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Insulin Pump Forecasting Project Summary January 1, 2007 TruSuccess Advisors, 27 Circle Dr. Rockaway, NJ 07866 (973) 784-3257 CONFIDENTIAL AND PROPRIETARY INFORMATION The information contained within this presentation is confidential and proprietary, and intended for review purposes only. All other uses are expressly forbidden, unless it receives prior, written permission from the Officers of TruSuccess or its subsidiaries. Copyright © 2006 TruSuccess, Inc. All rights reserved.
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TruSuccess Advisory 2 Project Summary Forecast the long-term demand and usage patterns within the insulin pump market. – Present and discuss the five-year market trends and primary drivers within this market segment Better understand insulin usage among the various patient-types, I.e. multiple-daily-injection (MDI) and pump patients Identify the strategic implications and key actionable insights of the various findings
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TruSuccess Advisory 3 Contents Pump Market Estimates & Five-Year Trends Key Strategic Implications Appendix:
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TruSuccess Advisory 4 Total Type 2 13.8MM Our estimates suggests that about 235K type 1 and type 2 patients are on pump therapy in the US in 2004 Total Type 1 1.08MM MDI 752K Self-Mix 864K Pump 31K Pre-Mix 1006K Basal only 1397K MDI patients are defined as having at least three injections per day of Basal & Bolus
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TruSuccess Advisory 5 Forecasting estimates also suggest that total pump usage will continue to grow significantly over the next 5 years Optimistic Estimates Benchmark Estimates Industry Estimates Pump Market Projections through 2009 - Secondary Data Comparison Number of Patients While our current market size is below industry estimates, projected growth rates over the next 5 years are consistent with other estimates Conservative Estimates
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TruSuccess Advisory 6 Contents Pump Market Estimates & Five-Year Trends Key Strategic Implications – Key Market Levers and Drivers – Likely Competitors Strategy – Proposed Brand Response Appendix:
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TruSuccess Advisory 7 The Brand currently faces a variety of strategic options to grow its business, by focusing on impacting four different volumes Grow Brand in MDI Grow Brand in pump Increase Brand share in pumps Convert Competitive Product’s Users Convert Competitive Product’s Users Increase primary demand for pump Capture new pump starts Drive Physician Prescribing Drive Physician Prescribing Drive Patient Requests Drive Patient Requests Specific details wihheld Convert Competitive Product’s Users Capture new MDI starts Increase Brand share in MDI Convert Human insulin Users Convert Human insulin Users
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TruSuccess Advisory 8 Patient requests play an important role in driving pump usage. Around three-quarters of pump requests are granted, regardless of the patient ’ s prior control status Total Pump Patients Total Pump Requestors Adequate Control Inadequate Control Prior Control Status % Granted Total Requests Granted 235K 107K 42K 65K 76.5K Pump Patient Requests Targeted DTC strategies could potentially influence this market by focusing directly on the end-users
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TruSuccess Advisory 9 A host of other barriers currently also limit pump use which, if overcome, can potentially grow the market Patient requests Pump Pump not requested Request Granted Request not granted Patient adequately controlled on current regimen Patient not achieving adequate control on current regimen Receive Pump Inadequate insurance coverage High cost of copays Low commitment to test blood sugar Limited patient knowledge Resistance to therapy change Pump complexity Reasons Remain on current therapy Potential Pump Patients Receive pump Remain on current therapy Pump Therapy Levers and Barriers Tree
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TruSuccess Advisory 10 17% 11% 35% 11% 31% 14% Total Patients on MDI Not on Pump Total Pump Patients Inadequate insurance coverage Not Controlled Adequately Controlled High cost of co-pays Low commitment to test blood sugar Limited patient knowledge Resistance to therapy change Pump complexity 204K 415K 622K 35K 207K 23K 72K 23K 64K 29K Note: some overlap present due to some patients facing multiple barriers Barriers to Pump Use for Type 1 Patients Most type 1 patients on MDI are considered well controlled. Of those who are not, patient resistance and low commitment to testing are chief barriers to pump use Percent of Patients Facing Barrier Number of Patients Facing Barrier Source: Physician Primary Research Results
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TruSuccess Advisory 11 21% 18% 32% 20% 24% 16% Total Patients on MDI Not on Pump Total Pump Patients Inadequate insurance coverage Not Controlled Adequately Controlled High cost of co-pays Low commitment to test blood sugar Limited patient knowledge Resistance to therapy change Pump complexity 31K 368K 751K 81K 384K 69K 123K 77K 92K 61K Note: some overlap present due to some patients facing multiple barriers Barriers to Pump Use for Type 2 Patients An even higher proportion of type 2 MDI patients are inadequately controlled. Here again, patient resistance, low commitment to testing, and limited insurance coverage are chief barriers Percent of Patients Facing Barrier Number of Patients Facing Barrier Source: Physician Primary Research Results
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TruSuccess Advisory 12 The various strategic options available to Brand differ both in the opportunity they offer and in their ability to be impacted Grow Brand in MDI Grow Brand in pump Increase Brand share in pumps Convert Competitive Product Users Convert Competitive Product Users Increase primary demand for pump Capture new pump starts Drive Physician Prescribing Drive Physician Prescribing Drive Patient Requests Drive Patient Requests Convert Competitive Product Users Capture new MDI starts Increase Brand share in MDI Convert Human insulin Users Convert Human insulin Users Brand share = 42% Brand share = 0% Brand share = 21% Opportunity: Impactability : High Medium High High Medium High High Medium Specific details wihheld
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TruSuccess Advisory 13 Back-up Slides
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TruSuccess Advisory 14 Three methods were employed to triangulate the quantitative market estimates, and arrive at an accurate assessment within the marketplace Public data analysis (Secondary data method) This method integrates existing studies which provide estimates of the market. Pros – Provides an independent source for validation of primary findings Cons – Specific methodologies and data sources used are often unclear Average number of pumpers per physician (Patient buildup method) This method calculates the average number of pump patients by physician quintile. Total pump patients are then projected from the sample to the population based on physician counts. Pros – Leverages known physician counts based on insulin prescribing Cons – Some double-counting possible if patients are seen by multiple MDs; Overstatement not easy to correct for; Results can also be sensitive to weighting based on quintile. Percentage of pumpers in physician’s practice (Percentage method) This method projects the percentage of patients on the pump to total patients in a physician’s practice based on number of type 1 and type 2 patients in the population, weighted by quintile Pros – Linked to solid epidemiological data; minimizes double counting and overstatement Cons – Results sensitive to weighting based on quintile.
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TruSuccess Advisory 15 Overall, the Brand accounts for under 18% of soluble insulin use in the last 12 months, but is the fastest-growing segment of the market Monthly TRx Share Trends in the Soluble Insulin Market Competitive Product Brand Human Insulin Over the past year the Brand’s volume has increased by 80% while Competitive Product saw an increase of only 1%, and Human short-acting insulin fell 5% Soluble Insulin Use over the past 12 months Source: NSP data
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TruSuccess Advisory 16 Significant future growth is expected in the incidence and diagnosis of type 2 diabetes within the U.S. CDC Historical Data Source: NHA NES Data Current Growth Estimates Projected Growth US Diabetes Projections
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