Oppenheimer analyst Esther Rajavelu lowered her price target for Vanda Pharmaceuticals to $21 from $29 after the company reported Q4 results that were higher than her estimates and provided 2019 guidance which came in below her estimates. While the analyst acknowledges management's comments that scripts for sighted N24 patients continue to grow robustly, Rajavelu is somewhat concerned by continued payor pushback on coverage for this patient pool despite Vanda Pharmaceuticals' efforts to increase access. She remains constructive on the potential for Hetlioz use in SMS patients and reiterates a Perform rating on the shares.