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2014 Cardiometabolic Projects To Watch Michael C. Rice Senior Consultant, Defined Health Therapeutic Area Partnerships 2014 November 19-21, 2014 The Hyatt Regency Boston, MA

2014 Cardiometabolic Projects To Watch · 11/19/2014  · cardiomyopathy and covers three MyoKardia programs: two for hypertrophic cardiopathy (HCM) and one for dilated (DCM) cardiomyopathy

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Page 1: 2014 Cardiometabolic Projects To Watch · 11/19/2014  · cardiomyopathy and covers three MyoKardia programs: two for hypertrophic cardiopathy (HCM) and one for dilated (DCM) cardiomyopathy

2014 Cardiometabolic Projects To Watch Michael C. Rice Senior Consultant, Defined Health

Therapeutic Area Partnerships 2014 November 19-21, 2014 The Hyatt Regency Boston, MA

Page 2: 2014 Cardiometabolic Projects To Watch · 11/19/2014  · cardiomyopathy and covers three MyoKardia programs: two for hypertrophic cardiopathy (HCM) and one for dilated (DCM) cardiomyopathy

The information in this report has been obtained from what are believed to be reliable sources and has been verified whenever possible. Nevertheless, we cannot guarantee the information contained herein as to accuracy or completeness. All expressions of opinion are the responsibility of Defined Health, and though current as of the date of this report, are subject to change. The opinions and information set forth herein are expressed solely for the benefit of the addressee and only for the purpose(s) for which the report was produced. Without the prior written consent of Defined Health, this report may not be relied on in whole or in part for any other purpose or by any other person or entity, provided that this report may be disclosed where disclosure is required by law. This report may contain information provided by third parties such as Thomson Reuters, Wolters Kluwer, EvaluatePharma, Datamonitor, Informa Healthcare, IMS Health and others with a proprietary interest in the data provided herein. Please note that you are not permitted to redistribute any such third party information without consent from the originator company. © Defined Health, 2014

Page 3: 2014 Cardiometabolic Projects To Watch · 11/19/2014  · cardiomyopathy and covers three MyoKardia programs: two for hypertrophic cardiopathy (HCM) and one for dilated (DCM) cardiomyopathy

Page 3 Therapeutic Area Partnerships 2014 © Defined Health

Environment Driving This Year’s Selection Criteria

♦ CVD, the once leading pharma market, appears to be stabilizing post generic erosion of nearly all cardiopreventative drug classes – Showing signs of renewed growth in later years.

♦ During this transitional period, many CVD franchises reallocated R&D portfolios towards adjacent growth areas such as Type 2 Diabetes and more recently, high need niche areas.

♦ Diabetes is continuing strong growth fueled by demographics and innovation; however, higher regulatory hurdles, need for CV outcomes and threats from genericization and biosimilars question how long this trajectory can continue.

♦ The obesity segment is expected to be among the highest growth segments in the pharma industry; however, despite the enormous prevalence it’s growing off a tiny revenue base and the market is just being shaped with recently approved agents.

♦ Even with such progress, unmet need remains: Downstream result of Diabetes and Obesity is worsening heart disease, macrovascular complication and significant M&M.

♦ However, it is increasingly difficult to prove outcomes benefits of new cardiometabolics drugs in late-stage trials on top of the SOC Generic – Many failed CV outcomes trials

♦ Investment and deal making in cardiometabolics has been anemic and accordingly, there is a dearth of novel clinical stage assets.

Page 4: 2014 Cardiometabolic Projects To Watch · 11/19/2014  · cardiomyopathy and covers three MyoKardia programs: two for hypertrophic cardiopathy (HCM) and one for dilated (DCM) cardiomyopathy

Page 4 Therapeutic Area Partnerships 2014 © Defined Health

Stabilizing Post Patent Cliff, CVD Is Still a Sizable Market; While Metabolics Is Steadily Growing – Nearing Parity With The Entire CV Market

0

20,000

40,000

60,000

80,000

100,000

120,000

140,000

160,000

180,000

200,000

$WW

Sal

es M

illio

ns

Worldwide Sales by Therapy Area, 2004-2020 CV

Diabetes

Obesity

CNS

Genito-Urinary

Musculo-skeletal

Oncology

Respiratory

Systematic Anti-infectives Others

EvaluatePharma

♦ Total WW Pharmaceutical Sales is expected to grow by $238B to an estimated $835B by 2020 ♦ Overall, the “cardiometabolics” segment will grow to $80B by 2020, 18% of the overall drug sales.

Page 5: 2014 Cardiometabolic Projects To Watch · 11/19/2014  · cardiomyopathy and covers three MyoKardia programs: two for hypertrophic cardiopathy (HCM) and one for dilated (DCM) cardiomyopathy

Page 5 Therapeutic Area Partnerships 2014 © Defined Health

Antidiabetics Leading Growth in the “Cardiometabolics” Segment – Generic Cardioprevention Now a “Medical Bargain” for Outcomes Benefit

0

10,000

20,000

30,000

40,000

50,000

60,000

70,000

$WW

Sal

es M

illio

ns

Total Worldwide CVD & Metabolics* Therapeutic Category Sales, 2000-2020

Anti-hypertensives

Anti-hyperlipidaemics

Cardiac therapy

Platelet inhibitors

Anticoagulants

Other cardiovasculars

Anti-diabetics

Anti-obesity

EvaluatePharma

* Metabolics sales 2004-2020

♦ Cardiovascular revenue is predicted to remain stagnant through 2020 while Diabetes and Obesity revenue are predicted to grow significantly.

♦ However, some new drug classes are starting to showing signs of renewed growth in later years: PCSK9s, Factor Xa, LCZ696 is an ARNI (Angiotensin Receptor Neprilysin Inhibitor)

Page 6: 2014 Cardiometabolic Projects To Watch · 11/19/2014  · cardiomyopathy and covers three MyoKardia programs: two for hypertrophic cardiopathy (HCM) and one for dilated (DCM) cardiomyopathy

Page 6 Therapeutic Area Partnerships 2014 © Defined Health

Breakthrough Therapies have Improved Outcomes, Yet CVD Remains the Highest Unmet Therapeutic Need in Terms of M&M

♦ Major breakthroughs in the treatment and prevention of heart disease led to steady improvements in CV outcomes; however, CVD remains most prevalent of all diseases: • ~60M+ Americans and 100M+ people in the

developed world suffer from forms of CVD

• Number one cause of death globally. ~17.3 million CVD deaths (30% of global deaths).

World Health Statistics 2014, 2013, and 2011, CDC.gov

♦ Ischemic heart and cerebrovascular diseases are most common causes of morbidity and mortality: • ~20% of individuals aged > 40 years are

predicted to die within 1 year of initial MI • ~20% of ACS patients are re-hospitalized

within 1 year; nearly 60% of costs result from re hospitalization

♦ Cost of CVD in the US is more than half a trillion dollars, escalating cost of health care.

0

100

200

300

400

500

600

700

Num

ber o

f dea

ths (

Thou

sand

s)

Leading Causes of Death Annually in the US (2011)

Despite increased chance of survival of acute events, heart disease is still the leading cause of death for both women and men in the United States

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Page 7 Therapeutic Area Partnerships 2014 © Defined Health

Cardiometabolic Risk Factors Act In Concert Promoting CHD and Resulting Morbidity and Mortality

♦ Hypertension, Dyslipidemia, Insulin Resistance, Inflammation, Environment/Lifestyle and Genetics all contribute to endothelial dysfunction and development of CHD

♦ As diabetes is a significant risk factor for CVD events, the epidemic of obesity and T2DM will increase future M&M

AHA Scientific Sessions 2011, S4; J Am Osteopath Assoc. 2007;107(suppl 2):Inside front cover–S3

ToC

Page 8: 2014 Cardiometabolic Projects To Watch · 11/19/2014  · cardiomyopathy and covers three MyoKardia programs: two for hypertrophic cardiopathy (HCM) and one for dilated (DCM) cardiomyopathy

Page 8 Therapeutic Area Partnerships 2014 © Defined Health

T2DM is a Challenging Health Problem in the 21st Century - It is One of the Most Common Non-Communicable Diseases Globally

♦ Global prevalence of diabetes 371M & expected to reach 552M by 2030 • diabetes increasing in all parts of the world yet

nearly 50% of people globally undiagnosed

International Diabetes Federation

♦ 43% (201 Billion USD) of Global Healthcare Expenditure Due To Diabetes in 2011 Was Generated In USA • Large disparity in healthcare spending on

diabetes between regions and countries.

• Only 20% of global healthcare expenditures due to diabetes were made in low- and middle-income countries, where 80% of people with diabetes live.

Page 9: 2014 Cardiometabolic Projects To Watch · 11/19/2014  · cardiomyopathy and covers three MyoKardia programs: two for hypertrophic cardiopathy (HCM) and one for dilated (DCM) cardiomyopathy

Page 9 Therapeutic Area Partnerships 2014 © Defined Health

>80% of Diabetics in 7 Major Markets are Overweight or Obese, Often Comorbid with T2DM, Hypertension and Dyslipidemia

♦ Developed countries, including U.S. and Western Europe, and women, exhibit highest rates of Obesity, defined as body mass index (BMI) above 30

♦ A remarkable one-third of the US adult population (~75MM individuals) meet clinical definition of Obesity (BMI>30). Another one-third is overweight (BMI 25-30).

♦ Obesity rates continue to rise steadily in other developed and developing countries of the world.

OECD (2014), OECD Health Statistics 2014

0%

5%

10%

15%

20%

25%

30%

35%

40%

Perc

ent o

f Adu

lts, A

ged

15 a

nd O

lder

, w

ith a

BM

I >=

30

Prevalence of Obesity by Country and Gender in 2010

Male Female

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Page 10 Therapeutic Area Partnerships 2014 © Defined Health

Cost of Diabetes Complications

♦ Much of the morbidity and cost of diabetes management is attributable to long-term, diabetes-related complications, particularly cardiovascular disease (CVD).

CVD Complications Generate The Greatest % Cost Of Chronic Diabetes Management

Defined Health Research

Page 11: 2014 Cardiometabolic Projects To Watch · 11/19/2014  · cardiomyopathy and covers three MyoKardia programs: two for hypertrophic cardiopathy (HCM) and one for dilated (DCM) cardiomyopathy

Page 11 Therapeutic Area Partnerships 2014 © Defined Health

To Address Residual Risk, Pharma Has Many Shots on Goal Towards Introducing New Drug Classes and Proving CV Outcomes Improvement

Defined Health, EvaluatePharma, *HoFH launches based on surrogate only

Timeline of Anticipated Launches Late Stage CV & Diabetes Drugs With Outcomes Data*

2010 2011 2012 2013 2014 2015 2016 2017

Victoza US Launch

Launch Date

Dapagliflozin US Launch

Invokana Canaglflozin US Launch

Nesina (alogliptin) US Launch

2009

Onglyza US Launch

CV a

gent

s T2

DM a

gent

s

Estimated Anacetrapib US Launch PPAR

Niacin

CETP

Lp-PLA2

GLP-1

DPP-IV

SGLT2 Estimated Evacetrapib US Launch

Statin/CAI

Vytorin (IMPROVE-IT,

Outcomes) PCSK9

ApoB 100

Kynamro HoFH Launch

MTP Juxtapid HoFH Launch

AMG145 Launch

REGN 727 Launch

Omega-3

Vascepa Reduce-It

Victoza LEADER Trial

Jardiance empagliflozi US Launch Tanzeum

(albiglutide) US Launch

Januvia CV Outcome Study TECOS

Page 12: 2014 Cardiometabolic Projects To Watch · 11/19/2014  · cardiomyopathy and covers three MyoKardia programs: two for hypertrophic cardiopathy (HCM) and one for dilated (DCM) cardiomyopathy

Page 12 Therapeutic Area Partnerships 2014 © Defined Health

Post Patent Cliff, Many Pharma Companies Announced Plans to Reallocate R&D $ To Higher Growth Areas

Bubble size correlates to 2013 WW Therapeutic Area Sales

CVD

Diabetes

Obesity

CNS

Genitourinary

Musculoskeletal

Oncology

Respiratory

Anti-infectives Other

-10%

-5%

0%

5%

10%

15%

20%

25%

30%

-10% -5% 0% 5% 10% 15% 20% 25% 30%

Expe

cted

Sal

es G

row

th C

AGR

(201

3-20

20)

Historical Sales Growth CAGR (2005-2012)

CVD yielded double-digit growth experienced since the 1980s.

Obesity has a CAGR of 28% between 2013-2020

EvaluatePharma

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Page 13 Therapeutic Area Partnerships 2014 © Defined Health

Metabolics and CVD Deals Lag Other Large Therapeutic Areas

0

50

100

150

200

250

300

350

Metabolics CVD Cancer CNS Infectious & viral disease

Musculoskeletal Respiratory Opthamology

Num

ber o

f Dea

ls

Number of Deals From 2012 to 2014 by Therapeutic Area

2014

2013

2012

Informa

Page 14: 2014 Cardiometabolic Projects To Watch · 11/19/2014  · cardiomyopathy and covers three MyoKardia programs: two for hypertrophic cardiopathy (HCM) and one for dilated (DCM) cardiomyopathy

Page 14 Therapeutic Area Partnerships 2014 © Defined Health

Majority of CVD Deals Occur After Phase III PoC; Whereas Most Metabolics Deals Based on Preclinical Evidence (Exception of Obesity)

Informa

Marketed 19%

Phase III/Filed

7%

Phase II 12%

Preclinical 62%

Metabolics

Marketed 60% Phase

III/Filed 11%

Phase II 8%

Phase I 5%

Preclinical 16%

Cardiovascular

Latest Development Phase At Time of Deal

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Page 15 Therapeutic Area Partnerships 2014 © Defined Health

Dearth of CV and Metabolic Agents in Both Preclinical and Clinical Development Compared to Other TAs

0

1000

2000

3000

4000

5000

6000

7000

8000

9000

10000

Filed Phase III Phase II Phase I Preclinical Research

Num

ber o

f Dru

gs

Number of Drugs in Development by Therapeutic Category

CVD Diabetes Obesity CNS Genito-Urinary Musculo-skeletal Oncology Respiratory Systematic Anti-infectives Others

Thomson Reuters Cortellis, ADIS R&D Insight

CVM

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Page 16 Therapeutic Area Partnerships 2014 © Defined Health

Pharma Doing Early Stage Deals to Enrich Cardiometabolic Clinical Pipeline

Company website, FiercePharma

Alliance Type Area (Phase)

Upfront (Mlns)

Total (Mlns)

Notes

Sanofi/ MyoKardia (Sept 2014)

Collaboration, Translation

Targeted therapies for patients with genetic forms of cardiomyopathy

$45.0 Licensing fee and an initial equity investment.

$200.0 Equity investments, milestone payments and R&D services through 2018

• Collaboration represents one of the largest R&D commitments to genetic forms of cardiomyopathy and covers three MyoKardia programs: two for hypertrophic cardiopathy (HCM) and one for dilated (DCM) cardiomyopathy.

• Sanofi and MyoKardia will equally share development costs on the HCM programs following initial demonstration of efficacy.

• Sanofi will fully cover the development costs of the DCM program.

AstraZeneca/ Moderna (March 2013)

Collaboration Messenger RNA therapeutics for the treatment of serious cardiovascular, metabolic, and renal diseases and cancer

$240.0 $420.0 Three technical milestone payments

• AstraZeneca will have exclusive access to select a target of its choice in cardiometabolic diseases over a period of five years for subsequent development of messenger RNA

• AZ will lead the preclinical, clinical, development and commercialization of therapeutics resulting from the agreement.

• Moderna will be responsible for designing and manufacturing the messenger RNA against selected targets

Page 17: 2014 Cardiometabolic Projects To Watch · 11/19/2014  · cardiomyopathy and covers three MyoKardia programs: two for hypertrophic cardiopathy (HCM) and one for dilated (DCM) cardiomyopathy

Page 17 Therapeutic Area Partnerships 2014 © Defined Health

10%

9%

8%

7%

5% 5%

3% 3% 3% 3%

44%

Novartis Sanofi AZN Pfizer Actelion Bayer Servier Takeda Merck Daiichi Sankyo Other

Dominant CV Franchises Changing Leadership – New Franchise Entering Specific Segments Fragmenting the Market

♦ Leading CV franchises such as Pfizer’s will become smaller in the next few years as the result of expired brands and lack of replacements.

♦ At the same time, multiple new entrants to the CV market (AZ, Janssen, Amgen, D-S) will influence change towards reshaping the marketplace as broad indications become sub-segmented.

♦ The epidemic of T2DM and obesity will contribute to CVD burden and the silo approach by Cardiologists and Endocrinologists to treat high risk patients may change as well.

Cowen Therapeutic Categories, Oct 2014, EvaluatePharma

Cardiovascular Category Market Share By $ Sales 2013: $78B 2020e: $76B

11%

9%

8%

7%

7% 6% 4%

4% 3% 3%

38%

AZN Merck Novartis Sanofi Pfizer Daiichi Sankyo Boehringer Ingelheim Servier Takeda Astellas Other

Page 18: 2014 Cardiometabolic Projects To Watch · 11/19/2014  · cardiomyopathy and covers three MyoKardia programs: two for hypertrophic cardiopathy (HCM) and one for dilated (DCM) cardiomyopathy

Page 18 Therapeutic Area Partnerships 2014 © Defined Health

Metabolics Category Market Share

♦ In 2013, Novo Nordisk, Sanofi, Merck, and Eli Lilly led the $36B diabetes category.

♦ In 2019, we forecast that these same four companies plus AstraZeneca (post its January 2014 acquisition of Bristol’s diabetes assets) will dominate a projected $56B market, driven by growth of their insulins , GLP-1 products and DPPIVs.

♦ SGLT-2s. are the latest OAD entrant. JNJ’s Invokana, AZN’s Forxiga and Lilly/BI’s Jardiance were all approve in the last year.

Cowen Therapeutic Categories, Oct 2014, EvaluatePharma

29%

16%

11%

10%

6%

5%

4%

3% 2% 14%

Novo Nordisk Sanofi Merck & Co Eli Lilly AstraZeneca Boehringer Ingelheim Johnson & Johnson Novartis Takeda Other

Metabolics Category Market Share By $ Sales 2013: $38B 2020e: $68B

30%

22% 15%

10%

4% 3%

3% 13% Novo Nordisk

Sanofi

Merck & Co

Eli Lilly

Bristol-Myers Squibb

Novartis

Takeda

Other

Page 19: 2014 Cardiometabolic Projects To Watch · 11/19/2014  · cardiomyopathy and covers three MyoKardia programs: two for hypertrophic cardiopathy (HCM) and one for dilated (DCM) cardiomyopathy

Page 19 Therapeutic Area Partnerships 2014 © Defined Health

2014 Cardiometabolic Projects To Watch

Page 20: 2014 Cardiometabolic Projects To Watch · 11/19/2014  · cardiomyopathy and covers three MyoKardia programs: two for hypertrophic cardiopathy (HCM) and one for dilated (DCM) cardiomyopathy

Page 20 Therapeutic Area Partnerships 2014 © Defined Health

Remove Unavailable

Agents

Evaluate Based on Selection

Criteria

Compare and Prioritize

Create CVD + Met Investigational Agent Database (Phase I to registered)

Invite Selected

Companies

Adis R&D Insight 1

2

Thomson Reuters Cortellis

Defined Health Ad-hoc Additions

1,110 CVD + Met Agents in Active Clinical Development WW

The Initial List of CVD and Metabolics Agents in Development was Compiled From Licensed Databases and Industry Experience

Combine, Remove

Redundancies

Defined Health analysis

Page 21: 2014 Cardiometabolic Projects To Watch · 11/19/2014  · cardiomyopathy and covers three MyoKardia programs: two for hypertrophic cardiopathy (HCM) and one for dilated (DCM) cardiomyopathy

Page 21 Therapeutic Area Partnerships 2014 © Defined Health

Diabetes Projects Represent Half the Pipeline – Most CVD Agents in Development for Thrombosis, HTN and CAD

0

100

200

300

400

500

600

Registered Phase III Phase II Phase I

Num

ber o

f Dru

gs

Number of CVD and Metabolics Drugs in Development by Indication

Diabetes

Obesity

Thrombosis/ Vascular Hypertension

Heart failure

CAD/Dyslipidemia

Arrythmia

ACS

Thomson Reuters Cortellis, ADIS R&D Insight

1,110 CVD + Met Agents in Active Clinical Development WW

Page 22: 2014 Cardiometabolic Projects To Watch · 11/19/2014  · cardiomyopathy and covers three MyoKardia programs: two for hypertrophic cardiopathy (HCM) and one for dilated (DCM) cardiomyopathy

Page 22 Therapeutic Area Partnerships 2014 © Defined Health

Remove Unavailable

Agents

Evaluate Based on Selection

Criteria

Compare and Prioritize

Create CVD Investigational Agent Database (Phase I to registered)

Invite Selected

Companies

1,100 CVD + Met Agents in Ph I to Registration WW

809 Available Agents

495 Optimistic Projects

Top CVD & Metabolics

Projects selected

CVD & Metabolics

Top 10 Projects

Projects Developed by Big Pharma or Companies with Substantial CVD or Metabolics Development Capabilities Were Deprioritized in the Database

Originator / Developer • Big Pharma • Specialty Franchise

Defined Health analysis

Page 23: 2014 Cardiometabolic Projects To Watch · 11/19/2014  · cardiomyopathy and covers three MyoKardia programs: two for hypertrophic cardiopathy (HCM) and one for dilated (DCM) cardiomyopathy

Page 23 Therapeutic Area Partnerships 2014 © Defined Health

While Pharma Controls More of the Metabolics Pipeline, Nearly 3/4 of All Cardiometabolics Drugs Are Being Developed by Biotech

Pharma 22%

Biotech 78%

CVD Drugs in Development by Company Type

Pharma 32%

Biotech 68%

Metabolics Drugs in Development by Company Type

Thomson Reuters Cortellis, ADIS R&D Insight

Page 24: 2014 Cardiometabolic Projects To Watch · 11/19/2014  · cardiomyopathy and covers three MyoKardia programs: two for hypertrophic cardiopathy (HCM) and one for dilated (DCM) cardiomyopathy

Page 24 Therapeutic Area Partnerships 2014 © Defined Health

Remove Unavailable

Agents

Evaluate Based on Selection

Criteria

Compare and Prioritize

Create CVD Investigational Agent Database (Phase I to registered)

Invite Selected

Companies

1,100 CVD + Met Agents in Ph I to Registration WW

809 Available Agents

495 Optimistic Projects

Top CVD & Metabolics

Projects selected

CVD & Metabolics

Top 10 Projects

Projects were Rated Based on Selection Criteria Indicating Project Attractiveness to a Potential Partner

Intrinsic to Agent • Unmet Needs • Market Potential • Novelty • Precedents • Clinical • Competition

Defined Health analysis

Page 25: 2014 Cardiometabolic Projects To Watch · 11/19/2014  · cardiomyopathy and covers three MyoKardia programs: two for hypertrophic cardiopathy (HCM) and one for dilated (DCM) cardiomyopathy

Page 25 Therapeutic Area Partnerships 2014 © Defined Health

Remove Unavailable

Agents

Evaluate Based on Selection

Criteria

Compare and Prioritize

Create CVD Investigational Agent Database (Phase I to registered)

Invite Selected

Companies

809 Available Agents

495 Optimistic Projects

Top 20 CVD & Metabolics

Projects selected

CVD & Metabolics

Top 10 Projects

Amongst Peers: • Exclude Prior Top 10 unless

clear progress achieved. • Exclude DH current client target • Company Management • WW Availability • “For out-license”

1,100 CVD + Met Agents in Ph I to Registration WW

Projects were Compared Among Their Peers Based On Company Attributes and Advertised Availability

Defined Health analysis

Page 26: 2014 Cardiometabolic Projects To Watch · 11/19/2014  · cardiomyopathy and covers three MyoKardia programs: two for hypertrophic cardiopathy (HCM) and one for dilated (DCM) cardiomyopathy

Page 26 Therapeutic Area Partnerships 2014 © Defined Health

Remove Unavailable

Agents

Evaluate Based on Selection

Criteria

Compare and Prioritize

Create CVD Investigational Agent Database (Phase I to registered)

Invite Selected

Companies

Companies Making the Final List were Invited

Defined Health analysis, Company websites

Page 27: 2014 Cardiometabolic Projects To Watch · 11/19/2014  · cardiomyopathy and covers three MyoKardia programs: two for hypertrophic cardiopathy (HCM) and one for dilated (DCM) cardiomyopathy

Page 27 Therapeutic Area Partnerships 2014 © Defined Health

2014 Cardiometabolic Projects To Watch*

*Not presented in any particular order

Agent Company MOA Indication Phase Comments

CER 001 Cerenis Therapeutics

Apolipoprotein A I stimulants

FPHA ACS Phase II

ApoAI repletion therapy.orphan designated for FPHA where ultra-low ApoAI defines the disease.

ETC 1002 Esperion Therapeutics

AMP activated protein kinase stimulants

CAD, dyslipidemia Phase II

first-in-class drug designed to LDL-C and improve other cardiometabolic risk in statin intolerant patients

PRC 4016 Pronova Biopharma (BASF)

Structurally Enhanced Fatty Acid

Mixed dyslipidemia Hypertriglyceridemia Phase II

Best-in-class Omega-3 drug that reduces LDL-C, non-HDL-C, total cholesterol, triglycerides and ApoB

JVS 100 Juventas Therapeutics

SDF-1, CXCR4 receptor agonists Heart failure Phase II

improves cardiac function in advanced heart failure more than a decade after having a heart attack by promoting tissue repair.

Ralinepag (APD-811)

Arena Pharmaceuticals

Prostacyclin (IP) receptor agonists

Pulmonary Arterial Hypertension Phase I

An orally available agonist of the prostacyclin (IP) receptor, orphan designated for PAH

GKM-001/2 Advinus Therapeutics

Glucokinase Activator Type 2 Diabetes Phase II

Liver selective - Reduces blood glucose levels by increased hepatic glucose uptake.

TTP 399 TransTech Pharma Glucokinase Activator Type 2 Diabetes Phase

I/II

Clinical evidence of normalizing HbA1c without inducing hypoglycemia in T2DM subjects on stable doses of metformin.

Page 28: 2014 Cardiometabolic Projects To Watch · 11/19/2014  · cardiomyopathy and covers three MyoKardia programs: two for hypertrophic cardiopathy (HCM) and one for dilated (DCM) cardiomyopathy

Roundtable Discussion: Creating New Opportunities and Partnerships in CV/Metabolic Drug Programs Moderator: • Mike Rice MS, MBA, Senior Consultant, Defined Health

Panelists: • John Delyani, Executive Director, Business

Development & Licensing, Merck & Co. • Barry Ticho MD, PhD, Head, Cardiovascular and

Metabolic Disorder & ERDI, Pfizer • Steve Cohen MD, Executive Director ,External

Scientific Affairs, Daiichi Sankyo • Tomas Landh, Director, Strategy & Innovation

Sourcing, Novo Nordisk

Therapeutic Area Partnerships 2014 November 19-21, 2014 The Hyatt Regency Boston, MA

Page 29: 2014 Cardiometabolic Projects To Watch · 11/19/2014  · cardiomyopathy and covers three MyoKardia programs: two for hypertrophic cardiopathy (HCM) and one for dilated (DCM) cardiomyopathy

Page 29 Therapeutic Area Partnerships 2014 © Defined Health

2014 Cardiometabolic Projects To Watch

Company Profiles

Page 30: 2014 Cardiometabolic Projects To Watch · 11/19/2014  · cardiomyopathy and covers three MyoKardia programs: two for hypertrophic cardiopathy (HCM) and one for dilated (DCM) cardiomyopathy

Page 30 Therapeutic Area Partnerships 2014 © Defined Health

CERENIS Company Profile

Company Overview

Company Cerenis Therapeutics

Location Labege, Toulouse, France

Description

Cerenis is a multinational biotechnology company dedicated to the discovery, development, and commercialization of novel HDL therapies for the treatment of cardiovascular and metabolic diseases.

Partners

In cardiology, Cerenis seeks to retain co-development and co-promotion rights in order to evolve to a commercial-stage specialty pharmaceutical company Cerenis is also exploring partnering options and ways to collaborate on non-core strategic assets outside of cardiology.

Company website, Google Finance, EvaluatePharma

Technology Platform

• Project to Watch: CER 001 for CAD/dyslipidemia, Phase II • Cerenis is developing a broad pipeline of HDL therapies to address the needs of a variety of patients in both the sub-acute and

chronic care CVD markets. • The lead product is CER-001, a recombinant high-density lipoprotein (HDL) mimetic: a complex of a human apolipoprotein A-I

(ApoA-I) and phospholipids. • The product is designed to rapidly regress atherosclerotic plaque among patients at high risk of cardiovascular events.

Company Overview

Financial

In 2010 the company raised €50 million in Series C financing. In October 2010 the total equity investment raised to date was 117 million Euros.

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Page 31 Therapeutic Area Partnerships 2014 © Defined Health

Company Overview

Financial Market Cap: $590.35M (as of 4-Nov-2014) No sales data available

ESPERION Company Profile

Company Overview

Company Esperion Therapeutics

Location Ann Arbor, MI

Description

Esperion is a pharmaceutical company focused on the development and commercialization of novel therapies for the treatment of patients with elevated levels of low-density lipoprotein cholesterol (LCL-C) and other cardiometabolic risk factors

Partners Esperion is interested in partnering but currently has no industry partners

Company website, Google Finance, EvaluatePharma

Technology Platform

• Project to Watch: ETC-1002 (Bempedoic acid) for CAD/dyslipidemia, Phase II • Esperion’s lead product candidate is an orally available, once-daily small molecule designed to lower LDL-cholesterol levels and

avoid the side effects associated with currently available therapies. • ETC-1002 has a dual mechanism of action with the potential to regulate both lipid and carbohydrate metabolism and is in

development primarily for patients with hypercholesterolemia and a history of statin intolerance

Page 32: 2014 Cardiometabolic Projects To Watch · 11/19/2014  · cardiomyopathy and covers three MyoKardia programs: two for hypertrophic cardiopathy (HCM) and one for dilated (DCM) cardiomyopathy

Page 32 Therapeutic Area Partnerships 2014 © Defined Health

Company Overview

Financial Market Cap (BASF): $63,6B (as of 12-Nov-2014)

Sales BASF acquired Pronova BioPharma for approximately $657M (NOK 3760m) in cash at price of $2.186/share (NOK 12.50/share).

PRONOVA (BASF) Company Profile

Company Overview

Company Pronova Biopharma Norge AS (part of BASF Omega-3 Verbund)

Location Oslo, Norway

Description

The BASF acquisition of Pronova Biopharma (2013), Equateq (2012), and Cognis (2010) has made BASF a global market leader for omega-3 fatty acids. The newly created portfolio now covers the full range of omega-3 fatty acids for pharmaceuticals, dietary supplements and clinical nutrition

Partners BASF’s pharmaceutical business is operated through Pronova BioPharma.

Company website, Google Finance, EvaluatePharma

Technology Platform

• Project to Watch: PRC 4016 for CAD/dyslipidemia, Phase II • Pronova BioPharma was a Norway based pharmaceutical company focused on development & manufacturing of marine-originated

omega-3 derived pharmaceutical products. • PRC 4016 is a structurally enhanced omega-3 fatty acid with potent triglyceride and cholesterol-lowering effects and has been

shown to prevent the development of atherosclerosis and improve liver steatosis in a CETP mouse model of mixed dyslipidaemias. • PRC 4016 may have better efficacy than currently approved drugs, with a broader therapeutic window and appears to have a

better safety profile than other lipid-lowering non-fatty acid based products.

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Juventas Therapeutics Company Profile

Company Overview

Company Juventas Therapeutics

Location Cleveland, Ohio

Description

Juventas Therapeutics is a private clinical-stage biotechnology company focused on the development of therapies for ischemic cardiovascular disease.

Partners

In 2011, Juventas Therapeutics spun-off SironRX Therapeutics to focus on development of dermal and bone related applications for JVS-100. In addition to its clinical programs, Juventas has on-going collaborative research programs with Cleveland Clinic, Center for Stem Cell & Regenerative Medicine, Global Cardiovascular Innovation Center, Summa Health System, and SironRX Therapeutics.

Company website, Google Finance, EvaluatePharma

Technology Platform

• Project to Watch: JVS-100 for Heart failure, Phase II • JVS-100, is a non-viral DNA plasmid that encodes from stromal cell-derived factor-1 (SDF-1). SDF-1 has been shown to significantly

increase end-organ function following tissue injury by promoting cell survival, recruiting endogenous stem cells to the damaged region and promoting new blood vessel growth.

Company Overview

Financial

In 2012 the company raised $22.2 Million in Series B financing co-led by Triathalon Medical Venture Partners and New Science Ventures. All previous venture firms participated in the round. New investors included Takeda Ventures, Venture Investors, Global Cardiovascular Innovation Center, Tri-State Growth Fund, Glengary and select angel investors. The company has received non-dilutive grant support through Cleveland Clinic, Ohio BioValidation Fund, Global Cardiovascular Innovation Center and Center for Stem Cell & Regenerative Medicine.

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Page 34 Therapeutic Area Partnerships 2014 © Defined Health

Company Overview

Financial Market Cap: $981M (as of 12-Nov-2014)

Sales

Arena Pharmaceuticals Company Profile

Company Overview

Company Arena Pharmaceuticals

Location San Diego, CA

Description

Arena Pharmaceuticals is a biopharmaceutical company focused on discovering, developing and commercializing novel drugs that target G protein-coupled receptors (GPCRs).

Partners Arena Pharmaceuticals has granted exclusive marketing and distribution rights for Belviq to Eisai for most worldwide territories.

Company website, Google Finance, EvaluatePharma

Technology Platform

• Project to Watch: APD-811 for Hypertension, Phase II • APD-811 is the lead from orally-active non-prostanoid prostacyclin (IP) receptor agonists, identified using the company's

Constitutively Activated Receptor Technology (CART) technology, as an once-daily formulation • Approach allows identification of drug leads that act as receptor agonists or inhibitors, inverse agonists, and ligand-dependent,

receptor activity. • The platform could eliminate the need to identify the native ligand for an orphan receptor and provide the ability to discover novel

and improved therapeutics directed at known receptors.

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Page 35 Therapeutic Area Partnerships 2014 © Defined Health

Advinus Therapeutics Company Profile

Company Overview

Company Advinus Therapeutics

Location Bengaluru, India

Description

A research-based pharmaceutical company and first of its kind in India to offer end-to-end development services to the global Pharma, Agro and Biotech industries. Advinus is focused on developing therapeutics in the areas of metabolism, inflammation, pain & neglected diseases.

Partners Advinus has established successful partnership with global pharma companies such as Merck, Novartis, J&J and DNDi.

Company website, Google Finance, EvaluatePharma

Technology Platform

• Project to Watch: GKM-002 for Diabetes, Phase II • GKM-002, a back-up compound of GKM-001, is in development for the potential treatment of type 2 diabetes. • Diabetes approach addresses glucose overproduction, peripheral insulin resistance, and insulin deficiency. • Obesity platform focuses on mechanisms involved in abnormal energy intake and expenditure or excessive energy storage to

provide safe therapies for weight loss.

Company Overview

Financial

The TATA Group is a rapidly growing business group based in India. The total revenue of Tata companies was $70.8 billion in 2008-09, with 64.8% coming from business outside India In 2012 Takeda and Advinus entered into an agreement to initiate a three-year discovery collaboration. Advinus will receive guaranteed research funding of $36 million over the term of the collaboration, $9 million in milestones leading up to candidate selection, and is eligible to receive future clinical and regulatory milestones payments of up to $45 million per product.

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Page 36 Therapeutic Area Partnerships 2014 © Defined Health

TransTech Pharma Company Profile

Company Overview

Company TransTech Pharma

Location High Point, NC

Description

TransTech Pharma is a clinical-stage pharmaceutical company focused on the discovery and development of human therapeutics. The pipeline includes clinical and preclinical small molecule drug candidates for the treatment of CNS disorders, diabetes and metabolic disorders, inflammation and oncology.

Partners TransTech has strategic alliances with Novo Nordisk, Cephalon, Forest Laboratories, Siga, Merck, Boehringer Ingelheim, and Pfizer.

Company website, Google Finance, EvaluatePharma

Technology Platform

• Project to Watch: TTP 399 for Diabetes, Phase I/II • TTP 399 is an orally available, small molecule glucokinase activator (GKA) for the treatment of type 2 diabetes mellitus • The proprietary drug discovery engine TTP Translational Technology is a highly automated and fully integrated drug discovery

process, which translates genomic & proteomic data into safe and effective small molecule therapeutics in high throughput fashion. • Three modules of TPP Translational Technology: TTPredict, TTPSpace, and TTPScreen that are integrated with an informatics system

that captures data from each optimization cycle of the drug discovery process. According to the company, TTP Translational Technology realizes higher success rates in the development phase of compounds selected versus compounds discovered traditionally.

Company Overview

Financial

TransTech Pharma is a privately held company. • 2003: TransTech announced the completion of two round of investments totaling $34.5M

• 2005: TransTech and SIGA Technologies announced the receipt of a $2.7M challenge grant from the NIH

• 2010: TransTech and High Point Pharma were awarded cash grants totaling $1.96M from the US Government’s Qualifying Therapeutic Discovery Project (QTDP) program

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Roundtable Discussion: Creating New Opportunities and Partnerships in CV/Metabolic Drug Programs Moderator: • Mike Rice MS, MBA, Senior Consultant, Defined Health

Panelists: • John Delyani, Executive Director, Business

Development & Licensing, Merck & Co. • Barry Ticho MD, PhD, Head, Cardiovascular and

Metabolic Disorder & ERDI, Pfizer • Steve Cohen MD, Executive Director ,External

Scientific Affairs, Daiichi Sankyo • Tomas Landh, Director, Strategy & Innovation

Sourcing, Novo Nordisk

Therapeutic Area Partnerships 2014 November 19-21, 2014 The Hyatt Regency Boston, MA