bristol myerd squibb American Diabetes Association (ADA) Highlights

1Not For Promotional Use

ADA 2008 Highlights*ADA 2008 Highlights*

Investor TeleconferenceJune 11, 2008

*American Diabetes AssociationJune 6 – June 10, 2008


Fred Fiedorek, MDVice President, Global Clinical Research


Roland Chen, MDGroup Director, Global Clinical Research



Comments will be about the CompanyComments will be about the Company’’s future plans and s future plans and prospects that may be forwardprospects that may be forward--looking statements under looking statements under thethe Private Securities Litigation Reform Act of 1995.Private Securities Litigation Reform Act of 1995.We caution that actual results may differ materially from We caution that actual results may differ materially from those indicated by these forwardthose indicated by these forward--looking statements aslooking statements asa result of various important factors, including those a result of various important factors, including those discussed in the Companydiscussed in the Company’’s most recent annual report on s most recent annual report on Form 10Form 10--K, periodic reports on Form 10K, periodic reports on Form 10--Q and current Q and current reports on Form 8reports on Form 8--K. These documents are available from K. These documents are available from the SEC, the Bristolthe SEC, the Bristol--Myers Squibb web site or fromMyers Squibb web site or fromBristolBristol--Myers Squibb Investor Relations. While we may elect Myers Squibb Investor Relations. While we may elect to update forwardto update forward--looking statements at some point in the looking statements at some point in the future, we specifically disclaim any obligation to do so,future, we specifically disclaim any obligation to do so,even if our estimates change. even if our estimates change.


Diabetes: A Growing, Global ProblemDiabetes: A Growing, Global Problem

Source: WHOSource: WHO

Type 2 Diabetes prevalence expected to grow Type 2 Diabetes prevalence expected to grow from 190 million to 330 million by 2030from 190 million to 330 million by 20305050--70% of patients are not controlled70% of patients are not controlled

3

Mexico Mexico –– highest highest prevalence rates in prevalence rates in

the world: 12.4%the world: 12.4%India and China will make up India and China will make up

nearly 50% of the total nearly 50% of the total number of patients with number of patients with

diabetes in 2030diabetes in 2030

Europe prevalence is Europe prevalence is lower (~4.6%), but lower (~4.6%), but

increasing, especially in increasing, especially in the southern countriesthe southern countries

Diabetes growing rapidly Diabetes growing rapidly in U.S. in U.S. –– current current

prevalence rate 6.7%prevalence rate 6.7%

NOT FOR PROMOTIONAL USE


Majority of Patients Are Not Optimally Majority of Patients Are Not Optimally ControlledControlled

Source: Adelphi, 2006 Disease SpecificProgrammes, NHWS 2006

6469

5851

6257

0

20

40

60

80

100Pa

tient

s (%

)60% of

US diabetic patients

do not know their A1c or FPG values

Lack of involvement / motivation / compliance / knowledge leads to progression of disease, with nearly 2/3 of patients not controlled

USUS UKUK FRFR GERGER ITLITL SPNSPN

Percentage of patients not controlled,Percentage of patients not controlled,by market (relative to HbA1c target of 7.0%) by market (relative to HbA1c target of 7.0%)


The Progressive Nature of Type 2 Diabetes The Progressive Nature of Type 2 Diabetes Ultimately Overwhelms MedicationsUltimately Overwhelms Medications

Glycemic Control in an Illustrative Patient

HbA

1c Goal*A1c=<7Goal*Goal*

A1c=<7A1c=<7

Normal***A1c=5%

Normal***Normal***A1c=5%A1c=5%

Goal**A1c=<6.5

Goal**Goal**A1c=<6.5A1c=<6.5

5yrs

~30 Years~30 Years

Slope =

0.75% per 5

yrs.

Potential Potential treatment treatment changechange

FirstAgent

Sources: ADOPT, UKPDS(*) According to the ADA; (**) according to the AACE/ACE; (***) according to the NIH


Pharmacologic Intervention in DiabetesPharmacologic Intervention in Diabetes

Several different classes of oral antidiabetic agents are Several different classes of oral antidiabetic agents are availableavailable

Most agents fail after 3Most agents fail after 3--5 years; the current paradigm is 5 years; the current paradigm is one of adding a new treatment to an existing regimenone of adding a new treatment to an existing regimen

Some patients do not even reach the 3Some patients do not even reach the 3--5 year time to fail 5 year time to fail point because of adverse events or poor tolerancepoint because of adverse events or poor tolerance

The market is and continues to be an addThe market is and continues to be an add--on marketon market

New classes have an important place in overall New classes have an important place in overall managementmanagement

There remains a need for new therapiesThere remains a need for new therapies


Site of Action of Oral Antidiabetic AgentsSite of Action of Oral Antidiabetic Agents

HyperglycemiaHyperglycemia

Increased glucoseIncreased glucoseproductionproduction

Reduced glucose uptake Reduced glucose uptake and utilizationand utilization

Carbohydrate Carbohydrate LoadLoad

Impaired Insulin Secretion

PancreasPancreas

LiverLiver

Skeletal Skeletal MuscleMuscle

MetforminMetforminThiazolidinedionesThiazolidinediones

MetforminMetforminThiazolidinedionesThiazolidinediones

DPPDPP--4 inhibitors4 inhibitors

SulfonylureasSulfonylureasDPPDPP--4 inhibitors4 inhibitors

SGLT2 inhibitorsSGLT2 inhibitors

KidneyKidneyGlucose Glucose reabsorptionreabsorption


Unmet Medical Needs Still RemainUnmet Medical Needs Still Remain

Optimal glycemic control on treatmentOptimal glycemic control on treatmentSustainable A1c reduction/glycemic Sustainable A1c reduction/glycemic efficacyefficacyConcurrent weight management Concurrent weight management Delaying or halting disease progressionDelaying or halting disease progressionImproving patient complianceImproving patient complianceFinding additional therapies that are Finding additional therapies that are efficacious, well tolerated and safeefficacious, well tolerated and safe


ADA Highlights: BristolADA Highlights: Bristol--Myers SquibbMyers Squibb

Key data presented for twoKey data presented for two--late stage pipeline late stage pipeline compounds in collaboration with AstraZeneca:compounds in collaboration with AstraZeneca:

Saxagliptin Phase 3 monotherapy study: Saxagliptin Phase 3 monotherapy study: Produced significant reductions in HbA1c, FPG, Produced significant reductions in HbA1c, FPG, PPG PPG

Dapagliflozin Phase 2B study: Reductions in all Dapagliflozin Phase 2B study: Reductions in all measures of glycemic control with addition of measures of glycemic control with addition of weight lossweight loss


Saxagliptin OverviewSaxagliptin Overview

Highly potent and selective DPPHighly potent and selective DPP--4 inhibitor4 inhibitor

Completed Phase 3 registrational programCompleted Phase 3 registrational program

Well toleratedWell tolerated

Produced significant reductions in all key Produced significant reductions in all key measures of glucose controlmeasures of glucose control

On track for midOn track for mid--year submissionyear submission


Patient Exposures Throughout Patient Exposures Throughout Saxagliptin ProgramSaxagliptin Program

Phase 1 and 2Phase 1 and 2~110 subjects exposed to saxagliptin at 20~110 subjects exposed to saxagliptin at 20--80x the80x the5 mg dose for up to 6 weeks5 mg dose for up to 6 weeks~670 subjects exposed to saxagliptin at 2~670 subjects exposed to saxagliptin at 2--10x the10x the5 mg dose for up to 12 weeks5 mg dose for up to 12 weeks

Phase 3 Phase 3 ~1000 patients treated at 10 mg dose for up to 2 years~1000 patients treated at 10 mg dose for up to 2 years>3000 patients treated at any dose in Phase 3>3000 patients treated at any dose in Phase 3

Clinical correlates to the skin lesions in monkeys have Clinical correlates to the skin lesions in monkeys have not been identified in human clinical trials of saxagliptinnot been identified in human clinical trials of saxagliptin


Previously Disclosed Saxagliptin DataPreviously Disclosed Saxagliptin Data

Pharmacokinetics and safetyPharmacokinetics and safety2.5 to 400 mg2.5 to 400 mgNo identified clinically meaningful drug interactionsNo identified clinically meaningful drug interactionsNo dose adjustment required with hepatic impairmentNo dose adjustment required with hepatic impairmentMay be administered without regard to age or genderMay be administered without regard to age or gender

Phase 2 data recently publishedPhase 2 data recently publishedDiabetes Obesity MetabolismDiabetes Obesity Metabolism 2008; 10: 3762008; 10: 376--386386

Phase 3 addPhase 3 add--on to metformin study presented aton to metformin study presented atADA 2007ADA 2007


Saxagliptin AddSaxagliptin Add--On to Metformin:On to Metformin:Significant HbA1c Reductions From BaselineSignificant HbA1c Reductions From Baseline

**PP values vs placebo + MET: values vs placebo + MET: PP<0.0001<0.0001..Bars indicate 95% twoBars indicate 95% two--sided confidence interval.sided confidence interval.

Adjusted Change From BaselineDifference in Adjusted Change FromBaseline vs Placebo + MET

PBO + MET PBO + MET (N = 175)(N = 175)

SAXA 2.5 mgSAXA 2.5 mg+ MET+ MET

(N = 186)(N = 186)

SAXA 5 mgSAXA 5 mg+ MET + MET

(N = 186)(N = 186)

SAXA 10 mgSAXA 10 mg+ MET+ MET

(N = 180)(N = 180)

%%

*--11* *--0.80.8

--0.60.6

--0.40.4

--0.20.2

00

0.20.2

0.40.4

--0.730.73 --0.720.72--0.830.83

Phase 3 Study Phase 3 Study --014, ADA June 2007014, ADA June 2007


Saxagliptin Monotherapy Study Design: Saxagliptin Monotherapy Study Design: ADA 2008ADA 2008

N = 401 Treatment-Naïve T2DM

N = 66 Treatment-Naïve T2DM

A1c7.0-10.0% to Enroll

2.5 mg Saxa QD*

A1c10.0-12.0%

PBO*

5 mg Saxa QD*

10 mg Saxa QD*

10 mg Saxa QD*

24 Weeks

*If rescue criteria met in ST, add Metformin 500*If rescue criteria met in ST, add Metformin 500--2000 mg total daily dose, enter LT phase; Metformin rescue also 2000 mg total daily dose, enter LT phase; Metformin rescue also available in LT extension (42 weeks)available in LT extension (42 weeks)

42 Months

Metformin 500 mg QD* (PBO if enter LT via rescue)

2.5 mg Saxa QD*

5 mg Saxa QD*

10 mg Saxa QD*

10 mg Saxa QD*

SuperioritySuperiority



2 Week

PBO Lead In



Significant Reductions in HbA1c, FPG, PPGSignificant Reductions in HbA1c, FPG, PPGFrom Baseline at Week 24 From Baseline at Week 24

A1cA1c((%)%)

Fasting Plasma GlucoseFasting Plasma Glucose(mg/dL)(mg/dL)

Postprandial GlucosePostprandial Glucose(mg(mg minmin/dL)/dL)

Saxagliptin + MetSaxagliptin + Met

PBO + MetPBO + Met2.5 mg2.5 mg 5 mg5 mg 10 mg10 mg

-0.43 -0.46-0.54

0.19

-1.0

-0.8

-0.6

-0.4

-0.2

0.0

0.2

0.4

0.6

-14.53

-8.67

-16.75

6.06

-25.0

-20.0

-15.0

-10.0

-5.0

0.0

5.0

10.0

15.0

20.0

-6868 -6896

-8084

-646.6

-12000

-10000

-8000

-6000

-4000

-2000

0

2000



PBOMain Cohort

N=95

Saxagliptin Main Cohort

N=306

SaxagliptinOpen-Label

Cohort N=66

Total patients with AEs (%) 68 (71.6) 231 (75.5) 40 (60.6)

Upper respiratory tract infection

11 (11.6) 27 (8.8) 6 (9.1)

Headache 7 (7.4) 25 (8.2) 5 (7.6)

Urinary tract infection 4 (4.2) 21 (6.9) 3 (4.5)

Nasopharyngitis 6 (6.3) 18 (5.9) 3 (4.5)

Sinusitis 3 (3.2) 17 (5.6) 1 (1.5)

Most Common (Most Common (≥≥5%) Adverse Events 5%) Adverse Events Reported In The Main CohortReported In The Main Cohort



Saxagliptin: WhatSaxagliptin: What’’s Next?s Next?

NDA submission by midNDA submission by mid--yearyear

Additional Phase 3 data planned for disclosure Additional Phase 3 data planned for disclosure at EASD in Septemberat EASD in September–– Combination studies with SU, TZDCombination studies with SU, TZD–– Initial combination therapy with metforminInitial combination therapy with metformin

Life cycle program underway Life cycle program underway


Dapagliflozin OverviewDapagliflozin Overview

First in a new class that inhibits renal glucose First in a new class that inhibits renal glucose reabsorption reabsorption

Stable CStable C--glucoside molecule that allowsglucoside molecule that allowsonceonce--daily dosingdaily dosing

In Phase 3 developmentIn Phase 3 development–– MonotherapyMonotherapy–– CombinationCombination


Effects of SGLT2 Inhibition on Renal Effects of SGLT2 Inhibition on Renal Glucose ReabsorptionGlucose Reabsorption

Intestine KidneyKidney

UrineUrinePlasmaPlasmaDiet

DapagliflozinDapagliflozin

GlucoseGlucoseSGLT1

SGLT1 SGLT2

Potential benefits of Potential benefits of selectiveselective SGLT2 inhibition:SGLT2 inhibition:InsulinInsulin--independent glucose loweringindependent glucose lowering

Loss of calories in urine, with potential for weight Loss of calories in urine, with potential for weight controlcontrol

GlucoseGlucose

GlucoseGlucose GlucoseGlucose GlucoseGlucose


At the ADA, data on dapagliflozin was presented from the At the ADA, data on dapagliflozin was presented from the largest and longest (12 weeks) trial of an SGLT2 Renal largest and longest (12 weeks) trial of an SGLT2 Renal Glucose Reabsorption Inhibitor to date. Results Glucose Reabsorption Inhibitor to date. Results demonstrated that dapagliflozin:demonstrated that dapagliflozin:

Induced controlled glucosuriaInduced controlled glucosuria

Improved glycemic controlImproved glycemic control-- Reduced fasting glucoseReduced fasting glucose-- Reduced postprandial glucoseReduced postprandial glucose-- Reduced HbA1cReduced HbA1c

Lowered weightLowered weight

Showed little propensity to cause hypoglycemiaShowed little propensity to cause hypoglycemia

Demonstrated no clear adverse safety or tolerability signals Demonstrated no clear adverse safety or tolerability signals over 12 weeksover 12 weeks

ADA 2008: Dapagliflozin ADA 2008: Dapagliflozin


Dapagliflozin Registrational ProgramDapagliflozin Registrational Program

Patient PopulationPatient Population Treatment TypesTreatment TypesTreatmentTreatment--NaNaïïveve Monotherapy vs. Monotherapy vs.

placeboplaceboInitial combination Initial combination with metforminwith metformin

AddAdd--on Therapyon TherapyTreatmentTreatment--Experienced Experienced (previous treatment (previous treatment failure)failure)

Versus placebo:Versus placebo:•• MetforminMetformin•• SulfonylureaSulfonylurea•• TZDTZD•• InsulinInsulin

Active control:Active control:•• SulfonylureaSulfonylurea•• Others under Others under

considerationconsideration


ADA 2008 Highlights*ADA 2008 Highlights*

Investor TeleconferenceJune 11, 2008







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