1

North American Neuromodulation Society Investor Update

January 12, 2018

Maulik Nanavaty

Senior Vice President and President, Neuromodulation

Jim Cassidy

Vice President and Franchise Lead, Pain Management

Milad Girgis

Vice President and Franchise Lead, Deep Brain Stimulation

2 2

Safe Harbor for Forward-Looking Statements and Regulatory Disclaimers

This presentation contains forward-looking statements within the meaning of Section 27A of the

Securities Act of 1933 and Section 21E of the Securities Exchange Act of 1934. Forward-looking

statements may be identified by words like “anticipate,” “expect,” “project,” “believe,” “plan,”

“estimate,” “intend” and similar words. These forward-looking statements are based on our beliefs,

assumptions and estimates using information available to us at the time and are not intended to be

guarantees of future events or performance. If our underlying assumptions turn out to be incorrect, or

if certain risks or uncertainties materialize, actual results could differ materially from the expectations

and projections expressed or implied by our forward-looking statements.

Factors that may cause such differences can be found in our most recent Form 10-K and Forms 10-Q

filed or to be filed with the Securities and Exchange Commission under the headings “Risk Factors”

and “Safe Harbor for Forward-Looking Statements.” Accordingly, you are cautioned not to place

undue reliance on any of our forward-looking statements. We disclaim any intention or obligation to

publicly update or revise any forward-looking statements to reflect any change in our expectations

or in events, conditions, or circumstances on which they may be based, or that may affect the

likelihood that actual results will differ from those contained in the forward-looking statements.

Market Estimates:

Unless noted otherwise, all references to market sizes, market share positions, and market growth

rates are BSX internal estimates.

Regulatory Disclaimers:

Vercise™ PC Deep Brain Stimulation System/Vercise™ Directional System - CE Marked. US:

“Caution: Investigational Device. Limited by Federal (or US) law to investigational use only. Not

available for sale.”

Vercise Gevia™ Deep Brain Stimulation System - CE Marked. Not available for use or sale in the U.S.

Next Gen DBS System: Device under development. Not for sale or use worldwide.

3 3

Positioned for Leadership in Two Fast-Growth Markets

Overview BSX Growth Drivers

• Spectra Wavewriter ™ SCS System

First & only system FDA approved to simultaneously

provide paresthesia and sub-perception therapy

• Comprehensive SCS Platform with Illumina 3D™

Personalized therapy with neural targeting algorithm

across broad IPG* and lead portfolio

• Cosman RF Ablation

Early stage treatment options for pain patients

• Vercise™ Deep Brain Stimulation Platform

First & only MICC*-based directional system

• International expansion

Under-penetrated market opportunity in both pain and

brain

Market

Size (2017E)

~$2.5B

Market

Growth (2017E)

+14%

2017-2020 est. Market

CAGR

+10%-15%

Preliminary

BSX 20171

Revenue Growth

+14%

*IPG: Implantable Pulse Generator; MICC: Multiple Independent Current Control

4

15+ ongoing clinical research studies & RCTs3 to help prove personalized therapy is the future of pain relief:

Pain: Expanding a Winning Pain Portfolio and Leading with Rigorous Clinical Research

Illumina 3D™ Spectra™ SCS

Systems Infinion CX™ Multiwave™ Cosman

Precision with Neural

Targeting Algorithm

Options for Patients (32 contacts, MRI

compatibility2, Non-Rechargeable)

Personalized Therapy

Through Multiple

Waveform Options

Broadest Coverage of

the Spine for Multi

Therapy Targeting

RF Ablation:

Denervation

Strong cadence of technology with 2 new platforms expected to launch over next 24 months

• PROCO4 (Q2:17): Double-blind crossover RCT to evaluate the role of frequency on SCS patient outcomes

• WHISPER5 (Q1:18): Crossover RCT to evaluate the safety and effectiveness at sub-perception amplitudes

• ACCELERATE6 (H2:18): Crossover RCT to evaluate the safety and effectiveness at high-rate SCS

• VERITAS7 (2019): Prospective, multicenter study to evaluate the effectiveness of multiple modalities with

Spectra WaveWriter

5

Challenges and Opportunities in SCS

Multiple recent studies (PROCO4,

SUNBURST9) show patients respond

variably to different therapies –

• Non-responders to one modality

may be responders to another

modality

Expect multiple mechanisms of

action involved11

Variation in Response

Opportunity to improve therapy

longevity • 3 - 6% annual explant rate due to

inadequate pain relief8

Recently launched modalities

haven’t resolved loss of therapy

issue • 10 kHz: 5% annual explant rate due

to inadequate pain relief8

• Burst: 5% of patients with diminished or loss of symptom relief after 24

weeks9

• DRG*: 9% of patients experience loss of stimulation after one year10

Longevity of Therapy

*DRG: Dorsal Root Ganglion

6

Spectra WaveWriter™ SCS System: Multiple Therapies. One Device.

Maximize Responders: • First system approved to simultaneously

provide paresthesia and sub-perception therapies

Simplify Personalization: • Real-time patient rating and data on

waveform usage

Spectra WaveWriter System Q1:18 US Launch

The Power of Combination Therapy with

the Simplicity of Waveform Automation

Early Clinical Data – NANS 2018 Multi-site observational outcomes collection12

∆ 6.0 reduction in NRS ~30 Day Follow Up

Significant Pain Reduction

in Early Follow-Up

0

2

4

6

8

10

Baseline

(N=79)

End of Trial

(N=69)

Last F/u Visit

(n=79)N

RS S

co

re (

0-1

0)

Change in Overall Pain Scores

(NRS*) at Last Follow-up

D = 6.0 (p < 0.0001)

*Numeric Rating Scale

7.7

2.0 1.7

7

Spectra WaveWriter™ SCS System: Multiple Therapies. One Device.

Combination Therapy New Sub-perception Algorithms

+ Waveform Automation

Paresthesia Responders

Sub-perception Responders

Multiple Therapies

~15% responder

increase13

Designed for deeper, lasting relief by layering waveforms simultaneously or sequentially

Competition 8-contact leads +

Conventional Bi-Pole

Limited Coverage

WaveWriter Infinon CX (16 contacts)

+ Contour

Multiple Vertebral Level

Coverage

vs

T8

T9

T1

0

T7

Infinion

Infinion

T8

T9

T1

0

T7

Infinion

Infinion

T8

T9

T1

0

T7

Infinion

Infinion

T8

T9

T1

0

T7

Infinion

Infinion

T8

T9

T1

0

T7

Infinion

Infinion

T8

T9

T1

0

T7

Infinion

Infinion

Designed to easily find and keep the optimal target with a personalized stimulation field

+

8

WHISPER & PROCO: Foundational Studies for Spectra WaveWriter™

PROCO RCT4

(de novo patients)

WHISPER RCT5

(previously implanted patients,

average ~4 years on therapy)

Key Takeaways • Similar pain relief across 1, 4, 7 & 10 kHz

• 1/3 charge burden with 1kHz

• Neural dosing algorithms are critical

Key Takeaways • <1.2 kHz delivered significant, long term,

sub-perception pain relief in a real world

population

• Multiple therapies provide superior

outcomes when patients are able to

choose most effective therapy

Spectra WaveWriter™

Next gen sub-perception technologies • Contour™Algorithm

• Therapy Rater and Waveform Automation

Impactful clinical outcomes • Exciting new data at NANS: WaveWriter

Observational Outcomes

• VERITAS Study (2019E)

9 9

WHISPER RCT5: Multiple Therapies Provide Superior Outcomes

Challenging Patient

Population

• WHISPER results showed clinical value

of SCS in challenging, long-term, implanted patients

Positive Outcomes in

Paresthesia Responders Superior Outcomes with

Waveform Options

• Subgroup : ≥50% improvement with supra-perception during crossover phase

• Outcomes consistent with de novo PROCO RCT patients

• Met primary endpoint • Superiority demonstrated

• 62% increase in responder rate

when patients are able to

choose between multiple

waveform options

Study

AspectsWHISPER SENZA

Patients

Previously

implanted

Precision

patients

De-novo

patients

Mean

duration of

implant

4 +/- 1.9 yrs. 0 yrs.

Duration of

chronic pain18.3 yrs. 13 yrs.

Disability per

Oswestry

Disability

Index

69.4

(Crippling)

54

(Severe)

CRPS

Yes

(19%)

No

(0%)

0

1

2

3

4

5

6

7

8

Baseline Best Option

(sub or supra)

NR

S S

co

re (

0-1

0)

7.2

2.5

n=20

0%

5%

10%

15%

20%

25%

30%

35%

40%

45%

50%

Supra-perception

only

Sub-perception

only

Best option

(supra or sub)

Re

spo

nd

er

Ra

te 29%

39%

47% n=70

62% increase

10 10

Our History in Neuromodulation: A Different Path to Deep Brain Stimulation

Advanced Bionics

technology, acquired by

Boston Scientific in 2004

A heritage in cochlear vs pacemaker

•Utilization of multi-channel stimulation

•Precise control

Applying cochlear technology to

neurological disorders

•Focus on stimulation modality

• Multiple Independent Current Control

•Focus on patient centric technology

• Wireless

• Rechargeable

• Ease-of-use

• Size

• Precision

DBS Vercise

RC System (EU)

1st DBS system with 16

independent sources of

current

SCS Spectra Platform (WW)

1st 32 Channel

Rechargeable Platform 2012

2004

SCS Precision Plus (WW)

1st and only MICC ,

1st Rechargeable Platform

11 11

Path to Leadership in Brain Modulation: Differentiated Technology, Strong Clinical Evidence

MRI and

personalized

visualization

Next Generation System

Vercise™ PC – First Directional System with

integrated Clinical Effects Map

Vercise™ Gevia™ – First MRI conditional

Rechargeable Directional System

Therapy Expansion

Vercise™ - U.S. launch with

first and only MICC powered,

rechargeable system, 8 level

leads, and 5 years of proven

therapy in Europe

2018 2019 2020+

Anticipate 18+3 ongoing clinical research studies will drive Brain Modulation to be a meaningful contributor:

• INTREPID14 (Q4:17) : First & only prospective, double-blind, sham-controlled, multi-center RCT;

evaluating Vercise™ DBS system for U.S. entry

• DBS Directional15 (2019): Evaluating therapeutic advantages of Cartesia™ Directional Lead with

Vercise™ PC DBS System

• DBS Registry16 (on-going): Comprehensive registry of real world outcomes to establish improvement

in quality of life

• Investments in indication expansion studies: Stroke rehabilitation, Alzheimer’s disease, depression,

others

U.S. expected

launch timeline

12

Revolutionizing Brain Modulation Therapy

BSX best-in-class system solution to meet market needs:

• High-growth, underpenetrated market

• ~$600M worldwide opportunity shifting away from a single player market

• BSX entering U.S. with compelling new technology

• System capabilities with potential to treat other neurological disorders

Vercise™ DBS Systems

Precision Control of

Directionality with MICC

Brainlab

Advanced Surgical

Planning

Visualization

Personalizes Programming

for Patients

Smart Programming

Captures Outcomes

13

Boston Scientific NANS 2018

WHISPER: A Multicenter, Prospective Randomized Controlled Trial

Evaluating Sub-perception SCS at ≤ 1.2 kHz

Friday, January 12

7:35AM - 7:45AM

Forum Ballroom 14, 15, and 16

James North, MD

Effects of Rate on Analgesia in Kilohertz Spinal Cord Stimulation:

Final Results of the PROCO RCT

Saturday, January 13

3:45PM - 3:55PM

Octavius Ballroom 7, 8, and 9

Simon Thomson, MBBS FRCA FIPP FFPMRCA

No Effects of High-Rate (Multi-kHz) Electric Fields on Brain Slice on Excitability Friday, January 12 7:15AM - 7:25AM Octavius Ballroom 5 and 6 Marom Bikson, PhD

Artifactual Hyperpolarization During Extracellular Electrical Stimulation: Proposed Mechanism of High-Rate Neuromodulation Disproved Friday, January 12

7:25AM - 7:35AM Octavius Ballroom 5 and 6 Steven A. Prescott, MD PhD

Dependence of c-Fos Expression on Amplitude of High-Frequency Spinal Cord Stimulation in an Animal Model Friday, January 12 4:45PM - 4:55PM Octavius Ballroom 7, 8, and 9

Robert Foreman, PhD A Computational Study of Dorsal Column Versus Dorsal Horn Modulation Using Higher Rate (≥250 Hz) Spinal Cord Stimulation Saturday, January 13

7:25AM - 7:35AM Forum Ballroom 14, 15, and 16 Tianhe Zhang, PhD

RCTs Basic Science and Mechanism Of Action

DBS

DBS Registry: Outcomes and Safety E-Poster Deuschl, Vesper

DBS Registry: Outcomes and Safety using the Directional Lead E-Poster Deuschl, Vesper

14

Neuromodulation: Strong Growth Driven by Leading Innovation

• Exciting, large, underpenetrated and high-growth markets: SCS and DBS

• Strong start to 2018 with significant new FDA product approvals

– Spectra WaveWriter™ SCS System

– WHISPER RCT sub-perception labeling

– Vercise™ DBS System

• Pain: Defining the future of SCS through personalized therapy

– Broadest portfolio: neural targeting algorithms &waveforms, MRI, primary cell, 32 contacts, RF

– Commitment to rigorous clinical and pre-clinical research: LUMINA17, PROCO4 , WHISPER5, ACCELERATE6

– Significant international expansion momentum and opportunity

• Brain: Poised for share gains with the most innovative platforms and U.S. market entry

– INTREPID14, VANTAGE18, CUSTOM19 data

– Differentiated directional system supported by extensive clinical data

– Integrated offering: Directional System, visualization, MRI, Brainlab partnership

• Convergence of technology and clinical insights unlocking new treatments for neurological disorders (stroke rehabilitation, Alzheimer’s disease, depression and others)

15 15

References

1) Neuromodulation reported revenue growth based on preliminary, unaudited sales results issued January 9,

2018. Results are preliminary and subject to completion of year end financial reporting processes, reviews and

audit.

2) 1.5 Tesla MRI conditional when all conditions of use are met

3) Includes company and investigator-sponsored research studies

4) Effects of Rate on Analgesia in Kilohertz Frequency Spinal Cord Stimulation: Results of the PROCO Randomized

Controlled Trial. Simon J. Thomson, MBBS, et al. Neuromodulation, November 2017

5) North, J., et. al. WHISPER: A Multicenter, Prospective Randomized Controlled Trial Evaluating Sub-perception

SCS at ≤ 1.2 kHz. NANS 2018, Las Vegas

6) Safety and Effectiveness Study of the Precision SCS System Adapted for High-Rate Spinal Cord Stimulation

(ACCELERATE) NCT02093793

7) Value of Multiple Modalities Using the Spectra WaveWriter Spinal Cord Stimulator System (VERITAS)

NCT03251937

8) Therapy-Related Explants After Spinal Cord Stimulation: Results of an International Retrospective Chart Review

Study. Dr. Jean-Pierre Van Buyten, MD; et al Neuromodulation, October 2017

9) Proclaim™ Implantable Pulse Generator CLINICIANS MANUAL, 2016-04 ARTEN100125494B

10) PREDICT: A prospective post-market trial to evaluate DRG stimulation for the management of chronic

intractable pain. S. Eldabe,, MD; et al. INS 2017

11) Rauck, R. PET Study. NANS 2015, Las Vegas

12)Metzger, C., et. al. Outcomes Using an SCS Device Capable of Delivering Combination Therapy (Simultaneous

or Sequential) and advanced waveforms/field shapes. NANS 2018, Las Vegas

13)Thomson et al., PROCO RCT, INS 2017

16 16

References

14) Deep Brain Stimulation (DBS) for the Treatment of Parkinson's Disease (INTREPID) NCT01839396

15) Directional Data:

• Steigerwald et al. “Directional deep brain stimulation of the subthalamic nucleus: a pilot study using a

novel neurostimulation device.” Movement Disorders. 2016;

• Reker et al, “Directional deep brain stimulation: A case of avoiding dysarthria with bipolar directional

current steering: Parkinsonism and Related Disorders 2016 Aug

• “Scientists Test Next Generation Deep Brain Stimulation Leads to Improve Targeting the Subthalamic

Nucleus with Fewer Adverse Effects” NEUROLOGY TODAY | Jul 2016

16) Registry of Deep Brain Stimulation With the VERCISE™ System: Vercise DBS Registry NCT02071134

17) Veizi et al, “SCS with Anatomically Guided (3D) Neural Targeting Shows Superior Chronic Axial Low Back Pain

Relief Compared to Traditional SCS.” Pain Medicine Jan 2017.

18) Vantage:

• 1 Year: Timmermann et al., Multiple-source current steering in subthalamic nucleus deep brain

stimulation for Parkinson’s disease (the VANTAGE study): a non-randomised, prospective, multicentre,

open-label study Lancet Neurology 2015; 14: 693–701

• 3 Years: Timmerman et al, “Three-Year Outcomes of a Prospective, Multi-center Trial Evaluating Deep

Brain Stimulation With a New Multiple-Source, Constant-Current Rechargeable System in Parkinson

Disease.” Neurosurgery. Aug 2016.

19) CUSTOM-DBS: Volkmann et al., Presented at 2014 Annual Meeting of the International Parkinson and

Movement Disorders Society, June 2014