-indent: -1in">(e)&#9;[ <B>x</B> ]&#9;An investment
adviser in accordance with section 240.13d-1(b)(1)(ii)(E) (as to PAI).</P>

<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0 0 0 1.5in; text-indent: -1in">&nbsp;</P>

<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0 0 0 1.5in; text-indent: -1in">(f)&#9;[ ]&#9;An employee benefit plan
or endowment fund in accordance with section 240.13d-1(b)(1)(ii)(F).</P>

<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0 0 0 1.5in; text-indent: -1in">&nbsp;</P>

<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0 0 0 1.5in; text-indent: -1in">(g)&#9;[ <B>x</B> ]&#9;A parent holding
company or control person in accordance with 240.13d-1(b)(1)(ii)(G) (as to Dr. Lee and Dr. Yun).</P>

<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0 0 0 1.5in; text-indent: -1in">&nbsp;</P>

<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0 0 0 1.5in; text-indent: -1in">(h)&#9;[ ]&#9;A savings association
as defined in section 3(b) of the Federal Deposit Insurance Act (12 U.S.C. 1813).</P>

<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0 0 0 1.5in; text-indent: -1in">&nbsp;</P>

<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0 0 0 1.5in; text-indent: -1in">(i)&#9;[ ]&#9;A church plan that is
excluded from the definition of an investment company under section 3(c)(14) of the Investment Company Act of 1940 (15 U.S.C. 80a-3).</P>

<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0 0 0 1.5in; text-indent: -1in">&nbsp;</P>

<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0 0 0 1.5in; text-indent: -1in">(j)&#9;[ ]&#9;A non-U.S. institution
in accordance with &sect;240.13d-1(b)(ii)(J).</P>

<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0 0 0 1.5in; text-indent: -1in">&nbsp;</P>

<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0 0 0 1.5in; text-indent: -1in">(k)&#9;[ ]&#9;Group, in accordance
with Rule 13d-1(b)(1)(ii)(K).</P>

<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0 0 0 1.5in; text-indent: -1in">&nbsp;</P>

<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0 0 0 0.5in; text-indent: 0in">If filing as a non-U.S. institution
in accordance with &sect;240.13d-1(b)(1)(ii)(J), please specify the type of institution _______________________________________________________________.</P>

<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0 0 0 1in; text-indent: -0.5in">&nbsp;</P>

<P STYLE="font: bold 11pt Times New Roman, Times, Serif; margin: 0 0 0 1in; text-indent: -1in">Item 4.&#9;Ownership.</P>

<P STYLE="font: bold 11pt Times New Roman, Times, Serif; margin: 0 0 0 1in; text-indent: -1in">&nbsp;</P>

<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0">See Items 5-9 and 11 of the cover page for each Filer.</P>

<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0 0 0 1in; text-indent: -0.5in">&nbsp;</P>

<P STYLE="font: bold 11pt Times New Roman, Times, Serif; margin: 0 0 0 1in; text-indent: -1in">Item 5.&#9;Ownership of Five Percent
or Less of a Class</P>

<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0 0 0 1in; text-indent: -1in"><FONT STYLE="font-weight: normal">&nbsp;</FONT></P>

<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0">If this statement is being filed to report the fact that as of the
date hereof the reporting person has ceased to be the beneficial owner of more than five percent of the class of securities, check
the following [ ].</P>

<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0">&nbsp;</P>

<P STYLE="font: bold 11pt Times New Roman, Times, Serif; margin: 0 0 0 1in; text-indent: -1in">Item 6.&#9;Ownership of More than
Five Percent on Behalf of Another Person.</P>

<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0 0 0 1in; text-indent: -1in"><FONT STYLE="font-weight: normal">&nbsp;</FONT></P>

<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0">PAI is a registered investment adviser and investment adviser of investment limited partnerships, and is the investment adviser to other investment funds.
PAI GP is the general partner of investment limited partnerships. PAI&rsquo;s clients have the right to receive or the power
to direct the receipt of dividends from, or the proceeds from the sale of, the Stock. No individual client outside of
Healthcare Master II separately holds more than five percent of the outstanding Stock.</P>

<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0">&nbsp;</P>

<P STYLE="font: bold 11pt Times New Roman, Times, Serif; margin: 0 0 0 1in; text-indent: -1in">Item 7.&#9;Identification and Classification
of the Subsidiary Which Acquired the Security Being Reported on By the Parent Holding Company.</P>

<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0 0 0 1in; text-indent: -1in"><FONT STYLE="font-weight: normal">&nbsp;</FONT></P>

<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0">Not applicable.</P>

<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0">&nbsp;</P>

<P STYLE="font: bold 11pt Times New Roman, Times, Serif; margin: 0 0 0 1in; text-indent: -1in">Item 8.&#9;Identification and Classification
of Members of the Group.</P>

<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0">&nbsp;</P>

<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0">Dr. Lee and Dr. Yun co-manage PAI. The Filers are filing this Schedule
13G jointly, but not as members of a group, and each of them expressly disclaims membership in a group. Each Filer disclaims beneficial
ownership of the Stock except to the extent of that Filer&rsquo;s pecuniary interest therein.</P><BR>

<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0">In addition, the filing of this Schedule 13G on behalf of Healthcare Master II should not be construed as an admission that any of them is, and each disclaims that it is, a beneficial owner, as defined in Rule 13d-3 under the Securities Exchange Act of 1934, of any of the Stock covered by this Schedule 13G.</P>

<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0">&nbsp;</P>

<P STYLE="font: bold 11pt Times New Roman, Times, Serif; margin: 0 0 0 1in; text-indent: -1in">Item 9.&#9;Notice of Dissolution
of Group.</P>

<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0">&nbsp;</P>

<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0">Not applicable.</P>

<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0">&nbsp;</P>

<P STYLE="font: bold 11pt Times New Roman, Times, Serif; margin: 0 0 0 1in; text-indent: -1in">Item 10.&#9;Certification.</P>

<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0">&nbsp;</P>

<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0">By signing below I certify that, to the best of my knowledge and belief, the securities referred to above were acquired and are held in the ordinary course of business and were not acquired and are not held for the purpose of or with the effect of changing or influencing the control of the issuer of the securities and were not acquired and are not held in connection with or as a participant in any transaction having that purpose or effect.</P>

<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0">&nbsp;</P>

<P STYLE="font: bold 11pt Times New Roman, Times, Serif; margin: 0 0 0 1in; text-indent: -1in">Exhibits.</P>

<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0">&nbsp;</P>

<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0 0 0 1in; text-indent: -1in"><FONT STYLE="font-weight: normal">Exhibit
A Joint Filing Agreement.</FONT></P>

<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0; text-align: center">SIGNATURE</P>
<BR>

<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0">After reasonable inquiry and to the best of my knowledge and belief,
I certify that the information set forth in this statement is true, complete and correct.</P>

<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0">&nbsp;</P>

<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0">Dated:&#9;Feburary 18, 2019</P>

<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0">&nbsp;</P>

<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0"></P>

<TABLE CELLPADDING="0" CELLSPACING="0" STYLE="border-collapse: collapse; font: 11pt Times New Roman, Times, Serif; width: 100%">
<TR STYLE="vertical-align: top; text-align: left">
    <TD STYLE="width: 50%"><P STYLE="margin-top: 0; margin-bottom: 0"><B>PALO ALTO HEALTHCARE MASTER FUND II, L.P.</B></P>
                           <P STYLE="margin-top: 0; margin-bottom: 0">&nbsp;</P>
                           <P STYLE="margin-top: 0; margin-bottom: 0">By: PAI LLC, General Partner</P>
                           <P STYLE="margin-top: 0; margin-bottom: 0"></P></TD>
    <TD STYLE="width: 50%"><P STYLE="margin-top: 0; margin-bottom: 0"><B>PALO ALTO INVESTORS LP</B></P>
                           <P STYLE="margin-top: 0; margin-bottom: 0">&nbsp;</P>
                           <P STYLE="margin-top: 0; margin-bottom: 0">&nbsp;</P>
                           <P STYLE="margin-top: 0; margin-bottom: 0">By: /s/ Angela Nguyen-Dinh, Chief Compliance Officer</P></TD></TR>
<TR STYLE="vertical-align: top; text-align: left">
    <TD><P STYLE="margin-top: 0; margin-bottom: 0">&nbsp;</P>
        <P STYLE="margin-top: 0; margin-bottom: 0"><B>PAI LLC</B></P>
        <P STYLE="margin-top: 0; margin-bottom: 0">&nbsp;</P>
        <P STYLE="margin-top: 0; margin-bottom: 0">By: /s/ Patrick Lee, MD</P></TD>
    <TD>&nbsp;</TD></TR>
<TR STYLE="vertical-align: top; text-align: left">
    <TD><P STYLE="margin-top: 0; margin-bottom: 0">&nbsp;</P>
        <P STYLE="margin-top: 0; margin-bottom: 0">/s/ Patrick Lee, MD</P></TD>
    <TD><P STYLE="margin-top: 0; margin-bottom: 0">&nbsp;</P>
        <P STYLE="margin-top: 0; margin-bottom: 0">/s/ Anthony Joonkyoo Yun, MD</P></TD></TR>
</TABLE>

<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0">&nbsp;</P>

<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0; text-align: center">EXHIBIT A<BR>
AGREEMENT REGARDING JOINT FILING<BR>
OF STATEMENT ON SCHEDULE 13D OR 13G</P>

<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0; text-align: center">&nbsp;</P>

<P STYLE="font: 11pt Times New Roman, Times, Serif; margin: 0">The undersigned agree to file jointly with the Securities and Exchange
Commission (the &quot;SEC&quot;) any and all statements on Schedule 13D or Schedule 13G (and any amendments or supplements thereto)
required under section 13(d) of the Securities Exchange Act of 1934, as amended, in connection with purchases and sales by the
undersigned of the securities of any issuer until such time as the undersigned file with the SEC a statement terminating this Agreement
Regarding Joint Filing of Statement on Schedule 13D or 13G. For that purpose, the undersigned hereby constitute and appoint Palo
Alto Investors, LP, a California limited partnership, as their true and lawful agent and attorney-in-fact, with full power
and authority for and on behalf of the undersigned to prepare or cause to be prepared, sign, file with the SEC and furnish to any
other person all certificates, instruments, agreements and documents necessary to comply with section 13(d) and section 16(a) of
the Securities Exchange Act of 1934, as amended, in connection with said purchases and sales, and to do and perform every act necessary
and proper to be done incident to the exercise of the foregoing power, as fully as the undersigned might or could do if personally
present, until such time as the undersigned file with the SEC a statement terminating this Agreement Regarding Joint Filing of
Statement on Schedule 13D or 13G.</P>

<P STYLE="font: 12pt Times New Roman, Times, Serif; margin: 0; text-align: justify">&nbsp;</P>

<P STYLE="font: 12pt Times New Roman, Times, Serif; margin: 0">Dated:&#9;Feburary 18, 2019</P>

<P STYLE="font: 12pt Times New Roman, Times, Serif; margin: 0">&nbsp;</P>

<TABLE CELLPADDING="0" CELLSPACING="0" STYLE="border-collapse: collapse; font: 11pt Times New Roman, Times, Serif; width: 100%"><TR STYLE="vertical-align: top; text-align: left"><TD STYLE="width: 50%"><P STYLE="margin-top: 0; margin-bottom: 0"><B>PALO ALTO HEALTHCARE MASTER FUND II, L.P.</B></P>
                           <P STYLE="margin-top: 0; margin-bottom: 0">&nbsp;</P>
                           <P STYLE="margin-top: 0; margin-bottom: 0">By: PAI LLC, General Partner</P>
                           <P STYLE="margin-top: 0; margin-bottom: 0"></P></TD>
    <TD STYLE="width: 50%"><P STYLE="margin-top: 0; margin-bottom: 0"><B>PALO ALTO INVESTORS LP</B></P>
                           <P STYLE="margin-top: 0; margin-bottom: 0">&nbsp;</P>
                           <P STYLE="margin-top: 0; margin-bottom: 0">&nbsp;</P>
                           <P STYLE="margin-top: 0; margin-bottom: 0">By: /s/ Angela Nguyen-Dinh, Chief Compliance Officer</P></TD></TR>
<TR STYLE="vertical-align: top; text-align: left">
    <TD><P STYLE="margin-top: 0; margin-bottom: 0">&nbsp;</P>
        <P STYLE="margin-top: 0; margin-bottom: 0"><B>PAI LLC</B></P>
        <P STYLE="margin-top: 0; margin-bottom: 0">&nbsp;</P>
        <P STYLE="margin-top: 0; margin-bottom: 0">By: /s/ Patrick Lee, MD</P></TD>
    <TD>&nbsp;</TD></TR>
<TR STYLE="vertical-align: top; text-align: left">
    <TD><P STYLE="margin-top: 0; margin-bottom: 0">&nbsp;</P>
        <P STYLE="margin-top: 0; margin-bottom: 0">/s/ Patrick Lee, MD</P></TD>
    <TD><P STYLE="margin-top: 0; margin-bottom: 0">&nbsp;</P>
        <P STYLE="margin-top: 0; margin-bottom: 0">/s/ Anthony Joonkyoo Yun, MD</P></TD></TR></TABLE>

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