`
`Dumaswala, Ashwini </O=CARTER-W ALLACE/OU=EXCHANGE
`ADMINISTRATIVE GROUP
`(FYDIBOHF23 SPDL T)/CN=RECIPIENTS/CN=ASUMASW ALA>
`Sent:
`Wednesday, November 2, 2011 3:40:52 PM
`Recipient:
`Roecklein, Bryan <Bryan.Roecklein@meda.us>
`Subject:
`RE: ET Dymista presentation
`Attachments: 2012 Dymista Strat Plan for ET Final.pptx
`
`Hello Bryan,
`
`Please see the attached.
`
`Thank you,
`
`Ashwini
`
`From: Roecklein, Bryan
`Sent: Wednesday, November 02, 2011 11:25 AM
`To: Dumaswala, Ashwini
`Subject: ET Dymista presentation
`
`Ashwini, can you send me an electronic copy of your slides.
`
`Thanks, Bryan
`
`Bryan Roecklein, Ph.D.
`Vice President, Marketing and Business Development
`Meda Pharmaceuticals
`Somerset NJ, 08873
`Office: 732-564-2366
`
`PLAINTIFFS'
`TRIAL EXHIBIT
`PTX1118 e
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`xhibitsticker.com
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`MEDA_APTX0177 4595
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`CIP2064
`Argentum Pharmaceuticals LLC v. Cipla Ltd.
`IPR2017-00807
`
`
`
`2(]~12 DYMISTA Strategic Plan
`
`Pnesented: October 28, 2011
`
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`Today's objectives
`
`• Present the Dymista 2012 Strategic Plan
`
`• Gain ET alignment
`
`• De~termine action steps to answer any outstanding questions
`
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`
`
`xecutive Summary
`
`Establish Dymistat as the
`branded TRx and sales
`leader in SAR
`
`2012 Financials:
`• TRx: 448K
`• Net sales: $33.1 MM
`• EBITDA: ($36MM)
`• Gross/net%: 61.5%
`
`2012 Commercial
`SUQ.Qort:
`
`• Personal & Nonpersonal
`Promotion
`• KOL initiatives
`• Managed Care
`• Public Relations
`• CRM/Digital
`
`----·Goals
`• Take share from other prescription SAR products (specifically,
`intranasal steroids and intranasal steroid/anthistamine combinations)
`
`• Achieve 4.5% share of the nasal spray market by the end of 2013
`
`• Deliver positive cash flow by the end of 2013 and Net Sales of $199
`million (with 375 sales force expansion in 2013)
`
`Key Strategies:
`
`•
`
`•
`
`•
`
`Ensure access to Dymista by eliminating 1managed care
`and trade barriers
`
`Drive early trial and repeat use of Dymista via successful
`first experience
`
`Maxirnize exposure of Dymista and drive efficiencies
`across communication touchpoints
`
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`
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`Where we are today:: Product churn
`
`I Patient tries 2nd OTC
`
`I
`
`First Rx: Patient goes to
`Dr. and receiv~es INS (in
`addition to their OTC)
`and/or Xyzal neplaces
`their OTC
`
`Second Rx: Patient returns to
`Dr. and receives Singulair or
`patie~nt goes to allergist and
`receives IN~+ INAH
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`Third Rx: Patient
`returns to Dr. and
`gets INS+ INAH
`flED"
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`
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`Where we are today:: The current situation
`
`1. HCPs recognize that while products in their current armamentarium treat the
`symptoms of SAR, their patients are not receiving "complete relief"
`
`• Patients and physicians often "churn" through several OTC and Rx products
`
`• Generic fluticasone is the "easy-·to-Rx" product when oral antihistarr1ines alone are
`not enough
`
`• There is a disconnect between HCP perception of SAR symptorns and patient
`perception
`
`2. INS + INJ~H therapy is the 2nd or 3rd Rx in the current treatment algorithm (mild
`patients are treated with OTCs)
`
`• The natural HCP positioning for INS + INAH therapy is for moderate to severe
`patients
`
`• Positive patient feedback is key to changing the algorithm and establishing a new
`standard of care
`
`• To date, there has been little ne·w news in the INS or INAH category to change the
`ft£i)£1 5
`algorithn1
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`Where we are today:: The current situation
`
`3. Impact of managed care and cost continue to be the main concern of HCPs
`
`• Patient out-of-pocket cost is an increasingly important decision critenion in
`prescribing decisions,
`
`• Obstacles at point of purchase vvould significantly impact prescriptions
`• Any payor restrictions would significantly impact prescriptions and will drive
`ne~1ative feedback
`• Unless there is meaningful product differentiation, HCPs Rx the product that
`is e,asiest, not always best
`
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`
`
`The overall Rhinitis market is flat; The nasal steroid market is growing 5°/o
`per year, increasing the opportunity for Dymista; Growth is bein~J driven by
`fluticasone~
`
`Millions of TRx
`90
`80
`70
`
`60
`
`50
`
`40
`
`30
`
`20
`
`10
`
`0
`
`MAT 9/2008
`
`MAT 9/2009
`
`MAT 9/2010
`
`MAT 9/2011
`
`W&..'tm Nasal Antihistamine
`=~=l=~=~=~~=~=~; Oral Antihistamine
`lllllilllllllliNS
`,.._,Rhinitis
`
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`D~tmista ChallengE3S & Opportunities
`
`Challenges
`
`Opportunities
`
`• Current treatment algorithm places INS +
`I NAH therapy 2 or 3rd Rx
`
`• There is a significant unmet need in the
`treatment of SAR
`
`• SAR is considered a nuisance condition by
`HCPs
`
`• Robust head-to-head clinical data for additional
`data mining (N=4633)
`
`• Lack of supportive data for INS+INAH combo
`• vs. oral antihistamines
`• vs. single entities used in combination
`• Pharmacoeconomic data
`
`• Efficacy superior to market leader
`
`• Rapid onset of action and more complete
`symptom relief vs. single entity therapies
`
`• Managed care supports low cost generics as
`the "easy-to-Rx" product and supports allergy
`treatment guidelines
`
`• First combination spray
`
`• Meda Allergy expertise
`
`• Limited Meda sales force reach
`
`• Branded market leaders leaving space
`
`• Limited KOL advocacy
`
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`Dymista Marketing Strategy
`
`~~
`
`Churning
`
`• INS+ INAH are
`2nd or 3rd Rx
`• SARis a
`nuisance
`condition
`• No product
`provides
`complete relief
`
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`More complete
`relief
`
`• Success with
`the first
`prescription
`
`• Fast and more
`complete relief
`
`• Patient
`satisfaction
`
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`
`
`Dyn1ista is the seasonal allergic rhinitis solution
`
`HCP NEEDS
`
`SOLUTION
`
`Product that provides fast
`and more complete
`symptom rE~Iief the first
`time
`
`I Product that is easy to Rx
`
`Product that makes
`patients happy
`
`Dymista provides-rapid and nnore complete
`symptom relief-that HCPs & patients can rely on
`
`Dymista is the first and only prescription
`medication to combine the effective anti(cid:173)
`inflammatory relief of a corticosteroid coupled with
`the rapid multi-symptom relief of a nasal
`antihistamine
`
`So that: patients can have fast, superior symptom
`control in a single spray
`
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`
`
`Dyn1ista Growth in TRx with the 375 rep expansion
`
`375 reps
`+10% !)rowth
`2.8MM TRx
`
`··············································+
`
`375 reps
`+475% growth
`2.5MM TRx
`
`.-. 3,000
`tn
`"C
`
`s::::: = :2,500
`
`:::l
`0
`~ :2,000
`._.
`~
`1- 1,500
`
`6/2011 Launch
`200 reps
`448K TRx
`
`~
`
`1,000
`
`500
`
`0
`
`2012
`
`2013
`
`2014
`
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`
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`Launch success is based upon a strong foundcition
`
`en
`><
`0:::
`I-
`
`Medical/
`KOL
`
`Push Through
`
`Sales
`
`Pull Through
`
`Trade
`
`Distribution
`
`1\/lanaged Care
`
`Access
`
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`
`
`Managed <~are: Situation A.nalysis
`
`• Astepro 0.15o/o covered on 2nd tier on the majority of plans as a result of line
`extension strategy and high rebates (35-40°/o)
`
`•
`
`2nd tier status for Astepro 0.15o/o has had minimal impact on market share gains
`
`• Rhinitis nnarket has shifted to OTC (Orals) and generic Rx in recent years decreasing
`the size of the category
`- Historically, MHC payers relied upon Tiered copays to manage the category
`- Currently, MHC would prefer not to actively manage the category any more than
`they do now
`
`• Net cost of new branded entrants will be compared to the overall net cost of currently
`available products
`- Convenience is not a reason to demand higher price
`- Solid outcomes or pharmacoeconomic rationale is key
`
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`
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`Managed Care Driving Principle: Maximize Profitability
`
`Without rebates, Dymista coverage is at risk however rebates similar to P\stepro 0.15o/a will
`impact profitability
`
`Example:
`
`W.AC
`A\JVP
`
`Dymista
`$120
`$150
`
`Astepro 0.15o/a
`$104
`$130
`
`A\JVP-17o/o
`Co pay
`Cost to plan
`Rebates
`Net cost to plan
`
`$124
`$ 50
`$ 74
`
`$ 74
`
`$108
`$ 25
`$ 83
`$ 36
`$ 47
`
`*Rebating (35%) to achieve Tier 2 status for Astepro; Assumes Tier 3 coverage for Dymista
`
`Hybrid Strate~~y
`•
`Unrestricted Tier 3 access on plans where we do not currently offer heavy rebates
`•
`On plans ·where we do, we would offer a 22% rebate to achieve unrestricted Tier 3 access
`•
`On the 4-~5 top national plans, rebate to get 2nd tier coverage
`•
`Note: Strategy will be confirmed through ZS research
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`
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`Pricing options and recommendation (Pro/Con anc~lysis)
`
`$120 WAC - Increase Astepro 0.15% in January and again in June to minimize the disparity in pricing
`between Dymista and Astepro 0.15% (+1 ~i% premium to Astepro 0.15%)
`
`-
`
`Pro's: With little price disparity between the two brands, a line extension strategy could be
`employed that avoids a full P&T Review. Access expected to be similar to Astepro 0.15%.
`
`- Con's: Rebates would be 35%-40% at launch affecting gross to net similar to Astepro 0.15%
`now (41.6% overall G2N)
`
`$114 WAC - Increase Astepro 0.15% in January and again in June to minimize the disparity in pricing
`between Dymista and Astpero 0.15%. Increase Dymista by 5% in January 2013 prior to spring allergy.
`(+15%/1 0% premium to Astepro 0.15%)
`
`-
`
`Pro's: Line Extension strategy easier to employ with little difference in cost between Dymista
`and Astepro 0.15%
`
`- Con's: Lost revenue of 5% from launch in 2012 to start of 2013
`
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`Ne:xt steps for Mana!~ed Care
`
`• Strategy & Pricing Finalization (Nov 2011)
`• ZS to validate strategy and co-pay acceptability
`• Estimate on tier status for Dymista by plan
`
`• P&L impact of hybrid approach (Dec 2011)
`
`• Pharmacoeconomic Data Conclusions (Dec 2011)
`
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`Executive Summary: Tnade
`
`• Will leverage previous success in Trade with Astepro 0.1 o/o and Astepro 0.15o/o
`
`• Anticipate similar launch deal ten11s for Dymista as we did for Astepro 0.15%
`-
`7.5~:, off invoice, 7.5% distribution allowance, 60 days additional dating
`
`• Retail will want to see our promotional efforts behind the product (Sales Reps, DTC,
`etc.) and understand managed care formulary status
`
`• We will need to differentiate Dymista by partnering with pharmacies to ensure patient
`access to Dymista
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`Trade Olbjective I Strate~lY
`
`• Objective:
`- Attain stocking better than Astepro 0.15% (approx 30,000 retail outlets) while
`limiting excess inventory in vvarehouses at a discount
`
`- Develop Advocacy with key stakeholders in differentiating standard of care
`treatment
`
`• Strategy:
`-
`Leverage Meda best practice in launching both Astepro 0.1% and Astepro 0.15o/a.
`
`- Differentiate Dymista from other SAR products by partnering with the retail
`pharmacies to remove barriers and leverage opportunities
`
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`
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`Ne:xt steps for Trade
`
`• Meet ·with key pharmacy chains to understand partnership opportunities (Nov/Dec)
`
`• Develop tactical plan to reach pharmacists (Nov/Dec)
`
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`
`
`Salles: Situation Anctlysis
`
`• There are fewer competitive details in the SAR space
`• Anti1histamine details from l'v~erck and sanofi-aventis (main competitors are
`OTC and generics) have declined vs. PY
`
`• To date there has been limited new noise in the SAR space however 2 new branded
`entries are expected by 2013 (leva and Sunovian)
`
`• Meda sales force will be realigned to Dymista targets as of Jan 2012 however there
`is still a need to optimize sales force size
`
`•
`
`In 2012, there will be a gap between approval of Dymista and when product is
`available
`
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`
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`Sales Guiiding Principle: !Launch with Excellence
`
`•
`
`LAUNCH: \Nith 200 rep sales force
`- Realign from current 80/120 structure effective January 2012
`-
`Territories optimized geographically for Dymista; Targets optimized for Astepro 0.15%>
`until 1 month prior to launch
`Training: assign 2 training managers to Dymista (add headcount for an additional
`trainin~~ manager)
`
`-
`
`• EXECUTE: Plans with excellence
`- Measure performance against re~ach, frequency and sample targets
`- Structure IC plan to support execution (Astepro 0.15°/o until Dymista launch)
`
`• EXPAND: Effective January 2013
`- Recruitment & training beginnin~l in Fall 2012
`- Consider utilizing outside resources for recruitment and interviewing so as to minimize
`field management disruption during the Fall allergy season
`
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`
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`Expansion
`
`Assumptions
`•
`Incremental 175 representatives
`• Fully trained and integrated into sales force so that impactful selling
`occurs during 2013 Spring allergy season
`Timing
`• Complete sales force ali!~nment analysis by August 1l 2012
`1\/lanagement team selections completed by Sept. 1l 2012
`•
`• Begin representative interviewing Sept. 2012
`()n-board the week of Oct. 29l 2012
`•
`•
`2 month training progran1
`1\Jew alignment effective January 1l 2013
`•
`- December 2012- new alignment POA meetings
`
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`
`
`Expansion
`
`Resources
`• Outside services
`-
`Identifying, contacting, and managing the recruiting process
`- Building the interview process, identifying teams, and provide any additional
`training around the procBss
`- Contracting for interview site services and managing the logistics of
`scheduling, travel, hotels, meals, etc.
`- Being on the interview sites as interviewers and managing thle sites
`-
`()n-boarding support (i.e. offer letters, reference checks, background
`checks, etc.)
`- Training support
`
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`
`
`Risk of not starting n3cruitment in 2012
`
`• Sales not maximized for 2013 spring allergy season
`
`• P&~L at risk and suboptirnal growth trajectory
`
`• De!crease in share of voice in an environment with increased noise
`(Teva and Sunovian launches)
`
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`
`
`ExE3cutive Summary: Medical Marketing
`
`• Objectives
`-
`Leverage KOLs to establish Dymista as the standard of care
`- Provide avenues to discuss product development and remove any obstacles to
`early trial and repeat use of Dymista
`- Build credible, evidence-based platform to be communicated for Dymista,
`surrounding 2012 launch and into 2013
`
`• Strategy
`
`- Disseminate our clinical and economic data to build a body of knowledge for the
`use of Dymista and establish as a standard of care
`
`- Discuss through case based learning and real world experience the benefits of
`Dymista to drive trial and repeat use as well as maximize exposure
`
`- Displace churn by exchanging inferior product offerings with Dyrnista
`
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`
`
`Dymista Gioal: Deliver $33MrVI NR by the end of 2012
`
`201 ~! Forecast & P&L )~ssumptions
`• Supply available and trade stocked for launch in June 2012
`• 200 reps at launch
`• VVAC $120/Rx
`• 5 1o/o Nasal market growth (driven by fluticasone)
`• Liimited restrictions frorn Managed Care
`• 61.5°/o Gross to Net
`• EBITDA reflects launch investment
`-- Trade unit cost at 16o/o of NR
`-- Sample unit cost at $4 and $6
`
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`
`
`2012 P&L
`
`Sales force size
`*Note: 2012 assumes a June launch
`2012 includes the cost of DTC exploration and sales force recruitment for +175 reps
`PDEs calculated based upon a 3 product detail
`
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`
`
`Revised C:ontract Having A Large Impact on Sample <~osts
`And P&L
`
`475%
`
`503%
`
`247%
`
`150%
`
`$1.5MM
`
`$3.6MM
`
`($26.5MIV1)
`
`($36.0MM)
`
`Revised Contract
`• Trade Units increased from $3.25/unit to 16% of Net sales
`
`• Sample unit costs increased from $2 to $4 & $6
`
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`
`
`Critical Success Metrics
`
`J
`J
`J
`
`J
`
`Provided unrestricted access to >80% of patient lives
`
`Gain distribution at >30,000 pharmacies
`
`Shipments & Daily Net Sales per plan
`
`NRx & TRx per plan
`
`Coupon redemption at launch> Astepro
`
`50% awareness 6 months post launch among HV
`Targets; Aided awareness +80% post launch
`
`Sales force achievement against reach, frequency and
`sam pie tatrgets
`
`Deliver targeted reach and lift via speaker programs
`
`Achieve ROI ~ benchmark for nan personal promotion
`tactic
`
`J
`J
`J
`J
`J
`
`J
`
`J
`J
`J
`J
`J
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`30
`
`
`
`IMrVIEDIATE NEXT ~3TEPS
`
`• El- Brand Plan Alignrnent (Oct 28th, 2011)
`• ZE> Forecast Validation (Oct 31st, 2011)
`• Supply Dates Confirrned (Oct 31 5t, 2011)
`• Final Positioning (Oct 31st, 2011)
`• Final Managed Care ~Strategy & Pricing (Nov. 20111)
`• Final Creative Concept (Dec. 2011)
`• Final inputs for Dymista Target List (Dec. 2011)
`• Final date for launch rneeting (Nov. 2011)
`• Budget approved by ~)wed en (Dec. 2011)
`
`• Reinstitute Bi-Monthly Steering Committee Updates
`
`HIGHLY CONFIDENTIAL-
`SUBJECT TO STIPULATED PROTECTIVE ORDER
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`30
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`PIED A
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`MEDA_APTX01774625
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`PTX1118-00031
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`31
`
`
`
`In C)rder to be successful we need to ...
`
`Continue the strong inte~Jration across cross functional teams
`
`Stay focused against the strategies
`
`Comrnunicate a consistent single-minded message
`
`Maintain communication between the US and Global
`
`Differentiate ourselves internally and externally
`
`HIGHLY CONFIDENTIAL-
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`31
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`PIED A
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`MEDA_APTX01774626
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`PTX1118-00032
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`32
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`
`
`SUBJECTTO
`STIPULATED
`PROTECTIVE
`ORDER
`
`< m
`0
`:;o
`c m
`:;o
`
`cn:::r: c(cid:173)mG>
`c.... I mr
`o-<
`-I(')
`-10 oz
`en!!
`-IC
`-m
`""'z
`c-1
`r (cid:173)
`)>)>
`- l r m•
`c
`"'tJ
`:;o
`0
`-I m
`(')
`-I
`
`HIGHLY
`CONFIDENTIAL-
`
`Appendix
`
`32
`
`3
`PI
`tl
`D
`
`MEDA_APTX01774627
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`33
`
`PTX1118-00033
`
`PTX1118-00033
`
`33
`
`
`
`
`
`IN~) are fueling the ~~x market stability ...
`
`Without INS, the market ,would have declined 8.4°/o with J~llegra OTC
`Millions of TRx
`4.0
`
`3.5
`
`3.0
`
`2.5
`
`2.0
`
`1.5
`
`1.0
`
`0.5
`
`0.0
`
`10
`-ii-2011
`
`.Jan
`
`February
`
`March
`
`April
`
`May
`
`June
`
`HIGHLY CONFIDENTIAL-
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`33
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`PIED A
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`MEDA_APTX01774628
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`PTX1118-00034
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`34
`
`
`
`Slide 33
`
`BR34
`
`What am I looking at here? Y axis is what? Total Rx's in category?
`
`From the graphs I don't see what supports the statements.
`
`what I see is a decline of X percent from 2010 to 2011 of Rx of something.
`
`Bryan Roecklein, 10/23/2011
`
`HIGHLY CONFIDENTIAL-
`SUBJECT TO STIPULATED PROTECTIVE ORDER
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`MEDA_APTX01774629
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`PTX1118-00035
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`35
`
`
`
`Growth in the INS market is being driven by fluticasone IBR:3~
`
`"II ions of TRx
`
`.5
`
`.0
`
`.... / ···· Fluticasone/Fionase
`
`-§-NASON EX
`
`NASACORT AQ
`~RHINOCORT AQUA
`VERAMYST
`-e-OMNARIS
`TOTAL INS
`
`~~~~~~~~~~~~~~~~~~~~~~~~~
`~~~~~~~~~~~~~~~~~~~~~~~~~
`~~~~~~~~~~~~~~~~~~~~~~~~~
`
`HIGHLY CONFIDENTIAL-
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`34
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`PIED A
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`MEDA_APTX0177 4630
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`PTX1118-00036
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`36
`
`
`
`Slide 34
`
`BR35
`
`Since you have total in the previous slide (I believe), I'd eliminate here and you'll see the dynamic for fluticasone and Nasonex better.
`Bryan Roecklein, 10/23/2011
`
`HIGHLY CONFIDENTIAL-
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`MEDA_APTX01774631
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`PTX1118-00037
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`37
`
`
`
`P&L
`
`448K
`TRx
`$53.8MM
`Gross Sales
`$33.1MM
`Net Sales
`$ 9.0MM
`Sample Cost
`$30.0MM
`A&P
`($36.0MM)
`EBITDA
`154K
`PDEs
`200
`Sales force size
`*Note: 2012 assumes a June launch
`**2013 Does not include DTC
`PDEs calculated based upon a 3 product detail
`
`2,578K
`$324.7MM
`$199.6.0MM
`$41.2MM
`$40.0MM**
`$39.9MM
`495K
`375
`
`47E) 0/o
`
`50~~%
`
`50~~%
`
`358°/o
`
`33~/o
`NA
`221%
`
`87~/o
`
`HIGHLY CONFIDENTIAL-
`SUBJECT TO STIPULATED PROTECTIVE ORDER
`
`PIED A
`
`MEDA_APTX0177 4632
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`PTX1118-00038
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`38
`
`
`
`&P Breakdovvn
`
`R~emember to
`print out full
`sheet
`
`Samples
`
`Selling materials
`
`Sales Force Expansion
`
`Other promotion
`
`E-Business
`
`DTC Evaluation and Development
`
`Direct Mail
`
`Managed Care/Trade
`
`MLB/KOL/Field Funds
`
`Lunch & Learn
`
`DTP/Patient Ed
`
`Public Relations
`
`HIGHLY CONFIDENTIAL-
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`MEDA_APTX0177 4633
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`PTX1118-00039
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`39
`
`
`
`Dyn1ista Growth in TRx with a 200 rep sales force
`
`200 reps
`+371% growth
`2.1MM TRx
`
`200 reps
`+10% growth
`2.3MM TRx
`
`+
`
`6/2011 Launch
`200 reps
`448KTRx
`
`Dymista
`
`.-.2,500
`tn
`"C
`s::::: ns
`~ 2,000
`0
`.c:
`1-
`-; 1,500
`0:::
`1-
`
`1,000
`
`500
`
`0
`
`2012
`
`2013
`
`2014
`
`HIGHLY CONFIDENTIAL-
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`37
`
`PIED A
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`MEDA_APTX0177 4634
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`PTX1118-00040
`
`40
`
`
`
`Ne1W Competitive Product Entries
`
`Sunovian - ciclesonide ~iF A nasal inhaler- NDA filed 6/2011
`
`Teva- beclomethasone dipropionate hydrofluoroalkane (BDH)
`nasal HFA- NDA filed 8/2011
`
`HIGHLY CONFIDENTIAL-
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`38
`
`PIED A
`
`MEDA_APTX0177 4635
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`PTX1118-00041
`
`41
`
`
`
`SUBJECTTO
`STIPULATED
`PROTECTIVE
`ORDER
`
`HIGHLY
`CONFIDENTIAL-
`
`cn:::r:
`c,... m \II
`c.... I mr
`o-<
`-I(')
`-10 oz
`en!!
`-IC
`""'m cz
`r-1
`)>(cid:173)
`-I)>
`m':'""
`c
`"'tJ
`:;o
`0
`-I m
`(')
`-I
`< m
`0
`:;o
`c m
`:;o
`
`
`
`3
`PI
`tl
`D
`
`MEDA_APTX01774636
`
`42
`
`PTX1118-00042
`
`PTX1118-00042
`
`42
`
`
`
`
`Peak azelastine franchis~e sales - MAT 2/2008 - 3.28MM TRx
`
`HIGHLY CONFIDENTIAL-
`SUBJECT TO STIPULATED PROTECTIVE ORDER
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`40
`
`PIED A
`
`MEDA_APTX01774637
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`PTX1118-00043
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`43
`
`