GenMark Diagnostics TRANSFORMING MULTIPLEX MOLECULAR TESTING J.P. Morgan Healthcare Conference 2018 1
Forward-Looking Statements This presentation contains forward-looking statements about GenMark Diagnostics, Inc. These statements involve known and unknown risks that relate to the Company s future events or future financial performance and the actual results could differ materially from those discussed in this presentation. Factors that may cause the Company's actual results to differ materially from those discussed in the presentation, include: failure of the Company s products to gain market acceptance domestically or internationally; failure to scale our manufacturing operations to sufficiently support our anticipated future growth; the refusal of third-party payors to reimburse the Company s customers for use of diagnostic systems and tests; the loss of the Company s largest customer; the Company s history of net losses; increases in the Company s projected expenditures on sales and marketing, research and development and administrative activities; less than anticipated growth in the market for diagnostic testing generally and for the tests the Company is developing or may develop in the future; inability to obtain regulatory clearance or approval for any of the Company s products; changes in the regulatory environment which may adversely impact the commercialization of the Company s new products and result in significant additional capital expenditures; failure to enter into or maintain successful strategic alliances, which may delay the development or commercialization of the Company s products or may result in significant additional expenditures; failure to obtain sufficient funding for the continued development and commercialization of the Company s products; inability to attract or retain skilled personnel for the Company s product development and commercialization efforts; and inability to protect the Company s intellectual property and operate the Company s business without infringing upon the intellectual rights of others, which could result in litigation and significant expenditures. Additional risks and uncertainties relating to the Company and its business can be found in the "Risk Factors" section of GenMark's most recent Annual Report on Form 10-K, Quarterly Report on Form 10-Q and other filings with the United States Securities and Exchange Commission. The forward-looking statements contained in this presentation represent the Company s estimates and assumptions only as of the date of this presentation and the Company undertakes no duty or obligation to update or revise publicly any forward-looking statements contained in this presentation as a result of new information, future events or changes in the Company s expectations. 2
Unique Opportunity for Growth and Value Creation Rapid, accurate, and actionable multiplex molecular diagnostics are needed for effective management of high-risk patients Complexity of current molecular diagnostic methods limits access to critical patient results GenMark s proprietary technologies are driving adoption of multiplex molecular sample-to-answer panels across care settings eplex is a uniquely differentiated solution in a large and growing market 3
Adoption Propelled by Favorable Macro Drivers Focus on value based care by enhancing patient outcomes, improving quality and reducing total cost-of-care CLINICAL Actionable information for high risk & acute care patients with > 65% faster time to result 1,2,5 10% increase in relative survival rate in ICU patients 3 18%-30% more positive test results reported 1,4,5 QUALITY Decrease in antibiotic duration drives key quality metrics such as antimicrobial stewardship 1,3,4 Supporting infection control by informing patient isolation strategies 2,4 and therapy guideline compliance 5 COST-OF-CARE > $8,000 cost savings / patient in ICU in a major IDN 3 Shorter length-ofstay improves bed management relative to conventional testing 5 Reduced hospital and antibiotic costs result in net cost savings 1 4 1. Rogers BB, Arch Pathol Lab Med. 2015 May;139(5):636-41 2. Xu M, Am J Clin Pathol. 2013;139(1):118 123. 3. Martinez RM, Clinical Virology Symposium, May 19-21, 2016, Daytona Beach, FL. Geisinger Health System, Danville, PA. 4. Subramony A, J Pediatr. 2016; 173:196-201. 5. Brendish NJ, Lancet Respir Med. 2017; 5(5): 401-11.
Complexity Limits Access to Conventional Molecular Diagnostics Specialized infrastructure and labor confines testing to centralized labs or send out Conventional Molecular Testing (~6-24h+) Sample Transport Sample Preparation Extraction Formulation Amplification Detection Report Results 5
Significant Global Market Opportunity for Multiplex Testing $2.5B+ global market for multiplex tests with 10 or more targets GI RP Sepsis CNS HCV Pipeline $800M $500M $475M $140M $100M > $500M 6 Management estimates subject to change.
eplex Dramatically Expands Market Opportunity True Sample-to-Answer solution opens opportunity in new care settings and geographic markets U.S. FOCUS ONLY ~1,000 Post-PCR Labs GLOBAL EXPANSION >12,000 Care Settings 7 Management estimates subject to change.
GenMark s Winning Strategy Leverage Proprietary Platform Technologies to establish a Strong Competitive Position Develop a robust and Differentiated Menu Pipeline to Address Critical Unmet Needs for laboratories and patients Scale Operations and Commercial Organizations for rapid growth Led by an Experienced Leadership Team with a track record of success 8
Proprietary and Enabling Platform Technologies Provides a sustainable competitive advantage and differentiation esensor Detection Low background signal & detection threshold enable high sensitivity, specificity Electrochemical detection delivers true multiplexing Proven technology with over 2 million tests performed Electrowetting Technology Precision fluid management using digital microfluidics Enables efficient, sample-to-answer performance and rapid time to result Innovative Cartridge Design Universally programmable cartridge with on-board reagents Enables industry leading ease-of-use 9
eplex: The True Sample-to-Answer Solution Order-to-Report efficiency to improve patient care outcomes and reduce hospital costs Designed for the Patient Rapid, accurate, clinically actionable results Informed treatment decisions for patient centered care Reduce avoidable medical error Optimized for the Lab Lean workflow for 24/7 lab efficiency Maximize uptime with focus on service & support Reduce administrative overhead with automated compliance management and data reporting 10
Simplifying and Streamlining Access to Multiplex Molecular Testing Proprietary technologies enabled automated onboard extraction, amplification, detection, and reporting Conventional Molecular Testing (~6-24h+) Sample Transport Sample Preparation Extraction Formulation Amplification Detection Report Results eplex: The True Sample-to-Answer Solution (< 2h) Sample Transport Load Sample Insert Cartridge Report Results 11
Flexibility to Scale with Growth in Volumes and Menu Expansion Configuration 1 Tower 2 Tower 3 Tower 4 Tower Bays 6 12 18 24 Nominal Shift Throughput 24 samples 48 samples 72 samples 96 samples Target Market Segments 150-300 bed hospitals Decentralized testing 300-500 bed hospitals Central lab in medium IDNs > 500 bed hospitals Central lab in large IDNs Reference labs 12
Introducing eplex NP New eplex configuration supports decentralized, near patient testing with a cost effective solution 3 cartridge analyzer 12 patient samples/shift IDNs & < 150 bed hospitals Same core eplex technology and functionality ensures quality, integration and scalability Eliminates significant send out costs and time delays 13
Strong and Differentiated Competitive Positioning eplex s proprietary technology and customer-centered design drive differentiation Complete Workflow Integration Limited Low Multiplexing Capability High 14
High Leverage Revenue Model Growing installed base of eplex instruments, recurring test cartridge revenue and menu expansion drive rapid growth YEAR 1 YEAR 2 YEAR 3 YEAR 4 15
Robust and Differentiated Product Pipeline 2016 2017 2018 2019 19 viral targets 2 bacterial targets CE-IVD FDA Clearance 10 Candida targets 6 other fungal targets CE-IVD FDA Clearance* 20 targets 4 resistance markers Pan-GN Pan-Candida 24 targets 6 resistance markers Pan-GP Pan-Candida CE-IVD CE-IVD FDA Clearance* FDA Clearance* ** 25+ clinically relevant bacterial, viral and parasitic targets CE-IVD* FDA Clearance* 16 Management estimates subject to change. * Product in development. Current expectations for timing of CE-IVD and/or FDA clearance are subject to change based on unforeseen delays due to risks and/or uncertainties. ** Not available for sale. Specifications subject to change.
The Respiratory Infection Challenge Clinical presentation of respiratory pathogens is very similar, complicating diagnosis and therapy selection ~1 billion colds in the United States per year 1 Influenza-like illness is caused by many distinct viruses and bacteria with differing therapy regimens Disease severity is elevated in high-risk patients with co-morbidities 2 Up to 50% of antibiotics are used inappropriately 3 17 1. The Common Cold Fact Sheet. National Institute of Allergy and Infectious Diseases, National Institutes of Health. December 2004 2. Flu Symptoms & Complications. Centers for Disease Control and Prevention. https://www.cdc.gov/flu/about/disease/complications.htm (Accessed May, 2017) 3. Center for Disease Control. Facts about Antibiotic Resistance. http://www.cdc.gov/getsmart/community/about/fast-facts.html. (Accessed May, 2017)
eplex Respiratory Pathogen (RP) Panel Comprehensive syndromic diagnostic for upper respiratory infections Panel detects >20 common respiratory pathogens 1 Achieved CE Mark in Q2 2016 and FDA Clearance in Q2 2017 Validated clinical performance U.S. clinical study showed 95.2% agreement with comparator method in 3,235 samples 2 Rapid, accurate, actionable results inform patient care Order-to-report workflow integration Fewest pre-analytical steps and shortest hands-on time Standard-of-care for high-risk patients including elderly, pediatrics and immunocompromised patients 18 1. CE-IVD RP Panel also detects Human Bocavirus, Middle East Respiratory Syndrome Coronavirus, Bordetella pertussis, Legionella pneumophila 2. eplex RP package insert. After discordant resolution. May 2017
Favorable Evidence Generating Support for eplex Growing body of peer reviewed journal articles & conference presentations demonstrate performance and utility 3 peer-reviewed publications in print 3+ peer-reviewed manuscripts in preparation 15+ posters and presentations at major conferences 10+ abstracts submitted/ accepted for major conferences in 1H 2018 6+ studies in process or planned for 1H 2018 19
The Sepsis Challenge Sepsis is common, costly, and deadly and time is critical in ensuring positive outcomes Sepsis strikes ~30 million people worldwide each year 1 Resulting in a death every 3-4 seconds 2 Sepsis is one of the most expensive conditions treated in hospitals 3 For every 1 hour delay in effective treatment, mortality increases by up to ~8% 4 and 20-30% of patients receive ineffective initial antibiotic therapy 5 20 1. Sepsis Fact Sheet, World Sepsis Day: www.world-sepsis-day.org. 2. Institut Pasteur, Sepsis/Septicemia: https://www.pasteur.fr/en/medical-center/disease-sheets/sepsis-septicemia 3. The UK Sepsis Trust Fact Sources; http://sepsistrust.org/fact-sources/ 4. Kumar, et. al., (2006) Crit Care Med, Vol. 34, No. 6 5. IDSA: Better Tests Better Care, The Promise of Next Generation Diagnostics
Gram Positive, Gram Negative, and Fungal Blood Culture Panels Unique panels designed to deliver high clinical value Three panels driven by gold-standard Gram stain result Achieved CE Mark in Q2 2017 59 distinct reportable targets Broad inclusivity designed to identify ~95% of positive blood bottles Pan targets improve co-detection and control for rare Gram stain misses Rapid time-to-result and resistance markers help support antimicrobial stewardship initiatives Inclusion of contamination rule out targets helps inform clinical, laboratory and pharmacy decision making 21
Addressing Challenges of Conventional Blood Culture The only test for rapid, routine BCID in a critical disease state Blood Draw Bottle Culture Gram Stain Sub-Culturing Conventional Blood Culture (~48-72h+) Organism ID & Antibiotic Susceptibility Testing (ID/AST) t=0 8h 16h 24h 32h 40h 48h 56h 64h 72-96h Blood Draw Bottle Culture ID/ AMR t=0 8h 10h eplex BCID* provides organism ID and detection of resistance genes within ~2 hours of bottle positivity 22 ID / AMR = Organism ID & Antimicrobial Resistance Testing * Product in development. Not available for sale in the U.S. Specifications subject to change.
Scaling Business to Support Rapid Growth Global Commercial Organization Direct salesforce of 35+ with plans for continued expansion Expanding distribution footprint in EMEA and globally eplex Manufacturing Capacity Fully dedicated eplex manufacturing facility Multiple manufacturing lines with space for additional lines to support future growth Key supply chain and automation investments to drive yield and margin accretion 23
Strong eplex Adoption and Commercial Progress Instrument placements in line with expectations 49 instruments placed in Q4 and total of 114 instruments placed in 2H17 Performance, workflow, ease-of-use leading to wins in major, strategic accounts Strong commercial execution to drive go-lives ahead of peak respiratory season Cumulative eplex Instruments Placed 196 147 82 51 1Q17 2Q17 3Q17 4Q17 24
Historical Financial Performance Revenue (USD millions) GROWTH 7% $49.3M $52.5M $39.4M $30.6M GROSS MARGIN 2014 2015 2016 2017 prelim 57% 61% 60% 25
Key Investment Highlights Large unmet clinical need driving adoption of multiplex molecular diagnostic testing GenMark s proprietary technologies dramatically expand addressable market eplex and robust menu pipeline create a strong, differentiated competitive position Business model delivers value to both customers and shareholders Experienced team with track record of success establish foundation for rapid growth 26