The Securities and Exchange Commission has not necessarily reviewed the information in this filing and has not determined if it is accurate and complete.
The reader should not assume that the information is accurate and complete.

UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
FORM 13F

FORM 13F INFORMATION TABLE
OMB APPROVAL
OMB Number: 3235-0006
Estimated average burden
hours per response: 23.8
COLUMN 1 COLUMN 2 COLUMN 3 COLUMN 4 COLUMN 5 COLUMN 6 COLUMN 7 COLUMN 8
VALUE SHRS OR SH/ PUT/ INVESTMENT OTHER VOTING AUTHORITY
NAME OF ISSUER TITLE OF CLASS CUSIP (x$1000) PRN AMT PRN CALL DISCRETION MANAGER SOLE SHARED NONE
ABBOTT LABS COM 002824100 78,886 938,000 SH   DFND 1 337,000 0 601,000
ABBVIE INC COM 00287Y109 14,544 200,000 SH Call DFND 1 44,500 0 155,500
ACADIA PHARMACEUTICALS INC COM 004225108 2,724 101,900 SH   SOLE   0 0 101,900
ADAPTIMMUNE THERAPEUTICS PLC SPONDS ADR 00653A107 5,430 1,350,655 SH   SOLE   1,350,655 0 0
ADAPTIVE BIOTECHNOLOGIES COR COM 00650F109 5,796 120,000 SH   DFND 1 23,900 0 96,100
ADVERUM BIOTECHNOLOGIES INC COM 00773U108 23,307 1,960,200 SH   SOLE   0 0 1,960,200
AEGLEA BIOTHERAPEUTICS INC COM 00773J103 14,834 2,165,524 SH   SOLE   2,165,524 0 0
AERPIO PHARMACEUTICALS INC COM 00810B105 4,726 5,193,946 SH   SOLE   5,193,946 0 0
AGILENT TECHNOLOGIES INC COM 00846U101 66,695 893,200 SH   DFND 1 304,700 0 588,500
ALCON INC ORD SHS H01301128 21,682 351,380 SH   DFND 1 125,800 0 225,580
ALECTOR INC COM 014442107 250,464 13,182,329 SH   DFND 1 12,890,829 0 291,500
ALEXION PHARMACEUTICALS INC COM 015351109 252,279 1,926,085 SH   DFND 1 398,400 0 1,527,685
ALPINE IMMUNE SCIENCES INC COM 02083G100 15,455 3,670,955 SH   SOLE   3,670,955 0 0
AMARIN CORP PLC SPONS ADR NEW 023111206 13,914 717,600 SH   DFND 1 56,500 0 661,100
AMGEN INC COM 031162100 22,501 122,100 SH   SOLE   0 0 122,100
AMICUS THERAPEUTICS INC COM 03152W109 6,468 518,309 SH   SOLE   0 0 518,309
ANTHEM INC COM 036752103 102,047 361,600 SH   DFND 1 110,800 0 250,800
APELLIS PHARMACEUTICALS INC COM 03753U106 46,213 1,823,700 SH   SOLE   0 0 1,823,700
APELLIS PHARMACEUTICALS INC COM 03753U106 1,901 75,000 SH Call DFND 1 17,000 0 58,000
ARENA PHARMACEUTICALS INC COM NEW 040047607 6,449 110,000 SH   SOLE   0 0 110,000
ARGENX SE SPONSORED ADR 04016X101 43,946 310,400 SH   SOLE   0 0 310,400
ARQULE INC COM 04269E107 11,010 1,000,000 SH   SOLE   0 0 1,000,000
ARVINAS INC COM 04335A105 58,907 2,678,810 SH   DFND 1 1,916,310 0 762,500
ASCENDIS PHARMA A S SPONSORED ADR 04351P101 442,944 3,846,673 SH   DFND 1 3,397,673 0 449,000
ASSEMBLY BIOSCIENCES INC COM 045396108 7,063 523,600 SH   SOLE   0 0 523,600
ATHENEX INC COM 04685N103 76,035 3,840,130 SH   SOLE   0 0 3,840,130
AUDENTES THERAPEUTICS INC COM 05070R104 64,857 1,713,069 SH   SOLE   1,713,069 0 0
AURINIA PHARMACEUTICALS INC COM 05156V102 23,234 3,531,002 SH   SOLE   0 0 3,531,002
AVEDRO INC COM 05355N109 83,276 4,240,128 SH   SOLE   4,240,128 0 0
AVROBIO INC COM 05455M100 1,724 106,000 SH   SOLE   0 0 106,000
BAUSCH HEALTH COS INC COM 071734107 94,340 3,740,700 SH   DFND 1 873,400 0 2,867,300
BIOGEN INC COM 09062X103 20,510 87,700 SH   SOLE   0 0 87,700
BIOLINERX LTD SPONSORED ADS 09071M106 379 1,038,600 SH   SOLE   1,038,600 0 0
BIOMARIN PHARMACEUTICAL INC COM 09061G101 6,424 75,000 SH   DFND 1 17,000 0 58,000
BIOMARIN PHARMACEUTICAL INC COM 09061G101 6,424 75,000 SH Put DFND 1 17,500 0 57,500
BOSTON SCIENTIFIC CORP COM 101137107 290,222 6,752,500 SH   DFND 1 1,682,300 0 5,070,200
BRISTOL MYERS SQUIBB CO COM 110122108 61,005 1,345,200 SH   DFND 1 307,000 0 1,038,200
BRISTOL MYERS SQUIBB CO COM 110122108 22,675 500,000 SH Call DFND 1 112,500 0 387,500
CAREDX INC COM 14167L103 29,785 827,600 SH   DFND 1 189,700 0 637,900
CIGNA CORP NEW COM 125523100 39,797 252,600 SH   DFND 1 91,000 0 161,600
CLOVIS ONCOLOGY INC COM 189464100 28,450 1,913,234 SH   DFND 1 332,200 0 1,581,034
CONSTELLATION PHARMCETICLS I COM 210373106 10,264 835,842 SH   SOLE   835,842 0 0
CORVUS PHARMACEUTICALS INC COM 221015100 24,556 6,565,685 SH   SOLE   6,565,685 0 0
CRINETICS PHARMACEUTICALS IN COM 22663K107 50,982 2,039,282 SH   SOLE   2,039,282 0 0
CTI BIOPHARMA CORP COM 12648L601 4,297 5,000,000 SH   SOLE   5,000,000 0 0
DECIPHERA PHARMACEUTICALS IN COM 24344T101 81,590 3,618,171 SH   DFND 1 548,800 0 3,069,371
DEXCOM INC COM 252131107 39,393 262,900 SH   DFND 1 59,700 0 203,200
DYNAVAX TECHNOLOGIES CORP COM NEW 268158201 2,328 583,500 SH   SOLE   0 0 583,500
EDWARDS LIFESCIENCES CORP COM 28176E108 132,089 715,000 SH   DFND 1 163,800 0 551,200
EHEALTH INC COM 28238P109 78,335 909,814 SH   DFND 1 103,000 0 806,814
ENDO INTL PLC SHS G30401106 25,402 6,165,464 SH   DFND 1 1,125,200 0 5,040,264
EXELIXIS INC COM 30161Q104 83,619 3,912,900 SH   DFND 1 555,200 0 3,357,700
FLEXION THERAPEUTICS INC COM 33938J106 1,106 89,919 SH   SOLE   0 0 89,919
FOAMIX PHARMACEUTICALS LTD SHS M46135105 12,365 5,195,330 SH   SOLE   0 0 5,195,330
GENFIT S A ADS 372279109 22,231 1,125,607 SH   DFND 1 265,290 0 860,317
GILEAD SCIENCES INC COM 375558103 27,132 401,600 SH   SOLE   0 0 401,600
GILEAD SCIENCES INC COM 375558103 6,756 100,000 SH Call DFND 1 22,500 0 77,500
HARPOON THERAPEUTICS INC COM 41358P106 31,803 2,446,409 SH   DFND 1 1,360,704 0 1,085,705
ILLUMINA INC COM 452327109 51,615 140,200 SH   DFND 1 25,600 0 114,600
IMMUNOMEDICS INC COM 452907108 11,348 818,200 SH   DFND 1 183,500 0 634,700
INSPIRE MED SYS INC COM 457730109 89,216 1,471,000 SH   SOLE   1,471,000 0 0
INTELLIA THERAPEUTICS INC COM 45826J105 5,363 327,600 SH   SOLE   327,600 0 0
INTUITIVE SURGICAL INC COM NEW 46120E602 110,313 210,300 SH   DFND 1 51,400 0 158,900
IOVANCE BIOTHERAPEUTICS INC COM 462260100 136,045 5,548,326 SH   DFND 1 1,337,800 0 4,210,526
KALA PHARMACEUTICALS INC COM 483119103 21,997 3,447,840 SH   SOLE   3,447,840 0 0
KARYOPHARM THERAPEUTICS INC COM 48576U106 18,859 3,148,475 SH   SOLE   0 0 3,148,475
KRYSTAL BIOTECH INC COM 501147102 25,854 642,006 SH   SOLE   0 0 642,006
LOGICBIO THERAPEUTICS INC COM 54142F102 84,068 6,466,783 SH   SOLE   6,466,783 0 0
MARINUS PHARMACEUTICALS INC COM 56854Q101 1,652 398,101 SH   SOLE   398,101 0 0
MEDICINES CO COM 584688105 5,526 151,515 SH   SOLE   0 0 151,515
MEDIGUS LTD SPONSORED ADS 58471G300 37 15,000 SH   SOLE   15,000 0 0
MEIRAGTX HOLDINGS PLC COM G59665102 69,537 2,586,951 SH   SOLE   0 0 2,586,951
MENLO THERAPEUTICS INC COM 586858102 4,035 673,700 SH   SOLE   0 0 673,700
MERCK & CO INC COM 58933Y105 215,503 2,570,100 SH   DFND 1 723,400 0 1,846,700
MERSANA THERAPEUTICS INC COM 59045L106 7,659 1,891,119 SH   SOLE   0 0 1,891,119
MYLAN N V SHS EURO N59465109 26,148 1,373,305 SH   DFND 1 310,700 0 1,062,605
MYOKARDIA INC COM 62857M105 47,899 955,300 SH   DFND 1 176,600 0 778,700
NABRIVA THERAPEUTICS PLC SHS G63637105 11,286 4,644,600 SH   SOLE   4,644,600 0 0
NATERA INC COM 632307104 88,927 3,224,328 SH   DFND 1 978,786 0 2,245,542
NEUROCRINE BIOSCIENCES INC COM 64125C109 154,777 1,833,200 SH   DFND 1 322,500 0 1,510,700
NEXTCURE INC COM 65343E108 40,611 2,711,013 SH   SOLE   2,711,013 0 0
NOVO-NORDISK A S ADR 670100205 16,843 330,000 SH   SOLE   0 0 330,000
NOVUS THERAPEUTICS INC COM 67011N105 3,215 3,183,314 SH   SOLE   3,183,314 0 0
NUVECTRA CORP COM 67075N108 1,173 350,000 SH   SOLE   0 0 350,000
OBSEVA SA COM H5861P103 29,469 2,605,531 SH   SOLE   2,605,531 0 0
PERSONALIS INC COM 71535D106 8,145 300,000 SH   SOLE   0 0 300,000
PFIZER INC COM 717081103 10,830 250,000 SH Put DFND 1 56,500 0 193,500
PREVAIL THERAPEUTICS INC COM 74140Y101 182,457 13,822,463 SH   SOLE   13,822,463 0 0
PRINCIPIA BIOPHARMA INC COM 74257L108 53,294 1,605,713 SH   SOLE   1,605,713 0 0
PROQR THRAPEUTICS N V SHS EURO N71542109 12,581 1,382,502 SH   DFND 1 235,002 0 1,147,500
PROTHENA CORP PLC SHS G72800108 32,400 3,065,278 SH   DFND 1 613,800 0 2,451,478
PTC THERAPEUTICS INC COM 69366J200 94,037 2,089,700 SH   DFND 1 330,400 0 1,759,300
PUMA BIOTECHNOLOGY INC COM 74587V107 7,934 624,249 SH   DFND 1 121,100 0 503,149
REALM THERAPEUTICS PLC SPONSORED ADS 75606L103 2,870 1,021,484 SH   SOLE   1,021,484 0 0
REATA PHARMACEUTICALS INC CL A 75615P103 9,435 100,000 SH Put DFND 1 22,000 0 78,000
REGENERON PHARMACEUTICALS COM 75886F107 67,545 215,800 SH   DFND 1 54,000 0 161,800
RESTORBIO INC COM 76133L103 49,270 4,830,387 SH   SOLE   4,830,387 0 0
RHYTHM PHARMACEUTICALS INC COM 76243J105 17,321 787,300 SH   SOLE   787,300 0 0
SAREPTA THERAPEUTICS INC COM 803607100 125,875 828,400 SH   DFND 1 129,400 0 699,000
SCPHARMACEUTICALS INC COM 810648105 10,877 3,409,865 SH   SOLE   3,409,865 0 0
SELECTA BIOSCIENCES INC COM 816212104 5,154 2,879,064 SH   SOLE   2,879,064 0 0
SI BONE INC COM 825704109 20,042 985,368 SH   SOLE   985,368 0 0
SINOVAC BIOTECH LTD SHS P8696W104 16,611 2,839,500 SH   SOLE   0 0 2,839,500
SPARK THERAPEUTICS INC COM 84652J103 22,513 219,900 SH   DFND 1 33,800 0 186,100
SPDR S&P 500 ETF TR TR UNIT 78462F103 29,300 100,000 SH Put DFND 1 22,500 0 77,500
SPERO THERAPEUTICS INC COM 84833T103 5,841 507,471 SH   SOLE   0 0 507,471
STOKE THERAPEUTICS INC COM 86150R107 3,792 130,000 SH   SOLE   0 0 130,000
STRYKER CORP COM 863667101 11,101 54,000 SH   SOLE   54,000 0 0
SYNDAX PHARMACEUTICALS INC COM 87164F105 1,974 212,000 SH   SOLE   212,000 0 0
SYNLOGIC INC COM 87166L100 18,473 2,029,996 SH   SOLE   2,029,996 0 0
SYNTHORX INC COM 87167A103 71,824 5,316,355 SH   SOLE   5,316,355 0 0
TAKEDA PHARMACEUTICAL CO LTD SPONSORED ADS 874060205 13,275 750,000 SH   DFND 1 172,000 0 578,000
TAKEDA PHARMACEUTICAL CO LTD SPONSORED ADS 874060205 17,700 1,000,000 SH Call DFND 1 70,000 0 930,000
TANDEM DIABETES CARE INC COM NEW 875372203 36,827 570,790 SH   DFND 1 134,200 0 436,590
THERMO FISHER SCIENTIFIC INC COM 883556102 135,915 462,800 SH   DFND 1 123,900 0 338,900
TRICIDA INC COM 89610F101 438,569 11,114,280 SH   SOLE   11,114,280 0 0
TURNING POINT THERAPEUTICS I COM 90041T108 104,499 2,567,550 SH   DFND 1 2,027,550 0 540,000
ULTRAGENYX PHARMACEUTICAL IN COM 90400D108 5,055 79,607 SH   DFND 1 7,100 0 72,507
UNIQURE NV SHS N90064101 70,163 897,800 SH   DFND 1 182,300 0 715,500
VERONA PHARMA PLC SPONSORED ADS 925050106 6,377 1,250,396 SH   SOLE   1,250,396 0 0
VERRICA PHARMACEUTICALS INC COM 92511W108 17,194 1,479,733 SH   SOLE   1,479,733 0 0
VERTEX PHARMACEUTICALS INC COM 92532F100 178,484 973,300 SH   DFND 1 156,900 0 816,400
VIEWRAY INC COM 92672L107 45,363 5,149,019 SH   SOLE   5,149,019 0 0
WRIGHT MED GROUP N V ORD SHS N96617118 124,880 4,187,799 SH   DFND 1 967,749 0 3,220,050
X4 PHARMACEUTICALS INC COM 98420X103 14,047 936,493 SH   SOLE   936,493 0 0
XENON PHARMACEUTICALS INC COM 98420N105 6,259 634,812 SH   SOLE   634,812 0 0
XTANT MED HLDGS INC COM NEW 98420P308 27,621 9,207,012 SH   SOLE   9,207,012 0 0
ZAI LAB LTD ADR 98887Q104 40,763 1,169,000 SH   SOLE   1,169,000 0 0