Slide 1: Investor Presentation September 2022
HELPING TO TREAT LIFE-THREATENING CONDITIONS IN THE ICU AND CARDIAC SURGERY AROUND THE WORLD NASDAQ: CTSO Investor Presentation September 2022
Slide 2: Safe Harbor Statement
Safe Harbor Statement This presentation contains “forward-looking statements” pursuant to the safe harbor provisions of the Private Securities Litigation Reform Act of 1995. Forward-looking statements include, without limitation, any statement that may predict, forecast, indicate, or imply future re
Slide 3: CytoSorbents: Leading the Prevention or Treatment of Life-Threatening Inflammation
CytoSorbents Leading the Prevention or Treatment of Life-Threatening Inflammation and other Deadly Conditions in the ICU and Cardiac Surgery using CytoSorb® Blood Purification 3
Slide 4: CytoSorbents At a Glance
CytoSorbents At a Glance (NASDAQ: CTSO) • U.S.-based international medical device company commercializing our E.U. approved CytoSorb® blood purification cartridge in 75 countries worldwide • $40.1M in 2021 product sales • Historically high (80+%) product gross margins • $31.9M in cash (6/30/22) • 20
Slide 5: Marketed Products and Product Pipeline
Marketed Products and Product Pipeline Internal development supplemented by strong government support with ~$40M in grants, contracts, other non-dilutive funds awarded to date for our technology from DARPA, NIH, NHLBI, U.S. Army, U.S. Air Force, HHS, and others Sepsis, Critical Care, Removal of High
Slide 6: What does CytoSorb do and How does it work?
What does CytoSorb do and How does it work?? 6
Slide 7: The CytoSorb adsorber
The CytoSorb adsorber The underlying blood purification technology is based on biocompatible, highly porous polymer beads that act like tiny sponges to remove harmful substances from blood • Massive surface area: 7 football fields in a single cartridge • 21 issued U.S. patents and multiple patents i
Slide 8: Expanding the Dimension of Blood Purification
Expanding the Dimension of Blood Purification CytoSorb is fundamentally different from, but complementary to, dialysis technology, removing a broad range of dissimilar toxins that dialysis does not remove well CytoSorb works like the liver Dialysis works like the kidney with some kidney function Lar
Slide 9: CytoSorb is Plug and Play Compatible
CytoSorb is “Plug and Play” Compatible Compatible with Existing Blood Pump Infrastructure In Hospitals Today Dialysis or CRRT ECMO (Continuous Renal Replacement Therapy) (Extracorporeal Membrane Oxygenation) Hemoperfusion CPB (Standalone Treatment) (Cardiopulmonary Bypass) 9
Slide 10: Targets Deadly Conditions That Afflict Millions of People
Targets Deadly Conditions That Afflict Millions of People Critical Care Cardiothoracic Surgery Removes the “fuel to the fire” of massive Reduces inflammation and blood thinners, uncontrolled inflammation that is often targeting reduction in complications of cardiac associated with organ failure and
Slide 11: Riding Many Macro Trends in Healthcare
Riding Many Macro Trends in Healthcare Aging Population is Getting Older The Use of Blood Thinners Millions worldwide are on blood thinners to reduce risk of stroke and heart attack >1 billion over 60 Chronic Liver Disease Opiate Crisis & Afflicts 1 in 11 worldwide Endocarditis 11
Slide 12: What is the Company's Business model and Financial performance?
What is the Company’s Business model and Financial performance? 12
Slide 13: CytoSorbents Has a Strong Hybrid Sales Model
CytoSorbents Has a Strong Hybrid Sales Model 75 Countries Worldwide and >179,000 devices utilized Critical Care and Cardiac Surgery Direct Sales Distributor and Partner Sales Direct sales in 15 countries: Distributor and Partner sales in >60 other countries Germany, Austria, Switzerland, Belgium, En
Slide 14: CytoSorb Commercialization Focus
CytoSorb Commercialization Focus By Market By Geography Other Critical Care – 17% • ARDS • Reversal of Shock 33% Distributor / Partner • Trauma 17% Critical Care 67% • Austria • Acute Liver / Pancreatic 15% Other Direct • Switzerland • Many Others Sepsis • 10 other Cardiac Surgery – 33% countries an
Slide 15: CytoSorb Is a High Margin Razorblade
CytoSorb Is a High Margin “Razorblade” • High margin “razorblade” fully compatible with existing installed base of “razor” blood pumps: Dialysis, CRRT, and ECMO machines (ICU), and heart-lung machines (OR) • Blended historic gross margins are 80+%, driven by volume production from our current manufa
Slide 16: Annual Product Sales
Annual Product Sales 1H 2022 core non-COVID-19 product sales were $14.9M, or $16.3M on a constant currency adjusted basis reflecting a weak Euro, roughly half of 2021 core sales. COVID-19 sales were nominal at $0.3M Product Sales $45.0 $39.5M $40.1M $40.0 $6.3 $9.4 $35.0 $33.8 $30.0 $30.1 $ IN MILLO
Slide 17: Recent Results Reflect Impact of COVID
However, Recent Results Reflect Impact of COVID Q1 Q2 2022 2022 • The macro environment has been challenging in Europe and Germany • Core business has been stable on a constant currency basis, averaging $8.2M for the past 4 quarters but Germany has been impacted by prior high rates of COVID which ha
Slide 18: What are the catalysts for growth?
What are the catalysts for growth? 18
Slide 19: Laser-Focused on 2022 Strategic Objectives
Laser-Focused on 2022 Strategic Objectives Despite the short-term impact of COVID-19 and geopolitical and economic events on our business, we continue to be disciplined in our focus and execution to position our company for success with key near-term goals: Execute on STAR-T and STAR-D to open the U
Slide 20: Open the U.S. Market via STAR-T and STAR-D Pivotal Trials
#1 Open the U.S. Market by Targeting FDA Marketing Approval via STAR-T and –D Pivotal Trials 20
Slide 21: EU Approval to Remove Brilinta and Xarelto During Cardiothoracic Surgery
EU Approval to Remove Brilinta and Xarelto “Blood Thinners” During Cardiothoracic Surgery CytoSorb has received E.U. approval to remove two well-known blockbuster “blood thinners” during cardiothoracic surgery, used in millions of patients to reduce risk of stroke and heart attacks Brilinta® (generi
Slide 22: Risk of Bleeding Is High in CABG Patients on Brilinta
Risk of Bleeding Is High in CABG Patients on Brilinta In the Brilinta (ticagrelor) registration PLATO (PLAeleT inhibition and patient Outcomes) trial, 1584 patients underwent CABG surgery, randomized between those who received either ticagrelor or clopidogrel. Those patients (%) with life-threatenin
Slide 23: By Removing Drug, CytoSorb Reduces Bleeding Complications
By Removing Drug, CytoSorb Reduces Bleeding Complications In a separate analysis done in the U.K., this has translated into a projected cost savings to the hospital of approximately $5,000 per patient, including the cost of CytoSorb • Hassan K, et al. Ann Thor Surg. 2019; 1:45-51. • Javanbakht, M, e
Slide 24: Targeting U.S. FDA Marketing Approval
Targeting U.S. FDA Marketing Approval • We seek U.S. FDA marketing approval of DrugSorb™-ATR to remove the blood thinners, Brilinta®, and Xarelto® and Eliquis® ($16.7B in 2021 sales) during open heart surgery, to reduce potentially fatal bleeding complications • We were awarded two FDA Breakthrough
Slide 25: Co-Principal Investigators of STAR-T
Co-Principal Investigators of STAR-T C. Michael Gibson, MS, MD Michael Mack, MD Interventional Cardiologist Cardiothoracic Surgeon • Professor of Medicine, Harvard Medical School • Chairman, Baylor Scott & White The Heart Hospital • President & CEO of non-profit Baim Institute • President, Baylor Sc
Slide 26: United States TAM for Ticagrelor Removal
United States TAM for Ticagrelor Removal 50,000 patients on ticagrelor needing emergent/urgent open heart surgery annually in US X $5,000 per device $250M Initial U.S. Total Addressable Market Ticagrelor market share expected to grow • DrugSorb-ATR would make ticagrelor the only reversible platelet
Slide 27: Addressable U.S. Market for Antithrombotic Removal by DrugSorb-ATR
Addressable U.S. Market For Current and Potential Future Indications for Antithrombotic Removal by DrugSorb-ATR Eliquis®, Xarelto® and Brilinta® $2.0B All surgery Eliquis®, Xarelto® and Brilinta® $1.0B Cardiac surgery Brilinta® Cardiac surgery $500M (Future) Brilinta® Cardiac surgery $250M (Today) 2
Slide 28: Restore Growth of CytoSorb Sales
#2 Restore Growth of CytoSorb Sales 28
Slide 29: Early but Encouraging Signs of Market Improvement
Early but Encouraging Signs of Market Improvement Although not yet showing up in our numbers, we see early, but encouraging signs of improvement, including: • More customer visits in Germany during the quarter Germany • Continued strong positive support from customers, where the feedback on lower or
Slide 30: Important Recent Developments
Important Recent Developments • Expansion of direct sales to U.K. • New dedicated reimbursement in Israel (cardiac) and Turkey (ICU and cardiac) • Important recent business developments that have the potential to drive future sales Germany • Preferred supplier agreement with Asklepios Group, one of
Slide 31: Transition to New Manufacturing Facility
#3 Transition to New Manufacturing Facility 31
Slide 32: Scaling Manufacturing Capacity to $300-400M
Scaling Manufacturing Capacity to $300-400M • Relocated to new headquarters in Princeton, NJ with new manufacturing facility that is expected to increase manufacturing capacity by 5x to $300-400M in annual sales, while expanding product gross margins beyond 85% due to volume manufacturing • Capital
Slide 33: More Partnerships
#A More Partnerships 33 CytoSorhents.
Slide 34: We are Central to Major Therapeutic Areas
We are Central to Major Therapeutic Areas Acute Care Cardiovascular Organ Transplant 34
Slide 35: Summary
Summary CytoSorbents has the potential to become a highly profitable performer in the therapeutics space with superior operating profit margins • High margin razorblade business model with excellent operating leverage and a solid track record of ex-US growth • Strong foundation and well-funded for p
Slide 36: Helping to Treat Life-Threatening Conditions in the ICU and Cardiac Surgery
HELPING TO TREAT LIFE-THREATENING CONDITIONS IN THE ICU AND CARDIAC SURGERY AROUND THE WORLD Dr. Phillip Chan Kathleen Bloch Chief Executive Officer Chief Financial Officer pchan@cytosorbents.com kbloch@cytosorbents.com