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Novadaq Corporate Presentation May 2016
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Empowering Physicians with Imaging at the Point of Care May 2016
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Forward Looking Statements 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.
NOVADAQ, SPY, PINPOINT and LUNA are registered trademarks of Novadaq Technologies Inc. DermACELL is a registered trademark of LifeNet Health.
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Investment Thesis
§ Experts in fluorescence imaging - Created market in surgery and wound healing - ‘Point-of-Care’ imaging: vascular flow, perfusion, lymph nodes - 180 publications à Improved outcomes, reduced costs
§ Large market opportunity (annual procedures in U.S.) - Complex surgeries: 1.4 Million - Wound vascular assessment: 0.6 Million
§ Growth - 2016 expected revenue: $84-86 million, representing 32-35% YoY growth - Pipeline of new products to sustain continued growth - Expanding patent portfolio - Two level 1 clinical studies recruiting
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SPY Fluorescence Imaging
SPY ELITE Therapy Delivery in Complex High Risk Open Surgery
SPY Elite System
Colorectal Surgery
Breast Reconstruction
Assess tissue perfusion, segment healthy from abnormal tissue
Vascular Surgery
Assess blood inflow and outflow and tissue perfusion
Assess tissue perfusion, guide transection margins
Assess microvascular blood flow, anastomotic patency and perfusion
Head and Neck Surgery
Colorectal Surgery
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PINPOINT Therapy Delivery in Complex, High Risk Minimally Invasive Surgeries
Colorectal Surgery
Assess tissue perfusion, healthy versus unhealthy tissue
Lap Cholecystectomy
Visualize critical anatomy, such as bile and cystic ducts
PINPOINT System
SLN
Visualize lymph nodes*, improve cancer staging
Gynecological Cancer* Bariatric Surgery
Visualize tissue perfusion and critical anatomy
*Not yet cleared of approved by the U.S. FDA 6
LUNA Transforms Outpatient Assessment of Wounds
Limb Salvage
Visualize hyperemia for better staging of wound disease
LUNA System
15 5
Serial Functional Imaging and Analysis
LUNA Score
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Ecosystem – Fluorescence Imaging Continuum Of Care
NOVADAQ Surgery
• SPY Elite Open
• PINPOINT Minimally Invasive
• Firefly Robotic
• DermACELL PRS
NOVADAQ Diagnostics
• LUNA Vascular assessment in clinics
• DermACELL WH
Operating Room Outpatient Clinic
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Opportunity > 2 Million Complex, High Risk Procedures / Year in U.S.
Application Pts. /Year (U.S.) Surgery Type Device
Breast Reconstruction 100,000 Open SPY
Other Reconstruction 250,000 Open SPY
Vascular 100,000 Open SPY
Abdominal Wall 50,000 Open SPY
Maxillofacial / Head & Neck 100,000 Open SPY
Gastrointestinal 200,000 Open or MIS SPY / PINPOINT (50:50)
Lymphatic 400,000 Open or MIS SPY / PINPOINT (25:75)
Gynecological Oncology 100,000 MIS PINPOINT
Cholecystectomy 100,000 MIS PINPOINT
Wound Healing 600,000 Outpatient LUNA
Opportunity Associated with Complex, High Risk Segment of Key Applications
ASPS and SAGES Procedure Statistics, 2015 Medtech Insight Report, U.S. Surgical Volumes 2014-2020
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Procedure Opportunity per System 70% Surgery, 30% Wound Healing
40%
30% 30%
Wound Healing
MIS Surgery
Open Surgery
Additional commercial relationships: LifeNet Health, Arthrex, ISRG
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180+!
200,000+!
760+!Standalone Systems!
1700+!FireFly Systems!
• Includes SPY technology licenses to ISRG • Data as of Dec 2015
SPY Imaging – Proven Across Multiple Specialties
Peer Reviewed Publications
SPY Technology Procedures SPY Hospitals
Documented Applications
75!
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Top 50 Cancer Hospitals* Use SPY
University of Texas M.D. Anderson Cancer Center
Houston, TX
Memorial Sloan-Kettering Cancer Center New York, NY
Johns Hopkins Hospital Baltimore, MD
Mayo Clinic Rochester, MN
Dana-Farber/Brigham and Women's Cancer Center
Boston, MA
University of Washington Medical Center Seattle, WA
Massachusetts General Hospital Boston, MA
UCSF Medical Center San Francisco, CA
Cleveland Clinic Cleveland, OH
Ronald Reagan UCLA Medical Center Los Angeles, CA
Duke University Medical Center Durham, NC
Stanford Hospital and Clinics Palo Alto, CA
University of Michigan Hospitals and Health Centers Ann Arbor, MI
University of Chicago Medical Center Chicago, IL
Hospital of the University of Pennsylvania Philadelphia, PA
Barnes-Jewish Hospital/Washington University
Saint Louis, MO
City of Hope Duarte, CA
Moffitt Cancer Center Tampa, FL
New York-Presbyterian University Hospital of Columbia and Cornell
New York, NY
Ohio State University James Cancer Hospital
Columbus, OH
Northwestern Memorial Hospital Chicago, IL
University of Maryland Medical Center Baltimore, MD
University of Minnesota Medical Center Minneapolis, MN
Yale-New Haven Hospital New Haven, CT
NYU Langone Medical Center New York, NY
Vanderbilt University Medical Center Nashville, TN
Roswell Park Cancer Institute Buffalo, NY
University of Iowa Hospitals and Clinics Iowa City, IA
University of Wisconsin Hospital and Clinics
Madison, WI
UPMC-University of Pittsburgh Medical Center
Pittsburgh, PA
Thomas Jefferson University Hospital Philadelphia, PA
Cedars-Sinai Medical Center Los Angeles, CA
Beth Israel Deaconess Medical Center Boston, MA
University of Colorado Hospital Aurora, CO
Shands at the University of Florida Gainesville, FL
University Hospitals Case Medical Center Cleveland, OH
Emory University Hospital Atlanta, GA
Fox Chase Cancer Center Philadelphia, PA
University of California, Davis Medical Center
Sacramento, CA
Rush University Medical Center Chicago, IL
Mount Sinai Medical Center NYU New York, NY
Hackensack University Medical Center Hackensack, NJ
Wake Forest Baptist Medical Center Winston-Salem, NC
University of Kansas Hospital Kansas City, KS
Magee-Womens Hospital of UPMC Pittsburgh, PA
Mayo Clinic Jacksonville, FL
UC San Diego Medical Center San Diego, CA
University of Virginia Medical Center Charlottesville, VA
USC Norris Cancer Hospital Los Angeles, CA
University of California, Irvine Medical Center
Orange, CA *U.S. News and World Report Rankings 2015 13
$10.3 $11.2
$12.1 $13.0
$11.7
$15.1
$17.0
$20.0
$17.7
$6.0
$8.0
$10.0
$12.0
$14.0
$16.0
$18.0
$20.0
$22.0
Q1 2014
Q2 2014
Q3 2014
Q4 2014
Q1 2015
Q2 2015
Q3 2015
Q4 2015
Q1 2016
Mill
ions
$
Total Revenue
528 559
581 591 575
611
647
710
760
450
500
550
600
650
700
750
800
Q1 2014
Q2 2014
Q3 2014
Q4 2014
Q1 2015
Q2 2015
Q3 2015
Q4 2015
Q1 2016
Uni
ts
Installed Base
$3.7 $3.4
$4.3
$5.0 $4.9
$5.7 $6.1
$6.7 $7.0
$2.0
$3.0
$4.0
$5.0
$6.0
$7.0
$8.0
Q1 2014
Q2 2014
Q3 2014
Q4 2014
Q1 2015
Q2 2015
Q3 2015
Q4 2015
Q1 2016
Mill
ions
$
Recurring Revenue
$6.7 $6.9 $7.8
$9.1
$7.5
$10.7
$12.6
$14.4
$12.7
$4.0
$6.0
$8.0
$10.0
$12.0
$14.0
$16.0
Q1 2014
Q2 2014
Q3 2014
Q4 2014
Q1 2015
Q2 2015
Q3 2015
Q4 2015
Q1 2016
Mill
ions
$
Gross Margin
Financial and Corporate Performance
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Growth Platform
16
0
2
4
6
8
10
12
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PILLAR II BSLR Trial
Anastomotic Leak Rate
Pillar II – prospective multicenter study
SPY Enables Single Stage Reconstruction
Eliminates a second surgery and multiple post-operative follow-ups
Improving Clinical Outcomes & Enabling New Surgical Procedures
N=139
Delivering More Effective Lifesaving Surgeries
Plante et al., Gyn Onc, 2015 (n=50) Howe et al., Gyn Onc, 2015 (n=100)
Technique SLN identified Bilateral SLNs Identified
Technetium Only 83% 19%
Blue Dye Only 79% 50%
Blue Dye + Technetium 87% 54%
PINPOINT Imaging Only 96% 88%
Sentinel Lymph Node (SLN) Identified in Gynecological Cancers
5-year survival in stage II- IV in ovarian cancer at best case is 70% and the worse case is 17%. 85% of patients with these types of cancers are in stage II- IV.
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Guaranteed By SPY
When SPY is used in the first surgery and a revision is still necessary, we’ll pay for the tissue.
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Growth Drivers
1. Expanded, Focused Sales Channels
2. International Expansion
3. New Product Introductions 2016
4. Outcomes Based Level I Clinical Studies
(FILM Trial)
(PILLAR III)
5. New Imaging Molecules
1. Expanded, Focused Sales Channels
%
10%
20%
30%
40%
50%
60%
70%
Surgery Wound Care
% Opportunity
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2. International Expansion
§ Key Markets – Europe: United Kingdom, Germany and the Nordics – Asia: China, Japan, Korea
§ Sales Channel – Regional distributors in place – NOVADAQ direct management and subsidiary companies in place in
Europe and in Asia
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3. New Product Introductions 2016
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Color Segmented Fluorescence Imaging
LUNA Score Functional Imaging and Analysis Handheld SPY Imaging
5.0mm PINPOINT Endoscopes
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4. Outcomes Based Level I Clinical Studies
Randomized multicenter trial of PINPOINT in Colorectal Surgery (n=500-900)
§ 25 U.S. centers § Recruitment on-going § Interim results report expected at SAGES 2017
FILM Trial
PILLAR III
Obtain FDA Indication for SLN Mapping
A Prospective, Open Label, Multicenter Study of PINPOINT in Gynecological Oncology (n=150)
§ 6-8 U.S. and Canadian Centers § Recruitment on-going § Results expected Q4-2016
Obtain Outcomes-Based FDA Label
Images Courtesy of Nadeem Abu-Rustum, M.D., NY,NY and Michael Stamos, M.D. Irvine, CA 23
5. New Imaging Molecules
Cancerous tumor fluorescing, the normal tissue is not
Image courtesy of Eben L. Rosenthal, MD, Stanford, CA
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Long-Term Growth
§ First molecule (ICG) – blood flow in vessels, perfusion, lymph nodes - Product upgrades, new clinical applications
§ Second molecule – on track for announcement in late 2016 - Critical anatomy - Enablement of certain new surgeries
§ License or acquire rights to cancer imaging molecules
Summary of Growth Drivers
Drivers 2016 2017 2018
1. Expanded, Focused Sales Channels
2. International Expansion 3. New Product Introductions 4. Level I Clinical Studies
FILM PILLAR III
5. New Imaging Molecules
Add 40 Sales Pros
NVDQ Direct Team
Clinical Trial and Results Submission to FDA
Clinical Trial and Results Submission to FDA
Hardware/Software
Molecule Identified, Clinical Trial Phases I and II Phase III & NDA or PMA Submission
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