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Need to improve health care quality

Health care challenge – part two

• Population growth

• Ageing

• Chronic diseases

• Lifestyle diseases

• Increasing wealth

Global demand for healthcare is growing, strong industry fundamentals

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Need to control health care expenditure

0

1000

2000

3000

4000

5000

6000

1980 1990 2000 2010

Expenditure on health / capita, USDSource: OECD Health Data 2015

France

Germany

Netherlands

United Kingdom

Need to improve health care quality

LSP HEF

The big impact opportunity

Unique investment focus on products which both improve health care and reduce cost

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Focused investment criteria

19

Investment criteria

Highly innovative

products

Strong scientific

and clinical

rationale

Breakthrough

potential

Sustainable

competitive

advantages (IP &

technology)

Strong

management teams

Clear milestones

achievable within

1-4 years post first

investment

Validating

partnerships in

place or

achievable

M&A take out

potential

Our focus

Scope

Medtech eHealth

20% 70% 10%

Stage (at initial investment)

Regulatory approved Revenues

50% 50%

Geography

Europe Other

67% 33%

Strong health

economics case

Diagnostics

LSP HEF 1 : 112 mln EURO LSP HEF 2: 280 mln EURO

LSP HEALTH ECONOMICS FUND

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LSP HEF

Investment strategy

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LSP HEF

Medtech sector in numbers

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Major device areas (by sales 2016 in $bln):❖ In vitro diagnostics: 49.4❖ Cardiology: 44.67❖ Diagnostic imaging: 39.2❖ Orthopedics: 35.0

CAGR 2016-2022:❖ ww medtech sales: +5.1%❖ ww drug sales: + 5.2%

Worldwide medtech R&D spend:❖ 2010 : 21.2 $bln❖ 2017: 27.1 $bln❖ % medtech sales: ~6%

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LSP HEF 1

Portfolio

More than 1,500 opportunities – 10 investments

• Implant for mitral

valve repair

• Shorter surgery

time and better

patient outcome

• Fast diagnosis of

hospital infections

• Less mortality and

morbidity

• Minimally invasive

bone fracture repair

system

• Significantly faster

recovery

• Medication safety

system for hospitals

• Reduces mortality

• Device to retrieve

clot from brain of a

stroke patient

• Prevents severe

disabilities

• Shoulder tendon

repair system

enabling regrowth

of tissue

• Faster recovery

• Implantable pump

system to remove

excess body fluids

• Fewer hospital

readmissions

• User-friendly insulin

pump for diabetes

patients

• Improves compliance

• Large hole closure

device for vessels

• Shorter procedure

times and less

complications

• Artificial heart

valves allowing

tissue regrowth

• Reduces number of

surgeries

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LSP HEF 1

Impact on health care costs

The products have the potential to significantly decrease health care cost

* Although there are differences from country to country, indicative savings for other EU countries can be calculated by multiplying with the number of inhabitants per

country and dividing by 17 mln (annual savings for other countries have also been specifically calculated, but are not shown).

Company Potential annual saving (NL)* Potential extra savings

Cardiac Dimensions EUR 95 mln Further market penetration

Curetis EUR 50 mln Sepsis, gastro-intestinal infections

IlluminOss EUR 25 mln Load bearing bones

Mint Solutions EUR 60 mln Long term care facilities

Neuravi EUR 100 mln Extension of therapy time window

Rotation Medical EUR 2.5 mln Other type of tendon tears

Sequana Medical EUR 1 mln Congestive heart failure, cancer

ViCentra EUR 20 mln Better long term outcome

Vivasure Medical EUR 9 mln More minimally invasive procedures

Xeltis EUR 3 mln High pressure valves

TOTAL>EUR 350 mln(3x fund size)

Worldwide (> 10 bln €)Economic and societal impact

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2 Multi impact fund

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Sequana Medical

Smartly removing excess fluid

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Sequana Medical

Smartly removing excess fluid

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Paracentesis / Large Volume Paracentesis (LVP)

Dramatic impact on Quality of Life

Ascitic fluid leaks

Bleeding

Bowel perforation and infection

Mortality

Intensive use of healthcare resources

Transjugular Intrahepatic Portosystemic Shunt (TIPS)

Significant risk of hepatic encephalopathy

Risk of right sided heart failure

Adverse impact on liver function

Limited ability to adjust

Significant contraindications

Liver transplantation

Very limited availability

High costs

Ongoing need for immunosuppression

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Sequana Medical

Smartly removing excess fluid

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Virtually eliminates need for

paracentesis

Improves patient Quality of Life

Potentially increases survival

rates

Remote monitoring

capability with the ability to adjust / stop

therapy

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Sequana Medical

Smartly removing excess fluid

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<5 months((2 LVP/month)

<3 months(3 LVP/month)

Cost recovery with alfapump

<10 months(1 LVP/month)

one year cost savings

> EUR 80k (3 LVP/month)> EUR 40k (2 LVP/month)

Current Patient Data

• mean alfapump implant duration = 8.4 months

• mean LVP frequency prior to alfapump = 10 days

• Model uses German DRG data for paracentesis cost

• (LVP = Large Volume Paracentesis)

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Xeltis

Re-growing your own heart tissue

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Xeltis

Re-growing your own heart tissue

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Stroke: a sudden, life-changing event

• 17 million strokes worldwide each year

• Leading cause of disability and second-

leading global cause of death

• Clot-dissolving drugs only effective in the

event of early treatment

THE MEDICAL NEED THE COMPANY & THE PRODUCT

• Reduction in mortality rate

• Reduction in number of severe disabilities

IMPACT ON QUALITY OF CARE

• 36,500 cases in The Netherlands

• Annual cost of stroke victims estimated at € 2.3 bln

• EmboTrap reduces the costs of care for treating disabilties

HEALTH ECONOMICS

Neuravi (acquired by J&J in 2017)

At the leading edge of stroke therapy

Neuravi is commercializing a minimally-invasive device to mechanically

retrieve a clot from the brain of a stroke patient, thus removing the cause

of the stroke

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LSP HEF

Impact on patients

We support products that improve survival and quality of life

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‘I am really pleased,

as I can do

everything by myself

again. Hooray!’

‘I can move my left

arm again, I can still

play my musical

instrument – and I’m

really happy about

that.’

‘The MedEye

absolutely adds

value. A computer is

simply more constant

and more stable

than a human being.’

‘If this procedure

hadn’t been

developed, I’d be

bedridden the rest

of my life’

‘Since the pump was

implanted, my life

has changed

radically.’

‘Before, I always

stayed at home.

Now I lead a full

life. Everything is

going really well.’