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Copyright © 2019 Zosano Pharma Inc. | Confidential Corporate Presentation October 2019

Corporate Presentation May 2017

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Page 1: Corporate Presentation May 2017

Copyright © 2019 Zosano Pharma Inc. | Confidential

Corporate Presentation

October 2019

Page 2: Corporate Presentation May 2017

Copyright © 2019 Zosano Pharma Inc. | Confidential

Forward-Looking Statements

2

This presentation contains forward-looking statements regarding Zosano’s technology and product candidates,

including ADAM, QtryptaTM and C213, and other future events and expectations. Readers are urged to consider

statements that include the words "may," "will," "would," "could," "should," "might," "believes," "estimates," "projects,"

"potential," "expects," "plans," "anticipates," "intends," "continues," "forecast," "designed," "goal," "approximately" or the

negative of those words or other comparable words to be uncertain and forward-looking. These statements are subject

to risks and uncertainties that are difficult to predict, and actual outcomes may differ materially. These include, without

limitation, risks and uncertainties associated with the process of discovering, developing and commercializing products

that are safe and effective for use as human therapeutics, risks inherent in the effort to build a business around such

products and other risks and uncertainties described under the heading "Risk Factors" in the Company's most recent

quarterly report on Form 10-Q. Although Zosano believes that the expectations reflected in these forward-looking

statements are reasonable, we cannot in any way guarantee that the future results, level of activity, performance or

events and circumstances reflected in forward-looking statements will be achieved or occur. All forward-looking

statements are based on information currently available to Zosano and Zosano assumes no obligation to update any

such forward-looking statements.

Page 3: Corporate Presentation May 2017

Copyright © 2019 Zosano Pharma Inc. | Confidential

Investment Highlights

▪ Proprietary intracutaneous drug delivery platform

▪ Lead program: QtryptaTM

▪ Acute migraine therapy

▪ Strong clinical data

▪ NDA filing in Q4 2019

▪ Portfolio Expansion 2019

▪ C213 for Cluster headache

▪ Unique application for delivery of Biologics

▪ Proteins

▪ Peptides

▪ Vaccines

▪ Partnering focus

▪ Qtrypta

▪ Biologics

3

Page 4: Corporate Presentation May 2017

Copyright © 2019 Zosano Pharma Inc. | Confidential

Transforming How Drugs Get Delivered

4

Stratum corneum

Cellular epidermis

Coated patch in skin

Coated patch in skin

Novel

Novel transdermal patch containing drug-coated microneedles

Large & Small Molecules

Microneedles can be coated with both large and small molecules

Rapid & Consistent

Allows for rapid and consistent dissolution of drugs into capillary bed

Minimizes stimulation

Shallow depth of penetration of proprietary microneedles into

superficial skin layers minimizes stimulation of nerve endings

Convenient & Discreet

Quarter size patch designed to be convenient and discreet

Easy to Use

Patient experience in trials are positive and demonstrate that the

system is easy to use

Page 5: Corporate Presentation May 2017

Copyright © 2019 Zosano Pharma Inc. | Confidential

Patch Application

5

Snap patch ring

assembly onto

applicator.

Twist applicator

cap from position

#1, to position #2 to

unlock for patch

application.

Press applicator

downward on skin

to apply.Patch is applied.

Remove spent patch ring to

apply consequent patches

1

2

3

4&5

Handheld, reusable applicator ensures that the same force is applied across multiple applications

and is user independent.

Page 6: Corporate Presentation May 2017

Copyright © 2019 Zosano Pharma Inc. | Confidential

▪Lead Program: Qtrypta™ (M207)

▪ Acute migraine therapy

▪ Novel

▪ Clinical studies completed

▪ Addresses unmet patient needs

▪ NDA filing in 4th Quarter

6

Page 7: Corporate Presentation May 2017

Copyright © 2019 Zosano Pharma Inc. | Confidential

Qtrypta – Completed Development

Preclinical studies

▪ Published in Journal of Pharmaceutics – May 2018

▪ Published in Journal of Pharmaceutical Sciences – June 2018

Phase 1 – PK study

▪ Published in Pain Management – August 2017

Pivotal efficacy study

▪ Published in Cephalalgia – November 2017

Phase 3 – 12 month safety study

▪ Data presented at IHC – September 2019

NDA filing – On track for year end

▪ PK bridging study – completed

▪ Human factors study – completed

▪ Registration batch stability testing - completed

▪ Pre-NDA clinical meeting – completed

▪ Pre-NDA CMC meeting in November 7

Page 8: Corporate Presentation May 2017

Copyright © 2019 Zosano Pharma Inc. | Confidential

39 Million People in the US Suffer From Migraines

8

▪ 3rd Most Prevalent Disorder in the World▪ Impacts ~25% of U.S. Households ▪ Occurs in 12% of U.S. Population▪ 85% of Chronic Migraine patients are women

▪ $36B in Lost Productivity▪ $5.4B in Treatment Costs

Source: Migraine Research Foundation

PREVALENT

DEBILITATING

COSTLY

▪ 90% Unable to Function Normally▪ 1.2 MM ER Visits per Year▪ 25% experience 4+ Migraines/month▪ Attacks Last 4-72 Hours

Page 9: Corporate Presentation May 2017

Copyright © 2019 Zosano Pharma Inc. | Confidential

MANY PATIENTS ARE DISSATISFIED AND WILLING TO TRY SOMETHING NEW

9

42%37%

50% 48%

39%

79%

0%

10%

20%

30%

40%

50%

60%

70%

80%

Inadequatepain relief

Slow onsetof action

Recurrence/worsening of pain

Inability to function/work quickly aftertaking medication

Undesireableadverse events

Would be willing totry another acute

medication to treatthe headache!

Areas of Dissatisfaction With Current Acute Therapies

Source: Bigal ME et al. Headache. 2007;47:475-479.

Page 10: Corporate Presentation May 2017

Copyright © 2019 Zosano Pharma Inc. | Confidential

41.5%

68.3%

14.3%

42.9%

0%

20%

40%

60%

80%

Pain Freedom MBS

% S

ub

ject

s A

chie

vin

g P

ain

Fre

edo

m o

r Fr

eed

om

fro

mM

BS

at 2

Ho

urs

Qtrypta 3.8mg Placebo

Need: Freedom from pain Statistically Significant Impact on Pain Freedom and MBS

10

p=<0.0001TG = 27.2

p=<0.0009TG = 25.4

ACHIEVEMENT OF CO-PRIMARY ENDPOINTS

Spierings ELH et al. Randomized, double-blind, placebo-controlled, parallel-group, multi-center study of the safety and efficacy of ADAM zolmitriptan for the acute treatment of migraine. Cephalalgia 2018 Feb;38(2):215-224.TG = Therapeutic Gain (difference between Qtrypta and Placebo)

Page 11: Corporate Presentation May 2017

Copyright © 2019 Zosano Pharma Inc. | Confidential

Need: Freedom from pain Need: Fast onset of action Pain Freedom: Over 48 Hours

11

7.3%

17.1%

26.8%

41.5%

51.2%54.9%

62.2%

69.5% 64.6%

0%

20%

40%

60%

30 minutes 45 minutes 1 hour 2 hour 3 hour 4 hour 12 hours 24 hours 48 hours% S

ub

ject

s A

chie

vin

g Pa

in F

reed

om

Pain Freedom 30 Minutes to 48 Hours

Qtrypta Placebo

*

**

**

****

**

****

Spierings ELH et al. Randomized, double-blind, placebo-controlled, parallel-group, multi-center study of the safety and efficacy of ADAM zolmitriptan for the acute treatment of migraine. Cephalalgia 2018 Feb;38(2):215-224.

*p=<0.05 **p=0.01

Page 12: Corporate Presentation May 2017

Copyright © 2019 Zosano Pharma Inc. | Confidential

12

23.2%

46.3%

56.1%

68.3%

80.5% 81.7% 82.9% 80.5%78.0% 78.0%

0%

20%

40%

60%

80%

15 minutes 30 minutes 45 minutes 1 hour 2 hour 3 hour 4 hour 12 hours 24 hours 48 hours

% S

ub

ject

s A

chie

vin

g P

ain

Re

lief

Pain Relief 15 Minutes to 48 Hours

Qtrypta Placebo

*

** ** ** ******

Spierings ELH et al. Randomized, double-blind, placebo-controlled, parallel-group, multi-center study of the safety and efficacy of ADAM zolmitriptan for the acute treatment of migraine.

Cephalalgia 2018 Feb;38(2):215-224. *p=<0.05 **p=0.01

Need: Substantial pain relief Need: Fast onset of action~ 80% Of Patients Had Pain Relief Through 48 Hours

Page 13: Corporate Presentation May 2017

Copyright © 2019 Zosano Pharma Inc. | Confidential

Need: No recurrence/absence of pain Qtrypta: Sustained Pain Freedom

13

31.7%26.8%

10.4% 9.1%

0%

10%

20%

30%

40%

2-24 Hours 2-48 Hours

% o

f Su

bje

cts

wit

h S

ust

ain

ed

Pai

n F

ree

do

mat

24

an

d 4

8 h

ou

rs

Qtrypta 3.8mg Placebo

p=0.0001 p=0.0035

Spierings ELH et al. Randomized, double-blind, placebo-controlled, parallel-group, multi-center study of the safety and efficacy of ADAM zolmitriptan for the acute treatment of migraine. Cephalalgia 2018 Feb;38(2):215-224.

76% of patients who were pain free at 2 hours realized sustained pain freedom through 24 hours65% realized sustained pain freedom though 48 hours

Page 14: Corporate Presentation May 2017

Copyright © 2019 Zosano Pharma Inc. | Confidential

Need: Ability to function/work quickly and consistentlyNeed: Eliminate hangover effectMigraine-ACT (Assessment of Current Therapy)

Proportion of participants who answered “Yes” at 48 weeks:

14

Question n (%)

Does your migraine medication work consistently, in the majority of your

attacks?104 (96%)

Does the headache pain disappear within 2 hours?92 (85%)

Are you able to function normally within 2 hours?91 (84%)

Are you comfortable enough with your medication to be able to plan your

daily activities?101 (94%)

A total of 342 subjects received study drug, 335 treated at least 1 migraine, 257 completed 6 months of the study and 128 completed 1 year.

84% of subjects

were able to

function normally

at 2 hours

Migraine-ACT questionnaire: a standardized evaluation completed by patients to assess the effectiveness of a patient’s acute treatment of migraine therapy (Highest score 4.0)

Migraine-ACT Scores Suggest Excellent Response to Qtrypta

Page 15: Corporate Presentation May 2017

Copyright © 2019 Zosano Pharma Inc. | Confidential

Long Term Safety Results – Presented at IHC

Efficacy consistent with pivotal study:• Pain Freedom at 2 hours: 44%• Pain Relief at 2 hours: 81%• Freedom from MBS at 2 hours: 68%

Well Tolerated Safety Profile• Most common AE was redness/swelling.

• 95% were mild and 80% resolved within 48 hours.• Less triptan-like side effects than typically found with the class.

• Less than 2% of patients reported effects like dizziness and paresthesia

15

Page 16: Corporate Presentation May 2017

Copyright © 2019 Zosano Pharma Inc. | Confidential

Target Market: Difficult to treat migrainesPublished in Headache – January 2019

16

Pain-Free 2 Hr MBS-Free 2 Hr

n(%)Placebo ADAM

Zolmitriptan 3.8 mg

P -Value* Placebo ADAM

Zolmitriptan 3.8 mg

P- Value*

Nausea/Vomiting (51) 14% (59) 44% 0.0005 (51) 45% (59) 68% 0.009

On Awakening (44) 16% (36) 44% 0.0056 (44) 39% (36) 72% 0.0031

Severe Pain (33) 15% (39) 26% 0.2489 (33) 42% (39) 64% 0.0376

Time To Treat ≥ 2hrs (40) 10% (36) 33% 0.0169 (40) 41% (36) 69% 0.0137

MBS: Most Bothersome Symptom *Nominal

▪ The rapid absorption profile of ADAM zolmitriptan may contribute to its ability provide pain- and MBS-freedom in

many patients even when treatment is delayed.

▪ Intracutaneous administration may provide an additional advantage in patients with nausea by bypassing the

need for swallowing or inhaling medication.

▪ The efficacy results seen in this trial suggest that ADAM zolmitriptan may be more effective than other routes

of administration of triptans, particularly oral.

EFFICACY OF ADAM ZOLMITRIPTAN (INTRACUTANEOUS ZOLMITRIPTAN) FOR THE ACUTE TREATMENT

OF DIFFICULT-TO-TREAT MIGRAINES

Results

Conclusions

Page 17: Corporate Presentation May 2017

Copyright © 2019 Zosano Pharma Inc. | Confidential

Qtrypta Highly Differentiated And Addresses Unmet Needs

17

81% Pain Relief in 2 Hours

EFFECTIVEFAST

Peak Plasma Concentration in 15 Mins

COMPLETE SUSTAINED

41.5% Pain

Freedom in 2 Hours63% Sustained Pain

Relief From 2-48 Hours

Kellerman DJ, Ameri M, Tepper SJ. Rapid systemic delivery of zolmitriptan using an adhesive dermally applied microarray. Pain Management doi: 10.2217/pmt-2017-0036 (2017). Spierings ELH et al. Randomized,

double-blind, placebo-controlled, parallel-group, multi-center study of the safety and efficacy of ADAM zolmitriptan for the acute treatment of migraine. Cephalalgia 2018 Feb;38(2):215-224.

41.5%

14.3%

Qtrypta 3.8 mg Placebo

Page 18: Corporate Presentation May 2017

Copyright © 2019 Zosano Pharma Inc. | Confidential

0

20

40

60

80

100

0 0.5 1 1.5 2

Time, hZomig 5mg Oral Zomig 5mg Nasal Imitrex 6mg Inj Imitrex 100mg Tab M207

Qtrypta™ (M207)

Qtrypta Is Well Positioned Against Current Triptans

18

PAIN RELIEF OVER TIME1 (REFERENCE COMPOUNDS)

1. Comparisons are not based on data resulting from head-to-head trials and are not direct comparisons of safety or efficacy. Different protocol designs, trial designs, patient selection and population number of patients, trial endpoints, trial

objectives and other parameters that are not the same between the relevant trials may cause any comparisons of results from different trials to be unreliable.

Page 19: Corporate Presentation May 2017

Copyright © 2019 Zosano Pharma Inc. | Confidential

Positioning Against New Entrants

19

41.5%

32.2%

38.8%

19.2% 19.6% 20.7% 21.8% 21.2%

34.3%

51.0%

68.3%

40.7%

48.7%

36.6% 37.6%

34.1%

38.9% 37.7%

64.1%

0%

20%

40%

60%

Qtrypta Lasmiditan 200mgSamurai study

Lasmiditan 200mgSpartan study

Rimegepant 75 mg301 study

Rimegepant 75 mg302 study

Ubrogepant 25mg Ubrogepant 50mg Ubrogepant 100mg Onzetra Xsail - nasal Zembrace 3 mg -injectable

% o

f Su

bje

cts

ach

ievi

ng

Pai

n F

ree

do

m a

nd

MB

S Fr

ee

do

m a

t 2

Ho

urs

Comparison of Pain Freedom and MBS Freedom at 2 Hours1

Pain Freedom MBS

2

1. Comparisons are not based on data resulting from head-to-head trials and are not direct comparisons of safety or efficacy. Different protocol designs, trial designs, patient selection and population number of patients, trial

endpoints, trial objectives and other parameters that are not the same between the relevant trials may cause any comparisons of results from different trials to be unreliable.

2. Onzetra Xsail was not tested for MBS Freedom

Page 20: Corporate Presentation May 2017

Copyright © 2019 Zosano Pharma Inc. | Confidential

Qtrypta Well Positioned Against New Entrants

20

81.0%

59.0% 56.0% 58.1%61.0% 67.6% 60.0%

0%

20%

40%

60%

80%

Qtrypta Lasmiditan 200mg Rimegepant 75 Samurai study mg 301 study

Rimegepant 75mg 302 study

Ubrogepant 100mg

Onzetra Xsail -nasal

Zembrace 3 mg -injectable

% S

ub

ject

s A

chie

vin

g P

ain

Rel

ief

at 2

Ho

urs

Comparison of Pain Relief at 2 Hours1

1. Comparisons are not based on data resulting from head-to-head trials and are not direct comparisons of safety or efficacy. Different protocol designs, trial

designs, patient selection and population number of patients, trial endpoints, trial objectives and other parameters that are not the same between the relevant trials may cause any comparisons of results from different trials to be unreliable.

Page 21: Corporate Presentation May 2017

Portfolio Expansion

Copyright © 2019 Zosano Pharma Inc. | Confidential

Page 22: Corporate Presentation May 2017

Copyright © 2019 Zosano Pharma Inc. | Confidential

Significant Unmet Need in Cluster Headache

▪ Highly disabling chronic neurological condition1

▪ Recognized as most severe pain known to humans

▪ 15%-22% have suicidal ideations2

▪ Short-lasting headache attacks characterized by3:

▪ Severe unilateral temporal/orbital pain

▪ Ipsilateral autonomic symptoms

▪ Lasting 15–180 minutes (when untreated)

▪ Sense of restlessness or agitation

▪ Prevalence of cluster headache

▪ Approximately 1 in 1000 (0.12%) suffer from the condition

▪ Prevalence similar to Parkinson's and Multiple Sclerosis4,5

▪ Over 300,000 people suffer from cluster headache in the US

22

1. Jürgens T, Gaul C, et al. Impairment in episodic and chronic cluster headache. Cephalalgia 2010; 31:671–682.2. Rozen TD, Fishman RS. Cluster headache in the United States of America: demographics, clinical characteristics, triggers, suicidality, and personal burden. Headache 2012;52:99-113. 3. Headache Classification Committee of the International Headache Society (IHS). The International

Classification of Headache Disorders, 3rd edition. Cephalalgia 2018: 38, 1–211. 4. Fischera M, Marziniak M, Gralow I, Evers S. The incidence and prevalence of cluster headache: a meta-analysis of population-based studies. Cephalalgia 2008;28:614-8. 5.

Ford HL, Gerry Em Johnson M et al. A prospective study of the incidence, prevalence and mortality of multiple sclerosis in Leeds. J Neurol 2002; 249:260-5. 6. Klapper, et all, (2011) Cluster Headache. Headache, Face, Neck Pain Science, Evaluation and Management. Retrieved from https” books.Google.com.

Page 23: Corporate Presentation May 2017

Copyright © 2019 Zosano Pharma Inc. | Confidential

Cluster Headache (C213): Clinical Trial Program

23

Cluster Patients: 120

Population: Chronic or episodic cluster headache sufferers

Design:Each cluster headache sufferer will take a single dose to treat a qualifying

headache

Dosing: 1.9 mg, and 3.8 mg vs placebo (1:1:1)

Co-primary Endpoints:• Proportion of subjects with pain relief at 15 minutes

• Proportion whose pain relief is sustained from 15 minutes to 60 minutes

IND filed in August 2019

Phase 2/3 Clinical Trial Design

Page 24: Corporate Presentation May 2017

Copyright © 2019 Zosano Pharma Inc. | Confidential

Future: Intracutaneous Delivery Biologics

▪ Original focus of Intracutaneous drug delivery

▪ Demonstrated delivery

▪ Proteins

▪ Peptides

▪ Vaccines

24

Page 25: Corporate Presentation May 2017

Copyright © 2019 Zosano Pharma Inc. | Confidential

Opportunity: Vaccines Consistent delivery at target site ensures optimal immune response

▪ Antigen-coated microneedles delivery

directly to epidermal/dermal skin layers

rich in AP cells

▪ Improved immune response

▪ Less adjuvant

▪ Microneedle coating accommodates

vaccine proteins, glycoconjugates,

microparticles and DNA

▪ Dry-coated formulation provides

antigen stability and rapid dissolution in

skin interstitial fluid

25

Page 26: Corporate Presentation May 2017

Copyright © 2019 Zosano Pharma Inc. | Confidential

Vaccines: Demonstrated clinical performance in Phase 1 study

▪ Zosano trivalent flu patch vs. commercial IM vaccine

▪ Excellent fold titer increase and seroprotection ▪ Comparable Immune response with only a 5 minute patch wear time 26

Page 27: Corporate Presentation May 2017

Copyright © 2019 Zosano Pharma Inc. | Confidential

2019 Milestones

27

Goal Timing

Publication of difficult to treat migraine data in Headache Q1 ✓

Completion of long term safety study – Qtrypta™ (M207) Q1 ✓

Initiate Phase II in Cluster Headache – Qtrypta™ (C213) Q3 ✓

Initiate Pre-clinical development with Biologics Q4

Non dilutive capital – Partnership Q4

File NDA - Qtrypta™ Q4

Page 28: Corporate Presentation May 2017

Copyright © 2019 Zosano Pharma Inc. | Confidential

Experienced Management Team

28

Name Title Experience

John Walker Chief Executive Officer

Greg Kitchener Chief Financial Officer

Hayley Lewis SVP, Operations

Dushyant Pathak, PhD SVP, Business Development

Donald Kellerman, PharmDVP, Clinical Development &

Medical Affairs

Page 29: Corporate Presentation May 2017