Potential to Transform the Treatment Paradigm for Migraine Prevention - August 2019

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Potential to Transform the Treatment Paradigm for Migraine Prevention - August 2019
June 14, 2018
    Potential to Transform the Treatment
    Paradigm for Migraine Prevention
    August 2019

                     Investor Presentation
Potential to Transform the Treatment Paradigm for Migraine Prevention - August 2019
Forward-Looking Statements
This presentation and the accompanying commentary contains certain forward-looking statements within the
meaning of Section 27A of the Securities Act of 1933, as amended, and Section 21E of the Securities
Exchange Act of 1934, as amended. Forward-looking statements include all statements that are not historical
facts and typically contain words such as “believe,” “will,” “may,” “estimate,” “continue,” “anticipate,” “intend,”
“should,” “plan,” “approximately,” “expect,” “predict,” “could,” “support,” “potential,” “opportunity,” “positive,”
“significant,” “unique,” “strong,” “unmet,” “need,” “design,” “strategy,” “advance,” “options,” “robust,” “path,”
“milestones,” “upcoming,” “enable,” “ensure,” “maintain,” “achieve,” “sufficient,” “projected,” “forecasted,”
“new,” “sets,” “establishes,” “on track,” “freedom” or the negative of these terms or other similar expressions.
You should consider forward-looking statements carefully because they discuss future expectations, contain
projections of future results of operations or financial condition, or state other “forward-looking” information.
These statements relate to our possible and future results of operations, financial condition, business
strategies, development plans, regulatory activities, competitive position, commercial plans, potential growth
opportunities and effects of competition and the assumptions that underlie these statements. These forward-
looking statements are subject to certain risks and uncertainties that could cause actual results to differ
materially from those anticipated in the forward-looking statements. Factors that might cause such a
difference include, but are not limited to, the risks outlined under the caption “Risk Factors” set forth in Alder’s
Quarterly Report on Form 10-Q for the quarter ended June 30, 2019, which was filed with the Securities and
Exchange Commission (SEC) on August 6, 2019 and is available on the SEC’s website at www.sec.gov, and
in other reports and filings we will make with the SEC from time to time. Forward-looking statements are
based on our management’s beliefs and assumptions and on information currently available to our
management. These statements, like all statements in this presentation, speak only as of the date of this
presentation (or an earlier date, where specifically noted), and except as required by law, we undertake no
obligation to update or revise these statements in light of future developments.
For investor audiences only.
                                                                                                                       2
                                                     Investor Presentation
Potential to Transform the Treatment Paradigm for Migraine Prevention - August 2019
Alder BioPharmaceuticals
Compelling Value Proposition

           Potential to Transform the Treatment
            Paradigm for Migraine Prevention

      LARGE
                                                                                                                                                            EXPANSION
   UNDERSERVED                                                                                   EPTINEZUMAB
                                                                                                                                                         OPPORTUNITIES
PATIENT POPULATION                        EPTINEZUMAB                                         WELL POSITIONED TO
                                                                                                                                                         IN EPTINEZUMAB
    AND MARKET                           DIFFERENTIATED                                        GAIN SIGNIFICANT
                                                                                                                                                        ACUTE STUDY AND
   OPPORTUNITY                           CLINICAL PROFILE                                       MARKET SHARE
                                                                                                                                                             ALD1910

              Investor Presentation - Eptinezumab and ALD1910 are investigational products and have not been approved by the FDA or any other regulatory body.            3
Potential to Transform the Treatment Paradigm for Migraine Prevention - August 2019
Migraine is a Serious Debilitating
Neurological Disease

                                                                                                                                                                     Economic loss due
                                                                                                                                                                        to migraines
             Most disabling
              disease during                                                                                                                                          ~$36B per year2
                 the most
             productive years                                                                                                                                          Lost work days
             of people’s lives1                                                                                                                                        113M per year2

                                                                                                                                                                   9/10 people with migraine
                                                                                                                                                                        can’t “function
      Attacks usually last
                                                                                                                                                                      normally” and 3/10
          4-72 hours2                                                                                                                                               require bed rest during
    Symptoms include                                                                                                                                                   migraine strikes3
  extreme pain, nausea,
    vomiting, extreme                                                                                                                                               Chronic migraine often
  sensitivities to light and                                                                                                                                        leads to depression,
  sound, gastrointestinal                                                                                                                                            anxiety, and sleep
           issues                                                                                                                                                      disturbances2
1Steiner,   TJ, Stovner, LJ, & Vos, T. The Journal of Headache and Pain (2018) 19:17 .”Most disabling disease of people under 50 years old.”
2Migraine    Research Foundation. Migraine Facts. Available at: https://migraineresearchfoundation.org/about-migraine/migraine-facts/. Accessed January 2, 2019.
3National   Headache Foundation, AMPP Fact Sheet. Available at: https://headaches.org/2007/08/11/ampp-fact-sheet/. Accessed May 16, 2019.

                                                  Investor Presentation - Eptinezumab is an investigational product and has not been approved by the FDA or any other regulatory body.       4
Potential to Transform the Treatment Paradigm for Migraine Prevention - August 2019
Patients are Suffering & Need Preventive
Medications that Work, and Work Faster1

  Migraine profoundly affects patients’ lives…

                                                                                                             %                                                                     %
                         34            %
                                                                                               63                                                                     66
                                                                                                                                                                      Say migraine attacks have
                                                                                                Say migraine affects
                          Have lost a job due                                                   their ability to maintain                                             affected their professional
                          to migraine2                                                          relationships1                                                        advancement1

     …And patients value efficacy and speed regardless of the mode of administration

                                  %       rate effectiveness                                                                                        rate fast acting as an
                                                                                                                                            %
                   87                     as important in determining
                                          whether they accept
                                                                                                                               79                   important treatment feature
                                                                                                                                                    when considering migraine
                                          treatment (highest-rated)1                                                                                prevention1

                                              90 %                  Say “I will never give up fighting to find a solution”1

1 Alder   proprietary patient market research, 2017 (N=250).
2 Chronic   Migraine in America Survey Results, 2013. Presented by migraine.com.

                                                   Investor Presentation - Eptinezumab is an investigational product and has not been approved by the FDA or any other regulatory body.             5
Potential to Transform the Treatment Paradigm for Migraine Prevention - August 2019
U.S. Anti-CGRP Migraine Prevention
Market Forecasted To Be >$5 Billion1

                     14M patient candidates suffer from 4+ headache days per month1
                        only 27% receive some form of preventive treatment

     Oral preventives fail to meet                                                                                                                                Up to 80% of patients discontinue
     needs of many patients:                                                                                                                                     use of oral preventives within 6-12
     adherence, safety,    tolerability
                  of Eligible                                                                                                                                       months due to lack of efficacy
     issues3      Patients on                                                                                                                                                    and/or tolerability4,5
                                                        Migraine
                                                        Prevention3

  Newly-launched subQ anti-CGRPs:                                                                                                                                  Q2’19 NBRx Share2
  ~383K NBRx since launch2                                                                                                                    Aimovig                   40.1%
  Commoditized market with similar                                                                                                                Ajovy                 21.9%
  clinical profile.                                                                                                                           Emgality                  38.0%
1 DRG   2018 Migraine Market report.
2 IQVIA  NPA Weekly through July 19, 2019
3 Parsekyan  D. Migraine prophylaxis in adult patients. West J Med. 2000;173(5):341-345.
4 Lipton RB, Bigal ME, Diamond M, et al. Migraine prevalence, disease burden, and the need for preventive therapy. Neurology. 2007;68(5):343-349.
5 Hepp Z, Dodick DW, Varon SF, et al. Adherence to oral migraine-preventive medications among patients with chronic migraine. Cephalalgia. 2015;35(6):477-488.

                                                        Investor Presentation - Eptinezumab is an investigational product and has not been approved by the FDA or any other regulatory body.              6
Potential to Transform the Treatment Paradigm for Migraine Prevention - August 2019
Alder BioPharmaceuticals
Compelling Value Proposition

           Potential to Transform the Treatment
            Paradigm for Migraine Prevention

      LARGE
                                                                                                                                                            EXPANSION
   UNDERSERVED                                                                                   EPTINEZUMAB
                                                                                                                                                         OPPORTUNITIES
PATIENT POPULATION                        EPTINEZUMAB                                         WELL POSITIONED TO
                                                                                                                                                         IN EPTINEZUMAB
    AND MARKET                           DIFFERENTIATED                                        GAIN SIGNIFICANT
                                                                                                                                                        ACUTE STUDY AND
   OPPORTUNITY                           CLINICAL PROFILE                                       MARKET SHARE
                                                                                                                                                             ALD1910

              Investor Presentation - Eptinezumab and ALD1910 are investigational products and have not been approved by the FDA or any other regulatory body.            7
Potential to Transform the Treatment Paradigm for Migraine Prevention - August 2019
Eptinezumab Differentiation Designed Into the
Molecule Enabling Delivery To Meet Patient Needs

         Eptinezumab mAb                                                                 Quarterly 30-Minute
                                                                                              Infusion

                                                                                                                                                                                 Eptinezumab’s
                                                                                                                                                                                      highly
                                                                                                                                                                                  competitive
       High specificity with                                                                 Total administered                                                                  clinical profile
      potent binding affinity                                                               dose is immediately
      to the ligand for rapid                                                                 active to inhibit
          suppression of                                                                     CGRP with 100%
          CGRP biology1                                                                       bioavailability1,2

  1. Baker B, Schaeffler B, Cady R, et al; Rational design of a monoclonal antibody (mAb) inhibiting calcitonin gene-related peptide, ALD403 (eptinezumab), intended for the prevention of migraine. Poster presented at the American
     Academy of Neurology (AAN) 2017 Annual Meeting.
  2. As compared to 50% -70% for subcutaneous anti-CGRPs; Vu et.al., Pharm Res. 2017 Sep; 34(9):1784-1795; Vermeersch, et al., J Pharmacol Exp Ther 354:350–357, September 2015.

                                            Investor Presentation - Eptinezumab is an investigational product and has not been approved by the FDA or any other regulatory body.                                                        8
Completed Pivotal Studies Demonstrate
Eptinezumab’s Unique Profile

                                                                                                                                                                                      FAST
 PROMISE 1 in Episodic Migraine Patients1                                                                                                                                             onset of prevention
                                                                                                                                                                                      Day 1 post-infusion
                    (N=888; baseline ~9 migraine days/month)

  • Met primary and key secondary endpoints
  • Safety and tolerability similar to placebo                                                                                                                                      POWERFUL
                                                                                                                                                                                    ≥50%, ≥75% and
                                                                                                                                                                                    100% reductions in
                                                                                                                                                                                    migraine days
   PROMISE 2 in Chronic Migraine Patients2
                 (N=1,072; baseline ~16 migraine days/month)                                                                                                                        SUSTAINED
                                                                                                                                                                                    for 3 months following
  • Met primary and all key secondary endpoints
                                                                                                                                                                                    a single administration
  • Safety and tolerability similar to placebo                                                                                                                                      and sustained or
                                                                                                                                                                                    further increased with
                                                                                                                                                                                    subsequent infusions

1. Saper J et al. Neurology. 2018;90(suppl 15):S20. Scientific Platform Presentation by Silberstein S at the American Academy of Neurology (AAN) 2018 Annual Meeting, April 21-27, 2018; Los Angeles, CA; Silberstein, S et al. Eptinezumab Results for the
   Prevention of Episodic Migraine Over 1 Year in the PROMISE-1 (PRevention Of Migraine via Intravenous eptinezumab Safety and Efficacy-1) Trial. Poster Presentation at the American Headache Society (AHS) 2018 Annual Scientific Meeting. June 28 –
   July 1, 2018; San Francisco, CA.
2. Lipton R et al. A Phase 3 Study to Evaluate Eptinezumab for Preventive Treatment of Chronic Migraine: Results of PROMISE-2 (PRevention Of Migraine via Intravenous eptinezumab Safety and Efficacy-2) Trial. Poster Presentation at the American
   Headache Society (AHS) 2018 Annual Meeting. June 28 – July 1, 2018; San Francisco, CA..

                                             Investor Presentation - Eptinezumab is an investigational product and has not been approved by the FDA or any other regulatory body.                                                                    9
Fast: Statistically Significant Day 1
Onset of Prevention Demonstrated
                                                                                       PROMISE 2: Chronic Migraine
                                                                                   % of Patients with Migraine, Days 1-28
                            60%                                                    Infusion 1

                                                                                                                                                               Day 1 Reduction in Migraine Prevalence
                                                                                                                                                              Eptinezumab, 300mg, 52% reduction+
                                                                                                                                                              Eptinezumab, 100mg, 50% reduction+
Patients with Migraine, %

                            50%
                                          Average Daily                                                                                                       Placebo 27% reduction
                                             Baseline
                                           Prevalence of
                                          Migraine: ~58%
                            40%

                            30%

                            20%
                                                                Day 0              Day 1                                  Day 7                                    Day 14                                     Day 21                                     Day 28
                            + statistically significant; Day 1 prevalence rate comparison between eptinezumab vs. placebo
                            Lipton R et al. A Phase 3 Study to Evaluate Eptinezumab for Preventive Treatment of Chronic Migraine: Results of PROMISE-2 (PRevention Of Migraine via Intravenous eptinezumab Safety and Efficacy-2) Trial. Poster Presentation at the
                            American Headache Society (AHS) 2018 Annual Meeting. June 28 – July 1, 2018; San Francisco, CA.

                                                                  Investor Presentation - Eptinezumab is an investigational product and has not been approved by the FDA or any other regulatory body.                                                                10
Powerful and Sustained: ≥50% Responder Rate by
Month 1 and Sustained or Further Increased Efficacy
with Subsequent Infusion
                                                                          PROMISE 2: Chronic Migraine
                                                                         ≥50% Migraine Responder Rates
                                                Eptinezumab 100 mg                                                 Eptinezumab 300 mg                                                   Placebo
                 70
                                                                                                                                                                                                     64.0
                                                  60.6                                                                      61.4 +                                                 61.0
                 60                                                                                     57.6 +
                                54.5
                 50
                                                                                                                                                                                                            44.0
                                                                                                                                              39.3
  Patients, %*

                 40                                                 36.1

                 30

                 20

                 10

                  0
                                         INFUSION 1                                                               INFUSION 1                                                                INFUSION 2
                                           Month 1                                                                 Months 1-3                                                                Months 4-6
    + statistically significant
    Lipton R et al. Eptinezumab for Prevention of Chronic Migraine: Results of 2 Quarterly Intravenous Infusions in the Phase 3 PROMISE-2 (PRevention Of Migraine via Intravenous eptinezumab Safety and
    Efficacy-2) Trial. Scientific Presentation at the American Headache Society (AHS) 2018 Annual Meeting. June 28 – July 1, 2018; San Francisco, CA.

                                                Investor Presentation - Eptinezumab is an investigational product and has not been approved by the FDA or any other regulatory body.                               11
Powerful and Sustained: ≥75% Responder Rate
by Month 1 and Sustained or Further Increased
Efficacy with Subsequent Infusion
                                                                        PROMISE 2: Chronic Migraine
                                                                       ≥75% Migraine Responder Rates
                                             Eptinezumab 100 mg                                                 Eptinezumab 300 mg                                                    Placebo
                50

                                                                                                                                                                                                   43.1
                40
                                                                                                                                                                                39.3
                                                36.9 +
                                      +
                                                                                                                         33.1 +
                            30.9
                30
 Patients, %*

                                                                                                    26.7 +
                                                                                                                                                                                                          23.8

                20
                                                                  15.6                                                                     15.0

                10

                 0
                                      INFUSION 1                                                                INFUSION 1                                                               INFUSION 2
                                        Month 1                                                                  Months 1-3                                                               Months 4-6
 + statistically significant
 Lipton R et al. Eptinezumab for Prevention of Chronic Migraine: Results of 2 Quarterly Intravenous Infusions in the Phase 3 PROMISE-2 (PRevention Of Migraine via Intravenous eptinezumab Safety and
 Efficacy-2) Trial. Scientific Presentation at the American Headache Society (AHS) 2018 Annual Meeting. June 28 – July 1, 2018; San Francisco, CA.

                                             Investor Presentation - Eptinezumab is an investigational product and has not been approved by the FDA or any other regulatory body.                                12
Powerful and Sustained: 100% Responder Rate
14.0% (100mg) and 19.1% (300mg) of epti-treated patients
experienced no migraines for at least half of the study period (≥3
months) compared with 4.9% of those on placebo
                            90%
                                                                                    PROMISE 2: Chronic Migraine
                                                                                 Number of Migraine-Free Study Months*
                            80%                                                      Over 6 Months of Treatment

                            70%
      Percent of Patients

                            60%

                            50%
                                                                                                                                                                          Eptinezumab 100 mg (n=356)
                            40%                                                                                                                                           Eptinezumab 300 mg (n=350)
                                                                                                                                                                          Placebo (n=366)
                            30%

                            20%

                            10%

                            0%
                                         0             ≥1                ≥2                ≥3                 ≥4                  ≥5                   6
                                                   Number of Migraine-Free Study Months
                                  *Defined as 28 consecutive days without migraine during a study month, with the first day of dosing used as the reference point.

     Winner P. et. al., Migraine-Free Months in Patients With Episodic or Chronic Migraine Treated With Eptinezumab: Results From the PROMISE-1 and PROMISE-2 Trials. Poster Presentation at the American Headache
     Society (AHS) 2019 Annual Meeting. July 11-14, 2019; Philadelphia, PA.

                                               Investor Presentation - Eptinezumab is an investigational product and has not been approved by the FDA or any other regulatory body.                                  13
Patient Reported Outcomes: HIT-6
Clinically Meaningful Changes as Early as Month 1
in Chronic Migraine Patients (PROMISE 2)
              Baseline score:
                  ~66.7                                         Dose 1                                                  Dose 1                                                    Dose 2
                                                                Month 1                                                 Month 3                                                   Month 6
                                          0

                                          -1
            Mean Change from Baseline*

                                          -2

                                          -3

                                          -4

                                          -5
                                                                                   -5.1                                                    -4.9
                                          -6
                                                                                                                                                                                                        -6.1
                                          -7                                                                   -6.7
                                                       -7.2
                                          -8
                                                                                                                             -7.9
                                          -9
                                                                                                                                                                        -8.3
                                                                     -9.0
                                         -10
                                                                                                                                                                                        -9.3
                                                 Eptinezumab 100 mg (n=223)                                  Eptinezumab 300 mg (n=230)                                    Placebo (n=241)
                                                     Clinically meaningful change
                                               *Clinically meaningful change in HIT-6 total score was defined as a ≥6-point decrease.
   Nagy A.J. et. al., Treatment With Eptinezumab Demonstrated Meaningful Improvements in Patients With Chronic Migraine Experiencing a High Frequency of Severe Migraines. Poster Presentation at the American
   Headache Society (AHS) 2019 Annual Meeting. July 11-14, 2019; Philadelphia, PA.
                                                                                                                                                                                                                 14
                                                   Investor Presentation - Eptinezumab is an investigational product and has not been approved by the FDA or any other regulatory body.
Safety Data – Integrated Summary of
Pivotal Studies

      Adverse reactions occurring with an incidence of ≥2% for either dose of
      Eptinezumab and ≥2% greater than placebo for PROMISE 1 & PROMISE 2

                                                                              Eptinezumab                              Eptinezumab                              Placebo every
                                                                              100 mg every                             300 mg every                               3 months
                        Adverse Reactions
                                                                                3 months                                 3 months
                                                                                 N=579                                    N=574                                       N=588
                Nasopharyngitis                                                             6%                                       8%                                6%

 Source: Data on file

                               Investor Presentation - Eptinezumab is an investigational product and has not been approved by the FDA or any other regulatory body.             15
Alder BioPharmaceuticals
Compelling Value Proposition

           Potential to Transform the Treatment
            Paradigm for Migraine Prevention

      LARGE
                                                                                                                                                            EXPANSION
   UNDERSERVED                                                                                   EPTINEZUMAB
                                                                                                                                                         OPPORTUNITIES
PATIENT POPULATION                        EPTINEZUMAB                                         WELL POSITIONED TO
                                                                                                                                                         IN EPTINEZUMAB
    AND MARKET                           DIFFERENTIATED                                        GAIN SIGNIFICANT
                                                                                                                                                        ACUTE STUDY AND
   OPPORTUNITY                           CLINICAL PROFILE                                       MARKET SHARE
                                                                                                                                                             ALD1910

              Investor Presentation - Eptinezumab and ALD1910 are investigational products and have not been approved by the FDA or any other regulatory body.            16
Concentrated Marketplace
Top 11% or ~2,000 Accounts Prescribe 80%
of Anti-CGRP subQ Treatments

                                  Alder To Target Top 2,000 Accounts, driving 80%1 of subQ Anti-CGRP volume
                                                                                                                                                                                      Academic, 5%

                                                                                                      Q1’19 Rx/             Q1’19 v Q4’18
                                                                                   Group
          80%                 80%
                                                                                                        Acct                   Growth
              % of Business

                                                                                                                                                                                      Community,
                                                                                   Alder                                                                            Medical             29%
                                                                                                        150 Rx                20 Rx / acct
                                                                                  Targets                                                                           Groups,
                                                                                                                                                                     66%
                                                                                   Others                 6 Rx                 2 Rx / acct
                              20%

           ~2,000                              •See an average of 150-200                                                95%                                   75%                             70%
      Headache / Pain                           migraine patients per month1                                    Have IV access                        Have prescribed                    Have prescribed
     Centers, Neurology
       Practices, and                          •Often see patients at a                                           70% have                             an IV to their                     Botox to their
                                                quarterly cadence1                                                 in-office                              patients                         patients for
         Hospitals
                                                                                                                   access1                             for migraine1                        migraine1

                                                                                                                                  Our specialty-sized
                                                                                                                          sales force will have 75-100 reps

1 IQVIA   Xponent & claims data – March 2019
                                                                                                                                                                                                       17
                                               Investor Presentation - Eptinezumab is an investigational product and has not been approved by the FDA or any other regulatory body.
Concentrated Marketplace
Top 3% or ~500 Accounts Prescribe 50%
of Anti-CGRP subQ Treatments

                             Alder Target To Include Top 500 Accounts, driving 50%1 of subQ Anti-CGRP volume
                                                                                                                                                                                       Academic,
                                                                                                                                                                                          5%

                                                                                                       Q1’19 Rx/             Q1’19 v Q4’18
                                                                                    Group
     80%                     50%
                                                                                                         Acct                   Growth
             % of Business

                                                                                    Alder                                                                              Medical           Community,
                                                                                                         346 Rx                33 Rx / acct                          Groups, 65%           30%
                                                                                   Targets

                             50%                                                    Others                13 Rx                 3 Rx / acct

             ~500                               •See an average of 200-300                                                95%                                   80%                                83%
    Headache/ Pain                               migraine patients per month1                                    Have IV access                        Have prescribed                     Have prescribed
   Centers, Neurology
     Practices, and                             •Often see patients at a                                           80% have                             an IV to their                      Botox to their
                                                 quarterly cadence1                                                 in-office                              patients                          patients for
       Hospitals
                                                                                                                    access1                             for migraine1                         migraine1

                                                                                                                                   Our specialty-sized
                                                                                                                           sales force will have 75-100 reps

 1 IQVIA   Xponent & claims data – March 2019
                                                                                                                                                                                                         18
                                                Investor Presentation - Eptinezumab is an investigational product and has not been approved by the FDA or any other regulatory body.
Market Research Suggests 83% of Neurologists and
Headache Specialists Plan to Prescribe Eptinezumab

                                                                                                            HCP perceptions of Advantages2
                Anticipated Eptinezumab
                       Prescribing1                                                                           Efficacy, Day 1 & Sustained Response:
                                                                                                              • Rapid noticeable improvement is very
        100%                                                                                                     welcome; “these patients are suffering”
                                                                                                              • Efficacy present throughout the injection
          90%                                                                                                    cycle
                    83%                                     Do not plan to
          80%                                                                                                 Efficacy Response Rate ≥75%:
                                                            prescribe                                         • In Both Episodic and Chronic
          70%                                               eptinezumab                                       • Data perceived better than other anti-CGRPs
                                                                                                              • Efficacy does not wear-off before next
          60%                                                                                                   quarterly IV dose

          50%
                                                                                                              IV Administration:
          40%                                                                                                 • 100% Bioavailable
                                                                                                              • MD knows if patient complies with treatment
          30%                                               Will prescribe
                                                            eptinezumab
          20%
                                                                                                              MOA:
          10%                                                                                                 • Some speculate eptinezumab’s binding to
                                                                                                                alpha/beta forms may yield better efficacy
            0%

    1RealTime   Dynamix Migraine Prevention Survey Q2 2019, Spherix Global Insights.
    For those patients for whom you would consider using eptinezumab, are you likely to give the infusion in your office or refer to another site of care? (n=104)
    2Benefit Ladder Qualitative Research May-June 2019; Techniclarity. When assessing IV infusion, providers segment: 1) those who already administer IVs at

    their practice; 2) those who have the potential to; and 3) those who can’t offer IVs because of limited space and/or staff (n=20).

                               Investor Presentation - Eptinezumab is an investigational product and has not been approved by the FDA or any other
                                                                                                                                                 19regulatory body.   19
Market Research Suggests Eptinezumab
Well-Positioned for Adoption

                                                                                                                HCP feedback on potential eptinezumab share of
                                                                       ~20-30%                                  anti-CGRP market based on clinical profile2

     Procedure-Oriented
    Headache Specialists,
     Neurologists, Pain                                                    3 in 5 physicians believe less frequent administration and rapid onset of effect are
    Specialists and PCPs1                                                  important to prescribing migraine prevention2

                                                                                               %                                                    %                                     %
                                                                                  52                                                    74                                            64
            14 MILLION                                            would choose a quarterly                                believe IV medications                             would always choose the
           PATIENTS3                                              IV with eptinezumab’s                                   work the fastest when                              most effective option
                                                                  profile over a monthly                                  compared to other                                  regardless of
                                                                  SubQ preventive                                         injection forms of                                 administration method4
                                                                  therapy4                                                administration4

1 Alder proprietary physician market research, 2017.
2 Alder proprietary ATU physician market research, 2018.
3 DRG 2018 Migraine Market report.
4 Alder proprietary patient market research, 2017 (N=250)

                                                                                                                                                                                                 20
                                               Investor Presentation - Eptinezumab is an investigational product and has not been approved by the FDA or any other regulatory body.
Alder is Uniquely Positioned to
Capture High-Value Market Opportunity

           Migraine is a Serious                                                                        Eptinezumab’s
           Debilitating Disease                                                                          Differentiated                                                ~ 2,000 accounts
                                                                                                        Characteristics2                                                  driving 80%
                                                                                                                                                                     of anti-CGRP subQ Rx4

                                                                                                            FAST
                                                                                                            onset of prevention Day 1
                                                                                                            post-infusion3                                          ~20-30% potential
                                                                                                                                                               eptinezumab share of anti-
                                                                                                                                                               CGRP prevention market5

              US Anti-CGRP
                                                                                                ✓ POWERFUL
                                                                                                            >50%, >75% and
            Migraine Prevention                                                                             100% reductions in                                          ~ 14M
             Forecasted to be a                                                                             migraine days                                          patients who are
            >$5 Billion Market1                                                                                                                                candidates for prevention
                                                                                                            SUSTAINED                                            Only 27% are treated         6,8

                                                                                                            for 3 months following
                                                                                                            a single administration and
                                                                                                            sustained or further
                                                                                                                                                                            52%
                                            $                                                               increased with subsequent                            of patients would choose
                                                                                                            infusions                                               eptinezumab over a
                                                                                                                                                                  subcutaneous therapy7
1                                                           6 DRG    2018 Migraine Market report.
  DRG 2018 Migraine Market report
2 Eptinezumab                                               7   Alder proprietary patient market research, 2017 (N=250)
                PROMISE 1 and PROMISE 2 studies
3 Benefit observed within the first infusion period         8 American    Headache Society Position Statement. Headache 2018 0:1-18.
4 IQVIA Xponent & claims data – March 2019
5 Alder proprietary market research ATU 2018
                                                      Investor Presentation. - Eptinezumab is an investigational product and has not been approved by the FDA or any other regulatory body.         21
Alder BioPharmaceuticals
Compelling Value Proposition

           Potential to Transform the Treatment
            Paradigm for Migraine Prevention

      LARGE
                                                                                                                                                            EXPANSION
   UNDERSERVED                                                                                   EPTINEZUMAB
                                                                                                                                                         OPPORTUNITIES
PATIENT POPULATION                        EPTINEZUMAB                                         WELL POSITIONED TO
                                                                                                                                                         IN EPTINEZUMAB
    AND MARKET                           DIFFERENTIATED                                        GAIN SIGNIFICANT
                                                                                                                                                        ACUTE STUDY AND
   OPPORTUNITY                           CLINICAL PROFILE                                       MARKET SHARE
                                                                                                                                                             ALD1910

              Investor Presentation - Eptinezumab and ALD1910 are investigational products and have not been approved by the FDA or any other regulatory body.            22
Phase 3 Acute Trial
Planned to Begin 2H19

                                                                                                  Co-Primary Endpoints
     100 mg eptinezumab                                                                        Measured 2 hours post-treatment
                 vs.
                                                                                •      Patients achieving freedom from pain
             Placebo                                                            •      Absence of most bothersome symptom

 Post hoc analysis of time-to-migraine resolution in patients entering 3 prior
 eptinezumab clinical trials with active migraine:
 •    2-hour resolution rates observed – demonstrating clear trend
 •    Supported design of well-powered Phase 3 trial to detect meaningful
      difference vs. placebo in acute setting

                     Investor Presentation - Eptinezumab is an investigational product and has not been approved by the FDA or any other regulatory body.   23
Acute Trial
Potential “Treat and Prevent” Label to Drive Brand Choice

                                                                              ~5M chronic migraine patients1
                  Prevention                                                  >50% chance of having a migraine the day of a physician visit2
                    Market
                                                                              ~9M episodic migraine patients1
                                                                              ~1/3 have a migraine the day of a physician visit2
                                                                             14M patients with 1-3 migraines per month1
                                                                             Opportunity to treat their migraines acutely with preventive
                                                                             benefit, further expanding market potential

         FirstWord Therapy Trends indicate that a CGRP mAb with a “treat and prevent” label
                             would be a strong driver of brand choice3

             KOLs demand treatments that are                                                                                          The ability to treat an acute migraine
             rapid in action, capable of sustaining                                                                                   with effective and sustained
             effect without burdensome side                                                                                           prevention for three months is a
             effects, with the ideal treatment also                                                                                   paradigm shift in the treatment
             preventing future attacks.3                                                                                              armamentarium3

1DRG   2018 Migraine Market report.
2Based  on mathematic likelihood of chronic (≥15 migraine attacks/month) and episodic (4-14 migraine attacks/month) patients presenting with headache.
3FirstWord Therapy Trends: Migraine Feb ’19

                                                                                                                                                                                          24
                                                   Investor Presentation - Eptinezumab is an investigational product and has not been approved by the FDA or any other regulatory body.
ALD1910 Aims to Expand Migraine
    Prevention with Anti-PACAP Antibody

     PACAP inhibition offers a differentiated approach to migraine prevention

                                                                                                                                                                                                    2
                                                                                                                                                                                          ALD1910
    • Like CGRP, infusion of PACAP has been
      shown to induce migraine attacks in migraine
      patients1
    • Preclinical data   indicate
                                  ~75%
                                  that
          Estimated to respond well to PACAP and
      CGRP    may  have    non-redundant
           eptinezumab (anti-CGRP)  2     pharmacology
      with respect to migraine-associated symptoms3
                                               5M
    ALD1910 is an anti-PACAP antibody
    • Highly potent and selective humanized antibody4
    • Ligand approach allows inhibition of binding with multiple PACAP receptors (PAC1, VPAC1 and VPAC2)4
    • GMP manufacturing and IND-enabling studies underway to enable Phase 1 initiation by the end of 2019
      and subsequently support IND

1 Schytz et al., Neurotherapeutics 2010; 7(2): 191–196
2 Modified from Kaiser & Russo, Neuropeptides 2013;47(6):1-24 (Refers to multiple PACAP receptors)
3 Alder unpublished research demonstrating that PACAP-driven migraine symptoms in rodents are not inhibited by anti-CGRP antibodies
4J Pharmacol Exp Ther 369:26–36, April 2019

                                                                                                                                                                                                        25
                                                       Investor Presentation - ALD1910 is an investigational product and has not been approved by the FDA or any other regulatory body.
Observation Time (min)

Pre-clinical Model Supports ALD1910 Inhibits
PACAP-Driven Photophobia, but an Anti-PAC1R
Antibody Does Not1

                                                       Tx2: Ab - scatter plot mAb
                                                      Anti-PAC1R
                                                200
                  Average Time in Light (sec)

                                                                                                  Vehicle + Con Ab n=10
                                                150
                                                                                                  Vehicle + PAC1 Ab n=8
                                                                                                  PACAP + Con Ab n=6                                 Anti-PACAP ALD1910
                                                                                                  PACAP + PAC1 Ab n=9
                                                100

                                                 50

                                                  0
                                                                        30mgs/kg
                Average Time in Light (sec)

                                                250
                                                                                                     Vehicle + Con Ab n=9
                                                200                                                  Vehicle + PAC1 Ab n=9
                                                                                                                                                                                        30mgs/kg
                                                                                                     PACAP + Con Ab n=7
                                                150                                                  PACAP + PAC1 Ab n=7

                                                100

                                                 50

                                                  0
                                                        Observation Time (min)
                                                                     100mgs/kg

                                                            Differential inhibition of photophobia in a predictive
                                                            pre-clinical model for migraine symptoms in humans

1 Alder   unpublished research results

                                                                                                                                                                                                        26
                                                                     Investor Presentation - ALD1910 is an investigational product and has not been approved by the FDA or any other regulatory body.
ALD1910 Inhibits PACAP-driven Vasodilation
 in Cynomolgus Monkeys

                                                                                                   1

                                                                     ALD1910 led to inhibition of PACAP-driven
                                                                        vasodilation under these conditions
                     Pre ALD1910                                                                                                        Post ALD1910
                                                                          Degree of Vasodilation
                                                                                                                                                                           high

                                                                 Injection site 1 – Saline Solution
                                                                 Injection site 2 – PACAP
                                                                 Injection site 3 – PACAP
                                                                 Injection site 4 – PACAP

                                                                                                                                                                           low

          Vasodilation post PACAP challenge (no                                                                            ALD1910 led to inhibition of PACAP-driven
                        ALD1910)                                                                                              vasodilation under these conditions
1 DPBS   is Dulbecco’s Phosphate Buffered Saline                                                                                                                                  27
                                        Investor Presentation - ALD1910 is an investigational product and has not been approved by the FDA or any other regulatory body.
Recent Execution and Key Upcoming
Milestones
                                                                                                                           Eptinezumab Anticipated Launch

                                                                                                                      Eptinezumab PDUFA Date
                                                                                                ALD1910 First in Human Study                                                     Q1 2020

                                                         Eptinezumab Phase 3 Acute Study Initiation                                                                   Feb. 21,
                                                                                                                                                                        2020
                                                                                                                                               2H 2019
                                                   BLA Acceptance – April 22, 2019
                                                                                                                             2H 2019
                                 BLA Submission – Feb. 21, 2019

                     PK Comparability Study Data

         Open Label Safety Study Data

PROMISE 2 Chronic Migraine

 PROMISE 1
                     Data
                                                                                                       ✓ Met all key milestones to
 Episodic Migraine
 Data
                                                                                                         date and on track to meet
                                                                                                         upcoming milestones for
                                                                                                         eptinezumab and ALD1910
                                                                                                         in 2019 & 2020

                   Investor Presentation - Eptinezumab and ALD1910 are investigational products and have not been approved by the FDA or any other regulatory body.                    28
2Q19 Financial Results
    and 2019 Financial Outlook*

    • 2Q19 Cash Position
              ‒ Cash position of $440.7M1 as of June 30, 2019

    • 2019 Outlook
              ‒ Total 2019 cash investment2 in the range of $285M and $315M

    • Sufficient cash to meet projected operating requirements through the
      anticipated launch of eptinezumab and into the latter part of 2020, with
      key activities including:
              ‒ Advancing eptinezumab’s supply chain
              ‒ Building commercial inventory
              ‒ Continued build out of Alder’s commercial footprint
                (e.g., marketing, sales, medical affairs, payer access, IT)
              ‒ Pre-launch market readiness

1   Includes cash, cash equivalents, investments and restricted cash
2   Net cash used in operating activities plus purchases of property and equipment, as defined under U.S. Generally Accepted Accounting Principles.
*Outlook as of Aug 6, 2019
                                                                                                                                                                                    29
                                 Investor Presentation - Eptinezumab and ALD1910 are investigational products and have not been approved by the FDA or any other regulatory body.
Appendix
           Investor Presentation   30
Fast: Statistically Significant Day 1
Onset of Prevention Demonstrated

                                                                                                      PROMISE 1: Episodic Migraine
                                                                                                   % of Patients with Migraine, Days 1-28
                                     35%
                                                                                                                                                         Day 1 Reduction in Migraine Prevalence
                                                                                        Infusion 1                                                      Eptinezumab, 300mg, 55% reduction+
                                                                                                                                                        Eptinezumab, 100mg, 52% reduction+
                                     30%
                                                                                                                                                        Placebo 24% reduction
 Percent of Patients with Migraine

                                                  Average (28 day)
                                                     Baseline
                                     25%           Prevalence of
                                                  Migraine: ~ 30%

                                     20%

                                     15%

                                     10%
                                                                        Day 0 Day 1                                      Day 7                               Day 14                               Day 21                               Day 28
                                     + Statistically significant (unadjusted)
                                     Silberstein, S et al. Eptinezumab Results for the Prevention of Episodic Migraine Over 1 Year in the PROMISE-1 (PRevention Of Migraine via Intravenous eptinezumab Safety and Efficacy-1) Trial. Poster
                                     Presentation at the American Headache Society (AHS) 2018 Annual Scientific Meeting. June 28 – July 1, 2018; San Francisco, CA.

                                                                         Investor Presentation - Eptinezumab is an investigational product and has not been approved by the FDA or any other regulatory body.                                  31
Powerful and Sustained: ≥50% Responder Rate by
Month 1 and Sustained or Further Increased Efficacy
with Subsequent Infusions

            Baseline: ~8.6                                                      PROMISE 1: Episodic Migraine
            Migraine Days
                                                                               ≥50% Migraine Responder Rates

                                                Eptinezumab 100 mg                                        Eptinezumab 300 mg                                          Placebo
                 80

                                                                                                                                                                                69.8§
                 70
                                                                                                                                                                64.7§
                                 59.3
                 60                              56.3                                                            56.3++                                                                          55.4
                                                                                                 49.8+
                 50
  Patients, %*

                                                                 40.5
                 40                                                                                                              37.4

                 30

                 20

                 10

                  0
                                         INFUSION 1                                                      INFUSION 1                                                     INFUSION 4
                                           Month 1                                                        Months 1-3                                                    Months 10-12
            ++ statistically significant; + statistically significant (unadjusted); §statistically significant (post-hoc)
            Saper J et al. Neurology. 2018;90(suppl 15):S20. Scientific Platform Presentation by Silberstein S at the American Academy of Neurology (AAN) 2018 Annual Meeting, April 21-27, 2018; Los Angeles, CA
            Silberstein, S et al. Eptinezumab Results for the Prevention of Episodic Migraine Over 1 Year in the PROMISE-1 (PRevention Of Migraine via Intravenous eptinezumab Safety and Efficacy-1) Trial. Poster
            Presentation at the American Headache Society (AHS) 2018 Annual Scientific Meeting. June 28 – July 1, 2018; San Francisco, CA.

                                                Investor Presentation - Eptinezumab is an investigational product and has not been approved by the FDA or any other regulatory body.                                  32
Powerful and Sustained: ≥75% Responder Rate
by Month 1 and Sustained or Further Increased
Efficacy with Subsequent Infusions
           Baseline: ~8.6                                                      PROMISE 1: Episodic Migraine
           Migraine Days
                                                                              ≥75% Migraine Responder Rates

                                               Eptinezumab 100 mg                                        Eptinezumab 300 mg                                          Placebo
                60
                                                                                                                                                                               54.1§

                50

                                                                                                                                                                39.4                            39.6
                40
 Patients, %*

                                             ++
                                30.8 ++ 31.5                                                                    29.7 ++
                30

                                                                                              22.2 NS
                                                                20.3
                20
                                                                                                                                16.2

                10

                 0
                                        INFUSION 1                                                      INFUSION 1                                                     INFUSION 4
                                          Month 1                                                        Months 1-3                                                    Months 10-12
           ++ statistically significant; §statistically significant (post-hoc); NS, not significant
           Saper J et al. Neurology. 2018;90(suppl 15):S20. Scientific Platform Presentation by Silberstein S at the American Academy of Neurology (AAN) 2018 Annual Meeting, April 21-27, 2018; Los Angeles, CA
           Silberstein, S et al. Eptinezumab Results for the Prevention of Episodic Migraine Over 1 Year in the PROMISE-1 (PRevention Of Migraine via Intravenous eptinezumab Safety and Efficacy-1) Trial. Poster
           Presentation at the American Headache Society (AHS) 2018 Annual Scientific Meeting. June 28 – July 1, 2018; San Francisco, CA.

                                               Investor Presentation - Eptinezumab is an investigational product and has not been approved by the FDA or any other regulatory body.                                  33
Powerful and Sustained: 100% Responder Rate
18.1% (100mg) and 25.2% (300mg) of epti-treated patients experienced
no migraines for at least half of the study period (≥6 months) compared
with 12.6% of those on placebo

                           70%                                                      PROMISE 1: Episodic Migraine
                                                                                 Number of Migraine-Free Study Months*
                                                                                     Over 12 Months of Treatment
                           60%

                           50%
     Percent of Patients

                           40%
                                                                                                                                                                         Eptinezumab 100 mg (n=221)
                           30%                                                                                                                                           Eptinezumab 300 mg (n=222)
                                                                                                                                                                         Placebo (n=222)
                           20%

                           10%

                           0%
                                   0     ≥1       ≥2       ≥3       ≥4         ≥5        ≥6         ≥7        ≥8         ≥9       ≥10 ≥11                12
                                                Number of Migraine-Free Study Months

                                 *Defined as 28 consecutive days without migraine during a study month, with the first day of dosing used as the reference point.

      Winner P. et. al., Migraine-Free Months in Patients With Episodic or Chronic Migraine Treated With Eptinezumab: Results From the PROMISE-1 and PROMISE-2 Trials. Poster Presentation at the American Headache
      Society (AHS) 2019 Annual Meeting. July 11-14, 2019; Philadelphia, PA.

                                              Investor Presentation - Eptinezumab is an investigational product and has not been approved by the FDA or any other regulatory body.                                    34
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