North American Neuromodulation Society Investor Update January 12, 2018 Maulik Nanavaty Senior Vice President and President, Neuromodulation Jim Cassidy Vice President and Franchise Lead, Pain Management Milad Girgis Vice President and Franchise Lead, Deep Brain Stimulation 1
Safe Harbor for Forward-Looking Statements and Regulatory Disclaimers This presentation contains forward-looking statements within the meaning of Section 27A of the Securities Act of 1933 and Section 21E of the Securities Exchange Act of 1934. Forward-looking statements may be identified by words like “anticipate,” “expect,” “project,” “believe,” “plan,” “estimate,” “intend” and similar words. These forward -looking statements are based on our beliefs, assumptions and estimates using information available to us at the time and are not intended to be guarantees of future events or performance. If our underlying assumptions turn out to be incorrect, or if certain risks or uncertainties materialize, actual results could differ materially from the expectations and projections expressed or implied by our forward-looking statements. Factors that may cause such differences can be found in our most recent Form 10-K and Forms 10-Q filed or to be filed with the Securities and Exchange Commission under the headings “Risk Factors” and “Safe Harbor for Forward - Looking Statements.” Accordingly, you are cautioned not to place undue reliance on any of our forward-looking statements. We disclaim any intention or obligation to publicly update or revise any forward-looking statements to reflect any change in our expectations or in events, conditions, or circumstances on which they may be based, or that may affect the likelihood that actual results will differ from those contained in the forward-looking statements. Market Estimates: Unless noted otherwise, all references to market sizes, market share positions, and market growth rates are BSX internal estimates. Regulatory Disclaimers: Vercise ™ PC Deep Brain Stimulation System/Vercise ™ Directional System - CE Marked. US: “Caution: Investigational Device. Limited by Federal (or US) law to investigational use only. Not available for sale .” Vercise Gevia ™ Deep Brain Stimulation System - CE Marked. Not available for use or sale in the U.S. Next Gen DBS System: Device under development. Not for sale or use worldwide. 2 2
Positioned for Leadership in Two Fast-Growth Markets Overview BSX Growth Drivers Market • Spectra Wavewriter ™ SCS System Size ~$2.5B First & only system FDA approved to simultaneously (2017E) provide paresthesia and sub-perception therapy • Comprehensive SCS Platform with Illumina 3D ™ Market Personalized therapy with neural targeting algorithm Growth +14% across broad IPG* and lead portfolio (2017E) • Cosman RF Ablation Early stage treatment options for pain patients 2017-2020 • Vercise ™ Deep Brain Stimulation Platform +10%-15% est. Market CAGR First & only MICC*-based directional system • International expansion Preliminary Under-penetrated market opportunity in both pain and BSX 2017 1 +14% brain Revenue Growth *IPG: Implantable Pulse Generator; MICC: Multiple Independent Current Control 3 3
Pain: Expanding a Winning Pain Portfolio and Leading with Rigorous Clinical Research Spectra ™ SCS Infinion CX ™ Illumina 3D ™ Multiwave ™ Cosman Systems Options for Patients Broadest Coverage of Personalized Therapy Precision with Neural (32 contacts, MRI RF Ablation: the Spine for Multi Through Multiple compatibility 2 , Non- Targeting Algorithm Denervation Therapy Targeting Waveform Options Rechargeable) 15+ ongoing clinical research studies & RCTs 3 to help prove personalized therapy is the future of pain relief: PROCO 4 (Q2:17): Double-blind crossover RCT to evaluate the role of frequency on SCS patient outcomes • WHISPER 5 (Q1:18): Crossover RCT to evaluate the safety and effectiveness at sub-perception amplitudes • ACCELERATE 6 (H2:18): Crossover RCT to evaluate the safety and effectiveness at high-rate SCS • VERITAS 7 (2019): Prospective, multicenter study to evaluate the effectiveness of multiple modalities with • Spectra WaveWriter Strong cadence of technology with 2 new platforms expected to launch over next 24 months 4
Challenges and Opportunities in SCS Longevity of Therapy Variation in Response Opportunity to improve therapy Multiple recent studies (PROCO 4 , longevity SUNBURST 9 ) show patients respond 3 - 6% annual explant rate due to • variably to different therapies – inadequate pain relief 8 Non-responders to one modality • Recently launched modalities may be responders to another haven’t resolved loss of therapy modality issue 10 kHz: 5% annual explant rate due • to inadequate pain relief 8 Burst: 5% of patients with diminished • or loss of symptom relief after 24 weeks 9 Expect multiple mechanisms of DRG*: 9% of patients experience loss • 11 action involved of stimulation after one year 10 *DRG: Dorsal Root Ganglion 5
Spectra WaveWriter ™ SCS System: Multiple Therapies. One Device. Spectra WaveWriter System Early Clinical Data – NANS 2018 Q1:18 US Launch Multi-site observational outcomes collection 12 Change in Overall Pain Scores (NRS*) at Last Follow-up 10 NRS Score (0-10) 8 D = 6.0 (p < 0.0001) 6 7.7 4 Maximize Responders: 2 First system approved to simultaneously • 2.0 1.7 provide paresthesia and sub-perception 0 therapies Baseline End of Trial Last F/u Visit (N=79) (N=69) (n=79) Simplify Personalization: ∆ 6.0 reduction in NRS Real-time patient rating and data on • ~30 Day Follow Up waveform usage Significant Pain Reduction The Power of Combination Therapy with in Early Follow-Up the Simplicity of Waveform Automation 6 *Numeric Rating Scale
Spectra WaveWriter ™ SCS System : Multiple Therapies. One Device. New Sub-perception Algorithms Combination Therapy + Waveform Automation + Designed for deeper, lasting relief by layering Designed to easily find and keep the optimal waveforms simultaneously or sequentially target with a personalized stimulation field Sub-perception Paresthesia Responders Responders Infinion Infinion Infinion Infinion vs WaveWriter Competition Multiple Therapies Infinon CX (16 contacts) 8-contact leads + ~15% responder + Contour Conventional Bi-Pole increase 13 Multiple Vertebral Level Limited Coverage Coverage 7
WHISPER & PROCO: Foundational Studies for Spectra WaveWriter ™ PROCO RCT 4 WHISPER RCT 5 (de novo patients) ( previously implanted patients, average ~4 years on therapy) Key Takeaways Key Takeaways <1.2 kHz delivered significant, long term, Similar pain relief across 1, 4, 7 & 10 kHz • • sub-perception pain relief in a real world 1/3 charge burden with 1kHz • population Neural dosing algorithms are critical • Multiple therapies provide superior • outcomes when patients are able to choose most effective therapy Spectra WaveWriter ™ Next gen sub-perception technologies Contour ™ Algorithm • Therapy Rater and Waveform Automation • Impactful clinical outcomes Exciting new data at NANS: WaveWriter • Observational Outcomes VERITAS Study (2019E) • 8
WHISPER RCT 5 : Multiple Therapies Provide Superior Outcomes Positive Outcomes in Superior Outcomes with Challenging Patient Paresthesia Responders Waveform Options Population 47% n=70 n=20 Study 8 50% WHISPER SENZA 7.2 62% increase Aspects 45% 7 Previously 39% implanted De-novo 40% 6 Patients NRS Score (0-10) Precision patients 35% 29% 5 patients Responder Rate 30% Mean 4 duration of 4 +/- 1.9 yrs. 0 yrs. 25% implant 3 2.5 20% Duration of 18.3 yrs. 13 yrs. 2 chronic pain 15% Disability per 1 10% Oswestry 69.4 54 0 5% Disability (Crippling) (Severe) Baseline Best Option Index 0% (sub or supra) Supra-perception Sub-perception Best option Yes No only only (supra or sub) CRPS (19%) (0%) Subgroup : ≥ 50% • WHISPER results improvement with supra- Met primary endpoint • • showed clinical value perception during Superiority demonstrated • of SCS in challenging, crossover phase 62% increase in responder rate • when patients are able to Outcomes consistent with long-term, implanted • choose between multiple de novo PROCO RCT patients waveform options patients 9 9
Our History in Neuromodulation: A Different Path to Deep Brain Stimulation A heritage in cochlear vs pacemaker Advanced Bionics 2004 technology, acquired by • Utilization of multi-channel stimulation Boston Scientific in 2004 • Precise control SCS Precision Plus (WW) 1 st and only MICC , Applying cochlear technology to 1st Rechargeable Platform neurological disorders • Focus on stimulation modality SCS Spectra Platform (WW) • Multiple Independent Current Control 1st 32 Channel • Focus on patient centric technology Rechargeable Platform • Wireless 2012 DBS Vercise • Rechargeable RC System (EU) • Ease-of-use 1st DBS system with 16 independent sources of • Size current • Precision 10 10
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