International Medical Cluster Project information for potential participants

Summary The International Medical Cluster (IMC) provides unique business development opportunities in the medical sector: The Cluster is established with the purpose of supporting the advancement of medical services, improving their quality, assisting the development of new drugs, medical technologies and products, enabling education and research efforts in the field of healthcare based on the best existing international practices The IMC operations are regulated by Federal Law No.160-FZ "On the International Medical Cluster" that specifies the conditions for building and developing an International Medical Cluster within the legislation context of the Russian Federation In accordance with the current regulations, the participants of the project are entitled to a number of exceptions in terms of applying OECD standards and recruiting foreign specialists. The IMC participants are also entitled to special support from the IMC Fund under the PPP framework In terms of cluster development, the IMC is now interested in finding investors and operators across a wide range of medical services, education, and R&D1 models In the near future the International Medical Cluster (IMC) will be located at the Skolkovo Innovation Center, occupying a dedicated territory of 57.6 hectares. The total area of the facilities will be up to 450,000 m2 1. Research & Development

Agenda General overview Opportunities for potential participants Appendix

In line with IMC vision and objectives, investors and operators are given a whole range of participation options Vision The International Medical Cluster (IMC) is intended to assist the development of Moscow healthcare sector in line with the best state-of-the-art international practices as well as key Russian sector development trends Objectives Enhancing medical care by providing medical assistance and improving its quality using best international practice and treatment methodologies Assisting the development and commercialization of drugs, medical technologies and products in Russia and abroad Developing education and research activities in healthcare with the involvement of international experts in medical education Promoting international cooperation in healthcare sector

In accordance with 160-FZ, IMC provides unique business development conditions in the medical sector Opportunity to participate in innovative development of healthcare system Special benefits for project participants Support from the Moscow City Government International Medical Cluster (IMC) is established in accordance with 160-FZ. This law provides a special area for business development within the IMC and a number of preferences to project participants Within the IMC, the permits issued by foreign OECD member countries are equally valid as the permits issued in the Russian Federation Project participants are not required to obtain special permits to recruit and use the services of expat specialists in the field of medicine, education, or scientific research Invitations and job permits are issued to foreign specialists, regardless of the existing quotas Education certificates and (or) qualification papers of expat specialists from OECD member countries are recognized by the IMC According to its Mission, the IMC Fund shall provide all necessary support to the participants of the project Supporting project participants by providing the necessary services Coordinating project participants and supporting the interfaces between them Setting up training and internship projects for the necessary talent pool Assisting the promotion of products and services, and developing the R&D cooperation of project participants Government relations Copyright and Branding The IMC Fund is prepared to address and set up various forms and types of support, including those under the PPP framework The International Medical Cluster (IMC) is intended to assist the development of Moscow healthcare sector in line with the best state-of-the-art international practices as well as key Russian sector development trends Developing medical activities and medical care, improving its quality Developing new drugs, medical technologies, and products Supporting education and research activities in the field of healthcare Promoting international cooperation in medical services and innovations

General cluster vision: medical services, education and R&D are the key components Funding and commercialization II Education Governing body III Research and Development IV Production Target development degree: Target development sequence High Medium Low 1st priority 2nd priority 3rd priority Key components

Three development horizons are considered for the Cluster Illustrative Pilot objects First cluster facilities to be commissioned in 2017-2018 Facilities located on Skolkovo territory Construction already in progress Skolkovo Cluster in Skolkovo A dedicated territory of 57.6 hectares is assigned for construction of IMC facilities Assumed total development area – up to 450,000 m2 Moscow Cluster in Moscow Further cluster development is not limited to Skolkovo territory Development in other Moscow areas could be carried out in parallel with construction of pilot and other facilities on Skolkovo territory

Territory of 57.6 hectares is assigned for IMC in Skolkovo IC IMC deployment at the Skolkovo Innovation Center D1 and D4 area plots D1 D4 Area of IMC facilities in the Skolkovo Innovation Center 57.6 hectares Planned development area 450,000 m2 D1 area plots D4 Area D4 area plots D1 Area IMC site

IMC will be located side by side with wide infrastructure of Skolkovo Innovation Center Readiness in 2015 Readiness in 2016 Readiness in 2017 Readiness by end of 2020 International Medical Cluster, development in 2016-2035 Projects undergoing development phase 75% Total construction area 2.6 M m2 NTC TMC Skoltech - MIT University HyperCube (completed) D2 apartment Family campus Technopark Renova Lab Boeing Technopark (completed) Sberbank DPC BCG Gallereya IT-cluster MFC «Kvadrat» Transport Hub Sberbank Technopark Facility Contractor readiness Total area, m2 Fund resources Investment Total SkolTech 214,704   by end 2015 - 2016 139,554 2017 2018-2020 75,150 Technopark 160,081 95,246 64,835 R&D offices and centers 724,420 Key partners 360,824 5,050 173,505 91,750 90,519 Other R&D offices and centers 363,596 5,856 73,271 79,127 78,300 206,169 Apartments, row houses, villas 690,730 8,642 41,953 81,928 558,207 Transport and engineering infrastructure 309,828 26,679 14,357 41,036 45,000 43,440 180,352 Social infrastructure 523,088 1,836 32,779 20,077 468,396 Total before 2018  979,223 Second construction phase (2018-2020) 1,643,628 Total in Skolkovo IC (rounded) 2,623,000 IMC (approximately) 400,000 3,023,000 * Facilities area and functional purpose to be clarified at project concept approval phase

Wide transport infrastructure is planned to be developed within the framework of Skolkovo Innovation Center Planned development of external and internal Skolkovo IC transport infrastructure until 2020 allows Managing daily inbound and outbound transport flows Ensuring comfortable movement within the city for citizens and visitors The ride to Moscow center will take 10-15 minutes after completion of North-Western chord Bicycle routes

IMC is actively developing; all necessary conditions are set-up for participants to join the cluster Current results IMC concept developed The Concept defines key development directions as well as requirements to cluster participants Medical technical assignment is prepared for the construction of Phase I and II facilities Phase I construction is already started Potential operator for Phase I and II facilities is identified Hadassah Medical center (Israel) Cluster territory already has all required engineering and transport infrastructure

Potential cluster composition has been visualized Illustration of possible cluster composition Pilot objects D1 area 1 Diagnostic building Construction in progress 2 Medical center (oncology) 3 Interdisciplinary medical complex with a clinical unit 1 4 Orthopaedics and traumatology 2 5 Multi-purpose rehabilitation center 3 6 Hotel facilities & Retail 7 Children clinic 8 ENT 4 9 Ophthalmology 18 10 Apartments 17 5 16 11 Offices & Retail 13 6 12 Endocrinology 15 14 13 Gastroenterology 12 10 11 14 Gynecology 15 Urology 16 Educational center 8 7 19 17 Neurology 9 18 Cardiology 20 19 Underground parking IMC plot borders 20 Above-ground parking

IMC facilities position on Skolkovo Innovation Center territory D1 Area IMC facilities D4 Area

Agenda General overview Opportunities for potential participants Appendix

The IMC is now looking for participants in the areas of medical services, education, and R&D Potential model examples — non-exhaustive Potential partners and operators Scope Potential development models Medical services Entire range from a multidisciplinary clinic to individual elements, e.g. Orthopedics and trauma center Specialized cardiovascular clinic Rehabilitation center International partner clinic Education Educational programs both within the framework of the clinic, as well as standalone education projects. E.g. Simulation center Continuous education and refresher programs for doctors and paramedical staff International medical schools MedTech producers Research and Development Focused research programs with the possibility of employing IMC clinics' resources. E.g. Development of standards Setting up clinical research Application of new treatment methods in cooperation with IMC clinics Pharmaceutical companies MedTech producers Attraction of international expertise and creation of international partnerships are an important requirement

Potential attractive models defined for medical providers – specific models to be discussed with IMC participants Medical services Indicative. Particular models and timing to be discussed with the participant 2016-2025 ~2025-2035 6 facilities 6 + 8 facilities Medical facilities 1 Diagnostic building 1 Diagnostic building Participants already defined 2 Medical centre 2 Medical centre 3 Interdisciplinary building1 3 Interdisciplinary building1 4 Cardiology 4 Cardiology 5 Orthopaedics and traumatology 5 Orthopaedics and traumatology 6 Multi-purpose rehabilitation centre 6 Multi-purpose rehabilitation centre 7 Urology 8 Gynecology Potential models for future IMC participants 9 ophthalmology 10 Children clinic 11 Endocrinology 12 Otolaryngology 13 Gastroenterology 14 Neurology 1. With a clinical unit, functionality to be defined

9 priority programs in education defined for IMC Operating models Requirements to medical provider (IMC participant) Standalone education operator (IMC participant) Target audience Program description Medical education Full-cycle programs Full-cycle education programs for doctors and nurses Standalone educational operator can deliver any of the proposed models Residency Residency/practical training program for doctors in line with international standards of partner’s clinic International exchange Long-term internship in international partner clinic Continuous education Professional development program in chosen TA for doctors and nurses Simulation center Practical education program to train medical equipment operating skills Advanced training courses Short-term professional development courses in particular areas of medical services Retraining of nurses Practical training program for nurses in line with international standards of partner’s clinic Business education MBA Business education and training program for executive management in medical sector Business trainings Short-term professional development courses on business topics for medical staff/management Doctors Nurses Managers

9 strategic target research areas were defined for R&D Overall principle of R&D development at IMC Priority – patients' needs and improvement of treatment results (patient-centric approach) 9 Strategic areas of R&D development at IMC Predictive Medicine 1 Cross-disciplinary patient care based on new technologies 2 Behavioral patient care 3 Personalized medicine 4 Minimally invasive surgery 5 Care closest to patient 6 7 Survivorship, surveillance and assistance guidance 8 Data-driven healthcare 9 Translational research Potential development topics also defined for key therapeutic areas (for more details – see Appendix) ... ...

Minimum operator participation Preferred operator participation A number of operator requirements will help ensure the high quality of services provided in the cluster Joint/ full investments Sharing financial risks and profits Defining strategy and controlling operations Leveraging internal best practices, own staff and management Brand Providing international/local participant brand for an annual fee Operations control Expertise Consulting services, access to in-house topic experts and best practices Access to operational practices Core medical staff Providing a team of core medical staff Staff training Training of medical and management staff at HQ/cross-trainings Management team Providing a management team Minimum operator participation Preferred operator participation Additionally, a medical facility operator may be required to participate in research and educational programs

Agenda General overview Opportunities for potential participants Appendix

Construction is already in progress As of today, the concept of the first pilot facilities is already in place Construction is already in progress First phase facilities PHASE III I LEGEND: 1(а). Diagnostic Center (total area: 12,888 m2) 1(b) Medical Center (total area: 19,062 m2) 2. Phase III facilities (total area: circa 28,000m2) 3. O2 and Gasification Station 4. Planned P3 parking lot Diagnostic Center - about 13,000 m2 comprising of: Check Up Center – about 3,000 m2 Simulation center and conference hall – about 1,600 m2 Facilities for other residents of the cluster and support infrastructure – about 8,400 m2 Second phase facilities II PHASE Medical Center – about 19,000 m2 Phase 3 facilities Functions being finalized. Total area of the facilities is about 28,000 m2

Visualization of Pilot Facilities Phase III Functions being finalized ~ 28,000 m2 Phase I Diagnostic Center ~ 13,000 m2 Phase II Medical Center ~ 19,000 m2

Possible R&D topics (1/3) Examples of therapeutic areas Examples of R&D topics (innovative approaches) related to patient care Oncology Cardiology1 Orthopaedics and traumatology 1 Vaccination against oncoviruses (e.g., HPV, hepatitis B) Minimally invasive diagnostic methods (for instance, "liquid biopsy" in oncology) 2 3 Immunotherapy (including cell-programming technologies) 4 Molecularly targeted therapy Oncolytic virotherapy 5 6 Gene transfer therapy Cancer stem cells therapy 7 8 Onco-psychology 9 Nano-drugs care 1. Including prevention and treatment of cardiometabolic syndrome Source: BCG analysis; interviews with external experts and BCG experts This topic is innovative (an R&D topic) and is relevant to this therapeutic area This topic is not innovative/is less relevant to this therapeutic area

Possible R&D topics (2/3) Examples of therapeutic areas Examples of R&D topics (innovative approaches) related to patient care Oncology Cardiology1 Orthopaedics and traumatology 10 Vaccination against atherosclerosis Atheroma state estimation-based therapy 11 12 Angiogenesis-based therapy 13 Tissue engineering therapy 14 Stem-cell therapy Polymedicine 15 Smart devices for blood circulation and arhythmia therapy support1 16 17 Modernized stents 18 Devices allowing to minimize repeated operations3 2. E.g. ICD – implantable cardioverter-defibrillator, including with an option of cardiac rhythm recording 3. E.g. self-powered cardiac pacemaker/valve fed by heart movements – excludes the need for surgical interference for battery changing Source: BCG analysis; interviews with external experts and BCG experts This topic is not innovative/is less relevant to this therapeutic area This topic is innovative (an R&D topic) and is relevant to this therapeutic area

Possible R&D topics (3/3) Examples of therapeutic areas Examples of R&D topics (innovative approaches) related to patient care Oncology Cardiology1 Orthopaedics and traumatology Osteoporosis prevention 19 20 Prevention and treatment using stem cells 21 Robot-assisted surgery Meniscus implant 22 Bone morphogenetic protein (BMP) application 23 Adaptive implant implementation 24 25 Bone implants 3D printing Treatment and rehab using exoskeletons 26 Development of biocompatible prostheses 27 Source: BCG analysis; interviews with external experts and BCG experts This topic is innovative (an R&D topic) and is relevant to this therapeutic area This topic is not innovative/is less relevant to this therapeutic area