EX-99.1 2 v425958_ex99-1.htm EXHIBIT 99.1

Exhibit 99.1

 

1 2015 Commercial Day December 1, 2015 Send questions to: investors@interceptpharma.com

 

 

2 Safe Harbor Statement This presentation contains "forward - looking statements" within the meaning of the Private Securities Litigation Reform Act of 1995 . These "forward - looking statements" are based on management's current expectations of future events and are subject to a number of important risks and uncertainties that could cause actual results to differ materially and adversely from those set forth in or implied by such forward - looking statements . These risks and uncertainties include, but are not limited to : the initiation, cost, timing, progress and results of our development activities, preclinical studies and clinical trials ; the timing of and our ability to obtain and maintain regulatory approval of OCA, INT - 767 and any other product candidates we may develop, particularly the possibility that regulatory authorities may require clinical outcomes data (and not just results based on achievement of a surrogate endpoint) as a condition to any marketing approval for OCA, and any related restrictions, limitations, and/or warnings in the label of any approved product candidates ; our plans to research, develop and commercialize our product candidates ; our ability to obtain and maintain intellectual property protection for our product candidates ; our ability to successfully commercialize our product candidates ; the size and growth of the markets for our product candidates and our ability to serve those markets ; the rate and degree of market acceptance of any future products ; the success of competing drugs that are or become available ; the election by our collaborators to pursue research, development and commercialization activities ; our ability to attract collaborators with development, regulatory and commercialization expertise ; regulatory developments in the United States and other countries ; the performance of third - party suppliers and manufacturers ; our need for and ability to obtain additional financing ; our estimates regarding expenses, future revenues and capital requirements and the accuracy thereof ; our ability to retain key scientific or management personnel ; and other factors discussed under the heading "Risk Factors" contained in Intercept’s Annual Report, Quarterly Reports and other filings with the Securities and Exchange Commission . All information in this presentation is as of the date hereof, and Intercept undertakes no duty to update this information unless required by law . Obeticholic acid (OCA) is an investigational drug . It is not approved for use by the FDA, EMA or any other regulatory body . No conclusions can be drawn concerning the safety or efficacy of OCA at this time .

 

 

3 Welcome & Introduction Mark Pruzanski , M.D. Chief Executive Officer, Intercept Pharmaceuticals

 

 

4 Building a Specialty Focused Business in Chronic Non - Viral Liver Diseases with High Unmet Medical Need 4 Novel Therapeutic Approach in Underserved Diseases  OCA is a farnesoid X receptor (FXR) agonist  Worldwide rights (outside of Japan, China and Korea)  Patent terms projected to expire at various times through 2033 PBC: Orphan Indication with Potential Near Term Approval  Positive data from Phase 3 POISE trial and two placebo - controlled Phase 2 trials  US/EU submissions completed, June 2015  Priority review granted, PDUFA Date: February 29, 2016  Pre - commercial activities and infrastructure build well underway  Confirmatory outcomes trial initiated with expected post - marketing completion NASH: Significant Market Opportunity  Breakthrough therapy designation from FDA for NASH w/ liver fibrosis  Phase 3 REGENERATE trial initiated in September 2015  Phase 2 CONTROL NASH Statin Trial initiation 4Q 2015  Broad NASH clinical development program planned Significant Upside from Further OCA Indications and Pipeline  OCA in development for additional underserved, chronic liver indications  INT - 767 Phase 1 initiated November 2015

 

 

5 Introduction Lisa Bright Chief Commercial and Corporate Affairs Officer, Intercept Pharmaceuticals

 

 

6 Establishing Intercept We are Intercept. A liver health company. Our people* rejuvenate the approach to extending life for people with underserved, chronic, non - viral liver diseases. We imagine, create and deliver vital medicines that restore hope . We want to be a trusted partner to physicians and patients, regulatory authorities, payors , public health policymakers, and shareholders * Our people: Smart about the science. Courageous and collaborative. Inspired to change lives.

 

 

7 Driving Change in Partnership with the PBC Community Endorsed by AASLD and EASL “From ‘cirrhosis’ to ‘cholangitis’ — the change has critical implications for patients. It removes the stigmata of cirrhosis and its implications of alcohol abuse. It removes the stigmata of a poor prognosis. Its removal reminds patients that they are living with this syndrome, not dying of it. Its removal improves their opportunities in the workplace and in their everyday social lives. Thus, we sincerely call on all medical professionals and all patients and their families and friends worldwide to use from this moment on the name ‘primary biliary cholangitis’ for the disease known by its abbreviation PBC! We owe this to our patients and to further our role as caring physicians .” Beuers B, et al. Gastroenterology. 2015; 149: 1627 – 1629.

 

 

8 Preparing for Our F irst L aunch of OCA in PBC in 2016 8 Our organization is aligned behind 5 key strategic imperatives Structuring for success Further establishing Intercept as a credible partner Enhancing the understanding of and care for PBC from a medical perspective Market Access at an optimal price Translating the science into a compelling story based on FXR (Post - Approval)

 

 

9 Preparing for Our F irst L aunch of OCA in PBC in 2016 9 Develop an understanding of the market to inform strategy and forecasting Establishing a first class commercial and medical affairs team Continuing launch preparedness – Anticipated to be on track for approval US and EU market research 80% have hepatology experience Global approach to Market Access: Global Value Dossier and economic models Further refining understanding of epidemiology in major markets Highly experienced global leadership team developed to focus on customer orientation and operational excellence Compliance processes established Thought leader, patient advocacy and payor advisory boards and interactions US: 45 Territory Business Managers in place 10/2015 to understand PBC management Distributor partners selected for US and EU Affiliates established covering 21 countries across Europe and Canada Patient Services Hub development underway in the US PBC grants program “From Practice to Policy” launched at AASLD Our approach is to right size our organization for PBC while having expertise to scale for NASH

 

 

10 Time Topic Presenter 8:00 – 8:30 a.m. Registration 8:30 – 8:35 a.m. Welcome Dr. Mark Pruzanski, M.D. CEO, Intercept Pharmaceuticals 8:35 – 8:45 a.m. Introduction Lisa Bright Chief Commercial & Corporate Affairs Officer, Intercept Pharmaceuticals PBC Disease Background & Unmet Need 8:45 – 9:00 a.m. Disease Background Dr. Juan Carlos Lopez - Talavera, M.D., Ph.D. Senior Vice President of Medical Affairs, Intercept Pharmaceuticals 9:00 – 9:15 a.m. PBC Patient Journey & Partnering with Patient Advocacy Community Lisa Bright Chief Commercial & Corporate Affairs Officer, Intercept Pharmaceuticals 9:15 – 9:30 a.m. OCA & PBC Dr. Juan Carlos Lopez - Talavera, M.D., Ph.D. Senior Vice President of Medical Affairs, Intercept Pharmaceuticals 9:30 – 9:45 ICPT Panel Lisa Bright , Juan Carlos Lopez - Talavera, Mark Pruzanski Launch Readiness 9:45 – 10:15 a.m. Commercial Overview Market Access Considerations Lisa Bright Chief Commercial & Corporate Affairs Officer, Intercept Pharmaceuticals 10:15 – 10:35 a.m. Launch Preparedness US Richard Kim Senior Vice President, Head of US Commercial, Intercept Pharmaceuticals 10:35 – 10:50 a.m. Launch Preparedness EU, CA Lisa Bright Chief Commercial & Corporate Affairs Officer, Intercept Pharmaceuticals 11:00 – 11:10 a.m. Medical Affairs - Dr. Juan Carlos Lopez - Talavera, M.D., Ph.D. Senior Vice President of Medical Affairs, Intercept Pharmaceuticals 11:10 – 11:05 a.m. Conclusions Lisa Bright Chief Commercial & Corporate Affairs Officer, Intercept Pharmaceuticals 11:05 – 11:30 a.m. ICPT Panel Lisa Bright, Richard Kim, Juan Carlos Lopez - Talavera, Mark Pruzanski 10 Today’s Agenda

 

 

11 Primary Biliary Cholangitis: Disease Background and Standard of Care Juan Carlos Lopez - Talavera , M.D. Ph.D. Senior Vice President of Medical Affairs, Intercept Pharmaceuticals

 

 

12 Historical Perspective ▪ 1851 - Addison and Gull are first to describe prolonged obstructive jaundice with patent bile ducts ▪ 1949 - Dauphinee and Sinclair coin the term “primary biliary cirrhosis” (PBC) ▪ 1959 - Sheila Sherlock portrays 42 cases of PBC that she personally followed, which are instrumental in establishing PBC as an autoimmune disorder ▪ 1970 - cDNA for major mitochondrial antigen of PBC is identified as pyruvate dehydrogenase complex ▪ 1989 – PBC becomes one of leading indications for liver transplant ▪ 2004 – Urso 250 and Urso Forte ( ursodeoxycholic acid) tablets, indicated for the treatment of PBC, launch in the US ▪ 2015 – Movement to rename “primary biliary cholangitis” 12 Reuben et al. Hepatology 2003, 225 - 228 Poupon R. Primary biliary cirrhosis: a 2010 update. J Hepatol. 2010;52(5):745 - 758. doi:10.1016/j.jhep.2009.11.027, Dauphinee JA, Sinc lair JC. Primary biliary cirrhosis. Can Med Assoc J. 1949;61(1):1 - 6., Heathcote EJ. Primary biliary cirrhosis: historical perspective. Clin Liver Dis. 2003;7(4):735 - 740. doi:10.1016/S1089 - 3261(03)00106 - 5, Yeaman SJ, Fussey SPM, Danner DJ, James OFW, Mutimer DJ, Bassendine MF. Primary biliary cirrhosis: identification of two major M2 mitochondrial autoantigens. Lancet . 1988;1(8594):1067 - 1070. doi:10.1016/S0140 - 6736(88)91894 - 6, Tzakis AG, Carcassonne C, Todo S, Makowka L, Starzl TE. Liver trans plantation for primary biliary cirrhosis. Semin Liver Dis . 1989;9(2):144 - 148. doi:10.1055/s - 2008 - 1040506., Urso 250/Urso Forte [package insert]. Birmingham, AL: Axcan Pharma US; 2004, Kamath, P.S., Poterucha, J.J., Ludwig, J., Primary Bi lia ry Cirrhosis by Another Name isStill PBC, Journal of Hepatology 2015, doi: http://dx.doi.org/10.1016/j.jhep.2015.08.013

 

 

13 PBC Background 13 Background ▪ PBC is a rare autoimmune cholestatic liver disease ▪ Commonly a disease of women (10:1): 13.5 in 100,000 adults ▪ Characterized by destruction of the interlobular and septal bile ducts that may lead to cirrhosis Normal bile ducts Inflammation and scar tissue destroy ducts Gallbladder Liver Hepatic duct Common bile duct Cystic duct Poupon R. Hepatology. 2010; 52: 745 – 758. Selmi C. Lancet 2011; 377: 1600 - 09

 

 

14 Cholestasis (toxic bile acid accumulation) Hepatocellular damage Inflammation Fibrosis Cirrhosis Healthy Liver  Serum ALP Clinical use as diagnostic/prognostic  AST, ALT, GGT  Bilirubin Albumin, platelets Cirrhotic Liver • An increase in Alkaline Phosphatase (ALP) is observed early in the disease and continues throughout the disease until late stage. • Hepatocellular damage can be seen with increases in AST, ALT, GGT • An increase in serum bilirubin occurs late in disease Alkaline Phosphatase is a Key P rognostic Marker in PBC Poupon R. Hepatology. 2010; 52: 745 – 758. Selmi C. Lancet 2011; 377: 1600 - 09

 

 

15 AMA + • Loss of tolerance to PDC - E2 Elevated ALP • Immune - mediated cholangitis Cholestasis • Ductopenia Portal Hypertension • Fibrosis • Cirrhosis Variceal Bleeding Liver - related Death/Liver Transplantation Primary Biliary Cholangitis is a Chronic , Progressive , Autoimmune D isease Impaired Quality of Life Fatigue Pruritus

 

 

16 Primary Biliary Cholangitis: Diagnosis

 

 

17 Clinical Features ▪ Clinical features vary greatly between patients : asymptomatic & slowly progressive to symptomatic & rapidly evolving ▪ Fatigue is most common symptom – Present in ~ 80% of patients – > 40% report moderate - to - severe symptoms – Mechanism unknown – Typically characterized as daytime somnolence, impairing QOL ▪ Pruritus reported by 20 - 70% of patients – Due to cholestasis – Preceding jaundice ▪ Concurrent autoimmune diseases: – Sjogren’s , autoimmune thyroid disorder, systemic sclerosis, rheumatoid arthritis ▪ Reduced bone density – Osteopenia (33%) & osteoporosis (11%) ▪ Hypercholesterolemia: elevated HDL, not associated with increased CVD risk ▪ Xanthoma and Xanthelasma – Cholesterol deposit around the eyes 23 Internal Use Only; Not for Distribution https ://thebileflow.wordpress.com/201 1/02/04/pathology - xanthelasma - of - pbc/ Selmi et al. Lancet 2011; 377: 1600 – 09, Lindor et al. Hepatology, Vol. 50, No. 1, 2009

 

 

18 Diagnosis ▪ Patient must have two of the following: 1. ALP > 1.5 times ULN for more than 24 weeks 2. Serum Antimitochondrial Ab ( AMA ) > 1:4 • Serum AMA highly sensitive & specific for PBC • Detected in nearly 95% of patients - specificity ~ 100% Liver biopsy findings 3. Liver biopsy findings: • Non - supporative cholangitis & interlobular bile duct injury Need for liver biopsy in PBC is controversial – Valuable for disease staging – Considering other etiologies for liver disease including PSC, sarcoidosis or drug - induced cholestasis – Not commonly performed Internal Use Only; Not for Distribution Selmi C. Lancet 2011; 377: 1600 – 09; Lindor et al. Hepatology, Vol. 50, No. 1, 2009 Elevated serum alkaline phosphatase activity Exclude other causes of liver disease including alcohol and drugs Cross sectional imaging of liver to exclude biliary obstruction AMA, ANA, ASMA Consider liver biopsy, especially if AST > 5x normal or AMA?

 

 

19 Primary Biliary Cholangitis: Standard of Care

 

 

20 Treatment - Ursodeoxycholic Acid (UDCA): Only FDA approved t herapy 20 ▪ Current standard of care for PBC – 85% of diagnosed patients treated with UDCA • Dose of 13 - 15 mg/kg/day (Divided 2 - 4 times/day) ▪ UDCA is a bile acid (BA) that is present in human bile (3%) – Most hydrophilic least toxic BA Mechanisms of action of UDCA “Diluting” the BA pool Reduces concentrations of hydrophobic BAs and becomes the major circulating BA, thereby reducing toxicity of the circulating bile Increasing BA secretion Stimulates secretion of bile from hepatocytes by increasing expression of relevant genes Cytoprotective effects Stabilizes hepatocyte membranes, protects against oxidative stress, and may inhibit apoptosis induced by several agents Immune response effects May interfere with basic mechanisms of autoimmunity and have anti - inflammatory effects Putative Poupon RE, et al. Gastroenterology . 1997;113:884 - 890. Lindor et al.Hepatology. 2009; 50(1): 291 – 308. Poupon et al. Hepatology . 2010; 52: 745 – 758. Lew JL. J. Biol. Chem. 2004, 279:8856 - 8861. Paumgartner G. et al. Hepatology . 2002;36:525 - 531.

 

 

21 Current T herapy: Ursodeoxycholic Acid ▪ Improves alkaline phosphatase & serum bilirubin ▪ Delays the progression of fibrosis and histological stage ▪ Increases liver transplant - free survival and overall survival Poupon RE, et al. Gastroenterology . 1997;113:884 - 890. European Association for the Study of the Liver. Journal of Hepatology 2009; 51: 237 – 267. Lindor et al.Hepatology. 2009; 50(1): 291 – 308. Poupon et al. Hepatology . 2010; 52: 745 – 758.

 

 

22 Currently Biochemical Criteria Defining Response are Inconsistent 1 Pares. Gastroenterology 2006, 2 Corpechot. Hepatology 2008, 3 Kuiper. Gastroenterology 2009, 4 Kumagi. Am J Gastro 2010, 5 Corpechot. Journal of Hepatology 2011, Criteria: Adequate r esponse defined as: Evaluation: Barcelona 1 ALP reduction ≥40% from baseline or normalization 1 year Paris – 1 2 ALP ≤3 x ULN and AST ≤2x ULN and bilirubin ≤1 mg/dl 1 year Rotterdam 3 Albumin and/or bilirubin < ULN 1 year Toronto 4 ALP ≤1.67 ULN 2 years Paris – 2 5 ALP ≤1.5 x ULN and AST ≤1.5 x ULN and bilirubin ≤1 mg/dl 1 year ▪ Different combinations of biochemical variables ▪ Variables are dichotomized, based on different thresholds

 

 

23 AASLD ‘09 and EASL ‘09 Treatment Guidelines • “A good biochemical response after one year of UDCA treatment is currently defined by a serum bilirubin 61 mg/dL (17 lmol/L), AP 63 ULN and AST 62 ULN (‘‘Paris criteria”) or by a decrease of 40% or normalization of serum AP (‘‘Barcelona criteria”). ” • No specific definition or guidance of treatment success • " About 20% of patients will have normalization of liver biochemistries after 2 years and a further 15% or 35% of the total will have normalization by 5 years. The effect of treatment can be based on response of serum alkaline phosphatase activity or Mayo risk score, which is dependent on age, and presence or absence of fluid retention“ “Definition of Treatment Success”…Needs to Be Updated

 

 

24 Treatment - Ongoing Unmet Medical Need in PBC ▪ UDCA – Only approved therapy for PBC – ~25 - 50 % of patients have an inadequate response (although definition of inadequate response varies) 37 Internal Use Only; Not for Distribution Trivedi et al. Hepatology 2015, Kumagi et al. Am J Gastroenterol 2010; Lindor et al.Hepatology . 2009; 50(1): 291 – 308 0 10 20 30 40 50 60 Barcelona Paris I Rotterdam Paris II Toronto % of Non - responders

 

 

25 Alkaline phosphatase (ALP) and Bilirubin Strongly Correlated with Increased Risk of Transplant or Liver - related Death in PBC 25 Global PBC Study : – 15 North American and European centers with ~6,200 patients’ outcomes data ; ongoing • Patients on SOC as it currently exists – Alkaline phosphatase and bilirubin levels correlate with the outcomes of death and liver transplantation. • A combination of both variables improves prognostic prediction for patients – The lower the alkaline phosphatase and bilirubin levels the better the transplant - free survival – This data support that both alkaline phosphatase and bilirubin may provide meaningful surrogate end points in PBC that can reasonably be used in clinical trials. Lammers et al. Ga stroenterology 2014 147, 1338 - 1349.e5DOI: (10.1053/j.gastro.2014.08.029) . SOC = Standard of Care This data support that both alkaline phosphatase and bilirubin may provide meaningful surrogate end points in PBC that can reasonably be used in clinical trials .

 

 

26 Key Points: PBC Overview ▪ PBC is a chronic, rare autoimmune, cholestatic liver disease ▪ Disproportionately affect middle - aged women ▪ Multi - factorial etiology – genetic and environmental triggers ▪ AMA and ALP are key biomarkers for diagnosis ▪ ALP is well accepted for monitoring disease and response to therapy ▪ Patients often report fatigue & pruritus that may interfere with QOL ▪ Inadequate response to treatment may lead to progressive disease, liver transplant & death ▪ Studies have shown ALP and total bilirubin levels correlate with outcomes ▪ UDCA only FDA approved therapy ▪ ~25 - 50 % of patients have an inadequate response to UDCA 26 Kumagi T, Heathcote EJ. Orphanet J Rare Dis. 2008;3:1, Lammers et al. Ga stroenterology 2014 147, 1338 - 1349.e5DOI: (10.1053/j.gastro.2014.08.029, Poupon et al. Hepatology. 2010; 52: 745 – 758 , Trivedi et al. Hepatology 2015, Kumagi et al. Am J Gastroenterol 2010, Lindor et al.Hepatology . 2009; 50(1): 291 – 308.

 

 

27 Primary Biliary Cholangitis: Patient Journey & Partnering with Patient Advocacy Community Lisa Bright Chief Commercial and Corporate Affairs Officer, Intercept Pharmaceuticals

 

 

28 Our PBC Patients Are… 28 ▪ 85% female ▪ On average ~50 - 60 years of age ▪ 30 - 40% struggle with fatigue or pruritus ▪ Present to physicians through routine care or symptoms (fatigue or itching) and eventually referred to specialist (GI or Hep ) ▪ Tend to be more knowledgeable about the disease ▪ Acknowledge the stigma associated with the word “cirrhosis ” ▪ Dissatisfied with current treatment options Lammers et al. Ga stroenterology 2014; Intercept Market Research

 

 

29 Our Patient Advocacy Focus 29 Highlight PBC patient stories Explore unmet patient needs Engage PBC leaders Highlight International PBC Day Support the community Share scientific updates Provide unique resources , info Focused on engaging physcians and patient communities early and consistently, and incorporating these perspectives into our work Devoted to fostering physicians and patient - centric collaborations , and standing with these communities to reshape the future of liver disease treatment Increase PBC awareness Date of Preparation: October 2015 NP/UK/2015/047

 

 

30 Patient Journey Largely S imilar A cross US and EU * LFT = liver function tests, AMA = antimitochondrial antibodies, ANA = antinuclear antibodies, ALP = alkaline phosphatase 6 – 12 months Initial LFT* Interim Repeat LFT Imaging ALP/AMA/ ANA Biopsy PBC Diagnosis Possible ER presentation ▪ PCP ▪ GI or Hep ▪ GI or Hep LT/Death ▪ GI or Hep ▪ Hep ▪ Transplant center 5 - 40 years Monitoring End - Stage Symptomatic Asymptomatic 1 – 3 months Referral Imaging/ Biopsy Adjunct Therapies Controlled Inadequate ALP* Reduction UDCA* Treatment Intolerant Present at PCP LFTs performed every 3 - 6 months to monitor enzyme levels; UDCA prescription is refilled Treatment Diagnosis Origination/Presentation Source: Intercept Commissioned Market Research

 

 

31 ALP is doctor’s #1 metric for monitoring PBC; 64% rely on it a great deal and 57% select it as the metric they rely on most 79 75 71 32 36 92 88 61 35 61 0 50 100 Experiences around ALP (%) PBC Patients Do not Fully Understand ALP Monitoring Test ALP at least once every 6 mos. Discuss ALP results always/most of the time Understand most/all of discussion* Patients know most recent ALP score Patients were given their target ALP score Only about one in three PBC patients knows their most recent ALP score; doctors reinforce this figure Yet , doctors overstate the share of their patients who should know their target ALP score Doctors Patients * Among patients, base=those who discuss ALP results with their doctor at least sometimes; n=181 Results of Project RAPID - a market research project conducted by Intercept and presented at AASLD 2015; see Appendix

 

 

32 91 88 66 43 34 93 87 64 66 46 0 50 100 Share of doctors and patients who believe… (%) Doctors/patients feel stigma associated with the word “cirrhosis” Talking about PBC is embarrassing - people just assume drinking or substance abuse Most people associate “ cirrhosis ” with alcoholism Patients tend to avoid using the word “ cirrhosis ” when talking about their disease There is a social stigma with cirrhosis of the liver However, doctors understate the level of embarrassment their patients feel discussing their condition – not to mention judgment from others In fact, 68% of patients surveyed say they hesitate to tell people they have PBC Patients feel judged as a result of their PBC Doctors Patients Source: Project RAPID March 2015 Results of Project RAPID - a market research project conducted by Intercept and presented at AASLD 2015; see Appendix

 

 

33 32% 68% PBC Patients May Not Understand That Symptoms Are Not Associated with Disease Progression Myth Reality / Not sure Patients believe that worsening PBC symptoms mean that a person's PBC is worsening is a… 22% 62% My PBC patients understand that worsening PBC symptoms are not an indicator of PBC progression I discuss the relationship between PBC symptoms and progression with every patient Doctors strongly agree that… Just one in three patients surveyed understand that PBC symptoms are not associated with disease progression; this is a bit higher than doctors give patients credit for And this is in spite of most doctors saying they discuss the relationship between symptoms and disease progression Patients need to understand that PBC may be progressing even if they are not experiencing symptoms

 

 

34 34 Bringing Global PBC Community Leaders Together in 9/2014 Resulted in Renaming PBC a nd the First Pan European Patient Hub - PBC Together

 

 

35 Online Pre - Launch PBC Education in the US for Patients and Physicians 35 U.S. PBC Physician Disease Website www.rethinkpbc.com U.S. PBC Patient Disease Website www.livingwithpbc.com Physician PBC Disease Education Patient PBC Disease Education Kit

 

 

36 Introducing the Intercept Practice to Policy Health Awards Program Open to Healthcare Organizations, Policy Groups, Patient Advocacy Groups and Academic Groups 36

 

 

37 Primary Biliary Cholangitis: Redefining Treatment Success Juan Carlos Lopez - Talavera , M.D. Ph.D. Senior Vice President of Medical Affairs, Intercept Pharmaceuticals

 

 

38 Global PBC Study Group: Overview ▪ Global PBC Study Group, an international and multicenter collaboration between 15 liver centers in 8 North American and European countries ▪ Combined individual patient data from major long - term follow - up cohorts ▪ Clinical data of 6191 PBC patients 1. Lindor KD, et al. Hepatology . 2009;50:291 - 308; 2. European Association for the Study of the Liver. J Hepatol . 2009;51:237 - 267; Lammers, WJ et al. Gastroenterology . 2014 Dec;147(6):1338 - 1349.e5. doi: 10.1053/j.gastro.2014.08.029 . Edmonton Dallas Seattle Rochester Toronto Milan Padua Barcelona Birmingham London Paris Rotterdam & Amsterdam Leuven 15

 

 

39 Current Therapy: Ursodeoxycholic Acid Current Management Paradigm ▪ Bile acid therapy (UDCA) – Hydrophilic bile acid, dilutes toxic endogenous bile acids – Goal is to break cycle of cholestatic injury For some patients: ▪ Improves serum bilirubin ▪ Delays the progression of fibrosis and histological stage ▪ Increases liver transplant - free survival and overall survival Poupon RE, et al. Gastroenterology . 1997;113:884 - 890. European Association for the Study of the Liver. Journal of Hepatology 2009; 51: 237 – 267. Lindor et al.Hepatology. 2009; 50(1): 291 – 308. Poupon et al. Hepatology . 2010; 52: 745 – 758.

 

 

40 ALP and Bilirubin Strongly Correlate with Outcomes Lammers, WJ et al. Gastroenterology. 2014 Dec;147(6):1338 - 1349.e5. doi: 10.1053/j.gastro.2014.08.029.

 

 

41 Clinical Outcomes of Uncontrolled PBC 41 1 : Kumagi et al. 2 : Trivedi 3: Lammers AASLD 2015 Histologic progression/Cirrhosis: • >80% of patients had histologic progression at ~ 10 years 1 HCC: • 12 - month biochemical non - response is associated with increased future risk of developing HCC 2 Transplant or Death: • ~15% of UDCA - treated patients underwent liver transplantation or died during a median 7 year follow - up period 3 Patients with elevated ALP were shown to be at increased risk for disease progression and further complications of the disease

 

 

42 OCA: Investigational Drug for PBC

 

 

43 Bile acids: role in digestion ▪ Bile acids are synthesized from cholesterol in the liver ▪ Facilitate dietary absorption of lipids and nutrients based on their natural detergent properties – Released by gallbladder into gut during digestion – Reabsorbed & conserved ( enterohepatic recirculation) Bile acids: cell signaling ▪ Dedicated bile acid receptors (e.g . FXR ): act as hormones regulating multiple biological pathways ▪ Key regulators of liver, intestinal & kidney function ▪ Modulate metabolic, inflammatory & immune pathways Bile Acids: Novel Role in Modulating Disease

 

 

44 OH O OH HO Me Me OH O OH HO Me Me OH O OH HO Me Me OCA 6a - ethyl chenodeoxycholic acid CDCA chenodeoxycholic acid UDCA ursodeoxycholic acid FXR EC 50 (agonist) 0.09 m M No activity Pellicciari R. J.Med.Chem 2002 ~ 100x  FXR agonism 8.6 m M Obeticholic Acid (OCA) is a N ovel T herapeutic O ption T argeting FXR 6 - C ethyl substitution

 

 

45 FXR Core Mechanism of Action ▪ What is FXR? – Farnesoid X receptor (FXR) is a nuclear receptor expressed at high levels in the liver and intestine, and is the master regulator of bile acid homeostasis 1 ▪ P revents the accumulation of toxic bile acids by: 1 – Decreasing synthesis – Increasing secretion – Decreasing re - uptake ▪ FXR activation has the potential to not only regulate bile acid homeostasis but also have positive effects on inflammatory and fibrotic pathways Fibrosis ↓ Stellate cell activation ( α - SMA) ↑ Stellate cell apoptosis (TIMP - 1) ↓ Fibrogenesis (TGF - β1) ↑ Matrix degradation (MMP - 2) ↓ NF - kB ↓ TNF - α , IL - 1 β , IL - 17, IFN - γ ↓ CRP Inflammation ↓ Bile acid synthesis (CYP7A1) ↑ Bile Salt Excretory Pump (BSEP) ↑ Intrahepatic bile flow Bile Acid Homeostasis Cholestasis Inflammation Fibrosis Cirrhosis 1: Fiorucci et al. Gastroenterology. 2004. 127:1497 - 1512

 

 

46 Trial Description Duration N= Dose Status Phase 2 201 OCA 12 weeks 59 10mg or 50mg Completed : m et primary and secondary endpoints 202 UDCA + OCA 12 weeks 165 10mg, 25mg or 50mg Completed: m et primary and secondary endpoints Phase 3 POISE UDCA + OCA 1 year 217 5mg or 10mg DB completed: m et primary & secondary endpoints; >95% enrolled in LTSE 302 Long - term confirmatory outcomes Up to 8 years 350 (target) 5mg or 10mg Enrolling All trials randomized, double - blind, placebo - controlled with long - term safety extension (LTSE) phases OCA Clinical Development in PBC

 

 

47 POISE: Phase 3 Trial Design UDCA = Ursodeoxycholic acid; ALP=Alkaline phosphatase; ULN=Upper limit of normal Screening OCA 10 mg (n=73) Placebo (n=73) M3 M12 M6 W2 0 M9 If on UDCA : Continue UDCA OCA 5 mg OCA Titration at 6 Months: Patients in OCA titration arm titrated from 5 mg to 10 mg at Month 6 if they met any of the following criteria at the Month 6 assessment: 1. The primary endpoint (ALP >1.67x ULN or bilirubin >ULN) was not achieved; and 2. No evidence of tolerability issues, e.g. pruritus Titrate to OCA 10 mg (n=33) Remain at OCA 5 mg (n=37) Primary endpoint : ALP < 1.67x ULN (with ≥ 15% reduction) & normal bilirubin at 12 months

 

 

48 48 OCA Met the Primary Endpoint of Phase 3 POISE Trial 10% 47% 46% 0% 10% 20% 30% 40% 50% Placebo* OCA 10mg* OCA 5-10mg* EFFICACY:  Primary endpoint: ALP < 1.67x ULN (with ≥ 15% reduction) & normal bilirubin at 12 months  OCA met the primary endpoint at every time point assessed during the trial; as early as 2 weeks  Builds on positive results from two Phase 2 trials  OCA met secondary endpoints: GGT, ALT, AST and total bilirubin (p< 0.0005 vs. placebo) SAFETY AND TOLERABILITY:  Pruritus, generally mild to moderate, was the most frequently reported AE (8 total discontinuations; 0 placebo, 7 in OCA 10mg, 1 in OCA titration)  OCA dose titration resulted in the lowest incidence of pruritus in PBC patients to date  Pruritus severity no different than placebo after 6 months of OCA (assessed by a visual analog scale)  >95% continued in the open - label LTSE Enrollment: 217 patients at 59 centers in 13 countries. * All patients allowed standard of care, including stable dose of ursodiol (p< 0.0001 vs. placebo in both groups) % Meeting Primary Endpoint n=73 n=73 n=70

 

 

49 Some UDCA/placebo P atients Experienced ALP E levation in POISE at 12 Months ~35% of placebo/UDCA patients experienced increases in ALP at month 12 in POISE study 49

 

 

50 98% of PBC patients on OCA 10mg (added to UDCA) improved or at least stabilized ALP over 12 months ~35% of placebo/UDCA patients experienced increases in ALP at month 12 in POISE study Some UDCA/placebo P atients Experienced ALP E levation in POISE at 12 Months

 

 

51 PBC: 2015 AASLD Rundown

 

 

52 Important Presence at AASLD 2015 CLINICAL Abstracts/Posters/Oral: OCA/PBC (N=17) 52 Poster Sustained Improvement in the Markers of Cholestasis in an Open Label Safety Extension Study of Obeticholic Acid in Primary Biliary Cirrhosis Patients [301 LTSE] Trauner Poster Efficacy and Safety of Obeticholic Acid (OCA) in PBC Patients with Advanced Disease as Evidenced by Abnormal Bilirubin: An Integrated Analysis Jones Poster Long - term safety and efficacy of Obeticholic Acid Treatmein in Primary Biliary Cirrhosis after more than 4 years of treatment [201 LTSE] Kowdley Poster Integrated Analysis of Efficacy of Obeticholic Acid Evaluating Subgroups of Patients Less Likely to Respond to UDCA (Age, Age at Time of PBC Diagnosis, and Sex) Pencek OCA PBC Poster Long - Term Safety of OCA in Patients with PBC Peters Poster Evaluation of the posology of Obeticholic Acid (OCA) in patients with PBC [301] Pencek HEOR Poster Obeticholic Acid (OCA) has Incremental Efficacy in Patients with Higher Baseline Alkaline Phosphatase (ALP) Levels Tracy Mayne Oral Presentation UKPBC POISE: OCA trial - based model of mortality and liver transplant Carbone Poster Monitoring Pruritus in Patients with Primary Biliary Cirrhosis (PBC): Equivalence of Visual Analogue Scale and Multi - Item Questionnaires Mayne Poster Hospitalization for primary biliary cirrhosis: a UK - PBC analysis of hospital episodes Hirschfield Poster Convergence of Two Predictive Models of Risk Reduction in Patients with Primary Biliary Cirrhosis (PBC) Hansen Poster The Need for Improved Liver Literacy in the US Population Swanson Poster Physician versus Patient Perceptions of Medical Care Quality in Primary Biliary Cirrhosis Saich Oral Presentation Clinical Epidemiology of Primary Biliary Cirrhosis based on a Large US Laboratory Database: Incidence and Trends in Serum Alkaline Phosphatase Kim Poster Characteristics of Incident PBC Patients in a Large US Laboratory Sample Lindor Poster Heat Mapping Incident PBC Patients in a Large US Laboratory Sample Lindor

 

 

53 Market Sizing and Market A ccess Lisa Bright Chief Commercial and Corporate Affairs Officer, Intercept Pharmaceuticals 53

 

 

54 Global PBC Patient Waterfall 128k 115k 54k 49k 43k 29k 15k 111k 109k 47k 42k 37k 25k 13k 29k 28k 11k 10k 8k 6k 3k 291k 274k 123k 110k 97k 66k 34k Prevalence Access Diagnosed Under treater care Treated Uncontrolled (ALP > ULN) Uncontrolled (ALP > 1.67) US EU5 Canada ANZ ROE Global Prevalence / OCA Candidate Assumptions US ROW Prevalence (rate / ~2015 pop.) 1,2 0.04% 0.035% Access to healthcare 3,4 89.7% 95% PBC Diagnostic rate 5 2016 46% 38% 2019 49% 42% 2025 54% 46% Under treater care 5 88% Treated w/ UDCA 6 85.0% Intolerant 5 3.0% Inadequate responder ALP >ULN 5,6 71.0% Adequate responder ALP <ULN 5,6 29.0% 1: Kim et al. J. Gastroenterology. 2000; 119(6): 1631 - 6; 2: CDA Epidemiology Research; 3: US Census Bureau 2015; 4: OCED Health Data 2014; 5: Intercept Commissioned Market Research; 6: Lammers el al Gastroenterology. 2014 Dec;147(6):1338 - 1349

 

 

55 Stratification of PBC Patients Based on ALP 55 35% 10% 13% 13% 29% ALP AFTER 12 MONTHS ON URSO ALP ULN - 1.67x ULN ALP 1.67 - 2.0x ULN ALP > 3.0x ULN ALP > 2.0x ≤ 3.0x ULN ALP < ULN Lammers el al Gastroenterology. 2014 Dec;147(6):1338 - 1349

 

 

56 Market Research: Current Physician Treatment Approach in PBC Base: Physicians who view ALP level reductions as a marker of treatment success - EU Total n=(156) UK n=(35), France n=(31), Ger many n=(22), Italy n=(36), Spain n=(32) Note: Current wave answer options changed significantly, and therefore, trending with EU ‘14 data is not possible. QC3a. What is the minimum target ALP level patients treated with Urso must achieve for their treatment to be considered successful? QD4a. When you treat a primary biliary cirrhosis (PBC) patient with ursodeoxycholic acid (Urso/UDCA), what ALP threshold are you hoping to achieve? Source: EU ATU (March’16) US Segmentation (Jan’15) Majority of U.S. Physicians hope for normal ALP or any reduction in ALP

 

 

57 Increasing Sensitivity A round Pricing in the US (as well as EU) Important to Price OCA Based on Value 57 OCA is on 2016 ICER Review list

 

 

58 Price Drivers Vary By Country There’s been a payor shift to demand more value in terms of patients outcomes for orphan disease products. Even where price is not negotiated we are seeing increasing willingness to impose restrictions in orphan indications Clinical effectiveness ▪ Patient - relevant clinical benefits compared with alterative treatment options HTA ▪ Costs and outcomes of a treatment versus comparator Free pricing ▪ Pricing set by the manufacturer Budget impact ▪ Economic impact to the payors ’ budget

 

 

59 Research on OCA Pricing in PBC 59 KOLs National Regional/ local USA 2 8 17 Canada 2 2 4 France 2 5 - Germany 2 3 5 Italy 2 2 6 Spain 2 2 6 UK 2 3 5 Sweden 2 2 4 Total 16 19 47 Qualitative research sample Research methodology Disease background presentation • Prior to interviews, payors received a 1 hour presentation on PBC disease background with a top KOL in both the US and Europe • Included exposure to Lammer’s data Baseline PBC product profile 1:1 Interviews with payors • 90 minute in - person / telephone interviews with payors and KOLs Total of 82 payors and KOLs were included in the qualitative research

 

 

60 The Orphan D rug L andscape P resents C ertain O pportunities and Challenges that will be Considered as Part of OCAs Pricing Strategy 60 Opportunity ▪ If approved, OCA will be the only therapeutic option for PBC patients with inadequate response to UDCA ▪ Orphan disease, limited budget impact ▪ There will be a push to ensure OCA is administered to the appropriate patient sometimes manifested through restrictions ▪ PBC may be perceived as a less severe orphan disease given the relatively asymptomatic nature for the majority of patients ▪ Surrogate markers may reduce perceived value and therefore price potential ▪ Real world data showing the impact on disease progression will be extremely important Challenges

 

 

61 Developing the OCA Value Story 61 ALP endpoints Bilirubin endpoints Inflammatory markers Fibrosis endpoints Availability of clinical evidence in POISE 100% 0% 100% Payor confidence in OCA ALP, the key biochemical marker of disease progression in PBC was reduced or not increased in 98% of patients following 12+ months of OCA treatment +/ - UDCA OCA stabilizes or reduces bilirubin levels Demonstrating reduction in time to fibrosis, or reversal of fibrosis would be ultimate evidence for payors OCA has a positive effect on inflammation pathways (i.e. IL12, CRP, TNF - alpha)

 

 

62 Health Economics Modelling is U nderway 62 Structure of HE model

 

 

63 US Launch Preparedness Richard Kim Head US Commercial, Intercept Pharmaceuticals

 

 

64 Significant Progress Made For U.S. Launch Readiness ▪ Key market insights gained – In 2015 alone, US Business Intelligence Team completed 12 major initiatives in preparation for launch with over 1000 hours of interviews with key customers (Patients, Physicians and Payors ) ▪ Sales team hired, trained and currently visiting physician offices to learn about current treatment practices for PBC ▪ Fully staffed marketing and managed markets teams ▪ Majority of vendor and third party partners selected and or contracted with ▪ Completed (or will by end of the year) 14 PBC advisory boards for physicians, payers, NP/PA, patient organizations – Payers and Patient Orgs – led by C ommercial – Physician and NP/PA – led by Medical Affairs ▪ Had significantly increased corporate presence at 2015 AASLD, San Francisco Nov 13 - 17 64

 

 

65 Intercept Was Front and Center at AASLD • 28 presentations including 4 oral presentations • AASLD Founder’s Club for AASLD Foundation • Medical sponsored 2 symposia, PBC and NASH

 

 

66 Challenges Exist, However the Launch of OCA Provides the Opportunity to Transform PBC…and Intercept ▪ Very established customer behavior in PBC ▪ Lack of universal view on treatment success ▪ Increased scrutiny on pharma pricing ▪ Low awareness of OCA for PBC in GI community practice ▪ Perceptions about pruritus ▪ Lack of outcomes data ▪ Built a new team quickly Challenges Opportunities ▪ Huge unmet need for PBC patients not well controlled with UDCA or UDCA intolerant ▪ Need for contemporary guidelines ▪ No “active” competitors ▪ Potential 1 st new treatment for PBC in 20 years ▪ Customers who have been exposed to the product profile generally have a positive perception of OCA ▪ Establish OCA as “THE FXR agonist” (and establish FXR agonist as a critical pathway in liver disease ) ▪ Have hired a highly experienced team with huge hep /orphan credibility Market OCA/ Intercept

 

 

67 ~90% Of PBC Patients in t he U.S. are Under the Care of a Physician and t he Ultimate OCA Opportunity Will Be Linked to How Treatment Success is Defined 67 46%^ 92% 88% 71% 35% 0.04% or intolerant to SOC* *3% of patients are intolerant to UCDA ^Access to healthcare assumed in calculation at 88.1% FY2015 Source: ICPT internal forecasting assumptions Launch will not focus on increasing broad general PBC awareness

 

 

68 Having Timely Patient Follow Up Will Be Critical to Inform About Potential New Treatment Options * LFT = liver function tests, AMA = antimitochondrial antibodies, ANA = antinuclear antibodies, ALP = alkaline phosphatase 6 – 12 months Initial LFT* Interim Repeat LFT Imaging ALP/AMA/ ANA Biopsy PBC Diagnosis Possible ER presentation ▪ PCP ▪ GI or Hep ▪ GI or Hep LT/Death ▪ GI or Hep ▪ Hep ▪ Transplant center 5 - 40 years Monitoring End - Stage Symptomatic Asymptomatic 1 – 3 months Referral Imaging/ Biopsy Adjunct Therapies Controlled Inadequate ALP* Reduction UDCA* Treatment Intolerant Present at PCP LFTs performed every 3 - 6 months to monitor enzyme levels; UDCA prescription is refilled Treatment Diagnosis Origination/Presentation Source: Intercept Commissioned Market Research 3 - 12 mon

 

 

69 State - level PBC Claims are Concentrated , 80% are in 21 States Source: PBC claims data: Intercept PBC Stakeholder Profile Analysis – Key Findings, Nov. 7, 2014 Update (IMS), Slide 41. PBC=Pri mary Biliary Cirrhosis PBC Claims: State - Level Quintile Profile 53,907 PBC claims. Excludes DGP, VET specialties. Regional PBC Claims: Top States by Quintiles (Ranked alphabetically by Q5, Q4 & Q3) Northeast Region • New York (Q5) • Ohio (Q4) • Pennsylvania (Q4) • Illinois (Q3) • Massachusetts (Q3) • Michigan (Q3) • New Jersey (Q3) Southeast Region • Florida (Q5) • Georgia (Q3) • Tennessee (Q3) Western Region • Texas (Q5) • California (Q4) PBC Claims Quintiled by State Q5 (4,082 - 5,093) (3) Q4 (2,268 - 3,670) (3) Q3 (1,485 - 2,085) (6) Q2 (877 - 1,295) (9) Q1 (28 - 815) (30)

 

 

70 We Know Where the Highest Prescribing PBC Treaters Are; As Expected They Are Concentrated in Urban Areas, But There Are Some in Remote Areas *Core - Based Statistical Area

 

 

71 Establish Intercept as a credible partner in unmet liver diseases U.S. Objectives Tightly Aligned with Global Strategic Imperatives 71 Ensure maximum patient access at the optimal price Communicate an inspiring and compelling brand story based on FXR Structure for success Prepare to appropriately address unsolicited NASH requests Redefine treatment success in PBC Demonstrate commitment in liver diseases by establishing ICPT as the PBC champion Make PBC relevant to a broader customer base Cultivate a great OCA experience Work as ONE PBC Team across functions and geographies Global Strategic Imperatives U.S. Objectives

 

 

72 In t e g r ated Hub In t e g r ated Hub and Distribution Model Co m prehensi v e Hu b Ser v ices M aster D ata M anage m ent D ashboards w ith Data Anal y tics Specialty Phar m acy C losed/Li m ite d / O p en Net w ork Prescribe r s Patients & C aregi v ers Pa y ers M anufa c t u r er Other Ancillary Pro v iders • Co p ay Card providers F ield N ursing RDs, DSAs, TBMs and Sales Ops A Best - in - Class Patient Services Hub Will Be a Key Advantage Comprehensive reimbursement services support platform Comprehensive care management support platform that will provide education, compliance and persistency Leverage technology for the most efficient and effective customer experience possible and provide Intercept with complete, actionable and appropriate data

 

 

73 Creating Best - in - Class D ata W arehouse and Analytics 73 ▪ Collect, process and analyze data from CRM, Patient Services HUB, Distribution Channels and IMS ▪ Provides unique data (beside Rx and Units) to help profile and serve our physicians and patients in the best way possible ▪ For each clinic, institution and practice where patients have enrolled in our program, ICPT will have additional visibility into a patient’s PBC journey ▪ Insights will support business planning ▪ Inform timing of engagement and enables TBMs to better understand their customers Create a fully integrated approach to understanding our customers in support of a timely, efficient and valued engagement Real - Time D Data Warehouse Intercept ERP s Doctor Rx Patients Diagnosis Specialty Pharmacies Insurance PBC Diagnosis Fulfill Rx PBC Rx Patient Services Hub PBC and Non - PBC data PBC Data rd 3 rd Party Logistics Intercept CRM Analytics Platform Intercept’s in Process Commercial Architecture 3 rd party prescription data

 

 

74 PBC Payor Coverage is Representative of Total Healthcare Expenditures 74 US National Health Expenditure, 2012 (Billions) Source: CMS. National Health Expenditure Data, 2014. Available online at http://www.cms.gov/Research - Statistics - Data - and - Systems/Statistics - Trends - and - Reports/NationalHealth.net. Accessed on January 11, 2015 Prescription Drug Spend (Billions) 2010 (actual) $255.7 2012 (actual) $260.8 2016 (projected) $311.6 2022 (projected) $455.0 Despite the perception of being a private market, public funding accounts for half of US’s healthcare expenditure. Private $930,600 Medicare $579,900 Medicaid & CHIP - Federal $416,800 Other Federal $107,900 Other State and Local , $451,200 OOP , $320,200 Medicaid 9% Commercial /Private 57% Military 1% Medicare 33% Private commercial payers account for majority of PBC claims U.S. total healthcare expenditures U.S. PBC breakout

 

 

75 Sales Force Sizing was Based on Optimal Coverage of Top Quintile Physicians and Will Be Adjusted Where Necessary 75 ▪ Hepatologists and gastroenterologists combined account for 72% of all patients being treated for PBC ▪ Hepatologists and gastroenterologists account for 80 - 85% of all high quintile (Q3 - Q5) prescribers ▪ TBMs will cover 100% of hepatologists and all gastroenterologists Q2 and above, additionally will cover high quintile PCPs, NP/PAs PBC treater defined as UDCA prescriptions with associated PBC claims

 

 

76 The Sales Teams Territories Have Been Aligned to Maximize C overage for PBC Prescribers and Clinical Nurse Educators Will P rovide A dditional Customer Service ▪ 6 regions managed by Regional Directors (RDs) – Span of control of 7 to 8 territories per region ▪ 45 territories managed by our sales representatives (Territory Business Managers, TBMs) ▪ Clinical Nurse Educators (CNEs) ▪ Additional mobile TBMs ( mTBMs ) to cover any additional coverage gaps 76

 

 

77 On Track to Support A February 29 th PDUFA date for OCA in PBC 77 ▪ Global trade name(s) approved for EMA and conditionally approved by FDA ▪ PBC launch campaign in late stage development and being tested with customers ▪ Promotional programs and training under development with program deployment shortly after approval ▪ First online presence to support PBC awareness: “rethinkPBC.com” and “livingwithPBC.com” ▪ AMCP dossier in development ▪ Customer relations management tool (CRM) rolled out and being tested

 

 

78 We Are Building a Best - in - Industry Team and Together as ONE Team Plan to Have a Strong PBC Launch ▪ Our customers are ready for a new treatment option for PBC – We will know who to see and when to see them ▪ Preparing the scientific message platform to communicate the OCA PBC value proposition ▪ Our programs and materials to support launch are on track for finalization and have deep market insights supporting their development ▪ We have a highly experienced and passionate group of people with lots of liver and orphan disease experience 78

 

 

79 Ex - US Launch Preparedness Lisa Bright Chief Commercial and Corporate Affairs Officer, Intercept Pharmaceuticals

 

 

80 • Intercept Teams established U.S. and across Europe: UK , Ireland, Canada, Nordic Region, France, Benelux Region, Germany, Austria, Switzerland, Spain, Portugal and Italy • Build out in Australia and NZ from 2017 • EU HQ in London, Kings Cross • Focused on market access (General Managers, market access and medical affairs • EU, Canada/Australia Field force expected to be similar in size to US Growing Our Global Presence 22 countries with distinct languages, legal systems, market access

 

 

81 EUCA Launch Preparedness Well Underway ▪ EUCA regional infrastructure in place – temporary offices in all countries ▪ High caliber leadership teams recruited covering 21 countries, consistent with our vision to establish high credibility in hepatology – ≥ 80% of hires have extensive hepatology therapeutic area experience – High degree of orphan, specialty care and launch experience ▪ Launch plans in place ▪ Full service distribution network anticipated to be in place across the region ▪ Market access plans in place in all countries – Pricing and reimbursement research ongoing 81

 

 

82 Medical Affairs Juan Carlos Lopez - Talavera , M.D. Ph.D. Senior Vice President of Global Medical Affairs, Intercept Pharmaceuticals

 

 

83 Medical Affairs Activities to Support a Successful PBC Launch 83 PBC Publication Plan Healthcare Outcomes Research Investigator Initiated Research Medical Science Liaisons Medical Communications Thought Leader Engagement

 

 

84 Medical Affairs Activities to Support a Successful PBC Launch 84 PBC Publication Plan Healthcare Outcomes Research Investigator Initiated Research (IIR) Medical Science Liaisons Medical Communications Thought Leader Engagement • PBC Publication Plan and process in place • ~ 20 Planned Manuscripts ; 40 abstracts published; 40 + planned abstracts • Ongoing development of compendia materials • Central process and strategy i mplemented • Creation of web portal for IIR submission and tracking • Full MSL team deployed (N=12) • On - going PBC awareness and education activities • Global Call Center build - out and training completed • Completed 11 Advisory Boards; 12 planned for 2016

 

 

85 Educating on Pruritus Management Overview - Medical Education Dissemination Medical Conferences • AASLD’14 (1 poster) and AASLD’15 (1 poster) • FXR Agonist Obeticholic Acid: Pruritus, A Common Side Effect Ameliorated by Dose Titration • Monitoring Pruritus in Patients with Primary Biliary Cirrhosis (PBC): Visual Analogue Performs as well as Multi - item Questionnaires • EASL’16 - 4 planned abstracts - predictors of OCA induced pruritus; pruritus management and impact on efficacy and severity Publications • Planned Manuscripts • HOR: PBC, OCA and Pruritus • HOR: Cost of Treating Pruritus in PBC • Pruritus – Integrated • White Paper on PBC Symptom Management – Pruritus MSLs • Proactive Pruritus Education - HCP Slide Deck • Pruritus is one of the most common symptoms of the disease • Pruritus is not correlated to disease severity or prognosis • Interactive Case Studies • Reactive OCA Education – HCP Slide Deck • POISE Data

 

 

86 86 PBC Advisory Boards: 2015 - 1H2016 Roadmap (N=64) Obtaining Insights from Varied Audiences through Launch Global N= 2 Q3’15 Q4’15 Q1’16 Q2’16 AASLD EASL National N= 37 Regional N= 23 NP/PA N=1 Patient Advocate N=1 Global N=15 - 20 Global N=15 - 20 Regional (7) N=8 - 12 Regional (7) N=8 - 12 National NP/PA N=12 - 15 Patient Ad N=12 - 15 Payer (2) N=10 webinar Payer (2) N=10 Payer Medical Patient Ad EU Country (11) N=8 - 12 EU Country (11) N=8 - 12 EU Country (11) N=8 - 12 National US (1 ) N=10 - 15 National US (1) N=10 - 15 Regional (7) N=8 - 12

 

 

87 US Advisory Boards Top - Line Summary (N=11) 87 Lack of consensus surrounding criteria for PBC treatment Advisors manage pruritus; recommend education tools PBC monitoring and defining treatment success “Encouraged” by OCA Biochemical Data Advisors see room for improvement in current PBC treatment. Current criteria are viewed as complex and unwieldy for daily use. Recommend early markers that could be used to identify predictors of UDCA nonresponse. Advisors were accepting of ALP as a surrogate marker. Advisors’ general consensus was that the lower the biochemical markers the better; “when it comes to ALP, the lower is better” Agreed pruritus management was part of their current practice; however, several advisors agreed that education or a tool to support other healthcare providers, patients, and caregivers would be valuable Advisors agreed that they would use OCA based on biochemical data

 

 

88 Conclusions Lisa Bright Chief Commercial and Corporate Affairs Officer, Intercept Pharmaceuticals

 

 

89 Conclusions ▪ Unmet need in PBC is significant ▪ Significant insights into all aspects of the disease gained over last 12 months ▪ Entire company aligned behind the 5 strategic imperatives ▪ Continuing to enhance understanding of and care for PBC ▪ Built outstanding commercial and medical affairs team with significant hepatology experience across all roles ▪ US is our priority market & our TBMs have been deepening our understanding of PBC management since October ▪ Ex US – we now have Intercept teams established and working with stakeholders in 21 countries ▪ We will be prepared to present the value proposition to payors across all countries 89

 

 

90 Intercept Commercial Q&A Send questions to: investors@interceptpharma.com

 

 

91 Appendix

 

 

92 Project RAPID: Overview An example of research undertaken and presented as a poster at AASLD 92 We spoke with 3 groups – doctors who treat PBC, PBC patients, and the General Public Doctors WHEN : From December 11, 2014 to January 12, 2015 SAMPLE SIZE : 322 HOW: Fieldwork was conducted online using a blend of online healthcare panels. In order to qualify, doctors had to be board certified gastroenterologists or hepatologists who have been practicing for at least two years and treat a minimum of two PBC patients in the past six months. The survey took 45 minutes on average to administer. Patients WHEN: From January 5 - 30, 2015 SAMPLE SIZE: 214 HOW: Fieldwork was conducted online using a blend of online consumer panels and recruitment via leading PBC patient advocacy groups, such as the PBCers . In order to qualify, patients had to have been doctor - diagnosed as having PBC. The survey took 38 minutes on average to administer. General Public WHEN: From January 6 - 12, 2015 SAMPLE SIZE: 511 HOW: Fieldwork was conducted online using GfK KnowledgePanel – the only large - scale representative panel of the American public. The KnowledgePanel covers 97% of U.S. households. Respondents are selected using random probability address - based sampling; computers and Internet servic e are provided to respondents who do not have them to ensure fuller representation of the American public. The survey took 14 minutes on average to administer. Final data were weighted by age, region, race/ethnicity, education, and in come, according to the March 2014 Current Population Survey. The margin of sampling error for this poll is +/ - 3.4 percentage points (total sample) – and is high er for subgroups.