1. Hale & Tempest Strategic Pharma Issues Dr. Brian W Tempest www.briantempest.com brian.tempest@clara.co.uk Mumbai, India January 2013

2. Hale & Tempest A Slide from a UK Headhunter

3. Hale & Tempest Asian Growth source: Bangkok Post 26 July 2012

4. Hale & Tempest The Biggest Healthcare Fraud in History Source: Daily Mail 3 July 2012

5. Hale & Tempest A Pfizer Decade of Bribery source: FT August 7 2012

6. Hale & Tempest Big Pharma Business Model Broken source: Pharmatimes World News April 2012

7. Hale & Tempest USA Life Expectancy & Pharma Costs Source: US Health in International Perspective Jan 2013

8. Hale & Tempest The Strategic Changes by Big Pharma Source: FT December 5 2012, Franz Humer, Roche Chairman Possible to cut 30-50% off development costs via CT efficiencies Shift from product focus to patient focus using diagnostic tools In Europe there isn’t one Government or politician interested in the health of the Industry USA & Latin American countries open to rewarding innovation Industry has to change fundamentally how it manages costs Leaner headquarters & smaller central functions Division of the industry into 2 parts A Innovative businesses able to charge a premium price B Large scale manufacturers who can compete on cost

9. Hale & Tempest Patent Expiries to 2018 source: EvaluatePharma 2012

10. Hale & Tempest The Teva Future – Standing Still Source: RBC Capital 12 December 2012

11. Hale & Tempest Teva Losing Control of Costs in the EU source: Teva June 2012

12. Hale & Tempest Reference Pricing in Central Europe Source : Istanbul September 2012  Pharma purchases reduced from 1.7% of GDP to 1.0% of GDP in Turkey  Russia, South Korea & Saudi Arabia health ministries now requesting Turkish prices  Everybody is referencing everybody else on Pharma prices in Europe  Bulgaria is currently referencing prices in 17 other countries

13. Hale & Tempest BiosimiIar Issues in EU/USA  Rituximab –100 pat Roche, >600 pat Generics  Interchangeability unlikely  Could be different INN name in USA and EU  Cabilly patents may delay US mAbs to 2018  EU first mAb in 2013 from Hospira/Celltrion  Pharmacovigilance data needed  EPO side effects in Thailand widely quoted  400 biosimilar manufacturers in China but none will reach EU/USA  Biobetters need a full dossier with health economic data

14. Hale & Tempest Sandoz Biosimilars – an 18 years ROI source: Pharmacloud June 2012

15. Hale & Tempest NIBS (tyrosine kinase inhibitors) Will these small molecules replace mAbs?  Axitinib, Pfizer, cancer  Cediranib, AZ, cancer  Pazopanib, GSK, cancer  Regorafenib, Bayer, cancer  Semaxanib, Sugen, cancer  Sorafenib, Bayer(Nexavar),cancer  Sunitinib, Pfizer, cancer  Toceranib, Pfizer, cancer  Vandetanib, AZ, cancer  Tofactinib, Pfizer, RA

16. Hale & Tempest Hisun-Pfizer JV to have 1500 staff in 2013 source: Fierce Pharma

17. Hale & Tempest Walgreens, Boots, Nanjing Axis Source: FT Sep 16 2012

18. Hale & Tempest Thank You brian.tempest@clara.co.uk www.briantempest.com