Fisher & Paykel Healthcare Corporation Limited · NZX:FPH

Fisher & Paykel Healthcare — Investor Day (October 2015)

130 slides from Fisher & Paykel Healthcare's investor day presentation, Oct 13, 2015

  1. Slide 1: Fisher & Paykel Healthcare Investor Day, Sydney

    Fisher & Paykel Healthcare Inspired and world-leading healthcare solutions INVESTOR DAY, SYDNEY 13TH OCTOBER 2015 1

  2. Slide 2: Agenda

    Agenda 10:00am Welcome Marcus Driller (Investor Relations & Corporate Affairs Manager) Changing Demographics Creating Opportunities Michael Daniell (Managing Director & CEO) Improving Care and Outcomes Lewis Gradon (Senior VP - Products & Technology, CEO Designate) AIRVO & Optiflow – World-Leading T

  3. Slide 3: Changing Demographics Creating Opportunities

    Changing Demographics Creating Opportunities Michael Daniell (Managing Director & CEO) 3

  4. Slide 4: Health Spending Growing 5%-7% Per Year

    Health Spending Growing 5%-7% Per Year Total Expenditure on Health (US$/capita)1 4

  5. Slide 5: Demographics Driving Growth

    Demographics Driving Growth Population age 60% of US Developing markets and weight both healthcare cost is increasing healthcare increasing after age 65 years4 spending US population 65 years+ to China healthcare grow ~80% over next 20 years2 expenditure increased 19% in 2012, expected US males 60 -

  6. Slide 6: Typical Hospital Cost Breakdown

    Typical Hospital Cost Breakdown 6% Medical devices6 94% Other – includes labour, utilities, drugs, supplies, food, depreciation. 6

  7. Slide 7: Lower Care Intensity = Lower Cost

    Lower Care Intensity = Lower Cost Mean Annual COPD-Related Medical, Pharmacy, and Total Costs by Care Intensity Cohort7 7

  8. Slide 8: Improving Care and Outcomes

    Improving Care and Outcomes Lewis Gradon (Senior VP - Products & Technology, CEO Designate) 8

  9. Slide 9: Consistent growth strategy

    Consistent growth strategy o Improving care and outcomes o Four key pillars: o Reducing cost to the healthcare Continuous product system improvement Increase • Effectiveness of care More devices for each patient • Efficiency of care Serve more patient groups Reduce • Intensity of care • Healthcare s

  10. Slide 10: Market Opportunity and Patient Groups

    Market Opportunity and Patient Groups RESPIRATORY & ACUTE CARE OBSTRUCTIVE SLEEP APNEA / HOMECARE “NEW APPLICATIONS” Applications outside of invasive ventilation 10

  11. Slide 11: Invasive Ventilation

    Invasive Ventilation Fisher & Paykel 1 HEALTHCARE

  12. Slide 12: Invasive Ventilation

    Invasive Ventilation o Almost always in the Intensive Care Unit (ICU) or Neonatal Intensive Care Unit (NICU) o Patients are intubated o Generally unconscious o Ventilator breathes for the patient 12

  13. Slide 13: The Intubated Airway

    The Intubated Airway o Majority of inspired gas o Need to deliver gas at conditioning occurs in the physiologically normal levels o upper airways • 37 C body core temperature • 44mg/L 100% saturated o Inadequate humidity is associated with secretion clearance complications 13

  14. Slide 14: Effect of Humidity and Temperature on Mucus Transport

    Effect of Humidity and Temperature on Mucus Transport 14

  15. Slide 15: Technology Advantage

    Technology Advantage Evaqua 2™ Breathing Circuits Uniquely designed with F&P’s MicroCell™ and Evaqua™ technology, Evaqua 2 is an advanced breathing circuit which aims to increase the effectiveness of patient care through an easy-to-use system. 15

  16. Slide 16: Patient Groups

    Patient Groups Certain common medical conditions may require invasive ventilation,8 including: ADULT o Acute obstructive disease, including acute severe o Fatigue/atrophy, including muscle overuse and disuse asthma o Head/spinal cord injury, including pulmonary edema o Burns and smoke inhalation, in

  17. Slide 17: Noninvasive Ventilation

    Noninvasive Ventilation | ae ans Fisher & Paykel

  18. Slide 18: Noninvasive Ventilation

    Noninvasive Ventilation o Generally in HDU / ICU / NICU / ED o Ventilator assists patient’s breathing through a mask o Success improved by comfort, tolerance and compliance 18

  19. Slide 19: Patient Tolerance

    Patient Tolerance NIV can be an uncomfortable therapy that some patients find difficult to tolerate o Up to 70% of NIV patients experience adverse effects9 AARC Clinical Practice Guideline 2012 Recommendations10 o Active humidification for NIV is suggested to improve adherence and comfort 19

  20. Slide 20: Leading Technology

    Leading Technology ADULT NEONATAL Infant Masks 20

  21. Slide 21: Patient Groups

    Patient Groups Why would somebody require noninvasive ventilation?11 ADULT NEONATAL o Chronic respiratory failure o Respiratory distress syndrome (typically due to o Chronic obstructive pulmonary disease preterm birth) o Cystic fibrosis o Neuromuscular disease o Amyotrophic lateral sclerosis o Obesi

  22. Slide 22: Hospital Respiratory Support

    Hospital Respiratory Support 22

  23. Slide 23: Displacing Conventional Oxygen Therapy Devices

    Displacing Conventional Oxygen Therapy Devices CONVENTIONAL NONINVASIVE OXYGEN THERAPY VENTILATION 23

  24. Slide 24: Optiflow – A Disruptive Therapy

    Optiflow – A Disruptive Therapy Our leading humidification systems allow the delivery of high flows of air/oxygen mixtures to spontaneously breathing patients via an innovative nasal cannula. 24

  25. Slide 25: Reduction of Dead Space

    Reduction of Dead Space Fisher & Paykel HEALTHCARE

  26. Slide 26: Dynamic Positive Airway Pressure

    Dynamic Positive Airway Pressure o Pressure dynamically changes depending on breath and flow Compared to unassisted breathing tidal o Inspiration is easier volume increased and respiratory rate o Increased expiratory pressure leads to reduced as flow increased prolonged expiration Tidal volume (VT)

  27. Slide 27: Comparing Low Flow Oxygen with Optiflow

    Comparing Low Flow Oxygen with Optiflow Increased airway pressure was significantly correlated with increased lung volume of 25.6%13 27

  28. Slide 28: Clinical Outcomes

    Clinical Outcomes Optiflow is associated with: ADULTS: PAEDIATRICS: Effectiveness o REDUCED intubation14 o REDUCED intubation18 o REDUCED re-intubation15, 16, 17 o REDUCED length of stay19 Efficiency o REDUCED bilevel ventilation15 o REDUCED respiratory distress20 o REDUCED nursing workload16 Intens

  29. Slide 29: Reducing Length of Stay

    Reducing Length of Stay Early Optiflow associated with:  Decreased length of stay in ICU  Decreased length of stay Post- ICU Gaunt et al. 2015 25  Reduced incidence of adverse events STUDY "Every 1-day delay to HFNC increases o Supplemental oxygen ineffective ICU stay by one half-day. This sugges

  30. Slide 30: Patient Groups

    Patient Groups What patient groups could benefit from Optiflow? ADULT NEONATAL o Asthma o Community acquired o Infant Respiratory Distress o Atelectasis pneumonia o Bronchiectasis o Emphysema o Bronchitis o Palliative Care o Burns o Pneumonia o Carbon monoxide poisoning o Pulmonary embolism o Chest

  31. Slide 31: Home Respiratory Support

    Home Respiratory Support HEALTHCARE

  32. Slide 32: Chronic Obstructive Pulmonary Disease

    Chronic Obstructive Pulmonary Disease Chronic obstructive pulmonary disease (COPD) is a lung disease which is commonly associated with smoking o Emphysema and chronic bronchitis are both forms of COPD o Chronic respiratory disease, primarily COPD, is the third leading cause of death in the US26 o 6%

  33. Slide 33: Surgical Humidification

    Surgical Humidification Fisher & Paykel 33 HEALTHCARE

  34. Slide 34: Surgical Humidification

    Surgical Humidification o Current standard of care is dry CO2 gas to the surgical site o Causes evaporation and cooling o Humidification reduces risk of complications, hypothermia, adhesion and infection 34

  35. Slide 35: Surgeries That May Benefit from Humidification

    Surgeries That May Benefit from Humidification Laparoscopic and open surgeries o Cardiovascular-Thoracic Procedures including aneurism repair, coronary artery bypass and heart valve replacement o General Procedures including gastric bypass, appendectomy o Obstetric-Gynecologic Procedures including h

  36. Slide 36: Obstructive Sleep Apnea

    Obstructive Sleep Apnea @ € wi wr, . Fisher & Paykel

  37. Slide 37: Obstructive Sleep Apnea

    Obstructive Sleep Apnea Temporary closure of airway during sleep o 2% - 7% OSA adult prevalence29 o 70%–80% of those affected remain undiagnosed o Prevalence increases with age and obesity o Estimate >50 million people in developed countries 37

  38. Slide 38: Looking Forward Next 12-18 Months

    Looking Forward Next 12-18 Months CONTINUOUS PRODUCT MORE PRODUCTS FOR SERVE MORE INCREASE OUR IMPROVEMENT EACH PATIENT PATIENT GROUPS INTERNATIONAL PRESENCE o Introduction of new products o Opportunity to add active o Growing body of clinical and o Direct hospital sales force – Optiflow+ nasal cann

  39. Slide 39: Key Points

    Key Points 10 million patients treated last year using Market could be our medical devices 200 million patients Exciting product per year in 10 - 15 pipeline 100 million patient years given Consistent opportunity demographics growth strategy 39

  40. Slide 40: Q&A

    Q&A Fisher & Paykel HEALTHCARE

  41. Slide 41: Optiflow & AIRVO World-Leading Technology

    Optiflow & AIRVO World-Leading Technology Chris Crone (AIRVO and Optiflow Marketing Manager) 41

  42. Slide 42: Product Showcase

    Product Showcase Optiflow’+ Optiflow’ junior AIRVO"2 (GJ s50"system Fisher & Paykel 42 HEALTHCARE

  43. Slide 43: From High-Acuity to Low-Acuity

    From High-Acuity to Low-Acuity CRITICAL CARE NON-CRITICAL CARE HOME 43

  44. Slide 44: Optiflow+

    Optiflow+ o Comfort for patients drives compliance for better outcomes o Confidence for clinicians from thoughtful design and robust research o Three sizes o Stable and versatile o Part of a system 44

  45. Slide 45: Optiflow+

    Optiflow+ 45

  46. Slide 46: Technology Spotlight

    Technology Spotlight Evaqua™ technology reduces formation of mobile condensate ... reducing risk of infection and associated costs 46

  47. Slide 47: Optiflow Junior

    Optiflow Junior Effective, gentle, easy o Effective Delivers the flows that the clinician needs o Gentle Facilitates development care o Easy Simple for caregivers 47

  48. Slide 48: The Previous “State of the Art”

    The Previous “State of the Art” o Designed for adults o Difficult to fit and secure o Added nurse workload means increased costs 48

  49. Slide 49: Technology Spotlight

    Technology Spotlight Wigglepads™ Evaqua™ flexi-tube 49

  50. Slide 50: Technology Spotlight

    Technology Spotlight Designed using Computational Fluid Dynamics (CFD) 50

  51. Slide 51: Optiflow Junior

    Optiflow Junior o Effective, Gentle, Easy o Designed as part of a system o Enhancing the therapy to improve outcomes 51

  52. Slide 52: AIRVO 2 – A Purpose-Built System

    AIRVO 2 – A Purpose-Built System o A purpose-built system for delivering Optiflow therapy o World-leading humidification and flow generation technology o Versatile and mobile Combines: o Standalone humidifier o Blender / Flow source o Oxygen analyser into a single, powerful, user-friendly device 52

  53. Slide 53: Technology Spotlight

    Technology Spotlight Oxygen analyser o Ultrasonic technology o Integrated into AIRVO o No calibration, maintenance or replacement required o Contributes to system-level safety with integrated alarms. 53

  54. Slide 54: AirSpiral

    AirSpiral AirSpiral tubes Conventional breathing tubes o Unique o Up to 96% less condensate o Improved therapy efficacy o Reduced clinician workload 54

  55. Slide 55: Technology Spotlight

    Technology Spotlight Integrated temperature sensors o Proprietary technology o No need for external sensors or probes o Saves preparation and reprocessing time 55

  56. Slide 56: AIRVO Mobility

    AIRVO Mobility o Continuous power means continuous therapy o AIRVO mobility solution simplifies care o Reduces workload and costs o Transportable throughout the hospital 56

  57. Slide 57: In Summary

    In Summary Optiflow'+ Optiflow” junior AIRVO"2 Fisher & Paykel 57 HEALTHCARE

  58. Slide 58: Q&A

    Q&A Fisher & Paykel HEALTHCARE

  59. Slide 59: Optiflow – A Growing Body of Evidence

    Optiflow – A Growing Body of Evidence Geraldine Keogh (Clinical Research Manager, RAC Product Group) 59

  60. Slide 60: Optiflow Clinical Evidence

    Optiflow Clinical Evidence Growing body of evidence now demonstrates that nasal high flow is an effective treatment for patients with respiratory compromise 60

  61. Slide 61: Clinical Evidence - Adult

    Clinical Evidence - Adult Number of NHF Publications 61

  62. Slide 62: Clinical Evidence – Adult (ICU)

    Clinical Evidence – Adult (ICU) 62

  63. Slide 63: Reduction in 90-day Mortality

    Reduction in 90-day Mortality  Optiflow reduced the need for mechanical ventilation in the most Frat et al. 2015 14 sick patients  Increased number of STUDY ventilator-free days o Randomised controlled trial, 23 intensive care units, France & Belgium  Halved 90-day mortality o 310 patients o Opti

  64. Slide 64: Improved Oxygenation & Greater Comfort

    Improved Oxygenation & Greater Comfort  Optiflow led to significantly improved oxygenation, greater Maggiore et al. 2014 15 comfort and fewer patients required STUDY reintubation or NIV o Randomised controlled trial, 2 intensive care units, Italy o 105 patients o Optiflow compared with face mask ox

  65. Slide 65: Lowers Nurse Workload

    Lowers Nurse Workload  Optiflow resulted in a similar rate of reintubation as BiPAP Stéphan et al. 2015 16  Significant advantages: STUDY • Less skin breakdown o Non-inferiority trial, 6 intensive care units, France • Lower nurse workload o 830 patients (fewer interface displacements) o Optiflow c

  66. Slide 66: Similar Rate of Reintubation as NIV

    Similar Rate of Reintubation as NIV High flow conditioned oxygen therapy for prevention of reintubation in critically ill patients at high risk for extubation failure: a multicenter randomised controlled trial  Optiflow resulted in a similar rate of reintubation as Hernandez et al. 2015 17 noninvas

  67. Slide 67: Fewer COPD Exacerbations

    Fewer COPD Exacerbations  Interim analysis showed patients treated with Optiflow had significantly: Storgaard et al. 2015 30 • fewer COPD exacerbations; and STUDY • less number of hospital o Randomised controlled trial, Denmark admissions o 86 patients, COPD o Optiflow compared with Long Term Oxyge

  68. Slide 68: Clinical Evidence

    Clinical Evidence o Demonstrated efficacy in neonates with respiratory compromise o Increasing evidence supporting the use of nasal high flow in older infants 68

  69. Slide 69: Clinical Evidence

    Clinical Evidence NHF PAPERS PUBLISHED FROM 2000-2014 (NEONATAL AND PAEDIATRIC) Growing body of evidence o >90 papers on NHF published in neonatal and paediatric population o >15 papers focus on paediatric population 69

  70. Slide 70: Decrease in Need for Intubation

    Decrease in Need for Intubation Use of High-Flow Nasal Cannula Support in the Emergency Department Reduces the Need for Intubation in Pediatric Acute Respiratory Insufficiency  Optiflow led to a 50% decrease in need for intubation and Wing et al. 2012 18 mechanical ventilation STUDY o Retrospective

  71. Slide 71: Improves Gas Exchange

    Improves Gas Exchange Is treatment with a high flow nasal cannula effective in acute viral bronchiolitis? A physiologic study  Optiflow generated enough airway pressure to improve gas exchange Milési et al. 2014 20  Decreased work of breathing by ~50% and STUDY led to a rapid o Physiological study

  72. Slide 72: Potential for Substantial Cost Savings

    Potential for Substantial Cost Savings High-flow nasal cannula oxygen therapy for infants with bronchiolitis: Pilot study  Demonstrated that Optiflow use in paediatric ward is safe Mayfield et al. 2014 31  Using Optiflow treatment in paediatric wards may STUDY result in substantial cost o Pilot st

  73. Slide 73: Large Multi-Centre RCT In Progress

    Large Multi-Centre RCT In Progress High Flow Nasal Cannula Treatment for Viral Bronchiolitis in Infants, a  Comparing transfer rate Randomised Controlled Trial from regional hospital to tertiary centre Schibler et al. STUDY o Multi-centre, randomised controlled trial, Australia & New Zealand o 1,40

  74. Slide 74: Consensus of Evidence - Infant

    Consensus of Evidence - Infant EARLY USE INTEGRATED USE PATIENT PATIENT PHYSIOLOGY JOURNEY 74

  75. Slide 75: Q&A

    Q&A Fisher & Paykel HEALTHCARE

  76. Slide 76: Surgical Humidification

    Surgical Humidification Michael Blackhurst (Product Group Manager, Surgical) 76

  77. Slide 77: Current Standard of Care

    Current Standard of Care Surgery 32 32 37 77

  78. Slide 78: 78

    78

  79. Slide 79: HumiGard – Latest Surgical System

    HumiGard – Latest Surgical System Technology o Plug and play for ease of use o Performance o Patented improvements A full suite of accesses for a wide variety of mounting equipment 79

  80. Slide 80: Hypothermia – Remains an Issue in Surgery

    Hypothermia – Remains an Issue in Surgery Did you know that hypothermia can lead to a: o 4-fold increase in mortality33 o 6-fold increase in stroke33 o 3-fold increase in surgical site infections34 80

  81. Slide 81: Maintaining Normothermia

    Maintaining Normothermia35 Control Cold, dry Warm, humidified AT THE START OF INSUFFLATION AFTER TWO HOURS OF INSUFFLATION 81

  82. Slide 82: Maintaining Normothermia

    Maintaining Normothermia Standard warming compared to standard warming with additional insufflation of humidified CO2 36 82

  83. Slide 83: Reduction in Surgical Site Infections

    Reduction in Surgical Site Infections A reduction in SSI rate from 12.1% to 4.7% with the use of warm, humidified CO2 37 during laparoscopic colorectal surgery has been reported37 Surgical Humidification mechanisms of action to help protect against SSI’s include: o Protecting from operative hypother

  84. Slide 84: Reduction in Costs Per Patient

    Reduction in Costs Per Patient o In laparoscopic colorectal resections: a retrospective case study of 252 patients o 1:1 ratio before and after adoption of HumiGard™ o SSI rate dropped from 12.1% to 4.7%37 o York Health Economics Consortium developed a model investigating laparoscopic and open surge

  85. Slide 85: Survival – Karolinska Institute

    Survival – Karolinska Institute o Presented at European meeting of ESCP Dublin 23-25 September 2015 o Insufflation of warm humidified carbon CUMULATIVE SURVIVAL dioxide into the open wound significantly increases wound and core temperatures o A small end-of-operation temperature difference between f

  86. Slide 86: Outcomes – All Related to ‘First Principles’

    Outcomes – All Related to ‘First Principles’ “Tumour cells rapidly fill the spaces left by the mesothelial cells, suggesting that the tumour cells have a strong preferential affinity for the basement 43 membrane. Tumour cells that do invade then proliferate into the connective tissue”42 86

  87. Slide 87: National Guideline Endorsement

    National Guideline Endorsement o Selection of HumiGard for a Technology Guideline in the Medical Technology Evaluation Programme by NICE. o Also considered for the ‘Inadvertent Perioperative Hypothermia’ guideline by NICE 44 o Potential to accelerate rate of adoption 34 45, 43 37, 46-48 *as shown in

  88. Slide 88: Q&A

    Q&A Fisher & Paykel HEALTHCARE

  89. Slide 89: Effective OSA Patient & Data Management

    Effective OSA Patient & Data Management Fiona Cresswell (Marketing & Clinical Manager, OSA Product Group) 89

  90. Slide 90: Stylish and Smart

    o Stylish and Smart o User-friendly with a simple menu system o 3 leading clinical technologies 90

  91. Slide 91: Our Informatics Platform

    Our Informatics Platform Goal: Simple, efficient, proactive patient data management 91

  92. Slide 92: Proactive Patient Management

    Proactive Patient Management 92

  93. Slide 93: Managed Data Transfer

    Managed Data Transfer InfoSmart"Web . —_— |) seeeener sas ano <essages InfoSmart Contact Uupioad your CPAP data to us on a regular basis. The process for this is simple Your CPAP data is now due. Please remove your InfoUSB and insert it in a USB port of a computer connected to the internet. Run Info

  94. Slide 94: Simple Workflows

    Simple Workflows InfoSmart Download an InfoUSB 100831016499 Monica Change patent PATENT CONTACT. DEM mooems REPORTS DOWNLOAD ANINFOUSA— ¢ CEL amneours Events Remncers Caso, Ben Chango prostion ceidy agen 30Sep 2011 Create A Prescription Ome 150303800086 ee fooastore4s0 | ) tawonas — romarzors ——waay

  95. Slide 95: Physician Collaboration

    InfoSmart | J omen | ‘Snecma Jem | od ‘ | roe serrcone 95 ores QF svorors0129 QD svonr21088 tos2ot04rea storzvo4ers? ssononen00ns soer4019679 ower stotororse17 somes ‘60s25s00002 aqeauacdpbhbaaad 1 aae2010 01 Jan 2010 12002011 5 un 2015 12May 2011 0 Mar 2015, s108e2019 13ay20%4 7 age2012 Mar 2013 2M

  96. Slide 96: Remote Prescription Management

    Remote Prescription Management 96

  97. Slide 97: Scalable to Enterprise

    Scalable to Enterprise Company user Region user Location user 97

  98. Slide 98: Comprehensive Patient Reports

    Comprehensive Patient Reports 98

  99. Slide 99: Easy Integration

    Easy Integration 4 Data available |) as a service } f / ~ Fisher & Paykel 99 HEALTHCARE

  100. Slide 100: Mask Matters Most

    Mask Matters Most Andrew Somervell (General Manager, Product Groups) 100

  101. Slide 101: F&P OSA Masks

    F&P OSA Masks o Market leading mask technology o Unique, patented designs o Mask Matters Most • Masks are key to compliance F&P ESON F&P SIMPLUS F&P PILAIRO Q 101

  102. Slide 102: F&P Pilairo Q

    F&P Pilairo™ Q Nasal Pillow Ground-breaking o Soft silicone AirPillow seal o Choice of two headgear o First manufacturer to come out with a single strap o Diffuser to mitigate noise and draft 102

  103. Slide 103: F&P Eson

    F&P Eson™ Nasal Set the standard for simplicity and ease-of-use o Unique RollFit™ Technology o Three key components – headgear, seal and frame o One frame fits 3 seal sizes o Diffuser to mitigate noise and draft 103

  104. Slide 104: F&P Simplus

    F&P Simplus™ Full Face Award-winning Full Face mask o Unique RollFit™ Technology o Recognised for seal performance and ease-of-use o Comfortable seal and headgear 104

  105. Slide 105: Introducing F&P Eson 2

    Introducing…F&P Eson™ 2 Confidence comes easy 105

  106. Slide 106: F&P Eson 2 – Get Ready for Easy

    F&P Eson™ 2 – Get Ready for Easy Intuitive o New RollFit™ seal Headgear VisiBlue™ o Intuitive, easy to use headgear o Long life washable diffuser o Introducing VisiBlue™, the use of colour cues to assist with Easy Frame mask use and care RollFit™ Seal Washable Diffuser 106

  107. Slide 107: Confidence comes easy with Eson 2

    Confidence comes easy with Eson 2… …because Eson 2 has been designed to meet the needs of patients and sleep professionals, at every important milestone in the CPAP therapy journey 107

  108. Slide 108: Q&A

    Q&A Fisher & Paykel HEALTHCARE

  109. Slide 109: Working More Closely with our US Hospital Customers

    Working More Closely with our US Hospital Customers Paul Shearer (Senior VP - Sales & Marketing) 109

  110. Slide 110: Agenda

    Agenda 1 US Opportunity 2 Why the Distribution Change? 3 Our Customers 4 Business Transition 110

  111. Slide 111: FPH Opportunity - US Healthcare Spending

    FPH Opportunity - US Healthcare Spending Total Expenditure on Health (US$/capita)49 US Healthcare costs are increasing at a rapid rate o US Healthcare costs 18% of GDP50 o ~$1 trillion hospital spend51 o ~100,000 ICU beds52 111

  112. Slide 112: FPH Opportunity - Drivers of Growth

    FPH Opportunity - Drivers of Growth Affordable Care Act 2010 (“Obamacare”) Increasing prevalence of obesity Aging demographics o Expanded insurance coverage o 2012: 32% of the o 2015: 15% of the US US population is o CMS Reimbursement linked population older obese54 to quality of care than 6556 o 20

  113. Slide 113: Why? Our Strategic Rationale

    Why? Our Strategic Rationale o Control sales process o Sales focus on FPH products o Develop new opportunities o Improve care and outcomes 113

  114. Slide 114: Why? Hospital Distributor Acquired

    Why? Hospital Distributor Acquired o Hospital Distributor acquired o Created uncertainty o Decision made to go direct o Alignment with FPH direct market strategy 114

  115. Slide 115: Customers - New Channel and Customers

    Customers - New Channel and Customers 115

  116. Slide 116: Customers - Product Distributor’s Role

    Customers - Product Distributor’s Role o Consolidate products and deliveries o Provide just in time inventory o Closely aligned with Hospitals o Critical to the Hospital’s supply chain o Fees paid to Distributors by Manufacturers and Hospitals 116

  117. Slide 117: Customers - FPH Distribution Partners

    Customers - FPH Distribution Partners National Distribution Other o Regional distribution and IDN self distribution 117

  118. Slide 118: Customers - Group Purchasing Organisations’ Role

    Customers - Group Purchasing Organisations’ Role o Represent ~98% of US hospitals o Combine the buying power of their members o Negotiate standardised pricing and contract terms o Offer consulting, data and technology programs 118

  119. Slide 119: Customers - GPO Process

    Customers - GPO Process + NEGOTIATE: —— ——_—_—_—> > PRICING Fisher &Paykel MEMBERSHIP > CONTRACTS HEALTHCARE Q\ > FEES y fo} HOSPITAL GPO xX S ‘ m PROMOTION TO HOSPITALS, Fisher &Paykel HEALTHCARE

  120. Slide 120: Customers - Estimated GPO Market Share

    Customers - Estimated GPO Market Share 57 120

  121. Slide 121: Customers - Integrated Delivery Networks (IDNs)

    Customers - Integrated Delivery Networks (IDNs) o An Integrated Delivery Network (IDN) is a network of facilities and providers that work together to offer a continuum of care to a specific geographic area or market o Negotiate dollar and volume commitments with GPO contracted suppliers o FPH Techno

  122. Slide 122: Transition - Operations Since July 2015

    Transition - Operations Since July 2015 o Staff Recruitment o New Distribution Facility o Increased Inventory o Implemented IT Systems 122

  123. Slide 123: Transition - Customers Since July 2015

    Transition - Customers Since July 2015 o Established Distribution Contracts o Established GPO Contracts o Shipping Product o Uninterrupted Supply to Hospitals 123

  124. Slide 124: Transition - Sales Strategy

    Transition - Sales Strategy Strengthen Customer Promote New Relationships Product Applications Improve Care Accelerate Customer and Outcomes Customer Education & Evaluations Adoption 124

  125. Slide 125: Q&A

    Q&A Fisher & Paykel HEALTHCARE

  126. Slide 126: Concluding Comments

    Concluding Comments Michael Daniell (Managing Director & CEO) 126

  127. Slide 127: References

    References 1. OECD Health data http://stats.oecd.org/index.aspx?DataSetCode=HEALTL_STAT 2. Grayson K. Vincent, Victoria A. Velkoff. The Next Four Decades. The Older Population in the United States: 2010 to 2050. US Census Bureau, 2010. 3. Cynthia L Ogden, Cheryl D Fryar et al. Mean Body Weight, Heig

  128. Slide 128: References

    References 24. Saslow JG, Aghai ZH, Nakhla TA et al. Work of breathing using high-flow nasal cannula in preterm infants. J Perinatol. 2006;26(8):476-80 25. Gaunt KA, Spilman SK, Halub ME et al. High-Flow Nasal Cannula in a Mixed Adult ICU. Respir Care. 2015;60(10):1383-9 26. Hoyert DL, Xu JQ. Deaths

  129. Slide 129: References

    References 45. Binda, M. M., Corona, R., Amant, F. & Koninckx, P. R. 2014. Conditioning of the abdominal cavity reduces tumour implantation in a laparoscopic mouse model. Surgery Today, 44(7):1328-35. doi: 10.1007/s00595- 014-0832-5. 46. National Institute for Health and Clinical Excellence (NICE).

  130. Slide 130: Glossary

    Glossary BiPAP Bilevel Positive Airway Pressure – used during New apps New applications in our RAC product group noninvasive ventilation outside of invasive ventilation (see slide 10) COPD Chronic Obstructive Pulmonary Disease NHF Nasal high flow therapy CPAP Continuous Positive Airway Pressure NICU

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