1. Ipsos*Vantis Weight Loss Research
Results and Commentary on Three Pipeline Drugs
Lorcaserin | Qnexa | Contrave
© 2010 Ipsos• [name of the entity issuing the document]. All rights reserved. Contains Ipsos' Confidential and
December 9, 2010 Proprietary information and may not be disclosed or reproduced without the prior written consent of Ipsos. Nobody’s Unpredictable

2. Obesity Analytical Group
Tom Young- Vice President, Healthcare
Office: 973.658.1686
Mobile: 201.755.6096
tom.young@ipsos.com
Bob Shekhdar - Senior Consultant
Office: 203.329.8756
Mobile: 203.559.7620
bob.shekhdar@ipsos.com
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3. Disclaimer
The following presentation has been prepared by analysts at Ipsos Vantis.
The information contained herein is based on research data collected by
Ipsos Vantis and other secondary, non-company affiliated sources and is
believed, but not guaranteed, to be accurate.
The presentation is for informational purposes only and nothing in this
presentation constitutes a representation of the accuracy of any forecast or
market prediction, nor does it recommend taking any action in regard to the
public companies named in the presentation. No representation or warranty,
either express or implied, is provided in relation to the accuracy,
completeness or reliability of the information contained herein nor is it
intended to be a complete statement or summary of the companies, markets
or drug developments referred to in the presentation. The analysis contained
herein is based on numerous assumptions. Different assumptions could
result in materially different results.
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4. Ipsos Overview
Ipsos-Vantis Ipsos-Novaction
Forecasting, modeling and consulting for Rx Forecasting, modeling and consulting for
drugs, B2B medical devices and personal FMCG & OTC drugs
health care – as well as durable products,
services & non-medical B2B
Health
Ipsos-ASI
Qualitative & Quantitative research for
Advertising testing and brand health Pharmaceutical industry
Ipsos-Public Affairs
Public opinion
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5. About Ipsos*Vantis
 Vantis Health is a group of specialists who predict the business impact of
marketing decisions and market events
 We reliably link research results to ROI to help clients make the right
strategic and tactical decisions
 …on a global basis and in the context of changing market conditions
 Vantis originated with BASES for the purpose of extending CPG models
 Categories
 Target audience
 Marketing channels (direct, medical, Internet etc)
 Influencers (medical professionals, patients on professionals)
 Product, pricing and positioning optimization, as well as marketing plan
simulation
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6. Setting the Stage
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7. “Corpulence is not only a disease itself, but the harbinger of others”
… Hippocrates
 Pharmaceutical companies have made efforts to develop Rx meds for
weight loss, but with such limited success then with Meridia’s withdrawal
this year, only Xenical remains on the market as an approved drug for long-
term use.
 The current market is dominated by generic phentermine, approved only
for short-term use, and is a controlled substance.
 Doctors are enthusiastic about the pipeline medications, but frustrated that
they currently have so few options.
 Bariatric surgery – currently popular and very effective, but expensive,
demonized by payors, and only a solution for a very slim group of
obese patients
 OTC Meds (alli – low dose Xenical)
 Diet and Exercise - great advice, outcomes good when followed,
seldom followed
 Liposuction
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8. Timeline: FDA and Weight Loss Drugs
J&J tests topiramate, an Vivus submits NDA
epilepsy / migraine headache Pfizer and Merck in for Qnexa
Pharma Companies
drug, in weight loss trials clinical trials to Sanofi-Aventis
develop CB-1 withdraws Zimulti Orexigen
blockers (rimonabant) NDA NDA for
Antidepressant Wellbutrin Contrave
(buproprion), in weight loss
clinical trials. J&J discontinues Arena
Topomax (topiramate) Merck, Abbott
Pfizer stop NDA for
weight-loss trials withdraws
CB-1 trials lorcaserin
Meridia
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010
FDA gives OTC approval Advisory Panel vote splits
FDA forms Obesity for low-dose orlistat (alli) 5-5 on Meridia withdrawal
Task Force
FDA says lorcaserin
FDA asks Abbott to and Qnexa “Not
FDA
FDA rejects Zimulti
withdraw Meridia approvable in
(rimonabant) NDA due to
(sibrutamine) from present form”
psychological side effects
US market
FDA 12/7 Advisory Committee voted
for approval of Contrave
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9. Wall Street Opinion on Weight Loss Drug Market
“Obesity is an epidemic; mortality escalates
with weight; the cost-effectiveness argument is
“We see a significant market opportunity in easy; the market is enormous. Hence, no one
obesity, although this remains controversial argues a good drug would not be a mega-
among investors. We believe the lack of blockbuster. The FDA remains a formidable
historical commercial success for obesity hurdle.”
Jefferies and Company, 2/10
drugs has been a function of poor efficacy and
intolerable side effects, both of which can be
addressed by lorcaserin's profile.” “We believe Qnexa would satisfy a significant
Jefferies and Company, 12/09
unmet need -- an extremely effective weight
loss medication that does not require behavior
modification.”
Jessup & Lamont 2/2010
“The FDA is highly unlikely to approve Qnexa
on the heels of the Meridia withdrawal without
requesting a thorough cardiovascular safety “While our view that lorcaserin may have the
trial for Qnexa.” best shot at approval among the late-stage
Cowen & Company, 10/10 obesity drug candidates – as we described
following the Qnexa panel – is unchanged, we
are no longer comfortable with the near-term
risk/reward. As such, we are downgrading
ARNA to Neutral.”
JP Morgan 8/10
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10. Understanding the obesity market from multiple
viewpoints
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11. One Concern – Is the FDA “out-of-sync?”
Stakeholder Quick Facts/Evidence Enthusiasm
for New Rx
Meds
Patients/Society  74% of Americans are overweight or obese (Forbes, 2007) High
 The WHO says that obesity will eclipse undernutrition and
infectious disease as the number one world health problem
Physicians  The focus of this presentation – extremely enthusiastic about Very High
having something to offer obese patients
Drug Manufacturers  Many large companies have de-emphasized weight loss, with High/Varied
pipelines oriented around cancer, biologicals, CNS and other
drugs that have a high unit cost.
The Investment  Generally aware of massive patient size, but analysts tend to be Varied
Community very enthusiastic, or at the opposite extreme
Managed Care  We suspect that pharmacoeconomic benefit will eventually sway Moderate
payors in favor of these drugs, but patient volume suggests that
getting on formulary will be an uphill battle initially.
Other businesses  No worries for this group. These medications are all taken as part Medium-High
taking part in the of regimens, which always include diet and exercise. In fact, we
$150 Billion Weight note that structured diet program participants are very likely to
Loss Industry take prescription pharmaceuticals.
The FDA/Regulatory  FDA action of this week was surprising. We earlier questioned Medium-low
Community whether “societal need” was being considered. Wait and see
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12. Recent and Current Obesity R&D by Major
Pharmaceutical Companies
 Contrary to some opinions major pharmaceutical companies have not
walked away from researching drugs for obesity and weight management
R&D Compound Manufacturer Clinical Trial Stage
BMS-830216 Bristol-Myers Squibb Phase 1, 2
‘2-0453 Novo Nordisk Phase 1,2
GSK-1521498 GlaxoSmithKline Phase 2
PF-04620110 Pfizer/Bristol-Myers Phase 1
Velneperit (S-2367) Shionogi Phase 2
Exenatide Amylin/Eli Lilly Phase 4
Pramlintide+Metreleptin Amylin/Takeda Phase 2
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13. Physician Obesity Study Findings and Implications
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14. Obesity Drugs - Study Design
Country  USA
Dates of Fieldwork  Summer, 2010
Data Collection Method  Online
 JPEG
Concept Specs
 1 pg
Sample Size  N=1500 (> 125 exposures per concept)
 General Practice Physicians, in practice between 2
and 35 years, Endocrine and Cardiac subspecialties
Sample Definition
included, geographically dispersed.
 Internet access
 Sequential monadic survey
Exposure Method  3 concepts per respondent
 Test concept exposure rotated to avoid order bias
Length of Survey  15 minutes
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15. Profiles: Investigational drugs with proposed indications for
treatment of obesity
Lorqess
(possible TM Qnexa Contrave
for lorcaserin)
Orexigen
Manufacturer Arena Pharma Vivus
Therapeutics
U.S.
Commercialization Eisai None announced Takeda
Partner
Fixed-dose combo of Fixed-dose combo of
Lorcaserin
Formula hydrochloride
generic phentermine and generic bupropion
topiramate and naltrexone
Four dosage strengths for
Maintenance dose
titration. Maximum
after titration - 8mg
Single 10mg maintenance dose - 15 mg
Dosing tablet, BID
naltrexone + 90 mg
phentermine + 92 mg ER
bupropion , 2 ER
topiramate, Single capsule,
tablets, BID
QD
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16. Percent of patients treated for obesity for whom the drug is
appropriate
 Physicians mention that lorcaserin and Contrave would be appropriate for
about one-half of their obesity patients.
100%
80%
60% 52%
47%
Patients for whom
39%
40% drug would be
appropriate
20%
0%
Lorcaserin Qnexa Contrave
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Year
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17. Comparisons to currently available medications to treat obesity
 Lorcaserin is most thought of as a break-through treatment.
 Qnexa is viewed as most similar to existing medications (phentermine and
topiramate).
100%
15% Is a breakthrough new
22%
treatment
80% 41%
60% Offers some
66% improvement compared
71% to existing medications
40%
52%
Similar to existing
20% medications and does
18% not offer any meaningful
6% 7% improvement
0%
Lorcaserin Qnexa Contrave
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18. Time to make drugs a standard therapy
 The overwhelming majority of physicians state that they would make any of
the drugs a standard therapy within two years.
100% 92%
86%
80% 72%
35% Less than 2 years
32%
60%
34%
Between 1-2 years
40%
54% 57% Less than 1 year
20% 38%
0%
Lorcaserin Qnexa Contrave
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Year
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19. Key measures suggest that lorcaserin has a high likelihood of
achieving in-market success
 The product scores in the top 20% of norms on key measures such as
prescribing intent, uniqueness and need fulfillment.
Lorcaserin Key Measure Scorecard
Bottom 20 Below Above Top 20
Percentile Average Average Average Percentile
Seek Information
85%
(Top Two Box %)
Prescribe Intent
27%
(Top Box %)
Prescribe Intent, When Asked
70%
(Top Two Box %)
New and Different
3.9
(Mean 5-Point Scale)
Need Fulfillment
71%
(Top Two Box %)
Believability
20%
(Top Box %)
Scores compared to Vantis norms for over 500 similar and relevant products
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Year
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20. If approved, key measures indicate an average probability of
market success for Qnexa
 Most key measures fall in the middle of the range of normative scores
when compared to the Vantis new product data base.
Qnexa Key Measure Scorecard
Bottom 20 Below Above Top 20
Percentile Average Average Average Percentile
Seek Information
74%
(Top Two Box %)
Prescribe Intent
(Top Box %)
19%
Prescribe Intent, When Asked
50%
(Top Two Box %)
New and Different
3.2
(Mean 5-Point Scale)
Need Fulfillment
56%
(Top Two Box %)
Believability
22%
(Top Box %)
Scores compared to Vantis database of norms for over 500 similar and relevant products
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21. Contrave is very well-placed to enter the market
 With almost all key measures falling in the top quintile, when
compared to Vantis’ norms, we expect that Contrave will achieve
market success if approved.
Contrave Key Measure Scorecard
Bottom 20 Below Above Top 20
Percentile Average Average Average Percentile
Seek Information
87%
(Top Two Box %)
Prescribe Intent
28%
(Top Box %)
Prescribe Intent, When Asked
76%
(Top Two Box %)
New and Different
3.7
(Mean 5-Point Scale)
Need Fulfillment
66%
(Top Two Box %)
Believability
28%
(Top Box %)
Scores compared to Vantis database of norms for over 500 similar and relevant products
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Year
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22. Key Measures Summary
 All three drugs have a reasonable chance of success if approved by the
FDA.
Summary Key Measure Scorecard
Bottom 20 Below Above Top 20
Percentile Average Average Average Percentile
Seek Information
Q L C
(Top Two Box %)
Prescribe Intent
Q L,C
(Top Box %)
Prescribe Intent, When Asked
Q L,C
(Top Two Box %)
New and Different
Q L,C
(Mean 5-Point Scale)
Need Fulfillment
Q L,C
(Top Two Box %)
Believability
L Q C
(Top Box %)
Scores compared to Vantis database of norms for over 500 similar and relevant products
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Year
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23. Ipsos Vantis Forecast Ranges
 Forecasts made during summer of 2010 - before Advisory Committee
meetings and FDA review of NDAs
 Assumes that manufacturers partner with large pharma company for U.S,
commercialization.
 Our order of entry assumptions have changed.
800 760
700 Annual U.S. sales
590 (retail) within 5 years
600 520 of launch
Millions of Dollars
500 570
400
440
300 390
200
100
0
Lorcaserin Qnexa Contrave
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24. What does the future hold?
 Based on our research with doctors, we predict an overall market more accepting of Rx
pharmaceutical solutions to weight loss – even in the case where there is a more severe risk
profile. This is based on our recent research of physicians.
 In the future, all doctors will ask themselves when suggesting diet and exercise if it will be
effective and if it is enough for the patient in question.
 It is very possible that some drugs will havel limiting labeling (indication for BMI > 32), or a
very serious co-morbidity.
 But the larger societal/public health issue can only partially be met with such solutions – and
as with bariatric surgery, the Rx approach is never going to be a broad solution for a wide
percentage of patients.
 The FDA seems to be evaluating the new entrants on merits and meeting the public need
halfway with the actions of the last few days
 While we think all marketers and strategists in the Rx industry should be ready to think about
obesity agents, the top pharmaceutical companies are not in this category now, have
definitely made strategic decisions in this regard, and we won’t see them back for at least five
years, based on the pipeline.
 As stated, we see Lorcaserin, Qnexa and Contrave entering the market and in general being
quite successful, based on good/superior physician reaction.
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