Investor presentation TASE & NASDAQ ‐ MDGS July 2015
Cautionary statements This presentation may contain statements that are “Forward-Looking Statements,” which are based upon the current estimates, assumptions and expectations of the company’s management and its knowledge of the relevant market. The company has tried, where possible, to identify such information and statements by using words such as “anticipate,” “believe,” “envision,” “estimate,” “expect,” “intend,” “may,” “plan,” “predict,” “project,” “target,” “potential,” “will,” “would,” “could,” “should,” “continue,” “contemplate” and other similar expressions and derivations thereof in connection with any discussion of future events, trends or prospects or future operating or financial performance, although not all forward- looking statements contain these identifying words. By their nature, Forward-Looking Statements involve uncertainties which may cause future results of the company’s activity to differ significantly from the content and implications of such statements. Among the factors which may cause the actual results to differ from the Forward-Looking Statements are changes in the target market and the introduction of competitive products, regulatory, legislative and policy changes, and clinical results. Forward-Looking Statements are pertinent only as of the date on which they are made, and the company undertakes no obligation to update or revise any Forward-Looking Statements, whether as a result of new information, future developments or otherwise. Nothing in this presentation should be deemed to be medical or other advice of any kind. [2] Investors presentation | July 2015
Leadership Chris Rowland Oded Yatzkan Dr Nissim Darvish CEO CFO Chairman Senior Managing Director, 25 years of medical device 19 years experience in OrbiMed Israel. MD, PhD. senior leadership experience, financial management, 12 Previously partner with Pitango, including 17 years in senior years at Medigus. Oded is a Founder and CEO of Impulse leadership roles at Boston CPA and received his MBA Dynamics - $250m realization Scientific, President Americas with specialization in finance event. Led investment through at Given Imaging, recently at Ben Gurion University of several exits including acquired by Covidien for the Negev. Participate at the SuperDimension ($300m to $860m, President/CEO of IPO on TASE (2006) and Covidien) IntraPace Medigus listing on NASDAQ (2015) [3] Investors presentation | July 2015
Leadership Jeremy Starkweather Milena Ridl Menashe Sonnenschein VP Sales & Marketing USA VP Operations EU VP Operations Israel Vice-President of Sales & Business 20 years experience in Founding member and Development at Xlumena. He led healthcare, fluent in 5 officer of Medigus, 20 years the US launch and languages. Vice President R&D leadership in starts- commercialization efforts for the Sales and Marketing Simpiria ups, directly responsible for AXIOS™ Stent leading to Spine, Vice President Europe, the development of the acquisition by BSX. Prior to Middle East Africa MiMedx MUSE platform. Menashe Xlumena, Jeremy spent 11 years in Group, Director has his M. Sc in electrical the GI Endoscopy Division of Medtronic/Kyphon engineering and electronics Boston Scientific. from Ben Gurion University of the Negev. [4] Investors presentation | July 2015
5 Company highlights L e ad pro duc t – MUSE ™ Syste m fo r minimally invasive GE RD surg e ry – F DA c le are d and CE marke d, initial re ve nue Cate g o ry 1 CPTCo de fo r E so phag o g astric F undo plasty T rans-Orific e Pro c e dure re c e ive d fro m AMA in Marc h 2015 L arg e marke t o ppo rtunity, hig h g ro ss marg in, sing le -use de vic e Co mpe lling te c hno lo g y; wo rld’ s smalle st vide o c ame ra c o mbine d with fle xible , e ndo surg ic al to o ls 71 issue d pate nts [5] Investors presentation | July 2015
6 What we do A flexible endoscope with vision + surgical capability Small, high resolution video camera Stapler using standard surgical staples Ultrasound MUSE ™ Syste m fo r GE RD; F DA c le are d & CE mark [6] Investors presentation | July 2015
GERD (gastric reflux) – the condition Problem Lax lower esophageal sphincter. stomach Good Result Stomach acid rising through lax sphincter stomach Bad Consequences GERD a precursor to esophageal cancer [7] Investors presentation | July 2015
GERD # population in the US 24m adults suffer from GERD 14.5m have GERD symptoms 2 x / week in the US 8.6m with severe GERD go untreated 7x increased probability of esophageal cancer from daily GERD Aliment Pharmacol Ther. 2010 Nov;32(10):1222 ‐ 7 www.ncbi.nlm.nih.gov/pubmed/20955441 [8] Investors presentation | July 2015
Current therapy Laparoscopic Nissen Fundoplication Medical treatment Huge market, but doesn’t solve underlying Unpopular (2% of patients) • • problem Invasive (laparoscopic) procedure • Dysphagia, bloating and pain are common ~40% not satisfied with PPI’s • • FDA warnings on chronic use • Source: Gut. 2012; 61(4): 501 ‐ 506 [9] Investors presentation | July 2015
MUSE hits the ‘Treatment Gap’ [10] Investors presentation | July 2015
Treatment gap – between PPI users & lap patients Long term PPI use Surgery None treated Chronic GERD (24M patients) Current Market GERD patients Severity of Symptoms and Dissatisfaction High Low None treated Long term PPI use MUSE™ Potential Surgery Chronic GERD (24M patients) MUSE™ Upside GERD patients High Low Severity of Symptoms and Dissatisfaction [11] Investors presentation | July 2015
How MUSE™ works Trans-oral Fundoplication The MUSE™ ratchet is The MUSE™ device is then The MUSE™ device is placed engaged and positioned to retroflexed below the Z line through the esophagus and correct stapling position. and the stapling position is into the stomach Ultrasound and located using direct concave/convex surfaces visualization and ultrasound. provide alignment [12] Investors presentation | July 2015
Similar clinical results – but less invasive MUSE™ LAF [13] Investors presentation | July 2015
MUSE™ multi center trial outcomes (http://rd.springer.com/article/10.1007%2Fs00464 ‐ 014 ‐ 3731 ‐ 3) 85% of patients stopped or significantly reduced PPI usage 65% were off PPI completely 20% reduced dosage by ≥ 50% 73% reduced GERD HRQL (off PPI) score by ≥ 50% Acid Exposure Mean percentage of time pH <4.0 significantly reduced from 10.9 to 7.3 between baseline and 6 months (p<.001) Anatomical Change The proportion of patients with Hill Grade score >2 was 0.661 before and 0.062 after the procedure (p<.0001) [14] Investors presentation | July 2015
Durability – 4 & 5 year results Medigus MUSE™ – Pilot Study of 13 patients 92% success GERD-HRQL score dropped ≥ 50% from baseline (12/13 patientss; remaining patient dropped 48%) 77% Stopped or reduced PPI usage ≥ 50% (10/13 patients) [15] Investors presentation | July 2015
Advantages of MUSE procedure 1. Reducing clinical risks related to open surgery. 2. Minimal invasive procedure See & treat 3. System includes: Vision + light + tools 4. Ultrasound guided 5. Endoscope mounted surgical stapler 6. Single operator 7. Disposable surgical device 8. Cost efficient [16] Investors presentation | July 2015
17 Competitive landscape Medig Medigus EG EGS Torax To Mederi Mederi Esophyx Esop Linx Lin Stre retta tta MUSE™ MUSE™ clinical True anterior fundoplication (identical to current standard) yes ye ye yes no no no no Minimally invasive yes ye ye yes no no yes ye ye yes yes ye no no no no Minimal risk of migration or damage to adjacent organs ye yes yes ye no no ye yes Minimal/no potential of erosion technology Direct vision as part of the endoscope, no other devices needed yes ye no no no no no no ye yes no no no no no no Ultrasound to guide tissue thickness and stapling accuracy yes ye no no no no no no Use of standard surgical staples yes ye no no no no no no Single use surgical endoscope yes ye yes ye no no ye yes MRI safety operator Number of operators 1 2 1 1 GI/Sur GI /Surgeon on GI/Sur GI /Surgeon on Surgeon Sur GI/Sur GI /Surgeon on Medical specialty [17] Investors presentation | July 2015
MUSE™ vs competition Summary – why MUSE™? High Clinical value L ap No Incision, no scar, less invasive MUSE ™ Nisse n True surgical anterior fundoplication Clinical equivalence to current standard Durable results using standard surgical staples reward T o rax/ E GS/ Economic benefit Stre tta Single operator, surgical endoscope Out patient procedure Potential to eliminate lifelong medication Efficient and cost effective drug s Low CE marked, FDA cleared Low risk High [18] Investors presentation | July 2015
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