Investor Update at North American Neuromodulation Society Maulik Nanavaty, SVP & President, Neuromodulation

Jesse Feinkind, Vice President, Global SCS

Milad Girgis, Vice President, Global DBS

January 18, 2019

2

Safe Harbor for Forward-Looking Statements & Disclaimers

This presentation contains forward-looking statements within the meaning of Section 27A of the Securities Act of 1933 and Section 21E of

the Securities Exchange Act of 1934. Forward-looking statements may be identified by words like “anticipate,” “expect,” “project,”

“believe,” “plan,” “estimate,” “intend” and similar words. These forward-looking statements are based on our beliefs, assumptions and

estimates using information available to us at the time and are not intended to be guarantees of future events or performance. If our

underlying assumptions turn out to be incorrect, or if certain risks or uncertainties materialize, actual results could differ materially from

the expectations and projections expressed or implied by our forward-looking statements.

Factors that may cause such differences can be found in our most recent Form 10-K and Forms 10-Q filed or to be filed with the

Securities and Exchange Commission under the headings “Risk Factors” and “Safe Harbor for Forward-Looking Statements.”

Accordingly, you are cautioned not to place undue reliance on any of our forward-looking statements. We disclaim any intention or

obligation to publicly update or revise any forward-looking statements to reflect any change in our expectations or in events, conditions,

or circumstances on which they may be based, or that may affect the likelihood that actual results will differ from those contained in the

forward-looking statements.

Market Estimates:

Unless noted otherwise, all references to market sizes, market share positions, and market growth rates are BSX internal estimates.

Regulatory Disclaimers:

GUIDE™ XT and Cartesia™ Lead - CE Marked. US: “Caution: Investigational Device. Limited by Federal (or US) law to investigational use

only. Not available for sale.”

MRI Labeling for Vercise Gevia™ Deep Brain Stimulation System - CE Marked. Not available for use or sale in the U.S.

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BSX Neuromodulation:

Expanding Leadership in Two Fast-Growth Markets

Overview* BSX Growth Drivers

Proven Spectra WaveWriter™ Therapy Success

• First and only FDA approved system with Combination Therapy to

simultaneously provide paresthesia and sub-perception therapy

• Simplifies delivery of personalized therapy with automation and patient

feedback

Cosman RF Ablation

• Versatile, reliable generator for broad range of upstream applications

• Significant synergies with SCS

Only MICC**-based DBS Directional Systems with Cartesia™ Lead

• U.S. expansion with recent Vercise™ PC & Gevia™ approvals

High-growth international expansion

• Under-penetrated market opportunities in both pain and brain

Market

Size (2018E)

~$3.3B

Market

Growth (2018E)

+15%

2018-2021 est. Market

CAGR

+10%-15%

Preliminary

BSX 20181

Reported

Revenue

Growth

+23%

*Includes SCS, DBS, and RF **MICC: Multiple Independent Current Control

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Pain: Personalized Therapy to Address the

Complexities of Treating Chronic Pain

Combination Therapy

Simultaneously deliver

paresthesia and sub-

perception therapies

Infinion CX™ Lead

Easier targeting of multiple

mechanisms of action and pain

areas

Wide Range of Options

Options for Patients (MICC, 32-contacts, MRI

compatibility2, Non-Rechargeable)

Cosman RF Ablation

Broad RF ablation portfolio with

most versatile, intuitive, and

reliable generator

Patient Engagement

Engaging the Right Patients at the Right Time

15+ clinical research studies, including RCTs3, to establish leadership in personalized therapy for pain relief

• PROCO RCT4 & WHISPER RCT5 (completed) : Prospective, multicenter RCTs provided the foundational evidence that outcomes can be optimized by providing options & the correct therapy dose

• COMBO RCT6 (H2:19E): Prospective, multicenter RCT to demonstrate value of multiple modalities and combining mechanisms using Spectra WaveWriter

• WaveWriter Outcomes7 (ongoing): Multicenter, observational real world data of Spectra WaveWriter

• ACCELERATE8 (H2:19E): Crossover RCT to evaluate the safety and effectiveness of high-rate SCS

• RELIEF9 (Q1:19E): Prospective, multicenter, global registry to compile real world evidence for commercially available BSX SCS systems

• NAVITAS10: Prospective, multicenter study to characterize the relationship between select objective metrics and clinical outcomes in chronic pain patients

(estimated initial data release timeline)

Personalized therapy is critical to improving patient outcomes today and over time

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An estimated 1 in 5 adults suffer from pain, and another 1 in 10 adults are diagnosed with chronic pain globally each year13

SCS Therapy Challenges and Opportunities for BSX

Low Therapy Awareness

Patient Education/Engagement

Engaging 100,000+ patients, digitally and at the point of care, from awareness to implant

Variation in ResponseLongevity of Therapy

Inadequate pain relief leads to 4.2% industry annual explant rate11

Multiple studies (PROCO4, SUNBURST12) show that non-responders to one modality may be responders to another modality

Proven Effectiveness and Reliability

of BSX SCS Systems

RELIEF Study9 – over 1,000 patients implanted with BSX SCS systems at 81 global sites

• 1.1 % annual explant rate due to inadequate pain relief

• 88% of the subjects at 3-year follow-up (n=302) reported overall improvement with their therapy

Spectra WaveWriter

Combination Therapy simultaneously provides paresthesia and sup-perception therapies (WHISPER RCT5, WaveWriter real-world outcomes7)

Waveform Automation and Patient Feedback simplify the delivery of personalized therapy

pain.com

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Spectra WaveWriter SCS System:

Delivering Industry Leading Real World Outcomes

WaveWriter Real World Outcomes14

p < 0.00017.3

1.9 2.1 2.10

2

4

6

8

10

Baseline (N=312) End of trial (N=294) 3 months (N=150) 12 months (N=42)

NR

S S

co

re (

0-1

0)

Changes in Overall Pain Scores NRS*

Distribution of Overall Pain Score NRS at Last Follow-up

(~106 days)

87

32

91

3042

1411 2 2 1

0

50

100

0 1 2 3 4 5 6 7 8 9 10

# o

f p

atie

nts

(n=

31

2)

NRS Score at Last F/u

At last follow-up: 67% reported minimal pain***

28% of all patients reported pain free

70% average pain reduction and 83% responder rate** at 3 months

Maximize Responder Rates with

Combination Therapy

Designed to engage multiple mechanisms to deliver lasting relief to more patients

Therapy Longevity with Sub-perception

Algorithms and Waveform Automation

+Designed to easily find and keep the optimal

target with a personalized stimulation field

*NRS: Numeric Rating Scale **Responder rate: ≥50% pain relief ***Minimal pain: Pain scores of 0-2

p < 0.0001

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Accelerating Access to Therapy:

Educating and Engaging Patients

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Brain Modulation: Most Compelling Portfolio with

Differentiated Technology, Strong Clinical Evidence

2012 2014 20162013 2015 2017 2018 2019

Vercise DBS System

CE MarkSept. 2012

Strategic Partnership

Vercise PC

Directional System

CE MarkSept. 2015

MR Conditional

Vercise Gevia

Directional System2

CE MarkJune 2017

Vercise DBS System

FDA ApprovalDec. 2017

GUIDE XT CE MarkMay 2018

US EXPANSION: Vercise PC & Gevia

Directional Systems With

Cartesia Lead

20+ clinical research studies3 to drive adoption and therapy expansion

• Ongoing data releases

• DBS Registry15: Comprehensive global registry to compile real world evidence with commercially available BSX DBS systems

• INTREPID16: First & only prospective, double-blind, sham-controlled, multicenter RCT with Vercise DBS System; evaluating utility of

visualization with GUIDE XT

• DIRECT DBS17: Prospective, RCT evaluating therapeutic advantages of Cartesia Directional Lead with Vercise DBS Directional Systems

• CLOVER18: Prospective, multicenter RCT to evaluate the use of external objective measures for closed-loop programming

• Investments in indication expansion studies

Unique Cochlear Neuro-prosthetic DNA

MICC Personalized Systems

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Vercise Directional Systems with MICC:

Reshaping DBS Therapy with Clinical Evidence

BSX Technology Equips Physicians To Achieve Optimal Patient Outcomes

DBS Therapy Goals

Accurately target stimulation area and avoid

side-effect structures

Maintain stimulation in therapeutic zone over time

Vercise Systems with MICC

Designed to allow physicians to truly fractionalize for

maximizing clinical benefit

• Improve outcomes (Double-blind sham-controlled

RCT: INTREPID19)

• Expand patients’ therapeutic windows (Double-

blind RCTs: DIRECT DBS16, CUSTOM-DBS20)

MICC Directional System with Cartesia Lead

Side Effect

Structure

Directional Lead with Single Power Source

MICC Directional System with Cartesia Lead

Side Effect

Structure

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One-year INTREPID Data Highlight Technological and

Clinical Advantages of BSX DBS Therapies

At 1 year, 41% of programs used 2 or more contacts

intended to optimize therapy

*2 year data; **6 month data

At 1 year, greater improvement in ON time vs.

competitive DBS devices

Percent of Programs Using Different Stimulation Contacts

Over Time19

1.8% 3.2% 4.8% 6.9%10.1%

19.2%22.5%

27.2%

33.8%

89.1%

79%74.3%

68%59.3%

0%

25%

50%

75%

100%

Baseline Week 4 Week 8 Week 12 Week 52

Pro

po

rtio

n o

f P

rog

ram

s

1

2

3 or more

5.0

4.0

4.4

3.1

6.0

0

1

2

3

4

5

6

7

Imp

rov

em

en

t in

ON

tim

e (

ho

urs

)

Improvement in ON Time as Documented by

Motor Diary

2012 Okun

(Abbott device)21

2010 Follett*

(Medtronic

device) 22

2006 Deuschl**

(Medtronic

device)23

2013 Oderkenken

(Medtronic

device)24

INTREPID

(N=160)19

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Future of Brain Modulation Is Now

Bringing Winning Portfolio to the U.S. in 2019

Vercise DBS Directional Systems with Cartesia Lead

Precision Control of Directionality

with MICC

Comprehensive SYSTEM designed to fully optimize neurostimulation today

and as disease progresses

Brainlab® Elements

Advanced Surgical Planning

GUIDE XT Visualization

Personalizes Programming for

Patients

Stimview™ Programming

Captures Outcomes

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Neuromodulation: Strong Growth Driven by

Meaningful Innovation

• Exciting, large, underpenetrated and high-growth markets

• Pain: Leading the industry with innovation focused on personalized therapy

– Spectra WaveWriter with Combination Therapy simultaneously delivering paresthesia and sub-perception therapy

– Compelling portfolio: neural targeting algorithms & waveforms, 32-contact rechargeable, primary cell, MRI2, RF

– Commitment to rigorous clinical and pre-clinical research in personalizing therapy for pain relief

– Accelerating access to new therapy by educating & engaging patients

• Brain: Transform therapy with the most innovative platforms in the U.S. (Q1:19 launch)

– First and only MICC-based Directional Systems with Cartesia Lead: Vercise PC and Gevia Directional Systems

– Integrated offering: Brainlab® Elements Surgical Planning , GUIDE XT Visualization, Stimview Programming, MRI2,

– Expanding clinical evidence portfolio:

• INTREPID RCT16, DIRECT-DBS RCT17, CLOVER18, CUSTOM-DBS RCT20 , VANTAGE25, Vercise DBS registry15

• Leading with technology and clinical insights to unlock new treatments for neurological disorders

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Boston Scientific NANS 2019

A Prospective Global Registry of Real-World Outcomes

Using Spinal Cord Stimulation Systems for Pain

Friday, January 18

7:35AM – 7:45AM

Spinal Cord Stimulation/Non-Invasive Stimulation

Richard Rauck, MD

Cost of Spinal Cord Stimulation as Early Treatment for

Spinal Pain Compared to Spine Surgery

Friday, January 18

2:45PM – 2:55PM

Advancement of Pain Practice: Understanding

Administrative, Healthcare Policy and Economic Factors

Joshua M. Rosenow, MD

Modeling the Effects of Spinal Cord Stimulation on

Nociceptive Processing in the Superficial Dorsal Horn

Friday, January 18

4:45PM – 4:55PM

Pain Practice: The Start of the Art

John Gilbert

Modeling the Effects of Spinal Cord Stimulation with a

Distributed Model of the Dorsal Horn

Saturday, January 19

7:55AM – 8:05AM

Engineering/Modeling

John Gilbert

Podium Presentations

WHISPER RCT Evaluating Sub-Perception SCS at ≤ 1.2kHz in

Highly Disabled, Previously-Implanted Cohort

Friday, January 18

Paper Poster Group 14 – Spinal Cord Stimulation

5:00PM – 7:00PM

James North, MD

Clinical Experience with a New Spinal Cord Stimulation

Lead for Multi-Ste Pain

Friday, January 18

Paper Poster Group 14 – Spinal Cord Stimulation

5:00PM – 7:00PM

Romanth Waghmarae, MD

Outcomes of a Prospective, Multicenter International

Registry of Deep Brain Stimulation for PD

Friday, January 18

Paper Poster Group 4 – Deep Brain Stimulation

5:00PM – 7:00PM

Jan Vesper, MD, PhD

Poster Presentations

Real-World Outcomes Using a Novel Directional Lead from

a Registry of DBS for Parkinson’s Disease

Jan Vesper, MD, PhD

A Registry of Real-World Outcomes Using Deep Brain

Stimulation for the Treatment of Dystonia

Howard Krauss, MD

A Case Series of Chronic Pain Patients in Europe Utilizing a

New Percutaneous Spinal Cord Stimulation Lead for Multi-

Site and/or Evolutive Pain Patterns

Jose Paz Solis, MD

Targeted Neurostimulation in Patients Reporting Chronic

Focal Pain Implanted with a Spinal Cord Stimulation

System Capable of Multiple Waveform Programming

Options

Ashish Gulve, MD

Outcomes Following Utilization of a Device Adaptor in

Previously-Implanted Patients Using SCS for Chronic Pain

Thomas L. Yearwood, MD

Evaluation of CRPS Patients Using an SCS System with

Multiple Waveform and Stimulation Frequency Options

Joseph N. Atallah, MD

VERITAS: Prospective Multicenter Study of a New SCS

System Capable of Multiple Neurostimulation Modalities

James North, MD

ePosters

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References

1) Neuromodulation reported revenue growth based on preliminary, unaudited sales results issued January 8, 2019. Results are preliminary and

subject to completion of year end financial reporting processes, reviews and audit.

2) 1.5 Tesla MRI conditional when all conditions of use are met

3) Includes company and investigator-sponsored research studies

4) Effects of Rate on Analgesia in Kilohertz Frequency Spinal Cord Stimulation: Results of the PROCO Randomized Controlled Trial. Simon J. Thomson,

MBBS, et al. Neuromodulation, November 2017

5) North, J., et. al. WHISPER RCT: Updated Post-Hoc Evaluation of Sub-Perception SCS at ≤1.2kHz in Highly Disabled, Previously-Implanted Cohort, NANS

2019, Las Vegas

6) Combining Mechanisms for Better Outcomes (COMBO) NCT03689920

7) Metzger, C., et. al. Outcomes Using an SCS Device Capable of Delivering Combination Therapy (Simultaneous or Sequential) and advanced

waveforms/field shapes. Oral Presentation at the 1st joint Congress of the INS European Chapters (INS), 2018.

8) Safety and Effectiveness Study of the Precision SCS System Adapted for High-Rate Spinal Cord Stimulation (ACCELERATE) NCT02093793

9) Rauck, R., et. al. A Prospective Global Registry of Real-World Outcomes Using Spinal Cord Stimulation Systems for Pain. NANS 2019, Las Vegas

10) NAVITAS: A Study to Characterize the Relationship Between Select Objective Metrics and Clinical Outcomes in Chronic Pain Patients Treated With

Boston Scientific Neurostimulation Systems NCT03240588

11) Therapy-Related Explants After Spinal Cord Stimulation: Results of an International Retrospective Chart Review Study. Dr. Jean-Pierre Van Buyten,

MD; et al Neuromodulation, October 2017

12) Proclaim™ Implantable Pulse Generator CLINICIANS MANUAL, 2016-04 ARTEN100125494B

13)Goldberg, Daniel S and Summer J McGee. “Pain as a global public health priority” BMC public health vol. 11 770. 6 Oct. 2011, doi:10.1186/1471-

2458-11-770

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References

14) North et al., VERITAS: Prospective Multicenter Study of a New SCS System Capable of Multiple Neurostimulation Modalities, NANS 2019 Las Vegas

15) Registry of Deep Brain Stimulation With the VERCISE™ System: Vercise DBS Registry NCT02071134

16) Deep Brain Stimulation (DBS) for the Treatment of Parkinson's Disease (INTREPID) NCT01839396

17) Study to Characterize Acute and Chronic Directional Aspects of Deep Brain Stimulation (DIRECT-DBS) NCT02835274

18) Closed Loop Programming Evaluation Using External Responses for Deep Brain Stimulation (CLOVER) NCT03037398

19) Vitek et al., INTREPID: A Prospective, Double Blinded, Multicenter Randomized Controlled Trial Evaluating Deep Brain Stimulation with a New

Multiple Source, Constant Current Rechargeable System in Parkinson’s disease, Oral Presentation at American Academy of Neurology (AAN) 2018,

Los Angeles, CA

20) CUSTOM-DBS: Volkmann et al., Presented at 2014 Annual Meeting of the International Parkinson and Movement Disorders Society, June 2014

21) Okun et al., Lancet Neurol. 2012 Feb;11(2):140-9. Subthalamic deep brain stimulation with a constant-current device in Parkinson's disease: an

open-label randomised controlled trial.

22) Follett et al., N Engl J Med. 2010 Jun 3;362(22):2077-91. Pallidal versus subthalamic deep-brain stimulation for Parkinson's disease.

23) Deuschl et al., N Engl J Med. 2006 Aug 31;355(9):896-908. A randomized trial of deep-brain stimulation for Parkinson's disease.

24) Oderkerken et al., Lancet Neurol. 2013 Jan;12(1):37-44. Subthalamic nucleus versus globus pallidus bilateral deep brain stimulation for advanced

Parkinson's disease (NSTAPS study): a randomised controlled trial

25) Vantage: Timmermann et al., Multiple-source current steering in subthalamic nucleus deep brain stimulation for Parkinson’s disease (the VANTAGE

study): a non-randomised, prospective, multicentre, open-label study Lancet Neurology 2015; 14: 693–701