CytoSorbents Corporation · NASDAQ:CTSO
CytoSorbents — Investor Presentation (November 2019)
34 slides from CytoSorbents's investor presentation, November 2019
Slide 1: Investor Presentation November 2019
HELPING REDUCE DEADLY UNCONTROLLED INFLAMMATION IN HOSPITALIZED PATIENTS WORLDWIDE NASDAQ: CTSO Investor Presentation November 2019
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 is a Leader in Critical Care Immunotherapy
CytoSorbents is a Leader in Critical Care Immunotherapy Leading the Prevention or Treatment of Life-Threatening Inflammation in the ICU and Cardiac Surgery using CytoSorb® Blood Purification 3
Slide 4: CytoSorbents At a Glance
CytoSorbents At a Glance (NASDAQ: CTSO $4.50) • CytoSorb® is E.U. approved as an extracorporeal cytokine adsorber with 73,000+ cumulative treatments (up from 51,000 a year ago) delivered and distributed in 58 countries • Trailing 12-month performance (as of 9/30/19) 2018 2019 Increase Total Revenue
Slide 5: Uncontrolled Inflammation is Deadly
Uncontrolled Inflammation is Deadly Sepsis Trauma Influenza Burn Injury Millions Die Of Uncontrolled Deadly Inflammation Each Year Lung Injury Cytokine Release Syndrome Pancreatitis Liver Failure Surgical Complications 5
Slide 6: Massive Inflammation Causes Organ Failure
Massive Inflammation Causes Organ Failure Organ failure occurs when vital organs stop working, causing nearly half of all deaths in the ICU. Little can be done to prevent or treat organ failure today 6
Slide 7: No Ideal Options to Treat Severe Inflammation
No Ideal Options to Treat Severe Inflammation Anti-Inflammatory Immunosuppressive (too weak) (too strong) NSAIDs Corticosteroids Aspirin Chemotherapy Anti-cytokine Organ transplant Anti-rejection drugs antibodies Radiation Anti-integrin antibodies Immune system ablation Anti-oxidants Anti-leukocyte
Slide 8: CytoSorb Bridges the Gap
CytoSorb Bridges the Gap Anti-Inflammatory Immunosuppressive (too weak) (too strong) NSAIDs Corticosteroids Aspirin Chemotherapy Anti-cytokine Organ transplant antibodies Anti-rejection drugs Anti-integrin Radiation antibodies Immune system Anti-oxidants ablation Anti-leukocyte Abs 8
Slide 9: CytoSorb Reduces the Fuel to the Fire
CytoSorb® Reduces the Fuel to the Fire • CytoSorb® targets the $20+ billion opportunity in critical care and cardiac surgery • Approved in the European Union as the first specifically approved extracorporeal cytokine adsorber • Broad indication for use where cytokines are elevated • Removes cytokine
Slide 10: Patented Blood Purification Technology
Patented Blood Purification Technology The underlying blood purification technology is based on biocompatible, highly porous polymer beads that act like tiny sponges to remove harmful substances from blood Each bead is about the size of a grain of salt . • Proprietary patented technology with multip
Slide 11: CytoSorb is Plug and Play
CytoSorb is “Plug and Play” Compatible with Existing Dialysis and Heart-Lung Machines • Place a temporary dialysis catheter in a major vein • Connect the device to a standard dialysis, ECMO, or heart-lung machine found in hospitals worldwide • Pump blood out of the body and through the cartridge • T
Slide 12: Goal: To Prevent or Treat Organ Failure
Goal: To Prevent or Treat Organ Failure Improve Decrease Patient Costs Of Outcome ICU and and Patient Survival Care Sepsis ARDS Burn Injury Trauma Pancreatitis Influenza Surgical The Potential to Revolutionize Critical Care Medicine 12
Slide 13: The World Needs CytoSorb
The World Needs CytoSorb® 13
Slide 14: Refractory Septic Shock
Refractory Septic Shock Prospective, single arm study in 20 patients with refractory late-stage septic shock using CytoSorb aggressively every 12 hours with a new cartridge • Patients had refractory shock despite high doses of vasopressors, respiratory failure requiring mechanical ventilation, oligo
Slide 15: CytoSorb Survival Benefit in Septic Shock
CytoSorb Survival Benefit in Septic Shock Retrospective study evaluating primary endpoint of 28-day mortality in 116 septic shock patients • Continuous renal replacement (CRRT) alone (n=49) • CRRT with CytoSorb (n=67) • At baseline, CytoSorb patients were more sick • SOFA score: 13.8 treatment vs 12
Slide 16: CytoSorb Has a Hybrid Sales Model
CytoSorb® Has a Hybrid Sales Model 58 Countries Worldwide and 73,000+ treatments Critical Care and Cardiac Surgery Direct Sales Distributor and Partner Sales Direct sales in 10 countries: Distributor and Partner sales in 48 countries Germany, Austria, Switzerland, Belgium, Recently added Mexico and
Slide 17: 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, ECMO machines (ICU), heart-lung machines (OR) • Blended gross margins are 77%, expected to rise to ~80% on a quarterly basis in Q4 2019, driven by v
Slide 18: Quarterly Product Sales
In Thousands of U.S. Dollars $0 $1,000 $2,000 $3,000 $4,000 $5,000 $6,000 Q3… $14 Q4… $88 Q1… $176 Q2… $128 Q3… $204 Q4… $314 Q1… $569 Q2… $663 Q3… $1,032 Q4… $871 Q1… $704 Q2… $773 Quarterly Product Sales Q3… $1,071 18 Q4… $1,496 Q1… $1,597 Q2… $1,852 Q3… $2,143 Q4… $2,613 Q1… $2,596 Q2… $3,041 Q3…
Slide 19: Product Sales (TTM) and Blended Gross Margins
Product Sales (TTM) and Blended Gross Margins $21,626,242 80% $20,000,000 $19,077,646 78% 76% $15,000,000 74% $11,698,607 72% 70% $10,000,000 68% $7,088,825 66% $5,000,000 $3,419,379 64% $2,578,396 62% $0 60% Q3 2014 Q3 2015 Q3 2016 Q3 2017 Q3 2018 Q3 2019 CytoSorb Sales Blended Product Gross Margin
Slide 20: Forecast CytoSorbents 2020: Faster Growth Ahead
Forecast CytoSorbents 2020: Faster Growth Ahead 20
Slide 21: Demand for CytoSorb Continues to Grow
Demand for CytoSorb Continues to Grow • CytoSorb sales are driven primarily by re-orders with ~85% of our invoices from repeat customers • The average number of CytoSorb cartridges per invoice at many accounts continues to rise, demonstrating increased usage and adoption • Usage is increasing becaus
Slide 22: Investing Heavily for Growth
Investing Heavily for Growth • Direct sales are ~75% of our product sales, with higher product gross margins • Doubled the number direct sales countries from 5 to 10 in 2019, adding Poland, Sweden, Netherlands, Norway and Denmark, to Germany, Austria, Switzerland, Belgium and Luxembourg (adding a po
Slide 23: Strong Focus on Germany
Strong Focus on Germany • Germany is the largest medical device market in the E.U. and the third largest in the world. The German market alone represents a $1.0-1.5 billion total addressable market for CytoSorb • CytoSorb has a strong foundation for growth in Germany • Outstanding sales team, includ
Slide 24: Sales of CytoSorb in Germany
Sales of CytoSorb in Germany 12 reps $24M $2.0M per • Subdivided Germany to shrink territories to allow maximization of revenue opportunity: rep $22M Enables focus and growth of key accounts, increased efficiency due to shorter travel, and ability to detail small and mid-sized hospitals better $1.8M
Slide 25: Near Term Clinical Data May Catalyze Sales
Near Term Clinical Data May Catalyze Sales Also CytoSorb® Indication Pre-Clinical Safety Feasibility Pivotal APPROVED Post-market Cytokine Storm, EU Liver Disease Extracorporeal Cytokine, Bilirubin, and Myoglobin Adsorber EU Endocarditis REMOVE Endocarditis Trial - Germany EU Endocarditis TISORB Tic
Slide 26: REMOVE Endocarditis Trial Data Read in Mid-2020
REMOVE Endocarditis Trial Data Read in Mid-2020 • Infective endocarditis (heart valve infection) occurs when bacteria seeds a heart valve from IV drug abuse and dirty needles, or from dental procedures • The incidence of endocarditis is rising due to the opiate crisis • Patients often require open h
Slide 27: REFRESH 2-AKI Interim Analysis Target in 1H 2020
REFRESH 2-AKI Interim Analysis Target in 1H 2020 • Heart disease is the leading killer worldwide, driving 1.5M open heart surgeries each year and fueled by the aging baby boomer generation • High risk invasive cardiac surgery generates inflammatory toxins (e.g. free hemoglobin and activated compleme
Slide 28: First CRS Trial Initiated in CAR-T Cell Immunotherapy
First CRS Trial Initiated in CAR-T Cell Immunotherapy • CAR-T cell cancer immunotherapy is a blood cancer treatment breakthrough. • However, ~40-50% of patients can develop severe, high grade cytokine release syndrome (CRS), a cytokine storm that can lead to rapid organ failure and potentially death
Slide 29: Projected Near-term Data Catalysts
Projected Near-term Data Catalysts US US REFRESH 2-AKI REFRESH 2-AKI CytoSorb Interim Analysis Targeted Completion PMA Submission Germany UK TISORB REMOVE Germany UK TISORB Start Endocarditis REMOVE Finish CAR T-cell Complete Data CAR T-cell CRS/CRES Start CRS/CRES Finish 2019 2020 2021 HemoDefend-R
Slide 30: Antithrombotic Drug Removal Is Important
Antithrombotic Drug Removal Is Important • Anti-thrombotic drugs, such as Eliquis®, Xarelto®, Pradaxa®, Brilinta®, Plavix® and others are blockbuster products with collective sales of more than $20 billion • 6+ million people in the U.S. are on these medication to reduce stroke and cardiac risk foll
Slide 31: Expanded Label Targets Liver Failure and Trauma
Expanded Label Targets Liver Failure and Trauma Recently received European approval to expand the use of CytoSorb in liver disease to reduce bilirubin, and in trauma to reduce myoglobin – both very large markets • Liver disease • 850 million people suffer from chronic liver disease due to viral hepa
Slide 32: HemoDefend Could Be Approved in US in 2020
HemoDefend Could Be Approved in US in 2020 • Point-of-care filter rapidly and efficiently removes non-infectious contaminants from transfused pRBCs that can cause transfusion reactions • Funded up to $4.7M by NHLBI (NIH) and USSOCOM • Compatible with pathogen reduction technologies • 100M pRBC trans
Slide 33: Investment Summary
Investment Summary • We believe we are a unique company in the medical device space with a high margin razorblade in another’s razor business model • We are helping to treat some of the largest unmet medical needs in modern medicine and are riding the wave of multiple macro trends • Aging baby boome
Slide 34: NASDAQ: CTSO Contact
NASDAQ: CTSO Dr. Phillip Chan, MD, PhD – CEO pchan@cytosorbents.com