RedHill Biopharma Ltd. -...

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RedHill Biopharma Ltd. (“RDHL”) Corporate Presentation January 2018

Transcript of RedHill Biopharma Ltd. -...

Page 1: RedHill Biopharma Ltd. - files.shareholder.comfiles.shareholder.com/downloads/AMDA-1C0OBF/5598246596x0x960…Highlights • Emerging U.S. GI specialty company (NASDAQ/TASE: RDHL) •

RedHill Biopharma Ltd. (“RDHL”)

Corporate Presentation

January 2018

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Disclaimer and Forward Looking Statements

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This presentation does not constitute an offer or invitation to sell or issue, or any solicitation of an offer to subscribe for or acquire any of the Company’s securities or to participate in any investment in the Company.

No representation or warranty is made to the accuracy or completeness of this presentation. You must make your own investigation and assessment of the matters contained herein. In particular, no representation or warranty is given, and the Company has no responsibility, as to the achievement or reasonableness of any forecasts, estimates, or statements as to prospects contained or referred to in this presentation.

Statements in this presentation that are not historical facts (including statements containing "believes," "anticipates," "plans," "expects," "may," "will," "would," "intends," "estimates" and similar expressions) are forward-looking statements within the meaning of the U.S. Private Securities Litigation Reform Act of 1995. These statements are not guarantees of future performance, are based on current expectations of future events and are subject to risks and uncertainties that could cause actual results to differ materially from those expressed or implied by such statements, including risks that we will not have sufficient working capital, that there will be delays in the initiation and progress of our studies, trials or other therapeutic candidate development efforts or delays in obtaining, or we will be unable to obtain, FDA or other regulatory approvals for our products, unable to establish collaborations, that our therapeutic candidates will not be commercially viable, that the products that we promote in the U.S. may not generate sufficient revenues and risks relating to our Expanded Access Policy (EAP), among other risks. Additional information about the risk factors that may affect the realization of forward-looking statements is set forth in the Company’s filings with Securities and Exchange Commission, including the Company’s Annual Report on Form 20-F filed on February 23, 2017. If one or more of these factors materialize, or if any underlying assumptions prove incorrect, our actual results, performance or achievements may vary materially from any future results, performance or achievements expressed or implied by these forward-looking statements. You should not place undue reliance on forward-looking statements as a prediction of actual results.

All forward-looking statements included in this presentation are made only as of the date of this presentation. We assume no obligation to update any written or oral forward-looking statement made by us or on our behalf as a result of new information, future events or other factors.

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Highlights

• Emerging U.S. GI specialty company (NASDAQ/TASE: RDHL)

• Focused on development and commercialization in the U.S. of late clinical-stage drugs for GI diseases and cancer

Robust Development Pipeline with Multiple Near-Term Milestones

3 Phase III-stage GI drugs

in development

Multiple Phase II programs targeting high

unmet medical needs

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3 GI products promoted by sales force of 40 in the

U.S.

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* Estimated timeline/indication in the pipeline is subject to changes in development plans and regulatory requirements/clarifications, including complementary /additional studies ** BEKINDA®, YELIVA® and TALICIA™ are proposed tradenames which are subject to FDA review and approval *** For full prescribing information see: www.Donnatal.com; ****EnteraGam® (a serum-derived bovine immunoglobulin/protein isolate, SBI) is a medical food which must be administered under medical supervision ***** For full prescribing information see: https://dailymed.nlm.nih.gov/dailymed/fda/fdaDrugXsl.cfm?setid=53240ab5-98e7-4050-b640-

e09c1271899a&type=display 4

Product** Indication Pre-Clinical Phase I/II Phase III Marketed

Donnatal® IBS and acute enterocolitis***

EnteraGam® Chronic diarrhea and loose stools****

Esomeprazole Strontium DR Capsules

GERD and other GI conditions*****

TALICIA™ (RHB-105)

H. pylori infection

RHB-104

Crohn’s disease

NTM infections

BEKINDA® (RHB-102)

Gastroenteritis

IBS-D

RHB-106 Bowel cleanser

YELIVA® (ABC294640)

Multiple indications

Upamostat (MESUPRON)

Oncology/GI

Worldwide rights licensed to Salix Pharmaceuticals

Successful first U.S. Phase III completed; Confirmatory U.S. Phase III ongoing

Phase III MAP US study and Phase III MAP US2 extension study ongoing

Positive results from Phase III U.S. study

Cholangiocarcinoma and other indications

Positive results from Phase II U.S. study

U.S. CO-PROMOTION

U.S. EXCLUSIVE LICENSE

Pivotal Phase III study planned

U.S. COMMERCIALIZATION LICENSE

Emerging U.S. Specialty GI Pharma - Robust Pipeline and Commercial Operation: Select Key Programs

Completed multiple clinical studies

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Emerging Specialty U.S. GI-Focused Pharma

Donnatal®

IBS and acute enterocolitis

EnteraGam®

Chronic diarrhea and loose stools

Esomeprazole Strontium DR Capsules 49.3 mg GERD and other GI conditions

2 x New GI-Products planed to be In-Licensed

TALICIA™ (RHB-105) H. pylori infection

RHB-104 NTM

BEKINDA® 24 mg

Gastroentiritis

BEKINDA® 12 mg

IBS-D

RHB-104 Crohn’s disease

YELIVA® Cholangiocarcinoma

A Leading U.S. GI-Focused Pharmaceutical Company

*Presented events are forward looking statements and estimates, and are subject to uncertainties including, among others, clinical and regulatory outcomes, marketing approvals, financial resources, and commercial viability; This slide and strategic plan is made for illustrative purposes only. Please see “Disclaimer and Forward Looking Statements”.

# of Marketed Products

3 5 6 9 11 13

YELIVA® GI

MESUPRON Oncology/GI

2017

Commercialization of RedHill’s products

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Planned Near-Term Milestones

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Product Study Planned

RHB-104 NTM Infections

Pivotal

U.S. Phase III

Initiation

H1/2018

RHB-104 Crohn’s Disease

MAP US

Phase III

Ongoing

Top-Line Results

Mid-2018

TALICIA™ (RHB-105) H. pylori Eradication

Confirmatory

U.S. Phase III

Ongoing

Top-Line Results

H2/2018

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Experienced Leadership Team

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Dror Ben-Asher, CEO P.C.M.I. Ltd.

Adi Frish, Senior VP Business Development & Licensing Y. Ben-Dror, MediGus

Reza Fathi PhD, Senior VP R&D XTL, PharmaGenics, Harvard Inst. of Chem. & Cell Biology

Patricia Anderson, VP Regulatory Affairs MAPI Group, OptumInsight, Bayer, Novopharm

Ira Kalfus MD, Medical Director Lev Pharmaceuticals, Aetna/US Healthcare

Terry F. Plasse MD, Medical Director Rhone Poulenc-Rorer, Cytokine PharmaSciences

Mark L. Levitt, MD, PhD, Medical Director, Oncology Teva, Sheba Medical Center, NIH

Aida Bibliowicz, VP Clinical Affairs Europe MSc Technion, MBA TAU, Cato Research Israel

Bruce P. Burnett, PhD, VP of Medical Affairs Entera Health, Primus Pharma, University of Colorado

Gilead Raday, Chief Operating Officer MSc Neurology, MBE Cambridge, Sepal Pharma

Guy Goldberg, Chief Business Officer Eagle Pharma, ProQuest, McKinsey

Micha Ben Chorin, Chief Financial Officer GVT, Pyramid Analytics, Starhome B.V.

Shani Maurice, VP Business Development & Communications Prime Minister’s Office

Clara Fehrmann, Director Clinical Operations Merck Canada, Santhera Pharmaceuticals, ICON

Danielle Abramson, PhD, VP IP & Research PhD Medical Sciences Brown, Patent Agent Greenberg Traurig

Craig Miller, VP US Business Operations, Market Access Salix, Oclassen Pharmaceuticals, Watson Pharmaceuticals

Valerie Graceffa, VP US Sales and Marketing Aurora Diagnostics, Warner Chilcott, TRAK Group Cincinnati

David Wasserman, VP Compliance Officer, US Operations Salix, Watson Pharmaceuticals, Glaxo PLC

* Personal background relates to selected former and current positions and education

Executive Management*

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Jeff Leighton, PhD Glaxo, Exogen, Genesis, Inspire

Werner Tschollar, MD Past SVP for Worldwide R&D, Novartis

Joshua Schein, PhD Past CEO and co-founder, Lev Pharma

June Almenoff, MD Furiex Pharmaceuticals, GSK

Prof. Chezy Barenholz, PhD Prof., Hebrew University of

Jerusalem, Co-inventor of Doxil®

Mr. Abe Schwartz Covalon Tech., CEO Cedara Software

Prof. Colin Blakemore, PhD

Oxford, Past CEO - UK Medical Research Council

Prof. Ran Oren, MD

Digestive and Liver expert, Hadassah

Prof. Thomas Borody, MD Founder Centre for Digestive

Diseases

Jerry Rosenblatt, PhD IIBD Consulting, IMS Health

Scott Harris, MD Lyric, Avaxia, Ocera, Napo

Experienced Leadership Team

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Dror Ben-Asher, CEO

P.C.M.I. Ltd.

Eric Swenden Alterphama nv, Lifeline Scientific

Kenneth Reed, MD Dermatologist; Director Minerva Biotechnologies

Shmuel Cabilly, PhD Scientist, Director in several life-science companies

Nicolas Weinstein Water Bear Investments, EMC2, Abbott, CFR

Dan Suesskind Teva, CFO, Director

Rick D. Scruggs Salix, Watson, Oclassen

Ofer Tsimchi Danbar, Polysack, Director in several companies

Nurit Benjamini Wix, Coppergate Communications, Compugen

* Personal background relates to selected former and current positions and education

Board of Directors*

Advisory Board*

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Financial Highlights*

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RedHill Biopharma Ltd. Symbol: NASDAQ: RDHL | Tel-Aviv Stock Exchange: RDHL

Market Cap (approx.) $109 million

Ordinary Shares Outstanding 212.7 million (Equivalent to approx. 21.27 million ADSs traded on NASDAQ)

Estimated Cash and Short Term Investments (approx.) at the end of 2017

$45 million

* Financial information as of January 15, 2018 unless otherwise noted

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U.S. GI-Specialty Pharma

RedHill initiated U.S. promotion of Donnatal® and EnteraGam® in June 2017 and of Esomeprazole Strontium DR Capsules 49.3 mg in September 2017

RedHill Biopharma Inc.

A wholly owned subsidiary with offices in Raleigh Durham, NC

Highly Trained & Motivated Sales Force

40 sales reps promoting Donnatal®, EnteraGam® and Esomeprazole Strontium DR Capsules 49.3 mg in select U.S. territories

Initial Net Revenues Approximately $1.5M in Q3/2017

RedHill’s GI Development Programs

Commercial operations are planned to pave the way for the potential future commercial launch of RedHill’s Phase III-stage GI development programs (TALICIA™/RHB-104/BEKINDA®)

Additional License Opportunities

RedHill continues to pursue licensing and acquisition of additional commercial product opportunities in the U.S. specialty GI area

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TALICIA™ (RHB-105)

A new combination therapy for treatment of H. pylori infection - with QIDP designation, including Fast-Track development status

Confirmatory Phase III Study Ongoing

Successful First Phase III Study Completed - Met Primary Endpoint with High Statistical Significance

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TALICIA™ (RHB-105) - First Line Treatment for H. pylori

Planned Indication First line treatment for eradication of H. pylori regardless of ulcer status

Drug A novel combination of two antibiotics and a PPI (proton pump inhibitor): rifabutin, amoxicillin and omeprazole - in a single oral capsule

Potential Advantages

Potential higher efficacy than current standard of care in eradication of H. pylori strains resistant to standard care

Potential to become a leading first line treatment

Significantly broader indication than that of current therapies, with a larger potential patient population

All-in-one capsule: convenient regimen - potentially improved compliance

QIDP Status TALICIA™ received FDA QIDP designation under the GAIN Act for serious or life-threatening infections, including Fast-Track development, Priority Review, and extended market exclusivity for a total of 8 years

Market Size 2015 U.S. and global market estimated at approximately $1.45 billion and $4.83 billion respectively*

* Jerry Rosenblatt, Ph.D., a member of RedHill’s Advisory Board and Partner at Foster Rosenblatt, RedHill Biopharma press release: ‘RedHill Biopharma’s Investor Webcast Forum Provides Update on the RHB-105 Phase III Program and Potential H. Pylori Eradication Market’, May 18, 2015

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H. pylori Infection → Progressive gastro-duodenal damage • Helicobacter pylori (H. pylori) infection is the strongest risk factor for the development of

gastric cancer* and peptic ulcer disease, and is associated with iron deficiency, B12 deficiency and drug malabsorption

• Gastric cancer is one of the leading causes of cancer deaths worldwide accounting for ~700,000 deaths per year

• Prevalence of H. pylori infection in the U.S.

is estimated at 30-40% of the population - over 100 million people**, with an estimated 3 million patients treated annually***

• Standard therapy fails in approximately 30% of

patients who remain H. pylori positive due to growing resistance of H. pylori to clarithromycin and metronidazole - antibiotics commonly used in standard combination therapies****

TALICIA™ (RHB-105) (H. pylori) - Increasing Global Disease

H. pylori Infection

Muscularis mucosae Inflammation

Gastric Ulcer

* Lamb A et al. Role of the Helicobacter pylori-induced inflammatory response in the development of gastric cancer. J Cell Biochem 2013 Mar;114(3):491-7; ** Chey WD et al. Management of Helicobacter pylori Infection . Am J Gastroenterol 2007;102:1808–1825 ; *** Company analysis; **** Malfertheiner P. et al. Management of Helicobacter pylori infection - the Maastricht IV/ Florence Consensus Report, Gut 2012;61:646-664; Graham DY et al. New concepts of resistance in the treatment of Helicobacter pylori infections. Nat Clin Pract Gastroenterol Hepatol. 2008 Jun;5(6):321-31 and Graham DY et al. Helicobacter pylori treatment in the era of increasing antibiotic resistance. Gut 2010;59:1143-1153

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• February 2017 – WHO published a global priority pathogens list of antibiotic-resistant bacteria to help in prioritizing the R&D of new and effective antibiotic treatments

• The purpose was to identify the most important resistant bacteria at a global level for which there is an urgent need for new treatments

• The list included 12 pathogens prioritized in 3 categories - Critical, High and Medium

• H. pylori (clarithromycin-resistant) was categorized as a pathogen for which there is a High Priority need to develop new treatments

World Health Organization: Urgent Need for New Antibiotic Treatments H. pylori Ranked as High Priority

Enterococcus faecium, vancomycin-resistant

Staphylococcus aureus, methicillin-resistant, vancomycin intermediate and resistant

Helicobacter pylori, clarithromycin-resistant

Campylobacter, fluoroquinolone-resistant

Salmonella spp., fluoroquinolone-resistant

Neisseria gonorrhoeae, 3rd generation cephalosporin-resistant, fluoroquinolone-resistant

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A Randomized, Double-Blind, Active Comparator, Two-Arm, Confirmatory Phase III Study (“ERADICATE Hp2”), Comparing TALICIA™ Against a Regimen of Amoxicillin and Omeprazole Alone in the Treatment of Confirmed H. pylori Infection in Dyspepsia Patients, Regardless of Ulcer Status

Number of subjects 444

Sites Up to 65 sites in the U.S.

Duration of Study Treatment

14 days

Primary Endpoint

- The occurrence of H. pylori eradication in the TALICIA™ group compared to the active comparator group as confirmed via 13C Urea Breath Test (UBT) testing 43-71 days after initiation of treatment

Development Status - Top-line results expected H2/2018

TALICIA™ (RHB-105) (H. pylori) - Confirmatory Phase III Study Ongoing

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A Randomized Placebo-Controlled Phase III Study (“ERADICATE Hp”) to Assess the Safety and Efficacy of TALICIA™ in the Treatment of Confirmed H. pylori Infection in Dyspepsia Patients, Regardless of Ulcer Status

Number of Subjects 118

Sites 13 sites in the U.S.

Duration of Study Treatment

14 days

Primary Endpoint

- The occurrence of H. pylori eradication as confirmed via 13C Urea Breath Test (UBT) testing 28-35 days after completion of treatment

- Superiority in eradication of H. pylori infection over historical standard of care efficacy levels of 70% effectiveness

Positive Phase III Results

- 89.4% efficacy in eradicating H. pylori infection with TALICIA™ (p< 0.001)

- The study successfully met its protocol-defined primary endpoint

- 63% eradication rate demonstrated in open-label treatment of patients in the placebo arm with SoC therapy for persistent H. pylori infection - supporting the potential superior efficacy of TALICIA™ over SoC

- No serious adverse events related to the drug were noted in the study

TALICIA™ (RHB-105) (H. pylori) - Successful First Phase III Study Completed

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RHB-104

Groundbreaking combination therapy targeting MAP bacteria for treatment of Crohn’s disease and potentially other autoimmune diseases

First Phase III Study Ongoing in Crohn’s Disease

Planned Pivotal Phase III Study for the Treatment of Nontuberculous Mycobacteria (NTM) Infections under QIDP Designation

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The Link between Crohn’s Disease and MAP

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• MAP (mycobacterium avium subsp. paratuberculosis) is the causative agent of Johne’s disease, an infectious disease in cattle, clinically and pathologically similar to Crohn’s disease

• An intracellular pathogen that proliferates in monocytes/macrophages

• Extremely slow growing and widely pervasive in the environment

• Advances in diagnostic technology have led to increasingly higher identification of MAP in Crohn’s diseases patients

• 92% (34/37 Crohn’s disease patients by PCR) - Bull, J Clin Microbiol, 2003

• 86% (52/60 Crohn’s disease patients) - Shafran, Dig Dis Sci, 2002

• Crohn’s disease is a multifactorial disease

• Defective innate immunity to intracellular bacteria

• Mutations in the NOD2 gene are strongly associated with Crohn’s disease

• Mycobacterial infections in humans are difficult to treat; Effective anti-mycobacterial agents require intracellular activity

• ATS/IDSA* and WHO advise triple antibiotic therapy for non-tuberculosis mycobacterial disease

* American Thoracic Society, Infectious Disease Society of America, World Health Organization

Johne’s disease

Crohn’s disease

Growing evidence that intracellular mycobacteria play a crucial role in Crohn’s disease

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RHB-104 (Crohn’s) - First Phase III Study Ongoing

Planned Indication

Treatment of Crohn’s disease in adult patients;

The product Patent-protected combination of 3 antibiotics (clarithromycin, clofazimine and rifabutin) in a single oral

capsule with potent intracellular, antimycobacterial and anti-inflammatory properties

Market Size Worldwide market exceeded $7.6 billion in 2016*

Development Status

Several clinical trials were conducted with earlier formulations of the drug, including two Phase II (2002 and 2005), a Phase III (published 2007) and a pediatric study (2013) in Australia;

Preliminary positive safety results in a Phase I study (2014)

First Phase III study ongoing; Enrollment completed and top-line results expected mid-2018

Open-label Phase III extension study (MAP US2) ongoing - intended to assess the safety and efficacy of RHB-104 in patients who completed 26 weeks of treatment in the MAP US study and remain with active

Crohn’s disease (CDAI>150) at week 26

Planned initiation of two additional ex-U.S. small-scale (20 subjects each) open-label clinical studies to evaluate RHB-104’s efficacy in newly diagnosed and treatment-naïve patients

Diagnostics Diagnostic test for Mycobacterium Avium Paratuberculosis in development with Q2 Solutions

* EvaluatePharma, estimated market for diagnosis and drug treatment of Crohn’s disease, January 2017 19

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Multi-center, randomized, double-blind, placebo-controlled, parallel group study (the “MAP US Study”) to assess the efficacy and safety of fixed-dose combination RHB-104 in subjects with moderately to severely active Crohn’s disease

Number of Subjects Approximately 325

Sites Up to 150 sites in the U.S., Canada, Europe, Australia, New Zealand and Israel

Primary Endpoint State of remission at week 26

Secondary and Exploratory Endpoints

- State of response at 26 weeks - Maintenance of remission through week 52 - Efficacy outcome measures in relation to presence of MAP infection - Safety

Phase III MAP US Development Status

- Unanimous positive recommendations from two DSMB meetings to continue the study (Dec. 2016 - safety focused, July 2017 - safety and efficacy)

- Patient enrollment completed November 2017

- Top-line results expected mid-2018

Phase III MAP US2 Extension Study

Open-label Phase III extension study to the MAP US study ongoing - Planned to enroll approximately 50-70 subjects with CDAI>150 at 26 weeks; Subjects are eligible for up to one year of treatment with RHB-104

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RHB-104 (Crohn’s) - First Phase III Study Ongoing

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66% (67/102)

p = .017

40% (41/102)

p = .003

30% (31/102)

p = .005

14% (16/111)

22% (24/111)

50% (55/111)

111 Placebo + prednisolone

102 Active + prednisolone

Remission Endpoint Reanalysis Randomized denominator at time 0

66% (67/102)

p = .017

39% (26/67)

p = .054

24% (10/41)

p = .14

43% (12/28)

56% (31/55)

50% (55/111)

111 Placebo + prednisolone

102 Active + prednisolone

Original Study Relapse Endpoint Skewed denominator at week 16

*Phase III study conducted by Pharmacia for Australian approval and published by Selby et al (2007), Gastroenterology 132:2313-2319.; Reanalysis published by Behr and Hanley (2008), Lancet Infectious Diseases 8:344. including all subjects randomized at the beginning of the study, disregarding any occurrence following randomization

16 Weeks

52 Weeks

104 Weeks

Lancet Reanalysis*

Patients not in remission excluded from study

213 Patients (100%)

Placebo Active Arm Active Arm Placebo

213 Patients (100%)

Remission

Relapse

Remission

Relapse

Relapse Relapse

Remission Remission

Remission

Remission

Remission

Remission

Australian Phase III (Pfizer) Study Showed Strong Signs of Efficacy*

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Australian Phase III (Pfizer) Study Data Would Have Compared Favorably to Remicade®

39% (44/113)

All subjects=23% (44/192)

28% (31/113)

All subjects=16% (31/192)

* Hanauer et al, (2002), The Lancet 359: 1541-1549. study similar to the reanalysis conducted by Behr and Hanley

Remission at 54 Weeks

Remission at 30 Weeks

Separate trials; Theoretical comparison

Response at 2 Weeks

Remicade® ACCENT I*

59% (113/192)

66% (67/102)

p = .017

40% (41/102)

p = .003

30% (31/102)

p = .005

14% (16/111)

22% (24/111)

50% (55/111)

111 Placebo + prednisolone

102 Active + prednisolone

Remission Endpoint Reanalysis (from Pfizer PIII Australian study)

Active Arm Placebo

213 Patients (100%)

Remission Remission

Remission

Remission

Remission

Remission

Remission at

16 Weeks

Remission at 52 Weeks

Remission at

104 Weeks

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RHB-104 - Multiple Barriers to Entry

• Limited availability of clofazimine (distributed by the World Health Organization (WHO) and Novartis) and generally requires name based individual import permit or Expanded Access Program (EAP) process for use

• Robust global patent portfolio covering RHB-104, with additional claims being pursued

• 3 years (and potentially 5 years) data exclusivity for treatment of Crohn’s disease

• Potential PK synergies of APIs administered in the RHB-104 formulation that disappear when administered concomitantly

• Lower concentrations of the triple combination of RHB-104 active components provide excellent synergistic anti-MAP growth activity compared to individual or dual combinations of the drugs*

• APIs are not available in doses being used in RHB-104

• Superior regimen of an all-in-one capsule solution for patients and physicians (reduced co-pays, etc.)

• Physicians’ potential liability exposure and complicated ramp-up period

* Alcedo KP, Thanigachalam S, Naser SA. RHB-104 triple antibiotics combination in culture is bactericidal and should be effective for treatment of Crohn’s disease associated with Mycobacterium paratuberculosis, Gut Pathogens, 2016, 8:32.

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Planned Indication

- Treatment of pulmonary nontuberculous mycobacterium disease (NTMD) caused by MAC infection

- Difficult to treat infection with no approved standard of care

- QIDP Designation Granted: Including Fast-Track development, Priority Review, and extended market exclusivity for a total of 8 years

The Product

- Patent-protected all-in-one combination of 3 antibiotic drugs (clarithromycin, clofazimine and rifabutin) each known to be active against NTM caused by MAC infection*

Potential Advantages

- On label, convenient, fixed-dose combination for first-line therapy - potentially a new standard-of-care for an underserved condition

Market Size - U.S. market potential estimated at over $500 million in 2017**

Development Status

- Potentially de-risked program in light of proven activity of each of the antibiotics for NTM caused by MAC and the growing RHB-104 safety database

- Ongoing discussions with FDA for design of a single pivotal Phase III study in support of NDA filing for first-line treatment

- Planned initiation of the pivotal Phase III study in H1/2018

*Wassilew et al, RESPIRATION 2016 ** Foster Rosenblatt

RHB-104 for NTM (Nontuberculous Mycobacteria Infections) - Pivotal Phase III Study Planned to be Initiated H1/18

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RHB-104 for NTM - Background and Epidemiology

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*Wassilew et al, RESPIRATION 2016; **American Thoracic Society; *** Daley et al CHEST 2017; **** Prevots DR et al, Am J Respir Crit Care Med 2010; ***** Foster Rosenblatt/Company estimates

• NTM have high levels of drug resistance and require long term dosing with three or more antibiotics**

• New antimicrobial agents for NTM are urgently needed***

• Approximately 80% of pulmonary NTM infections in the U.S. are associated with Mycobacterium avium complex (MAC)****

• NTM is considered an Orphan Disease with an estimated 110,000 pulmonary NTM patients in the U.S. in 2017*****

• NTM are a ubiquitous bacteria, mostly non-pathogenic but can cause human disease*

• Pulmonary manifestations account for 80-90% of NTM associated disease*

• Pulmonary NTM disease symptoms can include fever, weight loss, chronic or recurring cough, chest pain, blood in sputum and fatigue**

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A single, pivotal Phase III study to assess the efficacy and safety of RHB-104 as a first-line treatment for pulmonary nontuberculous mycobacteria (NTM) infections caused by MAC

Planned Initiation

H1/2018

Pivotal Phase III Development Plan

- Pending further discussion with FDA, a double-blind, placebo-controlled pivotal Phase III study in the U.S. is planned

Patient Population

- 100 subjects; Newly diagnosed or recent repeat culture positive non-cavitary MAC disease

Study Design

- 1:1 randomization to RHB-104 vs. placebo

- 6 month treatment for primary efficacy endpoint with

continued follow up treatment for an additional 12 months

- Primary endpoint: Sputum culture conversion at 6 months

with demonstration of clinical significance

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RHB-104 for NTM - Pivotal Phase III Study Planned to be Initiated H1/18

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BEKINDA® (RHB-102)

A bi-modal extended release, once-daily, ondansetron

BEKINDA® 24 mg - Positive Results from a U.S. Phase III Study for Gastroenteritis/Gastritis - Met Primary Endpoint

BEKINDA® 12 mg - Positive Results from a U.S. Phase II Study for IBS-D - Met Primary Endpoint

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A Randomized, Double-Blind, Placebo Controlled, Parallel Group Phase III Study (“GUARD”) to Assess the Safety and Efficacy of BEKINDA® 24 mg for the Treatment of Acute Gastroenteritis & Gastritis

The Product Patent-protected, once-daily extended release oral tablet ondansetron 24 mg

Number of Subjects 321 adults and children over the age of 12

Sites 21 sites in the U.S.

Primary Endpoint The absence of vomiting, without rescue medication and intravenous hydration, from 30 minutes post first dose of the study drug until 24 hours post dose

Potential Advantages

- If approved for marketing by FDA, BEKINDA® could become the first 5-HT3 antiemetic drug indicated for the treatment of acute gastroenteritis or gastritis in the U.S.

- Long lasting (24H) oral treatment with the potential to reduce dehydration and hospital visits and stays

Market Size

- Approximately 179 million cases of acute gastroenteritis annually in the U.S., leading to an estimated 470,000 hospitalizations*

- Worldwide potential market could exceed $650 million annually**

Development Status

‐ Positive top-line results from the Phase III study announced June 2017 - the study successfully met the primary endpoint

‐ RedHill is designing a confirmatory Phase III study for acute gastroenteritis and gastritis

BEKINDA® 24 mg: Gastroenteritis & Gastritis - Positive First Phase III Results

* Scallan E, Griffin PM, Angulo FJ, Tauxe RV, Hoekstra RM. Foodborne Illness Acquired in the United States - Unspecified Agents. Emerg Infect Dis. 2011;17(1):16-22** Gres S. Nancy, Acute Gastroenteritis, Prim Care Clin Office Pract 40 (2013) 727–741 and Company analysis 28

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A Randomized, Double-Blind, Placebo Controlled, Parallel Group Phase III Study (“GUARD”) to Assess Safety and Efficacy of BEKINDA® 24 mg for Treatment of Acute Gastroenteritis & Gastritis

Results

- The Phase III GUARD study successfully met its primary endpoint in the Intent to

Treat (ITT) population (p = 0.04), despite high positive outcome rate in the placebo

arm

- ITT: BEKINDA® 24 mg improved the efficacy outcome by 21%; 65.6% of BEKINDA® 24

mg treated patients as compared to 54.3% of placebo patients (p = 0.04; n=192 in the

BEKINDA® group and n=129 in the placebo group)

- PP: In patients who met all protocol entry criteria and for which the diagnosis of

gastroenteritis was confirmed (n=177 in the BEKINDA® group and n=122 in the

placebo group), BEKINDA® 24 mg improved the efficacy outcome by 27%; 69.5% of

patients in the BEKINDA® 24 mg group vs. 54.9% in the placebo group, (p = 0.01)

- BEKINDA® 24 mg was shown to be safe and well-tolerated; electrocardiogram results

showed no adverse changes with treatment

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BEKINDA® 24 mg: Gastroenteritis & Gastritis - Positive Phase III Results

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BEKINDA® 12 mg: IBS-D Positive Phase II Results

A Randomized, Double-Blind, Placebo-Controlled, 2-Arm Parallel Group Phase II Clinical Study

Designed to Evaluate the Safety and Efficacy of BEKINDA® 12 mg in Patients Suffering from

Diarrhea-Predominant Irritable Bowel Syndrome (IBS-D)

The Product Patent-protected, once-daily extended release oral tablet ondansetron 12 mg

Number of Subjects 126 patients

Sites 16 clinical sites in the U.S.

Primary Endpoint Response in stool consistency as compared to baseline, per FDA guidance definition

Market Size

- It is estimated that at least 30 million Americans may suffer from IBS, of which approximately 40% are of the IBS-D subtype*

- The U.S. market grew by approximately 550% between 2013-2016, to an estimated $473 million in 2016, and is expected to continue to grow by approximately 14% annually (2016 - 2022)**

Development Status

- Positive top-line results announced October 2017; Study successfully met primary endpoint

- FDA meeting planned for H1/2018 to discuss the design for one or two pivotal Phase III studies

* Lovell RM, Global prevalence of and risk factors for irritable bowel syndrome: a meta-analysis, Clin Gastroenterol Hepatol (2012), 10(7)712-721; Saito YA et al, The epidemiology of irritable bowel syndrome in North America: a systemic review, Am J Gastroenterol (2002), 97(8): 1910-5; ** EvaluatePharma 30

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BEKINDA® 12 mg: IBS-D Positive Phase II Results

A Randomized, Double-Blind, Placebo-Controlled, 2-Arm Parallel Group Phase II Clinical Study Designed

to Evaluate the Safety and Efficacy of BEKINDA® 12 mg in Patients Suffering from Diarrhea-Predominant

Irritable Bowel Syndrome (IBS-D)

Results

- Primary endpoint: The Phase II study successfully met its primary endpoint,

improving the primary efficacy outcome of stool consistency response (per FDA

guidance definition) by an absolute difference of 20.7% (p=0.036)

- 56.0% responders of subjects treated with BEKINDA® (n=75) vs. 35.3%

responders of the placebo subjects (n=51)

- Secondary endpoints: While not powered for statistical significance of the secondary

efficacy endpoints, the study suggested clinically meaningful improvement in both

abdominal pain response and overall response (combined stool consistency and

abdominal pain response)

- Safety: BEKINDA® 12 mg was shown to be safe and well tolerated

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YELIVA® (ABC294640)

Phase II-stage, first-in-class, orally-administered sphingosine kinase-2 (SK2) inhibitor targeting multiple oncology, inflammatory and GI indications

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The Product A first-in-class, orally-administered sphingosine kinase-2 (SK2) inhibitor - with anti-cancer and anti-inflammatory activities, targeting multiple oncology, inflammatory and GI indications

Potential Market

Significant market potential - multiple potential oncology, inflammatory and GI indications with a substantial unmet need

Development Status

- YELIVA® completed numerous successful pre-clinical studies in oncology, GI-Inflammation and radioprotection models

- Food effect study with YELIVA® was successfully completed in healthy subjects - Repeat-dose toxicology studies provided favorable safety margins

- Phase I study with YELIVA® in cancer patients with advanced solid tumors successfully met its primary and secondary endpoints

- Phase IIa study for the treatment of cholangiocarcinoma initiated December 2017

- Orphan Drug Designation for the treatment of cholangiocarcinoma

- Compassionate use for cholangiocarcinoma ongoing under Expanded Access Program

- Phase I/II studies ongoing for the treatment of refractory or relapsed multiple myeloma and hepatocellular carcinoma (HCC)

YELIVA® (ABC294640) - Phase II-stage SK2 Inhibitor for Oncology, Gastrointestinal and Inflammatory Diseases

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YELIVA®

• S1P promotes cancer growth and proliferation and pathological inflammation, including TNFα signaling and other inflammatory cytokine production

• Preliminary evidence suggests that because of its specificity for targeting SK2, rather than SK1, YELIVA® may have a better therapeutic ratio than nonspecific sphingosine kinase inhibitors or those targeting only SK1

• Phase I study results demonstrated that administration of YELIVA® resulted in a rapid and pronounced decrease in levels of S1P, with several patients having prolonged stabilization of disease

YELIVA®

YELIVA® (ABC294640) inhibits SK2, a lipid kinase that catalyzes formation of the lipid signaling molecule sphingosine 1-phosphate (S1P). By inhibiting S1P, YELIVA® potentially inhibits tumor

growth and proliferation and pathological inflammation

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YELIVA® (ABC294640) - Phase II-stage SK2 Inhibitor for Oncology, Gastrointestinal and Inflammatory Diseases

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A Phase I Clinical study of YELIVA® in Cancer Patients with Advanced Solid Tumors

Study Design - Open-label, dose-escalation, PK and PD, first-in-human Phase I study with YELIVA®

Site - Medical University of South Carolina

Subjects - 21 patients with advanced solid tumors, the majority of which were GI cancer patients

Endpoints

- Primary endpoints: to identify the maximum tolerated dose (MTD) and the dose limiting toxicities (DLTs) and to evaluate the safety of YELIVA®

- The study included the first-ever longitudinal analyses of plasma S1P levels as a potential PD biomarker for activity of a sphingolipid-targeted drug

Positive Phase I Results

(June 2016)

- The study successfully met its primary and secondary endpoints

- YELIVA® was found to be safe and well tolerated and can be safely administered to cancer patients at doses that provide circulating drug levels that are predicted to have therapeutic activity

- Administration of YELIVA® resulted in a rapid and pronounced decrease in S1P levels

- One patient had a prolonged partial remission and several patients had prolonged stabilization of disease

- Of the three patients with cholangiocarcinoma, one had a partial response and the other two stable disease, one of whom for over a year

YELIVA® (ABC294640) - Successful Phase I Study Met Primary and Secondary Endpoints

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YELIVA® (ABC294640) - Phase IIa Study for Cholangiocarcinoma Initiated

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A single-arm Phase IIa clinical study evaluating YELIVA® as a single agent in patients with advanced, unresectable, intra-hepatic, perihilar and extra-hepatic cholangiocarcinoma

Sites Mayo Clinic, MD Anderson

Initiated December 2017

Number of subjects Up to 39

Lead Investigator Dr. Mitesh J. Borad, MD, Associate Professor of Medicine and Director of Phase I Drug Development at the Mayo Clinic Cancer Center in Arizona

Development status

- YELIVA® was granted Orphan Drug designation for the treatment of cholangiocarcinoma

- Compassionate use for cholangiocarcinoma ongoing under Expanded Access Program

Primary endpoint - Response Rate (RR) - defined as CR+PR+SD of at least 4 months duration

Market Size - Approximately 8,000 people are diagnosed with intrahepatic and

extrahepatic bile duct cancers annually in the U.S.

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RHB-106

Bowel preparation capsule

Out-licensed to Salix Pharmaceuticals

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RHB-106 (Bowel Preparation) - Licensed to Salix Pharmaceuticals

Planned Indication Preparation of the Gastrointestinal (GI) tract for GI procedures/surgeries (such as colonoscopy)

The Product Patent-protected encapsulated formulation for bowel preparation

Potential Advantages Improved safety over existing encapsulated preparations on the market; No need to consume liquid solution; No bad taste

Potential Market Size Salix estimates peak year Rx share of 20% with annual sales of $280 million**

Development Status - Phase IIa conducted in 62 patients in Australia*** - Salix assumed responsibility for future development of RHB-106

* Salix Pharmaceuticals was acquired by Valeant Pharmaceuticals International in April 2015; ** Salix Pharmaceuticals Investor Day presentation, July 9, 2014; *** Borody et al (2006), Journal of Gastr and Hepat, 21: 87-88

Worldwide exclusive rights to RHB-106 were out-licensed to Salix Pharmaceuticals in February 2014 along with rights to other purgative developments*

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UPAMOSTAT (MESUPRON)

First-in-class small molecule targeting oncology and GI indications

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Upamostat (MESUPRON) An S1 Serine Protease Inhibitor

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The Drug

A first-in-class, orally-administered inhibitor of S1 family of trypsin-like serine proteases with potential for use in the treatment of cancer, inflammatory lung diseases, irritable bowel syndrome, inflammatory bowel disease and pancreatitis

Licensed worldwide rights from Heidelberg Pharma (formerly Wilex), excluding China, Taiwan, Macao and Hong Kong

Development Status

Initially developed and described as a synthetic small molecule inhibitor of the serine protease urokinase plasminogen activator (Ki ~ 0.9µM)

Established clinical safety profile from over 300 patients across 10 clinical studies, including Phase II studies in locally advanced pancreatic cancer and metastatic breast cancer

FDA Orphan Drug Designation awarded for treatment of pancreatic cancer (October 2017)

Intensive preclinical investigation sponsored by RedHill has revealed upamostat as a specific and potent inhibitor of human trypsin-3 (Ki ~ 20nM), trypsin-2 (Ki ~ 75nM), trypsin-6 (~100nM), trypsin-1 (Ki ~ 190nM) and matriptase-1 (~200nM)

Planning underway to use the newly identified targets to select most appropriate indications, patients and drug combinations

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Thank You!

RedHill Biopharma Ltd. 21 Ha’arba’a St. Tel-Aviv, 6473921 ,Israel Email: [email protected] Web: www.redhillbio.com Tel: +972-3-541-3131

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