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8-K - CURRENT REPORT - HARROW HEALTH, INC. | immy_8k.htm |
Exhibit 99.1
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Imprimis Pharmaceuticals,
Inc.
Inc.
“Positioned to Monetize One of the Largest
Databases of Compounded Drug Formulations”
Databases of Compounded Drug Formulations”
April 2013
Mark L. Baum, C.E.O.
1
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Safe Harbor Statement
The Company cautions you that the statements included in this presentation are not a description of historical
facts and are forward-looking statements within the meaning of Section 27A of the Securities Act of 1933 and
Section 21E of the Securities Exchange Act of 1934. These include statements regarding the Company’s
interpretation of the results of its Phase 3 clinical trial for Impracor™, the Company’s ability to obtain regulatory
approval to market Impracor™, the Company’s potential benefits arising from the Company’s relationship with
Professional Compounding Centers of America, Inc., the Company’s ability to leverage compounded generic
drugs to create a development pipeline and otherwise pursue its business plan and the Company’s ability to
leverage its Accudel™ technology in the development of potential product candidates.
facts and are forward-looking statements within the meaning of Section 27A of the Securities Act of 1933 and
Section 21E of the Securities Exchange Act of 1934. These include statements regarding the Company’s
interpretation of the results of its Phase 3 clinical trial for Impracor™, the Company’s ability to obtain regulatory
approval to market Impracor™, the Company’s potential benefits arising from the Company’s relationship with
Professional Compounding Centers of America, Inc., the Company’s ability to leverage compounded generic
drugs to create a development pipeline and otherwise pursue its business plan and the Company’s ability to
leverage its Accudel™ technology in the development of potential product candidates.
These forward-looking statements are based on management’s current expectations, estimates, forecasts and
projections about the Company and are subject to risks and uncertainties that could cause actual results and
events to differ materially from those stated in the forward-looking statements. Actual results may differ materially
from those set forth in this presentation due to the risks and uncertainties inherent in the Company’s business,
including, without limitation: the outcome of the final analyses of the data from the past and future Phase 3 clinical
trial may vary from the Company’s initial conclusions; the FDA may not agree with the Company’s interpretation
of such results or may challenge the adequacy of the Company’s future Impracor™ clinical trial design or the
execution of the same clinical trials; the FDA may continue to require the Company to complete additional clinical
trials for Impracor™ before the Company can submit a 505(b)(2) NDA application; the results of any future clinical
trials may not be favorable and the Company may never receive regulatory approval for Impracor™; and the
Company’s possible need to raise additional funding to complete its product development plans.
projections about the Company and are subject to risks and uncertainties that could cause actual results and
events to differ materially from those stated in the forward-looking statements. Actual results may differ materially
from those set forth in this presentation due to the risks and uncertainties inherent in the Company’s business,
including, without limitation: the outcome of the final analyses of the data from the past and future Phase 3 clinical
trial may vary from the Company’s initial conclusions; the FDA may not agree with the Company’s interpretation
of such results or may challenge the adequacy of the Company’s future Impracor™ clinical trial design or the
execution of the same clinical trials; the FDA may continue to require the Company to complete additional clinical
trials for Impracor™ before the Company can submit a 505(b)(2) NDA application; the results of any future clinical
trials may not be favorable and the Company may never receive regulatory approval for Impracor™; and the
Company’s possible need to raise additional funding to complete its product development plans.
More detailed information about the Company and the risk factors that may affect the realization of forward-
looking statements is set forth in the Company’s filings with the Securities and Exchange Commission, including
its Annual Report on Form 10-K and its Quarterly Reports on Form 10-Q filed with the SEC. Such documents
may be read free of charge on the SEC’s web site at www.sec.gov.
looking statements is set forth in the Company’s filings with the Securities and Exchange Commission, including
its Annual Report on Form 10-K and its Quarterly Reports on Form 10-Q filed with the SEC. Such documents
may be read free of charge on the SEC’s web site at www.sec.gov.
You are cautioned not to place undue reliance on these forward-looking statements, which speak only as of the
date hereof, given these risks and uncertainties. All forward-looking statements are qualified in their entirety by
this cautionary statement and the Company undertakes no obligation to revise or update this presentation to
reflect events or circumstances after the date hereof.
date hereof, given these risks and uncertainties. All forward-looking statements are qualified in their entirety by
this cautionary statement and the Company undertakes no obligation to revise or update this presentation to
reflect events or circumstances after the date hereof.
© Imprimis Pharmaceuticals, Inc. | *
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Imprimis Overview
© Imprimis Pharmaceuticals, Inc. | *
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Imprimis Snapshot
© Imprimis Pharmaceuticals, Inc. | *
• Approx. $19.5M in cash1
• Nominal debt; no preferred instruments
• Phase 3 topical NSAID pivotal to start mid 2013
• Exclusive commercial rights to PCCA development IP
• 10,000+ drug formulations
• 10+ drug delivery technologies
• Vast market “unmet need” database
• Accudel™ targeted drug delivery platforms
• Experienced science and management teams
1) Cash position at December 31, 2012 ($10M), and net proceeds $(9.5M) of public offering and over-allotment exercise February/March, 2013
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Imprimis Overview
© Imprimis Pharmaceuticals, Inc. | *
Low Risk
Low Margin
505(b)(2) … Lower Risk | Higher Margin
We develop proprietary drug assets using the 505(b)(2) pathway
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Less Development Time & Lower Cost
Application
|
505(b)(1) NDA
|
505(b)(2) NDA
|
505(j) ANDA
|
New Chemical Entity
(NCE) |
Yes
|
Yes/No
(Rely on RLD and Prior Investigation)
|
No
(RLD is off patent)
|
New Indication
|
Yes
|
Yes
|
No
|
New Form/Dose
|
Yes
|
Yes
|
No
|
Required Data for
Approval |
• Complete Pharmacology
• Complete Preclinical
Safety, including long term carcinogenicity in 2 species • Complete analytical
development and quality manufacturing • Complete Phase 1-3
clinical trials |
• Data from published literature
• FDA findings on efficacy/safety of
approved drug/formulation • Studies to support change
• Dermal/Eye Safety (topical drugs)
• Clinical Efficacy/Safety
• CMC (3 registration batches with
stability data) |
• Bioequivalence
|
• 505(b)(2) products can have Orange Book-listed patents, can enjoy 30-month protection against
generic competitors; NCE (5 yrs); Orphan Drug (7 yrs); Pediatric Extension (6 mos.)
generic competitors; NCE (5 yrs); Orphan Drug (7 yrs); Pediatric Extension (6 mos.)
• 505(b)(2) Development Budget Comparison: $2-7M versus $100M+ for (b)(1)
© Imprimis Pharmaceuticals, Inc. | 6
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Imprimis Development Model
© Imprimis Pharmaceuticals, Inc. | *
Imprimis Brings Innovation
from Pharmaceutical Compounders
to the >$300B U.S. Pharmaceutical Industry
Pharmaceutical
Compounders
1%
99%
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PCCA Strategic Relationship
• Professional Compounding Centers of America
(PCCA) is the largest compounding pharmacy
organization in North America
(PCCA) is the largest compounding pharmacy
organization in North America
1. Supply chemicals, equipment, accredited training, software,
and business/pharmacy consulting assistance
and business/pharmacy consulting assistance
• Over 3,900 pharmacy businesses/chains worldwide
• PCCA relationship gives Imprimis exclusive access to:
1. Proprietary and proven drug formulations
2. Proprietary and proven drug delivery technologies
(Lipoderm® and others)
(Lipoderm® and others)
3. Market data (>100,000 inbound calls per year)
4. Analytics
• Our strategic relationship is exclusive
• PCCA invested $4M into Imprimis at $4.80 per share
Risk Mitigated
Proprietary Drug Pipeline
+
© Imprimis Pharmaceuticals, Inc. | *
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Imprimis Vision
© Imprimis Pharmaceuticals, Inc. | *
Drive Shareholder Value
• Monetize vast PCCA IP
and development assets
• Selective internal
development
development
• Partner
• Out-license
Improve Patient Care
• Novel drug administration
• Reduce or eliminate
negative side effect
profiles
negative side effect
profiles
• Increase therapeutic
benefit to patients
benefit to patients
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Monetizing the PCCA Relationship
Step 1: Opportunity Matrix
X Axis: Drug Administration
Y Axis: Health Categories
• Competition
• Dollar Size
• Number of Annual RX
Internally Develop
Partner, Out-License
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Improving Patient Care:
Impracor™ Phase 3
Topical NSAID
Impracor™ Phase 3
Topical NSAID
© Imprimis Pharmaceuticals, Inc. | *
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The Case for a Topical NSAID
|
Oral NSAIDs
|
Topical NSAIDs
|
Efficacy in Acute Soft Tissue Injuries
|
Good
|
Good
|
Efficacy in Osteoarthritis
|
Good
|
Good
|
Incidence of Adverse Events
|
High
|
Low
|
GI Safety (Stomach)
|
Poor
|
Good
|
Hepatic Safety (Liver)
|
Poor
|
Good
|
Renal Safety (Kidney)
|
Poor
|
Good
|
Cardiovascular Safety (Heart)
|
Poor
|
Good
|
© Imprimis Pharmaceuticals, Inc. | *
Resultant Complications from Systemic (Oral) NSAID Use
• 16,000 deaths (US/yr)
• 100,000 hospitalizations (US/yr)
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The Topical NSAID Market
© Imprimis Pharmaceuticals, Inc. | 13
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The Case for Impracor™
© Imprimis Pharmaceuticals, Inc. | *
• Market Analysis:
• The $10B+ US NSAID Market is Transitioning to Topicals
• Voltaren Gel (1% diclofenac) has ~75% Rx share
• Despite Suboptimal Products, U.S. Topical NSAID Market is Growing
• 2016 Topical NSAID Market Possibly >$1B
• There is a compelling unmet need for an effective semi-solid NSAID
Factor
|
Impracor™
|
Voltaren®
|
Delivery Technology
|
Patented Accudel™ Micelles
|
None; Alcohol
|
Per Dose Quantity
|
3g
|
4g
|
Dose Frequency
|
BID (2X Daily)
|
QID (4X Daily)
|
API
|
10% Ketoprofen
|
1% Diclofenac
|
COX Selectivity
|
Cox 1
|
Cox 2
|
Smell
|
Neutral
|
Insect Repellant
|
Tactile
|
Smooth
|
Greasy
|
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Impracor™ Phase 3 Program
Initial Phase 3 Trial
• Removing subjects who should not have entered the trial: p=0.038
• Remove subjects who did not comply with the protocol: p=0.034
New Acute Pain Clinical Trials to Achieve FDA Approval
• Two adequate and well controlled acute pain trials
• Analgesic Solutions (Dr. Nathaniel Katz) design/execute program
• Use patented tools and methods to reduce placebo effect
• Rapid trial enrollment from “banking” of qualified patients
• Seek “sprains, strains and joint pain” label
• Could be the only acute pain topical NSAID (if FDA approved)
© Imprimis Pharmaceuticals, Inc. | *
Phase 3 Clinical Trials Planned - Mid 2013
Initial Trial Data - Q1 2014
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Impracor™ Commercialization
• Capture existing compounded topical ketoprofen market
• Doctors prefer FDA approved product
• Patients prefer insurance reimbursement
• Potentially more margin for pharmacies for FDA-approved
product
product
• Option to utilize PCCA member network to launch in US
• Out-license and compete against Voltaren in the large and
growing US topical NSAID market
growing US topical NSAID market
• Benefit from format, feel, potency, dosing & smell
advantages
advantages
© Imprimis Pharmaceuticals, Inc. | *
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Impracor™ Intellectual Property
FDA Exclusivity
• FDA protection with up to 3 years of new drug exclusivity
• “Paragraph IV” claims can prevent generics for up to 30 months
*** FDA “High Hurdles” for Topical Generics
• Voltaren™ - off exclusivity and off patent for years - no generics
• There are currently no generics in the topical NSAID market:
• FDA Guidance: Voltaren™ generics must complete clinical studies prior to ANDA
• Generic drug companies are not in the business of conducting clinical trials
• Conclusion: Bioequivalence for an ANDA for topical drugs is difficult to establish
USPTO Protections
• Core Accudel™ US/Canadian patents issued
• New Impracor™ packaging applications filed
© Imprimis Pharmaceuticals, Inc. | *
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Executive Team and
Select Financial Data
Select Financial Data
© Imprimis Pharmaceuticals, Inc. | *
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Management Team Snapshot
Strong operational and management experience within our leadership group
Compensation weighted in equity
Chief Executive Officer: Mark L. Baum, J.D.
15+ Years of Senior Executive Experience; Founder/President, YesRx.com (1999)
Founder of 3 private investment funds; Restructured numerous companies (private-to-public)
Responsible for Restructuring Imprimis, including ~$24M new equity investment and PCCA transaction
President: Balbir Brar, D.V.M., Ph.D.
25 Years of Senior Drug Development Experience
Senior Positions: Lederle/Wyeth, SmithKline & Beckman, and Allergan
Drugs: Botox, Ketorolac (Cataracts), Restasis (Dry Eye), Lumigam, Latisse, Alphagan and 8 other drugs
Chief Medical Officer: Joachim P.H. Schupp, M.D.
Senior Positions: Ciba-Geigy, Novartis, ProSanos, Adventrx, Apricus Biosciences
Senior Positions: Ciba-Geigy, Novartis, ProSanos, Adventrx, Apricus Biosciences
Drugs: Voltaren line extensions, Apligraf, Femara, Exjade and Sandoglobulin
VP, Accounting and Public Reporting: Andrew R. Boll
8+ years of experience in small capitalization company financial reporting; focus on restructured businesses
Led forensic-type accounting and financial reporting of historical Imprimis records during restructuring
© Imprimis Pharmaceuticals, Inc. | *
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Clinical and Regulatory Team Snapshot
Senior Regulatory Advisor: Lee S. Simon, M.D.
FDA Division Director of Analgesic, Anti-Inflammatory & Ophthalmologic Drug Products (2001-2003)
Served on multiple FDA advisory committees; 12 years as an NIH funded investigator
FDA Division Director of Analgesic, Anti-Inflammatory & Ophthalmologic Drug Products (2001-2003)
Served on multiple FDA advisory committees; 12 years as an NIH funded investigator
Senior consultant to Pharmacia/Searle on COX-2 development
Two terms on the BOD of the American College of Rheumatology; 110 Original Publications
Senior Clinical Advisor: Roy D. Altman, M.D.
Professor of Medicine, Division of Rheumatology/Immunology at UCLA ; 35+ yrs clinical experience
Founding Member/Past President of the Osteoarthritis Research Society International
Chairman for the Design and Conduct of Clinical Trials in Osteoarthritis as well as the Chairman on
Clinical Trials in Osteoarthritis; Over 200 juried manuscripts and over 60 books
Clinical Trials in Osteoarthritis; Over 200 juried manuscripts and over 60 books
Edited the 4th edition of Osteoarthritis: Diagnosis and Management.
Co-editor :Seminars in Arthritis and Rheumatism and Editor and Chief of Osteoarthritis and Cartilage
Senior Clinical Advisor: Marc C. Hochberg, M.D.
Faculty, The Johns Hopkins University SOM & University of Maryland SOM
Head of the Division of Rheumatology and Clinical Immunology at University of Maryland SOM
Focus on clinical epidemiology of musculoskeletal diseases, osteoarthritis and osteoporosis
PI of NIH and Dep’t Vet. Affairs funded studies, and is a Co-investigator on several other studies
Senior Regulatory Advisor: Allan M. Green, M.D., PhD, J.D.
Physician, Attorney, Inventor and Research Scientist
Operating and Management Experience with Numerous Biomedical Companies
Of Counsel to Mintz, Levin, Cohn, Ferris, Glovsky and Popeo, P.C.
Teaches Food and Drug Law at Boston College Law School
© Imprimis Pharmaceuticals, Inc. | *
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Capital Structure
|
Capital Structure
March 14, 2013
(Unaudited)
|
Percent
|
Common Shares
|
8,888,250
|
82.58%
|
Total Restricted Stock Units
|
200,000
|
1.86%
|
Total Options & Warrants - Weighted Avg. Ex. Price $5.49
|
1,675,487
|
15.56%
|
Total Common Shares - Diluted
|
10,763,737
|
100.00%
|
|
|
|
© Imprimis Pharmaceuticals, Inc. | *
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Summary
© Imprimis Pharmaceuticals, Inc. | *
• Imprimis is a Company with Vision
• Unique Drug Development Model
• Near Term Catalysts
• Robust and Compelling Development Assets
• Key Strategic Relationships
• Cash Resources to Execute
• Highly Capable Team
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Questions & Discussion
Imprimis Pharmaceuticals, Inc.
Delivering Safe, Effective and Direct Solutions
FOR MORE INFORMATION CONTACT:
Mark L. Baum, J.D.
(858) 433-2816 - Direct
mark@imprimispharma.com
© Imprimis Pharmaceuticals, Inc. | *
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Appendix - Investment
Summary & Support
Summary & Support
© Imprimis Pharmaceuticals, Inc. | A1
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Accudel™ Topical
Delivery Technology
Delivery Technology
© Imprimis Pharmaceuticals, Inc. | A2
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Introduction to Accudel™
Pluronic Lecithin Organogel (PLO) Platform
Lipophillic APIs
Hydrophillic APIs
Pluronic Phase
Lecithin Phase
• Accudel™ is a cream that “carries” drugs
through the skin, penetrating to the problem site
through the skin, penetrating to the problem site
• Pluronic Lecithin Organogel (PLO) drug carrier
• Accommodates different size molecules and large
quantities of active drugs
quantities of active drugs
• Works with drugs with different physicochemical
properties
properties
• Quickly absorbed and aesthetically pleasing
• Low toxicity and biodegradable; components are
non-immunogenic and are “Generally Regarded
As Safe” (GRAS) by the US FDA
non-immunogenic and are “Generally Regarded
As Safe” (GRAS) by the US FDA
• Thermodynamically stable, insensitive to moisture
and resistant to microbial contamination
and resistant to microbial contamination
Drug
© Imprimis Pharmaceuticals, Inc. | A3
Lecithin Phase
Drug
Pluronic Phase
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Introduction to Accudel™
In Vitro Penetration Data for Impracor™ and
European Marketed Products (Fastum®, Ketum®, Oruvail®)
European Marketed Products (Fastum®, Ketum®, Oruvail®)
• 63% - 70% of ketoprofen in Impracor that was available for
release diffused through the membrane (0.45 m Nylon) of a
Franz Cell Apparatus within 4 hoursi.
release diffused through the membrane (0.45 m Nylon) of a
Franz Cell Apparatus within 4 hoursi.
• (Fastum, Ketum, Oruvail) 2.5% topical ketoprofen were tested
in a Franz Cell Apparatus (Silicon membrane). Less than 20%
of ketoprofen present in the formulation was made available to
diffuse out of the formulation into the receptor phase in the un-
ionized formii.
in a Franz Cell Apparatus (Silicon membrane). Less than 20%
of ketoprofen present in the formulation was made available to
diffuse out of the formulation into the receptor phase in the un-
ionized formii.
i. DPT Study Report TC.0706.01
ii. Thesis Tettey-Amlalo, Dec 2005
Faculty of Pharmacy Rhodes University, Grahamstown
© Imprimis Pharmaceuticals, Inc. | A4
27
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Impracor™ Topical
NSAID
Competition and Market
NSAID
Competition and Market
© Imprimis Pharmaceuticals, Inc. | A5
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The Problem With Oral NSAIDs
Solution is to deliver NSAIDs topically to the specific site of pain or inflammation
Fact: Extremely Large Population Uses NSAIDs
• 70 Million prescriptions for NSAIDs each year in US (Wiegard in Medscape)
• Regularly used by more than 60M Americans (Arch Intern Med. 2005;165:171-177)
• 70% of all 65+ Year Olds Take NSAIDs Weekly
• Usage of oral NSAIDs is increasing
Result: Toxicity to Gastro Intestinal (GI) Tract, Kidneys and Liver
• Over 100,000 per year are hospitalized from NSAID complications
• Hospitalizations alone cost more than $2B per year
• Over 16,000 deaths every year from GI NSAID complications
• NSAID GI Toxicity - the 15th most common cause of death in US
Widespread Usage With Serious Side Effects
© Imprimis Pharmaceuticals, Inc. | A6
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Competitive Landscape
10% Ketoprofen
Cream
1 gram
3 x per day =
3 grams/day
3 x per day =
3 grams/day
Safe / Cutaneous
Elegant Formulation
Convenient / Cream
Accudel Delivery System
Local AEs 1-2%
Local AEs 1-2%
Seeking acute
musculoskeletal pain label
musculoskeletal pain label
IMPRACOR
(Imprimis)
1.3% Diclofenac
epolamine
epolamine
10 x 14 cm patch
2 x per day
2 x per day
Fixed one size patch
Adherence issues
Not to be worn in water
Local AEs 11%
Acute soft tissue
injury (positive data
in ankle sprain)
injury (positive data
in ankle sprain)
FLECTOR PATCH
(Pfizer/IBSA)
1% Diclofenac
sodium
2-4 gram
4 x per day =
16 grams/day
16 grams/day
Large Quantities
Sticky / Greasy
Odor / Staining
Local AEs 7%
Chronic OA of hand
and knee
and knee
VOLTAREN GEL
(Endo/Novartis)
1.5% Diclofenac
sodium
40 drops of liquid
(10 drops to each of 4 sides of knee)
(10 drops to each of 4 sides of knee)
3-4 x per day =
160 drops/day
160 drops/day
Dimethyl sulfoxide
(DMSO); Safety concerns
(DMSO); Safety concerns
Complicated application
Causes garlic taste/breath
Local AEs 47%
Chronic OA of knee
PENNSAID
(Covidien/Nuvo)
© Imprimis Pharmaceuticals, Inc. | A7
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Ketoprofen vs. Ibuprofen
“Meta-analysis of 26 trials (n=2,853) … showed that Ketoprofen was
significantly better than all other topical NSAIDs. In terms of efficacy,
Ketoprofen was significantly better than ibuprofen, felbinac, piroxicam and
indomethacin.”
significantly better than all other topical NSAIDs. In terms of efficacy,
Ketoprofen was significantly better than ibuprofen, felbinac, piroxicam and
indomethacin.”
Topical NSAIDs for acute pain: a meta-analysis
Lorna Mason, R Andrew Moore*, Jayne E Edwards, Sheena Derry and Henry J McQuay
BMC Family Practice 2004, 5:10
The Impracor Solution
Ketoprofen vs. Diclofenac
The proportion of participants experiencing successful treatment with topical
ketoprofen in seven clinical studies was 73% (251/346, range 57% to 89%)
ketoprofen in seven clinical studies was 73% (251/346, range 57% to 89%)
The proportion of participants experiencing successful treatment with topical
diclofenac in three clinical studies was 52% (166/319, range 39% to 92%)
diclofenac in three clinical studies was 52% (166/319, range 39% to 92%)
Ketoprofen is a Superior Active Ingredient
© Imprimis Pharmaceuticals, Inc. | A8
Topical NSAIDs for acute pain in adults.
Massey T, Derry S, Moore RA, McQuay HJ
Cochrane Database Syst Rev. 2010;6:CD007402
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Relative COX-1/COX-2 Selectivity
Vane S J Thorax 2000;55:S3-S9
5-50 fold
COX-2
COX-2
selective
<5-fold
COX-2
selective
COX-2
selective
-3
-2
-1
0
1
2
3
© Imprimis Pharmaceuticals, Inc. | A9
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Additional Impracor™
Clinical Materials
Clinical Materials
© Imprimis Pharmaceuticals, Inc. | A10
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Topical NSAIDs in Acute OA Knee Pain Model
© Imprimis Pharmaceuticals, Inc. | A11
|
Ketoprofen 20% Patch
(ENDO)
|
Ketoprofen Transfersome
Gel, Diractin™ (IDEA) |
Diclofenac Solution
Pennsaid™ (Nuvo) |
Phase
|
3
|
2/3
|
2
|
Study Dates
|
Aug 2006 - May 2007
|
Jul 2003 - Jan 2004
|
Jul 2010 - Mar 2011
|
# of Subjects/ Age
|
309 / above 18 years
|
397/ above 40 years
|
248 / 18 -80 years
|
Regimen/ Duration
|
Ketoprofen Patch applied o.d.
4 weeks
|
110 mg ketoprofen b.i.d. (n=138)
6 weeks
(1 placebo capsule b.i.d.
100 mg celecoxib capsule b.i.d.)
|
1.3 mL applied to front, back and sides of knee
b.i.d. (n=84) Vehicle and placebo controlled
4 weeks
|
Selection
|
Diagnosis of knee (unilateral or bilateral),
CRO: PPD |
Morning stiffness < 30’, crepitus, at least 3 on
Likert’s 5 point scale, not on NSAIDS |
Patients using NSAIDs underwent a 1-week
washout This was a non-flare study
|
Primary Endpoint
|
WOMAC (pain) week 2
|
WOMAC (pain ) week 6•
|
WOMAC (pain ) week 4
|
Secondary Endpoints
|
Pain Intensity/ relief (diary)
WOMAC (function), Rescue Medication,
quality of sleep, lost days of work. Pat./Phys. global assessment |
WOMAC (function)-week 6.
Patient global assessment (5 Point Likert)•
|
WOMAC (stiffness) , WOMAC (function), WOMAC
(pain on walking) - - week 4 Patient global assessment
Pain assessment 11 point scale
|
Conclusions
|
ITT Primary Endpoint met: Significant
differences vs placebo (p=0.014). All secondary endpoints met. Previously two Phase 3 sprain/strain trials failed, program discontinued. ENDO 10Q 2007 |
WOMAC pain LS mean reduction - 18.2 (-22.1 to -
14.3), -20.3 (-24.3 to -16.2) and -9.9 (-13.9 to - 5.8) osteoarthritis (p <0.01) All WOMAC subscale scores were normalized to
a scale of 0 to 100 by dividing the sum subscale score by the number of questions of each score. Ann Rheum Dis. 2007; 66(9): 1178-83. Swissmedic approval based on single study |
WOMAC pain reduction (5-Point Likert) from
baseline (-3.9 [- 4.8 to -2.9]) compared with vehicle -control solution (-2.5 [- 3.3 to -1.7]; p = 0.023) or the placebo solution (-2.5 [-3.3 to -1.7]; p = 0.016). CMAJ • AUG. 17, 2004; 171 (4) 5 Phase 3 trials have achieved all 3 primary end
points in OA. |
34
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Retrospective Analysis of 1st Phase 3 Study
p = 0.038
mITT ** (n=326)
Study Design Error
ITT * (n=361)
Mean reduction from baseline in mm (100 mm Visual Analogue Scale)
mm
“Once randomized, you’re analyzed” p = 0.087
* ITT = Intent-to-treat (ITT) population
** mITT = Modified ITT of ITT patients - 35 met study entry criteria, but were excluded from ITT due to exclusionary criteria:
(1) misdiagnosis, (30) positive drug screen, (4) other lab values at baseline making the patient ineligible for the trial
(1) misdiagnosis, (30) positive drug screen, (4) other lab values at baseline making the patient ineligible for the trial
*** mPP = Modified per protocol (mPP) analysis of mITT patients -- who complied with the protocol? (52) improperly dosed,
(22) no valid Day 3 primary endpoint assessment, and (4) were misdiagnosed
(22) no valid Day 3 primary endpoint assessment, and (4) were misdiagnosed
Design & Execution Optimization Lead to Statistical Significance (p = <0.05)
mPP *** (n=250)
Study Mgmt Errors
p = 0.034
© Imprimis Pharmaceuticals, Inc. | A12
Change from baseline
in pain intensity
during daily activities
over the past 24
hours on Day 3 Visit
(Day 3, +1 or +2 days)
in pain intensity
during daily activities
over the past 24
hours on Day 3 Visit
(Day 3, +1 or +2 days)
35
![](immy36.jpg)
New Impracor Phase 3 Program: 1H 2013
Old Phase 3 Trial
|
New Phase 3 Trial
|
Many sprains and strains trials have failed
|
• Acute OA flare (as a pain model) provides a more
reliable population with better chance for separation |
High placebo responses
|
• Utilize analgesia-specific proprietary implements and
methodologies to identify placebo responders |
Insufficient monitoring for patient eligibility
|
• Invest in trial design and management
• Use only experienced pain trial investigators
|
Patients were entered into the ITT up to 72 hours
after injury |
• OA flare model designed for NSAID “wash-out” and
immediate randomization of eligible patients |
People were allowed in if they had 6/10 pain level
over last 24 hours - regardless of pain at baseline |
• OA flare model has defined entry criteria for pain
intensity after NSAID “wash-out” and before randomization |
30 subjects used un-allowed drugs
|
• Local laboratory for eligibility (drugs, liver, kidney,
hematology) |
Major dosing compliance problems related to
smaller size of tube orifice vs. applicator card box |
• Provide scales and weigh tubes at any office visit
|
© Imprimis Pharmaceuticals, Inc. | A13
36
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Initial Phase 3 Trial
Design:
|
Randomized, double-blind, placebo-controlled at 26 sites
|
Study Population:
|
Efficacy, n = 361
Uncomplicated acute soft tissue injuries
Ankle (n=97), Shoulder (n=87), Knee (n=59), Wrist (n=57), Elbow (n=30), Calf/Anterior Tibialis
(n=11), Hamstring/Quadriceps (n=8), Forearm (n=5), Biceps/Triceps (n=3), Hand (n=3) Safety, n = 364
Ranging in age from 18 - 75 years
|
Key Entry Criteria:
|
Injury occurred within 72 hours, pain intensity ≥ 60mm on 100 mm Visual Analogue Scale
(VAS); no intake of unallowable medication |
Dosing Regimen:
|
Impracor vs. Placebo (Vehicle) cream, 1g t.i.d. x 7 days
|
Primary Endpoint:
|
Change from baseline in pain intensity during daily activities on Day 3 office
visit (+1, +2 days) with 100 mm VAS measurement |
Secondary
Endpoints: |
• Change from baseline in three times daily pain intensity immediately prior to medication
• Various other treatment satisfaction and safety assessments
• Pharmacokinetics in subset of patients
|
Sprain-Strain Soft Tissue Study
© Imprimis Pharmaceuticals, Inc. | A14
37
![](immy38.jpg)
Safety: Low Incidence of Adverse Events
* Clinical Study Report: TDLP-110-001, September 2010
** Prescribing Information for Flector Patch, Voltaren Gel and Pennsaid Solution
• No related gastrointestinal (GI), cardiac, liver, or other serious AEs
• Low incidence of cutaneous AEs
© Imprimis Pharmaceuticals, Inc. | A15
1g, 3x daily
180mg, 2x daily
4g, 4x daily
40 drops, 4x daily
**
**
**
**
**
*
*
38
![](immy39.jpg)
Pharmacokinetics: Low Systemic
Absorption
Absorption
* Cannavino, C. et al. Efficacy of Transdermal Ketoprofen in delayed onset muscular soreness,Clinical Journal of Sports Medicine, 13: 200-208,
2003 and Clinical Study Report Project No. 990808, Phase 1/2 Study Report Aug 2007
2003 and Clinical Study Report Project No. 990808, Phase 1/2 Study Report Aug 2007
**Orudis ketoprofen extended release capsule/ Oruvail capsule prescription information
Impracor*
10% ketoprofen cream
Oruvail**
1g t.i.d. (48hr)
2g t.i.d. (48hr)
© Imprimis Pharmaceuticals, Inc. | A16
Orudis**
39
![](immy40.jpg)
Clear Separation of Data Day 4 Onwards
Mean Change from Baseline in 3X/daily
Pain Intensity Prior to Medication (from Patient Diary)
Pain Intensity Prior to Medication (from Patient Diary)
All ITT patients (n=361)
* =.statistically significant
© Imprimis Pharmaceuticals, Inc. | A17
p = 0.041*
40
![](immy41.jpg)
We Believe We Know What Body Part to Study
Day 7
n=77
p=0.0396
Knees and Adjacent Muscle Injuries
© Imprimis Pharmaceuticals, Inc. | A18
Average Change in Pain Intensity from Baseline
41
![](immy42.jpg)
Phase 1/2 Study - Investigator IND Efficacy by Assessing DOMS
Cannavino, C. et al. Efficacy of Transdermal Ketoprofen in delayed onset muscular soreness,Clinical Journal of Sports Medicine, 13: 200-208, 2003
and Clinical Study Report Project No. 990808, Phase 1/2 Study Report Aug 2007
and Clinical Study Report Project No. 990808, Phase 1/2 Study Report Aug 2007
Time
0h
24h
48h
0
1
2
3
4
5
6
Impracor
Placebo
Time
0h
24h
48h
0
1
2
3
4
5
6
Impracor
Placebo
VAS muscle soreness means ± SE 0, 24 and 48 hours,
significantly less soreness in the Impracor vs placebo group
(p=0.0118) between 24 and 48 hours
significantly less soreness in the Impracor vs placebo group
(p=0.0118) between 24 and 48 hours
VAS muscle soreness means ± SE at 0, 24 and 48 hours.
Significantly less soreness in the Impracor vs placebo
(p=0.0104) between 24 and 48 hours
Significantly less soreness in the Impracor vs placebo
(p=0.0104) between 24 and 48 hours
No Adverse Events Reported
p=0.0118
p=0.0104
Either Active o (both legs) Placebo
n=16
1/2 Active/Placebo on R or L Legs
n=16
© Imprimis Pharmaceuticals, Inc. | A19
42
![](immy43.jpg)
Additional Corporate
Information
Information
© Imprimis Pharmaceuticals, Inc. | A20
43
![](immy44.jpg)
Board of Directors
Robert J. Kammer, D.D.S.
Managing Member of financial group that restructured Imprimis
Active Clinical Research & Consulting Practice
30+ Years Clinical Practice - Diplomate, American Board of Orofacial Pain
Retired Associate Professor & Course Director - Orofacial Pain, University of Colorado
Mark L. Baum, J.D.
15+ Years of Senior Executive Experience; Founder/President, YesRx.com (1999)
Founder of 3 private investment funds; Restructured numerous companies (private-to-public)
Responsible for Restructuring Imprimis, including $7.95M New Equity Investment and PCCA transaction
Paul Finnegan, M.D., M.B.A.
13+ Years Commercialization and Development Experience
Ops Experience: Avalon Ventures, Alexion, Pharmacia/Searle); Univ. of Chicago MBA
13+ Years Commercialization and Development Experience
Ops Experience: Avalon Ventures, Alexion, Pharmacia/Searle); Univ. of Chicago MBA
Senior Positions: Avalon Ventures, Alexion Pharmaceuticals, Pharmacia/Searle/Monsanto
Drugs: Celebrex, Bextra, Arthrotec, Soliris, Inspra and Aldactone/Soldactone
Jeff Abrams, M.D.
Founder and Director since 1998
Practicing primary care clinician for 20+ years
Co-developer of our Accudel drug delivery technology and Impracor topical NSAID
Stephen Austin, C.P.A.
Audit Committee Chairman; Board service on over 12 boards and related board committees
Partner at Swenson Advisors, LLP since May 1998
Manages audit, SEC, Sarbanes-Oxley and business consulting engagements with a focus on technology,
manufacturing, service, real estate, social media and non-profit organizations
manufacturing, service, real estate, social media and non-profit organizations
© Imprimis Pharmaceuticals, Inc. | A21
44
![](immy45.jpg)
Balance Sheet
ASSETS
|
|
December 31, 2012
|
||
Current Assets
|
|
|
||
|
Cash and cash equivalents
|
$
|
10,035,615
|
|
|
Other assets
|
|
670,381
|
|
|
|
TOTAL ASSETS
|
$
|
10,705,996
|
LIABILITIES AND STOCKHOLDERS' EQUITY
|
|
|
||
|
Accounts payable and accrued expenses
|
$
|
709,559
|
|
|
|
TOTAL LIABILITIES
|
|
709,559
|
Stockholder’s Equity
|
|
|
||
|
Common stock, $0.001 par value, 395,000,000 shares
authorized, |
|
|
|
|
|
6,772,066 shares issued and outstanding
|
|
6,772
|
|
Additional paid-in capital
|
|
34,093,933
|
|
|
Deficit accumulated during the development stage
|
|
(24,104,268)
|
|
|
|
TOTAL STOCKHOLDERS' EQUITY
|
|
9,996,437
|
|
|
TOTAL LIABILITIES AND STOCKHOLDERS' EQUITY
|
$
|
10,705,996
|
© Imprimis Pharmaceuticals, Inc. | A22
(Abbreviated)
45
![](immy46.jpg)
Imprimis Development Process
Ideas
Candidates
Projects
• Market Data
• Drug Master File
• Field Experience
• Out-License or Develop
• Complete Phase 3
• NDA via 505(b)(2)
• Market Launch/Partner
NDA & LAUNCH
Candidate
46