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May 2015 Enabling Physicians to Go Beyond the Visual Boundaries of the Human Eye

NOVADAQ Corporate Presentation May 2015_0

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NOVADAQ Corporate Presentation May 2015_0

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  • 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