VERMILLION Multi-Modal BioInformatics Solution for Ovarian Cancer NASDAQ: VRML l August 2019 - Aspira Labs

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VERMILLION Multi-Modal BioInformatics Solution for Ovarian Cancer NASDAQ: VRML l August 2019 - Aspira Labs
VERMILLION
Multi-Modal BioInformatics
Solution for Ovarian Cancer
NASDAQ: VRML l August 2019

                              ©2019 Vermillion Inc. All Rights Reserved
VERMILLION Multi-Modal BioInformatics Solution for Ovarian Cancer NASDAQ: VRML l August 2019 - Aspira Labs
FORWARD-LOOKING STATEMENTS

This presentation contains forward-looking statements, as defined in the Private Securities Litigation Reform Act of 1995. Words such as “may,”
“expects,” “intends,” “anticipates,” “believes,” “estimates,” “plans,” “seeks,” “could,” “should,” “continue,” “will,” “potential,” “projects” and similar
expressions are intendedto identify such forward-looking statements.

Readers are cautioned that these forward-looking statements speak only as of the date of this presentation, and the Company does not assume any
obligation to update, amend or clarify them to reflect events, new information or circumstances after such date except as required by law. Company
estimates set forth in this presentation are based on various sources of information and various assumptions and judgments made by the Company,
which Company management believes are reasonable. However, the Company cannot assure you that Company estimates are correct, and actual data
may materially differ from Companyestimates.

The forward-looking statements reflect the views of the Company as of the date of this presentation and are subject to certain risks, uncertainties and
assumptions, including those described in the section entitled “Risk Factors” in the Company’s Annual Report on Form 10-K for the year ended
December 31, 2017 and quarterly report on Form 10-Q for the quarter ended September 30,2018.

This presentation is © copyright 2019 by Vermillion, Inc. All RightsReserved.

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VERMILLION Multi-Modal BioInformatics Solution for Ovarian Cancer NASDAQ: VRML l August 2019 - Aspira Labs
Investment Highlights

                Commercial stage company with FDA-cleared multi-modal disease management
                approach to women’s health, with core focus on ovarian cancer
                FDA-cleared 2nd generation technology that is incorporated into clinical treatment
                guidelines

                Strong commercialization strategy addressing sizable potential markets

                Pipeline of compelling diagnostic bioinformatic product candidates

                Strong intellectual property protecting methods and use

                Broad managed care coverage: 2018 Clinical Laboratory Fee Schedule (“CLFS”)
                reimbursement rate of $897

                Seasoned management team

                                                                                                     3
                                                     3
VERMILLION Multi-Modal BioInformatics Solution for Ovarian Cancer NASDAQ: VRML l August 2019 - Aspira Labs
Vermillion’s Evolution

                                          Save Lives &
                                     Replace Standard of Care

                                                Expand
                              Q4 2018 Commercial Infrastructure

                       PQ4 2018             2nd Generation
                                                                              OVA1 Plus foundation in place
                                           OVA1 Plus Launch                            to become
                      P2018-2019                                                 NEW Standard of Care
                                                Payers

                P2016-2018                    Guidelines                             Payer Coverage:
                                                                                     5 out of 10 lives
              P2016          Bioinformatic Tools + Current Standard of Care
                                                                                      covered in U.S.

        P2010-2018                Strong IP and FDA-Cleared Science

                                                                                                         4
VERMILLION Multi-Modal BioInformatics Solution for Ovarian Cancer NASDAQ: VRML l August 2019 - Aspira Labs
The Size of the Pelvic Pain and Mass Market
                                                                          Technology
     TAM         Cost $                                                     Solutions       VRML
                                            Pelvic Masses +                  Today         Portfolio
         18.3M    $22B                (Endo + PCOS+ Func. Cysts)
                                                                             None         POC Complete
                                                                                          (DXA II) (2021)
         500K-                               Pelvic Masses
                                                                            2-4 X/yr       Watch + Wait
          1M                      (Benign masses, cancer, non-gyn mass)
                   $0.8B                                                     None         (DXA1) (2H 19)

         300-
                                       High Risk BRCA Monitoring             2X/yr            Portfolio
         500K                                                                CA125            Expansion

         200K                               Pelvic Masses to                 Ova1+           Ova1+
                                                Surgery                   (OVA1, Overa)   (OVA1, Overa)

         22K       $5.2B                                                     CA125
                                             Ovarian Cancer                                   Portfolio
                                                                          Recurrence
                                                                          Monitoring          Expansion
                                                  Ovarian

         15K                                      Cancer
                                                  Deaths

Total:   20M      $28B

                                                                                                5
                                                               5
VERMILLION Multi-Modal BioInformatics Solution for Ovarian Cancer NASDAQ: VRML l August 2019 - Aspira Labs
Paradigm Shift- Single Modality vs. Multi-modality Approach

          Protein Biomarkers      Additional Tech
                                                                      OVA 360
                                                                      - Systemic Dx
Q4 2018                                                   TBD

                                                                  =
                                                                      - Focused Dx (TVUS)
                         OVA360
                                                                      - Family Hx /
2H 2019                                                 2H 2019        Genetics
                                Hereditary Breast
          Clinical Assessment       and Ovarian
          & Imaging+              Cancer (HBOC)                       - Patient Reported
          Symptom Index                 Genetics                        Data (Symptom
                                                                        Index)
                                                                                      6
                                                    6
VERMILLION Multi-Modal BioInformatics Solution for Ovarian Cancer NASDAQ: VRML l August 2019 - Aspira Labs
Our Mission

              Enable Early
                Ovarian
                 Cancer
              Detection for
              All Ages and
               Ethnicities

                              7
VERMILLION Multi-Modal BioInformatics Solution for Ovarian Cancer NASDAQ: VRML l August 2019 - Aspira Labs
Ovarian Cancer: Severe Clinical Problem

                                  Presentation Stage and 5-Year Survival Rate(1)

                Presentation Stage                     Incidence             Five Year Survival Rate
                  (Stage I) Localized                     15%                            92%
                  (Stage II) Regional                     21%                            75%
                   (Stage III) Distant                    59%                            29%
                (Stage IV) Unstaged                        6%                            24%

                    Clinical Need for a Diagnostic Solution with Adequate Predictive Value to:

                     Ensure earlier cancer detection

                     Accurately identify patients needing timely treatments from gynecologic oncologists

          (1)   www.SEER.Cancer.gov.
                                                                                                           8
VERMILLION Multi-Modal BioInformatics Solution for Ovarian Cancer NASDAQ: VRML l August 2019 - Aspira Labs
Root Causes for Delayed & Non-Actionable Diagnoses

   Category      Clinical Assessment Blood Tumor Marker             Tissue Analysis
    Tools       § Physical exam &       § CA-125 (off-label)     § Pre-operative biopsy
                  ultrasound            § ROMA™
                                          (alternative)
  Limitations   § Subjective results    § Low sensitivity        § Biopsy rupture risks
                  due to specialists’                              (potential tumor
                                        § High false negative
                  interpretation                                   spread)
                                          rates, especially in
                                          pre-menopausal and
                                          early stage patients

                                                                                      9
VERMILLION Multi-Modal BioInformatics Solution for Ovarian Cancer NASDAQ: VRML l August 2019 - Aspira Labs
Current Care Pathway
Level A guideline for pelvic mass assessment results in ~70% unclear results and leads to ineffective care pathway

                                                                                                             Level A Guideline
                                                                                                         Pelvic Mass Transvaginal
                                                                                                      Ultrasound (TVUS) Assessment
                                                                                                           (0.5M – 1M Patients)(1)                  Clearly
                                                          Clearly                                                                                  Malignant
                                                        Benign (27%)                                                     Level B                     (3%)
                                                                                                                 Unclear Results (CA-125)
                                                                                                                            ~70% of Cases(1)
                                                                                                                                                    CA-125 &
                                                     Watchful Waiting /
                                                                                                                          (~400K Patients)     Immediate Referral to
                                                      Management of
                                                                                                                                                  Gynecological
                                                        Symptoms
                                                                                                                                                   Oncologist

                                                                       Ineffective Care Pathway Results:
                                                      § Late-stage detection (65%)(2)
                                                      § Gynecological oncologist referral delay (40%)(4)
                                                      § High cost with no improvement in clinical outcomes ($5B(3) of U.S.
                                                        annual costs with 52+% mortality(2))
 (1)   Based on management estimates and analysis.
 (2)   www.SEER.Cancer.gov.
 (3)   Estimates from Projections of the Cost of Cancer Care in the United States:2010–2020, J Natl Cancer Inst 2011;103:117–128.
 (4)   Racial Disparities in the Receipt of Guideline Care and Cancer Deaths for Women with Ovarian Cancer Cronin Et al 2018 Nov Cancer                                10
       Epi Prev Biom.
Our Solution = OVA1® + OVERA® (OVA1 +)
        For the detection of Ovarian Cancer Risk in Women with Pelvic Masses

                                          Launch 2010

    •    OVA1 evaluates the levels of five ovarian
          cancer-associated markers in the blood
        • Levels combined into a single ovarian
                    cancer risk score.

Multi-variate Index Assay (MIA) in ACOG Guidelines
   Positive NCCN and SGO position statements

                                         Launch
                                         Q4 2018

        •   Overa incorporates 2 new markers
                 • Global Platform
                    • Specificity +

                                                                                    11
                                                                               11
Improved Specificity
     OVA1 + - Ova1/Overa Reflex Offering- Launched Q4 2018

                                                                            Low Risk

                                                                     Intermediate Risk                          Reflex to:

              ACOG Endorsed
                                                                        Elevated Risk
                ACOG Endorsed

                                                                                                             OVA11               Overa1    OVA1 +    (95%      % Diff
Premenopausal2: Low Risk < 5.0; Intermediate
                                                                                                            (95%CI)             (95% CI)         CI)        OVA1 vs OVA1+
5.0-7.0;
Elevated Risk > 7.0                                                           Sensitivity                     92%                91%            88%              -4%
Postmenopausal2: Low Risk < 4.4; Intermediate                                                                                                   72%
4.4-6.0;                                                                      Specificity                     54%                 69%                           33%
Elevated Risk > 6.5

                                                                         > 30% improvement in specificity
1.   Coleman RL, Herzog TJ, Chan DW, et al. Validation of a second-generation multivariate index assay for malignancy risk of
     adnexal masses. Am J Obstet Gynecol 2016;215:82.e1-11.                                                                                                     12
2.   Reference Ranges established by ASPiRA Labs, Austin Tx.                                               12
How is this Care Pathway Different?
       Level A (TVUS) and Level B ACOG (OVA1)

             CLEARLY            Get CA-125 and refer to Gyn Onc Immediately
            MALIGNANT                                                                                                                                  Refer
               (3%)                                                                                                                                   Gyn Onc
                                                                                                   Elevated Risk
                                                                                                   of Malignancy                                      Gyn Onc
 Level A                                                                Level B                                                                       Consult
                      ~70% of
 PELVIC                 Cases
  PELVIC
  MASS                                                                                                    Ensure                                      CU study
                   Everything else                                                                                                                     results
MASS
  TVUS ON                                                                                                 Proper                                        100%
                  (3-10cm) not thin
0.5-U/S
     1.0M             walled, >1
                                                                                                          Triage                                    Proper Triage

                   septation, small                                                                                                              99% NPV**
                      nodules*                                                                     Lower Risk of                                  No Need
                                                                                                    Malignancy                               to Refer/Surgery by
                                                                                                  False Negative                                     Gyn
                                                                                                    Rate < 10%
              CLEARLY
                               Watchful waiting/management of symptoms                                                                       No Further Imaging
            BENIGN (27%)

                           •    This does NOT include other risk factors for ovarian cancer such as family history or Hereditary Cancer Syndromes
                           •    ** ACOG Nov 2016 citation
                                                                                                                                                             13
                                                                          13
Improved Early Stage Detection:
OVA1 vs Standard of Care in Stage I + II Patients

            94% Reduction in Rate of Cancer Missed with OVA1

                                                               14
                                               14
Early Detection Lowers Total Healthcare Costs
              Use of OVA1 Plus compared to CA-125 II can lower total costs while improving care
       § Total ovarian cancer-related costs = $5B total U.S. and $46.4B total global(3)

                                                           Cost Comparison of Early vs. Late Stage Detection(1,2)

                                                               84% Decrease in Cost Burden
                                                                                                                                                                                  Pre-Menopausal
                                  $224,922
                                                                                                                                                                                  Post-Menopausal
                                                                           $197,757

                                                                                                                                                                            81% Decrease in
                                                                                                                                                                             Cost Burden

                                                                                                                                        $35,754                         $37,195

                                                      Late Stage                                                                                          Early-Stage

        (1)    24-Month Average Reimbursement for Early and Late Stage Cancer.
        (2)    Brodsky B.S., Owens G.M., Scotti, D.J., et al. AHDB. 2017:10(7):351-359.
        (3)    Lindsey A. Torre, Farhad Islami, Rebecca L. Siegel, Elizabeth M. Ward and Ahmedin Jemal. Cancer Epidemiol Biomarkers Prev April 1 2017 (26) (4)
               444-457; DOI: 10.1158/1055-9965.EPI-16-0858; WHO fact sheet.
                                                                                                                                                                                                    15
Non-White Women, and African-American Women in Particular, Display
Significantly Lower CA125 Values Compared to Caucasian Women- 2001-2017
This disparity is found in healthy women, women at high risk for ovarian cancer, and women with
ovarian cancer(1-4)
                                                                                   CA125 (%, Caucasian Value is 100%)
                                                                                                                                                                    Skates et al. 2011
                            Babic et al. 2017                       Cramer et al. 2010                       Pauler et al. 2001                      (Post-menopausal)         (Pre-menopausal)
             100

                  75

                  50

                  25

                   0
                            Caucasian           Africa                Caucasian           Africa                Caucasian           Africa                Caucasian         Africa            Caucasian      Africa
                                              American                                  American                                  American                                American                         American
                                               or Non-                                   or Non-                                   or Non-                                 or Non-                          or Non-
                                                White                                     White                                     White                                   White                            White
                                                                                                                                                                 1968 (Premenopausal, non-African-American)
                                  3446 (Caucasian)                          582 (Caucasian)                        17852 (Caucasian)                                68 (Premenopausal, African American)
                                  1645 (Non-white)                          35 (Non-white)                       89 (African-American)                          1604 (Postmenopausal, non-African-American)
                                                                                                                                                                    52 (Postmenopausal, African-American)

            (1)    Pauler, D., et al. Factors Influencing Serum CA125II Levels in Healthy Postmenopausal Women. Cancer Epidemiology, Biomarkers & Prevention, 10: 489-493, 2001.
            (2)    Skates, S., at al. Large Prospective Study of Ovarian Cancer Screening in High-risk Women: CA125 Cut-point Defined by Menopausal Status. Cancer Prevention Research, 4(9), 1401–1408, 2011.
            (3)    Cramer, D., et al. Correlates of the pre-operative level of CA125 at presentation of ovarian cancer. Gynecologic Oncology, 119(3), 462–468, 2010.
            (4)    Babic, A., at al. Predictors of pretreatment CA125 at ovarian cancer diagnosis: a pooled analysis in the Ovarian Cancer Association Consortium. Cancer Causes & Control : CCC, 28(5), 459–468, 2017.
                                                                                                                                                                                                                          16
High Level Internal Data from ASPiRA LABS®
    OVA1® Superiority over CA125 in African American Women
                                                                                                                      Positive    Negative
                                                                                                                     Predictive   Predictive
                                                                                   Sensitivity (%) Specificity (%)     Value        Value
                        Caucasian (N=868)                                               93.2            45.3           40.8         94.3
OVA1®
                        African American (N=156)                                        79.2            66.7           30.2         94.6
                        Caucasian (N=868)                                               74.4            87.6           70.7         89.5
CA125
                        African American (N=156)                                        33.3            94.0           50.0         88.6

§ CA125 has an unacceptable sensitivity for cancer detection in African American women
§ Abstract accepted and presented at Mid Atlantic Gynecologic Oncology Society (MAGOS) in October 2018
§ Abstract accepted at American Association for Cancer Research (AACR)
§ Manuscript accepted for publication in Biomarkers in Cancer
§ OVA1® shows an acceptable sensitivity for cancer detection in African American women, cutoff adjustment is in
  process for pre and post menopausal women, to achieve the 90% sensitivity obtained for Caucasian women(1)
                 (1) ASPiRA Labs Data on File, Combined OVA1 and OVA500 studies.
                                                                                                                                           17
OVA1 Plus Summary
  OVA1 Plus improves early stage detection for all types of ovarian cancer for all ages compared to CA-125 ll

                                          Comparison of CA-125 II vs. OVA1+

      Sensitivity Across All Ovarian Cancer Stages(1)                                           CA-125 II                  • Ovarian cancer remains a diagnostic dilemma for
      Stage I                                                                                      X                   ✓     gynecologists and primary care physicians, making OVA1
      Stage II                                                                                     X                   ✓     Plus clinically relevant
      Stage III                                                                                       ✓                ✓
      Stage IV                                                                                        ✓                ✓   • For High Risk Patients:
      Sensitivity Across Menopausal Status(1)
                                                                                                                             Early detection and appropriate referral to gynecological
      Pre-menopausal                                                                                   X               ✓
                                                                                                                             oncologists give patients survival benefit and proven to be
                                                                                                                             cost-effective
      Post-menopausal                                                                                 ✓                ✓
      Sensitivity Across Histological Subtypes(1)
                                                                                                                           • For Low Risk Patients:
      Epithelial ovarian cancer                                                                       ✓                ✓     The negative predictive value (NPV) of OVA1 Plus will assist
      Non-epithelial cancer                                                                           X                ✓     in establishing correct treatment plan, and reassures both
      Low malignant potential                                                                         X                ✓     patient and gynecological provider when planning surgery
      Metastatic                                                                                      ✓                ✓
      Other gyn cancer                                                                                X                ✓   • OVA1 Plus demonstrates improved sensitivity in the African
      Sensitivity Across All Ethnicities(2)                                                                                  American population
      Caucasian and African American                                                                   X               ✓
                                                                                                                                           OVA1 Plus Changes
(1)    Longoria T.C. et al. Am J Obstet Gynecol 2014;210:78 e1-9.
(2)    From company’s 2019 AACR Abstract 1244, “Ethnic disparity in ovarian malignancy tumor markers: MIA and ROMA.”
                                                                                                                                           Patient Treatment                     18
Large and Growing Total Addressable Market
                                                                                                         Long-Term
                                                                                                     Addressable Markets
                                                                    Near-Term                         Endo + PCOS+ Func. Cysts
                                                                Addressable Markets                          Detection:
                                                                                                   § ~17M U.S. patients
                                                                                                   § No current solution available / CA-
                                                               Benign Masses, Non-Ovarian            125 used on case by case basis (off
                                                                 Cancer, Non-Gyn Mass                label)
                                                                      Monitoring:                  § VRML portfolio: POC Complete
                     Currently                                § ~750K-1M U.S. patients               (2021)
                 Addressable Market                           § Current solution: CA-125 2-4x/yr
                                                                monitoring (off-label)                     Ovarian Cancer
                                                              § VRML portfolio: Watch + Wait            Recurring Monitoring:
                                                                (2H 19)                            § ~230K U.S. patients
                                                                                                   § Current solution: CA-125 2-4x/yr
                     Pelvic Mass Detection:                                                          monitoring (on-label)
                                                              High Risk BRCA Screening and
               § Surgical triage or guided referral                                                § VRML portfolio expansion TBD
                                                                       Monitoring:
                 (~300-400K U.S. patients, incl.
                                                              § ~300K U.S. patients
                 surgery and low-risk patients)(1)                                                         TAM = ~17M
                                                              § Current solution: CA-125 2-4x/yr
               § ~5% VRML market share                          monitoring (off-label)
               § Current solution / VRML                      § VRML portfolio – (2021)
                 portfolio: Ova1 Plus
                                                                      TAM = ~1-1.3M
                                                                                                     Total TAM = ~18-20M
                     TAM = 0.3-4 M
                                                                            Time
                                                                                                                                           19
         (1)    Based on management estimates and analysis.
Growing Salesforce Driving Adoption
  Marketed directly to gynecologists, gynecology supergroups and healthcare systems

                                                        Salesforce Overview
                                                                                      Full-Time Sales Representative Pedigree
§ Completed Two-Phase Salesforce Expansion
 o20 full-time (“FTE”) territory sales reps hired
  in total
 oAverage ~15 years of experience in genetics,
  diagnostic labs and women’s health
 oStrong relationships with large Ob-Gyn
  practices/physicians in target markets
 oTop performers in companies with disruptive
  technology

                                                                                                                                20
Vermillion Commercial Momentum
Vermillion is at a commercial inflection point
                                                                                                Commercial Growth Phase
                                                                                           2.5x commercial investment Y-o-Y &
    Sales Volume
                                                                                              demonstrated positive Ob-Gyn
   3,300                                                                                               reception
                                                                                                                                 3,129
    3,100
                                                                    Launch of Decentralized
                                                                     Platform & OVA1 Plus

   2,900

   2,700

   2,500
                                                         6 FTEs
                                                        Territory                  Phase 2 Hiring
   2,300                                                                                                        2,313
                                                        Sales Rep

    2,100                                                       Phase 1 Hiring
                                                           1,981
                                            1,884                                     1,996                 20 FTEs
   1,900             1,818                                                                                 Territory
                                                        SVP Commercial Hired                              Sales Rep,
                                                                                                         Total 30 FTEs
    1,700                                Evicore Live
                   PAMA Rate

    1,500
                    Q1 2018                Q2 2018       Q3 2018                 Q4 2018                   Q1 2019              Q2 2019
                                                                                                                                          21
Two Pronged Commercial Strategy Satisfies
Provider Demand

         Test Processed by ASPiRA Labs                                           Test Processed by Providers
                                                           § Test performed locally by providers with access to Vermillion’s risk
§ Samples collected and shipped by providers to ASPiRA       assessment software via web service
  Labs, Vermillion’s centralized testing platform
                                                             o OVA1 performed on locally existing platform (e.g., Roche Cobas – 10K
§ Results shared with providers via portal, fax, etc.          installed units WW)
§ Led by experienced team with significant tenure in the     o Software subscription revenue model
  industry                                                 § U.S. – platform targeted towards hospital systems/large gynecology
§ Based in Austin, Texas                                     supergroup
                                                             o Increases distribution at Point-of-Care
                                                             o Positive policy/coverage facilitates utilization and reimbursement
                                                           § Ex-U.S. – studies in process to validate Overa & OVA1 (CE mark received)
                                                             on local high-risk populations, and technology transfer

                                                                                                         Algorithm
                                                                        Technology                       Warehouse
                                                                         Transfer                        OvaCalc®

                                                                              Customer                Vermillion Data Repository

                                                                                                                                   22
Reimbursement and Market Access
Unprecedented reimbursement success

                                     Coverage: Patient Lives In Millions                                            Weighted Average OVA1 Price Per Test

                                                                                    Oklahoma
                                                                                                Tennessee                                               Target Goal
                                                                                  New Mexico
                                                                                                                                                        PAMA(1) Price
                                                                                                 Arizona                                                    $897
                    167M                                                                Texas   Montana

                    120M
                                                                             Illinois                                                                      $361
                                                                                                                                                 $336

                                                                                                                               $236
                    100M

                                                                 CareFirst
                                                     Louisiana                                               $125
                     80M                  Arkansas
                               Michigan

                                                     Goal: Targeted Growth with Positive
                                                           Medical Policy Decisions
                     Novitas
                                                                                                            2014        2015          2016       2017             2018
                                                                                                                                                           2018-2020

               § Cigna added OVA1 to its national preferred coverage list in                                § OVA1 PAMA price set for 2018 – 2020 = $897
                 January 2019                                                                               § CPT code 81503
               § 51% of the population now under positive coverage

              (1)    Protecting Access to Medicare Act of 2014 (PAMA).
                                                                                                                                                                         23
Current Financial Priorities

                      Margin Expansion

                                         24
Catalysts Driven Momentum Through 2019
On track to deliver strong results in 2019

                    Q3 2018         Q4 2018           Q1 2019         Q2 2019          Q3 2019          Q4 2019          1H 2020          2H 2020

                                                                   Increased Market Access via Cigna
                                    CA-125II Disparity             § Q1 2019, Cigna added OVA1 to its national
                                    Validation                        preferred coverage list                                            Expanded Bio-
                                    § Q4 2018, presented           § 15 M lives added (167M total number covered                         informatics
                                       CA125 disparity data at        lives as of Q1 2019)                                               Platform- Beyond
                                       the Mid-Atlantic                                                                                  Proteins
                                       Gynecologic Oncology       Expanding Sales Team
                                       Society                    § Phase 2 hiring completed in Q1 2019 (11 FTE)
                                                                                                                         Decentralized Partnership
                                                                                                                         Expansion
                                                                            Hereditary Breast and Ovarian Cancer
                     Expanding Sales Team                                   (HBOC) Genetics (June 2019)
                     § Phase 1 hiring completed
                        in Q3 2018 (9 FTE)
                                                                                                  Clinical Assessment & Imaging+ Symptom Index (Q3
                                                                                                  2019)

                                                                                                  Watch and Wait Portfolio Expansion (2H 2019)

                   Payer Expansion                           Pelvic Mass Portfolio Expansion                                   OVA 360
                                                                                                                              §   Systemic Dx
                                                                                                    Data Repository           §   Focused Dx (TVUS)
                                                                                                   with Bioinformatics        §   Family Hx / Genetics
                                                                                                        Platform              §   Patient Reported Data
                                                                                                                                  (Symptom Index)
                                                                                                                                                            25
Compelling Growth Strategies

                                                                                               Expand
                                                                                               Distribution
                                                                                               Platform
                                                                                               Beyond the U.S. by
                                                                                               launching OVA1 Plus
                                                                                               while building the clinical
       Enterprise Value

                                                                        Expand Product         utility and health
                                                                        Offerings              economics foundation

                                                                        Offer pelvic disease
                                                    Become the          diagnostic and
                                                                        prognostic solutions
                                                    Standard of Care
                                                                        from puberty to cure
                                                    for Global Pelvic   from endometriosis
                          Leverage the              Mass Risk           and ovarian cancer
                          Largest Specimen          Assessment
                          and Data
                          Repository
                          Of gynecologic pelvic
                          mass patients worldwide
                                                                                                                             26
Investment Highlights

         Commercial stage company with FDA-cleared multi-modal disease management
         approach to women’s health, with core focus on ovarian cancer
         FDA-cleared 2nd generation technology that is incorporated into clinical treatment
         guidelines

         Strong commercialization strategy addressing sizable potential markets

         Pipeline of compelling diagnostic bioinformatic product candidates

         Strong intellectual property protecting methods and use

         Broad managed care coverage: 2018 Clinical Laboratory Fee Schedule (“CLFS”)
         reimbursement rate of $897

         Seasoned management team
Appendix
Trusted Solution: Care Pathway Guidelines

                             Published Evidence                         OVAI (MIA) Guidelines / Position Statements(1)

          Ueland, et al      Obstetrics and Gynecology, 2011
                                                                                       ACOG Practice Bulletin
                                                                                       Number 174, November 2016, page 10
                             Gynecologic Oncology, 2013 Am J Gynecol,
          Bristow, et al.
                             201

          Longoria, et al.   Am J Obstet Gynecol, 2013                                 National Comprehensive Cancer Network
                                                                                       Guidelines, Version 5, 2017
                                                                                       Updated Feb 2, 2018
          Goodrich, et al.   Am J Obstet Gynecol, 2015

          Forde, et al.      Curr Med Res Opin, 2015
                                                                                       Society of Gynecologic Oncology Position
                                                                                       Statements Issued 2011 Updated 2013
          Coleman, et al.    Am J Obstet Gynecol, 2016

          Eskander, et al.   Am J Obstet Gynecol, 2016

          Urban, et al.      Int. J Gynecol Cancer, 2017                       (1)In   100% of all Key Guidelines
          Brodsky, et al.    Am Health & Drug Benefits, 2017

                                                                                                                                  30
Protected Solutions: Strong IP

                      Granted                      Pending (Approx.)                Family

            USA        Ex US       Total     USA        Ex US          Total
             20         65          85        9           31            40            24

           Issued patents covering various   Pending patent applications          Algorithm –
              ovarian cancer biomarkers          including OVA1 and            kept as trade secret
                                                   Overa products

                                                                                                      31
Majority of Pelvic Masses Are Benign
A low false negative rate is critical for patient care

                                                                                                 Early Stage Sensitivity                     Early Stage False   False Positive
                                                                                                           (%)             Specificity (%)   Negative Rate (%)      Rate (%)

                                                    Clinical Assessment (CA)(1)                                  68.6           86.3               31.4              13.7

                                                    Ultrasound alone(2)                                         41.2(9)         74.7               58.8              25.3
                   Standalone Risk Stratification

                                                    CA125 alone(1)                                               62.8           89.6               37.2              10.4

                                                    ROMA (Ca125 & HE4)(3-4)                                      63.6            86                36.4               16

                                                    OVA1® alone(5)                                               91.4           53.5                8.6              46.5

                                                    Overa® alone(6)                                              88.6           69.1               11.4              30.9

                                                    OVA1 Plus(7,8)                                               86.8            72                13.2               28

                  1.          Longoria, TC et al. AJOG Jan 2014, 210(1,): 78.e1-78.e9                                                       Demonstration of
                  2.          Pavlik EJ, van Nagell JR Jr. Womens Health (Lond). 2013 Jan;9(1):39-55
                  3.          Partheen K, Kristjansdottir B, Sundfeldt K. J Gynecol Oncol. 2011;22(4):244-52.                          Improvement - Reducing False
                  4.          Chudecka-Glaz, A et al. J Mol Biomark Diagn. 2013, S4:003
                  5.
                  6.
                               Bristow, RE et al. Gynecol Cncol. 2013, 128:252-259
                              Coleman RL, Herzog TJ, Chan DW, et al. Am J Obstet Gynecol 2016;215:82.e1-11.
                                                                                                                                          Negatives by Over 50%
                  7.          ASPiRA Labs Data on File, Combined OVA1 and OVA500 studies.
                  8.          Internal data on file.
                  9.          Average of 4 trials in study.

                                                                                                                                                                                  32
OVA360 Disease Management
 Vermillion enables multi-modality approach to disease management

                                                                                OVA360 Disease Management

                                                                                                             Focused
                                                                       FDA-                                 Diagnostics
                                                                      Cleared                                  (MRI,
               § Vermillion is the first company to                    Blood                                Ultrasound)
                 develop FDA-cleared blood based                    Algorithms                360
                 detection algorithm

               § In current disease management
                 schema, adjacent technology such as
                 MRI, ultrasound have not been                                                                     Patient
                 incorporated into patient’s treatment       Genetics                                             Reported
                 plan                                         Panels                                                Data
                                                                                                                    (Hx,
               § Vermillion has collected a large volume                                                         Symptoms)
                 of data to create FDA-cleared
                 algorithms (proteins only) and in future
                 the vision is to combine multi-modalities
                                                                         Systemic
                                                                        Diagnostics                     ctDNA
                                                                          (Blood,
                                                                                             Exosomes             Subjective Modality
                                                                         proteins)

                                                                                                                  Objective Modality

                                                                                                                   Future Modality
                                                                                                                                        33
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