© 2018 Quest medical imaging B.V. Pn1
Beleggers bijeenkomst
Quest Photonic Devices B.V.
Quest medical imaging
Making the Invisible Visible
Fluorescent image guided surgery 2 © 2018 Quest medical imaging B.V. | Pn1
Disclaimer With the exception of historical information contained in this presentation, content herein may contain "forward looking statements" that are made pursuant to the Safe Harbor Provisions of the Private Securities Litigation Reform Act of 1995. These statements are based on management's current expectations and are subject to uncertainty and changes in circumstances. Investors are cautioned that forward-looking statements involve risks and uncertainties that could cause actual results to differ materially from the statements made. These factors include general economic conditions, delays and risks associated with the performance of contracts, risks associated with international sales and currency fluctuations, uncertainties as a result of research and development, acceptable results from clinical studies, including publication of results and patient/procedure data with varying levels of statistical relevancy, risks involved in introducing and marketing new products, potential acquisitions, consumer and industry acceptance, litigation and/or court proceedings, including the timing and monetary requirements of such activities, the timing of finding strategic partners and implementing such relationships, regulatory risks including approval of pending and/or contemplated 510(k) filings, the ability to achieve and maintain profitability in the Company's business lines, and other factors. The Company disclaims any obligation to update its forward-looking relationships. It is understood that here is a risk that not all current or future risks are known
Fluorescent image guided surgery 3 © 2018 Quest medical imaging B.V. | Pn1
Introduction
Richard Meester
• President/CEO Quest Group
• Started Company in 1998
Hendrik jan van Es
• VP Business development Quest Group
• Joined company in 2010
Fluorescent image guided surgery 4 © 2018 Quest medical imaging B.V. | Pn1
Introduction
Company & Structure
Key personnel
Treating cancer
Performing surgery
Battling cancer with photonics
Market (value chain)
Competitive landscape
Technology & Advantages
Strategy and business model
Milestones
Installed base
Summary
Presentation
Fluorescent image guided surgery 5 © 2018 Quest medical imaging B.V. | Pn1
Company Structure
Quest Innovations • Imaging Heads and Light
engines
• Production and manufacturing of Camera heads
• OEM Customers
Quest Medical Imaging • Medical end products
• Marketing & Sales
• Medical surgical application development
Quest Photonic Devices • Research and Development
of Spectral Imaging Systems
Fluorescent image guided surgery 6 © 2018 Quest medical imaging B.V. | Pn1
Main Personnel Richard Meester
• President/CEO Quest Group
• Started Company in 1998
• 20+ years experience in Imaging Systems and business management
Hendrik jan van Es • VP Business development Quest Medical Imaging B.V. (Benelux)
• Joined company in 2010
• 15+ years in business development and market strategy
Rob NGungu • COO Quest Medical Imaging Inc. (USA)
• Joined company in 2013
• 25+ years experience in regulatory filings with FDA
Frederic Wasielewski • Sales Director Quest Medical Imaging SAS (France)
• 15+ years in medical device sales
• Joined company in 2018
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Milestones
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Cancer
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Cancer Key is
removing the complete tumor during surgery
Any residual cancer cells increase chance of recurrance
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Treating cancer
Lifestyle Detection Biopsy/
Analysis Localize Therapy Result
Monitor &
Recurrence
Quest Medical
Product Focus Quest Innovations
customers
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Company position in the chain
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Everybody is different
Treatment
Treatment
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Improve surgical performance
Improve treatment process
• Localize (CT/MRI)
• Treatment (Surgical)
• Result (Pathology & Follow up)
Provide real time tissue
information to surgeon
Improve patient care overall
Focus on surgical intervention
Localize Therapy Result
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How to:
Identify the Tumor during surgery • CT/MRI done before, no real time imaging
Identify complete tumor removal
Identify remaining small tumor spread • CT/MRI resolution may not detect small tumors
Person is located differently, organs have shifted
Detection of vital structures
Detection of tissue types
Navigation through human body (specifically minimal invasive)
Patient information, everybody is different
Surgical Challenges
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You can visualize information to the surgeon in real
time instead of simulation?
What if:
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Targeted tumor examples
Color NIR Fluorescence
Color - NIR Merge
Cases at Leiden University Medical Center. A. Vahrmeyer. Targeted tumor agent ovarian
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Targeted lymph node examples
Cases at Leiden University Medical Center. A. Vahrmeyer. Targeted tumor agent in lymph node
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Clasification • Ex vivo study
- Pathology
- Spectral imaging
- False color indication of spectral similarities
• Tumor detection
• Currently only superficial
• Aid for different applications like: - Cervical cancers
- Melanoma tumor bed scan
Use other body chromophores than just blood
Requires OR environment control
Tissue tumor detection &
segmentation
Healthy tissue Tissue with tumor
Dept. of Surgery, Leiden University Medical Center, The Netherlands
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LUMC Presentation on moleculair imaging
Battling cancer with Photonics
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Company
Technology
Strategic partners
Market development
Socially
Improving patient outcome
Lowering costs for hospital and society
Why invest in Quest? Prism Technology
The camera is actually several cameras behind one lens, making perfect overlays possible
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Competition
Storz Mini Flare Fluobeam PDE Hypereye Pinpoint/Spy
Strong Add-on on tower Well developed distribution
Large install base Large install base (Mostly Japan)
Computer overlaid image
Large install base (Luna via Life Cell)
Relative Low price
Computer overlaid image Low price Low price
More market ready company + system
Weak Switching image Only NIR vision Only NIR vision No data collection Single Chip solution
Bad NIR image
Cannot be CE/ FDA certified
ICG or Methylene blue Can do only ICG Can do only ICG Can do only ICG
Only open system Only open system Only open system Only open or MIS system
Technical inferior Technical inferior Technical inferior Technical inferior Technical inferior
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Smart tumor targeting contrast agent provides
• 4 contracted 4 in progress
One agent works only with our camera
Registering exclusively with us (FDA)
Capability of seeing more than one agent at the time
Partnerships contrast agents
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Installed base
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Currently at the following locations
• #2 Memorial Sloan Kettering Cancer Center, new York
• #7 Cleveland Clinic, Cleveland
• #7 Upenn, Philadelphia
• #10 UCSF, San Diego
Goal focus on installing units at complete top 10.
Top 10 Cancer centers US
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Partners
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Camera systems
Novadaq => Stryker $ 701 Mln
Surgvision => Bracco $?
Vision sense => Medtronic $ 75 Mln
Targeted probes
On Target => Johnson & Johnson $ 40 Mln
Partners => Total investment last 3 yrs (> 150 Mln)
Recent take overs / investments
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Milestones
- 2017 ICG open application phase 2018 - 2019
ICG open & MIS applications phase 2020
Expected Start Targeted probe roll out phase. Gen 3 system
Key priority: - Build out distributor
network and via them install systems in key hospitals, building out install base.
- Build out production hospitals (not only university hospitals
- Expand product line
2021 Adding modules / integrate with OR setup
Several additional modalities are under development that can be added to the towers in the field.
The first targeted probes will have completed registration. Joint roll out based on install base already in place, distributor network of QMI and sales structure of probe developer.
Key priorities: - Recruitment of Sales
manager France/ internal sales/ clinical assistant
- Formalize agreements with 3 Probe developers
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Sales cycle
1.Identify & Demo
2. Budget allocation
3. Rent/
Sale
Step sales approach
1. Predefined target hospital list
Demonstrate machine in real use (perform surgery with surgeon)
2. Find budget
3. Acquire machine or place through rental or pay per surgery
Average sales cycle 9 – 15 months
Rental with option to buy shortens cycle
Pay per surgery easiest. Pay through kit (US only right now)
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Increase distribution network • New distributors under negotiation to close this year
• Increase demo systems
• Increase device production
Increase direct sales network • US East coast (Sales reps + clinical assistants)
• US West coast (Sales reps + clinical assistants)
• US Central clinical assistants
• Germany office (Sales reps + clinical assistants)
Strengthen office backbone
Build out product portfolio and technology
Short term action points
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Questions
Pn1 © 2018 Quest medical imaging B.V.
Quest Medical Imaging B.V.
PO Box 22, 1770 AA, Wieringerwerf
the Netherlands
T:+31(0)227 604046 ◊ F:+31(0)227 604053
www.quest-innovations.com/ www.quest-mi.com