Edwards Lifesciences 2012 Investor Conference 12/4/2012
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1 Carlyn D. Solomon Corporate Vice President, Critical Care Executive Summary Edwards is extending its leadership in global hemodynamic monitoring We expect continued growth of our gold standard products, especially in emerging markets Advanced monitoring of surgical patients continues to offer significant growth potential Noninvasive monitoring represents an exciting opportunity to benefit a broader group of patients GlucoClear remains challenging but represents a significant breakout opportunity 105
2 Edwards Has Been the Hemodynamic Monitoring Leader for Forty Years Critical Care sales, $ millions $600 Legacy Discontinued Business* Advanced Monitoring Swan-Ganz Catheter TruWave Sensor $ E 2013E Establishing a Best-in-Class Sales Channel Along the Way We Have Discontinued Sales of Non- Hemodynamic Monitoring Businesses Critical Care sales, $ millions $600 Legacy Discontinued Business* Advanced Monitoring Discontinued Business Hemofiltration Access Somanetics 2008 Sales $45M $30M $5M $80M $ E 2013E * Includes Hemofiltration, Somanetics and Central Venous Access 106
3 Emerging Markets Offer Growth Opportunity Critical Care sales, $ millions $600 Legacy Emerging Markets Discontinued Business* Advanced Monitoring New customers $ E 2013E Clinical practice varies from rest of world EW education programs in place Fully staffed commercial team Organization growth Adoption of Goal-Directed Therapy Has Driven Advanced Monitoring Growth Critical Care sales, $ millions $600 Legacy Discontinued Business Advanced Monitoring FloTrac Sensor PreSep Catheter $ E 2013E In 2012, ~17% of potential 1 surgical patients managed with goal-directed fluid therapy 2 1 In developed markets 2 Source: EW estimates, financial reports 107
4 Patient Care Trends Expected to Expand Opportunity Global Hemodynamic Monitoring ~$ Hemodynamic Share Outlook Competitors ~$0.6B Expense control Medical practice inertia Evolution to multiple decision makers Growing evidence Increasing awareness of benefits Focus on solutions, not products Edwards Source: EW estimates; displayed revenue is at 2012 FX rates Critical Care Patients are the Sickest, Most Costly and their Numbers are Increasing US Hospital Care = $815B 1 250M hospital visits & admissions US Critical Care = $85B 2 5M admissions (5x per patient cost) OR Conditions Higher risk surgery Cardiovascular Transplantation Abdominal Trauma ICU Conditions Sepsis Multi-organ failure Acute respiratory distress syndrome Hospitals are moving toward a higher overall concentration of sick people who need more care 3 1 Martin et al. Growth in US health spending remained slow in 2010; Health share of GDP was unchanged from Health Affairs; The Society of Critical Care Medicine. Critical Care Statistics in the United States; Stanton et al. Hospital nurse staffing and quality of care. Agency for Healthcare Research and Quality;
5 Edwards Solutions Drive Significant Value Goal-Directed Fluid Therapy Complications Too Dry Low Goal Fluid Status Too Wet Hi Potential Benefits 1 Patient Avoid infections and complications Reduce hospital length of stay Economic >$2,500 per patient expense averted (US) Goal-directed therapy in the perioperative period may improve longterm outcomes, in part due to its ability to reduce the number of perioperative complications. 2 1 Brienza, Crit Care Med 2009, Corcoran, Anesth and Analg 2012, Dalfino, Crit Care Med 2011, Hamilton Anesth and Analg Goal directed therapy in high risk surgical patients: a 15 year follow up study. Intensive Care Med Aug;36(8): Helping Various Stakeholders Understand Benefits of Goal-Directed Therapy is Key Traditional Stakeholders Anesthesiologists + Emerging Stakeholders Surgeon Surgical Intensivists Hospital Administrators Leveraging a Best-in-Class Sales Channel Bridge gap as anesthesia incurs cost while benefits seen later Provide hands-on training to hospital Edwards can provide hospitalspecific view of potential benefits 109
6 Adding Noninvasive Expands Our Hemodynamic Monitoring Portfolio Invasive Product Invasiveness Noninvasive Swan-Ganz Catheter VolumeView Set PreSep Catheter FloTrac Sensor BMEYE ++++ Richness of Insight ++ Allowing Clinicians to Determine the Right Tool for the Right Patient ccnexfin System Noninvasive, Continuous Hemodynamic Monitoring 110
7 Adding Noninvasive Expands Our Hemodynamic Monitoring Portfolio Invasive Product Invasiveness Noninvasive Swan-Ganz Catheter VolumeView Set PreSep Catheter FloTrac Sensor BMEYE ++++ Richness of Insight ++ Allowing Clinicians to Determine the Right Tool for the Right Patient Thought Leaders Support Need for Continuous Glucose Monitoring (CGM) There are many unanswered questions with glycemic control today with continuous glucose monitoring, we will be able to answer these questions. NICE-SUGAR concludes that hypoglycemia causes increased mortality. You need to get ICUs to realize how often they cause hypoglycemia this is strong evidence! q yp g y g Djillali Annane Advisor to Minister of Health, France Dean of Medical School Hôpital Raymond Poincaré All hypo is bad and there is a real need for continuous glucose monitoring. Nigel Scawn Head of Anesthesia Liverpool Heart and Chest Hospital Hypoglycemia does matter for everyone. Stan Nasraway Medical Director, Surgical ICU Tufts Medical Center Michael Agus Medical Director ICU Children s Hospital Boston 111
8 GlucoClear Continuous Glucose Monitoring 2013 Will be a Pivitol Year for GlucoClear, Including Limited EU Launch Product Development Complete development Improve clinical workflow Integrate glycemic protocol Goals: GlucoClear Sensor Clinical Evidence Generation Demonstrate ICU accuracy Reduce hypoglycemia Improve glycemic control Improve outcomes Regulatory Obtain CE Mark Define US approval pathway GlucoClear Monitor GlucoClear is not available for commercial sale in the U.S. 112
9 2013 Key Milestones and Anticipated Timing Increased adoption of goal-directed fluid therapy (GDT) Enhanced sensor algorithms, GDT-facilitating EV1000 screens Q4 Noninvasive monitoring Edwards launch Q1 BMEYE disposable ccnexfin monitor GlucoClear Receive CE Mark Q1 Limited EU launch Q2 Complete enrollment for ICU accuracy study Q4 GlucoClear is not available for commercial sale in the U.S. Execution of Long Term Strategy Can Lead to Significant Growth Opportunities Hemodynamic Monitoring Hospital CGM ~$ Hospital CGM Share Outlook Competitors Edwards ~$0.6B 2020 Hemodynamic Share Outlook Competitors Edwards Source: EW estimates; displayed revenue is at 2012 FX rates 113
10 Edwards Lifesciences Q&A 114
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