Accuray Incorporated · NASDAQ:ARAY
Accuray — Investor Day (October 2020)
71 slides from Accuray's investor day presentation, Oct 26, 2020
Slide 1: Accuray Innovation Driven Growth Strategy Investor Day
Accuray Innovation Driven Growth Strategy Investor Day October 26, 2020 EXHIBIT 99.1
Slide 2: Safe Harbor Statement
Safe Harbor Statement Statements in this presentation (including the oral commentary that accompanies it) that are not statements of historical fact are forward-looking statements and are subject to the “safe harbor” provisions of the Private Securities Litigation Reform Act of 1995. Forward-looking
Slide 3: Agenda
Welcome Company Vision and Growth Strategy Market Dynamics and Long-Term Growth Catalysts Enabling Technology and Product Roadmap Q & A Agenda
Slide 4: Radiation Therapy: Powerful, Non-Invasive, New Therapeutic Option
Powerful Non-Invasive Easy Patient Treatment Experience Potential for Improved Outcomes and Quality of Life New Therapeutic Option Hope Radiation Therapy…
Slide 5: Our Vision
To expand the curative power of radiation therapy to improve as many lives as possible. Our Vision Broader treatment options Beyond oncology Global patient access expand Enable advanced treatments Survival, long term outcomes Quality of life curative Precision technology Focused, agile organization
Slide 6: Accuray Growth Strategy: Deliver More. Better. Faster.
Accuray Growth Strategy: Deliver More. Better. Faster. Experienced leadership team Focused R&D investment to drive innovation Differentiated go-to-market strategy in China Growing operational leverage Unique, ultra-precision platforms Robotic, non-coplanar delivery Helical imaging and delivery Advan
Slide 7: Experienced Leadership Team
Experienced Leadership Team Suzanne Winter Chief Commercial Officer SVP R&D Medtronic, GE, Toshiba Shig Hamamatsu Chief Financial Officer Cepheid, PWC Scott Chapman SVP Global Service GE Healthcare Jesse Chew General Counsel Wilson Sonsini Michael Hoge SVP Global Operations GE. Generac Patrick Spine
Slide 8: Why Customers Choose Accuray
Enables Why Customers Choose Accuray Ultra-Precise, Radiation Therapy Planning and Delivery Platforms CyberKnife® Platform Robotic design SRS/SBRT Versatility across neuro and radiation oncology Helical imaging & delivery Broad patient treatment with SBRT growth Dedicated to oncology Outcomes Qualit
Slide 9: Operating Earnings and Installed Base Recent Trends
Operating Earnings and Installed Base Recent Trends Improving Fundamentals and Growing Installed Base Operating Leverage Growing Installed Base 582 932 5.4% CAGR Operating leverage expected to drive long-term profitability growth Generated >$200M+ of annual service revenue for the past six fiscal ye
Slide 10: Innovation Pipeline and Patent Portfolio
VOLO™ NeuroCK ClearRT™ Adaptive TomoTherapy® China/Value FY21-23 Synchrony® Global Patent Portfolio1 472 Issued 129 Pending As of June 30, 2020, we held exclusive field of use licenses or ownership of approximately 472 U.S. and foreign patents, and approximately 129 U.S. and foreign patent applicati
Slide 11: Strategy to Accelerate Long-Term Growth Trajectory
Strategy to Accelerate Long-Term Growth Trajectory FY2018 - FY2019 FY2022+ Plan FY2020 - FY2021 Plan Transform Culture and Begin Innovation Driven Growth Enhanced leadership team Won 50 out of 58 China Type A licenses and established China joint venture Reset cost structure to increase operating lev
Slide 12: Favorable Market Dynamics and Long-Term Growth Catalysts
Favorable Market Dynamics and Long-Term Growth Catalysts Suzanne Winter Chief Commercial Officer Senior Vice President, R&D
Slide 13: Favorable Market Dynamics and Long-Term Growth Catalysts
Favorable Market Dynamics and Long-Term Growth Catalysts Global Radiotherapy Market Overview China Market Opportunity and our Differentiated Strategy Treatment Modality Trend (SBRT vs. Conventional) RO-APM Update / How Accuray will Benefit
Slide 14: A Growing Addressable Market
A Growing Addressable Market Underpenetrated Global Radiotherapy Market1 18 MILLION 50-60% 30% 21,8002 +7,700 +150% New Cases Of Cancer Worldwide In 2018 Of Cancer Patients Worldwide Would Benefit From Radiation Therapy Currently Receive Radiation Therapy Total Number Of Linacs Needed By 2035 Number
Slide 15: Neurosurgery Market Opportunity
Growing global interest in stereotactic radiosurgery1 RSS/ISRS: >1,400 members Non-invasive, surgical alternative Aging Gamma Knife installed base2 Growing interest in movement disorders3 Capital equipment budget constraints expected to provide opportunity for shared systems4 Neurosurgery Market Opp
Slide 16: Aging Installed Base Upgrade to Advanced Capabilities
Developed Markets Aging Installed Base Upgrade to Advanced Capabilities Replacement and Upgrade Opportunity Age of Accuray Installed Base Median age of total US radiation therapy installed base: ≥ 8 years1 82% of purchases are replacements1 New capabilities driving purchase decisions IMV 2019 Radiat
Slide 17: China
ACCURAY C) China Propristary and Confidential Property of Accursy: ay
Slide 18: China: Unprecedented Long-Term Growth Opportunity
China: Unprecedented Long-Term Growth Opportunity China Expected Cancer Incidence Annual New Diagnosed1 12,000 4.3M (2.5x the amount in the U.S.) /day China’s lack of access to Radiotherapy: Linac Installed Base by Country Significant Gap1 Chen W, et al. Cancer statistics in China, 2015
Slide 19: Accuray's Differentiated Strategy China Joint Venture
Accuray’s Differentiated Strategy China Joint Venture “MADE IN CHINA 2025” INITIATIVE MARKET ACCESS UNIQUE POSITIONING EXPANDS TYPE B OPPORTUNITY Locally branded and manufactured product well-aligned with local policies Broad JV commercial infrastructure and access to hospitals Competitive advantage
Slide 20: Key Achievements and Future Milestones China JV
Key Achievements and Future Milestones China JV Status Update Key Operational Achievements Manufacturing facility construction complete Customer Training Center activated 20+ sub-dealer network established 40+ service engineers transferred from TomoKnife (legacy distributor) Future Milestones Manufa
Slide 21: Accuray Strong Win Rate in Type A 1st Round
Accuray Strong Win Rate in Type A 1st Round China Market Opportunity TYPE A “PREMIUM” TYPE B “CORE” QUOTA TYPE 188 1,451 Radixact® ACCURAY PRODUCT Tomo HDA™ and HD® CyberKnife® TomoH® New JV System2 ACCURAY WIN RATE 50 OUT OF 581 86% of Type A licenses awarded to Accuray systems in the first round T
Slide 22: Clinical Trends Toward Ultra-Hypofractionation
Clinical Trends Toward Ultra-Hypofractionation
Slide 23: Factors Accelerating Shorter Treatments
IMV 2019 Radiation Therapy Market Summary Report; Radiation Oncology Alternative Payment Model Treatment system consolidation Treatment demand increasing Reimbursement pressure Patient/provider impact due to COVID Clinical evidence and guidelines U.S.: 2014 - 2019 Factors Accelerating Shorter Treatm
Slide 24: Purchase Decisions Prioritizing Advanced Technologies
IMV 2019 Radiation Therapy Market Summary Report U.S.: 2014 - 2019 Purchase Decisions Prioritizing Advanced Technologies Clinical sites adopting advanced delivery methods1 SBRT Respiratory Motion Management Adaptive Therapy Neuro / SRS 46% 45% 35% 70% 50% 37% 28% 28% 86% 64% 67% 51% Next 3 years 201
Slide 25: Reimbursement Changes: Radiation Oncology Alternative Payment Model (RO-APM)
Reimbursement Changes Radiation Oncology Alternative Payment Model (RO-APM) Shawn Prince Senior Director, Patient Access
Slide 26: RO-APM Market Catalyst
RO-APM Market Catalyst Accuray technologies are expected to thrive in new environment Specifically designed to deliver ultra-hypofractionated treatments Enable treatments that are more cost efficient for the provider to deliver Provides the potential to reduce CAPEX and OPEX – treat more patients wi
Slide 27: RT Services Included in RO-APM Bundle
RT Services Included in RO-APM Bundle InCise™ Multileaf Collimator, TQA™ Software, Synchrony® Respiratory Vest CyberKnife® , Radixact® Systems PreciseART® Adaptive Radiation Therapy Accuray Precision® Treatment Planning System Treatment Planning Technical Prep & Special Services Radiation Delivery T
Slide 28: Accuray Capabilities Align With Key Diagnoses in RO-APM
Accuray Capabilities Align With Key Diagnoses in RO-APM Cancer Type ASTRO / NCCN Guidelines Percent of Radiation Therapy Cases** Mod-HF Ultra-HF Head & Neck * Brain Mets Bone Mets Prostate Lung Breast ~80% of All RT Cases HF – Hypofractionation * For recurrences ** Clinical Mix – Medicare Claims (20
Slide 29: Beyond CMS: Commercial Payers Mandate Hypofractionation
Example: Prostate Cancer Beyond CMS: Commercial Payers Mandate Hypofractionation 4M Covered Lives 22M Covered Lives 1.5M Covered Lives Fx Commercial payers are rapidly adopting clinical guidelines Blue Shield of California4 Prove medical necessity for conventional treatment eviCore5 Radiation Benefi
Slide 30: Provider Strategy: Ultra-Hypofractionation Increases Capacity
Provider Strategy: Ultra-Hypofractionation Increases Capacity SOME HEADING GOES HERE Door-to-Door Appointment Times Time Elements Linear Accelerator Uptime Conventional Moderate Ultra Conventional Moderate Ultra Greater adoption of ultra-hypofractionation increases the number of patients treated Tre
Slide 31: Ultra-Hypofractionation Supports Shift From Volume to Value
Ultra-Hypofractionation Supports Shift From Volume to Value Increase annual number of patients treated Shorter total treatment times Decrease treatment related costs Improved total cost of ownership Provide high quality patient outcomes and experiences Reduced toxicities due to tighter margins Accur
Slide 32: Enabling Technology and Product Roadmap
Enabling Technology and Product Roadmap Corey Lawson Vice President, Product Strategy
Slide 33: Aligning Innovation to Growth Opportunities
Aligning Innovation to Growth Opportunities New Clinical Paradigms Expanding Global Access Technology Advancements Personalized Precision Opportunity to innovate and grow
Slide 34: Radixact Roadmap Programs
ACCURAY Radixact® Roadmap Programs Propristary and ConfidentialProperty ofAccuray 34
Slide 35: Radixact System Ultra-Precise Helical Delivery
*ClearRT Helical kVCT Technology is 510(k) Pending Fast Warmup Intelligent Helical kVCT Imaging Quick Installation Helical Delivery Scalable Platform Motion Synchronization Connected Ultra-Precise Helical Delivery | Treats Simple to Complex
Slide 36: Synchrony
ACCURAY C) Synchrony® Propristary and ConfidentialProperty ofAccuray 3)
Slide 37: Managing Motion With Synchrony
Comfortable for the Patient and Easy for Clinical Staff Managing Motion With Synchrony® NATURAL PATIENT BEHAVIOR Greater Patient Comfort Improving the Patient Experience MINIMAL MARGINS Potential for Better Clinical Outcomes with Fewer Side Effects Freedom to Ultra-Hypofractionate Treatment Delivery
Slide 38: Managing Patient Respiration: Conventional Methods
Managing Patient Respiration: Conventional Methods Patient Restraint: Abdominal Compression Trained Breathing Device: Enable Predictable Gating
Slide 39: Synchrony on the Radixact System
Imaging + External camera AI-driven predictive model of target position with respiration Imaging enables in-treatment monitoring of target location External camera enables real-time monitoring of breathing cycle System creates an AI-driven predictive model of target location with breathing cycle Ena
Slide 40: Synchrony on the Radixact System: Dynamic Jaws
Imaging enables in-treatment monitoring of target location External camera enables real-time monitoring of breathing cycle System creates a model of the target location with breathing cycle Dynamic jaws and binary MLC enable the system to synchronize delivery with known target location Enables Conti
Slide 41: Patient Case Highlight: SBRT Lung
Courtesy of Froedtert & the Medical College of Wisconsin, Milwaukee, WI. Synchrony data compared to conventional technologies Patient Case Highlight: SBRT Lung1 Synchrony® on the Radixact® System Patient: 45-year old male with lung metastasis SBRT: 54 Gy in 3 fractions (18 Gy/fx) No fiducials: reduc
Slide 42: Synchrony Clinical Advantages Over Conventional Methods
Conventional Methods Clinical Advantages Synchrony® on the Radixact® System Fast Beam ON throughout range of motion Slow Beam OFF much of the motion cycle (Gating) Compromised Wider margins compensate for slow speed (ITV) Precise Tighter margins enabled when beam follows the target Enables Ultra-Hyp
Slide 43: Prof. Umberto Ricardi
Prof. Umberto Ricardi Chairman of Radiation Oncology and Dean of the School of Medicine at the University of Turin in Turin Italy, as well as the Director of the Department of Oncology at Health and Science Academic Hospital in Turin. Today, he’s using Radixact with Synchrony to deliver extremely pr
Slide 44: Dr. Chikao Sugie
Dr. Chikao Sugie Completed clinical training in the Department of Radiology at the Graduate School of Medical Sciences and Medical School, Nagoya City University. He then went on to become an Associate Professor in the Department of Radiology at Nagoya City University. He pursued research on radiati
Slide 45: ClearRT Imaging for the Radixact System
ClearRT™ Imaging for the Radixact® System 510(k) Pending *ClearRT Helical kVCT technology is 510(k) pending - This does not reflect a commitment to deliver products, software, features, functionality, or upgrades, and should not be relied upon in making purchasing decisions.
Slide 46: Imaging Center of Excellence
ClearRT Helical kVCT Technology is 510(k) Pending Experienced and Knowledgeable Team Imaging Center of Excellence Strategic investment in imaging High density of imaging companies and expertise Significant impact with iterative reconstruction and Synchrony® development programs Introduction of Clear
Slide 47: Clinical Value of Improved Imaging
Pre-Delivery Ensures proper patient positioning prior to each fraction Favors efficient setup, workflow, departmental efficiency Intra-Delivery Verifies ongoing tumor and beam alignment (Synchrony®) Post-Delivery Measures dose delivered to the target and surrounding healthy tissue Becomes the simula
Slide 48: ClearRT Helical kVCT Quality Leadership
ClearRT Helical kVCT Technology is 510(k) Pending Quality Leadership Bringing diagnostic-like quality images into the RT workflow Unmatched Flexibility Largest field-of-view (50cm) and scan length (up to 135cm) Fast 1-meter in 1-minute for long field registration No learning curve, familiar user int
Slide 49: Radixact Unique Helical Platform Advantage
Radixact® System’s Unique Helical Platform Advantage ClearRT™ Helical kVCT1 28cm 20cm 50cm 30cm 38cm High Speed Broad Imaging Beam Moderate Scatter High Quality Narrow Imaging Beam Low Scatter ClearRT Helical kVCT Technology is 510(k) Pending
Slide 50: Unique Advantages Over Other Offerings: Conebeam
Unique Advantages Over Other Offerings ClearRT™ Helical kVCT1 Conebeam 40cm 1.35 Meters Exceptional Spatial Resolution MR prone to geometric distortion Excellent uniformity and low noise across entire image Conebeam CT prone to scatter artifact Low-contrast anatomy such as skin, fat, and soft tissue
Slide 51: Unique Advantages Over Other Offerings: MVCT and Diagnostic CT
Unique Advantages Over Other Offerings ClearRT™ Helical kVCT1 MVCT ClearRT™ (High Speed Mode) Diagnostic CT (Note: Acquisitions performed several minutes apart, NOT exactly the same slice) ClearRT Helical kVCT Technology is 510(k) Pending Porcine image
Slide 52: ClearRT Plus Under Development
ClearRT Plus Technology is under development – This does not reflect a commitment to deliver products, software, features, functionality, or upgrades, and should not be relied upon in making purchasing decisions Further Enhances Soft-Tissue Contrast Directly competes with MR-linac on soft tissue con
Slide 53: Executing on the Imaging Vision and Roadmap
Conebeam CT Linacs Soft Tissue Visualization and Fiducial-Free Tracking Almost Anywhere in the Body Performance Cost/Complexity MR Linacs Executing on the Imaging Vision and Roadmap ClearRT™ Helical kVCT CTrue™ IR, MVCT ClearRT Helical kVCT1 ClearRT™ Plus2 Acquisition Costs Installation Costs Mainte
Slide 54: Tomo VOLO: Improved Treatment Planning and Efficiency
Tomo Volo technology is under development - This does not reflect a commitment to deliver products, software, features, functionality, or upgrades, and should not be relied upon in making purchasing decisions. Improved Treatment Planning and Operational Efficiency TOMO VOLO™1 Snapshots Auto pitch an
Slide 55: Emerging Market System Needs: Value Segment/China
Emerging Market System Needs Value Segment/China High throughput / workflow efficiency Reduced total cost of care Base clinical capabilities with options Upgradeability path Targeting calendar 2022 availability Product Priorities In Development
Slide 56: Radixact System Innovation Roadmap Summary
Synchrony® SBRT Expansion ClearRT™ Fundamental to Adaptive Therapy1 VOLO™ Fast Planning, Fast Treatments2 Beam follows moving targets in real-time, speeding delivery while improving delivery quality Improved Operational Efficiency Radixact® platform: foundation for therapy innovation Image the large
Slide 57: CyberKnife Roadmap Programs
CyberKnife® Roadmap Programs
Slide 58: CyberKnife Unique Robotic Platform
Quick Installation Industry-Leading Uptime Fast Treatment Planning Fast Treatment Delivery Unique Robotic Platform Moving or Stationary Targets Dose Minimization To Organs At Risk Flexible Dose Sculpting Industry-Leading Precision | Confident, Effective SRS And SBRT Treatment Delivery
Slide 59: Pioneering NeuroRadiosurgery With CyberKnife
A Practical Guide to Build an SRS Program Pioneering NeuroRadiosurgery With CyberKnife® Covers all intracranial and spine indications 38 Authors 14 Countries
Slide 60: Neuro Package for CyberKnife S7 System
Frameless or Frame-Based1 Choose based upon clinical need; maintain familiarity to those transitioning from other delivery systems Neuro Planning Integrates workflows and planning conventions recognized by neurosurgeons Oligometastatic Treatment Ability to treat multifocal disease with greater effic
Slide 61: ClearRT Volumetric Imaging for CyberKnife S7
Integrated 3D Volumetric Imaging Planning Supports efficient same-day simulation / plan / treat workflow Registration Enables imaging the patient in treatment position, increasing speed and confidence in initial setup and registration Advanced Adaptive Opens the door to advanced Adaptive features, t
Slide 62: CyberKnife System Innovation Roadmap Summary
CyberKnife® System Innovation Roadmap Summary Synchrony® with VOLO™ Enables SRS and SBRT Neuro Upgrades Expands Opportunity1 ClearRT™ Fundamental to Adaptive Therapy2 Efficient sub-millimeter precision delivery Image with diagnostic-like quality, quickly CyberKnife® S7™ platform: foundation for cont
Slide 63: Dr. Chris Loiselle
Dr. Chris Loiselle Board-certified Radiation Oncologist who practices at the Swedish Medical center in Seattle WA. Dr. Loiselle received his medical degree from John’s Hopkins University and completed his residency in Radiation Oncology from the University of Washington Medical Center. Dr. Loiselle
Slide 64: Adaptive Therapy Innovation Convergence
Adaptive Therapy Innovation Convergence
Slide 65: Clinical Decision Tree High-Level Adaptive Workflow
Clinical Decision Tree High-Level Adaptive Workflow Plan and enroll patient Accumulate dose over the course of treatment Deform the contours on daily image Calculate planned dose on daily image Acquire daily image Automated Workflow Clinical Decisions 1. Treat Review and decide 2. Shift Dose, Recalc
Slide 66: Adaptive Radiotherapy Strategy: Building Block Technologies
Building Block Technologies Provide Sound Benefits Along The Way Adaptive Radiotherapy Strategy Plan and enroll patient Review and decide Accumulate dose over the course of treatment Deform the contours on daily image Calculate planned dose on daily image Acquire daily image Automated Workflow Imagi
Slide 67: Oncology Information Systems and Partnerships
Oncology Information Systems Ensure connectivity between Accuray products and established / establishing OIS offerings Treatment Planning Expand interoperability with RaySearch’s RayStation Collaborative Effort Support customers’ demand for best-in-class treatment systems that aggregate information
Slide 68: ACCURAY
ACCURAY O asa Propristary and Confidential Property of Accursy: ay
Slide 69: Closing Remarks
ACCURAY C) Closing Remarks Propristary and Confidential Property of Accursy:
Slide 70: Expanding the Curative Power of Radiation Therapy to Improve as Many Lives as Possible
Expanding the Curative Power of Radiation Therapy to Improve as Many Lives as Possible Shareholder Value New product innovation enabling personalization and shorter treatment More convenient, and effective treatments Expand clinical application beyond oncology Patients Providers Value-based care ali
Slide 71: Thank you
- GD O Thank you ACCURAY ©