First Quarter 2017 Earnings Teleconference April 27, 2017

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1 First Quarter 2017 Earnings Teleconference April 27, 2017

2 1Q17 Earnings Call Agenda Introduction CEO Opening Remarks Financial Update Commercial Highlights R&D Highlights CEO Closing Remarks Q&A Elena Ridloff, Investor Relations Ludwig Hantson, Chief Executive Officer Dave Anderson, Chief Financial Officer Carsten Thiel, Chief Commercial Officer Martin Mackay, Global Head of R&D Ludwig Hantson, Chief Executive Officer All 2

3 Forward-Looking Statements This presentation contains forward-looking statements, including statements related to guidance regarding anticipated financial results for 2017, assessment of Alexion s commercialization efforts, and commercial potential for Soliris, Strensiq and Kanuma, medical and commercial potential of each of Alexion's product candidates, launch expectations for Strensiq and Kanuma, and plans for regulatory filings and clinical programs for our product candidates. Forwardlooking statements are subject to factors that may cause Alexion's results and plans to differ from those expected, including for example, decisions of regulatory authorities regarding the adequacy of our research, marketing approval or material limitations on the marketing of our products, delays, interruptions or failures in the manufacture and supply of our products and our product candidates, failure to satisfactorily address matters raised by the FDA and other regulatory agencies, the possibility that results of clinical trials are not predictive of safety and efficacy results of our products in broader patient populations the possibility that current rates of adoption of Soliris in PNH, ahus or other diseases are not sustained, the possibility that clinical trials of our product candidates could be delayed, the adequacy of our pharmacovigilance and drug safety reporting processes, the risk that third party payors (including governmental agencies) will not reimburse or continue to reimburse for the use of our products at acceptable rates or at all, risks regarding government investigations, including investigations of Alexion by the SEC and DOJ, the risk that anticipated regulatory filings are delayed, the risk that estimates regarding the number of patients with PNH, ahus, HPP and LAL-D are inaccurate, the risks of shifting foreign exchange rates, and a variety of other risks set forth from time to time in Alexion's filings with the U.S. Securities and Exchange Commission, including but not limited to the risks discussed in Alexion's Annual Report on Form 10-K for the period ended December 31, 2016 and in our other filings with the U.S. Securities and Exchange Commission. Alexion does not intend to update any of these forward-looking statements to reflect events or circumstances after the date hereof, except when a duty arises under law. In addition to financial information prepared in accordance with U.S. GAAP, this presentation also contains non-gaap financial measures that we believe, when considered together with GAAP information, provide investors and management with supplemental information relating to operating performance, trends and prospects that promote a more complete understanding of our operating results and financial position during different periods. We typically exclude certain GAAP items that management does not believe affect our basic operations and that do not meet the GAAP definition of unusual or non-recurring items. Other companies may define these measures in different ways. Non-GAAP financial measures are not intended to be considered in isolation or as a substitute for, or superior to, the financial measures prepared and presented in accordance with GAAP and should be reviewed in conjunction with the relevant GAAP financial measures. Further information relevant to the interpretation of adjusted financial measures, and reconciliations of these adjusted financial measures to the most comparable measures, may be found in our first quarter 2017 financial results press release issued April 27,

4 CEO Opening Remarks Ludwig Hantson Chief Executive Officer

5 Initial Observations: First Month Strong, sustainable and growing business 3 transformative therapies Positioned for continued double-digit growth Opportunity to extend complement leadership with Soliris and ALXN1210 High performing employees committed to our mission and patient-centric culture Strong Business Fundamentals, Continued Momentum 5

6 Imperatives Guiding My Strategic Plan 1. Grow our rare disease business Grow and defend our leadership position in complement Strensiq key driver of growth Assess Kanuma strategy 2. Improve R&D productivity and pursue disciplined business development 3. Drive operational efficiencies to improve margins 4. Emphasize compliance and culture Strategy Update on 2Q Call 6

7 1Q17 Highlights 1Q17 Quarterly Performance 24% YoY $870M Total Revenue (1) 26% YoY Volume Growth (1) Revenue Growth (1) $1.38 Highlights Impressive 1Q17 performance Soliris : Strong execution across geographies Strensiq : Key driver of growth ALXN1210: Enrollment on track Key priorities on track $0.75 GAAP EPS (2) Non-GAAP EPS (2) 1Q Positions Us for a Strong 2017 (1) Includes a $29M benefit from the change in revenue recognition, excluding the benefit, total revenue was $841M, representing 20% revenue growth YoY and 22% volume growth YoY. (2) A reconciliation of our GAAP to non-gaap financial results is set forth in our first quarter 2017 financial results issued April 27,

8 Financial Update Dave Anderson Chief Financial Officer

9 CFO Highlights 1. Pleased with strong start to 2017, reaffirming FY revenue and raising EPS guidance 2. Continued growth of Soliris across geographies and strength with Strensiq 3. Total revenue of $841M, excluding $29M from change in revenue recognition 4. 1Q restructuring included in 2017 outlook and aligns with corporate priorities 5. Focused on double digit revenue growth, expanding operating margin, and accelerating EPS growth to deliver shareholder return 9

10 Summary of Revenue Recognition Change 1Q reported total revenue of $870M, included revenue recognition benefit of $29M ~$21M attributed to bulk orders in Latin America ~$8M due to deferred sales in other non-us markets Total revenue of $841M, excluding $29M from change in revenue recognition Strong operational growth: 20% revenue growth YoY and 22% volume growth YoY Expect potential quarter-to-quarter revenue variability to continue 10

11 Millions ($) Millions ($) 1Q17 Net Product Sales YoY Net Product Sales 1Q17 Net Product Sales Analysis 1, $ % $869 (1) +17% $ Q15 1Q16 1Q17 US Europe APAC ROW % -2% +24% 0% $869 (1) $700 1Q16 Price Volume FX 1Q17 (1) Includes a $29M benefit from the change in revenue recognition. Excluding the benefit, net product sales were $840M, representing 20% revenue growth YoY. 11

12 1Q17 Financial Highlights $ Millions, Except EPS 1Q17 GAAP (1) Non-GAAP (1) YoY Change Non-GAAP (1) Total Revenue $870 (2) $870 (2) +24% (2) Soliris Revenue $783 (2) $783 (2) +18% (2) Strensiq Revenue $74 $ % Kanuma Revenue $12 $ % R&D % of Total Revenue $219 25% $194 22% -24 bps SG&A % of Total Revenue $262 30% $226 26% -169 bps Operating Income $212 $ % Operating Margin 24% 44% +231 bps Earnings Per Share $0.75 $ % (1) A reconciliation of our GAAP to non-gaap financial results is set forth in our first quarter 2017 financial results issued April 27, (2) Includes a $29M benefit from the change in revenue recognition, excluding the benefit, total revenue was $841M, or 20% increase YoY and Soliris revenue was $754M, or 14% increase YoY. 12

13 FY2017 Revenue Range Low End High End $3,400M USD appreciation Increased macroeconomic weakness in emerging markets Total Revenue USD depreciation Favorable emerging market macroeconomic environment $3,500M $3,025M Timing and geographic mix of ALXN1210 and other trial enrollment Soliris Increased patient identification Timing and geographic mix of ALXN1210 and other trial enrollment Favorable LATAM orders $3,100M $375M Timing of country launches More HPP patient initiations Accelerated LAL-D patient identification Metabolic $400M 12% Revenue Growth at Mid-Point of Guidance, 17% Excluding ALXN1210 and Fx Impact 13

14 FY2017 Updated Outlook 2017 Financial Guidance Key Assumptions $ Millions, Except EPS GAAP Guidance (1) Non-GAAP YoY Growth (2) Guidance (1) (Non-GAAP) Total Revenue $3,400 to $3,500 $3,400 to $3, % Soliris Revenue $3,025 to $3,100 $3,025 to $3,100 +8% Metabolic Revenue $375 to $400 $375 to $ % R&D % of Total Revenue SG&A % of Total Revenue 24% - 26% 22% - 23% +10 bps 28% - 30% 25% - 26% -140 bps Operating Margin 25% - 28% 43% - 44% +40 bps Earnings Per Share $ $3.20 $ $ % FX: Headwinds of $50-$60M Soliris: Identify a consistent number of new patients with PNH and ahus $70M to $110M headwind due to ALXN1210 and other trial recruitment Latin America similar to 4Q16 run-rate Metabolic: Continued new patient identification Additional country launches HPP: Consistent patient additions; reduced revenue per patient Revenue and Operating Margin on Track, EPS Guidance Increased (1) A reconciliation of our GAAP to non-gaap financial results is set forth in our first quarter 2017 financial results issued April 27, (2) YoY growth based on mid-point of guidance range. 14

15 2Q and 2H 2017 Outlook 2Q17 Expectation Total Soliris revenues down sequentially: 1Q revenue recognition change and LATAM orders ALXN1210 enrollment impact Operating margin below FY guidance High single-digit EPS growth YoY 2H17 Expectation Revenue in proportion with full year guidance Increased ALXN1210 enrollment impact Operating margin in-line with FY guidance EPS in-line with full year guidance Qualitative forecast based on current expectations for Soliris bulk orders in certain non-us markets. Timing and size of these orders may be materially different than our expectations. 15

16 Commercial Highlights Carsten Thiel Chief Commercial Officer

17 PNH: Consistent Identification of New Patients Annual Newly Identified Patients with PNH in Core Markets (1) Focus to Reach More Patients Continue to identify and serve a steady number of new patients E Global PNH Patients on Therapy (2) Expect continued treatment interruptions and delays in new patient starts in LATAM Continue to see majority of patients starting on Soliris are also newly diagnosed Majority of patients with PNH have yet to initiate treatment E (3) (1) Core markets of US, Europe and Japan; (2) 2017E based on 1Q17 run rate (3) 2017E based on full year forecast for PNH patients on Soliris and the estimated enrollment of PNH patients in the ALXN1210 studies. 17

18 Opportunity to Serve Even More Patients with ahus Global Patients Actively Treated with Soliris Matched for Time* US Patients on Soliris Ex-US Patients on Soliris Focus to Reach More Patients Growing number of new patients starting on Soliris PNH ahus PNH ahus *US: 22 quarters from approval; PNH as of Q3 2012; ahus as of Q Ex-US: 21 quarters from approval; PNH as of Q3 2012; ahus as of Q Global ahus Patients on Therapy Number of ahus patients being treated in the US, Spain and Turkey has now surpassed PNH Opportunity to serve patients with ahus is larger than PNH E (1) 2017E based on full year forecast for ahus patients on Soliris and the estimated enrollment of ahus patients in the ALXN1210 studies. (1) 18

19 Preparing to Serve Patients with Refractory gmg If approved, Soliris would be the first and only therapy to treat patients with refractory gmg Focusing on identified refractory patient population Refractory patients represent ~10% of the total MG population Patients continue to suffer from inability to walk, talk, breathe, or eat normally 19

20 Continue to Advance Leadership in Complement Continue to Penetrate Existing Markets Expand to New Indications Drive Continued Innovation Expand Patent Position Continued opportunity ahead in PNH and ahus Majority of growth still ahead Commercial, clinical operations, and regulatory capabilities to support future growth Soliris gmg: Regulatory submissions filed in the US, EU, and Japan Eculizumab NMOSD: Registration trial progressing ALXN1210: Phase 3 studies underway in PNH and ahus ALXN1210 Subcutaneous: New route of administration; Phase 1 enrollment complete Offer physicians and patients optionality Soliris CoM patent in the US and key EU countries through 2021/2020 Continue to file additional patents to expand and strengthen global Soliris IP ALXN1210 CoM patent in the US and EU through

21 Transforming the Lives of Patients with LAL-D Total Kanuma Revenue MIILLIONS ($) $11 $12 $9 $6 2Q16 3Q16 4Q16 1Q17 Focus to Reach More Patients Assessing strategy to drive an increase in testing to improve diagnosis and treatment of LAL-D Launch continues in the US, Germany, and Japan Additional country launches expected in 2017 Global LAL-D Patients on Therapy 2Q16 3Q16 4Q16 1Q17 21

22 MIILLIONS ($) Continued New HPP Patient Identification Total Strensiq Revenue $71 $74 $61 $45 2Q16 3Q16 4Q16 1Q17 Focus to Reach More Patients Identified consistent number of new patients Seeing shift in newly identified patients to younger children with HPP and expect this trend to continue Additional country launches expected in 2017 Global HPP Patients on Therapy Significant progress with NICE and NHS England Expect Strensiq to be a strong additional driver of growth 2Q16 3Q16 4Q16 1Q17 22

23 Commercial Highlights Strong 1Q results Continued growth of Soliris across geographies Strong uptake of Strensiq Positioned to deliver continued growth 23

24 R&D Highlights Martin Mackay Global Head of R&D

25 Pipeline PRECLINICAL EARLY CLINICAL DEVELOPMENT ADVANCED CLINICAL DEVELOPMENT REGISTRATION MARKETED Other Complement (4) ALXN1210 SC Eculizumab NMOSD Soliris gmg Soliris PNH ALXN1630 mrna CN-1 Samalizumab Solid Tumors Eculizumab AMR Soliris ahus Other Metabolic (3) Samalizumab AML* ALXN1210 PNH Strensiq HPP mrna Therapies (7) ALXN1210 ahus Kanuma LAL-D Other Preclinical (2) ALXN1101 MoCD Type A Complement Metabolic Immuno-Oncology Other *Part of the Leukemia and Lymphoma Society BEAT AML Master study 25

26 Eculizumab Phase 3 Studies Indication Status Refractory gmg Regulatory submissions filed in the US, Europe and Japan FDA filing accepted; PDUFA set for October 23, 2017 Regulatory decisions expected in US, Europe, and Japan Relapsing NMOSD Complete enrollment in the PREVENT registration trial in 2017 Data expected in

27 ALXN1210: Highly Innovative Next-Generation C5 Inhibitor ALXN1210 Innovative Engineering Immediate, complete, sustained reduction of free C5 activity 99% (regardless of source) Engineered for potent inhibition and enhanced Fc receptor recycling Terminal half-life of 42 days Orphan Drug Designation in PNH in the US and EU ~60% of patients either die or permanently lose renal function Phase 3 studies in PNH and ahus ongoing with Q8 week dosing ALXN1210 SC Program: PK and tolerability data supportive of advancing development 27

28 ALXN1210 Phase 3 Studies in PNH PNH Naïve Study PNH Switch Study Patient Population Complement inhibitor treatment-naïve adult patients with PNH Patient Population Adult patients with PNH who have been treated with Soliris for at least the past 6 months Design N=214; Open label; Randomized (1:1) vs. Soliris ; 26 week study Q8W dosing based on 3 weight cohorts Design N=192; Open Label; Randomized (1:1) vs. Soliris; 26 week study Q8W dosing based on 3 weight cohorts Co-Primary Endpoints Normalization of LDH levels Percentage of patients who achieve transfusion avoidance Primary Endpoint Hemolysis as directly measured by percentage change in LDH levels Status Enrolling Status Initiating enrollment in 2Q17 28

29 ALXN1210 Phase 3 Studies in ahus ahus Adolescent & Adult Study ahus Pediatric Study Patient Population Complement inhibitor treatment-naïve adolescent and adult patients with ahus Patient Population Complement inhibitor treatment-naïve children and adolescent patients with ahus Design N=55; Open label; Single-arm; 26 week study Q8W dosing based on 3 weight cohorts Design N=16; Open label; Single-arm; 26 week study Primary Endpoints Complete TMA response Primary Endpoints Complete TMA response Status Enrolling Status Initiating enrollment in 2Q17 29

30 Pharmacokinetic Data Support Advancing ALXN1210 SC ALXN1210 Mean Innovative Serum Engineering Concentration Following Single Dose of ALXN1210 SC (N=42) Bioavailability approximately 60%; Terminal half-life 42 days 30

31 2017 Milestones PROGRAM INDICATION STATUS US Regulatory Submission Soliris Refractory gmg EU Regulatory Submission Japan Regulatory Submission Soliris Refractory gmg US Regulatory Decision EU Regulatory Decision Japan Regulatory Decision Eculizumab Relapsing NMOSD Phase 3 Study Complete Enrollment ALXN1210 PNH Phase 3 Naïve Study Complete Enrollment Phase 3 Switch Study Complete Enrollment ALXN1210 ahus Phase 3 Naïve Study Complete Enrollment Initiate Enrollment in Pediatric Study ALXN1210 SC Multiple Phase 1 Study Progress Development ALXN1101 cpmp MoCD Type A Pivotal Study Progress Enrollment Samalizumab Solid Tumors Phase 1 Study Progress Study Samalizumab AML* Phase 1 Study Progress Study Complement Portfolio Metabolic Portfolio Immuno- Oncology *Part of the Leukemia and Lymphoma Society BEAT AML Master Study 31

32 Positioned for Continued Success Continue Strong Momentum Enhance Performance and Execution Strengthen Culture of Compliance Drive Value for Shareholders Update on Strategy on 2Q Call 32

33 Q&A 1Q17 Results April 27, 2017

34 Appendix 1Q17 Results April 27, 2017

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