1. Bringing J&J Innovation to Life CADTH Meeting APRIL, 2015

2. Innovation Centers

3. ‘The patients are waiting!’ - Dr. Paul Janssen ONCE EVERY Someone dies from diabetes or related medical issues 8 SECONDS

4. The diabetes epidemic is a “secondary epidemic” primarily following the epidemic in obesity. – If the obesity epidemic were to resolve, or disappear, type 2 diabetes would largely disappear as well, even without active diabetes-specific interventions. – Surgical interventions largely aimed at treatment of obesity ( i.e. bariatric surgery) often result in “cure” of early diabetes or remission or regression, or significant clinical improvement of later disease. The lipocentric view of diabetes suggests the abnormalities in excessive adipose tissue accumulation and ectopic deposition of fatty acids largely drives both insulin resistance and decrease insulin secretion contributing to the development of diabetes. 4 The Diabetes Epidemic Will Strain the Capacity of Healthcare Systems if Left Unchecked

5. 5 Intervention at the Pre-diabetic Stage Provides an Opportunity to Change the Course of Disease Persistent Insulin Resistance and Progressive β-cell Decline

6. Intervention of Pre-Diabetes Will Require Identification, Lifestyle Changes, and Treatment Biomarkers that aid in the identification of individuals that are most likely to progress to Type 2 Diabetes Education and other methods to increase compliance towards healthy lifestyle changes Development of therapies that focus on the root causes of diabetes (e.g. insulin resistance) which can delay/prevent the onset of frank diabetes –insulin sensitizers,  cell regeneration

7. ‘The patients are waiting!’ - Dr. Paul Janssen One person dies of melanoma EVERY HOUR

8. The underlying pathways that lead to proliferative dysregulation are continuing to be better understood Targeted therapies are moving cancer treatment towards more individually tailored treatments Combinations of existing and novel therapies are being explored to increase 5yr survival times across a number of cancer types Therapies designed to evoke powerful immune responses towards tumors are dramatically changing outcomes in a subset of late-stage tumor types 8 Increased Understanding of Oncogenic Drivers and the Rise of Immuno-oncology is Changing Cancer Treatment

9. Immuno-Oncology: An Exciting New Approach for Patients Living with Cancer 9 Confidential Reactivation and redirection of patient’s immune response towards malignant cells Four Approaches 1.T Cell Checkpoints PD1 and PD-L1 antibodies (BMS, Merck, Genentech, AZ/Medimmune) Ipilumumab (BMS) 2.T Cell Redirection Blinotumumab (Amgen BiTE) 3.Chimeric Antigen Receptor T cells Infusion of engineered T cells 4.Vaccines

10. The Future Treatment Paradigms in Oncology will Continue to Be More Personalized Approaches to rationally guide combination strategies Next generation immunotherapy agents/mechanisms Mechanisms of resistance to emerging immunotherapy (PD1, PDL1, CTLA4) Novel tumor antigen ID approaches and vaccine technologies Identification of pre-disposing mutations and subsequent prevention of disease 10 Confidential

11. ‘The patients are waiting!’ - Dr. Paul Janssen 1 in 3 Seniors Who Die Each Year Have Been Diagnosed With Alzheimer’s or Another Dementia

12. Alzheimer’s Disease Presents a Staggering Problem to Ageing Individuals, their Caregivers, and Society 12 Only one in four people with Alzheimer’s have been diagnosed (Alzheimer’s Disease International) The direct and indirect costs of caring for people with Alzheimer’s and dementia in the Canada is approximately $33B per year, worldwide it is greater than $600B (Alzheimer’s Society Canada) One in five Canadians aged 45 and older provides some form of care to seniors living with long-term health problems - in 2011, family caregivers spent in excess of 444 million unpaid hours looking after someone with cognitive impairment, including dementia. (Alzheimer’s Society Canada) There are currently no treatments that result in modification of the course of disease

13. The Challenges Presented by Alzheimer’s Disease Include Insufficient and Late Diagnosis, as Well as a Lack of Treatment Options 13 Brains of individuals with Alzheimer’s Disease are characterized by the presence of plaques (beta-amyloid) and tangles (tau) The presence of plaques and tangles can proceed the development of symptoms Both beta-amyloid and tau are the focus of a number of novel therapeutic approaches Image credit: Jannis Productions. Rebekah Fredenburg, computer animation; Stacy Jannis, illustration/art direction

14. The Future Treatment of Alzheimer’s Disease Will be Dependent on Identification of Individuals Early in Disease and Generation of Effective Treatments 14 More sensitive and specific methods for determining which individuals will go on to develop disease Beta-amyloid targeted treatments have had a challenging clinical history, although there are still many efforts underway that are hopeful Tau-based approaches are currently moving towards later-stage clinical testing and may provide new treatment options for people living with disease The evolving understanding of the brain biology and disease pathogenesis will provide the field with new insights to disease prevention, management, and treatment Public-private partnerships will be essential in the development of both new diagnostics as well as therapeutics

15. Tapping Innovation in Canada Boston IC Janssen Canada Innovation Incubator Consortium Montreal Boston IC Janssen Canada JJMP Innovation Incubator Dedicated Fund Toronto Janssen Canada Alberta Diabetes Foundation Government of Alberta California IC Judges $600k Dedicated Fund Edmonton Janssen Canada Government of British Columbia Government of Alberta California IC representatives $1m Dedicated Fund Vancouver California IC Janssen Canada Government of Canada National Contest Canada-wide California IC Janssen Canada Neuroscience TA Dedicated Fund Toronto Janssen Pharmaceuticals NV Industry Consortium Toronto BetaLogics Janssen R&D Industry Consortium Toronto

16. Thank You !!