Capital Market Day 2018

PRESENTATION CAPITAL MARKET DAY 2018

RADISSON BLU, ZURICH AIRPORT

4 OCTOBER 2018

CAPITAL MARKET DAY 2018 CREATING THE FUTURE

Etienne Jornod Executive Chairman MILESTONE 2020 WHAT IS NEXT?

WE ARE ON THE WAY

Worldwide pharmaceutical company

Central purchasing organisation for pharmacists

Ferinject® Exploit the potential

Veltassa® Drive to blockbuster

Vifor Fresenius Medical Care Renal Pharma Launch products and enhance value

PHASE 1 PHASE 2 PHASE 3 COMMERCIAL PHASE 4

AFFIRM-AHF

Ferroportin HEART-FID2) inhibitor1)

Paediatric AMBER

OWN PRODUCTS OWN DIAMOND

Anti-infectives

2019

Avacopan 20193)

LICENSING LICENSING CCX140

- PRODUCTS

IN Vadadustat4) CR845 1) Iron overload; leveraging iron metabolism expertise 2) Daiichi Sankyo clinical trial 3) Assumes CMA approval 4) U.S. Filing expected by the end of 2019

4 October 2018 GLOBAL I.V. IRON IN-MARKET SALES MAT Q2-19961)

1) Excluding the market share of Vifor Pharma products (0.6%). Source: IQVIATM MIDAS® Quarterly panel, GERS, Insight Health, DN, DLI, Q2-2018. Average 2017 exchange rates have been applied.

Source: IQVIATM MIDAS® Quarterly panel, GERS, Insight Health, DN, DLI, Q2-2018. Average 2017 exchange rates have been applied. © Vifor Pharma 4 October 2018 9 VELTASSA®

4 October 2018 GLOBAL POTASSIUM BINDER IN-MARKET SALES

MAT Q2-20151)

1) Excluding the market share of Sorbisterit (1.6%) Source: IQVIATM MIDAS® Quarterly panel, GERS, Insight Health, DLI, Q2-2018. Average 2017 exchange rates have been applied. © Vifor Pharma 4 October 2018 11 GLOBAL POTASSIUM BINDER IN-MARKET SALES

MAT Q2-2018

Source: IQVIATM MIDAS® Quarterly panel, GERS, Insight Health, DLI, Q2-2018. Average 2017 exchange rates have been applied. © Vifor Pharma 4 October 2018 12 GLOBAL I.V. IRON IN-MARKET SALES

MAT Q2 WORLDWIDE VIFOR 2018 PHARMA 1,698 MILLION CHF 1,219 MILLION CHF = 71.9% MAT Q2 WORLDWIDE 1996

96 MILLION CHF

VIFOR PHARMA = 28% 63 MILLION CHF MAT Q2 WORLDWIDE 2018

225 MILLION CHF

MAT Q2 WORLDWIDE 2015

175 MILLION CHF

4 October 2018

15 THE JOINT COMPANY UNIQUENESS OF THE BUSINESS MODEL

MEDICAL DIRECT ACCESS R&D CLINICAL REGULATORY PRODUCTION COMMERCIAL AFFAIRS TO THE PATIENT

CR845 Vadadustat

CCX140 Avacopan

THIS IS WHAT DIFFERENTIATES VIFOR PHARMA FROM A TYPICAL PHARMA COMPANY.

1) Fresenius Kidney Care (FKC): Fresenius Medical Care North America dialysis provider organization

4 October 2018

18 VIFOR PHARMA VS. TOP SPI PERFORMERS THE HIGHEST SHARE PRICE RETURN SINCE 1995

4'540%

3'444%

2'657% 2'537% 2'236% 2'107% 2'022% 1'995%

1'060% 1'017%

Vifor Pharma AG Logitech Tecan Group AG Sika AG Kuehne + Nagel Schindler Holding Chocoladefabriken Sonova Holding LEM Holding SA Cie Financiere International SA International AG AG Lindt & Spruengli AG Richemont SA AG

Source: Bloomberg Note: share price increase from 01.09.1995 to 31.08.2018; excludes market capitalization below CHF 100m as of 01.09.1995.

WE ARE CONFIDENT TO DELIVER ON “MILESTONE 2020”

THE OBJECTIVE 2025 IS TO CONTINUE TO GROW AT ONE OF THE FASTEST RATES IN THE PHARMACEUTICAL INDUSTRY… «WE HAVE BEEN • NET SALES GROWING EVERY YEAR • EBITDA FOR 22 YEARS1)!»

• NET PROFIT

1) Net profit before minorities, excluding non-cash one off effects and launch and ramp-up costs of Veltassa® in 2016 and 2017

Stefan Schulze President of the Executive Committee & COO STRATEGY 2025 EXPLOIT OUR COMPETITIVE ADVANTAGES

EXISTING GROWTH DRIVERS

Ferinject® – Exploit the potential

Veltassa® – Drive to blockbuster

VFMCRP – Launch products and enhance value

2019 2025

> CHF 2 billion Japan launch China launch in-market sales H2 2019 2021 potential AFFIRM-AHF FAIR-HF2 HEART-FID U.S. label completion completion completion update Post-approval study Post-approval study U.S. Post-approval study

Focus on cardiology, patient blood management, nephrology and gastroenterology

EU guidelines1) U.S. guidelines1) update based on update based on AFFIRM AHF HEART-FID

1) Targeted guidelines:

PATIENT BLOOD MANAGEMENT (PBM) – EU51) COMMENTS

96K • Patient focused approach to 109K blood management

• Medical benefit: i.v. iron improves outcomes, including mortality

1’365K1 • Economic benefit: reduction in 1’160K length of hospitalisation and blood transfusion

• In-market sales opportunity of > CHF 200m in EU5

With iron deficiency Other i.v. iron Ferinject® Not treated

1) France, Germany, Italy, Spain and UK

FERINJECT® IN-MARKET SALES A LEADING PRODUCT

• Most extensive clinical evidence with 28 published RCTs1) and 7’034 patients treated in RCTs

• More than 8 million patient-years experience2)

• Unique non-dextran-based carboxymaltose shell

• Only high-dose i.v. iron to demonstrate efficient iron 3) 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 utilization in the body

Europe U.S. ROW

1) Randomized clinical trials 2) Vifor Pharma analysis as of August 2018 3) Beshara, S et al. Br J Haematol 2003; 120:853-9

2019 2025

European rollout Japan launch Blockbuster Zeria status

AMBER Guideline1) DIAMOND Guideline1) completion updates based on completion updates based on Post-approval study AMBER results Post-approval study DIAMOND results

Label updates based on DIAMOND results

1) Targeted guidelines:

U.S. – 3.0 MILLION PATIENTS EU5 – 3.1 MILLION PATIENTS JAPAN – 1.3 MILLION PATIENTS Total population: 327 million Total population: 320 million Total population: 127 million

12 14 12 10.7 10.3 11.5 10 12 10

10 8 8 8 6 6 4.7 6 4.8 4 4 4 2.3 2.4 1.7 1.8 2 2 2 1.1 0.8 0.5 0.8 0.5 0.8 0.5 0.1 0.1 0 0 0 CKD 3-4 only CKD 3-4 with HF HF only CKD 3-4 only CKD 3-4 with HF HF only CKD 3-4 only CKD 3-4 with HF HF only

Total prevalence With hyperkalemia Total prevalence With hyperkalemia Total prevalence With hyperkalemia

Source: USRDS 2013 ADR, CDC Source: from House AJKD Vol 72 | Iss 2 | August 2018 . De Nicola et Source: Saito Y et al. PLoS ONE 12 (9): e0184402.. 2008 ESC Heart al Nephrol Dial Transplant (2016) 31: 335–336 Failure 2016; 3: 145–151 © Vifor Pharma 4 October 2018 27 LIFE CYCLE MANAGEMENT UNLOCK FULL POTENTIAL WITH CLINICAL DATA

STUDY AMBER DIAMOND

Strengthen evidence of RAASi enabling Beneficial effect on CLINICAL OBJECTIVES morbidity and mortality Beneficial effect on blood pressure

U.S. label change & STRATEGIC OBJECTIVES Guideline updates guideline updates

RESULTS EXPECTED H1 2019 2022

EXPECTED GLOBAL MARKET EVOLUTION FOR PHARMACEUTICALS IN NEPHROLOGY

2017 2025

2.7%

~$20bn >$40bn

VFMCRP current market share Rest of the nephrology market

Source: EvaluatePharma 2017-22 CAGR of 10.3%, 2022-25 CAGR assumed unchanged, Vifor Pharma analysis

2019 2025

RetacritTM Rayaldee® CR845 > CHF 1bn launch launch launch reported sales

Avacopan Vadadustat CCX140 Additional launches in launch1) launch launch nephrology

Avacopan / ANCA AV Vadadustat CR845 / Uremic Pruritus Phase III trial Phase III trials Phase III trial completion completion completion

Avacopan / C3G CCX140 / FSGS Phase II trial Phase II trial completion completion

1) Assumes Conditional Marketing Authorization approval

CURRENT INDICATIONS PIPELINE INDICATIONS POTENTIAL INDICATIONS

Hypernatremia Vascular calcification FSGS Iron deficiency Polycystic kidney disease ANCA associated vasculitis Anaemia Kidney stones aHUS Secondary hyperparathyroidism Hyperphosphatemia β-Thalassemia renal disease Hyperkalemia Uremic pruritus Metabolic acidosis Acute kidney injury C3G Diabetic nephropathy Fabry

PRE CLINICAL CLINICAL PRE-COMMERCIAL

PARTNERSHIP IN-LICENSING DEALS AND PARTNERSHIPS

CCX140 Avacopan DATAGENERATION

CR845 Vadadustat

COMMERCIAL COMMERCIAL

PRE DIALYSIS DIALYSIS TRANSPLANTATION

EXISTING GROWTH DRIVERS EXISTING INFRASTRUCTURE

Ferinject® – Exploit the potential • Leverage U.S. commercial infrastructure

Veltassa® – Drive to blockbuster • Become EU partner of choice for non-European growth companies VFMCRP – Launch products and enhance value

INORGANIC GROWTH – ADJACENT INDICATIONS NEW TECHNOLOGIES AND BUSINESS AREAS

Licensing/acquisition across geographies & TAs1): • Exploit data & pay-for-performance (anaemia and bone-mineral metabolism management, etc.) • Nephrology & Cardio-renal • Gastroenterology • Replicate VFMCRP structure in other therapeutic areas • Patient Blood Management • Ferroportin inhibitor

1) Therapeutic areas

BETA-THALASSEMIA MAJOR CURRENT TREATMENT NEW APPROACH – VIT-2763

• Diagnosis soon after birth • Bi-weekly blood transfusions • VIT-2763 binding to ferroportin associated to unwanted iron load, expected to prevent excessive • Death at around 5 year old if left treated with iron chelators iron release untreated • Iron chelators therapy bound with • Iron transporter ferroportin key in • Approximately 13 to 15 million potentially fatal chelator- regulating and controlling iron patients worldwide associated toxicities level in the blood

• Current chelator market size of • Clinical Phase I started in March, approximately USD 1 billion, results expected at the end of expected to double by 2022 2018

2018 2019 2020 2021 2022 2023 2024 2025 2026 2027

Phase I Phase II Phase III

Filing

Launch

Dario Eklund Chief Commercial Officer FERINJECT® BLOCKBUSTER BY 2020

IN-MARKET SALES1) 850-880 CHF MILLION 692 535 374 240 163 81 123 16 38 58

2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018E2)

Europe U.S. ROW

GLOBAL I.V. IRON MARKET (MAT Q2 2018)1) • Market totalled CHF 1’698 million, +15% versus prior year period • Ferinject® growth represented 88% of the total market growth, with +32% versus prior year period • Global market share of Ferinject® in value is 47% (54% in our top 10 markets)

MAT = Moving annual total 1) Based on Quarterly IQVIATM MIDAS® panel, GERS, Insight Health, DLI, historical data at constant exchange rate (average 2017) 2) Estimate based on IQVIATM

Ferinject® In-Market Volume Growth (MAT Q2 2017-18) Ferinject® Volume Per Capita (MAT Q2 2018) 100 mg eq./1’000 population Launch Date

5% Switzerland 253 2008

33% Australia 107 2011

47% New Zealand 51 2012

16% Sweden 36 2008

16% Germany 34 2007

39% Spain 29 2009

16% France 22 2011

22% UK 22 2008

53% Italy 22 2012

45% U.S. 12 2013

0% Japan 0 2019

0% China 0 2021

Source: Quarterly IQVIATM MIDAS® panel, GERS, Insight Health

Therapeutic • Heart Failure Strong • Partnering with leading areas • Patient Blood Management partnerships companies • Nephrology • Gastroenterology

Geographic • Japan Life Cycle • AFFIRM-AHF expansion • China Management • HEART-FID1) • Key pharmerging markets

1) Daiichi Sankyo clinical trial

PATIENT DROP-OFF - EU5 Ferinject® addresses only 4% of all patients 386K 47K 84K Further generate and exploit clinical data

1’932K Fastest growing indication in Europe 1’415K Oral iron ineffective1)

Sales opportunity of > CHF 450m With iron deficiency Oral iron Other i.v. iron Ferinject® Not treated

1) IRONOUT HF trial, JAMA. 2017;317(19):1958-1966 Source: CapSys patient drop-off analysis, April 2018, Countries included: DE, ES, FR, IT, UK

PATIENT DROP-OFF - EU5

® 96K Ferinject addresses only 109K 8% of all patients

Medical benefits for the patients

1’365K Economic benefits for the 1’160K providers

Sales opportunity of > CHF 200m

With iron deficiency Other i.v. iron Ferinject® Not treated

Source: Vifor Pharma analysis, Q1 2018, Countries included: DE, ES, FR, IT, UK

STUDIES SHOW CONTRIBUTION TO IMPROVED OUTCOMES1)

Transfusions Hospital stay Iron therapy EUR 76 EUR 1’050 EUR 340 Savings per patient Savings per patient Cost per patient

1) Froessler B et al, Ann Surg. 2016 Jul;264(1):41-6; German costs data

U.S. I.V. IN-MARKET SALES

• 20+ year partnership with Daiichi 1'000 Sankyo

Millions ® 750 • Injectafer high dose segment $364

$252 sales leader $181 $89 1) 500 $0 $24 • 44.5% MAT Q2 2018 growth ® USD USD million of Injectafer in local currency $324 $322 $321 $320 $324 $318 250 • 2025 goal: blockbuster franchise in the U.S. with Venofer® and $208 $214 $169 $184 $188 $195 Injectafer® 0 MAT Q2-2013 MAT Q2-2014 MAT Q2-2015 MAT Q2-2016 MAT Q2-2017 MAT Q2-2018

Other i.v. irons Venofer® FerinjectInjectafer®®

Source: IQVIATM NPA Audit from 2013 to 2018 1) Moving annual total

HIGH DOSE U.S. I.V. IRON PRODUCTS VOLUME SHARE January July Injectafer®2) 2017 2018 Injectafer® 70% Value share 29.5% 44.6%

60% Volume share 10.5% 20.5%

50%

® 1) • Injectafer is the fastest growing INFeD® 40% Shortage i.v. iron in the U.S. market Feraheme®

30% • Injectafer® has gained volume Volumeshare ® 20% share from Feraheme and INFeD® 10% ® INFeD • INFeD® product shortage in Q2 0%

2018

2015-03 2015-04 2015-05 2015-06 2015-07 2015-08 2015-09 2015-10 2015-11 2015-12 2016-01 2016-02 2016-03 2016-04 2016-05 2016-06 2016-07 2016-08 2016-09 2016-10 2016-11 2016-12 2017-01 2017-02 2017-03 2017-04 2017-05 2017-06 2017-07 2017-08 2017-09 2017-10 2017-11 2017-12 2018-01 2018-02 2018-03 2018-04 2018-05 2018-06 2018-07

1) 3 months rolling share 2) Including low dose i.v. iron Source: IQVIATM, volume in 100mg equivalents, data as of 09.2018

VOLUME PER THERAPEUTIC AREA

800 +57%

700

600 +38%

500 +41%

400

300

200

Volume in thousand 100mg equivalentsthousand Volumein 100mg +74% 100 +70%

0 Gastroenterology Hematology / Oncology Nephrology Ob / Gynecology Cardiology

MAT Q2 2017 MAT Q2 2018

MAT = Moving annual total Source: IQVIATM, U.S. claims data from 09.2018

1 Maintain Venofer® leadership in dialysis and hospital

Strengthen Injectafer® market share leadership with hematology and oncology 2 specialists

Expand Injectafer® use with gastroenterology, cardiology, ob / gyn and 3 nephrology specialists

4 Execute clinical studies to create future growth opportunities

2018 2019

Two phase III clinical Market access negotiation Expected launch by trials completed in preparation Zeria Pharmaceuticals

MARKET OPPORTUNITIES CHALLENGES

Oral market Ferinject® will have IDA label Build awareness around high-dose (excluding dialysis) i.v. iron as the new standard therapy Only one i.v. low dose drug Significant unmet patient needs in Market access / pricing Approx. 50% of women below 50 Women’s Health and 1) years old have low ferritin levels Gastroenterology

1) Below 14ng/mL: National Health/Nutrition Survey conducted in 2009 in Japan (based on publication dated 23 July 2018)

2017 2018 2019 2020 2021

Phase III clinical Partner Phase III clinical Expected trial initiation selection trial readout launch

MARKET OPPORTUNITIES CHALLENGES

Second largest iron market globally Significant medical unmet need Very competitive market ~ USD 200m1) in patient blood management Fast changing environment Estimated anaemia prevalence in ~3-5 Mio patients per year with 2) central and eastern China is IDA undergoing elective surgery3) 13.4% (so up to 180 Mio people)

1) Based on Quarterly IQVIATM MIDAS® panel, GERS, Insight Health, DLI 2) Southeast Asian J Trop Med Publi Health 2015 46(2) 306-21 3) As per Vifor Pharma internal research

> CHF 300m Additional 45 interventional Two major heart failure trials invested so far in company- clinical studies completed with > 4,000 enrolled patients sponsored trials & 11 on-going on-going

Source: Vifor Pharma

Antonio Jordao Regional Head Southern Europe IRON DEFICIENCY IN CHRONIC HEART FAILURE MAJORITY OF PATIENTS ARE LEFT UNTREATED

PATIENT DROP-OFF EU5

386K 47K 84K

1’932K

1’415K

With iron deficiency Oral iron Other i.v. iron Ferinject® Not treated

Source: CapSys patient drop-off analysis, April 2018, countries included: DE, ES, FR, IT, UK

INCREASED MORTALITY2)-5) OTHER CONSIDERATIONS

100 • Up to 50% of patients with chronic heart failure are iron deficient3)

P = 0.001 • Iron deficiency in chronic heart failure 60 is associated with:

40 o Reduced quality of life1)6)7)

Cumulative survival Cumulative survival (%) 20 o Increased risk of hospitalisation2) Patients without iron deficiency Patients with iron deficiency 0 0 1 2 3 4 5 6 7 8 Time in study (years) Numbers at risk Iron deficiency absent: 753 386 104 63 40 Iron deficiency present: 753 343 100 49 33

1) Enjuanes C et al. Int J cardiol 2014;174:268-75. 2) Martens P et al. Acta Cardiol 2018;73(2):115-23. 3) Klip IT et al. Am Heart J 2013;165(4):575-82. 4) Jankowska EA et al. Eur Heart J 2010;31:1872-80. 5) Yeo JT et al. Eur J Heart Fail 2014;16:1125-32. 6) Wienbergen H et al. Am J Cardiol 2016;118(12):1875-80. 7) Comin-Colet J et al. Eur J Heart Fail 2013;15(10):1164-72.

META-ANALYSIS – PATIENTS WITH EVENT OBSERVATIONS INCIDENCE PER 100 PATIENT-YEARS AT RISK • Improves heart failure symptoms2)-4) 20 • Improves quality of life and exercise 2)-4) 58% capacity 15 hazard ratio reduction1) • Significant risk reduction in chronic heart failure hospitalisations 10

0 Placebo Ferinject® 34 (15.1) 19 (6.3)

1) Anker SD et al. Eur J Heart Fail 2018;20(1):125-33 2) Ponikowski P et al. Eur Heart J 2016;37:2129-200. 3) Ponikowski P et al. Eur J Heart J 2015;36:657-68. 4) Anker SD et al. NEJM 2009;361:2436–48.

2014 – 2015

Awareness campaign 2015 – 2016

Education on diagnosis and appropriate treatment 2017 onwards

Focus on Ferinject® differentiation

IN-MARKET SALES IN CARDIOLOGY IN SPAIN

450 ® Ferinject CAGR 400 94%

350

300

250

200 360 150

100 207

Volume in thousand 100mg equivalentsthousand Volumein 100mg 50 96 0 MAT Q2-2016 MAT Q2-2017 MAT Q2-2018

Ferinject ® Venofer ® Other IVi.v. Ironirons

Source: Farma&Cia, Q2-2018, Vifor Pharma Data Analytics

Iron Deficiency Awareness Diagnosis and Treatment Ferinject® Differentiation

Fe Ferinject®

Focus on important heart-related Oral iron as easy and convenient 50% prevalence of iron deficiency in issues; iron deficiency perceived choice, even if ineffective chronic heart failure patients as harmless by Cardiologists in chronic heart failure patients

Source: CHF Psychodrama Market Research, K&A Brand Research, November 2017

IMPORTANCE OF IRON IN HEART FAILURE

IRON DEFICIENCY IMPAIRS CONTRACTILITY OF HUMAN CARDIOMYOCYTES1)

Normal Cardiomyocytes Iron-deficient cardiomyocytes (in vitro) (in vitro)

1) Hoes MF et al. Eur J Heart Fail 2018;20(5):910-19

MEDICAL EDUCATION DIGITAL AMPLIFICATION

Continuous online medical education on iron deficiency Integrated promotional program through digital channels

2018E 2019E 2018E 2019E

7’500 15’000 8’500 17’000 Cardiologists Cardiologists Cardiologists Cardiologists

CURRENT EVIDENCE GENERATING NEW EVIDENCE

CONFIRM-HF INCREASED AFFIRM-AHF DECREASE IN QUALITY OF LIFE MORTALITY

FAIR-HF HEART-FID IMPROVED BENEFIT IN ACUTE EXERCISE CAPACITY HEART FAILURE EFFICACY-HF FAIR-HF2

EFFECT-HF REDUCED RATE OF FAIR-HFpEF DECREASE IN HOSPITALISATION MORBIDITY

IN-MARKET SALES IN CARDIOLOGY IN EU51) NEXT STEPS

• Awareness campaign rolled out 1'200 Ferinject® CAGR in Q3 2018 76% 1'000 • Medical education and digital amplification programs to accelerate 800 diagnosis and treatment 600 • Further strengthen guidelines with clinical trials 400 740

200 467

Volume in thousand 100mg equivalentsthousand Volumein 100mg 239 0 MAT Q2-2016 MAT Q2-2017 MAT Q2-2018 ® ® Ferinject Venofer Other IVi.v. Iron irons

1) France, Germany, Italy, Spain and UK Source: Farma&Cia, Q2-2018, Vifor Pharma Data Analytics

Professor Aryeh Shander

Emeritus Chair, Department of Anesthesiology, Critical Care Medicine, Hyperbaric Medicine and Pain Mngmt, Englewood Hospital, NJ, USA Adjunct Clinical Professor, Department of Anesthesiology, Medicine and Surgery at Icahn School of Medicine at Mount Sinai, NY, USA Clinical Professor, Department of Anesthesiology, Rutgers New Jersey Medical School, NJ, USA

67 WHY PATIENT BLOOD MANAGEMENT?

• PBM extends to all patient populations

• PBM offers appropriate therapy for a disease or condition

• Anaemia management is central to PBM • Modifiable risk factor

• PBM is based on improving patient outcomes

• All consistent with “Clinical Care” and “Good Clinical Practice”

68 TRANSFUSION IS THE ‘DEFAULT’ TREATMENT FOR ALL ANEMIC PATIENTS

One treatment for all patients  One size (does not) fit all

Transfusions are associated with worse clinical outcomes  High risk with low benefit

Expensive therapy with low benefit = poor efficacy

Cure vs. Treatment  Transfusion a short term therapy  I.v. iron – a cure!

69 ACTIVITY-BASED COST OF TRANSFUSION FROM A PROVIDER’S PERSPECTIVE

Mean RBC product cost Mean cost per RBC txn Mean txn cost per surgical pt txed 4'000 3'514 3'500

3'000 2'694 2'579 2'500

2'070

2'000 USD 1'500 1'183

1'000 726 606 507 500 248 203 192 149 0 EHMC RIH CHUV AKH Linz

AKH Linz, General hospital Linz; CHUV, Centre Hospitalier Universitaire Vaudois; EHMC, Englewood Hospital and Shander A et al. Transfusion 2010;50:753–65 Medical Center; pt, patient; RIH, Rhode Island Hospital; txed, transfused; txn, transfusion 70 «TRANSFUSION ARE ONE OF THE MOST OVERUSED TREATMENTS IN MODERN MEDICINE AT A COST OF BILLIONS OF DOLLARS»

Anthes E. Evidence-based medicine: Save blood, save lives. Nature. 2015;520(7545):24-6. 71 POSITIVE IMPACT OF PBM IMPLEMENTATION ON HOSPITAL COSTS

Johns Hopkins Health System PBM Program across five hospitals Approximately 400% return on investment for PBM efforts (alone with blood product cost savings)

500 2014 • Across the entire health system changes in 2015 utilization (number of units per 1000 patients) are 400 2016 shown over time

2017 • Financial results 300 o $2,120,273 blood acquisition cost savings o Reductions in transfused units per 1000 patients

200 – RBCs 455 to 365 ( 19.8%; P<0.0001)

Blood utilisationBlood (units/1000 patients) 100

0 RBCs Frank SM et al. Anesthesiology 2017;127:754–64 72 A CALL FOR ACTION TIME TO LOOK BEYOND TRANSFUSION

Management of Iron Deficiency Anaemia

Managing the patient‘s own blood Resorting to donor blood to correct anaemia and improve care to correct hemoglobin values

Model of BUSINESS Model Patient Focus CARE Product Focus • Physician driven • Manufacturer driven • Evidence based • Behavior based • Outcome driven • Revenue & profit • Quality of care • Growth • Patient safety • Product safety

73 THE WORLD IS CHANGING!

13 RBCs units,RBCs millions … due to patient 12 blood management! 11 1992 1994 1997 1999 2001 2004 2006 2008 2011 2013 2015

RBCs distributed RBCs transfused

Menitove J. Hematologist 2018;15(3)

74 PATIENT BLOOD MANAGEMENT

“ “Is the scientific use of safe and effective medical and surgical techniques designed to prevent anaemia and decrease bleeding in an effort to improve patient outcome” ”

Patient and medical condition (disease) focused

75 THE ANSWER: 3 PILLARS CONCEPT OF PBM!

1. Optimise RBC Mass 2. Minimise Blood Loss 3. Optimise anaemia tolerance

Sixty-third World Health Assembly

Date: 17-21 May 2010 Location: Geneva, Switzerland

BloodMinimise Loss Optimise WHA63.12OptimiseAnemia redadopted cell by resolution May 21, 2010: blood &loss & Transfusionreserve of massID „Bearing in mind that patient blood managementbleedingBleeding means that before anaemiasurgery every

reasonable measure should be taken to optimize the patient’s own blood volume, to minimize the patient’s blood loss and to harness and optimize the patient-specific physiological tolerance of anaemia following WHO’s guide for optimal clinical use (three pillars of patient blood management)“

76 Hofmann A. Oncologist 2011;16 Suppl 3:3-11; Spahn DR, Goodnough LT. Lancet 2013;381:1855–65; Isbister JP. Best Pract Clin Anaesthesiol 2013;27:69–84; Goodnough LT, Shander A. Anesthesiology 2012;116:1367–76 THE GLOBAL BURDEN OF ANAEMIA

In 2010, 68.36m YLD or 8.8% of all conditions were attributable to anaemia

Malaria Hookworm disease Schistosomiasis Other infectious diseases

0.3 Other neglected tropical diseases Maternal haemorrhage Uterine fibroids Other gynaecological diseases 0.2 Sickle cell disorders Thalassaemias G6PD deficiency Other haemoglobinopathies and haemolytic anaemias Iron-deficiency anaemia 0.1 Other endocrine, nutritional, blood and immune disorders

Prevalence(proportion) Gastritis and duodenitis Peptic ulcer disease Chronic kidney disease (due to diabetes mellitus) 0.0 Chronic kidney disease (due to hypertension) 1990 2013 1990 2013 Chronic kidney disease (unspecified) Females Year Males

GBD 2013 Mortality and Causes of Death Collaborators. Lancet 2015;385:117–171 © Vifor Pharma 4 October 2018 77 ESTIMATION OF GLOBAL VOLUME OF SURGERY

Up to 28 Million anemic surgical patients

Source: Thomas G Weiser, Scott E Regenbogen, Katherine D Thompson, Alex B Haynes, Stuart R Lipsitz, William R Berry, Atul A Gawande 78 © Vifor Pharma 4 October 2018 META-ANALYSIS OF THE ASSOCIATION BETWEEN PREOPERATIVE ANAEMIA AND MORTALITY AFTER SURGERY

Systematic review . 949’449 patients of 24 studies analyzed . 39% of patients were anemic (WHO definition) . Anaemia was associated with . Perioperative mortality  - Odd Ratio (OR) 2.90 (2.30 – 3.68, p< 0.001) . Acute kidney injury  - OR 3.75 (2.95 – 4.76, p< 0.001) . Infections  - OR 1.93 (1.06 – 1.55, p< 0.01) . Stroke in cardiac surgery  - OR 1.28 (1.17 – 3.18, p< 0.01) . RBC transfusion  - OR 5.04 (4.12 – 6.17, p< 0.001)

Fowler A.J. et al. Br J Surg (2015) 102: 1314

79 # of cases RATES MORTALITY CORONARY COMPARING 1000 1200 200 400 600 800 0

485

508

375

1136

213

274 NJ OMR

764 n =8108

607 -

2.89

794 %

462

834

1043

448

198 1.23 1.51 3.54 Mortality Observed PBM OMR

0 1 2 3 4 5 6 80

THE BENEFIT OF PBM AND OPTIMAL ANAEMIA TREATMENT EXAMPLE OF A STATE-WIDE PBM IMPLEMENTATION

Improving outcomes while saving costs : PBM in all emergency and elective medical and surgical patients in four tertiary hospitals in Western Australia

Clinical results/patient outcomes: • In-hospital mortality  28% n=605,046 • Length of hospital stay  15% • Infection  21% • Stroke  31%

Key measures indicators: Financial results over 6 years: • Proportion admitted anaemic decreased from 20.8% to • $18’500,000 blood acquisition cost savings 14.4% (P=0.001) • $80’000’000 to 100’000’000 activity-based cost • 41% reduction in blood product usage (P<0.001) savings

Leahy MF et al. Transfusion 2017;57:1347-58

81 Curr Opin JAMA Intern Med. Anesthesiology 2017, Anesthesiology 2016, Anaesthesiol. 2017, 2018, 178(1):116-122 127(5):738-740 30(2):159-169 30 (2):243-249

SPECIAL REVIEW ARTICLE EDITORIAL REVIEW ARTICLE COMMUNICATION

Improving outcome of Promoting High-Value Promoting Safety, Patient Blood trauma patients by Practice by Reducing Quality, and Value Management Equals implementing patient Unnecessary through Patient Patient Safety blood management Transfusions with a Blood Management Zacharowski K. Spahn, DR Füllenbach C, Zacharowski K, and Waters MD Meybohm P Patient Blood Management Program Sadana D, Pratzer A, Sher LJ, Saag HS, Adler N, Volpicelli FM, Auron M, Frank SM

82 Anaesthesia. 2017, 72(2):233-247

CONSENSUS STATEMENT International Consensus Statement on the Peri-Operative management od Anaemia and Iron Deficiency

Munoz M et al

• Addresses the high prevalence of anaemia

• Identifies Iron Deficiency Anaemia (IDA) as number one condition

• Strongly recommends the treatment with i.v. iron

• Oral iron ineffective in this population

83 OPTIMAL ANAEMIA TREATMENT AND THE BENEFIT OF PATIENT BLOOD MANAGEMENT

Treatment of perioperative IDA with Ferinject® has been studied in 16 major studies with more than 1’300 patients, incl. RCTs, single-arm studies and observational studies

. Pre-operative iron deficiency anaemia treatment > 700 patients treated with Ferinject® . Post-operative iron deficiency anaemia treatment > 500 patients treated with Ferinject® . Iron deficiency anaemia treatment in the intensive care unit > 100 patients treated with Ferinject®

Key findings  Reduction of transfusion rate  Increase of Hb and iron store levels  Reduction of length of stay  Reduction of infection rates  Well tolerated treatment

Source: references added in the notes 84 OPPORTUNITIES FOR VIFOR PHARMA

• Become a leader in PBM through championing the anaemia cause • Deliver a compelling message to regulators and payers • Be on the forefront of this REAL change in paradigm • Develop relationships with other non competing industry partners to develop a comprehensive disease management approach

85 Part II – Veltassa® CAPITAL MARKET DAY 2018 VELTASSA® UPDATE

Patrick Treanor President ad interim, Relypsa

VELTASSA® OVERVIEW OF KEY FEATURES

Mode of action High safety profile Calcium-based, non-absorbed Limited undesirable effects

52-weeks data RAASi enabling AMETHYST-DN study Included in SmPC1) in Europe

Broad use Room temperature storage Acute & Chronic U.S.: 3 months / EU: 6 months

1) SmPC = summary of product characteristics

VELTASSA® DEMAND PER BUSINESS DAY1) HIGHLIGHTS NUMBER OF 30 COUNTS EQUIVALENT BOXES • One of the fastest growing drugs 700 in nephrology in last 10 years2)

600 • Year over year demand growth 500 of +81% (H1 2017 vs. H1 2018)

400 • All time high in demand reached 300 in August

200

100

Jul-16 Jul-17 Jul-18

Apr-16 Oct-16 Apr-17 Oct-17 Apr-18

Jan-16 Jun-16 Jan-17 Jun-17 Jan-18 Jun-18

Feb-16 Mar-16 Feb-17 Mar-17 Feb-18 Mar-18

Aug-16 Sep-16 Nov-16 Dec-16 Aug-17 Sep-17 Nov-17 Dec-17 Aug-18

May-16 May-17 May-18

1) Internal data 2) EvaluatePharma

32.1 86.1 Million CHF Million CHF

SPS1) 100%

MAT Q2 2015 MAT Q2 2018

1) Sodium polystyrene sulfonate Source: IQVIATM MIDAS® Quarterly panel Q2-2018, average 2017 exchange rates have been applied.

VELTASSA® PAYER COVERAGE HIGHLIGHTS U.S. LIVES COVERED, % • ~24M lives added or 100% All lives 88% improved coverage for 90% Veltassa® since early 2018 80% 70% Medicare 64% • 55% of U.S. lives covered 60% without prior authorization 50%

40% • Recent coverage expansion

30% increased Medicare Part D 1) 20% coverage to 64%

10%

Jul-16 Jul-17 Jul-18

Apr-16 Oct-16 Apr-17 Oct-17 Apr-18

Jan-16 Jun-16 Jan-17 Jun-17 Jan-18 Jun-18

Mar-16 Mar-17 Mar-18

Feb-16 Feb-17 Feb-18

Nov-15 Dec-15 Aug-16 Sep-16 Nov-16 Dec-16 Aug-17 Sep-17 Nov-17 Dec-17

May-16 May-17 May-18

1) Increase to at least 67% expected as of 1 January 2019

OUT-OF-POCKET (OOP) COSTS HIGHLIGHTS IN PERCENT OF U.S. LIVES COVERED • Median OOP is $6 for all approved claims

• ~50% of Veltassa® Medicare claims are Low-Income 25% Subsidy (LIS) $0-25 $26+

75%

Source: Symphony Source Health Analytics Primary-Final Plan Benefit Design Report (July 2017-June 2018)

Rated very highly by Nephrologists

of Nephrologists believe of Nephrologists believe ® VELTASSA is appropriate for VELTASSA® is effective in long-term treatment of restoring K+ levels to target range 94% Hyperkalemia 93%

Source: Based on a survey of 100 nephrologists conducted in August 2018 by Putnam Associates. Source: Based on a survey of 100 nephrologists conducted in August 2018 by Putnam Associates.

Prescribers continue to expand usage

of Nephrologists have prescribed Over 10,750 physicians have VELTASSA® in the past three treated nearly 65,000 patients with 89% months 65K VELTASSA® since launch

Source: Relypsa data on file. Source: Relypsa data on file.

3 MILLION HYPERKALEMIA PATIENTS IN THE U.S. U.S. MARKET OPPORTUNITY

• 3 million potential patients 12 10.7 • Gross price of USD 820 per month 10 • Targeted duration of treatment: 6 months • 10% treated with Veltassa® 8 = USD 1 billion in net sales (blockbuster) 6 4.7 Key drivers of success: 4 Patients(in million) • Awareness ✓ 2.3 2 1.7 • Access ✓ 0.8 0.5 • Duration of treatment ✓ 0 CKD 3-4 only CKD 3-4 with HF HF only

Total Prevalence With hyperkalemia

Source: USRDS 2013 ADR, CDC

PATIENTS TREATED PATIENT FEEDBACK

1000

750 “Being diagnosed with high potassium changed my life completely. I was so scared 500 in the beginning, but now there is hope.” 250

0 Mar-18 Apr-18 May-18 Jun-18 Jul-18 Aug-18 Sep-18

Commercial & PLA1)

1) Pre-License Access Program

REIMBURSEMENT OBTAINED Sweden Denmark LAUNCHED REIMBURSEMENT SUBMITTED Germany United Kingdom Switzerland

AVAILABLE Norway Austria

DELAYED France Italy Spain

INITIAL Scotland Finland REJECTION

STUDY AMBER DIAMOND

Expected enrolment of Enrolment of 290 ENROLLMENT 2’400 patients starting patients completed Q1 2019

Increase accessible U.S. label change patient pool Guideline updates STRATEGIC OBJECTIVES Guideline updates for the management of Increase access to arterial hypertension patients with CHF1)

RESULTS EXPECTED H1 2019 2022

1) Chronic heart failure

Novel therapeutic options Existing treatments

Sodium Zirconium Sodium Polystyrene Veltassa® (patiromer)1) Cyclosilicate2) Sulphonate3) No sodium content  ͯ ͯ Consistently well tolerated  ͯ* ͯ

Drug-drug interactions 3 hours None** 3-6 hours***

Robust evidence for onset of effect in 4-7 hrs   ͯ Onset of action 4-7 hours 2.2 hours 1-2 hours 1yr prospective data showing high tolerability and efficacy   ͯ RAASi enablement in SmPC  ͯ ͯ Once-daily oral dose   ͯ Available dosages 8,4 g, 16,8 g, 25,2 g (sachets) 5 g, 10 g (sachets) 15 to 60 g per day (powder)

1) Veltassa® SmPC En. 2017 2) LokelmaTM SmPC En. 2018 3) Sanofi-Aventis, Resonium A SmPC, 2014, Kayexalate PI, 2010 * hypokalaemia, oedema ** 2 hours separation in FDA label *** U.S. PI advise 3-6 hour drug separation

LABEL FEATURE ANALYST’S PREFERENCE Indication No difference

Limitations No difference

Mechanism Veltassa® - calcium exchange mechanism preferable to sodium (concerns about increasing sodium levels, particularly in cardiology) Dosage and Veltassa® - focus is on chronic management, clearer proposition, not convinced by administration 3x daily acute phase with LokelmaTM (potential confusion on positioning) Dosage forms LokelmaTM (just) – slight preference, on lower volume of water, appears to be more miscible powder Storage LokelmaTM - no need for cold chain distribution

Warnings and Veltassa® - similar potential impact on GI motility, but edema issue (sodium-related) precautions with LokelmaTM a key concern, requires more monitoring, changes to diet, diuretics Adverse reactions No difference - more apparent GI issues with Veltassa®, offset by edema issues with LokelmaTM Drug interactions LokelmaTM – 2h interval better than 3h, although drug-drug interactions more theoretical according to lab experiments Clinical data No difference

1) Stifel, Vifor Pharma Company Update, 22.05.2018

U.S. • Strong demand continues • Access improved to 88% of covered lives (Medicare 64%)

Product specific • Extremely high satisfaction level from clinicians • Uniquely differentiated versus competition • Continued focus on building awareness • Clinical studies focused on promoting benefits in cardiology

Europe • Successful commercial launch in five countries • Fragmented pricing & reimbursement process being systematically addressed

Division of Cardiology & Metabolism: Heart Failure, Cachexia and Sarcopenia

Dept of Cardiology & BCRT, Charité (CVK), Berlin, Germany

[email protected] The world of potassium

• The most abundant cation in the body

• 98% intracellular

• Complex regulation of intracellular/extracellular

• Long-term K+ homeostasis mainly governed by renal excretion

• Normal plasma K+ is tightly regulated despite variable intake

• Disorders of K+ levels profoundly affect membrane excitability and nerve, muscle and cardiac function

Nyirenda MJ, et al. BMJ 2009;339:bmj.b41114 Serum K+ Values

MILD MODERATE SEVERE

HypokalemiaHypokalemia NormokalemiaNormokalemia HyperkalemiaHyperkalemia

3.0 3.5 4.0 4.5 5.0 5.5 6.0 6.5

Serum K+ levels (mEq/L)

K+, potassium.

1. Rastegar A, et al. Postgrad Med J. 2001;77:759–64; 2. Einhorn LM, et al. Arch Intern Med. 2009;169:1156–62; 3. Kovesdy CP. Am J Med. 2015;128:1281–7. Major causes of hyperkalaemia

Mechanisms causing Causes hyperkalemia Potassium supplement Excess potassium intake Enteral nutrition (e.g. whole protein formulas with high electrolyte content) Acidosis Hyperglycemia Insulin deficiency or resistance Certain drugs, such as digoxin (toxicity) and succinylcholine Potassium redistribution Strenuous exercise Hemolysis Damage to tissue from rhabdomyolysis, burns, or trauma Tumor lysis syndrome Impaired renal function Diabetes mellitus Reduced potassium Heart Failure excretion Obstructive uropathy Diseases with low levels of or lack of response to aldosterone Renin-angiotensin-aldosterone system (RAAS) inhibitors

www.stedmansonline.com (accessed 28.8.2015) www.nlm.nih.gov/medlineplus/mplusdictionary.html (accessed 28.8.2015) What are the risks associated with hyperkalaemia?

* p=0.021

ECG, electrocardiogram.

1. Alfonzo A, et al. UK Renal Association Clinical Practice Guidelines. 2014; 2. Xi L, et al. J Geriatr Cardiol. 2015;12:119–26. Elevated K+ is associated with an increase in all-cause mortality

Predicted probability of mortality CKD, HF, DM An evaluation of medical records CKD, HF demonstrated an increase in all-cause DM N=911,698 Control group mortality with elevated K+ in those patients with comorbidities*

Co-morbidities included DM, HF, CKD Stages 3–5, CVD or hypotension

Baseline serum K+ level (mEq/L) Hypokalaemia Normokalaemia Hyperkalaemia

Shading surrounding lines indicates 95% confidence limits. *Evaluated through de-identified medical records (2007–2012) of individuals with ≥2 serum K+ readings (Humedica, Cambridge, MA). Spline analyses were performed to assess mortality at 0.1 mEq/L increments of serum K+ after adjusting for covariates and interactions. Patiromer clinical trials were not designed to measure mortality outcomes. CKD, chronic kidney disease; CVD, cardiovascular disease; DM, diabetes mellitus; HF, heart failure; K+, potassium Collins AJ, et al. Am J Nephrol. 2017;46:213–21. Patients with or without CKD who experience hyperkalaemia once, are at greater risk of recurrent hyperkalaemia events 50%

of patients with hyperkalaemia* had 2 or more recurrences within 1 year

Some patients experienced >20 recurrent episodes within 1 year†

*Hyperkalaemia was defined as serum K+ ≥5.5 mEq/L (1 mEq/L = 1 mmol/L); †70 individuals (0.21%) had more than 20 episodes in 1 year. CKD, chronic kidney disease. Einhorn LM, et al. Arch Intern Med. 2009;169:1156–62. Hyperkalaemia in heart failure patients increases as renal function declines Analysis based on RALES trial* 35 Placebo Spironolactone 30.2 30 25.6

20 18.2 15.4 15 13.3 8.5 10 6.7

(% of patients) of (% 6.0

5 Rate of hyperkalaemia hyperkalaemia of Rate 0 Baseline eGFR ≥60 Baseline eGFR <60 No WRF WRF Baseline renal function Intra-study change in renal function eGFR: estimated glomerular filtration rate; MRA: mineralocorticoid receptor antagonist; WRF: worsening renal function. * Randomized Aldactone Evaluation Study: Double-blind trial in 1,658 patients with NYHA functional Class III or IV heart failure and ejection fraction ˂35% randomized to spironolactone 25mg (which could be titrated to 50mg) or placebo daily. Go AS, et al. N Engl J Med 2004;351:1296–305. All RAAS inhibitors increase serum K+ levels

dRi Angiotensinogen

Angiotensin I

ACEi K+ retention

Angiotensin II Na+/water uptake

Mineralocorticoid receptor

AT1 receptor MRA

ARB Aldosterone production ARNi

ACEi, angiotensin-converting-enzyme inhibitor; ARB, angiotensin receptor blocker; ARNi, angiotensin receptor-neprilysin inhibitor; dRi, direct renin inhibitor; HF, heart failure;

MRA, mineralocorticoid receptor antagonist; RAAS, renin-angiotensin-aldosterone system. Rossignol P, et al. Circ Heart Fail 2014;7:51–58. Hyperkalaemia is common with RAASi

20.0 Hyperkalemia 18.6 Prevalence 17.0 RAASi 16.0 (% of Patients) Placebo 15.0

11.8 10.8 10.0 7.2 6.4 6.0 5.1 5.0 4.0 2.5 1.0 0.0 EMPHASIS PARADIGM SOLVD CHARM-Added RENAAL IDNT Eplerenone Placebo Enalapril LCZ696 Enalapril Placebo Candesartan Placebo Losartan Placebo Irbesartan Placebo Pts were also taking spironolactone at baseline

Clinical Trials EMPHASIS-HF1 PARADIGM-HF2 SOLVD3 CHARM-Added4 RENAAL5 IDNT6 Serum K+ Level > 5.5 mEq/L > 5.5 mEq/L > 5.5 mEq/L > 6.0 mEq/L ≥5.5 mEq/L >6 mEq/L HF with EF of 40% or less Patient HF with EF of 40% HF with EF of 35% HF with reduced EF and were treated with Diabetic nephropathy Diabetic nephropathy Population or less or less ACEi

s ACEi, angiotensin-converting enzyme inhibitor; EF, ejection fraction; HF, heart failure; K , potassium; Pts, patients; RAASi,renin-angiotensin-aldosterone system inhibitor. 1. Zannad F, et al. N Engl J Med. 2011;364:11-21. 2. McMurray JJ, et al. N Engl J Med. 2014;371:993-1004. 3. SOLVD Investigators, et al. N Engl J Med. 1991;325:293-302. 4. McMurray JJ, et al. Lancet. 2003;362:767-771. 5. Miao Y et al. Diabetologia. 2001;54:44-50. 6. Avapro [package insert]. Bridgewater, NJ: Sanofi-Aventis US LLC; 2014. Guidelines strongly recommend all RAASi to improve mortality and morbidity in HFrEF

EUROPE USA CANADA AUSTRALIA GLOBAL

HfrEF, heart failure with reduced ejection fraction; RAASi, renin–angiotensin–aldosterone system inhibitor. Hyperkalaemia frequently causes RAASi to be discontinued In a quarter of patients with a serum K+ of >5.5 mEq/L ACEis/ARBs were reduced in dose or discontinued in a study of 194,456 patients*

*Geisinger Health Care database, retro-spective analysis of patients with outpatient visit and a blood pressure measurement in 44 counties in Pennsylvania in the time period of January to October 2011 ACEi, angiotensin-converting enzyme inhibitor; ARB, angiotensin receptor blocker; RAASi, renin–angiotensin–aldosterone system inhibitor. Chang AR, et al. Hypertension 2016;67:1181-8. Maximum RAASi dose is associated with a reduced incidence of mortality in the cardio-renal setting*

40 Maximum dose

Submaximum dose

Discontinued

30.1% 27.7%

20.3% 22.4% Percent of patients Percentof 13.7% 9.8% 11.0% 8.2% 4.1% 0 CKD stages 3–4 Heart failure Total population (N=43’288 total patients (N=20’529 total patients (N=201’655 total patients across dose categories) across dose categories) across dose categories)

* A large US database study including over 200’000 patients with the requirement of 1 RAAsi prescription within 12 months prior to July 1, 2009 CKD, chronic kidney disease; RAASi, renin-angiotensin-aldosterone system inhibitor. Epstein M, et al. Am J Manag Care 2015;21:S212–20. Guidelines recommend RAASi dose modifications with increasing serum K+

>6.0 NICE CKD6: Stop RAASi if >6.0 3 Serum K+ ESC HFA : Stop MRA if >6.0* (mEq/L) K/DOQI7: Discontinue ACEi/ARB if >5.5 ESC HFA3: K/DOQI7: Discontinue ACEi/ARB if >5.5; Halve dose of MRA if >5.5 >5.5 Halve dose of RAASi if >5.0 NICE CKD6: don’t routinely start RAASi if >5.0

ACC/AHA HF2 and HFSA HF4: MRA not recommended >5.0

ACC/AHA/HFSA HF1, ESC HFA3: ACEi/ARB use with caution >5.0 >5.0 Most conservative Most aggressive Serum K+ threshold before change in RAASi guideline recommendation

KDIGO Guidelines do not provide recommendations.5 *ESC HFA: Management of acute hyperkalaemia (>6.0) may require a short-term cessation of K+-retaining agents and RAASi, but this should be minimised and RAASi should be carefully reintroduced as soon as possible while monitoring K+ levels.3 ACEi, angiotensin-converting enzyme inhibitor; ARB, angiotensin receptor blocker; MRA, mineralocorticoid receptor antagonist; RAASi, renin-angiotensin-aldosterone system inhibitor.

1. Yancy CW, et al. Circulation. 2016;134:e282–93; 2. Yancy CW, et al. Circulation. 2013;128:1810–52; 3. Ponikowski P, et al. Eur Heart J. 2016;37:2129–200; 4. Heart Failure Society of America, et al. J Card Fail. 2010;16:475–539; 5. KDIGO Clinical Practice Guideline for the Evaluation and Management of Chronic Kidney Disease. Kidney Int Suppl. 2013;3; 6. National Institute for Health and Clinical Excellence. Chronic kidney disease (partial update): Early identification and management of chronic kidney disease in adults in primary and secondary care. 2014; 7. National Kidney Foundation. Guideline 11. http://www2.kidney.org/professionals/kdoqi/guidelines_bp/guide_11.htm. Accessed February 17, 2015. Patients who benefit the most from RAASi therapy are the patients at greatest risk of hyperkalaemia

CARDIO-RENAL MANAGEMENT OF PROTECTION HYPERKALAEMIA Prescribe or continue Avoid, discontinue or RAASi and accept the down-titrate RAASi presence of and lose the benefits hyperkalaemia? on clinical outcomes?

RAASi, renin-angiotensin-aldosterone system inhibitor Palmer BF et al. N Engl J Med. 2004;351:585-92. Why is the recognition and treatment hyperkalaemia increasingly important?

The incidence of hyperkalemia is increasing, and this is exacerbated by RAAS inhibitor use1–3

CHRONIC KIDNEY DISEASE HEART FAILURE

46M 8M

26M 5.7M

2009 2022 2010 2030 US Patient Numbers US Patient

Reduced kidney function is the most Poor cardiac output leads to renal common cause of uncontrolled K+ insufficiency

A serum potassium level of ≥4.5 mEq/L is associated with mortality and arrhythmias

Unfortunately, current treatment have limitations

1. Einhorn LM, et al. Arch Intern Med 2009;169:1156–62; 2. Desai A, et al. Curr Heart Fail Rep. 2009;6:272-80; 3. Raebel MA, et al. J Gen Int Med 2010;25:326–33 Patiromer is a novel, non-absorbed K+ binder

Patiromer is a novel, spherical, non-absorbed polymer – High-capacity K+ binder – Average bead size (100 μM) is too large for Patiromer to be absorbed – Site of action is primarily from the colon where K+ is the most abundant cation and residence time of the polymer is the longest – Calcium is the counter-exchange ion

High-capacity polymer Uniform, spherical patiromer beads

GI, gastrointestinal; K+, potassium. Li L, et al. J Cardiovasc Pharmacol Ther. 2016;21:456–65. Patiromer clinical studies

Proof of Prevention Treatment Post-US Approval Concept

HK, CKD, T2DM, HF with/without HTN6 Effect of patiromer CKD3,4 205 taken with or (52-week safety & HK with CKD9 without food11 202 efficacy) 401 AMETHYST-DN 103 (TOURMALINE) PEARL-HF

2008 2009 2010 2011 2013 2014 2015 2016

Healthy CKD with HF5 volunteers1 HK with CKD7,8 DDI Studies10 102 204 301 (Phase 3 pivotal) Healthy OPAL-HK volunteers1 101 Haemodialysis subjects2 201

CKD, chronic kidney disease; DDI, drug–drug interaction; DN, diabetes nephropathy; HF, heart failure; HK, hyperkalaemia; HTN, hypertension; T2DM, type 2 diabetes mellitus.

1. Huang I-Z, et al. J Am Soc Nephrol. 2010;21(Suppl):482A(F-PO1615); 2. ClinicalTrials.gov. NCT02033317. 3. Pitt B, et al. Eur Heart J. 2011;32:820–8; 4. Buysse J, et al. Future Cardiol. 2012;8:17–28; 5. Pitt B, et al. ESC Heart Fail. 2018;5:257−66; 6. Bakris GL, et al. JAMA. 2015;314:151–61; 7. Weir M, et al. N Engl J Med. 2015;372:211–21; 8. Weir M, et al. Presented at the American Society for Hypertension 2015, New York, NY: Abstract#LB-P-01; 9. Bushinsky DA, et al. Kidney Int. 2015;88:14–27; 10. Lesko LJ, et al. J Cardiovasc Pharmacol Ther. 2017;22:434–46; 11. Pergola P, et al. Am J Nephrol. 2017;46:323–32. Populations studied in Patiromer trials

97% Hypertension1 88% CKD*1 49% Heart Failure1 Wide range of severity of hyperkalaemia** 42% of subjects had a serum K+ ≥5.5 mEq/L at baseline2,3 8% of subjects had a serum K+ ≥6.0 mEq/L at baseline1

60% over 65 Years***1,2 99.4% taking RAASi4 73% Diabetes Mellitus1

*88% had ≥stage 3 CKD (29% had stage 4 CKD) **K+ 5.1 to <6.5 mEq/L ***60% >65 years of age (20% ≥75 years) CKD, chronic kidney disease; K+, potassium; RAASi, renin-angiotensin-aldosterone system inhibitor. 1. Data on file. Relypsa, Inc. Redwood City, CA; 2. Weir MR, et al. N Engl J Med. 2015;372(3):211–21; 3. Bakris G, et al. Poster presented at: ASN Kidney Week 2014; Philadelphia, PA; November 11-16, 2014; Poster SA-PO1099; 4. Vifor. Veltassa® Summary of Product Characteristics 2017. Summary of Patiromer clinical studies

Design Results

AMETHYST-DN (Phase II)1 52-week, open-label, randomized, dose-ranging • Lowest starting doses effective with minimal titration required study in patients with T2DM, CKD* and HK on ≥1 • Long-term safety and efficacy data to support chronic use RAASi

OPAL-HK (Phase III):2 • Significant and clinically meaningful serum K+ reduction, with maintenance 12-week, two-part, single-blind randomized of serum K+ control and ability to keep patients on RAASi medications withdrawal study in patients with HK and CKD* • Recurrence of HK on treatment withdrawal demonstrated need for long- on ≥1 RAASi term chronic treatment

• In normokalaemic patients with CHF at risk of HK starting spironolactone PEARL-HF (Phase II):3 therapy, administration of patiromer compared with placebo: 4-week, double-blind, randomized, placebo- • Significantly reduced mean K+ levels controlled study in patients with HF and CKD* • Prevented hyperkalaemia on ≥1 RAASi or with a history of HK with • Allowed a significantly greater percentage of patients to increase discontinuation of ≥1 RAASi spironolactone doses to 50 mg/day

CHF, chronic heart failure; CKD, chronic kidney disease, DN, diabetic nephropathy, HF, heart failure; HK, hyperkalaemia; K+, potassium,; RAASi, renin-angiotensin-aldosterone system inhibitor; T2DM, type 2 diabetes mellitus * eGFR 15-59 mL/min/1.73 m² 1. Bakris GL et al. JAMA. 2015;314:151-61; 2. Weir MR et al. N Engl J Med. 2015;372:211-21. 3. Pitt B et al. Eur Heart J. 2011;32:820 New studies for more evidence – AMBER

100% Resistant Hypertension 100% CKD 51% Heart Failure Enabling spironolactone in in patients with resistant hypertension for prevention of hyperkalaemia

71% over 65 Years 99.3% taking RAASi4 47% Diabetes Mellitus

Baseline characteristics of first 146 patients

Results are projected to be available in H1 / 2019 Agarwal R et al. Am J Nephrol 2018;48:172–180 Conclusion

• Elevate K+ levels are associated with poor outcome • Hyperkalaemia is common and recurrent in CV diseases • Current treatments for hyperkalaemia have limitations, in particular in the long-term management • RAASi therapy is the cornerstone treatment in CV diseases • Patiromer can treat hyperkalaemia and shows promise to enable optimal use of life-saving RAASi therapy

CV, cardiovascular; K+, potassium; RAASi, RAASi, renin-angiotensin-aldosterone system inhibitor . Part III – Vifor Fresenius Medical Care Renal Pharma CAPITAL MARKET DAY 2018 THE JOINT COMPANY A UNIQUE PARTNERSHIP

David Bevan CEO, Vifor Fresenius Medical Care Renal Pharma

THE JOINT COMPANY THE RATIONALE

55% Stake STRONG IRON AND PHARMA EXPERTISE

CR8451)

Avacopan1) CCX1401) Vadadustat1)

GLOBAL LEADER IN DIALYSIS

45% Stake

1) Pre-commercial products

Etienne Jornod Stefan Schulze Colin Bond Executive Chairman President of the Executive Chief Financial Officer Committee and COO

David Bevan Chief Executive Officer VFMCRP

Rice Powell Michael Brosnan Frank Maddux Chief Executive Officer Chief Financial Officer Chief Medical Officer and Chairman FMCNA1)

1) Fresenius Medical Care North America

Sourcing of innovation Managed care expertise Evaluation of clinical assets Patient access (>300k patients) Acceptance of clinical risk Validation of innovation Regulatory and market access expertise Medications in FKC clinics1) become SoC2)

Focus on pharma needs of nephrology patients – Global Leader Access to patient data. Faster clinical trial execution Faster uptake and utilisation Partnership technically controlled by Vifor Pharma Registered in Switzerland

1) Fresenius Kidney Care (FKC): Fresenius Medical Care North America dialysis provider organization 2) Standard of care

CURRENT INDICATIONS PIPELINE INDICATIONS POTENTIAL INDICATIONS

Prof. Dr. Michel Burnier Stefan Wohlfeil Andrin Cerletti Vifor Pharma Board Member Chief Medical Officer Head Global Business Development Dr. of Internal Medicine and Nephrology Vifor Pharma Vifor Pharma

Frank Maddux Robert Kossman Ravi Thadhani Chief Medical Officer Chief Medical Officer Professor of Medicine FMCNA1) Renal Therapies Group, FMCNA1) Harvard Medical School

1) Fresenius Medical Care North America

External opportunities Pipeline products Marketed products

• Database screen of approx. • Ensure VFMCRP operates as • Optimise existing marketed 380 clinical stage assets per a highly efficient launch engine products year • Avacopan • Ferinject ® • Pre due diligence on approx. • CCX140 • Mircera® 10 to 15 assets per year • CR845 • RetacritTM • Full due diligence on approx. 5 to 6 projects per year • Rayaldee® • Velphoro® • Negotiations on approx. 1 to 3 • Vadadustat • Veltassa® deals per year • Venofer ®

2016 2017 2018 2019

VIFOR Due diligence

PHARMA

Ongoing oversight through SAB1) members VFMCRP BD&L process Joint Steering Committee &

Signing Joint Development Committee Project Initiation Project

FRESENIUS Unmet Data Sharing of Commercial MEDICAL need insights experience insights CARE analysis

Key interaction with partner

1) Scientific advisory board

Dr. Frank Maddux Chief Medical Officer, Fresenius Medical Care North America

FRESENIUS MEDICAL CARE RENAL DISEASE POPULATION AND TRENDS

EMPLOYEES PATIENTS DIALYSIS CENTERS

Q2 2018 Q2 2018 Q2 2018

111,263 325,188 3,815 (-1% yoy) (+3% yoy) (+3% yoy)

of which ~70,000 in the U.S. of which ~201,000 in the U.S. of which 2,500 in the U.S.

EXPECTED TREND KEY DRIVERS

CAGR 6.0 • Age, lifestyle and higher life 5.5% expectancy

• Increasing wealth and access 3.5 to medical treatments

• 10% of the U.S. population with Chronic Kidney Disease

Million of patients • Recognized as a public health condition since 2006 by Centers for Disease Control in the U.S. 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 Actual FMC forecast VFMCRP Projection • Strong growth in pharmerging markets Europe U.S. ROW

Note: based on FMC market and competitor survey 2015

Chronic kidney disease (CKD) still highly prevalent:

• 10% of the world’s population is affected by CKD

• CKD kills more people than breast or prostate cancer

• Diabetes is the leading cause of kidney failure (44% of new cases)

• Obesity is linked closely with CKD (30% of people worldwide in 2018)

VFMCRP is best positioned to drive innovation and help patients live better lives.

ESTABLISH BUILD PORTFOLIO ENHANCE VALUE

2010 2015 2020 2025

DRIVE INNOVATION

IDEA SOC1)

55% 45%

1) Standard of care

STRONG IRON AND PHARMA EXPERTISE GLOBAL LEADER IN DIALYSIS

55% 45%

VENOFER® MARKET SHARE AT FKC CLINICS1) HIGHLIGHTS • >23m patient years experience 100% • Gold standard in dialysis • Exclusivity for FMCNA in dialysis in the U.S. since 2008 • Expected to remain a key part

75% of the dialysis treatment protocol • Sold to other dialysis clinics • Currently no iron sucrose similar in the U.S.

50% 2008 2009 2010 2011 2012 2013 2015 2017 2018

1) Fresenius Kidney Care (FKC): Fresenius Medical Care North America dialysis provider organization

PATIENTS TREATED WITH MIRCERA® AT FKC CLINICS BENEFITS OF MIRCERA®

 Improved logistics

 Easier dose preparation

 90%+ of doses per electronic algorithm

 More patients in target range than any other short acting ESA

 Smoother path to stable dosing

 Fewer dosing changes required

 Adverse event rates low

FMCNA Data from Clinical Data Analytics Assessment – Ofsthun, Stennett 2018

2015 2016 2017 2018

Veltassa®/Relypsa Rayaldee®/OPKO1) CCX140/ Vadadustat1) License License ChemoCentryx1) U.S. License for (ex-U.S./Japan) (Europe and other) License (ex-U.S.) FMC dialysis clinics

Mircera®/Roche EU Affiliates Avacopan/ RetacritTM/Pfizer CR845/Cara U.S. License2) Acquisition from FMC ChemoCentryx1) U.S. License2) Therapeutics1) License (ex-U.S.) License (ex- U.S./Japan/South Korea)3)

1) Pre-commercial products 2) Only in dialysis 3) Profit sharing agreement in FMCNA dialysis clinics

Primary target: Uremic Pruritus 60%-70% of dialysis patients affected

Breakthrough designation by FDA; Phase-III study ongoing in Uremic No opioid addiction Pruritus

1.7 Global rights except U.S., Japan and South Korea, profit share for the sales to First sales expected in 2021/2022. 0.8 FKC clinics1).

1) Fresenius Kidney Care (FKC): Fresenius Medical Care North America dialysis provider organisation

ANAEMIA MINERAL & BONE KIDNEY CKD-ASSOCIATED CARDIO-RENAL MANAGEMENT MANAGEMENT PROTECTION COMPLICATIONS MANAGEMENT

Avacopan1) CR8451)

CCX1401)

Vadadustat1)

1) Pre-commercial products

Global Leader in Nephrology

The partner of choice for renal pharmaceuticals and innovative patient-focused solutions.

SPEEDING UP THE IDEA TO STANDARD OF CARE PROCESS

BASIC CLINICAL REGULATORY STANDARD IDEA RESEARCH TRIALS APPROVAL OF CARE

[] Pharma data (RCT, observational)

Consumer Electronic medical and Data health records

Pharmacy data Social Externally Real-World Meaningful Fit-for-purpose Media Validated Data (RWD) questions Validated findings findings

Mortality, Claim other registries databases

Test results, Hospital visits, lab values, Service details Pathology results

FMCNA CONVERTED PATIENTS TO VELPHORO® COMMENTS JULY 2018 TO SEPTEMBER 2018 • Program to migrate from calcium 1400 based phosphate to non-calcium based binders

1200 program

of of • Referencing guidelines and 1000 Velphoro® studies on the impact 800 of pill burden on adherence

600 • Panel Discussions and webinars for nurses and dietitians 400 • Evidence base communications 200 with prescribing physicians

Weekly conversion conversion during rollout Weekly 0 • Electronic algorithm to migrate 28 29 30 31 32 33 34 35 36 Week number patients

Thomas J. Schall, PhD. President and Chief Executive Officer October 2018

This presentation contains forward-looking statements from ChemoCentryx. These statements relate to future events or our future financial performance or condition and involve known and unknown risks, uncertainties and other factors that could cause our actual results, levels of activity, performance or achievement to differ materially from those expressed or implied by these forward-looking statements. These risks, uncertainties and other factors are described more fully in our periodic reports filed with the SEC, including our Annual Report on Form 10-K for the year ended December 31, 2017 filed with the SEC on March 12, 2018, particularly in the sections titled “Risk Factors” and “Management’s Discussion and Analysis of Financial Condition and Results of Operations”. This presentation also contains estimates, projections and other information concerning our industry, our business, and the markets for our drug candidates, as well as data regarding market research, estimates and forecasts prepared by our management. Information that is based on estimates, forecasts, projections, market research or similar methodologies is inherently subject to uncertainties and actual events or circumstances may differ materially from events and circumstances reflected in this information.

. Founded in 1997 by Dr. Thomas Schall, early discover of ‘chemoattractant cytokine’ (chemokine) superfamily . Envisioned an entirely new approach for autoimmune and inflammatory disease therapy . Precise mechanism; precision medicine: inhibition of specific chemoattractant receptors with orally-administered small molecules . Based in Mountain View, CA . NASDAQ listed since 2012

Exclusive Focus Highly SelectiveBroad Applicability ChemoCentryx is a leader in Leaves Rest of ImmuneApproach System applicable Intact to chemoattractant system science Inflammatory, autoimmune diseases and cancer

Highly-Selective Small Molecules

Leaves rest of immune system Orally-administered, convenience, intact; No immunosuppression greater patient compliance

Precision Broad Pipeline of Advanced Establishing Approach Unique, Orally- Programs Strong Global Leads to Better Administered, Small Focused on Commercial Medicines Molecule Therapeutics Orphan Diseases Capabilities

CCXI drug candidates selectively Targeting indications with clear Enrollment complete in Strategic commercial target a specific chemoattractant regulatory pathways and multi- landmark Phase III ADVOCATE alliance with Vifor or chemokine receptor billion dollar market potential trial in ANCA vasculitis Pharma

Leaves rest of the Robust clinical data generated Extending the reach of avacopan CCXI retains commercial immune system intact with avacopan and CCX140 –C3G trials ongoing; initiating rights in the U.S. clinical studies in hidradenitis suppurativa (HS) in US

THERAPEUTIC AREA DRUG/ INDICATION PRECLINICAL PHASE I PHASE II PHASE III TARGET ANCA-ASSOCIATED VASCULITIS Complement Avacopan Inhibition in Orphan (formerly C3 GLOMERULOPATHY Diseases CCX168)/ C5aR HIDRADENITIS SUPPURATIVA

Chronic and Orphan CCX140/CCR2 CKD, INCLUDING ORPHAN FOCAL SEGMENTAL GLOMERULOSCLEROSIS Kidney Diseases DIABETIC NEPHROPATHY, SUCCESSFULLY COMPLETED PHASE II

Other Inflammatory CCX507/CCR9 IBD: ULCERATIVE COLITIS and Autoimmune Diseases CCX587/CCR6 TH17 DRIVEN DISEASE, e.g. PUSTUALAR PSORIASIS

Immuno-Oncology CCX872/ CCR2 ADVANCED PANCREATIC CANCER

OTHER ONCOLOGY INDICATIONS

Targeted Approach to Complement Diseases: A ‘Pipeline in a Drug’

1. Avoids long-term biological consequences of upstream complement inhibition 1.

C5a Antibodies

2. Does not block production of C5b-9 leaving host defense Avacopan mechanism (MAC) in place C5aR 2.

Reason for black box warning for eculizumab 3. Preserves beneficial 3. functions of C5L2 pathway Targeting the Complement Pathway ‘Downstream’ is Best

© Vifor Pharma 163 ANTI-NEUTROPHIL CYTOPLASMIC AUTO-ANTIBODY (ANCA) VASCULITIS: A COMPLEMENT C5A ACTIVATED NEUTROPHIL-DRIVEN DISEASE Overview Prevalence • Highly inflammatory and progressive autoimmune disease caused by the over-activation of the complement system; generation of C5a • Kidney is a major target organ • Characterized by recurring flares, accruing into irreversible organ system ̴ 40K ̴ 50K damage (end-stage renal disease) and death; relapse is common • Significantly impacts multiple aspects of physical function, emotional well- ~4,000 new cases ~5,000 new cases being, and overall productivity per year in U.S. per year in EU

Rationale for Avacopan Current Treatments

Auto Antibodies → High-dose steroids Immuno-suppressants Activation of Complement Cascade → for 6 months Generation of C5a → . Prednisone . Cyclophosphamide OR C5a Binds C5a Receptor (C5aR) on Neutrophils . Methylprednisone . Rituximab C5aR-Activated Neutrophils Destroy Blood Vessels

Current ANCA Vasculitis High-Dose Steroid Standard of Care (SOC) Major Unmet Needs:

Rapid induction of remission • Prevent damage and Steroids . 11-16% die within 1st year of diagnosis* for 6 Months preserve renal function . Greatest risk to patients in first year . Prednisone . Methylprednisone comes from steroid-induced infections Durable remission . Current treatments contribute ~60% of • Majority of patients at risk for the mortality rate* relapse for many years Cyclophosphamide . Need to taper steroid = high relapse rate or . Irreversible organ damage with relapse Reduced side effects (especially in the kidney) Rituximab • Prevent glucocorticoid-related toxicity and infection

* Little et al, 2010 Ann Rheum Dis 69:1036–1043, Flossmann et al 2011 Ann Rheum Dis 70:488–494. © Vifor Pharma 165 AVACOPAN PROFOUNDLY INHIBITS COMPLEMENT- DRIVEN NEUTROPHIL ACTIVATION Avacopan Efficacy Established in Phase II CLEAR Trial

 Primary endpoint achieved  Marked improvements in renal parameters Reduction in vasculitis activity score (BVAS1, a signs and symptoms index) Significant lowering of proteinuria at week 12 with avacopan Phase II CLEAR Trial and shedding of kidney inflammation 2 Multi-center, randomized (1:1:1), double- markers; decrease in eGFR blind Phase II trial in patients with newly diagnosed or relapsed ANCA Vasculitis  Rapid onset of action with A. SOC Control Group = Placebo + High  Patients feel better Dose Steroid (+ CYC/RTX) avacopan treatment B. Avacopan + Low Dose Chronic Statistically significant Steroid (1/3 of SOC) (+ CYC/RTX) Disease remission by BVAS week 4 C. Avacopan + No Chronic Steroid enhancement in quality of life; (+CYC/RTX) favorable safety profile

ANCA Vasculitis Regulatory Designations for Avacopan: o FDA Grant and orphan drug designation o EMA PRIME designation and orphan medicinal product o Intractable disease designation in Japan designation o SwissMedic orphan drug designation 1Birmingham Vasculitis Activity Score 2Estimated Glomerular Filtration Rate © Vifor Pharma 166 AVACOPAN PHASE II “CLEAR” TRIAL MET PRIMARY ENDPOINT

BVAS High Dose Steroids SOC Avacopan Treatment Groups

# (Vasculitis Statistical Rapid Remission (BVAS = 0): Treatment Groups 2 Patients Activity Significance 29% avacopan + no steroid BVAS = 0 by week 4 1 Score) Only 5% on steroid standard of care therapy

Total Avacopan Patients 36/43 -84% P = 0.002

Avacopan + low dose 19/22 -86% P = 0.002 steroid

Avacopan + no steroid 17/21 -81% P = 0.01

1 pt 9 pts* High dose steroid standard 14/20 -70% N/A of care (SOC)

Primary Endpoint: Proportion of patients with BVAS response at week 12 BVAS individual participant data shows more rapid response and remission with avacopan compared to SOC

1BVAS response defined ≥ 50% from baseline, and no worsening in any body system 2P values refer to comparison of avacopan to SOC for non-inferiority * Thickness of line indicates multiple patients achieved 100% improvement in BVAS © Vifor Pharma 167 AVACOPAN: RAPID IMPROVEMENT IN RENAL PARAMETERS

**** P < 0.0001, *** P < 0.001, ** P < 0.01, * P < 0.05 for superiority of *** P < 0.001, ** P < 0.01, * P < 0.05 for superiority of avacopan avacopan vs. steroid control group; LSM change from baseline vs. steroid control group; LSM change from baseline ** P < 0.01, * P < 0.05 for avacopan vs. control Proteinuria improves faster and at greater No requirement for chronic high dose Neutrophil counts normalize within days magnitude in avacopan groups vs. control steroids to stabilize kidney function

Jayne et al, 2017 JASN doi: https://doi.org/10.1681/ASN.2016111179 © Vifor Pharma 168 AVACOPAN ENHANCES QUALITY OF LIFE IN ANCA VASCULITIS

Quality of Life After 12 Weeks of Avacopan Almost Same as General Population Controls

Physical Functioning Physical Functioning Physical Functioning General health perception Role Physical General health Role Physical General health Role Physical perception perception

Vitality Role emotional Vitality Role emotional Vitality Role emotional

Social Social Mental health functioning Mental health functioning Mental health Social functioning

Bodily pain Bodily pain Bodily pain

Avacopan + no steroid vs. High-dose steroid1 group All Avacopan general population controls2

1 Prednisone / Methylprednisone Significant improvement over 12 week dosing course 2Basu et al, 2014 Ann Rheum Dis 73:207–211

Fully-enrolled, top-line data expected in Q4 2019

Two primary endpoints: Remission Sustained remission (based on BVAS) (based on BVAS) Rationale Behind ADVOCATE Design Goals: (both analyzed after 52 weeks) at 26 Weeks at 52 Weeks

52-week treatment period Control SOC Group 1. Demonstrate effective, - 52 Weeks: rapid and sustained Avacopan, 30 mg twice daily Superiority Test Group remission of ANCA Placebo to Prednisone 26 Weeks: (N = 158) Numerical Superiority / vasculitis by BVAS RTX, 4 weeks or CYC, 12 weeks followed by AZA Non-Inferiority Difference in 2. Eliminate need for High rates of Relapsed Placebo avacopan twice daily Avacopan relapse over Patients corticosteroids in standard Treatment time associated with SOC1 Control SOC Group (Test Group) of care and associated Prednisone, 60 mg/day tapered to 0 RemissionScore BVAS + (N = 158) over 21 weeks toxic side effects RTX, 4 weeks or CYC, 12 weeks followed by AZA 4 Weeks 26 Weeks 52 Weeks Time

1Potentially leading to greater separation of BVAS between SOC and Avacopan groups © Vifor Pharma 170 OTHER OPPORTUNITIES FOR AVACOPAN

C3 Glomerulopathy (C3G) • Rare, life-threatening disease; affects young people; renal transplant not curative • Uncontrolled activation of the complement system leading to complement protein deposition in the kidney (glomeruli), disrupting kidney function • No approved therapy • Huge economic burden on health care systems • Potential registration-supporting trial with avacopan underway

Hidradenitis Suppurativa (HS): • Chronic disabling skin autoimmune disease that relentlessly progresses; with extremely painful inflammatory nodules, boils or abscesses • Neutrophil-driven disease where C5a involvement is validated • C5a blockade with avacopan via C5aR offers a strong potential to control neutrophil activation • Current incumbent therapy widely regarded as inadequate, yet sales in HS approach $1Bn US

Targeted Approach to Orphan Kidney Diseases Such as FSGS

Overview Prevalence Number of FSGS cases are rising more than • Orphan disease of the kidney’s filtering units (glomeruli), and is characterized any other cause of Nephrotic Syndrome by serious scarring that leads to permanent kidney damage • Presents with proteinuria, in which protein is found in the urine due to a ̴ 40K ̴ 40K breakdown of the normal filtration mechanism in the kidney • One of the causes of a serious condition known as Nephrotic Syndrome and ~5,400 new cases ~1,500 new cases often leads to ESRD; Primary FSGS often associated with genetic mutation per year in U.S. per year in EU

Rationale Current Treatments • Histologic lesion from glomerular injury affecting specialized kidney No Approved Therapies filtering cells, especially podocytes; new science shows CCR2 in FSGS • Non-specific treatment approaches include steroids to kidney and role for CCR2 in renal cell (podocyte) protection control proteinuria or immuno-suppressants • CCX140 has demonstrated a statistically significant reduction in proteinuria in previous Phase II clinical trial in DN patients

Status Two registration-supporting clinical trials underway

Rescue if no partial response; otherwise continue Trial #1: Nephrotic syndrome primary CCX140, Dose range from 5 mg QD to Screening FSGS (≥ 3 gram/day baseline proteinuria) 15 mg BID (n=6 to 13) Expand to 30-50 patients for pivotal part 21

CCX140, 5 mg QD (n=10) Trial #2: Sub-nephrotic primary FSGS (at least 1 gram/day baseline proteinuria) CCX140, 10 mg BID (n=10) Screening Highest safe dose ( 12 weeks open label) • Stratify by level of proteinuria and CCX140, 15 mg BID (n=10) immunosuppressant treatment (yes/no) (Biopsy-proven Placebo (n=10) primary FSGS & assess proteinuria levels) 0 12 24

Study Assessments – Reduction in Proteinuria from Baseline (weeks)

Trial #1: Nephrotic Syndrome Primary FSGS: Trial #2: Sub-Nephrotic Primary FSGS • ≥ 3 gram/day baseline proteinuria • At least 1 gram/day baseline proteinuria • First presentation or new flare following prior • Decrease in proteinuria from baseline anticipated effective treatment accelerated approval endpoint • *Significant decrease in proteinuria from baseline • Reduced in decline in eGFR anticipated full approval approvable endpoint endpoint

Over the next 2 years

Near-Term o Data from ADVOCATE, C3G, FSGS, HS clinical trials 2109-2020 o Continue to support Vifor market Recent Achievements readiness activities in their territories o Potential commercial launch of avacopan in U.S.  EMA validates CMA application for o Continue to promulgate o Continued expansion of pipeline into avacopan in ANCA Vasculitis development in ANCA, C3G, FSGS additional indications  Positive OS results with CCX872 in o Initiate comprehensive placebo- o Cash through ADVOCATE pivotal Pancreatic Cancer controlled clinical program with avacopan in HS data and filings  Launch of Late-stage trials of avacopan in c3G and CCX140 in FSGS o Strong cash reserves (>$200M Q2 2018 cash and investments)  Phase III ADVOCATE trial fully enrolled

October 2018