ROCKWELL MEDICAL, INC. TRANSFORMING IRON DEFICIENCY AND ANEMIA MANAGEMENT

Corporate Presentation April 2021

www.RockwellMed.com FORWARD-LOOKING STATEMENTS

Certain statements in this presentation may constitute "forward-looking statements" within the meaning of federal securities laws, including, but not limited to, Rockwell Medical’s intention to commercialize Triferic® Dialysate and Triferic® AVNU, develop FPC for new indications, and maintain concentrate sales. Words such as "may," "might," "will," "should," "believe," "expect," "anticipate," "estimate," "continue," “can,” "could," “would,” “develop,” "plan," "potential," "predict," "forecast," "project," "plan", "intend" or the negatives of these terms, and similar expressions, or statements regarding intent, belief, or current expectations, are forward-looking statements. While Rockwell Medical believes these forward-looking statements are reasonable, undue reliance should not be placed on any such forward-looking statements, which are based on information available to us on the date of this presentation. These forward-looking statements are based upon current estimates and assumptions and are subject to various risks and uncertainties (including, without limitation, those set forth in Rockwell Medical’s SEC filings), many of which are beyond our control and subject to change. Actual results could be materially different. Risks and uncertainties include: the potential impact of COVID-19 pandemic (including, applicable federal, state and local orders) on business, clinical development plans and operating results, including our supply chain, dialysis concentrates business and commercial launch of Triferic Dialysate and Triferic AVNU; statements about the challenges inherent in new product development and other indications and therapeutic areas for our products; the likelihood of success and timing of our international development and commercialization plans, including regulatory filings and clinical trials; the success of and our commercialization of Triferic Dialysate domestically and internationally; the success and timing of our commercialization of Triferic AVNU; the expected number of annualized treatments for Triferic Dialysate and Triferic AVNU; the risk that regulatory authorities delay or fail to approve FPC for new indications; the risk that market opportunities are smaller than estimated; the risk that Rockwell Medical is not able to seek reimbursement for FPC for new indications; the risk that FPC is unsafe for new indications; the risk that clinical study designs, timing and costs are different than estimated; expected financial performance, including cash flows, revenues, growth, margins, funding, liquidity and capital resources; and those risks more fully discussed in the “Risk Factors” section of our Quarterly Report on Form 10-Q for the quarter ended September 30, 2020 and of our Annual Report on Form 10-K for the year ended December 31, 2019, as such description may be amended or updated in any future reports we file with the SEC. Rockwell Medical expressly disclaims any obligation to update our forward- looking statements, except as may be required by law.

Triferic® is a registered trademark of Rockwell Medical, Inc. Triferic AVNU is pending with the U.S. Patent and Trademark Office. All other product names, logos, and brands are property of their respective owners in the United States and/or other countries. All company, product and service names used on this website are for identification purposes only. Use of these names, logos, and brands does not imply endorsement.

2 TRANSFORMING IRON DEFICIENCY & ANEMIA MANAGEMENT Commercial-stage & investing in growth Why Rockwell? • Growth Based on Unique, Proprietary Platform Technology - Ferric Pyrophosphate Citrate (“FPC”) • 100% bioavailable iron to transferrin immediately once in the blood • Two approved products for the dialysis market • Add’l products in development for Home Infusion & Heart Failure Target Populations for FPC (total # of eligible patients) • Building on the Success of a Significant Core Business • Important supplier of therapeutic products in the growing dialysis market In-Center Dialysis (US) 500k • #2 in Concentrates; ~$60m in revenue In-Center Dialysis (Global) 1.5m • Multiple Upcoming Milestones (in 2021 & 2022) • Clinical Progress Home Infusion (US)* >300k • Commercial (US growth, international expansion) Acute Heart Failure (US)* 630k • Well Capitalized Total ~3m • New Management Team • Experienced in clinical development & commercialization of renal products * future indications

3 ROCKWELL MEDICAL

HOME DIALYSIS PIPELINE INFUSION

Triferic® FPC for iron FPC for deficiency acute heart Concentrates anemia failure

Ferric Pyrophosphate Citrate Platform Technology Manufacturing & Transportation Core Capabilities GROWTH DRIVERS Commercial-stage, Global expansion, and New indications in pipeline

Development Pipeline Global Expansion Commercialized • FPC Platform Technology Products • Established license agreements for Home Infusion for Acute Heart Failure • Dialysis Concentrates • Additional market opportunities • Triferic® (ferric pyrophosphate citrate) • Triferic AVNU™ (ferric pyrophosphate citrate injection)

Leveraging our platform technology – ferric pyrophosphate citrate (FPC)

5 ROCKWELL PIPELINE

Preclinincal Phase 1 Phase II Phase III Submitted NDA Approved/Commercial Phase IV Chronic Kidney Disease - Dialysis Clinics Concentrates Dialysis Concentrates U.S. Baxter & DaVita International Nipro

Ferric Pyrophosphate Citrate Platform Triferic® Triferic® (Dialysate): U.S. Triferic® AVNU (IV): U.S. Triferic®: U.S. - with roxadustat1

Triferic® : Canada RMC Health Care Triferic® : Korea Jeil Pharma Triferic® : India Sun Pharma Triferic® : China Wanbang Biopharm (Fosun)

Iron Deficiency Anemia - Home Infusion Setting FPC Rock-201: U.S.

Acute Heart Failure - In-Patient FPC Rock-301: U.S.

1 - Pending FDA approval of Roxadustat; the efficacy, safety and compatibility of Triferic with Roxadustat has not yet been evaluated by FDA

6 STRONG PRESENCE IN HEMODIALYSIS

Dialysis Concentrates Triferic® Platform

• #2 supplier of dialysis concentrates products • Two FDA-approved drugs (bicarbonate & acetate) in the U.S. • Triferic Dialysate, Triferic AVNU (for intravenous use) • $60+ million of annualized sales • The only FDA-approved therapies indicated to • Facilitating nearly 20 million life-saving replace iron and maintain Hb for dialysis patients treatments each year • Unique physiologic mechanism of action • Provides immediately bioavailable iron to tissues • Maintained supply and distribution chain • Safety profile comparable to placebo throughout the COVID-19 pandemic • Potential for significant advantages in additional indications outside of dialysis

7 Ferric Pyrophosphate Citrate (FPC)

8 FPC IS A NEXT-GENERATION PARENTERAL IRON

• Water-soluble iron salt administered via slow infusion

• No complex carbohydrate shell; tightly bound to pyrophosphate and citrate1

• Donates 100% bioavailable iron to transferrin immediately once in the blood

• Utilizes the body’s natural iron transport process • Negligible free iron, no oxidative stress from macrophage accumulation of iron • No increase in markers of inflammation

Iron (III) complexed with one pyrophosphate and two citrate molecules in the solid state

9 1. Pratt R, et al. Biometals. 2018;31(6):1081-1089 EXCELLENT CLINICAL SAFETY PROFILE

Clinical Development Program in the U.S.1,2,3 • >100,000 Doses • No anaphylaxis • No iron overload (serum ferritin did not increase) • Adverse event rate similar to placebo • No difference in intradialytic hypotension (IDH) • No difference in infections • No difference in vascular access thrombotic events • No clinical laboratory abnormalities • No increase in oxidative stress or inflammation

1. Fishbane SN, Singh AK, Cournoyer SH, et al. Ferric pyrophosphate citrate (Triferic™) Post-Launch Experience in the U.S. administration via the dialysate maintains hemoglobin and iron balance in chronic hemodialysis patients. Nephrol Dial Transplant. 2015;30(12):2019-2026. • Over 1.2 million patient days administered 2. TRIFERIC Prescribing Information. Wixom, MI: Rockwell Medical, Inc.; 2018. 3. Gupta A, Lin V, Guss C, Pratt R, Ikizler A, Besarab A. Ferric pyrophosphate citrate administered via dialysate reduces erythropoiesis stimulatingagent use and • No reports of unexpected SAE or changes to U.S. product maintains hemoglobin in hemodialysis patients. Kidney Int. 2015;88(5):1187-1194. information

10 11 TRIFERIC® FOR HEMODIALYSIS PATIENTS

A PHYSIOLOGIC APPROACH TO Iron Maintenance for hemodialysis-dependent chronic kidney disease patients

Most patients on hemodialysis have sufficient iron stores • Anemia of CKD pathophysiology restricts iron bioavailability • Increased hepcidin levels prevent delivery of stored iron for erythropoiesis Triferic delivers 100% bioavailable iron, resulting in hemoglobin stabilty1-3* • Achieves iron maintenance by restoring the ~5-7mg of iron lost at every dialysis session.3 • Immediately binds to transferrin and is transported to erythroid precursor cells • Bypasses iron sequestration caused by hepcidin3 • Raises TSAT following dialysis without elevating serum ferritin levels and iron stores1-3

Triferic can be conveniently delivered via the dialysate2 Triferic is cost-effective4 Full Prescribing Information available at www.Triferic.com

1. Fishbane SN, et al. Ferric pyrophosphate citrate administration via the dialysate maintains Hb and iron balance in chronic HD patients. Nephrol Dial Transplant. 2015;30(12):2019-2026. 2. TRIFERIC Prescribing Information. Wixom, MI: Rockwell Medical, Inc.; 2018. 12 3. Gupta A, et al. Ferric pyrophosphate citrate administered via dialysate reduces ESA use and maintains hemoglobin in hemodialysis patients. Kidney Int. 2015;88(5):1187-1194. 4. Dellafera L, et al. Institutional Usage of Ferric Pyrophosphate Citrate in Reducing Erythropoiesis-Stimulating Agents. Critical Care Medicine. Jan 2021:49(1).551. TRIFERIC U.S. MARKET OVERVIEW

US In-Center Hemodialysis Patients Estimated Total U.S. In-Center HD Treatments SDO's / Indep. 74,000 73 million LDO MDO's LDO (Fresenius) 58,000 LDO 179,000 (Fresenius) 3 MDOs (DaVita) ➢ 179k Patients 58k Current target market is 27% or 20 million treatments 175k Patients 37% LDO (DaVita) Patients • SDOs, MDOs, and Independents 36%175,000 10% ➢ Long-term target market is 63% or 55 million treatments LDO (Fresenius) LDO (DaVita) MDO's SDO's / Indep. • LDOs

Metric Q2 2020 Q3 2020 Q4 2020 Contracted Clinics 39 52 65 U.S. Market Introduction Contracted Patients 2,784 3,314 4,824

13 LDO = Large Dialysis Organization MDO = Mid-sized Dialysis Organization SDO = Small Dialysis Organization TRIFERIC AVNU: A NEW FORMULATION Commercially launched in the U.S. February 9, 2021

Triferic AVNU is a line extension of Triferic for dialysis patients U.S. Hemodialysis • Triferic Dialysate is delivered via a central loop bicarbonate delivery system Treatments* by Bicarbonate Technology Type (the system utilized by ~53% of clinics*), while Triferic AVNU is delivered via slow intravenous infusion

Triferic AVNU opens new opportunities for the portfolio 11.7 10.5 million million • Triferic AVNU can be used regardless of the bicarbonate technology type used 53% 47% • Provides clinics the flexibility to individualize treatment

Triferic AVNU was commercially launched February 9th • Multichannel promotional campaign initiated to generate awareness Solid Bicarbonate Central Loop System

• Targeting independent and SDO customers with solid bicarbonate machines * Currently addressable market only – MDO’s, SDO’s, and Independents

14 15 STUDY SHOWS REDUCTION IN ESA’S, IV IRON & COST Report Published on Triferic usage from the dialysis center at NYU Langone Hospital – Long Island

Institutional Usage of Ferric Pyrophosphate Citrate in Reducing Erythropoiesis-Stimulating Agents Dellafera L, Wang S, Dhanani L, Dutka P., Malone B, Masani N. Critical Care Medicine: January 2020 – Vol 49 – Issue 1 – p.551 Retrospective chart review of 100 hemodialysis Research Snapshot: Quality and Patient Safety patients in an outpatient center METHODS Before FPC After FPC  • An outpatient dialysis clinic affiliated with an academic institution performed an IRB exempt retrospective chart review study Average weekly ESA ~53 mcg ~39 mcg -26.4% (P<0.0001) • ~100 patient charts reviewed before and after they received FPC and compared the doses of ESA and IV dose iron products RESULTS Before FPC After FPC  • The same 100 pts were followed before and after implementation of FPC provided via the central loop Total IV iron replacement 30,337 mg 10,400 mg -65.7% dialysate (iron sucrose) • In the 100 pts, there was a relative reduction in average weekly ESA dose of 26.4% Total IV iron • Total use of IV iron replacement therapy decreased replacement 303,680 mg 5,100 mg -98.2% (SFGC) • Relative reduction in IV iron was 95.4% CONCLUSIONS • FPC in an outpatient dialysis center was associated with the reduction of ESA’s and IV iron product usages. A net savings, inclusive of cost of Triferic, of >$296,000 in one fiscal year was associated with the decreased use of these agents.

16 1. Dellafera L, et al. Research Snapshot: Institutional Usage of Ferric Pyrophosphate Citrate in Reducing Erythropoiesis-Stimulating Agents. Critical Care Medicine. Jan 2020:49(1).551. 17 ROXADUSTAT PRESENTS A NEW OPPORTUNITY FOR TRIFERIC New anemia drug expected to transform treatment & change iron requirements for dialysis patients

Roxadustat is a new approach to treatment of the anemia of CKD • A physiologic approach to anemia mgmt. with improved safety vs. ESA’s* • Expected approval in Q1 2021

Roxadustat patients will require less iron • Reduces hepcidin & increases iron binding capacity (circulating transferrin), improving bioavailability of body iron stores & reducing requirement for IV iron supplementation • Evidence presented at ASN 2020 shows a monthly iron requirement of ~52mg

Triferic may be uniquely suited to meet iron requirements of HIF-PHI patients • Triferic provides 100% bioavailable iron, bypassing hepcidin block and donating directly to transferrin • Triferic in the dialysate alone (84mg per month) may be sufficient to meet iron needs of most roxadustat treated patients eliminating the need for I.V. iron supplementation Rockwell planning on conducting Triferic Phase 4 study for adjunctive use with roxadustat • To be initiated after FDA approval of roxadustat

18 * Erythropoietin Stimulating Agents 19 TRIFERIC: INTERNATIONAL MARKET Advancing Triferic internationally

China • Partnered to commercialize Triferic with Wanbang Biopharmaceutical • Registrational study started treating patients in Jan’21 • Low-to-mid 20% royalty due to Rockwell on Net Sales; $35 million potential milestone payments India • Signed licensing agreement with Sun Pharma in January 2020 • NDA submitted LATAM • Distribution agreements in place and commercial launch in Peru and Chile expected Q1 2022 Canada • Distribution agreement in place; NDS submitted in May 2020 and accepted for filing in June 2020 Korea • Signed licensing agreement with Jeil Pharma in September 2020 • Jeil Pharma submitted NDAs for both Triferic and Triferic AVNU in January 2021. Europe / Japan • Discussions ongoing with potential partners for Triferic AVNU

20 Newly formulated FPC products Novel presentations 505(b)(1) FDA approvals Unique J-codes Differentiated pricing

21 IRON DEFICIENCY ANEMIA IN THE HOME INFUSION SETTING A large and growing unmet medical need

❖ Why FPC in home infusion therapy? • Explosive growth – 3.2 million pts treated (+400% from 2010 to 2019)1 • Iron deficiency anemia (IDA) is a common co-morbidity • Management of IDA in home infusion patients is a ‘broken’ process • FPC may be uniquely suited; 100% bioavailable iron with excellent safety • Reimbursement landscape favorable (Medicare Part B) • FPC a good fit for home infusion therapy services model ❖ Total U.S. market opportunity estimated at ~$600M ❖ Clinical development is estimated to be a 27 – 40-month process

22 1. NHIA Infusion Industry Trends Report 2020. HOME INFUSION CLINICAL DEVELOPMENT PLAN Minimal safety and efficacy risk; low cost

1 Pre-IND Meeting with FDA Program allows for • Anticipated in Q3 2021 multiple data readouts 2 Phase II Observational Study over the next 3 years. • Confirm iron deficiency anemia rates and practice treatment patterns • 4-6 months

3 Phase II Dose Scheduling Study Phase II 13-18 mos. • Validate endpoints and confirm dose response • 9-12 months End of Ph II Meeting with FDA

4 Phase III Program • 200-300 patients, 1-2 pivotal trials Phase III 24 mos. • 24 months 5 PDUFA • 12 months

23 FPC FOR ACUTE HEART FAILURE

Rockwell is investigating the potential for FPC as a treatment for hospitalized acute heart failure patients. ❖ Why acute heart failure? • Over a million patients are hospitalized each year with acute decompensated heart failure • Iron deficiency a common co-morbidity in all forms of HF (50-70%) representing a significant unmet need • A significant body of evidence exists to support the use of IV iron therapy for improvement of cardiac energetics (not improvement of Hgb) • Iron uptake and clinical benefit limited by bioavailability for current IV iron products • FPC uniquely suited for hospitalized acute heart failure – 200mg of bioavailable iron can be delivered during an average 5-day hospital stay (therapeutically equivalent to over 1 gram of currently available IV iron products)

❖ A mechanistic proof of concept study would determine if 200mg of FPC over 5 days provides a sufficient influx of iron to the cardiac tissue to improve myocardial energetics and associated outcomes ❖ Company expects to hold an FDA Type C meeting in 2H 2021 to review a proposed clinical development program

24 UPCOMING MILESTONES NEAR TERM COMMERCIAL & DEVELOPMENT MILESTONES

2021 2022

Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 FDA pre-IND Ph II Study End of Ph II FDA Meeting Meeting Home Home Infusion Home Infusion Infusion Development FDA Type C Meeting Acute Heart Failure

Pivotal Study China

Clinical Trial Waiver* Commercial Launch India India

Global Expansion NDS Approval Commercial Launch Canada Canada

Commercial Launch Chile Commercial Launch Korea Commercial Launch Peru

Product Launch (U.S.) Commercial Triferic AVNU Products Triferic Sales (U.S.)

Dialysis Concentrates Sales (Global)

26 *Request for clinical trial waiver has been filed, but Technical Committee adjudication has been delayed due to COVID-19. EXPERIENCED MANAGEMENT TEAM Proven track record and expertise in biopharmaceutical commercialization and clinical development

Management Team

Russell Ellison, Marc Hoffman, M.D. M.D. Chief Medical Officer Chief Executive Officer Years: 30+ Years: 35+

Russell Skibsted Mike DeYoung Chief Financial Officer VP Operations Years: 25+ Years: 25+

Ray Pratt, M.D. Tim Chole Senior VP Sales and Chief Development Marketing Officer Years: 20+ Years: 25+

27 TRANSFORMING IRON DEFICIENCY AND ANEMIA MANAGEMENT Rockwell Medical is a commercial stage biopharmaceutical company investing in growth

• Building on the Success of a Significant Core Business • Important supplier of therapeutic products in the growing dialysis market (#2 in Concentrates ~$60M) • Growth Based on Unique, Proprietary Platform Technology - Ferric Pyrophosphate Citrate (FPC) • 100% bioavailable iron to transferrin immediately once in the blood • Two approved products for the dialysis market • Clinical development initiated in Home Infusion • Planned development in Heart Failure • Multiple Upcoming Milestones • Well Capitalized • New Management Team

28 THANK YOU