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Jefferies Global Healthcare Conference
June 6 – 9th, 2017
© 2017 ConforMIS, Inc.
Forward Looking Statements
• This presentation contains forward-looking statements that involve substantial risks and uncertainties. All statements, other than
statements of historical facts, contained in this presentation, including statements regarding our strategy, future operations, future
financial position, future revenues, projected costs, prospects, plans and objectives of management, are forward-looking
statements. The words “anticipate,” “believe,” “estimate,” “expect,” “intend,” “may,” “plan,” “predict,” “project,” “target,” “potential,”
“will,” “would,” “could,” “should,” “continue,” and similar expressions are intended to identify forward-looking statements, although not
all forward-looking statements contain these identifying words.
• We may not actually achieve the plans, intentions or expectations disclosed in our forward-looking statements, and you should not
place undue reliance on our forward-looking statements. Actual results or events could differ materially from the plans, intentions
and expectations disclosed in the forward-looking statements we make. The forward-looking statements contained in this
presentation reflect our current views with respect to future events, and speak only as of the date of this presentation. We assume
no obligation to update any forward-looking statements.
• Our business is subject to substantial risks and uncertainties, including those referenced in certain of our filings with the SEC under
the heading “Risk Factors.” You are encouraged to read our filings with the SEC, available at www.sec.gov, including our Form S-1
Registration Statement filed with the SEC on May 22, 2015 and the related amendments, as well as our Final Prospectus filed with
the SEC on July 1, 2015 and our quarterly statements filed on Form 10Q. Investors, potential investors, and others should give
careful consideration to these risks and uncertainties.
2
Disrupting a $15 Billion Industry
© 2017 ConforMIS, Inc. 3
Investment Highlights
Proprietary platform technology for customized joint replacement implants
Technology potentially applicable to ~ $15 billion joint replacement market
Broad IP ~ 450 patents and pending patent applications
Clinical data supporting superior clinical outcomes
Potential economic benefits over off-the-shelf implants
Highly scalable business model
© 2017 ConforMIS, Inc. 4
1 in 5 patients are not satisfied
with the results of their total
knee replacement1
© 2017 ConforMIS, Inc.
Patient Outcomes after Off-the-Shelf TKR
1 According to a study of 1,703 patients published by Bourne in 2009 in the peer-reviewed journal Clinical Orthopaedics and Related Research (In this study entitled Patient Satisfaction after Total
Knee Arthroplasty: Who is Satisfied and Who is Not?, “the overall satisfaction question was used to determine a two-category satisfaction outcome by combining patients who answered very
dissatisfied, dissatisfied, or neutral into one group, and patients who answered satisfied or very satisfied into the second group.”)
5
Off-the-Shelf Delivery Model
Knee Example
● 5-10 costly instrumentation trays required
for each procedure
● All instrument trays require set up, break
down and sterilization
● Potential source of costly infections
● Substantial inventory cost of instruments
borne by manufacturer
© 2017 ConforMIS, Inc. 6
“Patient-Specific” Industry Approach
● Used with reusable instruments
Cost of storing, sterilizing
Risk of infection
OR efficiency and turnover
● Does not change perceived fundamental
shortcomings of off-the-shelf implants
Improper implant fit, overhang, undersizing
Wrong geometry, not matching patient
Residual pain, functional limitations (limited
range of motion, mid-flexion instability)
© 2017 ConforMIS, Inc.
Patient-specific instruments or Robotics Standard, off-the-shelf implant
7
● Additional robotics challenges
Cost
OR efficiency and turnover
A Paradigm Shift in Orthopedics
© 2017 ConforMIS, Inc. 8
ConforMIS Platform Technology
● ConforMIS products for knee replacement
iTotal PS
iTotal CR
iUni
iDuo
● Potential opportunity to expand iFit technology to:
Hip
Spine
Shoulder
Extremities
Revisions
Resurfacing
● Digitally driven / Just-in-Time manufacturing
● Customized implants
● Patient-specific instruments
© 2017 ConforMIS, Inc. 9
iFit Design
© 2017 ConforMIS, Inc.
iFit Image-to-Implant Platform Technology
iFit JIT Delivery
Clinical
Benefits
Economic
Benefits
Intra-Op
Benefits
iFit 3D Additive Printing
10
ConforMIS Delivery Model: Intraoperative Benefits
● Single-use kit
● Delivered before surgery
● One reusable tray
● Simplified procedure with fewer steps
● Reproducible
© 2017 ConforMIS, Inc. 11
Why Patients Are Dissatisfied
Post-operative Pain Poor Function
Implant overhang/
under-sizing
Component
malrotation
• Limited range of
motion
• Stiffness
• Knee instability
• Unnatural feel
© 2017 ConforMIS, Inc. 12
© 2017 ConforMIS, Inc.
Personalized Position, Shape & Fit
13
Implant Overhang Leads to Pain
1 Mahoney, et al; Overhang of the Femoral Component in Total Knee Arthroplasty: Risk Factors and Clinical Consequences. The Journal of Bone and Joint Surgery; 2010, 92: 1115-1121
In a study of 437 total knee replacements, the prevalence of overhang ≥ 3mm was high¹
40%
60%
Men
Overhang of ≥ 3mm in at least one zone
< 3mm overhang
32%
68%
Women
Overhang ≥ 3mm associated with an almost
twofold increased risk of pain at two years1
© 2017 ConforMIS, Inc. 14
Implant Malrotation Leads to Pain
Off-the-shelf implants frequently
not aligned with proper rotational
axis of the knee
In a published study of anterior knee
pain, patients with improper
component rotation were 5X more
likely to experience knee pain1
1 Barrack, et al; Component Rotation and Anterior Knee Pain after Total Knee Arthroplasty. Clinical Orthopaedics and Related Research; 2001, 392: 46-55
© 2017 ConforMIS, Inc. 15
iTotal recreates patient’s
natural geometryiTotal designed to match natural
curves, corrected for deformities
© 2017 ConforMIS, Inc.
ConforMIS Respects Patient’s Natural Geometry
16
One Patient - One Implant
• Recreate and respect patient’s natural geometry
• Personalized shape & fit
• Eliminate implant overhang or under-sizing
• Eliminate implant malrotation
© 2017 ConforMIS, Inc. 17
© 2017 ConforMIS, Inc.
50.2 mm
36.3 mm
0 10 20 30 40 50
Off-the-shelf
ConforMIS iTotalCR
(n=54)
(n=66)
1 Source: William B. Kurtz, MD. Patient- Specific Knee Replacement Implant Preserve Bone and Decrease Blood Loss & Swelling. Presented at BASK 20132 Source: Slamin, J.E. et al Optimizing Knee Femoral Component Strength and Bone Preservation with Finite Element Analysis. Poster presented at ORS 2012
* Femoral cuts: distal & posterior. Tibial cuts: medial & lateral
Implant design advantage2: customized bone cuts, minimized for the geometry of each individual patient.
Difference of
total thickness is
27.6% (p<0.001)
Thickness of All* Bone Resections1
Total thickness of bone resections in mm
iTotal CR: Bone Preserving Design
18
© 2017 ConforMIS, Inc.
1Source: Katthagen et al; International Congress for Joint Reconstruction WAC 2015
20.0%
5.7%
0% 5% 10% 15% 20% 25%
Off-the-shelf
ConforMIS iTotalCR
(n=35)
(n=35)
p=0.15
Ligament releases1
% of patients with ligament releases
iTotal CR: Ligament Preserving Design
19
In multiple clinical studies iTotal CR patients have demonstrated better kinematic results compared to
OTS systems (Zimmer Biomet NexGen, Stryker Triathlon, and Zimmer Biomet Vanguard):
More Normal Lateral Roll Back with Deep Knee Bend1
More Normal Lateral Roll Forward with Chair Rise2
No Lift-off in Early/Mid Flexion During Knee Bend3
© 2017 ConforMIS, Inc.
1 Source: Zeller, Komistek et al; International Congress for Joint Reconstruction Pan Pacific 20162 Internal data analysis. Zeller, Komistek et al; International Congress for Joint Reconstruction Pan Pacific 20163 Source: Zeller IM, Sharma A, Kurtz WB, Anderle M, Komistek RD, Customized Versus Patient Matched Cruciate Retaining Total Knee Arthroplasty: An In Vivo Kinematics Study Using Mobile Fluoroscopy, The Journal of Arthroplasty (2016)
iTotal CR: More Natural Motion vs. Off-the-Shelf Implants
Abnormal
lift-offIncreased
load & wear
20
Clinical Results: Range of Motion
ConforMIS
iTotal CROff-the-shelf p-value
ROM ≥ 120 degrees (%) 84% 45% 0.003
ROM < 100 degrees (%) 0% 14% 0.046
Source: Richard G. Buch, M.D., Robert W. Eberle, Jason Davis, M.D., and Rylie Buch, MS. Does Implant Design Affect Hospital Metrics and Patents Outcomes? TKA Utilizing a “Fast-Track” Protocol
• Overall ROM significantly higher among ConforMIS patients (p<0.001)
Patient Reported Outcomes – average of 16 Months Follow-up (“Fast-Track” Protocol)
62 patients (32 iTotal CR, 30 off-the-shelf), comparable age, sex, BMI
© 2017 ConforMIS, Inc. 21
74.2 73.7
94.3
83.0
50.0
60.0
70.0
80.0
90.0
100.0
Off-the-Shelf
ConforMISiTotal
Patient Satisfactionp = 0.04
Knee Injury and Osteoarthritis
Outcomes Scorep = 0.037
© 2017 ConforMIS, Inc.
iTotal CR: Patient Satisfaction
Patient Reported Outcomes – 1 Year Follow-up
70 patients (35 iTotal CR, 35 off-the-shelf), matched pair analysis (age, sex, deformity)
Source: Katthagen et al; International Congress for Joint Reconstruction WAC 2015
%
22
iTotal CR: Clinical Benefits
• Bone Preserving Design
• Less Ligament Releases
• Natural Motion of the Knee
• Higher Range of Motion
• Higher Patient Satisfaction
© 2017 ConforMIS, Inc. 23
1 Katthagen et al; International Congress for Joint Reconstruction WAC 20152 Mont. J of Knee Surgery 2012. Single Use Instrumentation, Cutting Blocks and Trials Decrease Contamination during TKA
Surgery time
15 minutes less1
Instrument trays
5 fewer trays2
Set-Up and Tear
Down Time
$$$$
Surgeon OR StaffOR Staff
© 2017 ConforMIS, Inc.
Potential OR Cost Savings vs. Off-the-Shelf TKA
24
© 2017 ConforMIS, Inc.
1.6
2.7
0.0
0.5
1.0
1.5
2.0
2.5
3.0
Ave length of stay
Conformis iTotal
Off-The -Shelf
Source: Richard G. Buch, M.D., Robert W. Eberle, Jason Davis, M.D., and Rylie Buch, MS. Does Implant Design Affect Hospital Metrics and Patents Outcomes? TKA Utilizing a “Fast-Track” Protocol;
Days
p=0.004
62 patients (32 iTotal CR, 30 OTS), comparable age, sex, BMI (“Fast-Track” Protocol)
Clinical Results: Hospital Discharge Comparison
25
© 2017 ConforMIS, Inc.
66%
97%
30%
80%
0%
20%
40%
60%
80%
100%
120%
<24 Hrs Discharged to home
ConformisiTotal
Off-The -Shelf
Source: Richard G. Buch, M.D., Robert W. Eberle, Jason Davis, M.D., and Rylie Buch, MS. Does Implant Design Affect Hospital Metrics and Patents Outcomes? TKA Utilizing a “Fast-Track” Protocol;
p=0.006
62 patients (32 iTotal CR, 30 OTS), comparable age, sex, BMI (“Fast-Track” Protocol)
p=0.049
Clinical Results: Hospital Discharge Comparison
26
© 2017 ConforMIS, Inc.
iTotal CR: Potential for Economic Savings
A - attributed to a shorter length
of stay by 1.1 days.1
B - attributed to fewer patients
discharged to rehab (skilled
nursing facility).2
C - excludes OR savings
$1,100 $1,100
$2,200
$0
$500
$1,000
$1,500
$2,000
$2,500
A. Hospital StaySavings
B. DischargeDisposition Savings
C. Potential TotalSavings
© 2017 ConforMIS, Inc. 27
30%
12%14%
16%18%
42%
2% 3%5%
8%
0%
10%
20%
30%
40%
50%
<3 LOS* Transfusion* Adverse Events(at discharge)*
Rehab/Post-DischargeAcute Care Facilities*
Adverse Events(90 day)*
Off-the-Shelf
ConforMIS iTotal
>$900 total cost of care savings to payer1
1 Culler et al; Comparison of Adverse Event Rates and Hospital Costs between Customized Individually Made Implants and Standard Off-the-Shelf Implants for Total Knee Arthroplasty. Submitted for publication. 2 Culler et al; International Congress for Joint Reconstruction WAC 2015.
iTotal CR: Clinical and Economic Benefits
248 patients (126 iTotal, 122 off-the-shelf)
* Indicates Statistical Significance1,2
© 2017 ConforMIS, Inc. 28
Economic Benefits Summary
• Hospital and Payer Savings
– OR time
– Reusable instrument sterilization costs
– Length of stay
– Adverse events
– Discharge to home vs post acute care facilities
– Rehab cost
© 2017 ConforMIS, Inc. 29
PS55.8%
CR22.0%
PKR5.6%
Revision & other16.6%
PS55.8%
CR22.0%
PKR5.6%
Revision & other16.6%
Knee Replacement Market, US, by Revenue, 20132
● Cruciate-Retaining (CR) and Partial Knee Replacements (PKR)
● Posterior-Stabilized (PS) full launch in Q1 2016
PS launch nearly triples ConforMIS addressable market from ~ 28% to ~ 83% of knee market
1 Orthopaedic Industry Annual Report 20142 iData Research US Market for Large Bone and Joint Orthopedic Devices 2014
© 2017 ConforMIS, Inc.
Market Expansion: $7.5B Knee Replacement1
30
Targeted Regional Commercial Strategy
Targeted Regional Commercial Strategy
Market Adoption
● Target local markets with goal of achieving more
than 10% market share
● Select based on
Procedure / surgeon density
ASP
CJR
● Focus on high-volume influential surgeons
● Marketing strategy to increase consumer awareness
Source: Based on ConforMIS estimates© 2017 ConforMIS, Inc.
0% 5% 10% 15% 20% 25% 30% 35%
Provo-Orem, UT
Medford, OR
Cedar Rapids, IA
Miami-Fort Lauderdale-West Palm Beach, FL
Port St. Lucie, FL
Huntington-Ashland, WV-KY-OH
Casper, WY
Nashville-Davidson--Murfreesboro--…
Boston-Cambridge-Newton, MA-NH
Albany-Schenectady-Troy, NY
Battle Creek, MI
Boulder, CO
Las Vegas-Henderson-Paradise, NV
Dayton, OH
Gainesville, GA
Mobile, AL
Colorado Springs, CO
Naples-Immokalee-Marco Island, FL
Canton-Massillon, OH
Riverside-San Bernardino-Ontario, CA
Bay City, MI
Lewiston-Auburn, ME
New Haven-Milford, CT
Macon, GA
Dallas-Fort Worth-Arlington, TX
Fort Wayne, IN
● 2014: ≥10% market share in 12 US MSAs
● 2015: ≥10% market share in 22 US MSAs
● 2016: ≥10% market share in 26 US MSAs
31
1. Track My Implant – Patient Engagement 2. Live-Patient Education Department
3. Patient Ambassador Program 4. Viral Marketing
• Provide personal customer experience for each qualified inquiry
• Educate on ConforMIS vs “off-the-shelf”
• Provide surgeon names from locator• Provide second opinion resource
• Builds customer intelligence and market research
• Creates quality surgical leads
• Prescribed patient “opt-in” at office
• Six points of engagement featuring each stage of manufacturing process
• Keeps patient engaged with surgeons office and drives surgeon pre-op protocol
• No cost for enrollment
DTC - Empowering the Patient to Drive Adoption
• Real ConforMIS Patients
• Ambassadors are the center of our new “real patients” ad campaign
• Speak to other patients considering ConforMIS
• New website www.thisismyknee.com
• Cornerstone of our consumer facing brand
• Consumer Facing Brand - easy to remember
• Encourage patient participation
• Establishes emotional connection to brand
• Encourages Social media sharing
• Conversation Starter – Fun and Relatable
• Fills pipeline for future ambassadors and media stories
© 2017 ConforMIS, Inc. 32
2. Regional MicrositesGoogle paid search; drives new patients into office
3. Regional Patient Seminars 4. Regional Advertising
1. Regional News Media - Traditional
© 2017 ConforMIS, Inc.
Co-Marketing - Empowering the Patient to Drive Adoption
33
© 2017 ConforMIS, Inc.
Ambulatory Surgery Center (Outpatient)
• Opportunity• Outpatient procedures expected to grow in near term
• Driven by economics, surgeon reimbursement, advanced technologies
• Reimbursement - Medicare considering, private allowing selectively
• ConforMIS Value Proposition• Single-use, pre-sterilized kit
• No implant inventory (limited space)
• Only one reusable instrument tray (limited sterilization capacity)
• Simplified procedure, setup and turnover
• Fewer adverse events, transfusions and release to post-acute care
• More patients released within 24 hours
• ConforMIS Investing to Win in ASC• Outpatient program developed based on surgeon education
• Hiring dedicated ASC sales position to sell value proposition
• Differentiation messaging versus Off the Shelf 34
ConforMIS IP & Financials
© 2017 ConforMIS, Inc. 35
Patient-Specific Instruments (PSI)
Core patents expected to expire
2022 – 2031
Customized Orthopedic Implants
Core patents expected to expire
2022 – 2030
~450 patents and pending patent
applications owned or exclusively licensed
IP covers all joints and spine
© 2017 ConforMIS, Inc.
License agreements executed April 2015
• Use of patient-specific instruments; not customized
implants
• Wright lump-sum payment
• MicroPort lump-sum payment plus ongoing royalties
• High single digit to low double digit on PSI &
associated implant sales
Wright Medical and MicroPort
Lawsuit filed February 2016
• Alleges that Smith & Nephew‘s Visionaire® patient-
specific instrumentation and associated implants
infringes multiple CFMS patents
Smith & Nephew
Broad IP Portfolio
36
37
Product Revenue Growth
Product Revenue
$24.6
$34.6
$48.2
$62.8
$78.9
$20.0 $20.4
$0.0
$10.0
$20.0
$30.0
$40.0
$50.0
$60.0
$70.0
$80.0
$90.0
2012 2013 2014 2015 2016 YTD'16 YTD'17
Mill
ions
© 2017 ConforMIS, Inc.
39%
30%
26%
Represents YoY Growth
Annual YTD
Key Drivers
● Leverage clinical and economic benefits
● Sales force expansion
● Targeted regional commercial strategy
● Growth of iTotal CR, iUni, iDuo
● Full launch of iTotal PS
2017 Guidance
● Total revenue $80M to $84M
● Product revenue $79M to $83M / CC growth 1-6%
● Underlying CC growth 10-15% adjusted for recall
delayed surgeries and change in Germany partial
knee reimbursement
● Royalty revenue $0.8M
● Gross Margin 36% to 38%
40%
2%
38
Product Gross Margin Growth
Product Gross Profit / Margin
Mill
ion
s
0
5
10
15
20
25
30
2012 2013 2014 2015 2016 YTD'16 YTD'17
17%
28%
32% 32%
Represents product gross margin %
© 2017 ConforMIS, Inc.
Annual YTD
33%
Key Drivers
● Reduce material cost
Progressive vertical integration
3D printing, CNC machining
Vendor pricing - Increase volume
● Reduce labor cost
Design time reduction with progressive
software releases
Leverage lower labor cost OUS
● Overhead absorption - Increase volume7%
33%
Summary
© 2017 ConforMIS, Inc.
Long Range Goals
• Product Revenue
• Underlying Growth
• Gross Margin
• $79M - $83M
• 10% - 15% CC
• 36% - 38%
• Consistent Revenue Growth
• Expansion of Gross Margin
• Path to Profitability
2017 Guidance Long Range Goals
Improved Commercial Execution
Focused Operations
Platform Expansion
40
Compelling Investment Thesis
Proprietary platform technology for customized joint replacement implants
~ $15B joint replacement market
Superior clinical
outcomes
Broad IP portfolio Highly scalable
business model
Economic benefits
© 2017 ConforMIS, Inc. 41
Thank you