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Corporate Presentation
December 2016
Corporate Presentation v December 2016 Safe harbor statement This - - PowerPoint PPT Presentation
Corporate Presentation v December 2016 Safe harbor statement This presentation contains forward-looking statements within the meaning of Section 27A of the Securities Act of 1933, as amended, and Section 21E of the Securities Exchange Act of
v
Corporate Presentation
December 2016
Safe harbor statement
This presentation contains forward-looking statements within the meaning of Section 27A of the Securities Act of 1933, as amended, and Section 21E of the Securities Exchange Act of 1934, as amended that are intended to be covered by the "safe harbor" created by those sections. Forward-looking statements, which are based on certain assumptions and describe our future plans, strategies and expectations, can generally be identified by the use of forward-looking terms such as "believe," "expect," "may," "will," "should," "could," "seek," "intend," "plan," "estimate," "anticipate" or other comparable2
OUR MISSION
To partner with healthcare providers, payers, patients & advocacy groups to
help eradicate colon cancer
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Eradicating Colon Cancer: Challenges & Opportunity
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Colon cancer: America’s second deadliest cancer
new diagnoses in 2015
15,690 26,120 41,780 40,89049,190
158,080 Esophageal Prostate Breast Pancreas Colorectal LungAnnual cancer deaths
132,700
deaths in 2015
49,700
new diagnoses
deaths
5
10+ years
Sources: J Natl Cancer Inst. 2009; 101:1225-1227 (Itzkowitz) Gastro 1997;112:594-692 (Winawer)Why is colon cancer the “Most preventable, yet least prevented form of cancer”?
Pre-cancerous polyp Four stages of colon cancer
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Detecting colorectal cancer early is critical
9 out of 10 survive 5 years Diagnosed in Stages I or II Diagnosed in Stage IV 1 out of 10 survive 5 years
60% of patients are diagnosed in stages III-IV
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50% 52% 59% 58% 80% 80% 2005 2008 2010 2013 2018 2020
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95% of screened patients underwent colonoscopy2
Sources: 1. CDC NHIS survey results as published in the CDC’s MMWR between 2006 and 2015Care Gap
cervical (81%) & breast cancer (73%) achieve higher screening rates1
Actual colon cancer screening rate Goal screening rate
America’s stagnant colon cancer screening rate
Cologuard addresses the colon cancer challenge
List price - $649; Medicare rate - $509
published in New England Journal of Medicine
at 3 year interval:
Developed with Mayo Clinic
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Cancer detection
92%
(60/65)
Precancer detection
42%
(321/757)
Specificity
(clean colon*)
90%
(4002/4457)
*Clean colons have no need for a biopsy Sources: Imperiale TF et al., N Engl J Med (2014) Redwood DG, Asay ED, Blake ID, et al . Stool DNA Testing for Screening Detection of Colorectal Neoplasia in Alaska Native People. Mayo Clin Proc 2016; 91: 61-70.Cologuard’s performance confirmed in multiple studies
March 2014 October 2015
41%
(31/76)
100%
(10/10)
93%
(296/318)
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Cologuard: Becoming Standard of Care
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A multi-billion dollar U.S. market opportunity
U.S. market opportunity for Cologuard
Potential 80M-patient U.S. screening market*
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*80 million average-risk, asymptomatic people ages 50-85 **Assumes unscreened decreases from 42% to 30% ***Assumes 24M people screened with Cologuard every three years with ASP of $500 ****Assumes 30% market share for Cologuard *****Assumes 40% market share for colonoscopy & FOBT***** ****
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Cologuard becoming standard of care
Patient & physician demand increases with coverage & guideline inclusion
Medicare Star Ratings*
* CMS Star Ratings are guided by HEDIS quality measures. Cologuard's inclusion in the Star Ratings is expected in 2017.Regulatory & coverage Guideline inclusion Quality measures
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Sources: USPSTF, “Final Recommendation Statement, Colorectal Cancer: Screening (June 2016)” JAMA (2016) Screening Method Frequency Stool-Based Tests gFOBT Every year FIT Every year FIT-DNA Every 1 or 3 y Direct Visualization Tests Colonoscopy Every 10 y CT colonography Every 5 y Flexible sigmoidoscopy Every 5 y Flexible sigmoidoscopy with FIT Flexible sigmoidoscopy every 10 y plus FIT every yearCologuard included in USPSTF recommendations
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2016 HEDIS performance audit will use HEDIS 2017 rules. Screening credit given for patients screened using Cologuard in 2014, 2015 or 2016.
HEDIS 2017 measure for colon cancer screening
Fecal occult blood test during the measurement year. Flexible sigmoidoscopy during the measurement year or four years prior. Colonoscopy during the measurement year or nine years prior. CT colonography during the measurement year or the four years prior FIT-DNA test (FIT-DNA Value Set) during the measurement year or the two years prior to the measurement year
Source: NCQA, HEDIS 2017 Volume 2 Technical Update. Published October 3, 2016Cologuard drives quality credit
Quality measures increase colon cancer screening
>50% increase in screening after physicians were compensated on quality measures
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Sources: CMS 2017 Star Ratings Fact Sheet Kaiser Health News, March 1, 2016Quality measures impacting Medicare Advantage plans
Health plans aiming for ≥ 4 Star Rating to earn 5% bonus payments
12 67 107
97 67 14
Star Rating 5 4.5 4 3.5 3 2.5 2017 Medicare Advantage Plans Ratings by Star Level Key thresholds in Star Ratings: 5 Star Ratings: year-round open enrollment ≥ 4.0 Star Rating: ~$500 per member and top member rebate payments
Strong customer satisfaction with Cologuard
Physicians’ expectations met or exceeded 98% Patients rated Cologuard experience very positive
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Cologuard: Increasing America’s screening population
Source: Colorectal Cancer Screening with Multi-target stool DNA-based Testing Previous Screening History of the Initial Patient Cohort, poster presented at American College of Gastroenterology's Annual Scientific Meeting (ACG 2015), Oct. 16-21, 2015; ages 50-7449% screened with colonoscopy
42% never screened before
9% screened only with FIT/FOBT
Screening history of Cologuard users
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Patients and physicians supported by proactive outreach and 24/7 care center
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Order Cologuard delivered
Welcome call & letter Audit of patient’s age & interval Compliance call 1 Compliance call 2 Compliance letter
Cologuard returned
Week 1 Week 4
Proactive outreach from Exact Sciences
Week 2
Increasing compliance with a screening program
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Exact Sciences’ compliance program increases screening
Cologuard’s patient compliance rate is derived from the number of valid tests reported divided by the number of collection kits shipped to patients during the trailing 12-month period. Sources: 1. Exact Sciences Q2 2016 Earnings Call28% 34% 7%
67%
Returned with no compliance calls Returned with 1 compliance call Returned with 2 compliance calls Overall compliance rate
Percentage of compliant patients
Offering Cologuard increases patient compliance
USMD study highlights opportunity to expand screening & detect curable-stage cancer
American Association of Cancer Research Annual meeting 2016, New Orleans LA USA, LB-296, Proceedings of the American Association of Cancer Research, in pressNon-compliant Medicare patients
Cancers in curable stage; 21 advanced adenoma
Cologuard compliance
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A Strategy to Drive Cologuard Adoption
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Three-pronged commercial strategy
Physicians Primary care sales force National TV campaign Digital marketing Payers Clinical & health publications Market access team Guideline inclusion Patients Public relations Digital direct to consumer National TV campaign
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Cologuard’s growing provider penetration
4,100 8,300 14,700 21,000 27,000 32,000 Q1 Q2 Q3 Q4 Q1 41,000 August 2014 Sept 2016 Q2
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50,000 Q3
National TV campaign increasing ordering & adoption
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Digital advertising complements national TV campaign
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Increasing CologuardTest.com visits, order form downloads and patient guide downloads
46% 46% 8%
Source: US Census 2013 and AIS Directory of Health Plans: 2015; ages 50-85Medicare Commercial Military & Medicaid
Breakdown of current U.S. insurance market
~80M average-risk people age 50-85
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Medical coverage accelerating following Cologuard’s inclusion in USPSTF recommendations
40 60 80 100 120 140 160
Millions of beneficiaries
153M total USPSTF
Medicare Anthem HCSC BCBS MA IBC BCBS LA Health Net
Source: US Census data, AIS Directory of Health Plans: 201629
Cigna & TRICARE CareFirst Humana
Strategy to advance insurance coverage
Value proposition for payers
Sources: Imperiale TF et al., N Engl J Med (2014) Cologuard’s patient compliance rate is derived from the number of valid tests reported divided by the number of collection kits shipped to patients during the 12-month period ending 60 days prior to June 30, 2016.30
Quality
Economic value Member satisfaction
Close the care gap with a colon cancer screening test that’s 92% sensitive and 87% specific High compliance with Cologuard driven by patient satisfaction and customer service Cologuard can help increase quality rating and is cost saving to health plans
$
Cologuard growth accelerating in 2016
4,000 11,000 21,000 34,000 38,000 40,000 54,000 68,000
Q4 Q1 Q2 Q3 Q4 Q1 Q2 Q3 2014 2015 2016
~78,000 guidanceQ4
Cologuard tests completed
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Guidance
2015 2016
Projecting $93-95M revenue in 2016
104,000 $39.4M ~240,000 $93-95M
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Cologuard’s strong launch trajectory
BRACAnalysis (MYGN) Prolaris (MYGN) Oncotype Dx Prostate (GHDX) Oncotype Dx Breast/Colon (GHDX) FoundationOne (FMI) MaterniT21 (SQNM) Panorama (NTRA) Afirma (VCYT) VectraDA (MYGN) Assurex (MYGN)0K 10K 20K 30K 40K 50K 60K 70K 80K 90K 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19
Launch year Quarterly test volume
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Exact Sciences (EXAS)
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Foundation built on key milestones
Cologuard developed with Mayo Clinic
2009 – 2010
✔
10,000-patient DeeP-C clinical trial
2011 – 2012
✔
DeeP-C results published in NEJM
March 2014
✔
FDA approval
August 2014
✔
Medicare coverage and pricing
October 2014
✔
Inclusion in key guidelines
2014 – 2016
✔
Inclusion in HEDIS quality measures
October 2016
✔
Buildout of commercial infrastructure
2013 – present
✔
Broad commercial insurance coverage
Ongoing
Broad provider access to electronic ordering
Ongoing
Third-quarter financial results
Revenues Operating expenses Cash utilization Cash balance
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Third Quarter 2016 $28.1 million $54.2 million $30.5 million $337.8 million
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