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Immuron Ltd — Investor Presentation 2016
May 30, 2016
35121_rns_2016-05-30_b291772c-b3a7-4f82-9233-2a8cea0c93b9.pdf
Investor Presentation
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May 2016
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1 2 3 Antibodies Are Vaccines Are Harvested from Broad Therapeutic Effect Developed Colostrum Induction - Reduces systemic of inflammation regulatory - T-cells Lowers organ injury - Not associated with general + immune suppression - No risks of severe infection Disease Bovine Clearance of + or malignancy Specific adjuvants Targeted - Antibodies IgG (IgG1) Pathogens Easily tolerated by patients
- Not associated with general immune suppression
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An approach to treat inflammatory, infectious and autoimmune diseases through the oral delivery of antibodies and adjuvants
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An active process that uses the inherent ability of the GI tract's immune system to control unwanted systemic immune responses, by inducing systemic regulatory T cells to suppress inflammation
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Protectyn
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Other Launches (eg. Japan)
Additional Growth Opportunities
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$13.9M
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EU Full Year Launch
USA, China Full Year EU Launch USA Launch (Late 2016) $8.1M $4.6M $1.8M
Geographies: EU, Potential Rx + Japan and Russia Extensions
Product Line Extensions
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– Dr Arun Sanyal (MD) University of Virginia. Professor of Medicine and Former Chairman of the Division of
– Dr Stephen Harrison (MD) Professor of Medicine, Uniformed Services University of the Health Sciences, Bethesda,
– Dr Manal Abdelmalek (MD) Duke University Medical Center. Dr Abdelmalek is Associate Professor of Medicine at
– Dr Gerhard Rogler (MD, PhD) Zurich University. Dr Rogler is the Chairman of the Scientific Advisory Board of the
– Dr Miriam Vos (MD) Emory University. Dr Vos is an associate professor of pediatrics at the Emory University School of
– Dr. Dena Lyras (PhD) Monash University. Dr Lyras is associate professor at Monash University, is one of the world’s
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Financials Overview
Share Price Performance (Mar 15- May 16)
NASH C-Difficile Recruitment Results Update CVS
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Travelan
US Launch
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Chief Executive Officer
Head of Medical & NASH
COO & Scientific Officer
Medical and Scientific Advisor
Manufacturing Quality Director
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NASH
Obesity / Unhealthy Living…
… Drives Metabolic Diseases
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Metabolic syndrome is associated with the risk of developing cardiovascular disease, diabetes and fatty liver
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Some studies have shown the prevalence in the USA to be an estimated 34% of the adult population; Prevalence increases with age
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No end in sight to the epidemic: e.g.: 350 – 550 million people expected to be diabetic by 2030
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NASH: The most severe form of liver injury in the spectrum of nonalcoholic fatty liver disease (NAFLD)
Market Estimated to top $35B-$40B WW by 2030 driven by Size obesity epidemic (Deutche Bank – 2014)
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NASH – Pathophysiology
Key Takeaways
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Immunological Mechanisms
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IMM-124E
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GUT:
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Intestinal LPS ↓
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Intestinal Permeability ↓
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Microbiome antigen change
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Tolerance – Activation of Innate system to suppress inflammation (NKT, DC, macrophages)
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LIVER:
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Activated Kupffer Cells ↓ (F4/80 macrophages)
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Fibrosis and Inflammation ↓
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SERUM:
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Insulin resistance ↓
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Circulating LPS ↓
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TGF-β ↑
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TNF-α ↓
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IL-2, IL-6, IL-10, IL-12
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Treg ↑ (CD4, CD25, FoxP3)
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Anti-LPS and Adjuvants in IMM-124E A Synergistic Effect in Animal Models of NASH
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900
800
700
600
500
400
300
200
100
0
ALT levels (u/L)
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Results
lowering Triglycerides and liver enzymes in the
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* P<0.05; ** P<0.009
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An adjuvant effect through the gut
Adar T. Clin Exp Immunol., 2012
synergistic effect
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Fibrotic Liver
CCl4 (carbon tetrachloride)
IMM-124E Liver CCl4 (carbon tetrachloride)
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IMM124E
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Treatment with IMM-124E prevents Fibrosis and Inflammation
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Mizrahi M. 2013, AASLD; Hepatology 751A
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Group A: Group B: Naïve Group A: Group B:
Control anti LPS
Control Naïve anti LPS
Group C: Group D: Group C: Group D:
Treated Treated Treated Treated
Decrease Portal Inflammation Improved Metavir Fibrosis Score
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4 3.4 p<0.0009
3.5 ^^ p<0.0003
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2.5
1.8
2
1.5 1
1
0.5
0
0
A B C D
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2.4 p<0.02
2.5 ^^ p<0.01
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1.4 1.33
1.5
0.66
1
0.5
0 Mizrahi M. 2013,
A B C D AASLD;
Hepatology 751A
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Results of a Phase I/IIA clinical trial; N=10 30 Days Treatment Endpoint Met; NO SAFETY ISSUES REPORTED
Improved Liver Enzymes
Improved HBA1C, OGTT and HOMA
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Mizrahi M, J Inflamm Res. 2012;5:141-50
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Increased CD4+CD25+FOXP3+ TREGS
Increased GLP1 and Adiponectin
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Day 1
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Day 30
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Mizrahi M. J Inflamm Res. 2012
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Lead Principal Investigator: Arun Sanyal; Former President of the AASLD (American Association for the Study of Liver Diseases) and current Chair of the Liver Study Section at the NIH (National Institute of Health) Scope: Multi-Center, Developed Countries, Double-Blinded, Placebo controlled trial Sites: 25 sites running in US, Australia and Israel; 1 more to be added in 1H2016
Recruiting 120 patients with biopsy proven NASH; 44 patients already randomized; 18 patients have completed treatment
3 Arms: Placebo, High Dose and Low Dose
Primary Endpoints: Changes in Liver Fat Content confirmed by MRI; Changes in ALT (liver
Secondary Endpoints / Outcome Measures: E.g., Changes in BMI, Changes in
Timing: Top Line Results (TLR) by Mid-2017
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Competition
Bile Acid
Shire - LUM-002
Intercept - Obeticholic acid, modified bile acid
Galmed - Aramchol, Conjugate of Fatty acid and Fatty bile acid
Anti-fibrotic
IMM-124E Strong Differentiation
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Represents a mufti-factorial approach to NASH, not just one pathway
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Potentially superior safety profile - No safety issues as reported by competitors (e.g., Intercept with LDL)
Gilead - Simtuzumab, anti-fibrotic
Galectin - galectin proteins
Anti-Inflammatory + (anti-inflammatory, antidiabetic, cholesterol control, FFA)
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No significant safety concerns that would limit chronic / long term use
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Can be used across the spectrum of NASH / NAFLD
Immuron – Oral enriched with Anti-LPS Abs
Tobira - CCR2 / CCR5 inhibitor
Genfit - Peroxisome proliferator activated receptor alpha
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Can be used in combination with other agents
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Oral vs. IV/SubQ
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IMM- • Safety profile potentially opens all segments (Fibrosis – F0-F4 and NAFLD)
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124E Can potentially be used in combination with other agents, not only as monotherapy
Liver
Cancer
39K
US incidence
Galectin
Cirrhosis Conatus 0.63% of US Adults: Combo-therapy
potential
off label use potential 600K patients
Intercept: Recruiting F1 - F3
IMM-529
Genfit: Recruiting F1 - F3
F0 – F3; Mono
NASH Galmed: TBD 2-3% of US adults: 5-7M patients or Combo
Tobira: TBD
Therapy
Payor pushback for use in F0/F1
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X 19% of US Adults: 45M patients MonoNAFLD Likely limited offtherapy label use The prevalence of NAFLD is 80-90% in obese adults, 30-50% in patients Potential with diabetes and up to 90% in patients with hyperlipidemia
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C-DIFFICILE
Market Opportunity
Unmet Need
IMM-529 Positioning
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Spores – Infectious Particles
IMM-529 antibodies bind to surface antigens on spores & prevent adheres to host cells & limit germination.
Heat, ethanol & UV resistant. Survive gastric acid, adhere to cells in the colon & germinate
Vegetative Cells
Fimbriae & other surface layer proteins (SLP) contribute to bacterial colonization. Fimbriae are used to adhere to other bacteria & to host cells and isone of the primary mechanisms of virulence
IMM-529 antibodies bind to SLP on vegetative cells & limit colonization.
Toxin B
IMM-529 antibodies neutralise toxin B, inhibiting toxin mediated epithelial cell apoptosis & limit toxin translocation into the systemic circulation & inflammatory cascades
Toxin B is essential for virulence. Toxin B disrupt the cytoskeleton and tight junctions of intestinal epithelial cells
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S u rv iv a l
1 0 0
U n in fe c te d , N o tre a tm e n t
8 0 In fe c te d , N o tre a tm e n t
In fe c te d , N o n -im m u n e Ig G tre a tm e n t
6 0 In fe c te d , IM M -5 2 9 tre a tm e n t
In fe c te d , V a n c o m y c in tre a tm e n t
4 0
2 0
0
0 .0 0 .5 1 .0 1 .5 2 .0 2 .5 3 .0 3 .5 4 .0
h o u rs p o s t in fe c tio n
S u rv iv a l
1 0 0 U n in fe c te d , N o tre a tm e n t
In fe c te d , N o tre a tm e n t
8 0 In fe c te d , N o n -im m u n e Ig G tre a tm e n t
6 0 In fe c te d , IM M -5 2 9 tre a tm e n t
In fe c te d , V a n c o m y c in tre a tm e n t
4 0
2 0
0
0 1 2 3 4
D a y s p o s t in fe c tio n
1 1 0 S u rv iv a l
1 0 0 In fe c te d + S O C
9 0 ** In fe c te d + S O C + IM M -5 2 9
8 0 p=0.0027
7 0
6 0
5 0
4 0
3 0
2 0
1 0
0
0 2 4 6 8 1 0 1 2 1 4 1 6 1 8 2 0
D a y s a fte r v a n c o m y c in tre a tm e n t c e a s e d
P e rc e n t s u rv iv a l
P e rc e n t s u rv iv a l
Studies P e rc e n t s u rv iv a l
Prevention
Studies
Treatment
Relapse Studies
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Demonstrated 80% efficacy without use
Demonstrated 80% efficacy without use
Demonstrated ~90% survival rate vs. 22% survival rate in control
All studies statistically significant
Potentially only therapeutic (approved or in development) that can treat all phases of the disease:
(1) Prophylaxis (2) Treatment
(3) Recurrence
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Phase I/II
If positive
Phase IIA / IIB
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OTC BUSINESS
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The only therapy that
prevents Travelers’
Diarrhea by up to
90%
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Without Travelan [®] : With Travelan [®] : Bacteria
Bacteria attach to gut wall neutralized by Travelan [® ]
and infect antibodies
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Marketed in the US, Australia by Immuron and by Paladin/Endo in Canada
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Global market estimate: US$ 600M - 1.2B
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All-natural product;
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Clinically proven
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SAFE
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OTC
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Strong brand loyalty
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Multiple life-cycle opportunities
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- Significantly reduces adherence of CFA/I producing ETEC strains to a cell-line that mimics the human small intestinal epithelium
PreClinical Studies
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Significantly reduces the motility of ETEC strains through soft agar
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Binds to both the bacterial surface and flagella
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Has substantially greater reactivity against purified ETEC flagella antigen than IgG purified from non-immune colostrum powder
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Travelan has undergone clinical testing in patient randomised, double-blind, placebo-controlled clinical trials (90 patients)
Clinical Studies
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Results: Travelan confers protection of nearly 91% against infection of the major strain of E.coli that causes TD
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In addition these trials showed a significant reduction in abdominal cramps and stomach pain compared to those who did not receive Travelan. There were no reported treatment-related side effects
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Formulated with 13 Strains of E-Coli
Proven to Be Cross-Reactive (binds) to Other E-Coli Strains and Gram-Negative Bacteria
| Formulated with 13 E-Coli |
Strains of |
|---|---|
| Serotype | Strains�# |
| ETEC O6: H16 | B2C |
| ETEC O8: H19 | C55 3/3c3 |
| ETEC O15: H4 | PE 595 |
| ETEC O25: H42 | E11881A |
| ETEC O27: HR | C1067-77 |
| ETEC O63: H- | PE 673 |
| ETEC O78: H11 | H10407 |
| ETEC O114: H21 | E20738/0 |
| ETEC O115: H- | PE 724 |
| ETEC O128: H21 | EI 37-2 |
| ETEC O148: H28 | B7A |
| ETEC O153: H12 | E8772/0 |
| ETEC O159: H- | PE 768 |
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Other Launches (eg. Japan)
Additional Growth Opportunities
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$13.9M
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EU Full Year Launch USA, China Full Year EU Launch USA Launch (Late 2016) $8.1M $4.6M $1.8M
Geographies: EU, Potential Rx + Japan and Russia Extensions
Product Line Extensions
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OUTLOOK & VALUE
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(2016) Acquired Nimbus Phase I ACC inhibitor for $400m upfront + potential for future payments (total deal up to $800M)
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(2010) Acquired Arresto for $225m + potential for future payments : Phase I asset (LoxL2 antibody) targeting NASH, IPF
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• (2015) Phenex : Acquired NASH asset with Phase II running. Total deal value $470m . Undisclosed upfront, development
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(2012) Regulus: Preclinical deal. AZN paid $125m per
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(2014) Acquired Lumena for $260m . Company had two
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Total potential deal value $600m for 2 indications. A$39m
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Leader in NASH; In PIII; Positive Phase II funded by NIH ; Significant safety issues (e.g., LDL); $6B+ valuation increase with positive PII
Microbiome Leader; in PII in C-Diff; Only open-label Phase 1/2 positive; very strong institutional support
In PIII; Negative PII (placebo response very high); Lost 500M euro valuation on negative PII
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Average valuation for PII NASH companies: $54M US (2.5X current valuation)
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Average valuation for PIII NASH companies: $2.1B (100X current valuation)
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Average C-Diff Companies: $367M
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All NASH companies in PII: - Tobira: Finishing PII
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- Galectin: Cirrhotic patients
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- Conatus: Cirrhotic patients
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- Galmed: Just initiated PII; Recruiting slowly
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APPENDICES
- 7 Major patent families offering both matter of composition and formulation patents
Strong Patent Portfolio
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Approved / pending in major geographies including US, Europe, Japan, China
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Earliest patent to 2026; possible extension to 2030
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Immuron’s drugs are considered “biologics” by the FDA
Extended Market Exclusivity
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In the US, this will confer Immuron’s new drugs 12 years of market exclusivity, offering investors a long revenue tail
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Exclusively effectively extend time to potential first generic entry
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Immuron’s drug not absorbed in the blood
Generic Protection
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No baseline for PK studies
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This results in lengthy process for Gx manufacturers with many opportunities to challenge ANDA fillings
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