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TRANSFORMING THE PRACTICE OF MEDICINEJune 7-9th 2015, UBC, Vancouver, BC
Be part of the Personalized Medicine Revolution
personalizedmedsummit.com#PMSummit2015
© 2015 Invitae Corporation. All Rights Reserved. | CONFIDENTIAL | 1
The Path to a Billion People: Genetics and Genomics on course for Mainstream Medical Practice P E R S O N A L I Z E D M E D I C I N E S U M M I T J U N E 2 0 1 5
© 2015 Invitae Corporation. All Rights Reserved. | CONFIDENTIAL | 2
Disclaimer § This presentation contains forward-looking statements within the meaning of the Private
Securities Litigation Reform Act of 1995, including statements relating to the company’s belief that it can accelerate the adoption of comprehensive genetic information into mainstream medical care and realize its mission; the company’s expectations regarding the number of billable tests in 2015; the timing of any new testing service releases and the attributes of any such services; the company’s expectations regarding its average cost per billable test; the company’s beliefs regarding the benefits of its new pricing program; the attributes and benefits of the company’s genome management and genome network programs; and the indicators of the company’s success and its expected actions with respect to those indicators. Forward-looking statements are subject to risks and uncertainties that could cause actual results to differ materially, and reported results should not be considered as an indication of future performance. These risks and uncertainties include, but are not limited to: the company’s history of losses; the company’s need to scale its infrastructure in advance of demand for its tests and to increase demand for its tests; the company’s ability to develop and commercialize new tests and expand into new markets; the risk that the company may not obtain or maintain sufficient levels of reimbursement for its tests; risks associated with the company’s ability to use rapidly changing genetic data to interpret test results accurately and consistently; the company’s ability to compete; laws and regulations applicable to the company’s business, including potential regulation by the Food and Drug Administration; and the other risks set forth in the company’s filings with the Securities and Exchange Commission, including the risks set forth in the company’s Form 10-Q for the quarter ended March 31, 2015. These forward-looking statements speak only as of the date hereof, and Invitae Corporation disclaims any obligation to update these forward-looking statements.
© 2015 Invitae Corporation. All Rights Reserved. | CONFIDENTIAL | 3
It’s 1976 in silicon valley again
© 2015 Invitae Corporation. All Rights Reserved. | CONFIDENTIAL | 4
Disruption in process
Metcalfe’s “Law”
“Law” of Finite Genomes
Moore’s “Law”
DNA sequencing
technology is accelerating
Sharing genetic information will
accelerate clinical utility
Reverse Engineering Problem
© 2015 Invitae Corporation. All Rights Reserved. | CONFIDENTIAL | 5
Virtually everyone is carrying: • loss of function mutations in their genome, • recessive genetic conditions that may affect family members • genetic mutations that may affect response to drugs
Approximately 0.01% of the U.S. population has taken a genetic test. About 10% have a genetic condition, most of which is undiagnosed.
~5-10% of all cancers are likely to have a hereditary basis
~0.5-5%
of the populations carries the Factor V Leiden
variant that may increase risk for blood clotting
0.4%
of the populations has a cardiac genetic condition
that may lead to early onset cardiovascular
disease
~2%
of the population has one of 52 genetic variants
that should be reported to patients as medically
actionable
Virtually everyone is carrying: § Loss of function mutations in their genome § Recessive genetic conditions that may affect family members § Genetic mutations that may affect response to drugs
Genetic conditions affect everyone
© 2015 Invitae Corporation. All Rights Reserved. | CONFIDENTIAL | 6
Global opportunity for genetic testing
We believe genetic testing is a $3 billion U.S. market growing to at least $9 billion by 2021 (based on a UnitedHealth Group Inc. study)
There are more than 4,000 inherited genetic conditions with known genes and variants
There are over 39,000 different genetic assays currently available from over 650 commercial laboratories (according to genetests.org)
A multi-billion dollar market
© 2015 Invitae Corporation. All Rights Reserved. | CONFIDENTIAL | 7
Our mission
Bring comprehensive genetic information into mainstream medical practice to improve the quality of healthcare for billions of people Core Principles:
Genetic information is more valuable when shared
Driving down the cost of genetic information will increase its personal and clinical utility
Healthcare professionals are fundamental in ordering and interpreting genetic information
People should own and control their own genetic information
© 2015 Invitae Corporation. All Rights Reserved. | CONFIDENTIAL | 8
Near term focus on symptomatic disease
Simple ordering based on disease indication
multiple disease panels multiple disorders
multiple genes
One Laboratory Process
© 2015 Invitae Corporation. All Rights Reserved. | CONFIDENTIAL | 9
Where genetic testing is going – rapidly
Unknown
Limited
Low Uncertainty around probability of specific diagnosis
High
Locu
s he
tero
gene
ity
Exomes/Genomes
Large gene panels
Small gene panels
Single Gene Testing
Variant testing
© 2015 Invitae Corporation. All Rights Reserved. | CONFIDENTIAL | 10
screening
Unknown
Limited
High Prior probability of specific diagnosis
Low
Locu
s he
tero
gene
ity
Exomes/Genomes
Large gene panels
Small gene panels
Single Gene Testing
Variant testing
Where genetic testing is going – rapidly
© 2015 Invitae Corporation. All Rights Reserved. | CONFIDENTIAL | 11
Where genetic testing is going – rapidly diagnosis
screening
Unknown
Limited
High Prior probability of specific diagnosis
Low
Locu
s he
tero
gene
ity
Exomes/Genomes
Large gene panels
Small gene panels
Single Gene Testing
Variant testing
© 2015 Invitae Corporation. All Rights Reserved. | CONFIDENTIAL | 12
Where genetic testing is going – rapidly
Today, different diseases are tested or screened at different
points, at different prices
Exomes/Genomes
Large gene panels
Small gene panels
Single Gene Testing
Variant testing
© 2015 Invitae Corporation. All Rights Reserved. | CONFIDENTIAL | 13
Where genetic testing is going – rapidly
Soon, this ceases to be a clinical laboratory game and
turns into an information game
Exomes/Genomes
Large gene panels
Small gene panels
Single Gene Testing
Variant testing
© 2015 Invitae Corporation. All Rights Reserved. | CONFIDENTIAL | 14
The bottleneck moves toward interpretation
Sample Preparation Sequencing Medical Interpretation
costs will decline over time costs go up with the number of genes
© 2015 Invitae Corporation. All Rights Reserved. | CONFIDENTIAL | 15
The current market for genetic testing: ~$3-5B
Cancer
Cardio
Neuro
Peds
Etc..
Who gets tested is important for the approach
© 2015 Invitae Corporation. All Rights Reserved. | CONFIDENTIAL | 16
Accessibility is a major issue
Patients currently getting tested ($3-5 billion market today)
Between 1-2 billion people in the modern healthcare system
© 2015 Invitae Corporation. All Rights Reserved. | CONFIDENTIAL | 17
Accessibility is a major issue
Patients currently getting tested ($3-5 billion market today)
Patients who have or are directly affected by an inherited disease
Between 1-2 billion people in the modern healthcare system
© 2015 Invitae Corporation. All Rights Reserved. | CONFIDENTIAL | 18
Accessibility is a major issue
Patients currently getting tested ($3-5 billion market today)
Patients who have or are directly affected by an inherited disease
People who could benefit from testing to rule out inherited disease for similar symptoms or are family members of affected individuals
Between 1-2 billion people in the modern healthcare system
© 2015 Invitae Corporation. All Rights Reserved. | CONFIDENTIAL | 19
Accessibility is a major issue
Patients currently getting tested ($3-5 billion market today)
Patients who have or are directly affected by an inherited disease
People who could benefit from testing to rule out inherited disease for similar symptoms or are family members of affected individuals
Otherwise healthy individuals
Between 1-2 billion people in the modern healthcare system
© 2015 Invitae Corporation. All Rights Reserved. | CONFIDENTIAL | 20
Who pays matters – a lot
Patient Pay § Simple transaction § Cash up front § Very limited pre-
testing overhead
Cost of billing services
Institutional § Simple billing terms § Some contracting
involved § Some collections activity
required § Depending on institution,
there may be some pre-testing evaluation and triage
Insurance § Patient meets criteria § Pre-authorization § Claims and appeals are costly § Co-pays depending on plan/
provider § Benefits investigation § In criteria evaluation § Pre authorization § Billing/Collections § Appeals
© 2015 Invitae Corporation. All Rights Reserved. | CONFIDENTIAL | 21
Who pays matters – a lot
Patient Pay § Simple transaction § Cash up front § Very limited pre-
testing overhead
Cost of billing services
Institutional § Simple billing terms § Some contracting
involved § Some collections activity
required § Depending on institution,
there may be some pre-testing evaluation and triage
Insurance § Patient meets criteria § Pre-authorization § Claims and appeals are costly § Co-pays depending on plan/
provider § Benefits investigation § In criteria evaluation § Pre authorization § Billing/Collections § Appeals
© 2015 Invitae Corporation. All Rights Reserved. | CONFIDENTIAL | 22
Who pays matters – a lot
Patient Pay § Simple transaction § Cash up front § Very limited pre-
testing overhead
Cost of billing services
Institutional § Simple billing terms § Some contracting
involved § Some collections activity
required § Depending on institution,
there may be some pre-testing evaluation and triage
Insurance § Patient meets criteria § Pre-authorization § Claims and appeals are costly § Co-pays depending on plan/
provider § Benefits investigation § In criteria evaluation § Pre authorization § Billing/Collections § Appeals
© 2015 Invitae Corporation. All Rights Reserved. | CONFIDENTIAL | 23
As in any other market, pricing will reflect this
Cost of billing services
Patient pay $475
Payor in network or institutional contract
$950
Payor out of network $1,500
© 2015 Invitae Corporation. All Rights Reserved. | CONFIDENTIAL | 24
The merging of worlds – i.e. family history
© 2015 Invitae Corporation. All Rights Reserved. | CONFIDENTIAL | 25
The merging of worlds – i.e. family history
© 2015 Invitae Corporation. All Rights Reserved. | CONFIDENTIAL | 26
Expand genome content
Improve customer
experience
Drive traffic
Attract partners
Growth
Lower costs
Lower prices
The coming industrialization of the space