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NOVADAQ Corporate Presentation May 2015_0
Citation preview
May 2015
Enabling Physicians to Go Beyond the Visual Boundaries
of the Human Eye
NASDAQ:NVDQ; TSX:NDQ
The statements and discussions contained in this presentation that are not historical facts constitute forward-looking statements, which may be identified by the use of forward-looking words, including but not limited to, believes, expects, may, intends, anticipates, plans, estimates and analogous or similar expressions intended to identify forward-looking statements. These forward-looking statements and estimates as to future performance, estimates as to future valuations and other statements contained herein regarding matters that are not historical facts, are only predictions, and that actual events or results may differ materially. We cannot assure or guarantee you that any future results described in this presentation will be achieved, and actual results could vary materially from those reflected in such forward-looking statements due to numerous known and unknown risks and uncertainties, including the Risk Factors described in our filings with the Ontario Securities Commission and the U.S. Securities and Exchange Commission. Information contained in this presentation has been compiled from sources believed to be credible and reliable. However, we cannot guarantee such credibility and reliability. The forecasts and projections of events contained herein are based upon subjective valuations, analyses and personal opinions. All forward-looking statements are qualified in their entirety by this cautionary statement, and Novadaq undertakes no obligation to revise or update this presentation to reflect events or circumstances after the date hereof.
This presentation shall not constitute an offer to sell or the solicitation of an offer to buy any securities. Such an offer or solicitation, if made, will only be made pursuant to an offering memorandum and definitive subscription documents.
Forward-Looking Statements
Readmission following an acute care hospitalization is a costly and often preventable event.
Research shows that nearly one in five Medicare patients were
readmitted within 30 days and 90% of these were unplanned.
Cost of Medicare readmissions exceeded $17B
Affordable Care Act mandates readmission reductions - excessive readmissions reduces hospital payments.
Accountable Care Organizations: 2013 Program Analysis
Weiss, et al., AHRQ Pub. No. 10 (11)- EHC009-2-EF. Agency for Healthcare Research and Quality, Rockville, MD 2013
Unmet Need Data From AHRQ
Imaging
X-Ray
MRI
PET
CT
Sales channel Radiology, CIO, Cardiology
Large devices requiring significant infrastructure
Capital revenues >>$MM Service revenues Replacement cycles
Traditional Imaging Domain of the Diagnostician
Endoscopy
Rigid
Angled
Flexible
Video
Surgeons are limited to their Eyesight or Visible Light Endoscopes to See in the Operating Room
Imaging innovations in endoscopy have paralleled advances in commercial photography and delivery of visible light
Analog 2 M Pix Digital HD M Pix
Evolution of Endoscopy
SPY Fluorescence Imaging Blood Flow, Tissue Perfusion & More
SPY Elite Open Surgery
FIREFLY Robotic Surgery
PINPOINT Endoscopic Surgery
LUNA Wound Healing
Year introduced 2006 Updated Jan 2011
2011
2013 Updated Jan 2015
2013
SPY Imaging Products
PINPOINT System Overview Minimally Invasive Surgery
8
Versatile and easy to use in the OR On-demand SPY Fluorescence imaging HD images Real-time views of perfusion and anatomy not
visible to the human eye
PINPOINT System Key Laparoscopic Applications
Colorectal Surgery Cholecystectomy
Esophagectomy Lymphatics*
*The use of SPY imaging for lymph mapping has not yet been cleared or approved by the FDA
9
Enables surgeons to visualize blood flow and tissue perfusion, in real time in the operating room
Historically sold through LifeCell in the U.S.
Effective January 2015, all U.S. marketing and distribution rights transferred back to NOVADAQ
.
SPY Elite System Overview Open Surgery
10
SPY System Open Surgery Applications
11
Plastic Reconstructive Surgery Cardiac Surgery
Colorectal & General Surgery Vascular Intervention
Firefly System Overview Robotic Surgery
NOVADAQs SPY Fluorescence imaging technology is integrated into the Intuitive Surgical da Vinci Xi surgical robotic system as standard
12
LUNA is a perfusion assessment system designed specifically for the wound clinic
Drives clinical treatment decisions & enables serial follow-up
Generates revenue through increased patient referrals and compliance
Reimbursement coverage
13
LUNA System Overview Wound Healing
LUNA demonstrated an improvement in arterial perfusion and venous outflow from pre- to post-peripheral intervention
LUNA System Clinical Value
Building a Continuum of Care Ecosystem
NOVADAQ Surgery
Today
PINPOINT | Minimally Invasive Surgery
SPY Elite | Open Surgery
Firefly | Robotic Surgery
NOVADAQ Diagnostics
Today
LUNA | Wound Healing
Operating Room Primary Care Physician
Tomorrow
Radiopharmaceutical Imaging
Tomorrow
Laser Doppler Imaging
Outpatient Clinic Operating Room Primary Care Physician Outpatient Clinic
15
Application Patients/Year (U.S.) Surgery Type Device
Abdominal Wall 50,000 Open SPY
Breast Reconstruction 100,000 Open SPY
Cholecystectomy 100,000 MIS PINPOINT/Firefly
Gastrointestinal 200,000 Open or MIS SPY/PINPOINT/Firefly
Gynecological Oncology 100,000 MIS PINPOINT/Firefly
Lymphatic 400,000 MIS or open PINPOINT/Firefly
Maxillofacial/Head & Neck 100,000 Open SPY
Other Reconstruction 250,000 Open SPY
Vascular 100,000 Open SPY
Wound Care 600,000 Outpatient Open LUNA
16
A SPY In Every Operating Room Primary Imaging For Complex Surgery
Growth Strategy
Adoption Drivers Existing Support
Clinical Data More than 140 peer reviewed publications
Key Opinion Leading Advocates Install base includes the top 50 hospitals*
Case Studies Over 75 different surgeries reported
Surgeon Education More than 3000 surgeons attending iSPIES
Economic Studies and Evidence Emory, Mayo, Dartmouth, Cleveland- have it
Multiple Specialties Participate More than 10+ specialties today
Mind Share Size of the sales team >100
Continuous Product Development Investments $10M/year
Marketing Message for Hospitals Dynamic evolving branding
18
The SPY Imaging Revolution
* U.S. News and World Report, Best Hospitals in the U.S.
Laser-assisted fluorescent-dye angiography has confirmed the critical relationship between good perfusion and anastomotic healing2
PILLAR II
8% of patients benefited from a change in operative plan due to PINPOINT, resulting in a 0% anastomotic leak rate3
Esophagectomy Colectomy
represents the anastomotic leak rate in resections performed in the PILLAR II trial3 (n=139)
1.4%
of low anterior resections performed in the BSLR study resulted in an anastomotic leak4
12.6%
1. Jewell et al., Gynecol. Oncol. 2014 2. Zehetner J, et al. Ann Surg. 2014;00:1-5 3. Jafari et al. JACS. Submitted 2014 4. Senagore A, et al. Dis Colon Rectum. 2014 Mar;57(3):32430
0%
10%
20%
30%
40%
50%
Good Perfusion
Poor Perfusion
2% 45%
(n=150)
*SPY imaging for lymph mapping has not yet been cleared or approved by the FDA
130 + Clinical Publications
19
Ana
stom
otic
leak
rate
Detection of Sentinel Lymph Node Using Indocyanine Green for Gynecological Malignancies
Median SLNs removed per patient: 3, (n= 227) ICG has significantly higher bilateral detection
rate for SLNs and will greatly reduce the need for hemi-pelvic lymphadenectomy
Sentinel Lymph Node Mapping*
78 80 82 84 86 88 90 92 94 96
Uni
late
ral D
etec
tion
Rat
e
Randomized multicenter trial (n=500-900)
Establish evidence to promote standard of care in assessing perfusion in anastomosis
Confirm a significant reduction in anastomotic leak rates
Reduce patient complications and health care costs
12.6%
FILM Trial Obtain FDA Indication for SLN Mapping
A Prospective, Open Label, Multicenter Study Investigating the use of PINPOINT in SLN Mapping (n=150)
Objectives: To determine the safety and efficacy of ICG
fluorescence imaging in lymphatic mapping
Long-term Goals: Adoption of ICG-fluorescence guided SLN
mapping for all surgical oncology applications
PILLAR III Obtain Outcomes-Based FDA Label
Clinical Studies: Level One Data
LifeNet Health is the worlds largest provider of organs, tissues and cells for transplantation
Committed to maximizing the gift of donation
Vertically integrated from Recovery through Distribution
Distribute 440,000+ Implants per year in US
48 method and/or use patents
Continued Expansion of Ecosystem
21
NOVADAQ Appointed Exclusive Worldwide Distributor of LifeNets DermACELL Tissue Products
50+ patent families including granted patents and applications Hardware, software, methods - vascular flow, perfusion, perforators,
ingress/egress, simultaneous display, quantification
Recent additions surgical scintigraphy imaging, fluorescent marker, lymph node and nerve localization, erythrocyte loading, Laser Doppler
Continued Innovation
Our Development efforts fit into 3 general categories
1. Performance improvements to existing technologies 2. Innovation designed to address gaps in the continuum of care 3. Functional innovation that delivers additional clinical benefit
22
Corporate Performance
Strong Growth
0 250 500 750
1,000 1,250 1,500 1,750 2,000 Installed Base
Tota
l Ins
talle
d D
evic
es
0
2,000
4,000
6,000
8,000
10,000
P
roce
dure
s
$0
$2,000
$4,000
$6,000
$8,000
$10,000
$12,000
$14,000
Rev
enue
(US
$ 0
00s)
Q1-
14
Q1-
15
Q1-
14
Q1-
15
Q1-
14
Q1-
15
Q2-
14
Q3-
14
Q2-
14
Q3-
14
Q2-
14
Q3-
14
Q4-
14
Q4-
14
Q4-
14
Estimated Procedures
Revenue
24
In Conclusion
PINPOINT Endoscopic Surgery
LUNA Wound Healing
April 2014
May 2013
2014 Direct Sales / Partnered Sales Ratio = 30/70
Direct Products: 2014 Selling Two Products
DermACELL Plastic Surgery
SPY Elite Open Surgery
PINPOINT Endoscopic Surgery
LUNA Wound Healing
DermACELL Wound Healing
Jan 2015
Returned to
Direct Jan 2015
Completely Upgraded System
Jan 2015
May 2013
Jan 2015
2015 Direct Sales / Partnered Sales Ratio = 80/20
Direct Products: 2015 Selling a Complete Ecosystem