Annual Meeting of Stockholders Corporate Update - May 2013
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Transcript of Annual Meeting of Stockholders Corporate Update - May 2013
Annual Meeting of StockholdersCorporate Update
Tim Ruane, CEO
May 29, 2013
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Forward Looking Statements
Statements contained in this presentation regarding matters that are not historical facts are “forward‐looking statements” within the meaning of the Private Securities Litigation Reform Act of 1995. Because such statements are subject to risks and uncertainties, actual results may differ materially from those expressed or implied by such forward‐looking statements. Risks that contribute to the uncertain nature of the forward‐looking statements include: InSite’s ability to obtain additional financing; the success and timing of InSite’s preclinical studies and clinical trials; regulatory developments in the United States and foreign countries; the performance of third‐party manufacturers; changes in InSite’s plans to develop and commercialize its product candidates; InSite’s ability to obtain and maintain intellectual property protection for its product candidates; and the loss of key scientific or management personnel. These and other risks and uncertainties are described more fully in InSite’s most recently filed SEC documents, including its Annual Report on Form 10‐K and Quarterly Reports on Form 10‐Q, including those factors discussed under the caption “Risk Factors” in such filings. All forward‐looking statements contained in this presentation speak only as of the date on which they were made. InSite undertakes no obligation to update such statements to reflect events that occur or circumstances that exist after the date on which they were made.
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Our Approach: Novel Products, Reduced Risk, Efficient Development
DuraSite®: Polymer drug delivery technology• Increases efficacy• Improves dosing and compliance• New DuraSite® 2 – Improved delivery & long patent life
Low safety and regulatory risks • FDA approved technology• Combine with known agents
Shorter development timelines• Target indications with high unmet need• Leverage existing data on platform and products
Reduced development costs
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Undervalued Company with Strong Focus and Investment Fundamentals
Two partnered commercial products• Merck ‐ AzaSite• Bausch & Lomb ‐ Besivance
BromSite (ISV‐303): Positive 1st Phase 3 study results (p< 0.001) & Confirmatory Phase 3 study enrolling/ongoing
Two additional Phase 3 product candidates:• AzaSite Plus™ & DexaSite™: 1st Phase 3 study completed• Results anticipated end‐Q2
Potential new & improved DuraSite 2 platform technology
Multiple partnering opportunities• Own global rights to all three Phase 3 products & Phase I/2 product• DuraSite 2: Potential platform for new industry standard
Management team focus on execution
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InSite Vision’s Pipeline
Research Preclinical Phase 1 Phase 2 Phase 3 Filed Marketed
Lice
nsed
AzaSite®
Bacterial conjunctivitis(azithromycin ophthalmic solution 1%)
Besivance®
Bacterial conjunctivitis(besifloxacin ophthalmic suspension 0.6%)
Dev
elop
men
t
AzaSite Plus™ (ISV-502)Blepharitis(azithromycin + dexamethasone)
DexaSite™ (ISV-305)Blepharitis(dexamethasone)
BromSite™ (ISV-303)Post-op inflammation(bromfenac)
ISV-101Dry eye(low concentration bromfenac)
AzaSite® Xtra™
Infection treatment & prevention(azithromycin ophthalmic solution 2%)
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AzaSite® in North America Opportunity
Partner: Merck (via 2011 acquisition of Inspire Pharmaceuticals)• Approved in U.S. & Canada for bacterial conjunctivitis
25% North American royalty• 2013 minimum royalty guarantee: $19M
$4.75 payment for each quarter in 2013
• Includes AzaSite Xtra (2% azithromycin) @ 25% royalty• Royalty services non‐recourse debt
Patent protection• AzaSite: Issued IP to March 2019• AzaSite Xtra: Issued IP to October 2027
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Besivance® Opportunity
Partner: Bausch & Lomb
Approved in U.S. for bacterial conjunctivitis• Launched in mid‐2009 in U.S.• Asia/Latin America/ROW launches in 2011 • Additional filings during 2012
“Besivance Global Commercialization” ongoing
Patent protection to 2021
Royalty monetized in early April• $15M upfront• Additional $1M milestone potential based on 2013 sales targets• Potential to recapture portion/entire royalty after specified returns
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BromSite: Positive Phase 3 Study Results
1st Phase 3 Study results announced 3/18/13• Same primary & secondary endpoints as 2010 Phase 1/2 Study• BID dosing: will support large volume bottle to market
RN=268
BromSite BID N=180
DuraSite (vehicle) BIDN= 88
Primary Endpoint Secondary EndpointsReduction of inflammation, as measured by the absence of cells in anterior chamber of the eye at Day 15
Reduction of: • Pain• Others
All statistically significant
superiority @ Days 1, 8, & 15
65.6%
27.3%
p< 0.001
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Positive Phase 3 Results Confirm BromSite’s Efficacy & Safety Profile Following Strong Phase 1/2 Data
Phase 1/2 design evaluated BromSite administered once‐and twice‐daily against ISTA’s Xibrom™ and DuraSite
RN=169
53.3%
19.0%
p=0.0024
53.3%
42.9%
25%-58% less active drug/API
BromSite (BID)
BromSite (QD)
XiBrom (BID)
DuraSite (BID)
All statistically significant
superiority @ Days 8, 15 & 29
Primary Endpoint Secondary EndpointsReduction of inflammation, as measured by the absence of cells in anterior chamber of the eye at Day 15
Reduction of: • Flare • Pain & discomfort from inflammation • Others
52.5% 52.5%
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Positive Phase 3 Results Confirm BromSite’sCompetitive Positioning vs. NSAID Market Leader
Phase 2 pharmacokinetic study designed to evaluated BromSite against B&L’s Bromday™ (NSAID market leader)• Comparison of mean aqueous humor concentrations of bromfenac for the 2 treatment arms following only 3 QD doses
Study Design & AnalysisRandomizedDouble‐blindMulti‐center (N=3)Patients dosed QD• Day ‐2 & ‐1 pre‐surgery• Day 0 of surgery100‐200 µl fluid extractedHPLC‐MS analysis
RN=58
BromSite QD(0.075% bromfenac in DuraSite)
Bromday QD(0.09% bromfenac)
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BromSite, formulated with 25% less bromfenac, achieves>2x the tissue concentration in the eye vs. Bromday• Head‐to‐head QD dosing• Demonstrated superiority over NSAID market leader• Potential benefits in avoiding cystoid macular edema (CME), a potentially serious adverse event post‐surgery
P=0.0032RN=58
BromSite QD(0.075% bromfenac in DuraSite)
Bromday QD(0.09% bromfenac)
Mean concentrations of bromfenac in the aqueous humor Measured ~3 hours after last dose
Positive Phase 3 Results Confirm BromSite’sCompetitive Position vs. NSAID Market Leader
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BromSite in Post‐cataract Surgery: An Attractive & Growing Global Commercial Opportunity
B&L’s Bromday is the U.S. NSAID category market leader• ISTA revenue of approximately $80M (pre‐2012 B&L merger)• 3 million+ cataract surgeries performed annually• “Baby boomer” cataract surgery growth coming (National Eye Institute)
68.3% prevalence: aged 80+ 42.8% prevalence: aged 70‐79
2012 European NSAID segment • EU5 approximates €30M/$39M (44‐48% of total)• Rest of Europe, Middle East, Africa is another €30M/$39M
Japan/Asia‐Pacific – quantifying now
Cataract surgery procedures (World Health Organization)• Estimated 2010: 20 million• Estimated 2020: 32 million
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BromSite Phase 3 Program: Summary
1st Positive Phase 3 Study: Announced 3/18/13• Full data to be introduced at future peer‐reviewed forum
Confirmatory Phase 3 Study: Enrolling• Same primary endpoint • Same CRO (enrolled 1st Phase 3 Study in 4 months)• Target: 15 Sites• Additional secondary pain prevention & treatment endpoints (recent European regulatory inputs)
• Slightly different EU vs. FDA statistical analysis plan (SAP)to pursue differentiated labeling
Clinical packages aligned to fulfill regulatory requirements in North American, Europe and other markets (ex‐Asia‐Pacific)
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Goal: more patients to 100% inflammation free at Day 15
The Emerging Competitive Profile: BromSite™
Bromday Vehicle P-value Prolensa Vehicle P-Value Prolensa Vehicle P-Value BromSite Vehicle P-Value
n=230 n=225 n=112 n=108 n=110 n=110 n=180 n=88
46.1% 26.2% <0.0001 45.5% 13.0% <0.0001 45.5% 27.3% <0.0001 65.6% 27.3% <0.001
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Goal: more patients to 100% inflammation free at Day 15
The Emerging Competitive Profile: BromSite™
Bromday Vehicle P-value Prolensa Vehicle P-Value Prolensa Vehicle P-Value BromSite Vehicle P-Value
n=230 n=225 n=112 n=108 n=110 n=110 n=180 n=88
46.1% 26.2% <0.0001 45.5% 13.0% <0.0001 45.5% 27.3% <0.0001 65.6% 27.3% <0.001
46.1% 45.5%45.1%Bromday Prolensa Prolensa
No improvement in patient outcome
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Goal: more patients to 100% inflammation free at Day 15
The Emerging Competitive Profile: BromSite™
Bromday Vehicle P-value Prolensa Vehicle P-Value Prolensa Vehicle P-Value BromSite Vehicle P-Value
n=230 n=225 n=112 n=108 n=110 n=110 n=180 n=88
46.1% 26.2% <0.0001 45.5% 13.0% <0.0001 45.5% 27.3% <0.0001 65.6% 27.3% <0.001
46.1% 65.6%45.5%45.1%Bromday Prolensa Prolensa BromSite
BromSite: 44% improvement in patient outcome
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Low dose formulation of bromfenac (0.075%) in DuraSite
Rapid/efficient clinical development• IND filed July 2010• Strong Phase 1/2 clinical study results: March 2011• Superior PK performance vs. ISTA’s Bromday: October 2011• 1st Phase 3 Study enrolled: August – November 2012• EU Regulatory positioning: 2H 2012• Positive 1st Phase 3 Study results: March 2013• Confirmatory Phase 3 study enrolling: May 9th
Potential IND to NDA timeline: 4 years
Strong emerging competitive profile
Anticipate exclusivity into 2029 based on 2009 filings
BromSite™ (ISV‐303) for Reduction of Inflammation and Pain Post‐Cataract Surgery: Summary
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Blepharitis: Acute and/or Chronic Inflammation of the Eyelids
Blepharitis (also known as Lid Margin Disease)
Image Source: WebMD.com
Signs & Symptoms
• Redness• Flaking skin• Crusting• Cysts• Irritation
• Gritty sensation• Itching• Vision impairment• Discomfort
Possible Causes
• Bacteria• Viruses• Allergy• Environmental conditions• Systemic disease
Prevalence
• Estimated 34 million people in the U.S. alone
• Widely considered bothunder-diagnosed and misdiagnosed
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Blepharitis: Global Landscape Overview
No approved agents
Clear market need• Ophthalmologists see worst patients; many “silent sufferers”
Off‐label prescribing by ophthalmologists• Scant reimbursement; patients pay out‐of‐pocket
High FDA hurdle: traditional endpoint• Onerous in chronic settings of inflammation/infection (blepharitis)
Industry “Holy Grail”: front‐of‐eye focus
Classic first‐to‐market opportunity• Only company in Phase 3 development with FDA special protocol assessment (SPA) in place
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InSite Vision’s pursuit of the first approved agent for the treatment of blepharitis
2008 Phase 3 study: blepharoconjunctivitis• AzaSite Plus vs. AzaSite vs. DexaSite
2011 FDA Special Protocol Assessment (SPA) designation on new Phase 3 DOUBle study• AzaSite Plus vs. AzaSite vs. DexaSite• DexaSite vs. DuraSite• New recurrence endpoint, digital photography, scoring system• Patient Quality of Life instrument inclusion
2012 European Health Authority Meetings• 2008 results & DOUBle study design
DOUBle results anticipated by end‐Q2
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The InSite Vision Blepharitis Opportunity
Classic first‐to‐market advantage
Potential for broad payor strategy, reimbursement, promotion and use upon approval
Special protocol assessment (SPA) discussions/agreement reveal FDA interest in an approved blepharitis drug • Well aware of acute vs. chronic disease endpoint issue• Clearly understand reality of ophthalmology clinical practice• Hands‐on approach to DOUBle study protocol
Two InSite “pipeline shots on goal”• AzaSite Plus needs superiority over AzaSite and DexaSite• DexaSite needs only be superior to DuraSite (vehicle)
Third potential “BD shot on goal” with AzaSite vs. Vehicle• Potential 1st positive Phase 3 to support AzaSite blepharitis NDA path• Merck owns no rights to these data
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AzaSite Plus and DexaSite:Substantial Market Opportunities
Assuming moderate market penetration and current pricing of drugs prescribed for blepharitis, possible sales ranges are:• AzaSite Plus $500M to $1B
[Based on 10% at $120/prescription]• DexaSite $200M to $400M
[Based on 5% at $90/prescription]• AzaSite We haven’t examined possible $ effects of a
positive outcome for AzaSite via this study
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R&D Pipeline – What’s Next?
ISV‐101: Bromfenac solution in DuraSite• IND filed and Phase 1/2 study planned following results of Phase 3 programs
AzaSite Xtra™ (ISV‐405): Azithromycin (2.0%) solution in DuraSite• “Double strength” AzaSite with issued global IP through end‐2027• Completed all formulation/stability data and all GLP toxicology work to support
global IND and/or IND‐equivalent filings
ISV‐102: Tetracycline‐based solution in DuraSite• Completed formulation/stability studies• Potential therapy for the treatment of ocular infections
DuraSite 2
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IP/Legal Update
UCSF Patent Interference Case: Federal District Court of Appeals ruling on March 26th affirms the prior USPTO ruling in favor of InSite Vision’s inventorship/ownership• This case is now closed; we won
Sandoz paragraph IV/ANDA case vs. Sandoz• Merck’s case; InSite monitoring role• Early July 2013 trial date: confirmed
Accelerating our focus: ongoing IP prosecution• DexaSite & BromSite patents• DuraSite 2 patent
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DuraSite 2 ‐ Novel New Platform Technology
March 2009 filingBroad coverage claiming:
antibioticsantifungalsantineoplasticssteroidsnonsteroidals (NSAID)antiallergicsglaucoma-treating agentsantiviralsanesthetic agentanti-angiogenic agentsnamed disease (AMD), othersand combinations of the above
Potential 2029+ platform exclusivity
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DuraSite 2: Landmark Data Presented at ARVO
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DuraSite 2: Just how much better could it be?
Treatment Cmax (± SD) Tmax AUC0.25-24 h Fold Increase versus Acular LS(ng/mL) (h) (ng/mL*h) Cmax (ng/mL) AUC0.25-24 h (ng/mL*h)
ISV-304 (0.2%)-DuraSite 801 (± 205) 0.5 3241 2.9 2.3
ISV-304 (0.4%)-DuraSite 1212 (± 435) 0.5 5684 4.4 4.0
ISV-304 (0.2%)-DuraSite 2 1077 (± 415) 2 4490 3.9 3.2
ISV-304 (0.4%)-DuraSite 2 1889 (± 884) 2 6836 6.9 4.8
Acular LS 275 (± 83) 1 1424 - -
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DuraSite 2: Just how much better could it be?
Treatment Cmax (± SD) Tmax AUC0.25-24 h Fold Increase versus Acular LS(ng/mL) (h) (ng/mL*h) Cmax (ng/mL) AUC0.25-24 h (ng/mL*h)
ISV-304 (0.2%)-DuraSite 801 (± 205) 0.5 3241 2.9 2.3
ISV-304 (0.4%)-DuraSite 1212 (± 435) 0.5 5684 4.4 4.0
ISV-304 (0.2%)-DuraSite 2 1077 (± 415) 2 4490 3.9 3.2
ISV-304 (0.4%)-DuraSite 2 1889 (± 884) 2 6836 6.9 4.8
Acular LS 275 (± 83) 1 1424 - -
2.9 2.34.4 4.0
~2-4 fold improvement with DuraSite
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DuraSite 2: Just how much better could it be?
Treatment Cmax (± SD) Tmax AUC0.25-24 h Fold Increase versus Acular LS(ng/mL) (h) (ng/mL*h) Cmax (ng/mL) AUC0.25-24 h (ng/mL*h)
ISV-304 (0.2%)-DuraSite 801 (± 205) 0.5 3241 2.9 2.3
ISV-304 (0.4%)-DuraSite 1212 (± 435) 0.5 5684 4.4 4.0
ISV-304 (0.2%)-DuraSite 2 1077 (± 415) 2 4490 3.9 3.2
ISV-304 (0.4%)-DuraSite 2 1889 (± 884) 2 6836 6.9 4.8
Acular LS 275 (± 83) 1 1424 - -
3.9 3.26.9 4.8
~3-7 fold improvement with DuraSite 2
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Undervalued Company with Strong Focus and Investment Fundamentals
Two partnered commercial products• Merck ‐ AzaSite• Bausch & Lomb ‐ Besivance
BromSite (ISV‐303): Positive 1st Phase 3 study results (p< 0.001) & Confirmatory Phase 3 study enrolling/ongoing
Two additional Phase 3 product candidates:• AzaSite Plus™ & DexaSite™: 1st Phase 3 study completed• Results anticipated end‐Q2
Potential new & improved DuraSite 2 platform technology
Multiple partnering opportunities• Own global rights to all three Phase 3 products & Phase I/2 product• DuraSite 2: Potential platform for new industry standard
Management team focus on execution
Thank you
www.insitevision.com