Empowering Physicians with

Imaging at the Point of Care

May 2016

Forward Looking Statements

NASDAQ:NVDQ, TSX:NDQ
The statements and discussions contained in this presentation that are not historical facts
constitute forward-looking statements, which may be identified by the use of forward-looking
words, including but not limited to, believes, expects, may, intends, anticipates, plans,
estimates and analogous or similar expressions intended to identify forward-looking
statements. These forward-looking statements and estimates as to future performance,
estimates as to future valuations and other statements contained herein regarding matters that
are not historical facts, are only predictions, and that actual events or results may differ
materially. We cannot assure or guarantee you that any future results described in this
presentation will be achieved, and actual results could vary materially from those reflected in
such forward-looking statements due to numerous known and unknown risks and uncertainties,
including the Risk Factors described in our filings with the Ontario Securities Commission and
the U.S. Securities and Exchange Commission. Information contained in this presentation has
been compiled from sources believed to be credible and reliable. However, we cannot
guarantee such credibility and reliability. The forecasts and projections of events contained
herein are based upon subjective valuations, analyses and personal opinions. All forwardlooking statements are qualified in their entirety by this cautionary statement, and Novadaq
undertakes no obligation to revise or update this presentation to reflect events or circumstances
after the date hereof.
This presentation shall not constitute an offer to sell or the solicitation of an offer to buy any
securities. Such an offer or solicitation, if made, will only be made pursuant to an offering
memorandum and definitive subscription documents.
NOVADAQ, SPY, PINPOINT and LUNA are registered trademarks of Novadaq Technologies
Inc. DermACELL is a registered trademark of LifeNet Health.

Investment Thesis
Experts in fluorescence imaging
- Created market in surgery and wound healing
- Point-of-Care imaging: vascular flow, perfusion, lymph nodes
- 180 publications Improved outcomes, reduced costs
Large market opportunity (annual procedures in U.S.)
- Complex surgeries: 1.4 Million
- Wound vascular assessment: 0.6 Million
Growth
- 2016 expected revenue: $84-86 million, representing 32-35% YoY growth
- Pipeline of new products to sustain continued growth
- Expanding patent portfolio
- Two level 1 clinical studies recruiting

SPY Fluorescence Imaging

SPY ELITE
Therapy Delivery in Complex High Risk Open Surgery
Breast Reconstruction

Colorectal Surgery

Assess tissue perfusion, segment

healthy from abnormal tissue

Assess tissue perfusion, guide

transection margins

Head and Neck Surgery

Colorectal Surgery
Vascular Surgery

SPY Elite System

Assess microvascular blood flow,
anastomotic patency and perfusion

Assess blood inflow and outflow

and tissue perfusion

PINPOINT
Therapy Delivery in Complex, High Risk Minimally Invasive Surgeries
Colorectal Surgery

Lap Cholecystectomy

Assess tissue perfusion,

healthy versus unhealthy tissue

Visualize critical anatomy, such

as bile and cystic ducts

Gynecological Cancer*

Bariatric Surgery

SLN

PINPOINT System

Visualize lymph nodes*,

improve cancer staging

Visualize tissue perfusion

and critical anatomy

*Not yet cleared of approved by the U.S. FDA

6

LUNA
Transforms Outpatient Assessment of Wounds
Limb Salvage

Visualize hyperemia for better

staging of wound disease

LUNA Score

15

LUNA System
Serial Functional Imaging and Analysis
7

Ecosystem Fluorescence Imaging Continuum Of Care

NOVADAQ Surgery

Operating Room

SPY Elite

Open
PINPOINT

NOVADAQ Diagnostics

Outpatient Clinic

LUNA

Vascular assessment in clinics

DermACELL WH

Minimally Invasive
Firefly

Robotic
DermACELL PRS

Opportunity > 2 Million Complex, High Risk

Procedures / Year in U.S.

Opportunity Associated with Complex, High

Risk Segment of Key Applications
Application

Pts. /Year (U.S.)

Surgery Type

Device

Breast Reconstruction

100,000

Open

SPY

Other Reconstruction

250,000

Open

SPY

Vascular

100,000

Open

SPY

50,000

Open

SPY

Maxillofacial / Head & Neck

100,000

Open

SPY

Gastrointestinal

200,000

Open or MIS

SPY / PINPOINT (50:50)

Lymphatic

400,000

Open or MIS

SPY / PINPOINT (25:75)

Gynecological Oncology

100,000

MIS

PINPOINT

Cholecystectomy

100,000

MIS

PINPOINT

Wound Healing

600,000

Outpatient

LUNA

Abdominal Wall

ASPS and SAGES Procedure Statistics, 2015

Medtech Insight Report, U.S. Surgical Volumes 2014-2020
10

Procedure Opportunity per System

70% Surgery, 30% Wound Healing

40%

30%

Open Surgery

30%

Wound Healing

Additional commercial relationships: LifeNet Health, Arthrex, ISRG

MIS Surgery

11

SPY Imaging Proven Across Multiple

Specialties
200,000+!
760+!
Standalone Systems!

180+!

75!

Documented
Applications

Peer Reviewed
Publications

Includes SPY technology licenses to ISRG

Data as of Dec 2015

1700+!
FireFly Systems!

SPY Technology
Procedures

SPY Hospitals

12

Top 50 Cancer Hospitals* Use SPY

University of Texas M.D. Anderson Cancer
Center
Houston, TX

Memorial Sloan-Kettering Cancer Center

New York, NY

Johns Hopkins Hospital

Baltimore, MD

Mayo Clinic
Rochester, MN

Dana-Farber/Brigham and Women's

Cancer Center
Boston, MA

University of Washington Medical Center

Seattle, WA

Massachusetts General Hospital

Boston, MA

UCSF Medical Center

San Francisco, CA

Cleveland Clinic
Cleveland, OH

Ronald Reagan UCLA Medical Center

Los Angeles, CA

Duke University Medical Center

Durham, NC

Stanford Hospital and Clinics

Palo Alto, CA

University of Michigan Hospitals and

Health Centers
Ann Arbor, MI

University of Chicago Medical Center

Chicago, IL

Hospital of the University of Pennsylvania

Philadelphia, PA

Barnes-Jewish Hospital/Washington
University
Saint Louis, MO

City of Hope
Duarte, CA

Moffitt Cancer Center

Tampa, FL

New York-Presbyterian University

Hospital of Columbia and Cornell
New York, NY

Ohio State University James Cancer

Hospital
Columbus, OH

Northwestern Memorial Hospital

Chicago, IL

University of Maryland Medical Center

Baltimore, MD

University of Minnesota Medical Center

Minneapolis, MN

Yale-New Haven Hospital

New Haven, CT

NYU Langone Medical Center

New York, NY

Vanderbilt University Medical Center

Nashville, TN

Roswell Park Cancer Institute

Buffalo, NY

University of Iowa Hospitals and Clinics

Iowa City, IA

University of Wisconsin Hospital and

Clinics
Madison, WI

UPMC-University of Pittsburgh Medical

Center
Pittsburgh, PA

Thomas Jefferson University Hospital

Philadelphia, PA

Cedars-Sinai Medical Center

Los Angeles, CA

Beth Israel Deaconess Medical Center

Boston, MA

University of Colorado Hospital

Aurora, CO

Shands at the University of Florida

Gainesville, FL

University Hospitals Case Medical Center

Cleveland, OH

Emory University Hospital

Atlanta, GA

Fox Chase Cancer Center

Philadelphia, PA

University of California, Davis Medical

Center
Sacramento, CA

Rush University Medical Center

Chicago, IL

Mount Sinai Medical Center NYU

New York, NY

Hackensack University Medical Center

Hackensack, NJ

Wake Forest Baptist Medical Center

Winston-Salem, NC

University of Kansas Hospital

Kansas City, KS

Magee-Womens Hospital of UPMC

Pittsburgh, PA

Mayo Clinic
Jacksonville, FL

UC San Diego Medical Center

San Diego, CA

University of Virginia Medical Center

Charlottesville, VA

USC Norris Cancer Hospital

Los Angeles, CA

University of California, Irvine Medical

Center
Orange, CA

*U.S. News and World Report Rankings 2015

13

Financial and Corporate Performance

Total Revenue

Recurring Revenue

$22.0
$20.0

$14.0
$10.3

$11.2

$12.1

Millions $

Millions $

$15.1

$16.0
$13.0
$11.7

$6.7

$7.0

$17.7

$17.0

$18.0

$12.0

$8.0

$20.0

$5.7

$6.0
$5.0
$5.0
$4.0

$4.9

$3.4

$3.0

$8.0
$6.0

$2.0
Q1
Q2
Q3
Q4
Q1
Q2
Q3
Q4
Q1
2014 2014 2014 2014 2015 2015 2015 2015 2016

Q1
Q2
Q3
Q4
Q1
Q2
Q3
Q4
Q1
2014 2014 2014 2014 2015 2015 2015 2015 2016

Installed Base

Gross Margin
800

$16.0

760

$14.4
750

$14.0

$12.6

710

$12.7
700

$12.0

647

$10.7

$10.0

Units

Millions $

$6.1

$4.3
$3.7

$10.0

$8.0

$7.0

$9.1
$7.8
$6.7 $6.9

650
600

$7.5

$6.0

550

559

581

591

611
575

528

500
450

$4.0
Q1
Q2
Q3
Q4
Q1
Q2
Q3
Q4
Q1
2014 2014 2014 2014 2015 2015 2015 2015 2016

Q1
Q2
Q3
Q4
Q1
Q2
Q3
Q4
Q1
2014 2014 2014 2014 2015 2015 2015 2015 2016

14

Growth Platform

Improving Clinical Outcomes & Enabling New Surgical Procedures

14
12

Anastomotic
Leak Rate

SPY Enables Single Stage

Reconstruction

10
8

Eliminates a second surgery and

multiple post-operative follow-ups

6
4
2

N=139

0
PILLAR II

BSLR Trial

Pillar II prospective multicenter study

16

Delivering More Effective Lifesaving Surgeries

Sentinel Lymph Node (SLN) Identified in Gynecological Cancers
Technique

SLN identified

Bilateral SLNs Identified

Technetium Only

83%

19%

Blue Dye Only

79%

50%

Blue Dye + Technetium

87%

54%

PINPOINT Imaging Only

96%

88%

5-year survival in stage II- IV in ovarian cancer at best case is 70% and the worse
case is 17%. 85% of patients with these types of cancers are in stage II- IV.

Plante et al., Gyn Onc, 2015 (n=50)

Howe et al., Gyn Onc, 2015 (n=100)
17

Guaranteed By SPY

When SPY is used in the first surgery and a

revision is still necessary, well pay for the tissue.

18

Growth Drivers
1.

Expanded, Focused Sales Channels

2.

International Expansion

3.

New Product Introductions 2016

4.

Outcomes Based Level I Clinical Studies

(FILM Trial)
(PILLAR III)

5.

New Imaging Molecules

1. Expanded, Focused Sales Channels

70%

60%

50%

% Opportunity 40%
30%

20%

10%

Surgery

Wound Care

20

2. International Expansion
Key Markets

Europe: United Kingdom, Germany and the Nordics

Asia: China, Japan, Korea
Sales Channel

Regional distributors in place

NOVADAQ direct management and subsidiary companies in place in
Europe and in Asia

21

3. New Product Introductions 2016

Color Segmented Fluorescence Imaging

5.0mm PINPOINT Endoscopes

15

Handheld SPY Imaging

LUNA Score Functional Imaging and Analysis

22

4. Outcomes Based Level I Clinical Studies

FILM Trial

PILLAR III

Obtain FDA Indication for SLN Mapping

Obtain Outcomes-Based FDA Label

A Prospective, Open Label, Multicenter Study of

PINPOINT in Gynecological Oncology (n=150)

Randomized multicenter trial of PINPOINT in

Colorectal Surgery (n=500-900)

6-8 U.S. and Canadian Centers

25 U.S. centers

Recruitment on-going

Recruitment on-going

Results expected Q4-2016

Interim results report expected at SAGES 2017

Images Courtesy of Nadeem Abu-Rustum, M.D., NY,NY and Michael Stamos, M.D. Irvine, CA

23

5. New Imaging Molecules

Cancerous tumor fluorescing, the normal tissue is not

Image courtesy of Eben L. Rosenthal, MD, Stanford, CA

24

Long-Term Growth
First molecule (ICG) blood flow in vessels, perfusion, lymph nodes
- Product upgrades, new clinical applications
Second molecule on track for announcement in late 2016
- Critical anatomy
- Enablement of certain new surgeries
License or acquire rights to cancer imaging molecules

25

Summary of Growth Drivers

Drivers

2016

1. Expanded, Focused
Sales Channels

Add 40 Sales Pros

2. International Expansion

NVDQ Direct Team

3. New Product Introductions

2017

2018

Hardware/Software

4. Level I Clinical Studies

FILM

Clinical Trial and Results

PILLAR III

Clinical Trial and Results

5. New Imaging Molecules

Submission to FDA

Molecule Identified, Clinical Trial Phases I and II

Submission to FDA
Phase III & NDA or PMA Submission

26