Trials with Maya Z

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Hello, everyone. This is Maya and you're again with Trials with Maya Z and I have today a friend of mine from my LinkedIn network, Steve Wimmer. He's posting very interesting things, but one of the most interesting posts was about Facebook ads and patient recruitment.

I have followed Steve for quite some time, and I've seen very interesting perspectives when it comes to patient recruitment. So I decided to invite Steve to this podcast and get his perspective and opinions about things that are happening in this space. Steve, welcome. And I'll give you the word to introduce yourself.

Awesome. Thanks so much, Maya. Yeah. It's always cool to connect with people on LinkedIn and we've actually met in real life as well a couple of times. So thanks for having me. Just quick background so that you can understand, like, my perspective. I've been in the industry for about 4 years, and I think it doesn't matter how long I stay in the industry.

I still will feel like a newbie, because I don't really have a science background. And, I always feel like I'm learning something every time I talk to someone, but my background is more in e-commerce direct-to-consumer package goods was what I was doing right before coming to 1nHealth. So we're a patient recruitment company and my entire time in the industry has been focused on using the internet to facilitate patient recruitment and, it's been exciting. I have also joined a couple of trials as a patient because I'm constantly clicking around on the internet and then getting served these ads for trials.

And sometimes I want to follow them all the way through. So I have a little bit of a patient perspective as well.

Steve, I had the first question, but now that you presented yourself, we have something very much in common. I don't have a science background as well. And I joined the industry from a completely different background.

So I know exactly what you're speaking about when you said I learn about the industry every single day, let's say that now, 15 years later. It's less, but still, I learn a lot, and when it comes to patient recruitment, yes, a lot to be uncovered. But you mentioned something in your introduction, that you come from e-commerce.

And now the last four years you have worked in the patient recruitment space. What are, in your opinion, these common things between patient recruitment, clinical research in general, and e-commerce?

Sure. I think the biggest similarity is the mechanism of using the internet as a communication platform and getting people to take action. So you can think that a billboard on the side of the road is generally about branding and just awareness. Very few people are going to be able to take action because they're driving their car and they can't click a button.

They can't remember the thing. So it's more about just knowing that the thing exists and e-commerce is very different because if you're running these ads and people aren't adding the item to their cart and checking out, you don't have a business. So you have to be able to not only get people to take action but in such a way that it's like ROI positive and sustains your business.

So with patient recruitment, it's a very similar mechanism of action. We're trying to get people's attention. They didn't come on social media to look for a clinical trial. There are clinical trial search engines for that, so we're interrupting their day. The reason they picked up their phone in the first place and asked them to go to a different location. So it just has to be a very compelling message or offer, so to speak, to add to cart a clinical trial. And because these folks are generally not in the state of mind of thinking about their health or thinking of themselves as a patient, education is an important part of the journey.

But I think the first step to even want to take that journey is positioning the trial as something compelling. There was a post that went around a couple of weeks ago that I saw it from Brad, but it was, titled severely. Please be dying, but not too quickly. And it was an ER doctor talking about her husband's cancer journey. And, what was really interesting to me is that multiple times she alluded to consumer technology and how easy that was for her to do things like find a dress and just how far behind the interface and the technology was for clinical trials and just asking the question out loud. Like, why is this experience so far away from what we've been conditioned to expect as consumers?

So a big part of it is just aligning the journey with someone's expectation. If they're coming in the front door through an online channel, that whole journey needs to be consumer-grade, which really means. It looks modern, it's got a user interface that's understandable, and a patient can go as fast as they want to. People generally want to self-navigate as far as they can without interacting with customer service if they're shopping. And there's a similar situation going on with clinical trials. They do want to talk to someone eventually, but it's further down the road than I think a lot of people would imagine.

Hmm. Yeah. Makes sense. So if you have to think about your past e-commerce career, and you mentioned that article, and this story is actually one of the many out there. And as part of our platform, FindMeCure, we help patients to apply for clinical trials, and that happens all the time.

And I wonder if you now think about this story, the fact that, the lady mentioned a couple of things that she used from outside of the industry that were working much better and thinking about your past career in e-commerce. What would be these? I would say one thing, but let's say top three things that you think are working quite well in e-commerce could be working quite well in patient recruitment, but they're not there yet.

I'll try to answer this without maybe giving away too much of the secret sauce. I think a lot of the philosophy, about how we operate at 1nHealth is informed by e-commerce, which we could consider under the umbrella of performance marketing.

There's another category of awareness marketing, which is really getting your brand out there and capturing mind share.

I'll say one thing at each, each piece of what we would call 'the funnel'. So getting from the world of internet users down to an actual enrolled patient. So one thing, that e-commerce marketers do really well is they iterate on their messaging. So they will have 10 different versions of the same image and there'll be testing and testing and testing them to find the one. That outperforms the others, and then they will put all their eggs in that basket until the audience is exhausted and then they'll rotate to different creative, they'll do the same thing with messaging, just to get that initial click. And the difference between some of these creative assets is astounding. So one of the things I see when I look at competitor ads, or maybe ads that are being run by a sponsor or site. And it's clear that they don't have this philosophy that there's generally one or two images at most and they're almost always variations on the same theme.

You see a lot of stock photography, which in our testing has performed way worse than basically any other creative asset. So abstract images, vector images, videos. If we're going to use photography, we usually treat it pretty heavily. So we'll, you know, cut out the image and put a color filter on their text over.

So all that top-of-the-funnel one thing that e-commerce does really well is finding assets that work. They don't look to hit a home run. They don't spend 10 weeks brainstorming the most creative image, and then put that out into the world. They put a hundred images out in the world and then let the click-through rates dictate. Where they're going to invest, the middle of the funnel, something that e-commerce I think does pretty well is they make it really easy to do the thing that they want you to do. So if you go to a shopping page, there are not a lot of bells and whistles. Amazon's may be different, but that's its own thing.

But if you're clicking onto like a store page for Shopify or something, there's the image. There are some different angles. There's a little bit of text. There's add to cart. They really don't want you navigating sideways. It's going to be harder to get to like about the company or like the history of whatever.

They really want you to make that add-to-cart decision. And so they build landing pages. that are specifically designed to get you to check out.

And if you go to most study pages, they're very intense. And a lot of them have, tons of language scientific language that is generally beyond the average reading level, which in the U S it's like fifth or sixth grade, depending on who you ask.

and they have all this extra information about the mechanism of action of the drug and the history of the condition and the nature of clinical trials and all that stuff is information that people need to know, but probably not yet. If they just clicked on an ad, I think of it like a first date. You're not going to be asking about this person's social security number, and their family history, and their medical history.

You're just going to get to know each other. And so for us, we try to scale up the information, linearly with someone's expressed interest. So if they've just clicked an ad, We're going to give them enough to maybe take a small next step, share some information, and see if you want to go further. But, when we present them with so much information, we find a lot of people just bounce off the page because it becomes overwhelming. And then the last step, I would say, this is the Amazon, legacy in our world is people expect next-day shipping in the US. At least. If you can't get it the next day, it better be an awesome item, or it better be absolutely free. And this idea that things should happen really quickly, even online, is in our minds now. And so one of the things that I've found is that sites just don't often operate at the speed of life. That's a phrase we use around 1nHealth a lot.

We have to meet patients where they're at. And so if someone signed up for something online, They want to hear back as soon as possible. Whereas if Amazon was like, all right, you added this cart, you checked out two or three days from now, a person who confirms the checkouts is going to give you a call, they won't text you.

They're just going to call your phone. And if you miss it, they'll have to call back another time. And then eventually when you talk to them, you'll get your item shipped to you. That's how it's working for patient recruitment right now. Like maybe the site calls patients for one trial on a Tuesday.

We've seen this, so they'll miss the call on a Tuesday and then they'll come back next Tuesday and call again. And we have texting on our platform. So we'll go in and look

and it's like Tuesday at 11 oh four. Sorry, I just missed your call. I'm free now. Can you call back? And then the next action is the next Tuesday and it's another call. And sometimes the processes are not aligned with, the urgency that's felt, by the patient, maybe that's not even urgent. Maybe it's just an interest.

The expectations.

But that interest wanes. Yeah.

Yeah. Well, that's, one of the things that I see the industry really struggling with. We are all patients. We are all consumers. We're different generations. Our expectations change, our interactions with doctors, nurses, hospitals, and facilities change.

And, at the end of the day, the patient is, of course, sites as well, but the patient is the king. They're the ones to decide whether should you participate in the trial or not. Should you stay in the trial or not? Of course, investigators are the ones to invite them.

Investigators are the ones that they trust, usually. But at the end of the day, the final call is with the patients and their families. And if they have certain expectations, we better try to get closer to them. Otherwise, you're absolutely right. I guess, to summarize, we need more e-commerce people in the clinical research space.

Not just with patient recruitment, but there are plenty of things that can be changed. I actually have one question on the iteration thing that you mentioned. I love the idea because you're right. I would use a similar analogy. It's the same with the clinical trial design. We maybe should spend more, not just on the design, but the whole planning of the clinical trial.

We maybe should spend more time on planning to perfect our value proposition to patients, to investigators, the whole strategy. and then start to execute. And right now, I think we are doing some planning, but we do everything by template. And then we jump into the trial and suddenly we are, Oh my God, we're in trouble.

90 percent of the cases. So it's the same with patient recruitment from what I hear, but you mentioned that iterations can help. I would call it experiments, quick experiments to see where to spend most of your budget, most of your time and energy. But, wouldn't that make it also more expensive, for example, like these iterations?

Like, have you done these experiments with or without, iterations, and, yeah, how does it work?

Yeah. I don't think it necessarily makes it more expensive. I think it may be for us, like the main expense associated with creative development. IRB approval. So, submitting it to ethics committees. There are some IRBs that are charging by the image versus by whatever.

So those costs, though, to a sponsor are usually pretty nominal. But our advertising packets for review are 50-70 pages long.

A lot of that's images. So it's not like 50 pages of text, but we are really, putting together like a bank of options for everything. And then once everything's approved, We don't need to go back to the sponsor and ask for approval and we don't need to go to their BNS for approval.

We can just mix and match with this giant pool of approved content versus sticking to one thing. And from a digital marketing perspective, there's really no cost. And in fact, some of these platforms will do it for you. you. can upload images and text and they'll dynamically shift them around and lay them on top of one another and tell you what the winner is.

That's why, Meta, which is Facebook and Instagram is such a powerful advertising tool because they have options like Dynamic Creative where they're going to do the switching for you. Some newer platforms are a little bit behind, like TikTok, I don't think has that yet. It's a couple of years behind where Meta is as an advertising platform, but yeah. Iterating on Creative, I think, is not really an expense at all. It should be table stakes in my opinion.

Yeah. Speaking about different platforms that we can use for advertising, do you have a winner in the space, or which is the number one platform that you would recommend for patient recruitment?

Yeah, I'll maybe give a qualified answer here in that it's Meta, for sure. Which is Facebook and Instagram, for a number of reasons. One, just between those two platforms, their user base in most countries is higher than anything else that you'll see. So not just the US but, but really like across the globe, they've just been around longer and so they have more user base plus, with that Facebook and Instagram combo, they've got a really wide demographic range.

There are a lot of people who have Facebook accounts who haven't logged in in like a year or more than a year, but. may be using Instagram. The other piece is that, like I mentioned, as a platform, it's the most sophisticated one there is. So, there's plenty of social media where you can advertise, but Meta has been just building an insanely effective platform for 15 years.

And so they are way ahead of the curve when it comes to tools to serve advertisers. And so. The downside is that everyone knows this and because it's the easiest to use, like you could be running Facebook ads in 20 minutes if you went to YouTube and watched the right video. And so, a lot of study sites are like, well, we get this budget from our sponsor and our chief medical officer's nephew knows how to run Facebook ads.

So they're going to throw some ads up there and they do, they deliver a degree of results. And what I think is that The industry has been conditioned to expect a certain type of result from online ads, and it usually falls under the umbrella of fine. And there's not really a lot of insight, in my opinion, into what's possible when some really sophisticated marketers get behind the scenes and start running these.

We're just constantly hearing 'oh, wow, we didn't think that was possible'. So Facebook is by far and away the number one, for us, TikTok is number two. And it is. Wildly successful in part because there's less clutter, and there are fewer people running ads there.

And, two, yeah, the audience is just really engaged, but it's the degree of difficulty on TikTok. Five to 10 X, what it is on Facebook. If you Facebook, you can roll out a single image and it can be meaningful for a couple of months,

honestly, before you need to rotate, Tik Tok your creative needs to change pretty much weekly and it has to be good, it has to be video. Like you can't just have a static image, or else people just won't interact with it.

So, I think for that reason, a lot of people shy away. There's also the whole privacy concern stuff, which. Not my area of expertise.

All I know is that there are a lot of engaged patients there and, it's been a very meaningful platform for us.
Okay. Listening to you, I'm thinking, everything makes sense except one thing. I don't know much about marketing. That's not my background, per se, but, what I know is that everything starts with the persona. And the channels that they're using, shouldn't we be using the channels that, the different people, let's say the target patients are using, and they may be Meta, Facebook, Instagram, they may be others, for example?

So shouldn't we create like a bundle of channels or identify the main channels based on the target people? What are your thoughts on that?

Yeah. There are probably two schools of thought here. Uh, one is what you're talking about, where you want to build a strategic plan that aligns with the main demographics of the channel. So if less than 1 percent of the user base is, Elderly population, then you're not going to run ads there.

If you're looking to recruit for, a study for Alzheimer's, the other school of thought is that the Internet is just so big and there are so many people on all these platforms that even if it is 1 percent of the population. It might be meaningful and so, that's kind of where we live.

We will generally carve out 85 to 90 percent of our budget for things that make sense. And then we'll keep in reserve maybe 10 percent for things that, surprise us. So we just know that the internet is a weird place and the best approach we can have is to believe that we don't have it all figured out because that's when you get lazy and that's when you get cocky and that's when you stop experimenting. So just a quick story. We had to recruit for. Folks who are over the age of 65 and naive to colonoscopies, which are recommended at the age of 50 now, so they spent 15 years saying, no, thank you to this procedure, which is a meaningful one, and generally covered in the U. S. So it's not an extra expense. And we had to get them to do a colonoscopy as part of this study. So, 1 of the things we wanted to do was make sure that we were getting, a demographically representative sample. And we know that in some communities of color, these health decisions might be more communally made. So we put some ads together for TikTok about, having the colon conversation with your grandparents. Um, and the idea was like communities of color, particularly maybe they would be closer, be more communal, and talk to their grandparents about the importance of having the screening because of how treatable colon cancer is if it's caught.

And we decided we're already running ads on TikTok. Let's just put some patient-facing ads there as well. And see what happens. You can start with a budget of 5 a day. It's inconsequential. And if it doesn't do anything, just turn it

off. We doubled our budget every day for two weeks before we started to see signs of exhaustion. And by the end, we ended up contributing, I think 2400 patients to this study. It was a very large, sensitive study and about half of them came from TikTok. So 65 and up. Not from the family campaign, but direct these 65-year-olds, there's not a bunch of them, but there's enough of them. And so that's the point that I want to make broadly is that people are everywhere.

And so, yes, have a strategic plan, like rolling into the boardroom and being like, all right, folks, 65 and up, we're going to Tik Tok. Like, everyone's going to say, oh, cool guys. No, thanks. We're going to go with the other company that makes sense, but at least like being willing to play around and experiment. Is important, I think.

Yeah. You're absolutely right. That reminded me of another story that I have. I used to do patient recruitment campaigns many years ago. and we had to deal with elderly people with I don't remember the exact diagnosis, but they were, let's say 65 plus, like minimum.

And, it turned out that their disease is so severe that they don't have the energy or anything basically to search for alternatives or whatever. Like they're on chemotherapy and really severe side effects. And they really felt very weak, but their caregivers were their, family members, children. or people who take care of them. So sometimes we forget that it's not just the patient per se, it's the people around them that may be searching for alternatives, for one more chance, for an opportunity. And you mentioned that people are not searching for clinical trials. Maybe you're right, but at the same time, they are searching for what happens in research, and what other options there are.

Maybe they don't know that. The answer may be in clinical trials, but they are exploring different options. And that's actually one of the things you mentioned when you discussed, the e-commerce things that we can apply to patient recruitment, you also mentioned the funnel and something that you've perfected quite well.

You mentioned that people don't want to learn about, let's say the drug and the procedures more in detail, et cetera. My experience is actually on the opposite, but what I've seen is not that they don't want to know about the procedure, but they want to be explained in a much-simplified version So they want to know about the side effects.

They want to know about the procedures They want to know about the science behind the new treatment the new drug, but in just much more simplified version So yeah I guess, what you're also saying every single patient recruitment campaign needs a lot of customization and also flexibility to work with either patients, caregivers, community, providing customized information and everything.

That brings me to my next question. We met last time at the CNS summit last week, basically. It was like really fun. And one of the best sessions that I attended was about the localization of patient recruitment.

And, there were different people on the panel discussion and they all discussed, things like site selection and diversity, in clinical trials, and they all agreed that actually, localization can happen quite well on multiple levels, but when it comes to patient recruitment, like local patient recruitment, that's challenging.

What's your experience? You mentioned with Meta, with Instagram, you can reach multiple countries, but how successful are you with these different cultures and different countries? Or what's your recipe for success?

Sure. So, we've had experience in Eastern, Central, Western Europe, and Latin America, Australia, New Zealand, and that's pretty much where we've been asked to deploy, so we haven't, had a lot of shots and go in the rest of the world, but our finding is generally the further the culture gap, the more important it is to work with someone, who can like fact check and logic check and it goes beyond translation. So we usually provide base English assets, and then, we'll have someone local, pull them into the local look and feel. If the images feel foreign, we'll try and rework them or have someone local, give some input, because it's not just translating word for word and getting it comprehensible, like it really needs to feel, trustworthy. And so if it, feels too out of context, it doesn't feel trustworthy. So when it comes to localization, like my whole. thesis is that there are two broad sets of people, those who are known to the investigator already, and then those who are not known to the investigator. And where we sit is trying to activate people who are not known to the investigator and pull them into that orbit and make those introductions. For the people who are already known to the investigator. Like that's on the site like they go for it, do whatever it takes to activate those people Um, we're just trying to use one single channel, which is digital to activate folks who maybe are Local but not aware of what's going on and I'll say just for clarity clarification on the education piece I don't think there's anyone who's rolling into trial, not wanting to know about side effects and how the drug is working and all that stuff. Our goal is simply to advance people as soon as possible to a conversation with the study coordinator or the PI so that they can have that conversation face-to-face or at least voice-to-voice over the phone. Because we find that's a lot more sticky than folks who are trying to self-educate, reading a website. So yeah, agree, in principle, people need that content to really feel comfortable to take the most important step, which is consenting. We just have found generally that if we try to give that all to them on a website, it's less effective than if we just try and scoot them along to talking to a person.

you're right, You mentioned that you try to focus on the patients that are unknown to the investigators and that you think that the quicker you put them in touch with the investigator, the better for the final outcome, let's say, for patients to decide to participate or not in the trial.

But I wonder, in this life where We get information from multiple places and try to get information from multiple places. Is it also worth to actually work with the already known patients to the investigator? Because, nowadays, it's not that you have a lot of time to build this relationship with your doctor.

Actually, it depends. It really depends on the doctor. It really depends on even the country, the culture. But even if you have this relationship with the doctor, Don't get me wrong. I just think that we are doing a poor job of training the investigators on how to explain the clinical trial to the patients.

We're training them on the protocol, on the execution, let's say the more medical side of the execution of the protocol. But I haven't heard of an investigator meeting where they have a special session- how can you explain this clinical trial to the patient? So, I wonder, is there maybe a room where patient recruitment vendors like you guys can actually contribute to this better clarity of clinical trials, even with patients that are known to the investigators?

Yeah, perhaps. I think there's a whole conversation to be had around like how patients who are already in databases are activated or could be activated. And I know my experience just I've been in. 2, back pain studies, and 1 of them, it just felt very commercial, like, in the door turn style.

Here you go. Here's the thing sign the form. And then the other 1, the doc came in and sat with me and talked through options and was very present and in the room. So it's, yeah, it's wide-ranging and I'm not even going to try and answer this one, it's too big. Pass. I'm going to press the call a friend button.

I'm going to call you.

Yeah, it's a topic for another time. Awareness is a big thing. How we communicate about clinical trials. I think we did a very big mistake when we didn't use the COVID 19 pandemic times to actually leverage that clinical trials in the news and position clinical trials much better than what it is now.

I hope there will be may be another more positive event that will help us again position clinical trials more on the positive side, but let's see.

Um, and Steve, before my last question, from everything I hear, you guys have a lot of know-how how to handle campaigns, how to customize messages, even experience with localization, for example. I wonder at what stage sponsors and clinical research organizations should contact people like you and companies like you guys.

At the risk of sounding like too much of a company man, I think as early as possible, like during protocol design, there are plenty of things that companies like us can do to validate some of that stuff. You talk about patient panels, right? To give feedback on endpoints or feedback on particular assessments or whatever.

That's sort of like a market research focus group, right? They come in and they look at the thing. They know that they're being asked questions. And so they're trying to sound good and intelligent. And they're speaking on behalf of a bunch of other people who are at them. It's valuable. One of the things we did in e-commerce, instead of focus grouping stuff, if we had a new product we wanted to launch, we would just put it on Amazon and see if people bought it instead of trying to ask a bunch of questions. We would just order a minimum run and restaurants do this to like, uh, in the US fast food restaurants, especially if they're rolling out a new menu item, they'll just throw it on the menu and like Jacksonville and Austin and Madison, Wisconsin, and see what happens.

And so, one of the things companies like us can do is take an idea from a protocol and just put it in front of a thousand patients really quickly. And there are other groups that work with patients specifically. I know Savvy Cooperative does that. There are a few others, but the earlier the better, I think, because there's some stuff that just people aren't thinking about.

How would the average person respond to this? And it's pretty easy to model. Companies like ours tend to be user experience experts as well. So it doesn't have to be us, but someone, so I would say, find someone you trust and engage them early.

Yeah, I guess anyone who's engaged and has this direct communication with patients can really provide valuable feedback. So I think that every single vendor says the same thing to sponsors and CROs 'Engage with us earlier'. We have this know-how that will actually be a challenge for you as you go and we can prevent a lot of these challenges.

I have one last question for you, Steve. In your opinion, from your perspective, what makes or breaks clinical trials?

So I am not a scientist. My perspective is mostly the things that move the needle on how easy something is to enroll or not easy, but how likely it is to enroll. So we have some internal metrics around enroll ability, basically, a coefficient that we apply to any study and the things that are most important from our end, at least in the data around our patients clicking on this.

Are they submitting their information? Are they flowing through from I submitted a form to I'm showing up at the site are all about, 2 things. 1. Is it attractive? So I think earlier you mentioned value proposition to the patient. So, there's a range here, but like some studies actually are really attractive and some are attractive just because they're not awful, if that makes sense, but then there are some that just, it's like, why would anyone participate in this?

It just seems horrible. So the burden, I guess, that's been being placed on the patient for the upside, and that covers everything from compensation per study visit to delivery mechanism of the drug to the number of visits, all that stuff. There's a scale there and the more attractive it is to a patient, obviously, maybe this is just a truism, but easier to enroll.

And the other is how hardcore the IE is, like how exclusive it is. I think there's been a lot of chatter recently about how specific some of these studies are getting and whether are they actually, getting so specific that they're looking for patients who don't exist.

I've heard a lot of folks say that clinicians, like folks who are actually seeing patients are not really weighing in as much. On study design, as maybe they should be, or they're seeing it too late and it's leading to a lot of amendments. We had 1 recently where, like, 1 of the things that we do before we send a proposal is we'll run ads to the patient population on our own dime, just to see, like. How much does it cost to get patients like this to click ads so that we can model effectively what it's going to cost to get patients to click for the thing? And we'll ask him a couple of questions about the IE. And so it was a study where the BMI had to be I think below 35. And so we were asking people and when we came back and reported the sponsor, we were like, Hey, just so you know. About half of the patients who responded would have been disqualified based on the BMI We've seen other similar studies where it's at 38 and that would have gotten you 30 percent of those patients back Is there a reason why it's at 35 and the sponsor was just like no it was just 35 in the last one we've been talking about it.

No one really knows what to do with that. So it's just crazy to me that like I don't know. These people want that. They were interested in clinical research. They would have at least taken the next step and they're being excluded because of an almost arbitrary coin flip of a decision. I just have no idea how deep that goes and how much of it is behind the scenes. And I'm sure there are really scientifically valid reasons. So that was a very long answer to the more attractive it is to a patient and the more real-life patients actually qualify for the study. I think the rest of it is manageable.

yeah, that was absolutely to my heart basically because I'm super big on this topic with patient feasibility otherwise said, is the trial feasible from a patient point of view?

Steve, thank you so much for this. Incredible conversation. It was very informative to me and I'm pretty sure for everyone else listening. Thank you once again for your time.

Thanks for the invite, Maya. Always a pleasure.