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Home , Dasiglucagon, Diabetes management, Type 2 diabetes

ZEGALOGUE® () injection for the treatment of severe in patients with ages six years and above

U.S. FDA APPROVAL CONFERENCE CALL

March 23, 2021

ZEGALOGUE® (dasiglucagon) injection FDA Approval Call 1 Forward-looking statements

This presentation contains “forward-looking statements”, as that term is defined in the Private Securities Litigation Reform Act of 1995, as amended, that provide Zealand Pharma’s expectations or forecasts of future events regarding the research, development and commercialization of pharmaceutical products.

The reader is cautioned not to rely on these forward-looking statements. Such forward-looking statements are subject to risks, uncertainties and inaccurate assumptions, which may cause actual results to differ materially from expectations set forth herein and may cause any or all of such forward- looking statements to be incorrect, and which include, but are not limited to, the occurrence of adverse safety events; risks of unexpected costs or delays; unexpected concerns that may arise from additional data, analysis or results obtained during clinical trials; failure to protect and enforce our data, intellectual property and other proprietary rights and uncertainties relating to intellectual property claims and challenges; regulatory authorities may require additional information or further studies, or may fail to approve or may delay approval of our drug candidates or expansion of product labeling; failure to obtain regulatory approvals in other jurisdictions; product liability claims; and the direct and indirect impacts of the ongoing COVID-19 pandemic on our business, results of operations and financial condition.

If any or all of such forward-looking statements prove to be incorrect, our actual results could differ materially and adversely from those anticipated or implied by such statements. The foregoing sets forth many, but not all, of the factors that could cause actual results to differ from our expectations in any forward-looking statement.

All such forward-looking statements speak only as of the date of this presentation and are based on information available to Zealand Pharma as of the date of this release. We do not undertake to update any of these forward-looking statements to reflect events or circumstances that occur after the date hereof. Information concerning pharmaceuticals (including compounds under development) contained within this material is not intended as advertising or medical advice.

ZEGALOGUE® (dasiglucagon) injection FDA Approval Call 2 ZEGALOGUE® is indicated for the treatment of severe hypoglycemia in pediatric and adult patients with diabetes aged 6 years and above.

ZEGALOGUE® (dasiglucagon) injection FDA Approval Call 3 Indication and Important Safety Information

INDICATION ZEGALOGUE (dasiglucagon) injection is indicated for the treatment of severe hypoglycemia in pediatric and adult patients with diabetes aged 6 years and above.

IMPORTANT SAFETY INFORMATION Contraindications ZEGALOGUE is contraindicated in patients with because of the risk of substantial increase in pressure and in patients with because of the risk of hypoglycemia.

Warnings and Precautions ZEGALOGUE is contraindicated in patients with pheochromocytoma because products may stimulate the release of catecholamines from the tumor. If the patient develops a substantial increase in and a previously undiagnosed pheochromocytoma is suspected, 5 to 10 mg of phentolamine mesylate, administered intravenously, has been shown to be effective in lowering blood pressure.

In patients with insulinoma, administration of glucagon products may produce an initial increase in blood ; however, ZEGALOGUE administration may directly or indirectly (through an initial rise in blood glucose) stimulate exaggerated release from an insulinoma and cause hypoglycemia. ZEGALOGUE is contraindicated in patients with insulinoma. If a patient develops symptoms of hypoglycemia after a dose of ZEGALOGUE, give glucose orally or intravenously.

Allergic reactions have been reported with glucagon products; these include generalized rash, and in some cases anaphylactic shock with breathing difficulties and . Advise patients to seek immediate medical attention if they experience any symptoms of serious hypersensitivity reactions.

ZEGALOGUE is effective in treating hypoglycemia only if sufficient hepatic glycogen is present. Patients in states of starvation, with adrenal insufficiency or chronic hypoglycemia may not have adequate levels of hepatic glycogen for ZEGALOGUE administration to be effective. Patients with these conditions should be treated with glucose.

Adverse Reactions The most common adverse reactions (≥2%) associated with ZEGALOGUE in adults were nausea, vomiting, headache, diarrhea and injection site pain; in pediatrics: nausea, vomiting, headache and injection site pain.

Drug Interactions Patients taking beta-blockers may have a transient increase in pulse and blood pressure when given ZEGALOGUE. In patients taking indomethacin, ZEGALOGUE may lose its ability to raise blood glucose or may produce hypoglycemia. ZEGALOGUE may increase the anticoagulant effect of warfarin.

Please see Full Prescribing Information at (www.zegalogue.com/prescribing-information)

ZEGALOGUE® (dasiglucagon) injection FDA Approval Call 4 With this approval we have taken another important step in pursuing our ambition as a fully integrated biotech

Invest in innovative research platform and robust pipeline 5x25 Have 5 commercialized products by 2025

Optimize commercial operations Secure strong financial situation1

DKK thousand Fully operational US 1,500,000 infrastructure 1,000,000 High prescriber coverage Established relationships 500,000 with KOLs and HCPs 0 2016 2017 2018 2019 2020 Cash & cash equivalents Restricted cash Securities

ZEGALOGUE® (dasiglucagon) injection FDA Approval Call 1: Additional DKK 749 million gross proceeds secured through directed issue in January 2021 5 ZEGALOGUE® (dasiglucagon) is our first approval in this franchise with other indications currently under investigation Approved/ Preclinical Phase 1 Phase 2 Phase 3 Cleared

V-Go® Wearable Insulin Delivery management

ZEGALOGUE® (dasiglucagon) injection Severe hypoglycemia in diabetes Metabolic

Dasiglucagon S.C. Continuous Infusion Congenital

Dasiglucagon Bi-Hormonal Artificial Pump management

Dasiglucagon Adjustable Mini-Dose PBH/ T1D -induced hypo

BI 456906 GLP-1/GLU Dual Agonist1 / NASH/T2D Metabolic ZP 8396 Analog Obesity

ZP 6590 GIP Agonist Obesity

Glepaglutide GLP-2 Analog Short Bowel Syndrome

Dapiglutide GLP-1/GLP-2 Dual Agonist SBS+

ZP 9830 Kv1.3 Ion Channel Blocker IBD+

ZP 10000 ɑ4β7 Inhibitor IBD

GI & Inflammatory Complement C3 Inhibitor2 Undisclosed 1. Licensed to : EUR 345 million outstanding potential development, regulatory and commercial milestones + high single to low double digit % royalties on global sales 2. Licensed to Alexion: USD 610 million potential development, regulatory and commercial milestones + high single to low double digits % royalties on net sales ZEGALOGUE® (dasiglucagon) injection FDA Approval Call 6 Severe hypoglycemia is a major issue for people on insulin

• Insulin treatment is the main cause of severe hypoglycemia in people with diabetes1 • 8.4M Adults and Children on Insulin Therapy2 • Approximately 4.0M patients are on Multiple Daily Injections of Insulin3 • Despite this, there were only approximately 540,000 patients with glucagon therapy in 20204 • Glucagon should be prescribed for all individuals at increased risk of level 2 or 3 hypoglycemia so that it is available should it be needed5

1. The International Hypoglycemia Study Group. Lancet Diab and Endo 2019; 7,(5): 385-96.; 2. Diabetes Surveillance System, Centers for Control: gis.cdc.gov/grasp/diabetes/diabetesatlas.html; Accessed March 1, 2021. 3. Brixner et al. ClinTher. 2019 Feb;41(2):303-313. 4. Symphony Health Trx Quantity; 5.ADA Standards of care. Diabetes Care 2021 Jan; 44 (Supplement 1): S1-S2 7 ZEGALOGUE® (dasiglucagon) injection FDA Approval Call The primary efficacy endpoint of time to plasma glucose recovery (PGR) was met in all pivotal P3 trials evaluating dasiglucagon

50

40 40 35 30 30 • Most common adverse reactions (≥ 2%) were 20 nausea, vomiting, headache, 12 diarrhea and injection site 10* 10† 10* 10 Median time to PGR, mins 10 pain4

0 First pivotal trial1 Second pivotal trial2 Pediatric pivotal trial3 (n = 168) (n = 44) (n = 41) Dasiglucagon Injected glucagon (GlucaGen®) Placebo

*p<0.001 Dasiglucagon compared to placebo, P<0.0001 Dasiglucagon compared to placebo. Data derived from full analysis set = patients who were randomized and treated. PGR = plasma glucose recovery (first increase in plasma glucose of ≥ 20 mg/dL from baseline, without administration of rescue IV glucose). 1. Pieber et al. Oral presentation presented at ADA, 286-OR; June 10, 2019; San Francisco, CA; https://clinicaltrials.gov/show/NCT03378635 . 2. Bailey et al. Oral presentation presented at ADA, 1053-P; June, 2020 (Virtual Annual Meeting); https://clinicaltrials.gov/show/NCT03688711. 3. Battelino et al. Oral presentation presented at ADA, 180-OR; June 2020 (Virtual Annual Meeting); https://clinicaltrials.gov/show/NCT03667053. 4. Zegalogue US Prescribing Information. Zealand Pharma; 2021. GlucaGen® is a registered trademark of Novo Nordisk A/S ZEGALOGUE® (dasiglucagon) injection FDA Approval Call 8 The primary efficacy endpoint of time to plasma glucose recovery (PGR) was met in all pivotal P3 trials evaluating dasiglucagon

Most common adverse reactions (≥2%) associated with ZEGALOGUE are: • Adults: nausea, vomiting, headache, diarrhea, and injection site pain

ZEGALOGUE® (dasiglucagon) injection FDA Approval Call • Pediatrics: nausea, vomiting, headache, and injection site pain 9 ZEGALOGUE is an antihypoglycemic agent indicated for the treatment of severe hypoglycemia in pediatric and adult patients with diabetes aged 6 years and above.

ZEGALOGUE® (dasiglucagon) injection FDA Approval Call 10 ZEGALOGUE will launch at the right time in a growing market that is driven by innovation

Launch timed to capture Rescue market growing with Innovation driven market with ‘Back to school’ seasonality new entrants new entrants capturing share

TRx Units Dispensed (M)

1.2

+60% Rx Volume Lift +10% +6% 0.9 ~300m USD 63% 78%

0.6 100% TRx Volume 1.0 0.9 0.9 Weekly Glucagon Market Market Glucagon Weekly 0.3 37% 22% Jun Jul Aug Sep Oct 0.0 2018 2019 2020 2018 2019 2020 Legacy products New Entrants

ZEGALOGUE® (dasiglucagon) injection FDA Approval Call Source: Symphony Health TRx Quantity 11 ZEGALOGUE provides an attractive treatment option for patients and providers alike

Recovery

Consistent 99% of patients in the main adult phase 3 trial recovered within 15 minutes

10 minutes All pivotal phase 3 studies reported the same median time to recovery

Median time to blood glucose recovery of 10 minutes in adults and children

ZEGALOGUE® (dasiglucagon) injection FDA Approval Call 12 Four strategic objectives to ensure a successful launch of ZEGALOGUE

Presence Establish a clear and distinct product positioning with HCPs, patients, and caregivers

Focused execution during the “back to school” season Precision prioritizing high-value customer segments

Access Establish favorable market access early among top National and Regional Payers, PBMs, and health systems

Support Address patient and caregiver access and education needs through a “fit for purpose” patient support capability

ZEGALOGUE® (dasiglucagon) injection FDA Approval Call 13 ZEGALOGUE is coming soon – Commercial launch in late-June 2021

ZEGALOGUE will be available in an autoinjector (shown) and prefilled syringe

ZEGALOGUE® (dasiglucagon) injection FDA Approval Call 14 Zealand is well positioned for delivering success

Experienced Field Force Established Market Access Team

§ 15 years average diabetes experience § 20 years average experience with US payers § Long-standing presence with diabetes HCPs § Existing relationships with key national through V-Go and regional payers and PBMs through V-Go § Mix of live and inside sales resources covering § Expanded account management footprint across >80% of the Glucagon prescribing market commercial, medicaid, and medicare accounts

Scalable Patient Services Footprint COVID Ready Promotional Mix § Existing V-Go® Patient Support capabilities & § Live and virtual customer engagement mix personnel across sales, marketing, market access, patient § Optimized patient support capability for support, and medical affairs ZEGALOGUE to help address patient and HCP § Tested and optimized to succeed in COVID and needs at launch post-COVID selling environment

ZEGALOGUE® (dasiglucagon) injection FDA Approval Call 15 Zealand Pharma is looking forward to an exciting 2021

Launch ZEGALOGUE® and optimize Advance our early pipeline commercialization Advance pre-clinical drug candidates towards Phase 1 initiation Execute launch readiness program for ZEGALOGUE® Initiate new pre-clinical projects Launch ZEGALOGUE® in US for the treatment of severe hypoglycemia in patients with Strengthen and develop our peptide platform diabetes age 6 or above Deliver on net revenue target for ZEGALOGUE® Deliver on net revenue target for V-Go®

Execute on clinical pipeline Maintain a strong financial and organizational Dasiglucagon for severe hypoglycemia: Receive NDA approval from U.S. FDA position Dasiglucagon for dual-hormone artificial pancreas pump: Initiate Phase 3 study Secured a total of DKK gross 749.0 million through a direct issue and private placement of Dasiglucagon for congenital hyperinsulinism: Deliver second phase III in 2021 and prepare new shares – January 2021 NDA/MAA for execution in 2022 –ongoing Ensure disciplined financial management and productive investments Glepaglutide for short bowel syndrome: Continue patient enrolment in Phase 3 study – Focus company on operational performance and organizational health ongoing Dapiglutide for short bowel syndrome: Complete MAD Phase 1 program

We will share further commercial updates on ZEGALOGUE in coming investor calls (including Q1 earnings) as we approach launch

ZEGALOGUE® (dasiglucagon) injection FDA Approval Call 16 Q&A session•

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