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Extending Legacy Of Leadership In Hematology Brian Goff President, Hematology
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Page 1: Extending Legacy Of Leadership In Hematologys2.q4cdn.com/643609687/files/doc_events/2015/Hematology_FINAL.pdf · • Strengthening our hematology leadership for sustainable and profitable

Extending Legacy Of Leadership In Hematology

Brian Goff President, Hematology

Page 2: Extending Legacy Of Leadership In Hematologys2.q4cdn.com/643609687/files/doc_events/2015/Hematology_FINAL.pdf · • Strengthening our hematology leadership for sustainable and profitable

Deliver transformative and personalized

therapies to improve the lives of patients with blood disorders

Our Strategic Priority:

Page 3: Extending Legacy Of Leadership In Hematologys2.q4cdn.com/643609687/files/doc_events/2015/Hematology_FINAL.pdf · • Strengthening our hematology leadership for sustainable and profitable

Key takeaways

• Strengthening our hematology leadership for sustainable and profitable growth

• Building personalized care through patient-centric innovation

• Elevating access to treatment and standards of care globally

• Diversifying to transform care in adjacent blood disorders by leveraging our core expertise

Poised For 3% - 5% Sales CAGR Across Hematology Business Through 2020

Extending Legacy Of Leadership In Hematology

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Disease description & pathology

• Hemophilia is a congenital bleeding disorder caused by a deficiency or absence of FVIII or FIX

• Most common complication is development of chronic arthropathy due to repeated bleeding into joints

• Hemorrhages into skin, muscles, soft tissue and mucous membranes

• Intracranial hemorrhage, a serious life-threatening complication, occurs in ~2% of patients1

• ~$10B market size (Hemophilia A & B and Inhibitors) growing to ~$13B by 2020 at CAGR of 4% - 6%

Hemophilia Is A Rare Bleeding Disorder Affecting ~480,000 People Worldwide

Data Source: World Federation of Hemophilia; Baxalta internal analysis, 1 Witmer, C., et al. (2011). Br J Haematol 152(2): 211-216.

80-85% Hemophilia A:

deficiency of FVIII

15-20% Hemophilia B:

deficiency of FIX

Over 75% of Hemophilia A & B

patients are in developing countries

Page 5: Extending Legacy Of Leadership In Hematologys2.q4cdn.com/643609687/files/doc_events/2015/Hematology_FINAL.pdf · • Strengthening our hematology leadership for sustainable and profitable

Challenges and opportunities

• Improvement in diagnosis and treatment, especially in developing countries

• Adequate diagnosis and care for patients with inhibitors:

– 30% of Hemophilia A and 5% of Hemophilia B patients develop inhibitors to factor treatment

• Wider adoption of prophylaxis

• Optimization of outcomes through personalization of care

• Sustained high trough levels to enhance quality of life

Significant Opportunity To Raise Global Standard Of Care

Majority Of Hemophilia Patients Worldwide Lack Adequate Treatment

30% Treated

480,000 Worldwide

Hemophilia A & B population

40% Diagnosed

8% Prophylaxis

3% Achieve Zero Annual

Bleeds

Data Source: World Federation of Hemophilia Annual Global Survey 2013; Baxalta internal analysis

Page 6: Extending Legacy Of Leadership In Hematologys2.q4cdn.com/643609687/files/doc_events/2015/Hematology_FINAL.pdf · • Strengthening our hematology leadership for sustainable and profitable

Baxalta Hematology Revenue

Hematology: Delivering Sustainable Growth Of 3% - 5%

Strengthening Hemophilia leadership

through innovation

Raising standard of care for patients with

Inhibitors

Expanding global access and improving treatment standards

Accelerating game-changing therapies in

blood disorders

~$3.5B

$3.5 $3.8 $4.1

~$4.3B

$0

$2

$4

$6

2015Expectation*

HemophiliaA & B

InhibitorTherapy

BloodDisorders

2020Outlook

$ In

Bill

ions

CAGR 3% - 5%

New Products $1B+

BAX 855 BAX 817 OBIZUR RIXUBIS VONVENDI** BAX 555

*Actual rates **VONVENDI = BAX 111

Page 7: Extending Legacy Of Leadership In Hematologys2.q4cdn.com/643609687/files/doc_events/2015/Hematology_FINAL.pdf · • Strengthening our hematology leadership for sustainable and profitable

Therapy advancements have made zero annual bleeds a

reality for some patients

Strengthening Hemophilia leadership through innovation

Page 8: Extending Legacy Of Leadership In Hematologys2.q4cdn.com/643609687/files/doc_events/2015/Hematology_FINAL.pdf · • Strengthening our hematology leadership for sustainable and profitable

Market dynamics

• Competitive entries will double

• Growing austerity measures

Baxalta Hemophilia Revenue*

Hemophilia A & B: Solid Foundation For Sustainable Growth

A high bar with ADVATE-based therapy • Direct factor replacement to address

well-understood pathophysiology

• Proven safety and effectiveness

• Zero annual bleeds through prophylaxis

• Improving outcomes through personalization of care

~$2.7B

$0.0

$1.0

$2.0

$3.0

2015Expectation

BaseFVIII & FIX

BAX 855 2020Outlook

CAGR 1%-3%

*Reflects sales of FVIII and FIX therapies **At actual rates

**

~$3.0B

Page 9: Extending Legacy Of Leadership In Hematologys2.q4cdn.com/643609687/files/doc_events/2015/Hematology_FINAL.pdf · • Strengthening our hematology leadership for sustainable and profitable

ADVATE: The Worldwide rFVIII Leader Approved In Over 65 Countries

1 Iorio A, Marcucci M, Cheng J, et al. Patient data meta-analysis of Post-Authorization Safety Surveillance (PASS) studies of haemophilia A patients treated with rAHF-PFM. Haemophilia. 2014:1-7

Proven Safety in the Real World

Proven Effectiveness in the Real World

Personalization with Reliable Pharmacokinetic

(PK)-based dosing

1.66 Annual Bleed Rate (ABR) Real World1

0.15% incidence of de novo inhibitors in severe Previously Treated

Patients (PTPs)1

Page 10: Extending Legacy Of Leadership In Hematologys2.q4cdn.com/643609687/files/doc_events/2015/Hematology_FINAL.pdf · • Strengthening our hematology leadership for sustainable and profitable

Building On A Well-Understood Scientific Platform With Direct Factor Replacement

Bridging Market Insights To Science To Drive Innovation

• Freedom from pain

• To engage in activities of daily living

• A treatment that works for them and fits their lifestyle

• A treatment that is safe

• A cure

• Efficacy profile to achieve zero bleeds

• Reliable assays for optimum dose-tailoring

• Lifestyle-aligned personalization

• Well established long-term safety with low inhibitor risk

• Sustained multi-year elevated trough levels with innovation in gene therapy

Patient Needs Our Solution

Page 11: Extending Legacy Of Leadership In Hematologys2.q4cdn.com/643609687/files/doc_events/2015/Hematology_FINAL.pdf · • Strengthening our hematology leadership for sustainable and profitable

We Strive For A Bleed-Free World… One Person At A Time

EVERY BLEED MATTERS

PROPHYLAXIS FOR ALL

PERSONALIZED FOR ONE

Page 12: Extending Legacy Of Leadership In Hematologys2.q4cdn.com/643609687/files/doc_events/2015/Hematology_FINAL.pdf · • Strengthening our hematology leadership for sustainable and profitable

Right Product + Right Dosing Regimen = Personalized Outcomes

High Patient Variability Drives Need For Personalized Treatment Patient factors Treatment requirements

Variability in patient PK parameters: Product half-life and dosing regimen to achieve optimum factor activity levels between infusions

PK Response to Clotting Factor

Bleed Risk/Phenotype

Patient Lifestyle/

Physical Activity Levels

Frequency and intensity of physical activity: Peak factor protection and time spent in ‘safe zone’ at time of physical activity

Bleed risk and joint health: Patient-specific baseline factor activity levels and time spent in ‘safe zone’

Page 13: Extending Legacy Of Leadership In Hematologys2.q4cdn.com/643609687/files/doc_events/2015/Hematology_FINAL.pdf · • Strengthening our hematology leadership for sustainable and profitable

Annual Number Of Joint Bleeds According To FVIII Activity

Higher Baseline FVIII Activity Level Is Associated With Fewer Annual Joint Bleeds

0

2

4

6

0 5 10 15 20

Annu

al N

umbe

r Of J

oint

Ble

eds

% FVIII Activity (IU dL-1)

Baseline activity levels of over 10% were shown to be associated with significant decrease in annual joint

bleeds

(N= 377)

Hemophilia Severity

Severe (<1%)

Moderate (1% - 5%)

Mild (5% - 40%)

Adapted from den Uijl, et al, 2011

den Uijl IEM et al. Haemophilia. 2011, 17: 849-853

Page 14: Extending Legacy Of Leadership In Hematologys2.q4cdn.com/643609687/files/doc_events/2015/Hematology_FINAL.pdf · • Strengthening our hematology leadership for sustainable and profitable

Annual Number Of Joint Bleeds According To FVIII Activity

Changing Treatment Paradigm With Gene Therapy

Portfolio Strategy To Elevate Baseline FVIII Activity Level

0

2

4

6

0 5 10 15 20

Annu

al N

umbe

r Of J

oint

Ble

eds

% FVIII Activity (IU dL-1)

Base FVIII

Factor Replacement Therapies

Extended Half-Life

Gene Therapy

Adapted from den Uijl, et al, 2011

Hemophilia Severity

Severe (<1%)

Moderate (1% - 5%)

Mild (5% - 40%)

den Uijl IEM et al. Haemophilia. 2011, 17: 849-853

Page 15: Extending Legacy Of Leadership In Hematologys2.q4cdn.com/643609687/files/doc_events/2015/Hematology_FINAL.pdf · • Strengthening our hematology leadership for sustainable and profitable

• High structural and functional consistency

• Extensively tested for safety and efficacy prior to clinical development

• Successful Phase III clinical trial

– 1.4-1.5 fold increase in ADVATE’s half-life

– 95% reduction in median ABR vs. on-demand

– No patients developed inhibitors

• Accelerated product development and robust manufacturing positions Baxalta for competitive market entry

• U.S. BLA filed in Q4 2014; Japan Q2 2015

• U.S. pediatric and EU filing expected in 2016

BAX 855 Is Built On The Proven Safety And Efficacy Of ADVATE

Building An ADVATE-Based Family Beginning With BAX 855

BAX 855

Page 16: Extending Legacy Of Leadership In Hematologys2.q4cdn.com/643609687/files/doc_events/2015/Hematology_FINAL.pdf · • Strengthening our hematology leadership for sustainable and profitable

• Polysialylation of full-length rFVIII with no mutation in the protein structure

• Prolong ADVATE half-life; potential for once-weekly or less frequent dosing

• Leveraging real world long-term safety and efficacy of ADVATE-based direct factor replacement

• Expect to initiate Phase I clinical trial end of 2015

Prolong ADVATE Half-Life And Reduce Dosing Frequency With BAX 826

Expanding The ADVATE-Based Family With BAX 826

BAX 826

Page 17: Extending Legacy Of Leadership In Hematologys2.q4cdn.com/643609687/files/doc_events/2015/Hematology_FINAL.pdf · • Strengthening our hematology leadership for sustainable and profitable

Gene therapy programs in Hemophilia

• Acquired Asklepios BioPharmaceuticals (Chatham Therapeutics) Hemophilia Gene Therapy program in 2014

• BAX 888 (FVIII) and BAX 335 (FIX) induces the body to produce factor

• BAX 888 FVIII gene construct selection under evaluation

• Phase I/II trial in progress to assess safety and optimal dosing level of BAX 335

• 7 patients treated in three dosing cohorts; FIX activity level ~10% or above in two patients; no bleeding events or inhibitor development

• Additional data at ISTH in June 2015

Shifting The Paradigm In Hemophilia Care With Sustained High Factor Levels

Our Gene Therapy Pipeline Offers Potential For Multi-Year Treatment

Page 18: Extending Legacy Of Leadership In Hematologys2.q4cdn.com/643609687/files/doc_events/2015/Hematology_FINAL.pdf · • Strengthening our hematology leadership for sustainable and profitable

Raising standard of care for patients with Inhibitors

Only 35% of patients with Inhibitors are on prophylaxis

in developed countries

Data Source: Baxalta internal analysis

Page 19: Extending Legacy Of Leadership In Hematologys2.q4cdn.com/643609687/files/doc_events/2015/Hematology_FINAL.pdf · • Strengthening our hematology leadership for sustainable and profitable

Raising The Bar On Outcomes For Patients With Inhibitors

Addressing Key Unmet Needs For Fragile Patient Segment

Acute Bleed Control

• Rare autoimmune disease

• Unmet needs: delay in diagnosis and treatment, high patient mortality (20%)

ACUT

E/

EMER

GEN

CY

Acquired Hemophilia A

(~10,500 patients/y) 2

1 World Federation of Hemophilia Annual Global Survey 2013, 2 Collins PW, et al. Blood. 2007 Mar 1; 109(5):1870-7

CHRO

NIC

/ LO

NG-

TERM

Prophylaxis

Congenital Hemophilia

with Inhibitors (~5,000 diagnosed

patients) 1

• Development of anti-bodies that neutralize clotting factor

• Unmet needs: Low prophylaxis rates, limited choice of by-pass therapy agents

PIPELINE

BAX 817 (rFVIIa)

Anti-TFPI

Page 20: Extending Legacy Of Leadership In Hematologys2.q4cdn.com/643609687/files/doc_events/2015/Hematology_FINAL.pdf · • Strengthening our hematology leadership for sustainable and profitable

Key studies

• FEIBA PROOF Study: Prospective, randomized, open label study of FEIBA prophylaxis vs. on-demand therapy showed significant reduction in bleeds1

• FEIBA GO Study: Long-term prophylaxis observational study to track outcomes; interim results expected in 2017

FEIBA prophylaxis

• Only bypass therapy indicated for prophylaxis • Growth driven by increase in global

prophylaxis; opportunity due to low (~35%) prophylaxis rate

Differentiated Label With FEIBA Prophylaxis

Strong Bleed Reduction With FEIBA Prophylaxis

Reduced median

ABR for all bleeds by 72.5%

(P=0.0003)

When compared with FEIBA on-demand treatment, FEIBA prophylaxis 85±15 U/kg given every other day

Global FEIBA Revenue

$0.0

$0.5

$1.0

2012 2013 2014

$ In

Bill

ions

~10% CAGR*

1 Antunes SV,et al. Haemophilia. 2014;20(1):65-72. *Constant Currency

Page 21: Extending Legacy Of Leadership In Hematologys2.q4cdn.com/643609687/files/doc_events/2015/Hematology_FINAL.pdf · • Strengthening our hematology leadership for sustainable and profitable

OBIZUR meets a significant unmet need for patients • Only therapy for AHA that allows for

measurement of FVIII

• Elevates clinician confidence by providing faster response time, better safety and optimum dosing

• 100% of bleeds successfully treated since U.S. launch

• Regulatory review ongoing in EU, Colombia, and Canada

• Exploring additional indications

$250M Peak Sales Opportunity

OBIZUR: First And Only Clinically Approved Treatment For Acquired Hemophilia A

Page 22: Extending Legacy Of Leadership In Hematologys2.q4cdn.com/643609687/files/doc_events/2015/Hematology_FINAL.pdf · • Strengthening our hematology leadership for sustainable and profitable

70% of Hemophilia patients worldwide do not receive

any or adequate treatment

Data Source: World Federation of Hemophilia, Baxalta internal analysis

Expanding access and improving global treatment standards

Page 23: Extending Legacy Of Leadership In Hematologys2.q4cdn.com/643609687/files/doc_events/2015/Hematology_FINAL.pdf · • Strengthening our hematology leadership for sustainable and profitable

Global Patients By Regimen & Severity Global Patients By Regimen & Severity

Majority Of Hemophilia Patients Do Not Have Access To Prophylaxis Treatment

0%

25%

50%

75%

100%

Mild Moderate Severe

Prophylaxis On-Demand

% O

f Pat

ient

s

~15% Of Patients On Prophylaxis Treatment

% O

f Pat

ient

s

~30% Of Patients On Prophylaxis Treatment

0%

25%

50%

75%

100%

Mild Moderate Severe

Prophylaxis On-Demand

Data Source: Baxalta internal analysis

Hemophilia A Hemophilia B

Page 24: Extending Legacy Of Leadership In Hematologys2.q4cdn.com/643609687/files/doc_events/2015/Hematology_FINAL.pdf · • Strengthening our hematology leadership for sustainable and profitable

% Prophylaxis Penetration Severe Hemophilia A Patients

Expanding Prophylaxis Opportunity In Developed Markets

98% 90% 87% 84%

70% 71%

51%

68%

Germany U.S. France Japan

Pediatric (0-18 years) Adult (18+ years)

Opportunity

Data Source: Baxalta internal analysis

Page 25: Extending Legacy Of Leadership In Hematologys2.q4cdn.com/643609687/files/doc_events/2015/Hematology_FINAL.pdf · • Strengthening our hematology leadership for sustainable and profitable

Treatment Rates Recombinant Conversion

>20 Billion IU Potential If UK Standard Of Care Is Achieved

Achieving Higher Standard Of Care In Developing Countries

Data Source: World Federation of Hemophilia Annual Global Survey 2013, China - 2012 MRB report; Baxalta Internal Analysis

0%

25%

50%

75%

100%

UK Russia Turkey Brazil China India

0

2

4

6

8

UK Russia Turkey Brazil China India

IU/C

apita

% rF

VIII

By U

nits

UK: 7.7 IU/Capita UK: 90% Recombinant FVIII

Page 26: Extending Legacy Of Leadership In Hematologys2.q4cdn.com/643609687/files/doc_events/2015/Hematology_FINAL.pdf · • Strengthening our hematology leadership for sustainable and profitable

Strategic initiatives

Leveraging Global Presence And Strong Relationships In Local Markets To Raise Standards Of Care

Implementing Diverse And Localized Strategies In Developing Countries

RUSSIA • Local manufacturing agreement for Hemophilia therapies • ADVATE launched in 2014; FEIBA included in national tender

TURKEY • ADVATE launched in 2014: 400+ patients added since 2014

BRAZIL • 20-year exclusive partnership with Hemobrás • 4,000+ patients now have access to ADVATE

CHINA • Improving affordability and access to ADVATE with patient

access programs • Local partnerships with city-based funding organizations

INDIA • Awareness and education among stakeholders • Secure Government funded access; improve infrastructure

Page 27: Extending Legacy Of Leadership In Hematologys2.q4cdn.com/643609687/files/doc_events/2015/Hematology_FINAL.pdf · • Strengthening our hematology leadership for sustainable and profitable

Brazil Conversion To rFVIII

Brazil: Long-Term Growth Strategy Through Hemobrás Partnership

Amauri has been on ADVATE prophylaxis since it was launched in Brazil

0% ~25%

40%+ 50%+

65%

1.68

2.55 2.79

2.95

4.10

2012 2013 2014 2015E 2020E

% rF

VIII

Patie

nts

IU/Capita

Page 28: Extending Legacy Of Leadership In Hematologys2.q4cdn.com/643609687/files/doc_events/2015/Hematology_FINAL.pdf · • Strengthening our hematology leadership for sustainable and profitable

Accelerating game-changing therapies in other blood disorders

Bringing paradigm shift to current therapies

Page 29: Extending Legacy Of Leadership In Hematologys2.q4cdn.com/643609687/files/doc_events/2015/Hematology_FINAL.pdf · • Strengthening our hematology leadership for sustainable and profitable

Building Depth And Breadth To Compete In A $16B+ Market

Leveraging Heritage In Hemophilia To Expand In Other Blood Disorders

Current therapy areas in Hemophilia Future growth in Blood Disorders

Hemophilia A Hemophilia with inhibitors

Sickle Cell Disease

Hereditary TTP*

Disease Population ~400,000 ~80,000 ~20,000-

40,000 ~70 M

(~700K require treatment)

~3,000-4,000 ~200,000 (U.S. and EU)

Hemophilia B von Willebrand Disease

Depth Breadth

Segment Size in 2020 = ~$13B

Under-penetrated Segment Potential = ~$3.0B

*Thrombotic Thrombocytopenic Purpura

Data Source: World Federation of Hemophilia, CDC, NIH, EMA, answeringttp.org, Baxalta internal analysis

Page 30: Extending Legacy Of Leadership In Hematologys2.q4cdn.com/643609687/files/doc_events/2015/Hematology_FINAL.pdf · • Strengthening our hematology leadership for sustainable and profitable

VONVENDI (BAX 111): The First Recombinant Pure von Willebrand Factor

VONVENDI (BAX 111) For Hereditary von Willebrand Disease (vWD)

Disease Description

• Most common inherited bleeding disorder; prevalence of symptomatic disease:1in 10,0001

• Low prophylaxis (~20%) in Severe Type 3 • Currently treated with desmopressin and/or combination pdFVIII/vWF

Product Attributes and Targeted Indications

• First highly purified recombinant vWF

• Can be used with or without FVIII therapy for added flexibility

• Advanced manufacturing to preserve the vWF profile including ultra-large multimers

Studies and Timelines

• Phase III met its primary efficacy endpoint

• U.S. BLA submission Q4 2014

• Surgery study initiated Q4 2014

Potential

• ~$1.0B peak sales opportunity

• Significantly under-developed segment

• Exploring additional indications

1 Ng C,et al. Blood. 2015 Feb 23.

Page 31: Extending Legacy Of Leadership In Hematologys2.q4cdn.com/643609687/files/doc_events/2015/Hematology_FINAL.pdf · • Strengthening our hematology leadership for sustainable and profitable

BAX 930: First Disease-Specific Treatment For hTTP

BAX 930 For Hereditary Thrombotic Thrombocytopenic Purpura (TTP)

Disease Description

• Life-threatening coagulation disorder affecting 3,000 - 4,000 patients globally

• Currently treated with infusions of fresh frozen plasma (FFP)

Product Attributes and Targeted Indications

• First recombinant factor replacement therapy with rADAMTS13

• For on-demand treatment of TTP episodes and prophylactic treatment of hereditary TTP

Studies and Timelines

• Preclinical IND-enabling studies completed

• Phase I initiated in 2014

Potential • ~$1.0B including additional indications

• New therapy options expected to outgrow the market

Page 32: Extending Legacy Of Leadership In Hematologys2.q4cdn.com/643609687/files/doc_events/2015/Hematology_FINAL.pdf · • Strengthening our hematology leadership for sustainable and profitable

BAX 555: A Potential New Treatment Option For Patients With Sickle Cell Disease

BAX 555 For Sickle Cell Disease

Disease Description

• World’s most common blood disorder with ~200,000 patients diagnosed in U.S./Europe

• Currently only one approved drug — low adoption rates and requires frequent monitoring

Product Attributes

• First-in-class, oral, small molecule compound • Early studies indicate the compound may reduce the sickling of red blood cells

Studies and Timelines

• Phase I studies completed • First cohort of Phase II study initiated in 2014 • Received FDA Orphan designation; eligible in EU

Potential • ~$1.0B • New therapy options expected to expand market

potential

Page 33: Extending Legacy Of Leadership In Hematologys2.q4cdn.com/643609687/files/doc_events/2015/Hematology_FINAL.pdf · • Strengthening our hematology leadership for sustainable and profitable

Key takeaways

• Strengthening our hematology leadership for sustainable and profitable growth

• Building personalized care through patient-centric innovation

• Elevating access to treatment and standards of care globally

• Diversifying to transform care in adjacent blood disorders by leveraging our core expertise

Poised For 3% - 5% Sales CAGR Across Hematology Business Through 2020

Extending Legacy Of Leadership In Hematology

Page 34: Extending Legacy Of Leadership In Hematologys2.q4cdn.com/643609687/files/doc_events/2015/Hematology_FINAL.pdf · • Strengthening our hematology leadership for sustainable and profitable

Baxalta Incorporated 2015 Investor Conference


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