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S T R I C T L Y P R I V A T E A N D C O N F I D E N T I A L
Broader Healthcare Market Update
Michael Margolis, R.Ph.
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Table of Contents
1. Broader Market Overview
2. Biotech M&A Market Overview
3. Private Biotech Financing Market Update
4. Key Advice For Israeli Healthcare Companies
Appendix: Oppenheimer M&A Capabilities
1. Broader Market Overview
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China’s Progress Reversal with the West
• The past two years have seen the largest drop in China’s share of global GDP
since the 1960s; lack of internal demand to replace western purchasing power
• Population stagnation signals a generational reversal of internal growth
• Decoupling with the West in areas perceived to be of national security
importance – biotech, semi-conductors, renewable energy and social media
Democratic Recession
• Democracy continues to weaken amid a surge of authoritarianism around the
world; the 6-year decline is the longest consecutive period of deterioration2
• Notable decline in terms of representation when it comes to elections and the
functioning of parliaments, as well as decreasing independence of judicial
systems
Current State of Play
Energy Independence
• Europe is too dependent on Russian energy – while imports of Russian gas via
pipeline to the EU have decreased since February 2022, Russia has increased
from prewar levels its LNG exports to the bloc
• Drilling and nuclear are being considered for purposes of energy
independence and national security; significant investment required
Globalization is Adrift
• The Pandemic, geopolitical and climate-related shocks have caused supply
chain challenges and forcing a wide scale reorganization
• Governments and corporations have been investing substantially in
near-shoring, reshoring and onshoring of critical technologies
• Globalization is less coordinated, deliberate and efficient than before but still
in most countries’ interest given how much worse the alternatives are
Ukraine / Israel
• Israel and Middle East ties deepen with trade amongst Abraham Accord
countries increasing to over $4 billion, a 16% increase year-over-year
• Ukraine continues to make headway with accelerated dialogue to join the
European Union while affirming NATO’s support in parallel
• Existential threat to the West will be met with full investment in Aerospace,
Defense and Military spending for modernized nuclear triad1
Global Elections Supercycle of 2024
• An unprecedented convergence of elections is set to take place, with voters in
countries representing 54% of the world population
• As the U.S. moves closer to the 2024 elections, brinksmanship between the
political parties on economic issues adds a level of volatility to the markets
Cybersecurity & Corruption
• Foreign governments fomenting anger through deep fake disinformation
• Crypto used to circumvent AML and finance global bad actors / regimes
• Private sector investments needed to protect our democracy, individual safety
and financial system
Economy
• The U.S. economy continued to show resilience in 1Q24 even as the Fed
remained committed to keep monetary policy tight to curb inflation
• Recession risk appears mitigated though not eliminated by resilience in
employment and corporate earnings
1 https://www.defense.gov/Multimedia/Experience/Americas-Nuclear-Triad/
2 https://freedomhouse.org/explore-the-map?type=fiw&year=2024&mapview=trend
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Jun-23 Jul-23 Aug-23 Sep-23 Oct-23 Nov-23 Dec-23 Jan-24 Feb-24 Mar-24 Apr-24 May-24
70.0%
80.0%
90.0%
100.0%
110.0%
120.0%
130.0%
140.0%
Healthtech,
-1.0%
IHI, 2.6%
XHS, +3.99%
XBI, +8.9%
Russell 2000,
+21.5%
Nasdaq,
+35.3%
(1) Source: Capital IQ, Bloomberg; Market data as of 05/16/24. Note: HC Services represented by XHS (SPDR S&P Health Care Services ETF); Medtech represented by IHI (iShares U.S. Medical Devices ETF); Biotech
represented by XBI (SPDR S&P Biotechnology ETF). Healthtech includes ACCD, AGL, ALHC, AMWL, AUGX, CCSI, CERT, CGM, COP, CPSI, CRW, DH, DOCS, DSY, EHTH, ESMT, EVH, GDRX, GOCO, HCAT, HIMS, HQY, HSTM,
LFMD, LFST, MDRX, ME, MODN, MPLN, NXU, OMCL, OPRX, PGNY, PHR, PINC, PRVA, RCM, SDGR, SHCR, SLP, SLQT, SPOK, TALK, TDOC, VEEV, WEAV, WELL.
May-23
Nasdaq, +35.3%
Russell 2000, +21.5%
XBI, +8.9%
Services, +4.0%
Medtech, +2.6%
Healthtech, -1.0%
Healthcare has Underperformed the Broader Market Over the Last Twelve Months
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Signal-to-Noise is Getting Worse
2014 (~565 ) 2024 (~1,064)
Publicly traded healthcare companies on major U.S. exchanges
Source: Bloomberg as of 5/16/24.
Note: Excludes companies trading over-the-counter (OTC).
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7
7
44
81
105
12 13 8
13
16
35
2
2
2
2
3
2019 2020 2021 2022 2023 2024
Life Sciences Medical Technology Services
Healthcare IPO Activity has Decreased Significantly Since 20–21 Pandemic Levels
2019 2020 2021 2022 2023 YTD 2024
Number of Healthcare IPO Transactions
Source: Dealogic as of 05/16/24
Note: Includes U.S. listed healthcare deals with transaction values >$20M.
Biotech
8
8
160
245
197
102
115
68
28
69
57
14
25
6
2
5
2
3
2
2019 2020 2021 2022 2023 2024
Life Sciences Medical Technology Services
Biotech Financing Activity Has Remained Robust in 2024
Number of Healthcare FO Transactions
2019 2020 2021 2022 2023 YTD 2024
Source: Dealogic as of 05/16/24
Note: Includes U.S. listed healthcare follow-on transactions with deal values >$20M. Excludes PIPE transactions.
Biotech
9
9
41
67 67 63 69
22
37
25
47
26
29
7
29
50
74
42
40
9
2019 2020 2021 2022 2023 2024 YTD
Number of Announced Healthcare M&A Transactions
Life Sciences Medical Technology Services
Biotech M&A Market Remains Incredibly Active
Note: Data as of 03/31/24.
(1) Includes announced biopharma M&A deals with disclosed transaction value; excluding deals <$100M. Sourced from FactSet and Company filings.
(2) Includes medtech acquisitions with purchase enterprise values of $100M or greater. Sourced from FactSet and Company filings.
(3) Includes transactions classified as Health Care Services and Healthcare Technology, excluding deals <$100M. Sourced from CapitalIQ.
(1) (2) (3)
Biotech(1)
2. Biotech M&A Market Overview
11
11
M&A Activity is Rebounding
Note: Data as of 03/31/24. Includes announced biopharma M&A deals with disclosed transaction value; excluding deals <$100M.
Source: Wall Street Research, Factset, Capital IQ, Biomed Tracker, BioCentury, and Company Filings.
($ in millions)
2018 2019 2020 2021 2022 2023 2024 YTD
$459.3 $950.0 $506.0 $500.0 $405.0 $580.1 $325.9
Median
Deal Value
$119.5
$222.4
$91.8
$54.3 $59.9
$123.4
$12.5
$11.1
$43.4
$31.3
$27.7
$29.7
$24.0
$6.2
38
41
67 67
63
69
22
0
20
40
60
80
$0.0
$50.0
$100.0
$150.0
$200.0
$250.0
$300.0
2018 2019 2020 2021 2022 2023 2024 YTD
Aggregate Public Deal Value Aggregate Private Deal Value No. of Deals
12
12
Company Drug LoE / Expiration 2023 Total Sales
2023 $14.4
2023 10.9
2024 1.3
2025 5.2
2024 – 2026 9.5
2025 – 2026 5.3
2026 19.0
2026 5.0
2026 3.4
2027 7.1
2027 4.8
2028 25.0
2028 9.0
2027 – 2029 6.1
Big Pharma Upcoming Patent Expirations
Source: Company filings, S&P Global, Nature, Fierce Pharma. Note: “LoE” stands for Loss of Exclusivity.
$130B+ in big pharma annual blockbuster sales will come off patent or lose exclusivity between 2023 and 2029
$USD in billions
Denotes that drug already faces biosimilar competition.
13
13
Since November 2023 Oncology has accounted for over half of all M&A
Source: Capital IQ and company reports as of 05/16/24.
Note: Values are based on pre-acquisition public holdings and disclosed upfront cash consideration for closed deals or close price 1 day post-announcement for deals that have not yet closed. Includes selected recent
acquisitions with total consideration of $500M+.
Acquiror
Date 11/30 12/07 12/12 12/22 12/26 12/26 01/08 01/08 01/23 02/05 02/12 03/19 04/10 04/29
Total Value
$10,100
$8,700
$1,100
$14,000
$4,100
$1,000
$2,000
$680
$1,700
$2,900
$4,300
$2,400
$4,900
$2,400
$0
$2,500
$5,000
$7,500
$10,000
$12,500
$15,000
$USD
in
Millions
= Oncology Deals
Since November 2023, oncology-focused biotech companies have attracted more than $25B in M&A value
14
14
Oncology, Autoimmune / I&I, and CV & Metabolic Remain the Top Areas in M&A
Source: Company Filings and Biomedtracker as of 03/31/24.
Note: Deal value includes upfront payment and contingent / milestone payments. Other therapeutic area primarily includes Endocrine and therapeutic area not disclosed.
Q1 2023 Deal Value Q1 2024 Deal Value
$4,508
$27
$0
$0
$4,332
Oncology
CV & Metabolic
CNS
Autoimmune / I&I
Ophthalmology
Other
$8,084
$7,173
$3,104
$1,300
$25
$0
Oncology
Autoimmune / I&I
CV & Metabolic
Other
Ophthalmology
CNS
$USD in millions
$43,198
15
15
Small Molecule Beats Out All Other Modalities in M&A Despite IRA Concerns
Source: Company Filings and Biomedtracker as of 03/31/24.
Note: Deal value includes upfront payment and contingent / milestone payments.
Q1 2023 Deal Value Q1 2024 Deal Value
$5,400
$2,800
$850
$682
$0
$101
ADC & Radiopharma
Small Molecule
Antibody
Cell & Gene Therapy
AI-Based Discovery
Peptide
Other
$8,500
$4,400
$3,800
$2,100
$1,100
$0
$0
Small Molecule
ADC & Radiopharma
Antibody
Cell & Gene Therapy
Peptide
AI-Based Discovery
Other
$43,198
$USD in millions
16
16
Value of Big Pharma Acquisitions by Therapeutic Area in Q1 2024
Source: Company Filings and Biomedtracker. As of 03/31/24.
Note: Includes upfront and milestone payments; Companies listed not representative of all collaborations in respective therapeutic area
CV & Metabolic
$4.2B
$2.8B
$310M
CNS
$1.3B
Oncology
$3.1B
$1.5B
$1.6B
$875M
$793M
$1.2B
3. Private Financing Market Update
18
18
$14.0
$13.1
$22.1
$26.7
$18.3
$19.6
$5.8
$22.5
$23.1
254
270
350
390
326
355
83
$0.0
$5.0
$10.0
$15.0
$20.0
$25.0
$30.0
2018 2019 2020 2021 2022 2023 2024YTD
Aggregate Deal Value No. of Deals
2024 Private Placement Activity On Track to Approach, If Not Exceed, 2020 Levels
Source: Pitchbook as of 03/31/2024.
Note: Series A, B, and C aggregated deal values incorporate subsequent tranche investments for the given series investment. Excludes transactions <$10M. Deal size includes amount raised from add-on investments.
Deals >$500M have not been included in median and aggregate placement activity calculations throughout the deck as they are statistically-significant outliers from the data set.
(1) $22.5B includes Altos Labs $3B deal in Jan 2022, Resilience $625M deal in Jun 2022, and Eikon Therapeutics $517M deal in Jan 2022.
($ in billions)
(1)
Pre-Pandemic Pandemic Post-Pandemic
Increased uncertainty
around our FY estimate,
as current run rate is only
based on Q1 2024
activity
19
19
Oncology, Particularly Solid Tumor, Continues to Attract VC Investors…
Source: Pitchbook as of 03/31/2024.
Note: Excludes transactions <$10M; includes add-on investments; does not include investments in life sciences companies that fall under the following categories: medical devices, healthcare software, diagnostics,
and/or consumer wellness.
2023 Deal Value Q1 2024 Deal Value
$1,918
$1,481
$954
$866
$207
$32
$373
$0 $750 $1,500 $2,250
Oncology
I&I and Autoimmunity
CV, Metab, & Pulm
CNS
Ophthalmology
Infectious Disease
Other
$6,297
$3,286
$2,927
$1,946
$1,044
$644
$3,495
$0 $2,000 $4,000 $6,000
Oncology
I&I and Autoimmunity
CNS
CV, Metab, & Pulm
Ophthalmology
Infectious Disease
Other
$342 Liquid
$3,987 Solid
$730 Multiple
$1,239 Unspecified
$- Liquid
$1,562 Solid
$174 Multiple
$181 Unspecified
($ in millions)
20
20
Despite the IRA, Small Molecules Continue to Attract VC Dollars
Source: Pitchbook as of 03/31/2024.
Note: Excludes transactions <$10M; includes add-on investments; does not include investments in life sciences companies that fall under the following categories: medical devices, healthcare software, diagnostics,
and/or consumer wellness; “Other” includes vaccines, undisclosed and other modalities.
2023 Deal Value Q1 2024 Deal Value
$7,247
$4,629
$4,199
$1,334
$818
$1,412
$0 $2,000 $4,000 $6,000 $8,000
Small Molecule
C&GT
Antibody
Peptide
Multiple
Other
$2,824
$1,078
$792
$276
$24
$837
$0 $500 $1,000 $1,500 $2,000 $2,500 $3,000
Small Molecule
Antibody
C&GT
Peptide
Multiple
Other
($ in millions)
21
21
Preclinical-Stage Companies Make Up Almost Half of Private Placements in 2023
($ in millions)
Source: Pitchbook as of 03/31/2024.
Note: Excludes transactions <$10M; includes add-on investments; does not include investments in life sciences companies that fall under the following categories: medical devices, healthcare software, diagnostics,
and/or consumer wellness.
The opposite has been observed in the public markets where capital almost exclusively flows towards clinical-stage companies
2023 Deal Value Q1 2024 Deal Value
$8,679
$3,187
$4,523
$930
$0
$0
$2,320
$0 $2,000 $4,000 $6,000 $8,000 $10,000
Preclinical
Phase 1
Phase 2
Phase 3
NDA
Approved
Undisclosed
$1,446
$1,897
$1,089
$396
$140
$151
$712
$0 $500 $1,000 $1,500 $2,000
Preclinical
Phase 1
Phase 2
Phase 3
NDA
Approved
Undisclosed
($ in millions)
22
22
$35
$42 $37
$80
Preclinical Phase 1 Phase 2 Phase 3
$50
$95 $98
$138
Preclinical Phase 1 Phase 2 Phase 3
Valuations by Development Stage – 2023
Source: Pitchbook as of 12/31/2023.
Note: Deals for companies of undisclosed clinical stage and commercial stage companies have been excluded. Pre-$ analysis excludes add-on investments.
Clinical-stage companies raised money at higher valuations compared to companies in preclinical-stage
($ in millions)
Preclinical Phase 1 Phase 2 Phase 3
Median
Deal Size
Median
Pre-$
Valuation
N = 175 N = 53 N = 86 N = 11
N = 73 N = 22 N = 33 N = 6
Phase 3 companies commanded a
larger deal size
Phase 3 companies commanded a
valuation premium over Phase 1 and
Phase 2 companies
Bump in valuation from preclinical
to clinical-stage companies
23
23
$1.32
$1.07
$0.98
$0.90
$0.89
$0.82
$0.79
$0.75
$0.67
$0.59
$0.57
$0.55
$0.48
$0.47
$0.47
$0.46
$0.46
$0.44
$0.41
$0.40
OrbiMed
RA Capital Management
Alexandria Venture…
Cormorant
ARCH Venture Partners
Lilly
RTW Investments
Sofinnova
venBio
Invus
Logos Capital
Fidelity
Forbion
Sanofi Ventures
Viking Global Investors
Bristol-Myers Squibb
GV
Catalio Capital Management
The Column Group
Samsara BioCapital
Typical Biotech Investors Remained Active in Q1 2024
Source: Pitchbook as of 03/31/2024.
Note: Excludes transactions <$10M; does not include investments in life sciences companies that fall under the following categories: medical devices, healthcare software, diagnostics, and/or consumer wellness.
(1) Aggregated deal values depicted; individual investor participation in each transaction not available; considers investor activity between 12/31/2023 and 03/31/2024.
(2) Transactions >$500M have not been included in median and aggregate placement activity calculations throughout the deck as they are statistically-significant outliers from the data set.
Top 20 Investors by Invested Capital in Q1 2024(1,2)
($ in billions)
24
24
Company
Deal Size
($M)
Deal Type Date
Pre-$
Valuation ($M)
Post-$
Valuation ($M)
Therapeutic Area Modality
Development
Stage
Key Investors
$400 Series A 03/21/2024 N/A N/A
I&I and
Autoimmunity
N/A N/A
259 Series C 03/06/2024 N/A N/A
I&I and
Autoimmunity
Small
Molecule
Phase 2
181 Series C 03/06/2024 300 481 Cystic Fibrosis
Small
Molecule
Phase 1
175 Series B 03/20/2024 325 500
I&I and
Autoimmunity
Cell Therapy Preclinical
170 Series D 02/13/2024 200 370 Metabolic
Small
Molecule
Phase 1
162 Series D 01/06/2024 N/A N/A Cardiovascular
Small
Molecule
Phase 3
157 Series B 03/19/2024 93 250 CNS
Small
Molecule
Phase 2
150 Series A 03/26/2024 N/A N/A Oncology
Small
Molecule
Phase 1
150 Series A 03/20/2024 N/A N/A Oncology Bispecific N/A
Eyconis 150 Series A 01/29/2024 N/A N/A Ophthalmology N/A N/A
23 $100M+ Deals were Raised in Q1 2024
($ in millions)
Oncology, I&I and Autoimmunity, CNS and CV&M made up the majority of largest deals in Q1 2024, most of which are clinical-stage
Source: Pitchbook as of 03/31/2024.
Note: Deal sizes are arranged in descending order. Valuation figures from Pitchbook subject to inaccuracies. Not all valuations are publicly disclosed.
25
25
Despite a perceived lack of interest in biotech, LPs continue to funnel capital into biotech-focused funds
Biotech Fundraising Momentum Continued into 2024
Source: Pitchbook. Select relevant fundraising activity shown.
Company Fund Name Fund Type Fund Size ($M) Open Date Close Date
Regeneron Ventures Venture – General $500 04/15/24 Currently Open
Cormorant Private
Healthcare Fund V
Venture Capital –
Early Stage
390 07/28/23 Currently Open
ORI Healthcare Fund II Venture – General 260 2021 02/22/24
Earlybird Health Fund II
Venture Capital –
Early Stage
187 2024 02/13/24
Scion Life Sciences Fund
Venture Capital –
Later Stage
310 2024 02/06/24
TCG Labs Fund I Venture – General 400 09/27/23 02/01/24
TCGX Fund II Venture – General 1,000 2023 01/04/24
Venrock Associates X Venture – General 650 2023 01/04/24
West Street Life Sciences I Growth 650 08/11/22 01/03/24
Hadean Capital II Venture – General 158 2021 12/21/23
Pivotal bioVenture Partners
Fund II
Venture – General 389 04/22/21 12/18/23
4. Key Advice For Israeli Healthcare Companies
27
27
33
25
19
9 8 7
4
1
1
6
10
1
2 1
1
1
2
1
3
1
Canada Israel United
Kingdom
China France Germany Denmark Sweden Spain
Life Sciences Medical Technology Services
Although Israel has Strong Presence on US Public Markets, There is Room to Grow
Source: Capital IQ as of 05/16/24.
3.5% of the 1,064 healthcare companies listed on major US exchanges are based in Israel
Life Sciences Medical Technology Services
730 205 129
Number of Companies
on US Public Markets
28
28
Telling Your Story Effectively
 Always remember the needs of your audience: investors are busy and have a constant stream of
companies trying to gain their attention
 It's easier to move on to a new company rather than struggle to get the information needed to make an
investment decision
 Information about your company and its value proposition need to be clear, concise, and easily
obtainable
 Your website is where most investors will have first contact with your company
– Don't make investors play hide and seek for the information they need
 Clearly explain the problems/health conditions you are trying to solve and present realistic market
estimates based on data
 Give investors enough information so that they can understand your potential pathway to, and through
the clinic and beyond
– How much capital will be required to deliver value-creating milestones
29
29
Interacting with Investors to Build Long-term Credibility
 Present a balanced view of your company’s value
proposition
 Don't oversell, but don't under sell
 Being too promotional can lose credibility
 Set expectations for catalyst timing and cash runway
 However, make sure you are 95%+ certain that you will
deliver
 Prepare the market for potential outcomes before data
events
 Give clear indications of what you think would be good,
medium or bad data
 Both good and bad data provide opportunities to build
credibility
 Don’t try to spin negative data as the market will
ultimately reflect reality leaving management’s
reputation tainted
 Meet with investors when you have something new to say
or you have access to new investors
 Over exposure can be as negative as under exposure
 Don’t be afraid to say “I don't know” if you don't know the
answer to the question
 Get back to the investor quickly with the answer if
possible
 The currency of biotech is data: raise enough funds when
you can that enable you to get well beyond your next value
creating event
 Raise before the funds are needed, one never knows
what the state of the market will be when cash gets low
 Investors favor managements who plan for
contingencies
30
30
Seven Simple Rules for Pitch Decks
1. Start your presentation with an investment highlights slide telling who you are and why your company is
differentiated and compelling
– A company mission statement is nebulous and does not belong in an investor deck
2. Keep slide design simple and uncluttered
– White space is not the enemy
– Limit colors and use clearly readable sans serif fonts such as Calibri
3. Make graphics as simple as possible: will your audience need to spend time deciphering hieroglyphics or
can they pay attention to you?
– Show Me the Numbers and Storytelling With Data should be required reading
4. Tell investors what value creating events you expect to deliver and when you expect them to happen
5. Combining multiple slides into one may make for fewer slides, but it does not shorten the talk and
usually hurts comprehension
6. Come prepared with backup information in an appendix for a rapid deeper dive if needed
7. Keep presentations short enough to allow for substantive dialogue
Appendix: Oppenheimer M&A Capabilities
32
32
Healthcare Mergers & Acquisitions – Over $7 Billion in Transaction Value Since 2018
Advisor on sale to
GI Alliance
January 2024
November 2021
December 2021
Advisor on sale to
VSP Global
November 2021
July 2022
Advisor on sale to
SVP
October 2022
Advisor on sale to
Humana
November 2022
Advisor on sale to
Tandem
Advisor on merger
with Viewpoint
Molecular
Advisor on sale to
Anthem
February 2023
Advisor on sale to
a Private Investor
February 2023
Advisor on sale to
Humana
March 2023
Advisor on merger
with Graybug
Vision
August 2023
Advisor on merger
with Elicio
Therapeutics
March 2023
June 2023
Advisor on sale to
ClareMedica
September 2023
Advisor on sale to
MPM BioImpact
Fairness opinion on
acquisition of
AngioDynamics
product lines
June 2023
Fairness opinion on
asset divestiture to
CenterWell Senior
Primary Care
December 2023
Valuation for
Nasdaq listed
biotech company
Project
Calypso
Terminated
Divestiture of
Meritage Medical
Network
March 2024
Advisor on
acquisition of
AlmataBio
Advisor on sale to
Dentsply Sirona
January 2021 September 2020 June 2020
November 2020
Advisor on sale to
Intersect ENT
December 2020
Advisor on sale to
MBMG Medical
Centers
December 2020
Advisor on merger
with Ocuphire
Pharma
December 2020
Advisor on sale to
Sun Capital
September 2020
Advisor on sale to
InnovaCare Health
Advisor on
acquisition of PHM
MultiSalud
Advisor on sale to
Audax Group
Advisor on merger
with Humacyte
February 2021
Advisor on sale to
Humana
August 2021 March 2021
July 2021
Advisor on sale to
Anthem
August 2021
Advisor on
acquisition of
Grace Therapeutics
August 2021
Advisor on sale to
Rancho Family
Medical Group
May 2021
Advisor on recap
by Clayton Dubilier
& Rice
April 2021
Advisor on merger
with ChemomAb
March 2021
Advisor on sale to
Sharecare
Advisor on sale to
BCBS Michigan
Advisor on sale to
RAYUS Radiology
November 2021
Advisor on sale to
Pediatric
Associates
May 2020
Advisor on sale to
CCL Industries
February 2020 June 2019
September 2019
Advisor on sale to
Merit Medical
Systems
October 2019
Advisor on
partnership with
CryoLife
January 2020
Advisor on sale to
AngioDynamics
September 2019
October 2019
Advisor on sale to
MCNA Dental
Advisor on merger
With Histogen
Advisor on sale to
Medtronic
June 2019
Advisor on recap
by Amulet Capital
Since 2018, Oppenheimer has closed over $7.0B in healthcare transaction value
33
33
 On March 27, 2024, Avalo announced that it had acquired a Phase 2-ready anti-IL-1β mAb through the acquisition of privately held AlmataBio
and concurrently entered into a securities purchase agreement for a private placement financing that is expected to result in gross proceeds of
up to $185.0MM, including an upfront investment of $115.6MM priced at $5.80 per share
– Investors were issued (i) $115.6MM of non-voting preferred stock which is convertible into approx. 19.9MM shares of common stock upon
shareholder approval and (ii) warrants to purchase up to approx. 12.0MM shares of Avalo’s common stock or an equivalent amount of non-
voting convertible preferred stock for an aggregate exercise price of $69.4MM
 The PIPE financing was led by Commodore Capital and TCGX, with participation from BVF Partners, Deep Track Capital, OrbiMed, Petrichor, and
RA Capital Management, as well as other investors
– >3x oversubscribed on a real allocable demand basis
– Very limited wall cross to high-quality healthcare-dedicated funds with final allocation to a tight group of investors
– Deal upsized from $35MM to $185MM based on buy side engagement and evolving therapeutic area discussions
– Investors responded very positively to the transactions with the stock jumping +275% on the first day of trading
 Oppenheimer acted as Sole Placement Agent for the PIPE financing
Company Overview
Transaction Summary
 Avalo Therapeutics is a clinical stage biotechnology company focused on the treatment of immune dysregulation
 Avalo’s recently expanded pipeline includes AVTX-009, a Phase 2-ready humanized monoclonal antibody (mAb) that binds to interleukin-1β (IL-
1β) with high affinity to target inflammatory diseases with an initial focus on hidradenitis suppurativa (HS)
 The Company intends to use the net upfront proceeds to achieve topline results from a planned Phase 2 trial for AVTX-009 in HS
– In addition to HS, Avalo intends to develop AVTX-009 in at least one other chronic inflammatory indication
– Avalo is also developing quisovalimab (anti-LIGHT mAb) and AVTX-008 (BTLA agonist fusion protein)
Deal Stats
Transaction
Price Performance(1)
Avalo Therapeutics: Marquee Financing to Fund Newly Acquired mAb in Multiple Indications
Oppenheimer & Co. Inc. acted as Sole Placement Agent on Avalo Therapeutics’ PIPE financing of up to $185.0MM, including an initial upfront investment of $115.6MM
Current Stats(1)
Listing/Ticker NasdaqCM:AVTX
Share Price $15.39
52 wk. High/Low $1,130.39 / 3.95
Market Cap $15.9 / 544.2MM
(2)
Cash
(3)
$112.4MM
Debt
(3)
N/A
TEV
(3)
$(96.5) / 431.8MM
(2)
Pricing Date 03/27/2024
Offering Price $5.80
Offer Premium 22.1%
Market Cap at
Announcement
$3.8MM
Gross Proceeds $185.0MM
Gross Proceeds as a %
of Market Cap
6,166.7%
Offer‐to‐1‐Day 275.0%
Offer‐to‐Current 165.3%
Up to $185,000,000
PIPE
March 2024
Jun '23 Jul '23 Aug '23 Sep '23 Oct '23 Nov '23 Dec '23 Jan '24 Feb '24 Mar '24 Apr '24 May '24
$0.00
$10.00
$20.00
$30.00
$40.00
$50.00
$1,200.00
Price
0
1,000
2,000
3,000
4,000
5,000
Volume
(Thousands)
06/26/23: AVTX
announces negative
results for AVTX-002in
non-eosinophilic asthma
09/13/23: AVTX
announces divestiture
of AVTX-800Series
03/27/24: Oppenheimer serves as
Sole Placement on AVTX's
$185.0MM PIPE concurrent with
the acquisition of Almata; AVTX
trades up +371% next-day
AVTX Volume
Lead Placement Agent
(1) As of 05/02/2024.
(2) Reflects full conversion of the convertible preferred shares issued in the private placement and the acquisition of AlmataBio.
(3) Cash and debt as of 12/31/2023, cash adjusted for net upfront proceeds from the private placement.
34
34
 On February 6th 2023, Isoray completes merger with Viewpoint Molecular Targeting; market cap pre-closing was ~$57.0MM
– Combined company later changed its name and ticker symbol to Perspective Therapeutics and CATX respectively
– Oppenheimer & Co. Inc. acted as Isoray’s financial advisor on the merger
 On January 18th 2024, Perspective priced a $69.0MM underwritten public offering of shares and pre-funded warrants
– The public offering was anchored by a marquee healthcare-dedicated investor combined with notable allocations from high
quality healthcare-dedicated and long only accounts
– Offering capitalized on positive momentum in the radiopharma space, including the recent acquisition of Rayze Bio
• File/offer discount of 15.0% was 150bps tighter than recent CMPOs for similarly sized biotechs
– Wall crossed investors meeting conversion rate of 55%; meeting to indication conversion rate of 31%
– Oppenheimer & Co. Inc. acted as Lead Bookrunner on the offering
– CATX shares were up 48.6% and a full greenshoe was exercised on the offer+1
 On March 4th 2024, Perspective Therapeutics entered into an investment agreement with a select group of institutional accredited
investors to sell 92,009,981 shares of its common stock at a price of $0.95 per share in a private placement financing with gross
proceeds of $87.4MM
– Deal was led by the Company’s largest existing investors
– Oppenheimer & Co. Inc. acted as Lead Placement Agent on the private placement
Company Overview
Transaction Summaries
 Perspective Therapeutics is a radiopharmaceutical company that is pioneering advanced treatment applications for cancers
throughout the body
 The Company's melanoma 212Pb VMT01 and neuroendocrine tumor 212Pb VMT-α-NET programs are currently in Phase 1/2a imaging
and therapy trials for the treatment of metastatic melanoma and neuroendocrine
– Perspective has begun recruitment for the second dosing cohorts in clinical studies for both programs
 Perspective recently entered an exclusive license agreement with Stony Brook University for the rights to its Cuburbit[7]uril-
admantane (CB7-Adma) pre-targeting platform and was awarded $2.4MM from the National Institutes of Health (NIH) National
Cancer Institute in support of CB7-Adma
 In January the Company announced a co-development option arrangement with Lantheus Holdings for the [212Pb]VMT-α-NET program
which included a $28.0MM upfront payment
 The Company also signed an exclusive license agreement with Mayo Clinic for the rights to the PSMA Alpha-PET DoubLET platform
technology for the treatment of PSMA-expressing cancers, with an initial focus on prostate
Deal Stats
Transactions
$69,000,000
CMPO
January 2024
Price Performance(1)
Perspective Therapeutics: Transformational Financing and Follow-up PIPE
Oppenheimer & Co. Inc. acted as Lead Bookrunner on Perspective’s $69.0MM CMPO in January 2024, and Lead Placement Agent on the Company’s $87.4MM PIPE in March 2024
(1) As of 03/13/24
(2) As of 09/30/23
1/1/24 2/1/24 3/1/24
$0.00
$1.00
$2.00
Price
0
3
7
10
13
Volume
(Millions)
01/09/24: CATX enters into
co-development option with
Lantheus
02/01/24: CATX enters
exclusive license agreement
with Stony Brook University
01/18/24: CATX prices
$60.0MM CMPO
03/04/24: CATX prices
$87.4MM PIPE
PerspectiveTherapeutics, Inc. Volume
Lead Bookrunner
$87,400,000
PIPE
March 2024
Lead Placement Agent
Current Stats(1)
Listing/Ticker NYSEAM:CATX
Share Price $1.05
52 wk. High/Low $1.10 / 0.21
Market Cap $503.2MM
Cash
(2)
$18.0MM
Debt $1.7MM
TEV $486.9MM
Pricing Date 01/17/2024 03/04/2024
Offering Price $0.37 $0.95
Market Cap at
Announcement
$124.0MM $468.1MM
Gross Proceeds $69.0MM $87.4MM
Gross Proceeds as a %
of Market Cap
55.6% 18.7%
Offer‐to‐1‐Day 48.6% 11.6%
35
35
THIS DOCUMENT IS FOR DISCUSSION PURPOSES ONLY AND DOES NOT CONSTITUTE ADVICE OF ANY KIND, INCLUDING TAX, ACCOUNTING, LEGAL
OR REGULATORY ADVICE, AND OPPENHEIMER & CO. INC. IS NOT AND DOES NOT HOLD ITSELF OUT TO BE AN ADVISOR AS TO TAX, ACCOUNTING,
LEGAL OR REGULATORY MATTERS.
THE INFORMATION CONTAINED HEREIN WAS OBTAINED FROM THE COMPANY AND PUBLIC SOURCES AND WAS RELIED UPON BY OPPENHEIMER &
CO. INC. WITHOUT ASSUMING RESPONSIBILITY FOR INDEPENDENT VERIFICATION AS TO THE ACCURACY OR COMPLETENESS OF SUCH
INFORMATION. ANY ESTIMATES AND PROJECTIONS FOR THE COMPANY CONTAINED HEREIN HAVE BEEN SUPPLIED BY THE MANAGEMENT OF THE
COMPANY OR ARE PUBLICLY AVAILABLE, AND INVOLVE NUMEROUS AND SIGNIFICANT SUBJECTIVE DETERMINATIONS, WHICH MAY NOT BE
CORRECT. NO REPRESENTATION OR WARRANTY, EXPRESS OR IMPLIED, IS MADE AS TO THE ACCURACY OR COMPLETENESS OF SUCH
INFORMATION AND NOTHING CONTAINED HEREIN IS, OR SHALL BE RELIED UPON AS, A REPRESENTATION OR WARRANTY, WHETHER AS TO THE
PAST OR THE FUTURE.
THE INFORMATION CONTAINED HEREIN WAS DESIGNED FOR USE BY SPECIFIC PERSONS FAMILIAR WITH THE BUSINESS AND AFFAIRS OF THE
COMPANY AND OPPENHEIMER & CO. INC. ASSUMES NO OBLIGATION TO UPDATE OR OTHERWISE REVISE THESE MATERIALS.
OPPENHEIMER & CO. INC.’S RESEARCH DEPARTMENT IS REQUIRED TO BE INDEPENDENT FROM ITS INVESTMENT BANKING DEPARTMENT, AND ITS
RESEARCH ANALYSTS MAY HOLD AND MAKE STATEMENTS OR INVESTMENT RECOMMENDATIONS WITH RESPECT TO THE COMPANY AND/OR ANY
OFFERING CONDUCTED BY THE COMPANY THAT DIFFER FROM THE VIEWS OF ITS INVESTMENT BANKERS. FURTHER, PURSUANT TO APPLICABLE
LAW OPPENHEIMER & CO. INC. IS (AMONG OTHER THINGS) PRECLUDED FROM OFFERING FAVORABLE RESEARCH, A SPECIFIC RATING OR A
SPECIFIC PRICE TARGET, OR THREATEN TO CHANGE RESEARCH, A RATING OR A PRICE TARGET, TO THE COMPANY AS CONSIDERATION OR
INDUCEMENT FOR THE RECEIPT OF BUSINESS OR COMPENSATION.
OPPENHEIMER & CO. INC. TRANSACTS BUSINESS ON ALL PRINCIPAL EXCHANGES AND MEMBER SIPC 6631306.1.
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  • 2. 2 2 Table of Contents 1. Broader Market Overview 2. Biotech M&A Market Overview 3. Private Biotech Financing Market Update 4. Key Advice For Israeli Healthcare Companies Appendix: Oppenheimer M&A Capabilities
  • 3. 1. Broader Market Overview
  • 4. 4 4 China’s Progress Reversal with the West • The past two years have seen the largest drop in China’s share of global GDP since the 1960s; lack of internal demand to replace western purchasing power • Population stagnation signals a generational reversal of internal growth • Decoupling with the West in areas perceived to be of national security importance – biotech, semi-conductors, renewable energy and social media Democratic Recession • Democracy continues to weaken amid a surge of authoritarianism around the world; the 6-year decline is the longest consecutive period of deterioration2 • Notable decline in terms of representation when it comes to elections and the functioning of parliaments, as well as decreasing independence of judicial systems Current State of Play Energy Independence • Europe is too dependent on Russian energy – while imports of Russian gas via pipeline to the EU have decreased since February 2022, Russia has increased from prewar levels its LNG exports to the bloc • Drilling and nuclear are being considered for purposes of energy independence and national security; significant investment required Globalization is Adrift • The Pandemic, geopolitical and climate-related shocks have caused supply chain challenges and forcing a wide scale reorganization • Governments and corporations have been investing substantially in near-shoring, reshoring and onshoring of critical technologies • Globalization is less coordinated, deliberate and efficient than before but still in most countries’ interest given how much worse the alternatives are Ukraine / Israel • Israel and Middle East ties deepen with trade amongst Abraham Accord countries increasing to over $4 billion, a 16% increase year-over-year • Ukraine continues to make headway with accelerated dialogue to join the European Union while affirming NATO’s support in parallel • Existential threat to the West will be met with full investment in Aerospace, Defense and Military spending for modernized nuclear triad1 Global Elections Supercycle of 2024 • An unprecedented convergence of elections is set to take place, with voters in countries representing 54% of the world population • As the U.S. moves closer to the 2024 elections, brinksmanship between the political parties on economic issues adds a level of volatility to the markets Cybersecurity & Corruption • Foreign governments fomenting anger through deep fake disinformation • Crypto used to circumvent AML and finance global bad actors / regimes • Private sector investments needed to protect our democracy, individual safety and financial system Economy • The U.S. economy continued to show resilience in 1Q24 even as the Fed remained committed to keep monetary policy tight to curb inflation • Recession risk appears mitigated though not eliminated by resilience in employment and corporate earnings 1 https://www.defense.gov/Multimedia/Experience/Americas-Nuclear-Triad/ 2 https://freedomhouse.org/explore-the-map?type=fiw&year=2024&mapview=trend
  • 5. 5 5 Jun-23 Jul-23 Aug-23 Sep-23 Oct-23 Nov-23 Dec-23 Jan-24 Feb-24 Mar-24 Apr-24 May-24 70.0% 80.0% 90.0% 100.0% 110.0% 120.0% 130.0% 140.0% Healthtech, -1.0% IHI, 2.6% XHS, +3.99% XBI, +8.9% Russell 2000, +21.5% Nasdaq, +35.3% (1) Source: Capital IQ, Bloomberg; Market data as of 05/16/24. Note: HC Services represented by XHS (SPDR S&P Health Care Services ETF); Medtech represented by IHI (iShares U.S. Medical Devices ETF); Biotech represented by XBI (SPDR S&P Biotechnology ETF). Healthtech includes ACCD, AGL, ALHC, AMWL, AUGX, CCSI, CERT, CGM, COP, CPSI, CRW, DH, DOCS, DSY, EHTH, ESMT, EVH, GDRX, GOCO, HCAT, HIMS, HQY, HSTM, LFMD, LFST, MDRX, ME, MODN, MPLN, NXU, OMCL, OPRX, PGNY, PHR, PINC, PRVA, RCM, SDGR, SHCR, SLP, SLQT, SPOK, TALK, TDOC, VEEV, WEAV, WELL. May-23 Nasdaq, +35.3% Russell 2000, +21.5% XBI, +8.9% Services, +4.0% Medtech, +2.6% Healthtech, -1.0% Healthcare has Underperformed the Broader Market Over the Last Twelve Months
  • 6. 6 6 Signal-to-Noise is Getting Worse 2014 (~565 ) 2024 (~1,064) Publicly traded healthcare companies on major U.S. exchanges Source: Bloomberg as of 5/16/24. Note: Excludes companies trading over-the-counter (OTC).                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      
  • 7. 7 7 44 81 105 12 13 8 13 16 35 2 2 2 2 3 2019 2020 2021 2022 2023 2024 Life Sciences Medical Technology Services Healthcare IPO Activity has Decreased Significantly Since 20–21 Pandemic Levels 2019 2020 2021 2022 2023 YTD 2024 Number of Healthcare IPO Transactions Source: Dealogic as of 05/16/24 Note: Includes U.S. listed healthcare deals with transaction values >$20M. Biotech
  • 8. 8 8 160 245 197 102 115 68 28 69 57 14 25 6 2 5 2 3 2 2019 2020 2021 2022 2023 2024 Life Sciences Medical Technology Services Biotech Financing Activity Has Remained Robust in 2024 Number of Healthcare FO Transactions 2019 2020 2021 2022 2023 YTD 2024 Source: Dealogic as of 05/16/24 Note: Includes U.S. listed healthcare follow-on transactions with deal values >$20M. Excludes PIPE transactions. Biotech
  • 9. 9 9 41 67 67 63 69 22 37 25 47 26 29 7 29 50 74 42 40 9 2019 2020 2021 2022 2023 2024 YTD Number of Announced Healthcare M&A Transactions Life Sciences Medical Technology Services Biotech M&A Market Remains Incredibly Active Note: Data as of 03/31/24. (1) Includes announced biopharma M&A deals with disclosed transaction value; excluding deals <$100M. Sourced from FactSet and Company filings. (2) Includes medtech acquisitions with purchase enterprise values of $100M or greater. Sourced from FactSet and Company filings. (3) Includes transactions classified as Health Care Services and Healthcare Technology, excluding deals <$100M. Sourced from CapitalIQ. (1) (2) (3) Biotech(1)
  • 10. 2. Biotech M&A Market Overview
  • 11. 11 11 M&A Activity is Rebounding Note: Data as of 03/31/24. Includes announced biopharma M&A deals with disclosed transaction value; excluding deals <$100M. Source: Wall Street Research, Factset, Capital IQ, Biomed Tracker, BioCentury, and Company Filings. ($ in millions) 2018 2019 2020 2021 2022 2023 2024 YTD $459.3 $950.0 $506.0 $500.0 $405.0 $580.1 $325.9 Median Deal Value $119.5 $222.4 $91.8 $54.3 $59.9 $123.4 $12.5 $11.1 $43.4 $31.3 $27.7 $29.7 $24.0 $6.2 38 41 67 67 63 69 22 0 20 40 60 80 $0.0 $50.0 $100.0 $150.0 $200.0 $250.0 $300.0 2018 2019 2020 2021 2022 2023 2024 YTD Aggregate Public Deal Value Aggregate Private Deal Value No. of Deals
  • 12. 12 12 Company Drug LoE / Expiration 2023 Total Sales 2023 $14.4 2023 10.9 2024 1.3 2025 5.2 2024 – 2026 9.5 2025 – 2026 5.3 2026 19.0 2026 5.0 2026 3.4 2027 7.1 2027 4.8 2028 25.0 2028 9.0 2027 – 2029 6.1 Big Pharma Upcoming Patent Expirations Source: Company filings, S&P Global, Nature, Fierce Pharma. Note: “LoE” stands for Loss of Exclusivity. $130B+ in big pharma annual blockbuster sales will come off patent or lose exclusivity between 2023 and 2029 $USD in billions Denotes that drug already faces biosimilar competition.
  • 13. 13 13 Since November 2023 Oncology has accounted for over half of all M&A Source: Capital IQ and company reports as of 05/16/24. Note: Values are based on pre-acquisition public holdings and disclosed upfront cash consideration for closed deals or close price 1 day post-announcement for deals that have not yet closed. Includes selected recent acquisitions with total consideration of $500M+. Acquiror Date 11/30 12/07 12/12 12/22 12/26 12/26 01/08 01/08 01/23 02/05 02/12 03/19 04/10 04/29 Total Value $10,100 $8,700 $1,100 $14,000 $4,100 $1,000 $2,000 $680 $1,700 $2,900 $4,300 $2,400 $4,900 $2,400 $0 $2,500 $5,000 $7,500 $10,000 $12,500 $15,000 $USD in Millions = Oncology Deals Since November 2023, oncology-focused biotech companies have attracted more than $25B in M&A value
  • 14. 14 14 Oncology, Autoimmune / I&I, and CV & Metabolic Remain the Top Areas in M&A Source: Company Filings and Biomedtracker as of 03/31/24. Note: Deal value includes upfront payment and contingent / milestone payments. Other therapeutic area primarily includes Endocrine and therapeutic area not disclosed. Q1 2023 Deal Value Q1 2024 Deal Value $4,508 $27 $0 $0 $4,332 Oncology CV & Metabolic CNS Autoimmune / I&I Ophthalmology Other $8,084 $7,173 $3,104 $1,300 $25 $0 Oncology Autoimmune / I&I CV & Metabolic Other Ophthalmology CNS $USD in millions $43,198
  • 15. 15 15 Small Molecule Beats Out All Other Modalities in M&A Despite IRA Concerns Source: Company Filings and Biomedtracker as of 03/31/24. Note: Deal value includes upfront payment and contingent / milestone payments. Q1 2023 Deal Value Q1 2024 Deal Value $5,400 $2,800 $850 $682 $0 $101 ADC & Radiopharma Small Molecule Antibody Cell & Gene Therapy AI-Based Discovery Peptide Other $8,500 $4,400 $3,800 $2,100 $1,100 $0 $0 Small Molecule ADC & Radiopharma Antibody Cell & Gene Therapy Peptide AI-Based Discovery Other $43,198 $USD in millions
  • 16. 16 16 Value of Big Pharma Acquisitions by Therapeutic Area in Q1 2024 Source: Company Filings and Biomedtracker. As of 03/31/24. Note: Includes upfront and milestone payments; Companies listed not representative of all collaborations in respective therapeutic area CV & Metabolic $4.2B $2.8B $310M CNS $1.3B Oncology $3.1B $1.5B $1.6B $875M $793M $1.2B
  • 17. 3. Private Financing Market Update
  • 18. 18 18 $14.0 $13.1 $22.1 $26.7 $18.3 $19.6 $5.8 $22.5 $23.1 254 270 350 390 326 355 83 $0.0 $5.0 $10.0 $15.0 $20.0 $25.0 $30.0 2018 2019 2020 2021 2022 2023 2024YTD Aggregate Deal Value No. of Deals 2024 Private Placement Activity On Track to Approach, If Not Exceed, 2020 Levels Source: Pitchbook as of 03/31/2024. Note: Series A, B, and C aggregated deal values incorporate subsequent tranche investments for the given series investment. Excludes transactions <$10M. Deal size includes amount raised from add-on investments. Deals >$500M have not been included in median and aggregate placement activity calculations throughout the deck as they are statistically-significant outliers from the data set. (1) $22.5B includes Altos Labs $3B deal in Jan 2022, Resilience $625M deal in Jun 2022, and Eikon Therapeutics $517M deal in Jan 2022. ($ in billions) (1) Pre-Pandemic Pandemic Post-Pandemic Increased uncertainty around our FY estimate, as current run rate is only based on Q1 2024 activity
  • 19. 19 19 Oncology, Particularly Solid Tumor, Continues to Attract VC Investors… Source: Pitchbook as of 03/31/2024. Note: Excludes transactions <$10M; includes add-on investments; does not include investments in life sciences companies that fall under the following categories: medical devices, healthcare software, diagnostics, and/or consumer wellness. 2023 Deal Value Q1 2024 Deal Value $1,918 $1,481 $954 $866 $207 $32 $373 $0 $750 $1,500 $2,250 Oncology I&I and Autoimmunity CV, Metab, & Pulm CNS Ophthalmology Infectious Disease Other $6,297 $3,286 $2,927 $1,946 $1,044 $644 $3,495 $0 $2,000 $4,000 $6,000 Oncology I&I and Autoimmunity CNS CV, Metab, & Pulm Ophthalmology Infectious Disease Other $342 Liquid $3,987 Solid $730 Multiple $1,239 Unspecified $- Liquid $1,562 Solid $174 Multiple $181 Unspecified ($ in millions)
  • 20. 20 20 Despite the IRA, Small Molecules Continue to Attract VC Dollars Source: Pitchbook as of 03/31/2024. Note: Excludes transactions <$10M; includes add-on investments; does not include investments in life sciences companies that fall under the following categories: medical devices, healthcare software, diagnostics, and/or consumer wellness; “Other” includes vaccines, undisclosed and other modalities. 2023 Deal Value Q1 2024 Deal Value $7,247 $4,629 $4,199 $1,334 $818 $1,412 $0 $2,000 $4,000 $6,000 $8,000 Small Molecule C&GT Antibody Peptide Multiple Other $2,824 $1,078 $792 $276 $24 $837 $0 $500 $1,000 $1,500 $2,000 $2,500 $3,000 Small Molecule Antibody C&GT Peptide Multiple Other ($ in millions)
  • 21. 21 21 Preclinical-Stage Companies Make Up Almost Half of Private Placements in 2023 ($ in millions) Source: Pitchbook as of 03/31/2024. Note: Excludes transactions <$10M; includes add-on investments; does not include investments in life sciences companies that fall under the following categories: medical devices, healthcare software, diagnostics, and/or consumer wellness. The opposite has been observed in the public markets where capital almost exclusively flows towards clinical-stage companies 2023 Deal Value Q1 2024 Deal Value $8,679 $3,187 $4,523 $930 $0 $0 $2,320 $0 $2,000 $4,000 $6,000 $8,000 $10,000 Preclinical Phase 1 Phase 2 Phase 3 NDA Approved Undisclosed $1,446 $1,897 $1,089 $396 $140 $151 $712 $0 $500 $1,000 $1,500 $2,000 Preclinical Phase 1 Phase 2 Phase 3 NDA Approved Undisclosed ($ in millions)
  • 22. 22 22 $35 $42 $37 $80 Preclinical Phase 1 Phase 2 Phase 3 $50 $95 $98 $138 Preclinical Phase 1 Phase 2 Phase 3 Valuations by Development Stage – 2023 Source: Pitchbook as of 12/31/2023. Note: Deals for companies of undisclosed clinical stage and commercial stage companies have been excluded. Pre-$ analysis excludes add-on investments. Clinical-stage companies raised money at higher valuations compared to companies in preclinical-stage ($ in millions) Preclinical Phase 1 Phase 2 Phase 3 Median Deal Size Median Pre-$ Valuation N = 175 N = 53 N = 86 N = 11 N = 73 N = 22 N = 33 N = 6 Phase 3 companies commanded a larger deal size Phase 3 companies commanded a valuation premium over Phase 1 and Phase 2 companies Bump in valuation from preclinical to clinical-stage companies
  • 23. 23 23 $1.32 $1.07 $0.98 $0.90 $0.89 $0.82 $0.79 $0.75 $0.67 $0.59 $0.57 $0.55 $0.48 $0.47 $0.47 $0.46 $0.46 $0.44 $0.41 $0.40 OrbiMed RA Capital Management Alexandria Venture… Cormorant ARCH Venture Partners Lilly RTW Investments Sofinnova venBio Invus Logos Capital Fidelity Forbion Sanofi Ventures Viking Global Investors Bristol-Myers Squibb GV Catalio Capital Management The Column Group Samsara BioCapital Typical Biotech Investors Remained Active in Q1 2024 Source: Pitchbook as of 03/31/2024. Note: Excludes transactions <$10M; does not include investments in life sciences companies that fall under the following categories: medical devices, healthcare software, diagnostics, and/or consumer wellness. (1) Aggregated deal values depicted; individual investor participation in each transaction not available; considers investor activity between 12/31/2023 and 03/31/2024. (2) Transactions >$500M have not been included in median and aggregate placement activity calculations throughout the deck as they are statistically-significant outliers from the data set. Top 20 Investors by Invested Capital in Q1 2024(1,2) ($ in billions)
  • 24. 24 24 Company Deal Size ($M) Deal Type Date Pre-$ Valuation ($M) Post-$ Valuation ($M) Therapeutic Area Modality Development Stage Key Investors $400 Series A 03/21/2024 N/A N/A I&I and Autoimmunity N/A N/A 259 Series C 03/06/2024 N/A N/A I&I and Autoimmunity Small Molecule Phase 2 181 Series C 03/06/2024 300 481 Cystic Fibrosis Small Molecule Phase 1 175 Series B 03/20/2024 325 500 I&I and Autoimmunity Cell Therapy Preclinical 170 Series D 02/13/2024 200 370 Metabolic Small Molecule Phase 1 162 Series D 01/06/2024 N/A N/A Cardiovascular Small Molecule Phase 3 157 Series B 03/19/2024 93 250 CNS Small Molecule Phase 2 150 Series A 03/26/2024 N/A N/A Oncology Small Molecule Phase 1 150 Series A 03/20/2024 N/A N/A Oncology Bispecific N/A Eyconis 150 Series A 01/29/2024 N/A N/A Ophthalmology N/A N/A 23 $100M+ Deals were Raised in Q1 2024 ($ in millions) Oncology, I&I and Autoimmunity, CNS and CV&M made up the majority of largest deals in Q1 2024, most of which are clinical-stage Source: Pitchbook as of 03/31/2024. Note: Deal sizes are arranged in descending order. Valuation figures from Pitchbook subject to inaccuracies. Not all valuations are publicly disclosed.
  • 25. 25 25 Despite a perceived lack of interest in biotech, LPs continue to funnel capital into biotech-focused funds Biotech Fundraising Momentum Continued into 2024 Source: Pitchbook. Select relevant fundraising activity shown. Company Fund Name Fund Type Fund Size ($M) Open Date Close Date Regeneron Ventures Venture – General $500 04/15/24 Currently Open Cormorant Private Healthcare Fund V Venture Capital – Early Stage 390 07/28/23 Currently Open ORI Healthcare Fund II Venture – General 260 2021 02/22/24 Earlybird Health Fund II Venture Capital – Early Stage 187 2024 02/13/24 Scion Life Sciences Fund Venture Capital – Later Stage 310 2024 02/06/24 TCG Labs Fund I Venture – General 400 09/27/23 02/01/24 TCGX Fund II Venture – General 1,000 2023 01/04/24 Venrock Associates X Venture – General 650 2023 01/04/24 West Street Life Sciences I Growth 650 08/11/22 01/03/24 Hadean Capital II Venture – General 158 2021 12/21/23 Pivotal bioVenture Partners Fund II Venture – General 389 04/22/21 12/18/23
  • 26. 4. Key Advice For Israeli Healthcare Companies
  • 27. 27 27 33 25 19 9 8 7 4 1 1 6 10 1 2 1 1 1 2 1 3 1 Canada Israel United Kingdom China France Germany Denmark Sweden Spain Life Sciences Medical Technology Services Although Israel has Strong Presence on US Public Markets, There is Room to Grow Source: Capital IQ as of 05/16/24. 3.5% of the 1,064 healthcare companies listed on major US exchanges are based in Israel Life Sciences Medical Technology Services 730 205 129 Number of Companies on US Public Markets
  • 28. 28 28 Telling Your Story Effectively  Always remember the needs of your audience: investors are busy and have a constant stream of companies trying to gain their attention  It's easier to move on to a new company rather than struggle to get the information needed to make an investment decision  Information about your company and its value proposition need to be clear, concise, and easily obtainable  Your website is where most investors will have first contact with your company – Don't make investors play hide and seek for the information they need  Clearly explain the problems/health conditions you are trying to solve and present realistic market estimates based on data  Give investors enough information so that they can understand your potential pathway to, and through the clinic and beyond – How much capital will be required to deliver value-creating milestones
  • 29. 29 29 Interacting with Investors to Build Long-term Credibility  Present a balanced view of your company’s value proposition  Don't oversell, but don't under sell  Being too promotional can lose credibility  Set expectations for catalyst timing and cash runway  However, make sure you are 95%+ certain that you will deliver  Prepare the market for potential outcomes before data events  Give clear indications of what you think would be good, medium or bad data  Both good and bad data provide opportunities to build credibility  Don’t try to spin negative data as the market will ultimately reflect reality leaving management’s reputation tainted  Meet with investors when you have something new to say or you have access to new investors  Over exposure can be as negative as under exposure  Don’t be afraid to say “I don't know” if you don't know the answer to the question  Get back to the investor quickly with the answer if possible  The currency of biotech is data: raise enough funds when you can that enable you to get well beyond your next value creating event  Raise before the funds are needed, one never knows what the state of the market will be when cash gets low  Investors favor managements who plan for contingencies
  • 30. 30 30 Seven Simple Rules for Pitch Decks 1. Start your presentation with an investment highlights slide telling who you are and why your company is differentiated and compelling – A company mission statement is nebulous and does not belong in an investor deck 2. Keep slide design simple and uncluttered – White space is not the enemy – Limit colors and use clearly readable sans serif fonts such as Calibri 3. Make graphics as simple as possible: will your audience need to spend time deciphering hieroglyphics or can they pay attention to you? – Show Me the Numbers and Storytelling With Data should be required reading 4. Tell investors what value creating events you expect to deliver and when you expect them to happen 5. Combining multiple slides into one may make for fewer slides, but it does not shorten the talk and usually hurts comprehension 6. Come prepared with backup information in an appendix for a rapid deeper dive if needed 7. Keep presentations short enough to allow for substantive dialogue
  • 32. 32 32 Healthcare Mergers & Acquisitions – Over $7 Billion in Transaction Value Since 2018 Advisor on sale to GI Alliance January 2024 November 2021 December 2021 Advisor on sale to VSP Global November 2021 July 2022 Advisor on sale to SVP October 2022 Advisor on sale to Humana November 2022 Advisor on sale to Tandem Advisor on merger with Viewpoint Molecular Advisor on sale to Anthem February 2023 Advisor on sale to a Private Investor February 2023 Advisor on sale to Humana March 2023 Advisor on merger with Graybug Vision August 2023 Advisor on merger with Elicio Therapeutics March 2023 June 2023 Advisor on sale to ClareMedica September 2023 Advisor on sale to MPM BioImpact Fairness opinion on acquisition of AngioDynamics product lines June 2023 Fairness opinion on asset divestiture to CenterWell Senior Primary Care December 2023 Valuation for Nasdaq listed biotech company Project Calypso Terminated Divestiture of Meritage Medical Network March 2024 Advisor on acquisition of AlmataBio Advisor on sale to Dentsply Sirona January 2021 September 2020 June 2020 November 2020 Advisor on sale to Intersect ENT December 2020 Advisor on sale to MBMG Medical Centers December 2020 Advisor on merger with Ocuphire Pharma December 2020 Advisor on sale to Sun Capital September 2020 Advisor on sale to InnovaCare Health Advisor on acquisition of PHM MultiSalud Advisor on sale to Audax Group Advisor on merger with Humacyte February 2021 Advisor on sale to Humana August 2021 March 2021 July 2021 Advisor on sale to Anthem August 2021 Advisor on acquisition of Grace Therapeutics August 2021 Advisor on sale to Rancho Family Medical Group May 2021 Advisor on recap by Clayton Dubilier & Rice April 2021 Advisor on merger with ChemomAb March 2021 Advisor on sale to Sharecare Advisor on sale to BCBS Michigan Advisor on sale to RAYUS Radiology November 2021 Advisor on sale to Pediatric Associates May 2020 Advisor on sale to CCL Industries February 2020 June 2019 September 2019 Advisor on sale to Merit Medical Systems October 2019 Advisor on partnership with CryoLife January 2020 Advisor on sale to AngioDynamics September 2019 October 2019 Advisor on sale to MCNA Dental Advisor on merger With Histogen Advisor on sale to Medtronic June 2019 Advisor on recap by Amulet Capital Since 2018, Oppenheimer has closed over $7.0B in healthcare transaction value
  • 33. 33 33  On March 27, 2024, Avalo announced that it had acquired a Phase 2-ready anti-IL-1β mAb through the acquisition of privately held AlmataBio and concurrently entered into a securities purchase agreement for a private placement financing that is expected to result in gross proceeds of up to $185.0MM, including an upfront investment of $115.6MM priced at $5.80 per share – Investors were issued (i) $115.6MM of non-voting preferred stock which is convertible into approx. 19.9MM shares of common stock upon shareholder approval and (ii) warrants to purchase up to approx. 12.0MM shares of Avalo’s common stock or an equivalent amount of non- voting convertible preferred stock for an aggregate exercise price of $69.4MM  The PIPE financing was led by Commodore Capital and TCGX, with participation from BVF Partners, Deep Track Capital, OrbiMed, Petrichor, and RA Capital Management, as well as other investors – >3x oversubscribed on a real allocable demand basis – Very limited wall cross to high-quality healthcare-dedicated funds with final allocation to a tight group of investors – Deal upsized from $35MM to $185MM based on buy side engagement and evolving therapeutic area discussions – Investors responded very positively to the transactions with the stock jumping +275% on the first day of trading  Oppenheimer acted as Sole Placement Agent for the PIPE financing Company Overview Transaction Summary  Avalo Therapeutics is a clinical stage biotechnology company focused on the treatment of immune dysregulation  Avalo’s recently expanded pipeline includes AVTX-009, a Phase 2-ready humanized monoclonal antibody (mAb) that binds to interleukin-1β (IL- 1β) with high affinity to target inflammatory diseases with an initial focus on hidradenitis suppurativa (HS)  The Company intends to use the net upfront proceeds to achieve topline results from a planned Phase 2 trial for AVTX-009 in HS – In addition to HS, Avalo intends to develop AVTX-009 in at least one other chronic inflammatory indication – Avalo is also developing quisovalimab (anti-LIGHT mAb) and AVTX-008 (BTLA agonist fusion protein) Deal Stats Transaction Price Performance(1) Avalo Therapeutics: Marquee Financing to Fund Newly Acquired mAb in Multiple Indications Oppenheimer & Co. Inc. acted as Sole Placement Agent on Avalo Therapeutics’ PIPE financing of up to $185.0MM, including an initial upfront investment of $115.6MM Current Stats(1) Listing/Ticker NasdaqCM:AVTX Share Price $15.39 52 wk. High/Low $1,130.39 / 3.95 Market Cap $15.9 / 544.2MM (2) Cash (3) $112.4MM Debt (3) N/A TEV (3) $(96.5) / 431.8MM (2) Pricing Date 03/27/2024 Offering Price $5.80 Offer Premium 22.1% Market Cap at Announcement $3.8MM Gross Proceeds $185.0MM Gross Proceeds as a % of Market Cap 6,166.7% Offer‐to‐1‐Day 275.0% Offer‐to‐Current 165.3% Up to $185,000,000 PIPE March 2024 Jun '23 Jul '23 Aug '23 Sep '23 Oct '23 Nov '23 Dec '23 Jan '24 Feb '24 Mar '24 Apr '24 May '24 $0.00 $10.00 $20.00 $30.00 $40.00 $50.00 $1,200.00 Price 0 1,000 2,000 3,000 4,000 5,000 Volume (Thousands) 06/26/23: AVTX announces negative results for AVTX-002in non-eosinophilic asthma 09/13/23: AVTX announces divestiture of AVTX-800Series 03/27/24: Oppenheimer serves as Sole Placement on AVTX's $185.0MM PIPE concurrent with the acquisition of Almata; AVTX trades up +371% next-day AVTX Volume Lead Placement Agent (1) As of 05/02/2024. (2) Reflects full conversion of the convertible preferred shares issued in the private placement and the acquisition of AlmataBio. (3) Cash and debt as of 12/31/2023, cash adjusted for net upfront proceeds from the private placement.
  • 34. 34 34  On February 6th 2023, Isoray completes merger with Viewpoint Molecular Targeting; market cap pre-closing was ~$57.0MM – Combined company later changed its name and ticker symbol to Perspective Therapeutics and CATX respectively – Oppenheimer & Co. Inc. acted as Isoray’s financial advisor on the merger  On January 18th 2024, Perspective priced a $69.0MM underwritten public offering of shares and pre-funded warrants – The public offering was anchored by a marquee healthcare-dedicated investor combined with notable allocations from high quality healthcare-dedicated and long only accounts – Offering capitalized on positive momentum in the radiopharma space, including the recent acquisition of Rayze Bio • File/offer discount of 15.0% was 150bps tighter than recent CMPOs for similarly sized biotechs – Wall crossed investors meeting conversion rate of 55%; meeting to indication conversion rate of 31% – Oppenheimer & Co. Inc. acted as Lead Bookrunner on the offering – CATX shares were up 48.6% and a full greenshoe was exercised on the offer+1  On March 4th 2024, Perspective Therapeutics entered into an investment agreement with a select group of institutional accredited investors to sell 92,009,981 shares of its common stock at a price of $0.95 per share in a private placement financing with gross proceeds of $87.4MM – Deal was led by the Company’s largest existing investors – Oppenheimer & Co. Inc. acted as Lead Placement Agent on the private placement Company Overview Transaction Summaries  Perspective Therapeutics is a radiopharmaceutical company that is pioneering advanced treatment applications for cancers throughout the body  The Company's melanoma 212Pb VMT01 and neuroendocrine tumor 212Pb VMT-α-NET programs are currently in Phase 1/2a imaging and therapy trials for the treatment of metastatic melanoma and neuroendocrine – Perspective has begun recruitment for the second dosing cohorts in clinical studies for both programs  Perspective recently entered an exclusive license agreement with Stony Brook University for the rights to its Cuburbit[7]uril- admantane (CB7-Adma) pre-targeting platform and was awarded $2.4MM from the National Institutes of Health (NIH) National Cancer Institute in support of CB7-Adma  In January the Company announced a co-development option arrangement with Lantheus Holdings for the [212Pb]VMT-α-NET program which included a $28.0MM upfront payment  The Company also signed an exclusive license agreement with Mayo Clinic for the rights to the PSMA Alpha-PET DoubLET platform technology for the treatment of PSMA-expressing cancers, with an initial focus on prostate Deal Stats Transactions $69,000,000 CMPO January 2024 Price Performance(1) Perspective Therapeutics: Transformational Financing and Follow-up PIPE Oppenheimer & Co. Inc. acted as Lead Bookrunner on Perspective’s $69.0MM CMPO in January 2024, and Lead Placement Agent on the Company’s $87.4MM PIPE in March 2024 (1) As of 03/13/24 (2) As of 09/30/23 1/1/24 2/1/24 3/1/24 $0.00 $1.00 $2.00 Price 0 3 7 10 13 Volume (Millions) 01/09/24: CATX enters into co-development option with Lantheus 02/01/24: CATX enters exclusive license agreement with Stony Brook University 01/18/24: CATX prices $60.0MM CMPO 03/04/24: CATX prices $87.4MM PIPE PerspectiveTherapeutics, Inc. Volume Lead Bookrunner $87,400,000 PIPE March 2024 Lead Placement Agent Current Stats(1) Listing/Ticker NYSEAM:CATX Share Price $1.05 52 wk. High/Low $1.10 / 0.21 Market Cap $503.2MM Cash (2) $18.0MM Debt $1.7MM TEV $486.9MM Pricing Date 01/17/2024 03/04/2024 Offering Price $0.37 $0.95 Market Cap at Announcement $124.0MM $468.1MM Gross Proceeds $69.0MM $87.4MM Gross Proceeds as a % of Market Cap 55.6% 18.7% Offer‐to‐1‐Day 48.6% 11.6%
  • 35. 35 35 THIS DOCUMENT IS FOR DISCUSSION PURPOSES ONLY AND DOES NOT CONSTITUTE ADVICE OF ANY KIND, INCLUDING TAX, ACCOUNTING, LEGAL OR REGULATORY ADVICE, AND OPPENHEIMER & CO. INC. IS NOT AND DOES NOT HOLD ITSELF OUT TO BE AN ADVISOR AS TO TAX, ACCOUNTING, LEGAL OR REGULATORY MATTERS. THE INFORMATION CONTAINED HEREIN WAS OBTAINED FROM THE COMPANY AND PUBLIC SOURCES AND WAS RELIED UPON BY OPPENHEIMER & CO. INC. WITHOUT ASSUMING RESPONSIBILITY FOR INDEPENDENT VERIFICATION AS TO THE ACCURACY OR COMPLETENESS OF SUCH INFORMATION. ANY ESTIMATES AND PROJECTIONS FOR THE COMPANY CONTAINED HEREIN HAVE BEEN SUPPLIED BY THE MANAGEMENT OF THE COMPANY OR ARE PUBLICLY AVAILABLE, AND INVOLVE NUMEROUS AND SIGNIFICANT SUBJECTIVE DETERMINATIONS, WHICH MAY NOT BE CORRECT. NO REPRESENTATION OR WARRANTY, EXPRESS OR IMPLIED, IS MADE AS TO THE ACCURACY OR COMPLETENESS OF SUCH INFORMATION AND NOTHING CONTAINED HEREIN IS, OR SHALL BE RELIED UPON AS, A REPRESENTATION OR WARRANTY, WHETHER AS TO THE PAST OR THE FUTURE. THE INFORMATION CONTAINED HEREIN WAS DESIGNED FOR USE BY SPECIFIC PERSONS FAMILIAR WITH THE BUSINESS AND AFFAIRS OF THE COMPANY AND OPPENHEIMER & CO. INC. ASSUMES NO OBLIGATION TO UPDATE OR OTHERWISE REVISE THESE MATERIALS. OPPENHEIMER & CO. INC.’S RESEARCH DEPARTMENT IS REQUIRED TO BE INDEPENDENT FROM ITS INVESTMENT BANKING DEPARTMENT, AND ITS RESEARCH ANALYSTS MAY HOLD AND MAKE STATEMENTS OR INVESTMENT RECOMMENDATIONS WITH RESPECT TO THE COMPANY AND/OR ANY OFFERING CONDUCTED BY THE COMPANY THAT DIFFER FROM THE VIEWS OF ITS INVESTMENT BANKERS. FURTHER, PURSUANT TO APPLICABLE LAW OPPENHEIMER & CO. INC. IS (AMONG OTHER THINGS) PRECLUDED FROM OFFERING FAVORABLE RESEARCH, A SPECIFIC RATING OR A SPECIFIC PRICE TARGET, OR THREATEN TO CHANGE RESEARCH, A RATING OR A PRICE TARGET, TO THE COMPANY AS CONSIDERATION OR INDUCEMENT FOR THE RECEIPT OF BUSINESS OR COMPENSATION. OPPENHEIMER & CO. INC. TRANSACTS BUSINESS ON ALL PRINCIPAL EXCHANGES AND MEMBER SIPC 6631306.1. CONFIDENTIAL