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Ventrus Biosciences Inc (VTUS)
                                                                    ®
                                                                                 RAISING TARGET PRICE                                                   Michael J Higgins
                                                                                                                                                              212-430-1784
                                                                                                                                                       mhiggins@rodm.com
                                                                                 LIFE SCIENCES

May 3, 2011                      Market Outperform / Aggressive Risk
       FDA’s agrees on iferanserin's endpoints; Raises our price target from $12 to $25.

MARKET DATA                                                          5/2/2011              Like a blowout Super Bowl, the FDA may not want to stick around
Price                                                              $17.00                  for the second half. After the close yesterday, Ventrus announced that
Exchange                                                         NASDAQ                    the FDA determined that a seven day treatment arm should be included
Target Price                                                       $25.00                  in the previous plans to dose the company’s novel 0.5% iferanserin
52 Wk Hi - Low                                              $17.51 - $5.75                 cream for fourteen days in a placebo-controlled Phase 3 trial. Given that
Market Cap(MM)                                                     $122.2                  the iferanserin cream has shown statistical efficacy in three days, it
EV(MM)                                                             $109.5                  appears that the FDA would like to see if this intra-anal cream can work
Shares Out (MM)                                                        7.2                 when dosed for seven days instead of fourteen days. Similar to the
Avg. Daily Vol                                                     46,032                  FDA’s proposal earlier this year, we see this proposal as one which
Short Interest                                                     33,210
                                                                                           improves the value of this program. Specifically, if the seven day arm
BALANCE SHEET METRICS                                                                      becomes the recommended labeling it not only increases iferanserin’s
Cash (MM)                                                                      $14.6
                                                                                           pricing power but gathers increased revenues from the patients that
LTD (MM)                                                                        $0.0       keep applying the intra-anal cream for more than seven days. To be
Debt/Capital                                                                     NA        clear, we expect the company will price the product for its clinical benefit,
Cash/Share                                                                     $2.16       not based on a pre-determined CGS ratio.
Book Value(MM)                                                                   NA
Book Value/Share                                                               $1.72
                                                                                           No change to “game time”… results are expected in less than 12
EARNINGS DATA ($)                                                                          months. We recall that when the S-1 was filed in late 2010 that
FY - Dec                          2010A               2011E                   2012E        management had mentioned an increase in clinical site requests for
Q1 (Mar)                                --             (0.36)                       --     inclusion in the iferanserin Phase 3 trial. Investors should recall that
Q2 (Jun)                                --             (0.47)                       --     there are roughly four million physician visits annually for hemorrhoid
Q3 (Sep)                                --             (0.42)                       --     therapy despite no FDA approved product… which translates to pent-up
Q4 (Dec)                                --             (0.44)                       --     physicians and patient demand. Therefore, we believe management will
Full Year EPS                      (2.13)              (1.69)                  (1.88)      have little trouble opening up more sites to accommodate the 50%
Revenue (MM)                          0.0                 0.0                     0.0      increase in the number of patients to enroll in this third arm. We estimate
                                                                                           the cost at $2 to $3 million more, with cash running into Q212 instead of
VALUATION METRICS                                                                          Q312. While Ventrus is conservative with their capital (burning <$1
Price/Earnings                         NM                  NM                    NM        million per month in 2011), we believe investors are primarily focused on
EV/Revenue                                                                                 the value for Ventrus’ clinical stage assets, including their revenue
Y/Y EPS Growth                  108.8%                     NM                 11.2%        potential and the clinical/regulatory risk in reaching the market. While the
                                                                                           fourteen day arm is more likely to demonstrate a clinical benefit over the
INDICES                                                                                    seven day arm, we believe management will only need to take the
DJIA                                                                    12,807.4           fourteen day arm forward to the confirmatory Phase 3 trial (scheduled to
SP-500                                                                   1,361.2           start 2H12), which keeps the remaining $20 million budget untouched
NASDAQ                                                                   2,404.2           and on track.
NBI                                                                      1,124.0
                          1 Year Price History
                                                                                           We maintain our Market Outperform rating and increase our Price
                                                                                      18   Target from $12 to $25. As noted in our initiation report, we had
                                                                                      15
                                                                                      12   attributed a 40% discount rate in reaching our price target to account for
                                                                                      9
                                                                                      6
                                                                                           the “first to NDA” assets that supported our price target. With the FDA
 Q3                                              Q1                              Q2
                                                                                      3    agreeing to “the definition of the primary and secondary endpoints that
                   2011
                                                                                 0.25      had been proposed and with the basic design elements of the study”,
                                                                                 0.2
                                                                                 0.15
                                                                                 0.1
                                                                                           along with the improved risk profile from these two proposed trial design
                                                                                 0.05
                                                                                 0
                                                                                           changes, we believe it is appropriate to reduce the risk in the company
                                                      Created by BlueMatrix
                                                                                           reaching our financial projections from 40% to 35%. We continue to
                                                                                           model a 22.5% royalty rate on iferanserin and diltiazem sales. On
                                                                                           estimated 2017 royalty revenues of $90 million producing a diluted EPS
                                                                                           forecast of $4.27 we place a PE of 35x to account for the growth rate
                                                                                           during that period to reach our $25.00 price target.




For definitions and the distribution of analyst ratings, and other disclosures, please refer to pages 9 - 10 of this report.
Ventrus Biosciences Inc                                                                                                                                   May 3, 2011




            FDA  has  offered  two  notable  proposals  this  year.    
              
            The   current   management   team   has   been   dutifully   meeting   with   the   FDA   regarding   the   Phase   3   trial  
            design  in  anticipation  of  starting  the  first  Phase  3  trial  around  mid-­year  2011.  Since  the  beginning  of  the  
                                                                                                                                            th
            year,  the  company  has  offered  clarity  regarding  the  ongoing  discussions  with  the  FDA.  On  March  18   the  
            company   reported   that   the   FDA   has   proposed   a   change   in   the   definition   of   the   Primary   endpoint.   From  
                                                                             nsecutive  days,  the  FDA  proposed  the  endpoints  noted  
            in  Exhibit  1.  Using  the  121  patient  Phase  2/3  study  conducted  in  Germany  on  Grade  I  to  III  patients  by  the  
            original  sponsor,  the  chance  that  the  upcoming   Phase  3  trials   would  succeed  increased,  as  the  p-­value  
            changed   from   p<0.01   to   p<0.0001   as   the   primary   endpoints   changed.   Yesterday,   the   company  
            announced  that  the  FDA  has  proposed  adding  a  third  arm  to  the  trial,  one  which  includes  patients  being  
            dosed  for  seven  days  with  active  drug  and  seven  days  with  a  placebo  cream  (see  Exhibit  1  again).  While  
            there  is  no  German  data  to  leverage  for  insights  into  how  this  design  change  could  impact  the  outcome  of  
            the  upcoming  Phase  3  trials,  we  can  speculate  that  lower  dosing  can  translate  to  lower  efficacy.  Given  the  
            p-­value   of   0.0001   for   the   14   day   endpoint   (57%   versus   20%,   almost   a   3x   difference)   and   the   greater  
            separation  of  the  curves   at  day  seven  than   at   day  14,   we   believe  Ventrus   has   breathing  room  to  reach  
            this  primary  endpoint  at  seven  days  (see  Exhibits  4,  5  &  6).  As  outlined  in  our  February  initiation  report  we  
            believe  the  safety  profile  of  this  acute  dosed,  topical  5HT-­3  cream  with  low  bioavailability  will  be  excellent.  
                                                                                                                             e  should  be  low.  
                                                                                                                                   
              
              
            Exhibit  1                                                                                      
            Primary:  Proportion  of  patients  with  cessation  of  bleeding  by  the  end  of  Day  7  that  persists  for  the  remainder  of  the  
            treatment  period  (through  Day  14);;  and  
            Key  Secondary:  Proportion  of  patients  with  cessation  of  pain  and/or  itching  by  the  end  of  Day  7  that  persists  for  the  
            remainder  of  the  treatment  period  (through  Day  14).  
              
            Arm  1:  placebo  ointment  twice  daily  intra-­anally  for  2  weeks;;  
            Arm  2:  Iferanserin  ointment  twice  daily  for  2  weeks;;  and  
            Arm  3:  Iferanserin  ointment  twice  daily  for  1  week  followed  by  placebo  ointment  twice  daily  for  1  week  
            Sources:  Ventrus  Biosciences,  Inc  and  Rodman  &  Renshaw  estimates.  
              
              
              
            During  the  development  stage,  pricing  is  elastic  
              
            We  expect  Ventrus  will  price  iferanserin  cream  based  on  the  outcome  of  the  course  of  therapy  and  will  in  
            no  way  be  impacted  by  which  study  duration  will  move  ahead  into  the  second  Phase  3  trial.  So,  if  the  one  
            week  arm  is  equally  or  more  effective  than  the  two  week  arm  we  expect  the  one  week  arm  to  get  clinical  
            and   regulatory   green   light   to   move   ahead.   This   would   not   cut   our   pricing   assumptions   in   half.   On   the  
            contrary,  a  shorter  treatment  that  demonstrates  some  residual  improvement  with  continued  dosing  could  
            cause  us  to  add  a  row  in  our  models  to  account  for  those  patients  taking  more  than  one  week  of  dosing.  
            For   example,   if   results   suggest   that   one   week   dosing   is   the   preferred   regimen   yet   a   third   of   patients  
            appear  to  benefit  from  another  week,  or  two,  we  would  increase  our  revenue  estimates  by  a  third  or  two-­
            thirds.    
              
                                                                                     th
            This   trial   design   change   reminds   us   of   the   March   18    announcement   in   which   the                        clinical  
            endpoints  added  value  to  VTUS.  Here,  the  one  week  arm  not  only  offers  higher  annual  revenues  for  the  
            one-­time   upfront   cost   of   a   200   patient   14   day   arm   but   we   would   expect   the   one   week   dosing   would  
                                                                                              rin  cream.  As  noted  in  Exhibit  2,  we  expect  

            hemorrhoid  patients  that  are  more  sensitive  to  compliance  factors  than  the  more  severe  patients.  Seven  
            day   therapy   not   only   reduces   any   safety   risk,   but   the   efficacy   drop   may   be   overcome   by   the   increased  

                                                                                                should  be  scoring  in  the  years  ahead.    




RODMAN & RENSHAW EQUITY RESEARCH                                                                                                                                   2
Ventrus Biosciences Inc                                                                                                                                     May 3, 2011




              
            Exhibit  2:  Peak  iferanserin  revenue  estimate  
                 F our  G rades   of  hem orrhoids                                I             II            III           IV           T o ta l
                 E s tim ated  s hare  of  4.2  m illion,  by   G rade          40%           30%           20%            10%             na
                 E s tim ated  perc ent  on  iferans erin,  by   G rade         15%           40%           80%            90%           43%
                 N um ber  on  iferans erin  (in  m illions )                  0.252         0.504          0.672         0.378          1.806
                A t  $300/y ear,  projec ted  iferans erin  revenues            $76           $151          $202           $113          $542         
            Source:  Rodman  &  Renshaw  estimates  
              
              
              
                                
              
            We  believe  the  company  and  the  FDA  need  to  agree  on  the  statistical  methods  underpinning  the  relative  
            value  of  the  

            inclusion   of   the   third   arm   in   a   placebo   controlled   trial   directs   the   company   towards   a   pre-­specified  
            statistical   method.   From   our   understanding,   this   can   be   determined   before   the   clinical   trial   data   is  
                                                                                                                                                  -­
            recruited  sites  with  the  news  that  they  can  include  more  patients  in  the  trial,  we  believe  the  company  will  
            meet   with   the   FDA   to   gain   some   clarity   on   this   new   issue,   a   determination   of   the   statistical   methods   to  
            measure  efficacy   in  this  new,  three-­arm  trial.  We  summarize  our  opinion  of  the  value  of  this  SPA   in  the  
            next  section.    
              
              
                                                                     
              
            At   this   stage   we   believe   it   is   important   to   remind   ourselves   and   investors   that   we   might   be   taking  
                                                                                 et  cap  is  just  north  of  $100  million  with  enough  cash  to  

            2012,  the  value  of  the  company  
            mean   that   it   shows   an   efficacy   advantage   over   the   placebo   cream   with   no   real   safety   concerns.   We  
            believe  larger  partners  are  likely  to  come  running  and  generate  a  bidding  war,  regardless  of  the  SPA  or  
            potential   need   to   repeat   this   first   Phase   3  

            pharma  is  interested  (and  we  believe  several  GI-­                                        will  take  a  deep  dive  in  12  
            months),   they   would   have   little   difficulty   in   embarking   on   a   $50+   million   trial   program   to   confirm  

            keeping  our  feet  on  the  floor  and  recognizing  the  bird  in  the  hand,  we  believe  the  ongoing  back-­and-­forth  
            meetings   with   the   FDA   ha                                                          currently   planned   pivotal   trial  
            design.    
              
              
            Key,  material  iferanserin  events  
              
            We   look   forward   to   the   peer-­reviewed   publication   of   the   German   study   and   further   details   of   the  
            bioavailability  of  iferanserin.  We  believe  the  low  systemic  absorption  and  wide  inter-­patient  variability  will  
                                                                                                                                 claiming  
            bioequivalency  to  the  reference  listed  drug.  Regardless  of  the  outcome  of  the  battle  between  ViroPharma  

            suggestive   that   there   will   continue   to   difficulty   for   ANDA   filers   to   gain   approval   without   running   clinical  
            trials.  And  finally,  we  look  forward  to  the  start  of  the  first  Phase  3  iferanserin  trial  this  summer.    
              
              




RODMAN & RENSHAW EQUITY RESEARCH                                                                                                                                     3
Ventrus Biosciences Inc                                                                                                                May 3, 2011




              
            Exhibit  3:  Valuation  matrix  
                                                                            D isco u n t  ra te
                                              20%      25%          30%            35%             40%      45%      50%
                                        15   $21.80   $17.07       $13.49         $10.75          $8.65    $7.00    $5.72
                                        20   $29.07   $22.75       $17.98         $14.34          $11.53   $9.34    $7.62
                                        25   $36.34   $28.44       $22.48         $17.92          $14.41   $11.67   $9.53
                          M u ltip le




                                        30   $43.60   $34.13       $26.97         $21.51          $17.29   $14.01   $11.43
                                        35   $50.87   $39.82       $31.47         $25.09          $20.17   $16.34   $13.34
                                        40   $58.14   $45.51       $35.97         $28.68          $23.06   $18.68   $15.24
                                        45   $65.41   $51.20       $40.46         $32.26          $25.94   $21.01   $17.15
                                50     $72.67           $56.89      $44.96       $35.85           $28.82   $23.35   $19.05     
            Sources:  Ventrus  Biosciences,  Inc  and  Rodman  &  Renshaw  estimates.  
              
              
            Exhibit  4:  Cessation  of  bleeding  




                                                                                                                                    
            Source:  Ventrus  Biosciences  and  Rodman  &  Renshaw  estimates  
              




RODMAN & RENSHAW EQUITY RESEARCH                                                                                                                4
Ventrus Biosciences Inc                                                                May 3, 2011




              
            Exhibit  5:  Cessation  of  pain  




                                                                                    
            Source:  Ventrus  Biosciences  and  Rodman  &  Renshaw  estimates  
              
              
            Exhibit  6:  Cessation  of  itching  




                                                                                    
            Source:  Ventrus  Biosciences  and  Rodman  &  Renshaw  estimates  
              




RODMAN & RENSHAW EQUITY RESEARCH                                                                5
Ventrus Biosciences Inc                                                                                                                                                   May 3, 2011




              
            Exhibit  7:  Key  events  in  the  development  of  iferanserin.    
            11/91                                    IND  filed  by  investigator    
            1992                                     Method  of  use  patent  filed  by  Sam  Amer,  PhD  (former  Dir  of  R&D,  BMS)    
            1/14//94                                 IND  transferred  to  Sam  Amer  &  Co  
            7/14/98                                  Composition  of  matter  patents  granted  on  S-­isomer  by  Dr.  Amer    
            1998                                     Licensed  Japanese  rights  to  Tsumura  &  Co.  
            1998  &  1999                            Tsumura  &  Co  conducted  pharmacology  studies:  one  single  dose  in  18  healthy  patients  and  six  
                                                     receiving  the  1%  dose  for  six  days  (S-­isomer)  
            2002  &  2003                            Sam  Amer  &  Co  conducted  a  non-­pivotal  Phase  3  study  in  Germany  
            2/28/03                                  Tsumura  returned  Japanese  rights  to  Sam  Amer  after  running  two  Phase  1  and  two  Phase  2  trials    
            2003                                     Novartis  in-­licensed  the  rights,  improved  the  manufacturing  process,  ran  toxicology  and  metabolite  
                                                     studies    
            2005                                     Novartis  returned  rights  to  Sam  Amer  after  the  GI  franchise  was  marginalized  
            2/5/08                                   Amer  and  Ventrus  held  an  end-­of-­Phase  2  meeting  with  FDA  
            3/17/08                                  Ventrus  in-­licensed  exclusive  WW  rights  to  topical  forms  of  iferanserin  from  Sam  Amer  
            6/08                                     Filed  SPA,  process  not  completed  due  to  lack  of  funding    
            3/10                                     Filed  new  SPA  submission;;  clarified                                                
            May  -­                                  Communication  with  FDA  on  SPA  filing:  definition  of  PE,  how  to  assess  itching,  pain  &  recurrence,  
                                                     etc  
            8/23/10                                                                                                                                     
            10/28/10                                 Officially  filed  SPA  submission  based  on  the  recent  FDA  discussions    
            2/1/11                                   Completes  hiring  of  Clinical  Development  staff  
            3/3/11                                                                                                          
            6/11                                     Expected  completion  of  SPA  process  
                                                              st
            Q311                                     Start  1   Phase  3  study  
            2H11                                     Start  dose-­ranging  carcinogenicity  program  
            2H11                                     First  publication  of  the  Phase  2/3  German  study  
                                                                     st
            Q112                                     Data  from  1   Phase  3  study  
            1H12                                     Start  carcinogenicity  program  
            Mid-­12                                  Potentially  secure  North  American  marketing  partner  
            2H12                                     Start  drug  interaction  studies  
            2H12                                     Start  thorough  QT  study  
                                                              nd
            2H12                                     Start  2   Phase  3  study  
                                                                     nd
            YE13                                     Data  from  2   study  
            Mid-­14                                  Data  from  carcinogenicity  studies  
            2014                                     Potential  start  of  life  cycle  extension  products:  combinations  with  steroids,  etc.    
            2H14                                     File  NDA  
            2H15                                     FDA  approval  &  launch  
            8/7/15                                                                     -­isomer)  
            1/23/18                                                        expires  (S-­isomer)  
            2H20                                     5  year  Hatch-­Waxman  NCE  protection  expires  
            2030                                     If  granted,  the  dose-­range  patent  (0.5%)  expires  
              Source:  Ventrus  Biosciences  and  Rodman  &  Renshaw  estimates  




RODMAN & RENSHAW EQUITY RESEARCH                                                                                                                                                   6
Ventrus Biosciences Inc                 May 3, 2011




              




                                     
              




RODMAN & RENSHAW EQUITY RESEARCH                 7
Ventrus Biosciences Inc                 May 3, 2011




                                     




RODMAN & RENSHAW EQUITY RESEARCH                 8
Ventrus Biosciences Inc                                                                                                                   May 3, 2011




 RODMAN & RENSHAW RATING SYSTEM: Rodman & Renshaw employs a three tier rating system for evaluating both the potential
 return and risk associated with owning common equity shares of rated firms. The expected return of any given equity is measured on a
 RELATIVE basis of other companies in the same sector, as defined by First Call. The price objective is calculated to estimate the potential
 movement in price a given equity could achieve given certain targets are met over a defined time horizon. Price objectives are subject to
 exogenous factors including industry events and market volatility. The risk assessment evaluates the company specific risk and accounts
 for the following factors, maturity of market, maturity of technology, maturity of firm, cash utilization, and valuation considerations.
 Potential factors contributing to risk: relatively undefined market, new technologies, immature firm, high cash burn rates, intrinsic value
 weighted toward future earnings or events.


 RETURN ASSESSMENT
         ●
                Market Outperform (Buy): The common stock of the company is expected to outperform a passive index comprised of all the
                common stock of companies within the same sector, as defined by First Call.
         ●
                Market Perform (Hold): The common stock of the company is expected to mimic the performance of a passive index comprised
                of all the common stock of companies within the same sector, as defined by First Call.
         ●
                Market Underperform (Sell): The common stock of the company is expected to underperform a passive index comprised of all
                the common stock of companies within the same sector, as defined by First Call.

 RISK ASSESSMENT
         ●
                Speculative - The common stock risk level is significantly greater than market risk. The stock price of these equities is
                exceptionally volatile.
         ●
                Aggressive - The common stock risk level is materially higher than market level risk. The stock price is typically more volatile
                than the general market.
         ●
                Moderate - The common stock is moderately risky, or equivalent to stock market risk. The stock price volatility is typically in-line
                with movements in the general market.




                      Rating and Price Target History for: Ventrus Biosciences Inc (VTUS) as of 05-02-2011

     02/02/11
     I:MO:$12

                                                                                                                             18

                                                                                                                             15

                                                                                                                             12


                                                                                                                             9

                                                                                                                             6

                                                                                                                           3
    Q1           Q2       Q3              Q1      Q2      Q3               Q1      Q2      Q3                 Q1         Q2
                                 2009                              2010                            2011




                                                                                                     Created by BlueMatrix



 RATING SUMMARY
                                               Distribution of Ratings Table
                                                                                                 IB Serv./Past 12 Mos
                   Rating                                  Count            Percent             Count           Percent
   Market Outperform(MO)                                    143             57.90%                35            24.48%
   Market Perform(MP)                                       45              18.20%                 4             8.89%
   Market Underperform(MU)                                    8              3.20%                 0             0.00%
   Under Review(UR)                                          51             20.60%                16            31.37%
   Total                                                    247              100%                 55             100%

RODMAN & RENSHAW EQUITY RESEARCH                                                                                                                       9
Ventrus Biosciences Inc                                                                                                            May 3, 2011


 Investment Banking Services include, but are not limited to, acting as a manager/co-manager in the underwriting or placement of
 securities, acting as financial advisor, and/or providing corporate finance or capital markets-related services to a company or one of its
 affiliates or subsidiaries within the past 12 months.


 ADDITIONAL DISCLOSURES
 Rodman & Renshaw, LLC. (the "Firm") is a member of FINRA and SIPC and a registered U.S. Broker-Dealer.

 ANALYST CERTIFICATION
 I, Michael J Higgins, hereby certify that the views expressed in this research report accurately reflect my personal views about the subject
 company(ies) and its (their) securities.
 None of the research analysts or the research analyst's household has a financial interest in the securities of Ventrus Biosciences Inc
 (including, without limitation, any option, right, warrant, future, long or short position).

 As of Mar 31 2011 neither the Firm nor its affiliates beneficially own 1% or more of any class of common equity securities of Ventrus
 Biosciences Inc.

 Neither the research analyst nor the Firm has any material conflict of interest with Ventrus Biosciences Inc, of which the research analyst
 knows or has reason to know at the time of publication of this research report.
 The research analyst principally responsible for preparation of the report does not receive compensation that is based upon any specific
 investment banking services or transaction but is compensated based on factors including total revenue and profitability of the Firm, a
 substantial portion of which is derived from investment banking services.
 The Firm or its affiliates did not receive compensation from Ventrus Biosciences Inc for any investment banking services within twelve
 months before, but intends to seek compensation from the companies mentioned in this report for investment banking services within
 three months, following publication of the research report.

 Neither the research analyst nor any member of the research analyst's household nor the Firm serves as an officer, director or advisory
 board member of Ventrus Biosciences Inc.

 The Firm does make a market in Ventrus Biosciences Inc securities as of the date of this research report.

 Any opinions expressed herein are statements of our judgment as of the date of publication and are subject to change without notice.
 Reproduction without written permission is prohibited. The closing prices of securities mentioned in this report are as of May 02 2011.
 Additional information is available to clients upon written request. For complete research report on Ventrus Biosciences Inc, please call
 (212) 356-0500.
 Readers are advised that this analysis report is issued solely for informational purposes and is not to be construed as an offer to sell or
 the solicitation of an offer to buy. The information contained herein is based on sources which we believe to be reliable but is not
 guaranteed by us as being accurate and does not purport to be a complete statement or summary of the available data. Past performance
 is no guarantee of future results.




RODMAN & RENSHAW EQUITY RESEARCH                                                                                                            10

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Rodman & Renshaw - $VTUS May 2011 Update

  • 1. Ventrus Biosciences Inc (VTUS) ® RAISING TARGET PRICE Michael J Higgins 212-430-1784 mhiggins@rodm.com LIFE SCIENCES May 3, 2011 Market Outperform / Aggressive Risk FDA’s agrees on iferanserin's endpoints; Raises our price target from $12 to $25. MARKET DATA 5/2/2011 Like a blowout Super Bowl, the FDA may not want to stick around Price $17.00 for the second half. After the close yesterday, Ventrus announced that Exchange NASDAQ the FDA determined that a seven day treatment arm should be included Target Price $25.00 in the previous plans to dose the company’s novel 0.5% iferanserin 52 Wk Hi - Low $17.51 - $5.75 cream for fourteen days in a placebo-controlled Phase 3 trial. Given that Market Cap(MM) $122.2 the iferanserin cream has shown statistical efficacy in three days, it EV(MM) $109.5 appears that the FDA would like to see if this intra-anal cream can work Shares Out (MM) 7.2 when dosed for seven days instead of fourteen days. Similar to the Avg. Daily Vol 46,032 FDA’s proposal earlier this year, we see this proposal as one which Short Interest 33,210 improves the value of this program. Specifically, if the seven day arm BALANCE SHEET METRICS becomes the recommended labeling it not only increases iferanserin’s Cash (MM) $14.6 pricing power but gathers increased revenues from the patients that LTD (MM) $0.0 keep applying the intra-anal cream for more than seven days. To be Debt/Capital NA clear, we expect the company will price the product for its clinical benefit, Cash/Share $2.16 not based on a pre-determined CGS ratio. Book Value(MM) NA Book Value/Share $1.72 No change to “game time”… results are expected in less than 12 EARNINGS DATA ($) months. We recall that when the S-1 was filed in late 2010 that FY - Dec 2010A 2011E 2012E management had mentioned an increase in clinical site requests for Q1 (Mar) -- (0.36) -- inclusion in the iferanserin Phase 3 trial. Investors should recall that Q2 (Jun) -- (0.47) -- there are roughly four million physician visits annually for hemorrhoid Q3 (Sep) -- (0.42) -- therapy despite no FDA approved product… which translates to pent-up Q4 (Dec) -- (0.44) -- physicians and patient demand. Therefore, we believe management will Full Year EPS (2.13) (1.69) (1.88) have little trouble opening up more sites to accommodate the 50% Revenue (MM) 0.0 0.0 0.0 increase in the number of patients to enroll in this third arm. We estimate the cost at $2 to $3 million more, with cash running into Q212 instead of VALUATION METRICS Q312. While Ventrus is conservative with their capital (burning <$1 Price/Earnings NM NM NM million per month in 2011), we believe investors are primarily focused on EV/Revenue the value for Ventrus’ clinical stage assets, including their revenue Y/Y EPS Growth 108.8% NM 11.2% potential and the clinical/regulatory risk in reaching the market. While the fourteen day arm is more likely to demonstrate a clinical benefit over the INDICES seven day arm, we believe management will only need to take the DJIA 12,807.4 fourteen day arm forward to the confirmatory Phase 3 trial (scheduled to SP-500 1,361.2 start 2H12), which keeps the remaining $20 million budget untouched NASDAQ 2,404.2 and on track. NBI 1,124.0 1 Year Price History We maintain our Market Outperform rating and increase our Price 18 Target from $12 to $25. As noted in our initiation report, we had 15 12 attributed a 40% discount rate in reaching our price target to account for 9 6 the “first to NDA” assets that supported our price target. With the FDA Q3 Q1 Q2 3 agreeing to “the definition of the primary and secondary endpoints that 2011 0.25 had been proposed and with the basic design elements of the study”, 0.2 0.15 0.1 along with the improved risk profile from these two proposed trial design 0.05 0 changes, we believe it is appropriate to reduce the risk in the company Created by BlueMatrix reaching our financial projections from 40% to 35%. We continue to model a 22.5% royalty rate on iferanserin and diltiazem sales. On estimated 2017 royalty revenues of $90 million producing a diluted EPS forecast of $4.27 we place a PE of 35x to account for the growth rate during that period to reach our $25.00 price target. For definitions and the distribution of analyst ratings, and other disclosures, please refer to pages 9 - 10 of this report.
  • 2. Ventrus Biosciences Inc May 3, 2011 FDA  has  offered  two  notable  proposals  this  year.       The   current   management   team   has   been   dutifully   meeting   with   the   FDA   regarding   the   Phase   3   trial   design  in  anticipation  of  starting  the  first  Phase  3  trial  around  mid-­year  2011.  Since  the  beginning  of  the   th year,  the  company  has  offered  clarity  regarding  the  ongoing  discussions  with  the  FDA.  On  March  18  the   company   reported   that   the   FDA   has   proposed   a   change   in   the   definition   of   the   Primary   endpoint.   From   nsecutive  days,  the  FDA  proposed  the  endpoints  noted   in  Exhibit  1.  Using  the  121  patient  Phase  2/3  study  conducted  in  Germany  on  Grade  I  to  III  patients  by  the   original  sponsor,  the  chance  that  the  upcoming   Phase  3  trials   would  succeed  increased,  as  the  p-­value   changed   from   p<0.01   to   p<0.0001   as   the   primary   endpoints   changed.   Yesterday,   the   company   announced  that  the  FDA  has  proposed  adding  a  third  arm  to  the  trial,  one  which  includes  patients  being   dosed  for  seven  days  with  active  drug  and  seven  days  with  a  placebo  cream  (see  Exhibit  1  again).  While   there  is  no  German  data  to  leverage  for  insights  into  how  this  design  change  could  impact  the  outcome  of   the  upcoming  Phase  3  trials,  we  can  speculate  that  lower  dosing  can  translate  to  lower  efficacy.  Given  the   p-­value   of   0.0001   for   the   14   day   endpoint   (57%   versus   20%,   almost   a   3x   difference)   and   the   greater   separation  of  the  curves   at  day  seven  than   at   day  14,   we   believe  Ventrus   has   breathing  room  to  reach   this  primary  endpoint  at  seven  days  (see  Exhibits  4,  5  &  6).  As  outlined  in  our  February  initiation  report  we   believe  the  safety  profile  of  this  acute  dosed,  topical  5HT-­3  cream  with  low  bioavailability  will  be  excellent.   e  should  be  low.         Exhibit  1   Primary:  Proportion  of  patients  with  cessation  of  bleeding  by  the  end  of  Day  7  that  persists  for  the  remainder  of  the   treatment  period  (through  Day  14);;  and   Key  Secondary:  Proportion  of  patients  with  cessation  of  pain  and/or  itching  by  the  end  of  Day  7  that  persists  for  the   remainder  of  the  treatment  period  (through  Day  14).     Arm  1:  placebo  ointment  twice  daily  intra-­anally  for  2  weeks;;   Arm  2:  Iferanserin  ointment  twice  daily  for  2  weeks;;  and   Arm  3:  Iferanserin  ointment  twice  daily  for  1  week  followed  by  placebo  ointment  twice  daily  for  1  week   Sources:  Ventrus  Biosciences,  Inc  and  Rodman  &  Renshaw  estimates.         During  the  development  stage,  pricing  is  elastic     We  expect  Ventrus  will  price  iferanserin  cream  based  on  the  outcome  of  the  course  of  therapy  and  will  in   no  way  be  impacted  by  which  study  duration  will  move  ahead  into  the  second  Phase  3  trial.  So,  if  the  one   week  arm  is  equally  or  more  effective  than  the  two  week  arm  we  expect  the  one  week  arm  to  get  clinical   and   regulatory   green   light   to   move   ahead.   This   would   not   cut   our   pricing   assumptions   in   half.   On   the   contrary,  a  shorter  treatment  that  demonstrates  some  residual  improvement  with  continued  dosing  could   cause  us  to  add  a  row  in  our  models  to  account  for  those  patients  taking  more  than  one  week  of  dosing.   For   example,   if   results   suggest   that   one   week   dosing   is   the   preferred   regimen   yet   a   third   of   patients   appear  to  benefit  from  another  week,  or  two,  we  would  increase  our  revenue  estimates  by  a  third  or  two-­ thirds.       th This   trial   design   change   reminds   us   of   the   March   18   announcement   in   which   the   clinical   endpoints  added  value  to  VTUS.  Here,  the  one  week  arm  not  only  offers  higher  annual  revenues  for  the   one-­time   upfront   cost   of   a   200   patient   14   day   arm   but   we   would   expect   the   one   week   dosing   would   rin  cream.  As  noted  in  Exhibit  2,  we  expect   hemorrhoid  patients  that  are  more  sensitive  to  compliance  factors  than  the  more  severe  patients.  Seven   day   therapy   not   only   reduces   any   safety   risk,   but   the   efficacy   drop   may   be   overcome   by   the   increased   should  be  scoring  in  the  years  ahead.     RODMAN & RENSHAW EQUITY RESEARCH 2
  • 3. Ventrus Biosciences Inc May 3, 2011   Exhibit  2:  Peak  iferanserin  revenue  estimate   F our  G rades  of  hem orrhoids I II III IV T o ta l E s tim ated  s hare  of  4.2  m illion,  by  G rade 40% 30% 20% 10% na E s tim ated  perc ent  on  iferans erin,  by  G rade 15% 40% 80% 90% 43% N um ber  on  iferans erin  (in  m illions ) 0.252 0.504 0.672 0.378 1.806 A t  $300/y ear,  projec ted  iferans erin  revenues $76 $151 $202 $113 $542   Source:  Rodman  &  Renshaw  estimates             We  believe  the  company  and  the  FDA  need  to  agree  on  the  statistical  methods  underpinning  the  relative   value  of  the   inclusion   of   the   third   arm   in   a   placebo   controlled   trial   directs   the   company   towards   a   pre-­specified   statistical   method.   From   our   understanding,   this   can   be   determined   before   the   clinical   trial   data   is   -­ recruited  sites  with  the  news  that  they  can  include  more  patients  in  the  trial,  we  believe  the  company  will   meet   with   the   FDA   to   gain   some   clarity   on   this   new   issue,   a   determination   of   the   statistical   methods   to   measure  efficacy   in  this  new,  three-­arm  trial.  We  summarize  our  opinion  of  the  value  of  this  SPA   in  the   next  section.               At   this   stage   we   believe   it   is   important   to   remind   ourselves   and   investors   that   we   might   be   taking   et  cap  is  just  north  of  $100  million  with  enough  cash  to   2012,  the  value  of  the  company   mean   that   it   shows   an   efficacy   advantage   over   the   placebo   cream   with   no   real   safety   concerns.   We   believe  larger  partners  are  likely  to  come  running  and  generate  a  bidding  war,  regardless  of  the  SPA  or   potential   need   to   repeat   this   first   Phase   3   pharma  is  interested  (and  we  believe  several  GI-­ will  take  a  deep  dive  in  12   months),   they   would   have   little   difficulty   in   embarking   on   a   $50+   million   trial   program   to   confirm   keeping  our  feet  on  the  floor  and  recognizing  the  bird  in  the  hand,  we  believe  the  ongoing  back-­and-­forth   meetings   with   the   FDA   ha currently   planned   pivotal   trial   design.         Key,  material  iferanserin  events     We   look   forward   to   the   peer-­reviewed   publication   of   the   German   study   and   further   details   of   the   bioavailability  of  iferanserin.  We  believe  the  low  systemic  absorption  and  wide  inter-­patient  variability  will    claiming   bioequivalency  to  the  reference  listed  drug.  Regardless  of  the  outcome  of  the  battle  between  ViroPharma   suggestive   that   there   will   continue   to   difficulty   for   ANDA   filers   to   gain   approval   without   running   clinical   trials.  And  finally,  we  look  forward  to  the  start  of  the  first  Phase  3  iferanserin  trial  this  summer.         RODMAN & RENSHAW EQUITY RESEARCH 3
  • 4. Ventrus Biosciences Inc May 3, 2011   Exhibit  3:  Valuation  matrix   D isco u n t  ra te 20% 25% 30% 35% 40% 45% 50% 15 $21.80 $17.07 $13.49 $10.75 $8.65 $7.00 $5.72 20 $29.07 $22.75 $17.98 $14.34 $11.53 $9.34 $7.62 25 $36.34 $28.44 $22.48 $17.92 $14.41 $11.67 $9.53 M u ltip le 30 $43.60 $34.13 $26.97 $21.51 $17.29 $14.01 $11.43 35 $50.87 $39.82 $31.47 $25.09 $20.17 $16.34 $13.34 40 $58.14 $45.51 $35.97 $28.68 $23.06 $18.68 $15.24 45 $65.41 $51.20 $40.46 $32.26 $25.94 $21.01 $17.15 50 $72.67 $56.89 $44.96 $35.85 $28.82 $23.35 $19.05   Sources:  Ventrus  Biosciences,  Inc  and  Rodman  &  Renshaw  estimates.       Exhibit  4:  Cessation  of  bleeding     Source:  Ventrus  Biosciences  and  Rodman  &  Renshaw  estimates     RODMAN & RENSHAW EQUITY RESEARCH 4
  • 5. Ventrus Biosciences Inc May 3, 2011   Exhibit  5:  Cessation  of  pain     Source:  Ventrus  Biosciences  and  Rodman  &  Renshaw  estimates       Exhibit  6:  Cessation  of  itching     Source:  Ventrus  Biosciences  and  Rodman  &  Renshaw  estimates     RODMAN & RENSHAW EQUITY RESEARCH 5
  • 6. Ventrus Biosciences Inc May 3, 2011   Exhibit  7:  Key  events  in  the  development  of  iferanserin.     11/91                 IND  filed  by  investigator     1992                                   Method  of  use  patent  filed  by  Sam  Amer,  PhD  (former  Dir  of  R&D,  BMS)     1/14//94                           IND  transferred  to  Sam  Amer  &  Co   7/14/98                   Composition  of  matter  patents  granted  on  S-­isomer  by  Dr.  Amer     1998                                 Licensed  Japanese  rights  to  Tsumura  &  Co.   1998  &  1999             Tsumura  &  Co  conducted  pharmacology  studies:  one  single  dose  in  18  healthy  patients  and  six   receiving  the  1%  dose  for  six  days  (S-­isomer)   2002  &  2003   Sam  Amer  &  Co  conducted  a  non-­pivotal  Phase  3  study  in  Germany   2/28/03   Tsumura  returned  Japanese  rights  to  Sam  Amer  after  running  two  Phase  1  and  two  Phase  2  trials     2003                               Novartis  in-­licensed  the  rights,  improved  the  manufacturing  process,  ran  toxicology  and  metabolite   studies     2005                                 Novartis  returned  rights  to  Sam  Amer  after  the  GI  franchise  was  marginalized   2/5/08               Amer  and  Ventrus  held  an  end-­of-­Phase  2  meeting  with  FDA   3/17/08                 Ventrus  in-­licensed  exclusive  WW  rights  to  topical  forms  of  iferanserin  from  Sam  Amer   6/08                         Filed  SPA,  process  not  completed  due  to  lack  of  funding     3/10                         Filed  new  SPA  submission;;  clarified     May  -­     Communication  with  FDA  on  SPA  filing:  definition  of  PE,  how  to  assess  itching,  pain  &  recurrence,   etc   8/23/10                   10/28/10             Officially  filed  SPA  submission  based  on  the  recent  FDA  discussions     2/1/11     Completes  hiring  of  Clinical  Development  staff   3/3/11                                 6/11                   Expected  completion  of  SPA  process   st Q311                           Start  1  Phase  3  study   2H11                       Start  dose-­ranging  carcinogenicity  program   2H11                     First  publication  of  the  Phase  2/3  German  study   st Q112                     Data  from  1  Phase  3  study   1H12                   Start  carcinogenicity  program   Mid-­12                         Potentially  secure  North  American  marketing  partner   2H12                         Start  drug  interaction  studies   2H12                         Start  thorough  QT  study   nd 2H12                         Start  2  Phase  3  study   nd YE13                       Data  from  2  study   Mid-­14                     Data  from  carcinogenicity  studies   2014                   Potential  start  of  life  cycle  extension  products:  combinations  with  steroids,  etc.     2H14                         File  NDA   2H15                     FDA  approval  &  launch   8/7/15                     -­isomer)   1/23/18                    expires  (S-­isomer)   2H20                     5  year  Hatch-­Waxman  NCE  protection  expires   2030                             If  granted,  the  dose-­range  patent  (0.5%)  expires    Source:  Ventrus  Biosciences  and  Rodman  &  Renshaw  estimates   RODMAN & RENSHAW EQUITY RESEARCH 6
  • 7. Ventrus Biosciences Inc May 3, 2011       RODMAN & RENSHAW EQUITY RESEARCH 7
  • 8. Ventrus Biosciences Inc May 3, 2011   RODMAN & RENSHAW EQUITY RESEARCH 8
  • 9. Ventrus Biosciences Inc May 3, 2011 RODMAN & RENSHAW RATING SYSTEM: Rodman & Renshaw employs a three tier rating system for evaluating both the potential return and risk associated with owning common equity shares of rated firms. The expected return of any given equity is measured on a RELATIVE basis of other companies in the same sector, as defined by First Call. The price objective is calculated to estimate the potential movement in price a given equity could achieve given certain targets are met over a defined time horizon. Price objectives are subject to exogenous factors including industry events and market volatility. The risk assessment evaluates the company specific risk and accounts for the following factors, maturity of market, maturity of technology, maturity of firm, cash utilization, and valuation considerations. Potential factors contributing to risk: relatively undefined market, new technologies, immature firm, high cash burn rates, intrinsic value weighted toward future earnings or events. RETURN ASSESSMENT ● Market Outperform (Buy): The common stock of the company is expected to outperform a passive index comprised of all the common stock of companies within the same sector, as defined by First Call. ● Market Perform (Hold): The common stock of the company is expected to mimic the performance of a passive index comprised of all the common stock of companies within the same sector, as defined by First Call. ● Market Underperform (Sell): The common stock of the company is expected to underperform a passive index comprised of all the common stock of companies within the same sector, as defined by First Call. RISK ASSESSMENT ● Speculative - The common stock risk level is significantly greater than market risk. The stock price of these equities is exceptionally volatile. ● Aggressive - The common stock risk level is materially higher than market level risk. The stock price is typically more volatile than the general market. ● Moderate - The common stock is moderately risky, or equivalent to stock market risk. The stock price volatility is typically in-line with movements in the general market. Rating and Price Target History for: Ventrus Biosciences Inc (VTUS) as of 05-02-2011 02/02/11 I:MO:$12 18 15 12 9 6 3 Q1 Q2 Q3 Q1 Q2 Q3 Q1 Q2 Q3 Q1 Q2 2009 2010 2011 Created by BlueMatrix RATING SUMMARY Distribution of Ratings Table IB Serv./Past 12 Mos Rating Count Percent Count Percent Market Outperform(MO) 143 57.90% 35 24.48% Market Perform(MP) 45 18.20% 4 8.89% Market Underperform(MU) 8 3.20% 0 0.00% Under Review(UR) 51 20.60% 16 31.37% Total 247 100% 55 100% RODMAN & RENSHAW EQUITY RESEARCH 9
  • 10. Ventrus Biosciences Inc May 3, 2011 Investment Banking Services include, but are not limited to, acting as a manager/co-manager in the underwriting or placement of securities, acting as financial advisor, and/or providing corporate finance or capital markets-related services to a company or one of its affiliates or subsidiaries within the past 12 months. ADDITIONAL DISCLOSURES Rodman & Renshaw, LLC. (the "Firm") is a member of FINRA and SIPC and a registered U.S. Broker-Dealer. ANALYST CERTIFICATION I, Michael J Higgins, hereby certify that the views expressed in this research report accurately reflect my personal views about the subject company(ies) and its (their) securities. None of the research analysts or the research analyst's household has a financial interest in the securities of Ventrus Biosciences Inc (including, without limitation, any option, right, warrant, future, long or short position). As of Mar 31 2011 neither the Firm nor its affiliates beneficially own 1% or more of any class of common equity securities of Ventrus Biosciences Inc. Neither the research analyst nor the Firm has any material conflict of interest with Ventrus Biosciences Inc, of which the research analyst knows or has reason to know at the time of publication of this research report. The research analyst principally responsible for preparation of the report does not receive compensation that is based upon any specific investment banking services or transaction but is compensated based on factors including total revenue and profitability of the Firm, a substantial portion of which is derived from investment banking services. The Firm or its affiliates did not receive compensation from Ventrus Biosciences Inc for any investment banking services within twelve months before, but intends to seek compensation from the companies mentioned in this report for investment banking services within three months, following publication of the research report. Neither the research analyst nor any member of the research analyst's household nor the Firm serves as an officer, director or advisory board member of Ventrus Biosciences Inc. The Firm does make a market in Ventrus Biosciences Inc securities as of the date of this research report. Any opinions expressed herein are statements of our judgment as of the date of publication and are subject to change without notice. Reproduction without written permission is prohibited. The closing prices of securities mentioned in this report are as of May 02 2011. Additional information is available to clients upon written request. For complete research report on Ventrus Biosciences Inc, please call (212) 356-0500. Readers are advised that this analysis report is issued solely for informational purposes and is not to be construed as an offer to sell or the solicitation of an offer to buy. The information contained herein is based on sources which we believe to be reliable but is not guaranteed by us as being accurate and does not purport to be a complete statement or summary of the available data. Past performance is no guarantee of future results. RODMAN & RENSHAW EQUITY RESEARCH 10