Investor Presentation • Oct 21, 2020
Investor Presentation
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October 21, 2020

This document has been prepared by GRIFOLS, S.A. (GRIFOLS or the "Company") exclusively for use during the 2020 Investor and Analyst Meeting on October 21, 2020. Therefore it cannot be disclosed or made public by any person or entity with an aim other than the one expressed above, without the prior written consent of the Company. The Company does not assume any liability for the content of this document if used for different purposes thereof. The information and any opinions or statements made in this document have neither been verified by independent third parties nor audited; therefore no express or implied warranty is made as to the impartiality, accuracy, completeness or correctness of the information or the opinions or statements expressed herein. Neither the Company, its subsidiaries nor any entity within the GRIFOLS group or any subsidiaries, the company's advisors or representatives assume liability of any kind, whether for negligence or any other reason, for any damage or loss arising from any use of this document or its contents. Neither this document nor any part of it constitutes a contract, nor may it be used for incorporation into or construction of any contract or agreement.
This document does not constitute an offer or invitation to purchase or subscribe shares, in accordance with the provisions of the Spanish Securities Market Law (Royal Legislative Decree 4/2015, of 23 October, as amended and restated from time to time), Royal Decree 1310/2005, of November 4, and its implementing regulations. In addition, this document does not constitute an offer of purchase, sale or exchange, nor a request for an offer of purchase, sale or exchange of securities, nor a request for any vote or approval in any other jurisdiction.
This document contains forward-looking information and statements about GRIFOLS based on current assumptions and forecast made by GRIFOLS management, including pro forma figures, estimates and their underlying assumptions, statements regarding plans, objectives and expectations with respect to capital expenditures, synergies, products and services, and statements regarding future performance. Forward-looking statements are statements that are not historical facts and are generally identified by the words "expected", "potential", "estimates" and similar expressions.
Although GRIFOLS believes that the expectations reflected in such forward-looking statements are reasonable, various known and unknown risks, uncertainties and other factors could lead to material differences between the actual future results, financial situation, development or performance of the Company and the estimates given here. These factors include those discussed in our public reports filed with the Comisión Nacional del Mercado de Valores and the Securities and Exchange Commission, which are accessible to the public. The Company assumes no liability whatsoever to update these forwardlooking statements or conform them to future events or developments. Forward-looking statements are not guarantees of future performance. They have not been reviewed by the auditors of GRIFOLS.





Applying the Same Ethics for More Than 110 Years of History

Grifols has been guided by a long-term vision and commitment to sustainable and ethical growth since its establishment more than 110 years ago

Applying the Same Ethics for More Than 110 Years of History



Company's Employees Are Our Most Valuable Asset

Employees Society Environment Economy


* Adjusted gender pay gaps are calculated using econometric models which allow isolate the effect on wages of the differences between men and women, both in their socio-economic characteristics (age, seniority, educational level or academic or professional attainment), and in their job post (working hours, sectors in which they work or type of occupation, among others). In this way, the adjusted gender pay gaps represent a more reliable indicator to measure whether men and women receive the "same pay for the same job".
Invested Close to €40m in 2019, a Rise of 20% vs. 2018

Employees Society Environment Economy
• Promote and provide access to treatments • Educational programs and activities Patient Organizations 15.4m • Awards to advance scientific, research and educational projects Research Awards & Education 3.4m • Compensation for donors' commitment • Supporting local communities Supporting Donors & Local Communities 17.2m • Ebola Project and others Special Projects & Others 2.9m €40m in 2019… Public Healthcare Systems + • Industrial fractionation services for hospitals 65m

Employees Society Environment Economy

Aggregated Employment Impact

Employees Society Environment Economy
Investor and Analyst Meeting October 21 2020 - 11 x6.4 Grifols generates 5.4 jobs for every 1 job 148,000 Total jobs 150,000 120,000 90,000 60,000 30,000 Job Creation 2019 # jobs +52,000 new jobs 2015 growth +55% Direct Impact Indirect and Induced Impact Total Impact 2019 2015-2019
Aggregated Economic Impacts
Employees Society Environment Economy

Employees Society Environment Economy
Responding to the Needs of Society

(1) Corresponds to the high-end of the sensitivity analysis performed



€8.5bn
Total Economic Impact*
Total Jobs*
148k

€6.2bn
Social Value
Social Value Ratio 2.1x
* Total impact includes direct, indirect and induced impacts

Eduardo Herrero President, Bioscience Industrial Group


| • Grifols • Bioscience • |
Long-term vision guides our organization in benefit of patients and stakeholders Ongoing business optimization grounded on technology and continuous improvement Consolidating a history of trust and progress for our employees and donors |
||
|---|---|---|---|
| Plasma supply Centers, Testing labs, Plasma logistics |
Manufacturing operations |
Grifols Bioscience initiatives against COVID-19 |
|
| • Reference in the plasma industry • Growth in sustainable plasma collection, ensuring the highest standards of quality and safety • Continuous expansion and improvement in supply chain efficiencies across all plasma testing labs and logistics |
• Expansion and development of state-of-the-art manufacturing facilities • Ongoing operational improvements based on a model of sustainable growth • Robust inventory management to become the most reliable provider of human plasma derivatives |
• More than 25 initiatives in the fight against COVID-19 • SARS-COV-2 hyper immunoglobulin manufactured in record time thanks to company know-know on HyperIG • Set-up of convalescent plasma collection system for transfusion and for plasma pathogen inactivated by methylene-blue technique |


Grifols' Plasma Supply Increase
320 centers in the U.S. and EU network by December 2020 Addition of 136 donor centers over the last 4 years through acquisitions and new openings
Donations per donor center increase annually thanks to optimized processes: new technologies, effective training and standardization lead to better donor and product flow times, fewer rejects and enhanced performance
1
2
Effective donor recruitment tools and customer service, with loyal donors through culture of service
Grifols increased its plasma collections by +13% annually
Market (w/o Grifols) increased 10% annually during the same period


Recovering From COVID-19 Impact

Investor and Analyst Meeting
October 21 2020 - 21 -
Expanded Sourcing and Diversification Proves Valuable Against COVID Impact

263 Plasma Donation Centers in 34 States

*Includes whole blood donation centers
Diversified donor centers present throughout the U.S.: 34 states
Haema manufactures whole blood products for clinical use and plasma for fractionation
Centers and process upgrades, together with new centers, rendered +30% increase in average monthly collection over the last 2 years
Action plan in place on logistics and staff efficiencies to convert the dual-donor center model into a specialized platform cluster for plasma and whole blood collections
+90% of centers converted to plasma bottle collection
Plasmavita opening 3 centers in Austria


Sharing Expertise and Lessons Learned (COVID-19 Impact Management)
SRAAS: 41 centers in 11 provinces


Source: Report released by listed manufacturers. Updated on Jan. 6, 2020 (1) Includes 21 branch centers; (2) Includes 6 branch centers; (3) Includes 1 branch center


Expansion and Diversification in the U.S. and EU

Recent acquisitions enable us to continue to hold a privileged position in U.S. and EU markets
Expansion and diversification plan is ambitious and one of our main priorities in plasma supply
COVID-19 will not interfere with our donor-center expansion plan
Third-party supply agreements in EU and the U.S. to secure additional reliable plasma source
Plasma self-sufficiency has been achieved (92% for source plasma and 94% for specialty plasma)
| 1 | |
|---|---|
| Acres |
B
Donor commitment compensation remained flat A until COVID-19 spread in the U.S.
Compensation increases to recognize donor loyalty against COVID-19 fears
Compensation flexibility allows a dynamic D response to pandemic and return to normal levels

Positive Trends in the U.S. Over the Last 5 Months

Several Initiatives to Support Plasma Awareness









Investor and Analyst Meeting October 21 2020 - 31 -

Grifols' Global Footprint Today

Guarantees Product Delivery During COVID-19


New Ongoing Projects Under Digital Transformation Scope
Big Data Analysis

Automatic data sourcing Messaging and alert system

Artificial Intelligence applied on the downstream enables:



+1.5 m liter fractionation capacity
Other proteins capabilities


Investor and Analyst Meeting October 21 2020 - 39 -

U.S. clinical trial with the FDA, BARDA and NIH to evaluate the safety and efficacy of hyperimmune globulin using plasma from recovered COVID-19 donors collected at Grifols donor centers in hospitalized patients.
Assess the efficacy of high-dose intravenous immunoglobulin (immunomodulation effect) to stabilize or improve the health of COVID-19 patients
Collection of convalescent plasma in the U.S., Spain and Germany
Clinical trials in Spain in collaboration with blood banks to study the efficacy of inactivated plasma from recovered COVID-19 donors for direct transfusion in non-hospitalized and hospitalized patients with diverse levels of severity
Clinical trials in EU and the U.S. to evaluate the efficacy and safety in hospitalized and ICU patients of several plasma-derived medicines such as antithrombin III and alpha-1 antitrypsin

Pathogen inactivation through blue-methylene-process have been transferred to Clayton, NC facilities for use in SARS-CoV-2 convalescent plasma
TESTING
DEVELOPMENT OF SARS COV2:
SARS-CoV-2 TMA Manufacturing ELISA Test for detection of antibody for SARS-CoV-2 (EMV)
Hyper Immunoglobulin Facility and Methylene-Blue Plant

Pioneer MPF (Multi-Purpose-Facility) designed to manufacture hyper immunoglobulin for Ebola pandemic has allowed Grifols to manufacture SARS-COV-2 hyper immunoglobulin in less than 3 months
Methylene-blue technique has been used for pathogen inactivation of recovered plasma in Spain
A new facility for applying methylene-blue technique to convalescent plasma for direct transfusion was built in less than 3 months



Grifols IG Used in +9.3m Infusions With Well-Known Safety and Efficacy Profile
Based on Gamunex formulation approved since 2003
BLOOD




HYPERIMMUNE IMMUNOGLOBULIN
ANTI-SARS-COV-2

Grifols accelerates investments in new donor centers to reach ~435 by 2025 in the U.S. and Europe
Commitment to sustainable growth in plasma collection by promoting a fully integrated supply chain organization
KPI improvements over the last 3 years supported an efficient plasma supply growth
Grifols expects significant growth in plasma supply in 2021 based on historical performance and diversification in the U.S., EU and experience in China
Grifols reached self-sufficiency levels, leading to better performance and cost benefits
Industrial capacities are constantly expanded to align with plasma supply growth
Global fractionation capacity expansion to reach 21m liters by 2022 and 28m liters by 2026
Efficient inventory management of plasma, intermediate pastes and finished goods ensured continued operations during COVID-19 outbreak
Digitalization and optimal KPI performance provide overall business optimization in manufacturing operations
Grifols has a key role in the fight against COVID-19, fulfilling its commitment to society
Daniel Fleta Chief Industrial Officer



Keep Meeting Future Growing Demand

(*) Includes land and common infrastructures

Focused on Expanding and Diversifying Plasma Sourcing

Investor and Analyst Meeting October 21 2020 - 50 -





Continued Expansion to Meet Growing Demand



Investor and Analyst Meeting October 21 2020 - 54 -


Investor and Analyst Meeting
October 21 2020 - 57 -

North America Operations Diversification





Capacity Expansion and Geographical Diversification



Investor and Analyst Meeting October 21 2020 - 61 -

Capacity Expansion and Vertical Integration

2 story building 1,540m2

Oct. 2019 FDA approved

Fleboflex® Luer bags Aug. 2020 FDA approval


"…The main reason is the impressive success of their no-limits attitude […]. The company has secured a rock solid, leading position in a high-value market segment […]. The company is preparing the digestion of further growth by adopting top notch practices in supply chain management, or smart manufacturing while at the same time managing talent development".

Eduard Calvo IESE professor and Director of the award in Spain



The outstanding commitment of our teams, together with our global footprint and vertical integration has allowed us to maintain operations in all our factories, ensuring the steady and timely supply of our products while continuing to protect the safety of all our employees
Grifols Engineering capabilities give us a competitive advantage in terms of flexibility and speed with far less investment
Grifols plasma-protein-balanced expansion plan is a top priority to ensure company leadership
Grifols' COVID-19 pandemic response unleashed internal potential as well as partnering business opportunities in the therapeutic and diagnostic fields



Revenue Has Grown at 7.2% CAGR Since 2016

(*) From July 2019 to June 2020
2020 Has Been an Unprecedented Year

(3) AHA Report, June 2020






ULTRIO PLEX E







Acceleration of Revenue Growth Since 2016

(*) From July 2019 to June 2020
Note: Year-over-year variance as reported in constant currency (CC) for the period 2016-2019 and reported variation for LTM
Leading Position With Core Business of Plasma-Derived Therapies in 2019
| Global Market Share |
Grifols Global Position |
U.S. Market Share |
Grifols U.S. Position |
|
|---|---|---|---|---|
| IG | 24% | #1 | 33% | #1 |
| Alpha-1 | 68% | #1 | 69% | #1 |
| Albumin | 16% | #2 | 33% | #2 |
| pdFVIII (*) | 15% | #4 | 50% | #1 |

| Immunology | Gamunex® • continues to fuel double-digit revenue growth in 2020 • COVID-19 impacting plasma collections with an impact on industry IG supply for 2021 Early customer acceptance of Xembify® • gives us great confidence in the future potential of 92% of those that have prescribed Xembify®, prescribe again) this medicine (e.g. COVID-19 has impacted our ability to generate awareness, trial and usage of Xembify® |
|---|---|
| Autoimmune/ Neuromotor |
Tavlesse® EU launch achieved in July with first sales in Germany and UK First Bioscience non-plasmatic product launched in Europe expands Grifols rare disease platform |
| Pulmonology | |
| Hematology | |
| Hepatology / Critical care |
Solid Year Over Year Growth and Investing for the Future

Solid Year Over Year Growth and Investing for the Future
| Immunology | ||
|---|---|---|
| Autoimmune/ Neuromotor |
||
| Pulmonology | ||
| Hematology | • Continue building on our efforts to meet patients' needs around the world including future acquisitions and business development |
|
| Hepatology / Critical care |
||
| 2020 October 21 |
Investor and Analyst Meeting - 79 - |
Solid Year Over Year Growth and Investing for the Future
| Immunology | |
|---|---|
| Autoimmune/ Neuromotor |
|
| Pulmonology | |
| Hematology | |
| Hepatology / Critical care |
• Albumin market shows a solid growth mainly driven by China • Consolidating presence in China with new launch and SRAAS partnership • Strategically focused in liver cirrhosis, a disease that is increasing. Here, we have a unique commitment with its own clinical program and supports independent investigations US Albutein® • Flexbag launch in 2021 |
Investor and Analyst Meeting October 21 2020 - 80 -
For more than 110 years, people throughout the world have relied on Grifols to provide healthcare solutions when and where needed
2
1
Grifols has an established end-to-end commercial infrastructure with robust experience and a proven track record in rare and serious disease
3
Grifols competes by focusing on unmet medical needs through awareness, education, appropriate diagnosis, and timely treatment with demonstrable outcomes
We pride ourselves on quality, safety, compliance, teamwork, flexibility, and delivering results
Grifols is dedicated to working effectively and building productive relationships with healthcare providers, payers, channel partners, and patient advocacy groups
Seeking to strategically align our established resources in Immunology, Neurology, Pulmonology, Hematology, Critical Care Medicine, and Infectious Diseases with companies that share a similar vision, mission and values and have assets which would benefit from what we have to offer 6
4
5
Deep Knowledge, Capabilities and Networks Across Our Therapeutic Areas


Xembify® Expanded Our U.S. IG Portfolio to Meet Large, Unmet Medical Need in PIDD
awareness, trial and usage
patients access to care temporarily limited
salesforce access and engagement with customers altered

• Highest IG volume growth area (~10% CAGR expected 2018- 2025*) includes hematological malignancies, transplantation
• New clinical data for all Ig portfolio products (PFS, wearable injectors/ambulatory pumps), exploring novel infusion approaches coupled with digital health platforms
• On-going clinical development of anti-SARS-CoV-2 hIVIG (INSIGHT Protocol: 13 in partnership with NAID); on-going clinical evaluation of potential for anti-SARS-CoV-2 hIMIG
Currently evaluating the potential for plasma derived and nonplasma derived candidates in infectious diseases
HyperRAB® continues to exert leadership in the rabies prophylaxis market; US launch of new 3-mL (900 IU) vial with additional FDA submissions to improve label with room temperature storage and 1 year extension of shelf-life


Sources: *US PPTA Distribution Data, Source: **Grifols Internal Data August 2020 SID: Secondary Immune Deficiency (not an FDA approved indication in the U.S.)
Investor and Analyst Meeting October 21 2020 - 85 -

Grifols Alpha-1 Volume Growth Has Consistently Outpaced the Market

Investor and Analyst Meeting October 21 2020 - 87 -

Empowering Patients with Information Investing in Patient Needs
Multi-channel marketing initiatives with pulmonologists and primary care physicians raises awareness of the need for genetic screening of all COPD patients
Continue seeing strong interest among COPD sufferers wanting to understand their genetic health risk status related to alpha-1
Consumer testing using the remains an important strategy, and Grifols continues to explore innovative ways to expand the screening program
Developing new formulations to improve the product administration and patients' quality of life
Exploring the potential for Prolastin® to help hospitalized COVID-19 patients
Continuing to support a variety of programs evaluating the benefits of augmentation therapy
We Are a Major Contributor to This Growth; Strong Position in Liver Cirrhosis

US Albutein® Flexbag launch in 2021
Physicians clearly see a clinical benefit for their patients

HEAL Hepatic encephalopathy and albumin study

Grifols Consolidating Presence With New Launch and SRAAS Partnership

Grifols Hospital sales remain solid (YTD Aug +18.0%) growing above the market (YTD +8.9%) as per CPA* Data

* Chinese Pharmaceutical Association (CPA) data provides monthly hospital procurement information


New clinical studies sponsored by Grifols on the key role of pdFVIII/VWF in the evolving treatment paradigms for Patients with Hemophilia A and inhibitors (US and EU ISR programs)
Local initiatives at developing countries contributing to increase the standards of care in PWH still represent an untapped market potential: improve diagnosis and treatment through outreach programs and low dose prophylaxis approach
Looking to continue our growth through future acquisitions and business development to meet evolving patient needs
*PWH: patients with Hemophilia
First European non-plasmatic product launch in Bioscience history
Approved for the treatment of chronic immune thrombocytopenia (ITP) in adult patients who are refractory to other treatments
Novel MOA - First and only approved SYK-inhibitor that blocks platelet destruction
In Ph. III for warm autoimmune hemolytic anemia (wAIHA)
Meets Bx objectives to treat more chronic and rare diseases; increase revenue growth from new products



TAVLESSE® is welcomed by physicians as new treatment option for chronic ITP patients
Grifols has adapted launch to COVID-19 environment with stronger focus on digital activities, virtual customer meetings, congresses, and symposia
Included as robust option in ITP International Working Group Guidelines and German Guidelines
Pricing & Reimbursement: dossiers have been submitted for EU5 & are in preparation for next wave of EU countries
Newly published data on second line use can be used to promote to broader patient base
Despite the current environment, uptake has been promising during first 3 months of launch

>90% of target customers contacted by sales team >50 patients on Tavlesse®

Phased rollout to additional countries in Europe planned over the next 18 months
Pulmonology

Sustainable Growth Over the Last 5 Years

(*) From July 2019 to June 2020
Note: Year-over-year variance as reported in constant currency (CC) for the period 2016-2019 and reported variation for LTM
COVID-19 Has Impacted Blood Collection Numbers Globally

Source: Internal Data * Does not include plasma collections donations tested every minute with a Procleix® assay* 70+

Biomat relies on Grifols' antigens and molecular assays for plasma testing
We are converting all Grifols testing locations to Procleix® instruments and assays
Grifols Has Development Projects and Commercial Plans in Place

Growth Rate Accelerating and Surpassing 50 Million Gel Cards Sold

We Almost Triple Number of Erytra Eflexis® Placement Since Our LTM

Three Major IDN Wins Demonstrates Success Across All Customer Segments


Revenue Has Grown at 6.0% CAGR Since 2016

(*) From July 2019 to June 2020
Note: Year-over-year variance as reported in constant currency (CC) for the period 2016-2019 and reported variation for LTM
Clear Path to Strengthening Portfolio for Growth

Investor and Analyst Meeting October 21 2020 - 107 -
As Hospitals Continue to Open up Access, a Return to Growth Is Expected

units (2022)
Revenue Has Grown at 49.9% CAGR Since 2016

(*) From July 2019 to June 2020
Note: Year-over-year variance as reported in constant currency (CC) for the period 2016-2019 and reported variation for LTM
Biological Products for Non-Therapeutic Use
| Bioscience Products | Cell Culture Products | Fractionation Products | Transfusion Blood Components |
|---|---|---|---|
| Therapeutic proteins used as an excipient for cell culture media or drug products: • Immunoglobulins • Albumin • Plasmanate |
GMP products developed as a supplement for cell culture: • Plastem • Human Male AB serum heat inactivated |
Intermediate fractionation products for further protein purification: • Fraction V • Cryopaste… |
Blood components for transfusion: • Red Blood cells • Platelets • Plasma for transfusion • Only for German market |





Investor and Analyst Meeting October 21 2020 - 115 -
Post-Deal Structure and Valuation

(1) Based on DCF and multiples from trading companies and comparable transactions
(2) Based on market stock price per agreement
(3) Based on market stock price average for 3Q 2020


Investor and Analyst Meeting October 21 2020 - 117 -
(1) Includes China, Hong Kong SAR, Taiwan and Macao SAR (2) From July 2019 to June 2020 (3) Shanghai RAAS H1 Semi-Annual Report
Continuous Improvement of Shanghai RAAS Financials

(1) From July 2019 to June 2020
Leading the Way: #2 and #3 Global Market for Blood Products and IVD


(1) Batch Release Jan-Sep 2020; Growths shown YTD Q3 2020 vs YTD Q3 2019 (2) Chinese Pharmaceutical Association (CPA) procurement data Jan-Aug 2020
(3) Grifols Plasma Industry Database

• GOVERNANCE: Creation of a China Executive Committee reporting to co-CEO's to ensure global alignment and execution

QUALITY: Quality Agreement commitment being implemented: Year 1 milestones completed
MANUFACTURING: Operational efficiency and best practices; harmonization of processes and
COMMERCIAL STRATEGY: Commercial platform assessment & network integration to avoid any potential disruptions and maximize the opportunity

PLASMA: Expansion on plasma center network; best practices in donor recruitment
KPIs; Virus removal and yields
MARCH
27
DIAGNOSTIC: Phased implementation of Grifols NAT solutions (TMA technology) at SRAAS facilities (collection, manufacturing pool and finished product)
BUSINESS DEVELOPMENT: Exploring across the whole spectrum (i.e. Bio Supplies; Biosurgery; Immunoassay; Robotics system for hospital pharmacy; 3rd parties)

INDUSTRIAL: Grifols expertise to develop best-in-class facilities and position SRAAS as the industrial engineering leader in China's healthcare industry
AMBAR: Real-world evidence in Alzheimer's and partnership through establishment of Center of Excellence

R&D: Unite R&D capabilities & scientific know-how. Lines of work around Ig products (10% & SCIG 20%), Coagulation and Hyper Ig portfolio expansion

Investor and Analyst Meeting
October 21 2020
David Bell Chief Innovation Officer


A Recognized Leader of Innovation
Research and innovation has been in our DNA for more than 110 years
We are a company founded on Plasma Therapeutics
We are a company grounded in Plasma Science

An open innovation ecosystem that encompasses both in-house projects and investee-led initiatives that complement the company's operations

Continuous Efforts to Enhance Therapeutic and Diagnostic Solutions


Comprehensive Discovery and Development Platform Delivering Transformational Therapeutics

The Plasma Proteome Is the Highway of the Body

Investor and Analyst Meeting October 21 2020 - 128 -
Continuous Efforts to Enhance Therapeutic and Diagnostic Solutions

| Hematology/ Hepatology |
Bleeding Disorders | Stroke | Wound Healing | Cirrhosis | Acute Chronic Liver Failure |
|
|---|---|---|---|---|---|---|
| PID | Infectious Diseases | Emerging Pathogens | ||||
| Immunology | SID | Oncology | ||||
| Autoimmune/ | CIDP | MNN | Other AI diseases | |||
| Neuromotor | MG ITP |
Parkinson's | ||||
| Pulmonology | Alpha-1 Deficiency | Inflammatory response | Bronchiectasis | COPD | ||
| Neurology/ Cognitive Disorders |
Alzheimer's | Parkinson's MCI/Parkinson's Dementia |
Dementia | Other cognitive disorders | ||
| Other Other |
Bullous Pemphigoid | Oncology | nAMD | Diabetic retinopathy | COVID-19 |
The AMBAR Project
Primary efficacy endpoints – the ADAS – Cog1 and ADCS-ADL2 scales
Investor and Analyst Meeting October 21 2020 - 131 -
Milestones of 15 Years of Rigorous Scientific Research
Secondary endpoints such as memory, language and processing speed

| December 2018 | March 2019 | July 2019 | December 2019 | July 2020 | Beyond |
|---|---|---|---|---|---|
| 11th Clinical Trials on Alzheimer's Disease (CTAD) Congress Barcelona (Spain) |
14th International Conference on Alzheimer's and Parkinson's Diseases Lisbon (Portugal) |
Alzheimer's Association International Conference (AAIC) 2019 Los Angeles (U.S.) |
12th Clinical Trials on Alzheimer's Disease (CTAD) Congress 2019 San Diego (U.S.) |
Results published at Alzheimer's & Dementia: The Journal of the Alzheimer's Association |
ASFA guidelines + |
| Other relevant secondary | + |
Neuroimaging and biomarkers
Journal of the Alzheimer's Association + Submission to the
American Society for Apheresis (ASFA)
Would strongly support larger use of this treatment and its reimbursement
Potential inclusion in ASFA guidelines + Opening of referenced sites in Spain, other EU countries, U.S. and China to obtain real world evidence
endpoints to evaluate functional and cognitive capacity (CDR-Sb and ADCS-CGIC)

Bioscience and Diagnostic Collaboration

Karoly Nikolich Alkahest's CEO
THERAPIES BORN FROM THE SCIENCE OF AGING®
New Promising Horizons

Chronokines: Proteins With Biological Impact that Change With Age


Lehallier, B. … Wyss-Coray, T. Nature Med. 2019
60+ diseases 23,566 mechanistic connections

"Molecular microscope" of normal aging
Protein increasing with age DETRIMENTAL CHRONOKINES: Small molecule blockers as therapeutics
Compounds and Targets in the clinic or in preclinical development
Protein decreasing with age SUPPORTIVE CHRONOKINES: Plasma fractions & proteins as direct therapeutics
Recombinant proteins and plasma fractions in clinic or in preclinical development

| Biology / Indication Area | Biological Validation | Preclinical Development | |
|---|---|---|---|
| Selected Plasma Fractions | |||
| Peripheral Neuropathy | |||
| Regenerative Indications | |||
| Age-Related Disorders | |||
| CNS Disorders | |||
| Recombinant Proteins | |||
| AKST1200 – Neurology |
|||
| Small Molecules & Antibodies | |||
| AKST1220 – Neurology |
|||
| AKST1250 – Neurology |
|||
| AKST1260 – Neurology |
|||
| AKST1340 – Ophthalmology |


Identification of single cells in the hippocampus
Age-Related Gene Changes Reversed by Plasma Fraction Treatment in Brain Endothelial Artery Cells
| GRF6021 | |
|---|---|
| Healthy Aging |
A Powerful Platform to Mine the Plasma Proteome for Therapeutics


Investor and Analyst Meeting October 21 2020 - 142 -



Comprehensive discovery and development platform delivering transformational therapeutics based on the plasma proteome
Focused on core therapeutic areas; ready to partner where appropriate; meeting the risks and opportunities of developing science
A collaborative approach without boundaries balancing internal and external resources
Pioneering the molecularization of plasma with innovative methods to identify new therapeutics


Alfredo Arroyo Chief Financial Officer


• Strategic alliance with Shanghai RAAS in China • In 4Q 2019, debt-refinancing completed for €5,800m, improving terms and conditions significantly • In 2Q 2020, reinforcement of liquidity position up to €1,900m, upsizing the multicurrency revolving credit facility from \$500m to \$1,000m • Agreement to acquire a plasma fractionation facility in Canada and 11 plasma centers in the U.S. for \$460m • Payout at 40% of the group's consolidated net profit for 2019 • R&D investments: €329m in 2019 • Integrated innovation strategy: Grifols continues to support internal and external projects • AMBAR results published in Alzheimer's & Dementia: The Journal of the Alzheimer's Association • Tackling new therapeutic areas with Alkahest pending on 100% acquisition • CAPEX: €332m in 2019, in line with the plan • Plasma-center network: up to 310 plasma centers in the U.S. and Germany • Plasma centers, production facilities and sales network remained operational throughout COVID-19 • Bioscience continues to lead business growth • Solid underlying demand for key proteins lead by Immunoglobulins including hyperimmunes and albumin • Operating growth in all key geographic areas • New products launch: Xembify®, Vistaseal® and Tavlesse® • Diagnostic Division benefits from sale of COVID-19 tests • Pre-COVID-19 full recovery of plasma volumes estimated in 2021. +30% in 2021 vs. 2020


Investor and Analyst Meeting October 21 2020 - 149 -
Focus on Profitability – COVID-19 Temporarily Impacts Our Results

(1) From July 2019 to June 2020 (2) Excluding COVID-19 impact

Strengthening Grifols' Balance Sheet – Liquidity Increase in 2020 up to c.\$2bn

Senior Debt Refinancing – Amortization Schedule

| Goals Achieved | P&L Impact | COVID-19 Measures |
|---|---|---|
| • Tenor: from 4.6 to 7.3 years • Structure optimization: Currency and fixed/floating interest rate mixes • Covenants: Gained flexibility • Rating Agencies: Rating and outlook confirmed |
• Average cost of the debt is 2.8%, with a reduction of 80 bps • Estimated positive impact of €85m for 2020 |
• In 2020, upsizing multicurrency revolving credit facility from \$500m to \$1,000m • Cash Position June 2020: €1.9bn |
Strategic Investments Lead to Higher Leverage Ratio. Deleveraging Remains a Priority

Investor and Analyst Meeting October 21 2020 - 154 - 4,500
4,700
4,900
5,100
5,300
5,500
5,700
5,900
Leverage Ratio defined as Net Financial Debt to EBITDA excluding any IFRS 16 impact

Capital Discipline Focused on Supporting Growth and Creating Value


(1) From July 2019 to June 2020


1 Investments 2 Acquisitions 3 Dividends

Value Growth Plans on Track
Driving long-term sustainable growth across all divisions despite extraordinary times
Keeping up with investments in CAPEX and Innovation to support future growth
Working to increase plasma collections, organically and inorganically
Integrated innovation strategy as a pillar
Strengthening international expansion through the strategic alliance with Shanghai RAAS and acquisitions in Canada and in the U.S.
Business fundamentals remain very solid
We are more committed than ever to our values and to our stakeholders. Taking all the necessary steps to further strengthen our solid business performance.


Long-Term Success Is Based on Excelling in Four Strategic Pillars

Long-Term Success Is Based on Excelling in Four Strategic Pillars

Holistic approach to grow beyond plasma in our core Bioscience therapeutic areas; leverage our expertise to grow in Clinical Diagnostic

Innovation Pillar
30% of current growth already coming from new products (i.e. Xembify®, Fibrin Sealant®, Tavlesse®, etc.)

Alkahest as an innovation engine to create a New Generation of Products Derived from Understanding the Plasma Science


Short-term
Medium Long-term

COVID-19 Outbreak Has Pushed Grifols to Greater Excellence


Investor and Analyst Meeting
October 21 2020
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