Enabling Physicians to Go

Beyond the Visual Boundaries

of the Human Eye

May 2015

NASDAQ:NVDQ; TSX:NDQ
Forward-Looking Statements
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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 forward-looking
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.

Unmet Need
Data From AHRQ
Accountable Care Organizations: 2013 Program Analysis
Readmission following an acute care hospitalization is a costly and

often preventable event.

Research shows that nearly one in five Medicare patients were

readmitted within 30 days and 90% of these were unplanned.

Cost of Medicare readmissions exceeded $17B
Affordable Care Act mandates readmission reductions - excessive

readmissions reduces hospital payments.

Weiss, et al., AHRQ Pub. No. 10 (11)- EHC009-2-EF. Agency for Healthcare Research and Quality, Rockville, MD 2013

Traditional Imaging
Domain of the Diagnostician

Sales channel Radiology, CIO, Cardiology

X-Ray

Large devices requiring significant

infrastructure
Capital revenues >>$MM
Service revenues

CT

Imaging

Replacement cycles
PET

MRI

Evolution of Endoscopy
Surgeons are limited to their Eyesight or Visible Light Endoscopes to
See in the Operating Room
Rigid

Video

Endoscopy

Angled

Imaging innovations in endoscopy

have paralleled advances in
commercial photography and
delivery of visible light
Analog

Flexible

2 M Pix

M Pix

Digital HD

SPY Fluorescence Imaging

Blood Flow, Tissue Perfusion & More

SPY Imaging Products

SPY Elite
Open Surgery

Year introduced
2006
Updated Jan 2011

FIREFLY
Robotic Surgery

2011

PINPOINT
Endoscopic
Surgery

2013
Updated Jan 2015

LUNA
Wound Healing

2013

PINPOINT System Overview

Minimally Invasive Surgery
Versatile and easy to use in the OR
On-demand SPY Fluorescence imaging
HD images
Real-time views of perfusion and anatomy not

visible to the human eye

PINPOINT System
Key Laparoscopic Applications
Colorectal Surgery

Cholecystectomy

Lymphatics*

Esophagectomy

*The use of SPY imaging for lymph mapping has not yet been cleared or approved by the FDA

SPY Elite System Overview

Open Surgery
Enables surgeons to visualize blood flow and

tissue perfusion, in real time in the operating

room
Historically sold through LifeCell in the U.S.
Effective January 2015, all U.S. marketing

and distribution rights transferred back to

NOVADAQ

10

SPY System
Open Surgery Applications
Plastic Reconstructive Surgery

Cardiac Surgery

Colorectal & General Surgery

Vascular Intervention

11

Firefly System Overview

Robotic Surgery
NOVADAQs SPY Fluorescence imaging technology is integrated into the
Intuitive Surgical da Vinci Xi surgical robotic system as standard

12

LUNA System Overview

Wound Healing
LUNA is a perfusion assessment system
designed specifically for the wound clinic
Drives clinical treatment decisions &

enables serial follow-up

Generates revenue through increased

patient referrals and compliance

Reimbursement coverage

13

LUNA System
Clinical Value

LUNA demonstrated an improvement in arterial perfusion and venous outflow

from pre- to post-peripheral intervention

Building a Continuum of Care Ecosystem

NOVADAQ Surgery

Operating
Room
Operating
Room

Today
PINPOINT |

Minimally Invasive
Surgery

NOVADAQ Diagnostics

Outpatient
Clinic
Outpatient
Clinic

Tomorrow
Radiopharmaceutical

Imaging

Today
LUNA | Wound

Healing

PrimaryCare
Care
Physician
Primary
Physician

Tomorrow
Laser Doppler

Imaging

SPY Elite | Open

Surgery
Firefly | Robotic

Surgery
15

A SPY In Every Operating Room

Primary Imaging For Complex Surgery
Application

Patients/Year
(U.S.)

Surgery Type

Device

Abdominal Wall

50,000

Open

SPY

Breast Reconstruction

100,000

Open

SPY

Cholecystectomy

100,000

MIS

PINPOINT/Firefly

Gastrointestinal

200,000

Open or MIS

SPY/PINPOINT/Firefly

Gynecological Oncology

100,000

MIS

PINPOINT/Firefly

Lymphatic

400,000

MIS or open

PINPOINT/Firefly

Maxillofacial/Head & Neck

100,000

Open

SPY

Other Reconstruction

250,000

Open

SPY

Vascular

100,000

Open

SPY

Wound Care

600,000

Outpatient Open

LUNA

16

Growth Strategy

The SPY Imaging Revolution

Adoption Drivers

Existing Support

Clinical Data

More than 140 peer reviewed publications

Key Opinion Leading Advocates

Install base includes the top 50 hospitals*

Case Studies

Over 75 different surgeries reported

Surgeon Education

More than 3000 surgeons attending iSPIES

Economic Studies and Evidence

Emory, Mayo, Dartmouth, Cleveland- have it

Multiple Specialties Participate

More than 10+ specialties today

Mind Share

Size of the sales team >100

Continuous Product Development

Investments $10M/year

Marketing Message for Hospitals

Dynamic evolving branding

* U.S. News and World Report, Best Hospitals in the U.S.

18

130 + Clinical Publications

Colectomy
PILLAR II
50%
40%
30%
20%
10%

(n=150)

45%
2%

0%
Good
Perfusion

Poor
Perfusion

Laser-assisted fluorescent-

dye angiography has

confirmed the critical
relationship between good
perfusion and anastomotic
healing2
1.
2.
3.
4.

1.4%

represents the
anastomotic leak rate in
resections performed in
the PILLAR II trial3 (n=139)

12.6%

of low anterior
resections
performed in the
BSLR study
resulted in an
anastomotic leak4

8% of patients benefited

from a change in operative

plan due to PINPOINT,
resulting in a 0%
anastomotic leak rate3

Jewell et al., Gynecol. Oncol. 2014

Zehetner J, et al. Ann Surg. 2014;00:1-5
Jafari et al. JACS. Submitted 2014
Senagore A, et al. Dis Colon Rectum. 2014 Mar;57(3):32430

Sentinel Lymph Node Mapping*

Unilateral Detection Rate

Anastomotic leak rate

Esophagectomy

96
94
92
90
88
86
84
82
80
78

Detection of Sentinel Lymph Node

Using Indocyanine Green for
Gynecological Malignancies
Median SLNs removed per patient: 3, (n= 227)
ICG has significantly higher bilateral detection
rate for SLNs and will greatly reduce the need for
hemi-pelvic lymphadenectomy

*SPY imaging for lymph mapping has not yet been cleared or approved by the FDA

19

Clinical Studies: Level One Data

PILLAR III

FILM Trial

Obtain Outcomes-Based FDA Label

Randomized multicenter trial (n=500-900)
Establish evidence to promote standard of

care in assessing perfusion in anastomosis

Confirm a significant reduction in

anastomotic leak rates

Obtain FDA Indication for SLN Mapping

A Prospective, Open Label, Multicenter Study
Investigating the use of PINPOINT in SLN
Mapping (n=150)
Objectives:
To determine the safety and efficacy of ICG
fluorescence imaging in lymphatic mapping

Reduce patient complications and health

care costs

Goals:
12.6% Long-term
Adoption of ICG-fluorescence guided SLN
mapping for all surgical oncology applications

Continued Expansion of Ecosystem

NOVADAQ Appointed Exclusive Worldwide Distributor of LifeNets
DermACELL Tissue Products
LifeNet Health is the worlds largest provider

of organs, tissues and cells for transplantation

Committed to maximizing the gift of donation
Vertically integrated from Recovery through

Distribution
Distribute 440,000+ Implants per year in US
48 method and/or use patents

21

Continued Innovation
50+ patent families including granted patents and applications
Hardware, software, methods - vascular flow, perfusion, perforators,

ingress/egress, simultaneous display, quantification

Recent additions surgical scintigraphy imaging, fluorescent marker,

lymph node and nerve localization, erythrocyte loading, Laser Doppler

Our Development efforts fit into 3 general categories

1. Performance improvements to existing technologies
2. Innovation designed to address gaps in the continuum of care
3. Functional innovation that delivers additional clinical benefit

22

Corporate Performance

Strong Growth

8,000

1,500
Procedures

1,250
1,000
750
500

6,000
4,000

Q4-14

Q3-14

Q2-14

Revenue

$12,000
$10,000
$8,000
$6,000
$4,000

Q4-14

Q3-14

Q2-14

$0

Q1-15

$2,000
Q1-14

Revenue (US$ 000s)

$14,000

Q1-15

Q4-14

Q3-14

Q2-14

Q1-15

Q1-14

2,000

250
Q1-14

Total Installed Devices

1,750

Estimated Procedures

10,000

Installed Base

2,000

24

In Conclusion

Direct Products: 2014

Selling Two Products
PINPOINT
Endoscopic Surgery

April 2014

LUNA
Wound Healing

May 2013

2014 Direct Sales / Partnered Sales Ratio = 30/70

Direct Products: 2015

Selling a Complete Ecosystem
DermACELL
Plastic Surgery

Jan 2015

SPY Elite
Open Surgery

Returned to
Direct
Jan 2015

PINPOINT
Endoscopic
Surgery

Completely
Upgraded
System
Jan 2015

LUNA
Wound Healing

DermACELL
Wound Healing

May 2013

Jan 2015

2015 Direct Sales / Partnered Sales Ratio = 80/20