delivering gene therapy to patients - jefferies - the ... · pdf fileactual results or events...
TRANSCRIPT
Delivering gene therapy to patients
2
FORWARD-LOOKING STATEMENTS
This presentation contains forward-looking statements that involve substantial risks and uncertainties. All statements, other than statements of historical facts, contained in this presentation, including statements regarding our strategy, future operations, future financial position, future revenues, projected costs, prospects, plans and objectives of management, are forward-looking statements. The words “anticipate,” “believe,” “estimate,” “expect,” “intend,” “may,” “plan,” “predict,” “project,” “target,” “potential,” “will,” “would,” “could,” “should,” “continue,” and similar expressions are intended to identify forward-looking statements, although not all forward-looking statements contain these identifying words.
We may not actually achieve the plans, intentions or expectations disclosed in our forward-looking statements, and you should not place undue reliance on our forward-looking statements. Actual results or events could differ materially from the plans, intentions and expectations disclosed in the forward-looking statements we make. The forward-looking statements contained in this presentation reflect uniQure’s current views with respect to future events, and uniQure assumes no obligation to update any forward-looking statements except as required by applicable law.
These forward-looking statements include, but are not limited to, statements regarding the risk of cessation or delay of any of the ongoing or planned clinical studies and/or development of our product candidates, the risk of delay or failure to successfully commercialize or obtain further regulatory approval of Glybera, and the risk that our collaborations with Chiesi or our other collaboration partners will not continue or will not be successful. Our actual results could differ materially from those anticipated in these forward-looking statements for many reasons, including, without limitation, risks associated with our clinical development activities, regulatory oversight, product commercialization, intellectual property claims, and the risks, uncertainties and other factors described under the heading “Risk Factors” in uniQure’s form 20-F and the prospectus dated February 5, 2014, both documents filed with the Securities and Exchange Commission. Given these risks, uncertainties and other factors, you should not place undue reliance on these forward-looking statements, and we assume no obligation to update these forward-looking statements, even if new information becomes available in the future, or to update the reasons why actual results could differ materially from those anticipated in the forward-looking statements, except as required by law.
3
Glybera - 1st Approved Gene Therapy in the EU Glybera for Lipoprotein Lipase Deficiency
4
Gene Therapy and uniQure:
Changing the Future of Medicine
Gene
therapy
– a real
opportunity
uniQure has
all the
building
blocks
A new
chapter in
the history
of medicine
1 time interventions
Long term effect
Ultimate patient benefit
Highly disruptive*
Cutting edge science
Manufacturing leadership
Modular portfolio development
Regulatory expertise
Commercialization experience
Strong management team
*) MIT Review / Fierce 15:
uniQure among 50 most
disruptive companies in 2013
Establish Gene Therapy Leadership
Build a Portfolio
Milestones
6
Glybera – Gene Therapy for an Orphan Disease Single intervention to restore lipoprotein lipase enzyme
Lack of lipoprotein lipase
Prevents metabolism of post-prandial
TG/chylomicron complexes
Leads to Accumulation of
post-prandial chylomicrons in plasma
Provokes recurrent pancreatitis
7
Glybera Trial Results over 8 Years in 27 Patients
Glybera, uniQure Platform
Considered Safe
by EMA
Restoration of LPL Activity
Leads to
Improved Lipid Clearance
1 Yr Post a Single
Intervention
ZERO ICU Stays
in 6 Years
Post a Single Intervention
in the Label Population
ZERO Severe Pancreatitis
in 6 Years
Post a Single Intervention
in the Label Population
8
EU Post-approval Commitments
Foundation for US Filing
EU approval under
exceptional circumstances
2012 2013 2014 2015 2016 2017
Post-approval commitments
Clinical trials
leading to
EU Glybera
approval
Registry (incl. natural history)
Post-approval study
US filing based on
EU-post approval
commitments
9
uniQure Retains Rights in Attractive Key Markets
Retained key markets include
North America and Japan
Commercialization
in North America
by uniQure
Distribution agreements in
other geographies
> Israel agreement signed
> 5 more planned for 2014
Chiesi have European
commercialization rights
> EUR 31 m down payment
> 20 – 30% royalty from Chiesi
uniQure Territories
Chiesi Territories
10
Glybera EU Launch Preparations Led by Chiesi Chiesi confident for a launch in mid-2014
Finalizing 1st wave countries Germany, UK, NL, Sweden, Austria, Italy > Product released for patient treatment
> Centers of Excellence prepared
Site preparations including Registry set-up finalized
Health care staff training on track
Patients identified, consent procedures ongoing
> European pricing strategy and implementation plan finalized
List prices in several countries soon to be known
> Germany: NUB (in-patient) and AMNOG (out-patient) processes started – Charité, Berlin
> UK list price submission soon - Manchester
> Sweden – List price negotiation hospital/County – Karolinska, Gothenborg
> Other countries to follow soon
11
Gene Therapy Platform Building Blocks
Administration
GENE/VECTOR
COPIES INTO
THE CELLS
Manu-
facturing
GENE /
VECTOR
COPIES
Vector
DELIVERY
VEHICLE
Gene
“Blueprint”
THERAPEUTIC
“Protein Factory”
in the body
PROTEIN
FACTORY
12
natural AAV DIRECTED EVOLUTION optimized AAV
uniQure’s Vector Platform Strategy
TROPISM
AAV1 Exclusive
for LPLD in Muscle
AAV2
AAV5 Exclusivity for
LIVER / CNS
AAV6
AAV8
AAV9
Synthetic
AAV Mutants Synthetic
AAV Mutants Synthetic
AAV Mutants Synthetic
AAV Mutants Synthetic
AAV Mutants Synthetic
AAV Mutants Synthetic
AAV Mutants Synthetic
AAV Mutants Synthetic
AAV Mutants Synthetic
AAV Mutants Synthetic AAV
Super Mutants
4D Therapeutics
13
uniQure
Baculo-based
Plasmid-based
adherent cultures
Plasmid-based
Suspension cultures Herpes-based Adenovirus-based
Suspension
Cell Culture ++ - ++ + ++
Efficiency
DNA Transfection ++ + - ++ ++
Scalability ++ -- - + ++
Safety ++ - - concerns concerns
Low COGs ++ - - + +
EU Regulatory Approved ++ - - - -
FTO / IP Protection ++ - - complex complex
uniQure’s Leading Insect Cell Manufacturing Platform
Mammalian Cells Insect Cells
14
World-leading Manufacturing Capabilities in EU and US Building the world’s largest dedicated AAV manufacturing unit in the US
Amsterdam, NL > 2 x 50 L
> EMA approved facility
Lexington, MA, USA
> 2 x 500 L
(expansion to 2 x 2000 L possible)
> Copy/scale of existing technology
> Estimated time of completion for
test batches end of 2014
> Site opened for employees
on May 1, 2014
Establish Gene Therapy Leadership
Build a Portfolio
Milestones
16
Pipeline 2014
GLYBERA EU
GLYBERA US
HEMOPHILIA B
ACUTE INTERMITTENT PORPHYRIA
SANFILIPPO B
PARKINSON’S DISEASE
HEMOPHILIA A, Huntington’s miRNA, etc ….
PRECLINICAL I II III MARKET
uniQure sponsored investigator led
17
Hemophilia B Spontaneous bleeds, joint damage, compliance
18
AAV8/FIX Single Intervention Using uniQure Gene
Cassette Reduces Need for Prophylactic Treatment(1)
1) Third party trial conducted by St. Jude’s Children Research Hospital and UC London
Patient 1 2 3 4 5 6 7 Patient 8 Severe
Moderate
Mild
Disease
Severity Low-dose Mid-dose High-dose
Oral Presentation Presented in New England Journal of Medicine 12/2011
12
11
10
9
8
7
6
5
4
3
2
1
% Expression
of normal
St Jude/UCL trial started 4 yrs. ago demonstrated sustained, dose dependent effect:
after single treatment 6/8 patients off prophylaxis, 2/8 significantly lower frequency
19
AAV5/FIX Phase I/II Dose Escalation Study in 2014
Population
> ≦ 1% of normal plasma
factor IX levels
> On prophylactic therapy
Objectives
> Assess safety/tolerability
> Define optimal therapeutic dose
Key efficacy assessments
> Factor IX plasma levels
> Need for FIX replacement
therapy
> Incidence of spontaneous
bleeding
> Health related quality of life
High (2.0 × 1013)
Do
se
(gc/k
g)
Mid (2.0 × 1012)
Low (2.0 × 1011)
ST Jude
ST Jude
ST Jude
uniQure
uniQure
AAV5 insect cell
production
AAV8 mammalian
cell-based
20
AAV5/FIX - Efficacy in Primates
Human AAV5/FIX expression
levels in macaques similar to
those achieved in humans from
current AAV8 clinical study
(UCL/St Jude’s)
Linear dose response levels
of human AAV5/FIX
in dose escalating GLP tox study
Preclinical data suggests
AAV5 works as well as AAV8
Porphyria
Porphyria
Key
AMT-060 in Rhesus Monkeys
Porphyria
AMT-060 in Cynomolgus Monkeys
0 5 0 1 0 0 1 5 0
0 .1
1
1 0
1 0 0
A M T -0 6 0 in C y n o m o lg u s m o n k e y s
D a y s a fte r v e c to r in fu s io n
hF
IX p
ro
tein
(% o
f n
orm
al
hu
ma
n l
ev
els
)
5 e 1 1 g c /k g
2 .5 e 1 3 g c /k g
9 .3 e 1 3 g c /k g
5 e 1 2 g c /k g
0 5 0 1 0 0 1 5 0
0 .1
1
1 0
1 0 0
A M T -0 6 0 in C y n o m o lg u s m o n k e y s
D a y s a fte r v e c to r in fu s io n
hF
IX p
ro
tein
(% o
f n
orm
al
hu
ma
n l
ev
els
)
5 e 1 1 g c /k g
2 .5 e 1 3 g c /k g
9 .3 e 1 3 g c /k g
5 e 1 2 g c /k g
0 5 0 1 0 0 1 5 0
0 .1
1
1 0
1 0 0
A M T -0 6 0 in C y n o m o lg u s m o n k e y s
D a y s a fte r v e c to r in fu s io n
hF
IX p
ro
tein
(% o
f n
orm
al
hu
ma
n l
ev
els
)
5 e 1 1 g c /k g
2 .5 e 1 3 g c /k g
9 .3 e 1 3 g c /k g
5 e 1 2 g c /k g
0 5 0 1 0 0 1 5 0
0 .1
1
1 0
1 0 0
A M T -0 6 0 in C y n o m o lg u s m o n k e y s
D a y s a fte r v e c to r in fu s io n
hF
IX p
ro
tein
(% o
f n
orm
al
hu
ma
n l
ev
els
)5 e 1 1 g c /k g
2 .5 e 1 3 g c /k g
9 .3 e 1 3 g c /k g
5 e 1 2 g c /k g
0 5 0 1 0 0 1 5 0
0 .1
1
1 0
1 0 0
A M T -0 6 0 in C y n o m o lg u s m o n k e y s
D a y s a fte r v e c to r in fu s io n
hF
IX p
ro
tein
(% o
f n
orm
al
hu
ma
n l
ev
els
)
5 e 1 1 g c /k g
2 .5 e 1 3 g c /k g
9 .3 e 1 3 g c /k g
5 e 1 2 g c /k g
21
Competitors:
Spark, Baxter, Dimension,
Biomarin
AAV5/FIX – uniQure’s Competitive Position Timeline puts AA5-FIX as first to market –
no other gene therapy competitor has full FTO or validated manufacturing
Gene cassette
exclusive from
St. Jude
AAV5 vector
exclusive from NIH
Proprietary, validated,
scalable, manufacturing
22
Patients Well Controlled – A Myth! Enzyme Replacement Therapy Standard of Care Cost per Patient
per Lifetime
> US$ 10 m
Hospitalization Days
per Patient per Lifetime
> 1.500 2 Interventions
per Patient per Week
> 6,000 Treatments
over 6 Decades
23
Strong Savings Potential at Profitable GT Pricing Lifetime cost for a severe hemophiliac – prophylaxis: > US$ 10 m
Pricing will depend upon duration of gene
therapy effect
> Proven expression in animals > 10 years
> Proven expression in humans > 4 years
Performance based annuity payments possible
> Ease of measurement of FIX in plasma
US$ 9 m
US$ 1.5 m
Drug
Related
Cost
Non-Drug
Related
Prophylaxis
US$ 10 m
US$ ? m
US$ ? m
Gene
Therapy
Refs. Carlsson KS et al. On-demand vs. Prophylactic treatment forsevere haemophilia in Norway and Sweden:
differences in treatment characteristics and outcome. Haemophilia 2003; 9:555-566
Henrad s et al. The health and economic burden of haemophlia in Belgium: a rare, expensive and challenging disease.
Orphanet Journal of Rare diseases 2014: 9:39
Refs. Carlsson KS et al. On-demand vs. Prophylactic treatment forsevere haemophilia in Norway and Sweden:
differences in treatment characteristics and outcome. Haemophilia 2003; 9:555-566
Henrad s et al. The health and economic burden of haemophlia in Belgium: a rare, expensive and challenging disease.
Orphanet Journal of Rare diseases 2014: 9:39
Refs. Carlsson KS et al. On-demand vs. Prophylactic treatment forsevere haemophilia in Norway and Sweden:
differences in treatment characteristics and outcome. Haemophilia 2003; 9:555-566
Henrad s et al. The health and economic burden of haemophlia in Belgium: a rare, expensive and challenging disease.
Orphanet Journal of Rare diseases 2014: 9:39
Refs. Carlsson KS et al. On-demand vs. Prophylactic treatment forsevere haemophilia in Norway and Sweden:
differences in treatment characteristics and outcome. Haemophilia 2003; 9:555-566
Henrad s et al. The health and economic burden of haemophlia in Belgium: a rare, expensive and challenging disease.
Orphanet Journal of Rare diseases 2014: 9:39
Carlsson, et al., Henrad et al., company estimates
24
Market Volume (in US$ bn)
Hemophilia A
Hemophilia B
Hemophilia Enzyme Replacement Market Big market volume to protect for current ERT competitors
Market:
US$ 8 bn
Growth
6% p.a. Sources: Morningstar Estimates
25
Pipeline 2014
GLYBERA EU
GLYBERA US
HEMOPHILIA B
ACUTE INTERMITTENT PORPHYRIA
SANFILIPPO B
PARKINSON’S DISEASE
6 HEMOPHILIA A, Huntington’s miRNA, etc ….
PRECLINICAL I II III MARKET
uniQure sponsored investigator led
✔
✔
✔
✔
8/8 pts., safety established,
DNA/RNA expressed, data
H2/14
4/4 pts. dosed, data H2/15
3/24 pts. dosed, data 2015
Establish Gene Therapy Leadership
Build a Portfolio
Milestones
27
Cash position of EUR 77.5 m / QU1 2014 to reach
multiple clinical milestones
2014 2015 2016
H1 H2 H1 H2 H1 H2
Glybera – EU launch
Porphyria results
Hemophilia B results
Sanfilippo B results
Glybera Data to Support
U.S. Filing
28
Gene therapy and uniQure:
Changing the future of medicine
Gene
therapy
– a real
opportunity
uniQure has
all the
building
blocks
A new
chapter in
the history
of medicine
1 time interventions
Long term benefit
Highest possible patient benefit
Highly disruptive*
Cutting edge science
Manufacturing leadership
Modular portfolio development
Regulatory expertise
Commercialization experience
Strong management team
*) MIT Review / Fierce 15:
uniQure among 50 most
disruptive companies in 2013
The Leader in Gene Therapy