U.S. Disease Awareness Launch Paul Janczyk Manager, Global Health Economics & Reimbursement, Disease Awareness, U.S. (with Anna Sohlberg Director, Health Economics & Reimbursement, THV, EMEA And Annabell Merklin Communications Manager, Marketing Communications, EMEA)

Most sSAS patients are out-of-system (undiagnosed) The disease awareness work aims to diagnose more patients Estimated 2016 U.S. sSAS Patient View Patient “Leak” Points Total Prevalence: ~650K Patient stays home (asymptomatic/unaware) Patient sees doctor and symptom/murmur missed Doctor finds symptom/murmur but doesn’t refer for echo Echo ordered but AS missed AS identified but not diagnosed or followed No Echo Out-of-System Echo In-System Treated with AVR Age sSAS = severe symptomatic aortic stenosis

Learning essential to developing strategy DA Kick-off and Learning Tour Direct-to-Patient (DTP) Messaging Ideation Develop Quality Measure Concepts D.C. Heart Valve Disease (HVD) Awareness Day Policy Strategy Mapping D.C. Screening Coalition Meeting Patient “Leak” Points Research and Analysis KOL Workshop and **Strategy Development** Today Jan Feb Mar April May June Jul Aug Sept Oct Nov Dec Jan Feb Mar 2017 2018 In progress Accomplished Projected DA = Disease Awareness. DTP = Direct-to-Patient HVD = Heart Valve Disease

Disease awareness strategy Proof and Focus Activators Enablers Solidify evidence to support the unmet need and establish strategic foundation Engage stakeholders to facilitate patient journey Build on current Edwards and external development of enabling technologies Develop public evidence of disease burden, including costs and prevalence Leverage current research Explore new data sources Expand patient awareness of AS via non-traditional Direct-to-Patient (DTP) messaging With Corporate Strategy, support and accelerate development of external tools to enable diagnosis POC identification tools Functional screener to identify potential AS patients Support screening and policy initiatives for AS in select patient populations Clear patient journey research to understand unmet need Establish call to action for AS Identify underserved patient Engage cardiologists and patients to raise targeted PCP awareness Collaborate with HCS to invest and develop internal capabilities Other opportunities to be explored Evidence Policy and Legislation Awareness Campaign Strategy Expansion from KOL Workshop POC = Point of Care PCP = Primary Care Physician HCS = Healthcare Solutions

Disease awareness strategy  initiatives  projects 1 Evidence of burden Retrospective secondary research Prospective secondary research Patient experience Primary research on patients and caregivers Primary research on underserved groups A Proof and Focus B 2 C D DTP messaging Create DTP pilot roadmap Launch DTP pilots Screening and policy Activities to generate/consolidate screening evidence Collaboration with patient advocates and industry initiatives Screening legislation development Quality strategy to support screening and policy PCP awareness Create PCP pilot roadmap Launch PCP pilots 3 E F 4 G Activators H I 5 J K L 6 Enabler accelerator Assess emerging diagnosis tools Act on tool investment strategy Enablers M = Begun in 2017 N

Direct-to-Patient (DTP) complements evidence generation Direct-to-Patient (DTP) Pilots Evidence Generation Increase ECHO/AS treatment rates locally Identify key motivators for each segment Validate DTP model for future expansion Provide evidence for pathway gaps Bolster screening policy and guidelines Quantify patient fall-out at each step Expand definition of treatable AS Inform DTP targeting and approach Advance our policy agenda, challenge skepticism, and address the unmet need

DTP pilot planning in-progress for Q1 2018 launch DA Kick-off and Learning Tour Direct-to-Patient (DTP) Messaging Ideation Develop Quality Measure Concepts **DTP Pilot Planning** Submit Medicare Echo Abstract Launch DTP Pilot(s) D.C. Heart Valve Disease (HVD) Awareness Day Policy Strategy Mapping D.C. Screening Coalition Meeting Finalize Data Agreement with OxVALVE Submit CMS Quality Measure Grant Application Patient “Leak” Points Research and Analysis KOL Workshop and **Strategy Development** Today Launch AS Fact Sheets Complete US Cost Burden Analysis Accelerate Diagnostic Technology Development Jan Feb Mar April May June Jul Aug Sept Oct Nov Dec Jan Feb Mar 2017 2018 In progress Accomplished Projected DA = Disease Awareness. DTP = Direct-to-Patient HVD = Heart Valve Disease

It is normal to begin to have difficulty with every day tasks. Can we change thinking? From To Fatigue, shortness of breath and difficulty exercising are simply signs of aging. It is normal to begin to have difficulty with every day tasks. As long as there is an annual physical exam when the doctor listens to my loved ones and my heart, I’m sure that any heart problems will be properly diagnosed. These symptoms are more than just normal aging and I will discuss these changes with a doctor. To protect the ones I love and myself, I will make sure the doctor does more than just listen to the heart – I will make sure we verify heart health by asking for an echocardiogram.

Europe can leverage U.S. evidence consolidation, generation and primary research AS burden of illness Ex. OxValve follow-up work ‘Part of the solution beyond the technology’

Build on existing disease awareness work Heart Valve Disease Day Initiative by five European patient groups Supported by PCR Local events and European event with policy-makers planned European-specific circumstance Across countries and languages Patient outreach restrictions

Build on existing disease awareness work Awareness Surveys Survey of people over 60 years old 11,000 people in 11 European countries Survey results to be published in scientific journal Survey results to be used for national media campaigns In 2013 and 2015, awareness surveys were conducted amongst people over 60 years old across Europe 2017 follow-up survey will aim to evaluate if awareness has improved Survey of 11,000 people aged 60 years or older in 11 European countries Survey to published in scientific journal Survey results to launched on first European Heart Valve Disease Awareness Day 2018