A leader in speciality gastrointestinal and metabolic diseases – Leveraging attractive clinical pipeline with growing revenue

July 2017

1 Forward-looking statements

This presentation contains information pertaining to Zealand Pharma A/S (“Zealand"). Neither Zealand nor its management, directors, employees or representatives make any representation or warranty, express or implied, as to the accuracy or completeness of any of the information contained in this presentation or any other information transmitted or made available to the viewer or recipient hereof, whether communicated in written or oral form.

This presentation does not constitute or form part of, and should not be construed as, an offer to sell or issue or the solicitation of an offer to buy or acquire Zealand securities, in any jurisdiction, or an inducement to enter into investment activity, nor shall there be any sale of securities in any state or jurisdiction in which such offer, solicitation or sale would be unlawful prior to registration or qualification under the securities laws of any such state or jurisdiction. No part of this presentation, nor the fact of its distribution, should form the basis of, or be relied on in connection with, any contract or commitment or investment decision whatsoever.

This presentation contains forward-looking statements that reflect management's current views with respect to Zealand's product candidates' development, clinical and regulatory timelines and anticipated results, market opportunity, potential financial performance and other statements of future events or conditions. Although Zealand believes that the expectations reflected in such forward-looking statements are reasonable, no assurance can be given that such expectations will prove to have been correct. Accordingly, results could differ materially from those set out in the forward-looking statements as a result of various factors, many of which are beyond Zealand’s control. No reliance should be made on such forward-looking statements.

Zealand does not intend to update the presentation, including the forward-looking statements contained therein, following distribution, beyond what is required by applicable law or applicable stock exchange regulations if and when circumstances arise that lead to changes compared to the date when these statements were provided.

2 Zealand is advancing a portfolio of metabolic and gastrointestinal medicines

A leader with a strong track record in Zealand Pharma A/S peptide drug development

5,000 10 > 500 Founded in 1998 peptides projects patents1 synthesized advanced to registered clinical development Listed on Nasdaq Copenhagen: ZEAL Focus on speciality gastrointestinal and Market cap 3 July ‘17: metabolic diseases DKK 3.5 bn / USD 0.52 bn > 1802 60 million people2 gastrointestinal (GI) in the U.S. suffer ~ 130 employees, diseases from GI diseases mainly in R&D

1 Total of 556 registered, of which 276 published. 2 National Institutes of Health, U.S. Department of Health and Human Services. Opportunities and Challenges in Digestive Diseases Research: Recommendations of the National Commission on Digestive Diseases. Bethesda, MD: National Institutes of Health; 2009. NIH Publication 08–6514.

3 Zealand attractive pipeline and anticipated growing revenues to serve as catalysts of value creation

Proven ability to Type 2 diabetes drug* partnered with Sanofi advance new drug launched in the U.S. and EU in 2017 candidates • New combination treatment addressing large market • Strong peptide • Key portfolio asset for Sanofi research capability

Advanced pipeline Multiple near-term value-driving • One Phase 3 program • Two Phase 2 programs catalysts – One approaching Phase 3 • One Phase 1 program • Two programs approaching Phase 1

*Soliqua® 100/33 (U.S.)/Suliqua® (EU) – a combination product of basal insulin (Lantus®) and GLP-1 analog (Adlyxin®) and Adlyxin® (U.S.)/Lyxumia® (EU and RoW) – a once-daily GLP-1.

4 Marketed products

5 Type 2 diabetes drug partnered with Sanofi launched in the US and EU in 2017

Combination product of basal insulin (Lantus®) and GLP-1 analog Once-daily GLP-1 (Adlyxin®)

® Soliqua® 100/33 (U.S.) Suliqua® (EU) Adlyxin (U.S.) Lyxumia® (EU and RoW)

• Combined market of USD 15 bn* • USD 5 bn market, growing at the rate of ~ • Basal insulin: USD 10 bn 25%* • GLP-1: USD 5 bn • Low double-digit royalty • Commercialized by Sanofi from Sanofi • Low double-digit royalty • Up to an additional USD 100m in milestone payments outstanding

* Based on 2016 annual reports from Sanofi, Novo Nordisk, Eli Lilly, AZ and GSK for Lyxumia®, Victoza®, Bydureon™, Trulicity®, Syncria® and Byetta® and for insulin products.

6 Soliqua® 100/33 is a strategic priority product for Sanofi with growing prescriptions

Soliqua® 100/33 weekly prescriptions Strong commitment by Sanofi • Soliqua® 100/33 is one of Sanofi’s six priority products, with projected combined revenues of USD 12-14 billion in 2020** • Available in U.S. pharmacies just six weeks after approval

• As this is the first marketed GLP-1 /insulin combination in the U.S., Sanofi is continuing to educate physicians

* Week including Memorial Day. Source: Symphony market data. ** 2016 Sanofi corporate presentation (34th annual JP Morgan conference, January 2016).

7 Payor access is growing for Soliqua® 100/33

Secured U.S. formulary access in April 2017

34% • Co-pay program to Commercially accelerate patient and insured payor uptake patients • Pragmatic and transparent pricing

• Payor access expected to grow steadily

31% Medicare patients

Source: Sanofi Q1 2017 Conference call.

8 Attractive pipeline reaching later stages of clinical development

9 Important milestones in 2017 for our product candidates

Product 2017 candidate Indication Development stage milestone Status Preclinical Phase 1 Phase 2 Phase 3 Registration Phase 2 Glepaglutide*1 Short bowel Phase 2 GLP-2 analog syndrome results Achieved

Dasiglugacon*1 Acute, severe Phase 3 Phase 3 hypoglycemia Commenced Rescue pen initiation (insulin shock)

Phase 2a 1 Dasiglucagon* Type 1 diabetes Phase 2a Achieved Pump therapy management results

Phase 1 Dasiglucagon*1 Congenital Phase 2 Rare diseases Hyperinsulinism initiation

Preclinical GLP1-GLU2 Obesity/type 2 Phase 1 dual agonist diabetes initiation

Preclinical Amylin Obesity/type 2 Phase 1 analog2 diabetes initiation

* Glepaglutide and dasiglucagon are proposed International Nonproprietary Names (pINN). 1 Fully owned by Zealand. 2 Global development and commercial rights are owned by Boehringer Ingelheim.

10 Glepaglutide GLP-2 analog for the treatment of short bowel syndrome (SBS)

11 Short bowel syndrome is a severe condition with significant therapeutic needs

SBS patients cannot absorb enough Patients can be dependent on nutrients and fluids through the gastro- parenteral support for up to 16 intestinal tract hours/day

Parental nutrition (PS) Desired energy level

Normal person SBS patient Start PS End PS Start PS Length of gastro- Length of gastro- intestinal tract: intestinal tract: ~ 8.5 m/~ 25 ft < 2 m/~ 6.5 ft

9 PM 3 AM 9 AM 3 PM 9 PM Timeline (hours)

Energy level Eat/drink real food

12 Jeppesen PB. J Parenteral Enteral Nutr. 2014;38 (supplement 1):8S-13S. Zealand data on file; ZP-SBS User Research v1. Potential to capitalize on growing market

SBS prevalence doubled in one Current market (dependent on parenteral support) Increased market* decade1 due to increased awareness Growth drivers: and improved care Prevalence continues to grow USD +1 billion5

USD Broaden SBS ~ 6005 patient segment 20,000-40,000 million Ready-to-use SBS patients solution in the U.S. and Europe 2

USD Increase 2204 awareness USD 395,000 million

Cost of therapy in the U.S. per 2016 2020 2020+ patient per year3 < 1,000 > 2,000 patients patients

1 Brandt, 2016, Journal of Parenteral and Enteral Nutrition. 3 Truven Redbook, 2016 WAC price. 2 Jeppesen P. New approaches to the treatments of short bowel syndrome-associated intestinal failure. 4 Shire annual report, 2016. Curr Opin Gastroenterol 2014;30:182–8.; Howard L, et al. Current Use and Clinical Outcome of Home 5 Transparency Market Research, SBS Parenteral and Enteral Nutrition Therapies in the United States Gastroenterology 1995;109:355–65. Market, January 2017. 13 * Current marketed product, teduglutide, available for patients on parenteral support. In 2016, less than 30% of eligible patients were treated with a GLP-2 (Truven Health analysis, Zealand data on file). Assumed growing prevalence and greater treatment adoption in patients with SBS by 5% per year in addition to annual single digit price increases. Glepaglutide has potential as a best-in-class long-acting GLP-2 analog

Glepaglutide significantly Glepaglutide Teduglutide (Gattex®) increases small intestinal mass in preclinical study • 39 amino acids • 33 amino acids

• 14-17 hours half-life • 1.3-2 hours half-life 125

100 • Ready-to-use pen • Lyophilized powder

over vehicle) over vehicle) 75

50

increased increased 25

Small intestinal wet weight weight wet Smallintestinal (%

0 10 100 1000 Compound (nmol/kg) Glepaglutide GLP-2 analog

Glepaglutide is a proposed International Non-proprietary Name (pINN). Data on file (Zealand Investigator Brochure, edition 3). Gattex® [prescribing information] NPS Pharmaceuticals, Bedminster, NJ. 2015. Teduglutide required supplies: vial of lyophilized teduglutide, diluent syringe, needle, dosing syringe, seven-step preparation instruction.

14 Glepaglutide met Phase 2 primary end-point of reduction in fecal wet weight

Relative fecal wet weight output reduction in Phase 2 trial in patients with short bowel syndrome*  50% Fecal wet weight output reduction  40% “This is the most comprehensive 30% Phase 2 trial conducted to date in patients with short 20% bowel syndrome, and I am 30% truly impressed with the 23% 10% clinical results seen for glepaglutide in these 0% patients.” -10% -10% Professor Palle Jeppesen 0.1 mg 1 mg 10 mg Daily doses Principal Investigator, MD, Department of Gastroenterology, Rigshospitalet, University of Copenhagen, Denmark  Increases in gastrointestinal fluid and energy absorption observed  Observed to be safe and well tolerated in the trial

15 * Zealand company release, June 19, 2017. Dasiglucagon Stable liquid glucagon analog for the treatment of diabetes

16 Multiple opportunities for new treatments based on dasiglucagon

Zealand dasiglucagon franchise Market opportunity

Rescue pen for severe Potential to switch current hypoglycemia users and grow market

Automated diabetes care Potential paradigm shift with a dual-hormone pump for type 1 diabetes

Pump treatment for chronic Rare disease low blood sugar

17 Severe hypoglycemia is one of the most feared complications among patients on insulin therapy1

Currently available glucagon Zealand has developed a ready- rescue kits are complex to use to-use glucagon analog

• Formulated as a powder • Single-dose formulation • Multi-step preparation before injection • Favorable stability in a liquid formulation • High risk of administration failure • Easy and intuitive to use

For illustration only

“...the complexity of the kit is a problem ...”*

*Research Commissioned by Zealand Pharma n = 11,373 posts on hypoglycemia in diabetes for a. Results from human factor studies published by Locemia and Xeris; Center for Disease Control and Prevention.cdc.org; Harris et al. 2001, Practical Diabetes International.

1 18 Kalra 2013: p2A; p9A. The glucagon rescue market holds significant growth potential

U.S. glucagon market is worth more than USD 300m

Current market Market expansion

Growth drivers: USD Improved product ? Ready-to-use solution1 million3

Increased awareness No promotion of current kits

USD 315 million Increased penetration < 25% use glucagon today

20162 2020+

… but is significantly underpenetrated ~ 3 million diabetics have increased risk of severe hypoglycemia

1 Vast majority of parents of T1DM children or adolescents struggled to use the rescue kit. Source: Harris 2001: p1A; p2A.B; p3A,B. 2 IMS Health data, 2016 value of glucagon market. 3 2016 U.S. volume (IMS Health) forecasted with an increase in T1D prevalence of 3% per year (JDRF), increased adoption of rescue treatments with new options available (+2% from 2019) in addition to applying a 5% price growth. 19 Dasiglucagon rescue pen is a potential game changer in the treatment of severe hypoglycemia

Phase 2 results indicate fast and effective rescue from hypoglycemia with dasiglucagon Phase 2 key results

Mean time to 20 mmol/l increase in blood glucose (+SEM) was 9 minutes with the 0.6 mg dasiglucagon dose

Nausea and vomiting were the most frequent adverse events, with similar rates to

marketed glucagon plasma glucose profiles profiles glucose plasma

Mean Mean Phase 3 has been initiated

Dasiglucagon is a proposed International Non-proprietary Name (pINN). Data from the Phase 2 trial presented at 77th Scientific Sessions of the American Diabetes Association.

20 Tight glucose control remains a significant challenge with current T1D treatment options

Potential when treating with insulin and Insulin-only treatment glucagon in a dual hormone pump system

Insulin dispense • Gaining more effective and stable glucose control • Eliminating the fear of hypoglycemia Blood sugar • Reducing concerns about living with diabetes

Insulin and glucagon treatment Dasiglucagon and a breakthrough Insulin dispense pump solution may offer a paradigm shift in diabetes treatment

Blood sugar

Glucagon dispense

21 Glucagon market potential in dual hormone setting is a significant product opportunity

Zealand partners with U.S. insulin pump market is expected to grow2 Beta Bionics

No. of type 1 diabetes patients on pump in the U.S.

“A dual-hormone 560,0002 pump has the potential to significantly improve Growth drivers: glucose control in diabetes

400,0001 and enable a paradigm Increased prevalence shift.” Edward Damiano Improved technology / President and CEO, Beta Bionics fully automated pumps

Broader patient segment

2015 2020

iLet™ from Beta Bionics

1 American Association of Diabetes Educators. 2 Meddevicetracker, Informa, March 2017. 22 Automated diabetes management with a dual-hormone pump therapy would enable a paradigm shift

Treatment with both insulin and glucagon in a dual-hormone system has shown improved glucose control over insulin-only treatment1:

Treatment with insulin only in a pump: Daily Continuous Glucose Monitoring glucose level

Treatment with both insulin and glucagon in a dual-hormone pump system: Daily Continuous Glucose Monitoring glucose level

The Lancet, December 2016: S0140-6736(16)32567-3 and Elkhatib F, Buckingham BA, Buse JB, et al. Abstract 77-OR. at: ADA 76th Scientific Sessions; June 10-14, 2016; New Orleans, LA. Association. N=39 adults with type 1 diabetes, 24 hour daily treatment.

23 Phase 2a trial results support development of dasiglucagon in the iLet™ pump for type 1 diabetes

“Microdose” study “Pump” study May 2017 June 2017

Pharmacokinetic and Hypoglycemic challenge by pharmacodynamic profile of fasting, higher basal insulin concentrated formulation rates and exercise

Percentage time in various glucose ranges Adequate blood glucose  Dasiglucagon Lilly Glucagon increases in response to 80% “Stable glucagon was the missing microdoses of dasiglucagon 71% piece we needed to make the 60% 65% benefits of this technology available to patients. I very much look forward No safety issues observed 40%  to contributing to the next, more extensive, long-term clinical studies Positive results reported1 20%  18% with Beta Bionics' iLet™ and 13% 0% Zealand’s stable glucagon analog.” Time with glucose < 60 Time with glucose 70- mg/dl 180 mg/dl

To assess safety and efficacy in Steven J. Russell the Beta Bionics dual-hormone Principal Investigator, MD Massachusetts General Hospital pump Diabetes Center, Boston, U.S.

No local tolerability issues observed

24 1 Zealand Pharma company announcement – No. 16/2017. Management, financials and news flow

25 Highly skilled management with significant experience in all aspects of biotech development

 Joined Zealand in 2015  CEO of Dako (part of Agilent Technologies) Britt Meelby Jensen  11 years’ experience in managerial positions at Novo Nordisk President,  Management consultant at McKinsey & Company Chief Executive Officer

 Joined Zealand in 2010  CFO positions at Swedish Orphan International, Active Biotech and Mats Blom Anoto Executive Vice President,  More than five years’ experience in management consulting Chief Financial Officer positions

Adam Steensberg  Joined Zealand in 2010 Executive Vice President, Chief Development and  Medical director positions at Novo Nordisk Medical Officer  Clinician at Rigshospitalet, University of Copenhagen

 Joined Zealand in July 2016  General partner and Scientific Director for the Life Sciences Andrew Parker Investment Fund Eclosion2 & Cie Executive Vice President,  More than 20 years’ experience in senior leadership and Chief Science Officer managerial positions at Shire, Opsona and AstraZeneca

26 Zealand ends Q1 2017 with strong cash position

Revenue 2016 increased by Net operating expenses 2016 Total cash at March 31, 2017 25% to DKK 234.8 (USD 33.5) increased by 29% to DKK of DKK 417.0 (USD 59.6) million* 319.0 (USD 45.6) million* million

* Compared to FY2015. 27 Multiple near-term value-driving catalysts

Expected news flow for 2017 Dasiglucagon – Rescue pen Initiation of Phase 3 Glepaglutide GLP-2  program Soliqua® 100/33  analog Dasiglucagon – Pump available in the U.S. Topline results from Glucagon GLP-1 dual therapy Phase 2 trial (end of agonist for EU approval of Suliqua® Initiation of Phase 2b June) obesity/diabetes Triggers USD 10 million trial expected Start of Phase 1 milestone payment  Q2 Q3 Q4 Q1 Q2

Dasiglucagon –  Amylin analog for Glepaglutide GLP-2 Soliqua® 100/33/Suliqua®  Pump therapy obesity/diabetes analog and Adlyxin® Topline results of Start of Phase 1 Quarterly sales updates Patient recruitment Phase 2a trial in dual- ® completed for hormone pancreas Soliqua 100/33/ ® ® Phase 2 trial system (Beta Bionics) Suliqua and Adlyxin Quarterly sales updates

Glepaglutide and dasiglucagon are proposed International Non-proprietary Names (pINN).

28 Attractive clinical pipeline with growing revenue

Proven ability to Type 2 diabetes drug partnered with Sanofi advance new drug launched in 2017 in the U.S. and EU candidates • New combination treatment addressing large market • Strong peptide • Key portfolio asset for Sanofi research capability

Advanced pipeline Multiple near-term value-driving • One Phase 3 program • Two Phase 2 programs catalysts – One approaching Phase 3 • One Phase 1 program • Two programs approaching Phase 1

29 Thank you

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