Acacia Pharma : Corporate Presentation October 2020

Acacia Pharma Group plc

Non-Confidential Corporate Presentation

September 2020

Our Vision:

Delivering innovative products to enhance surgical patients' recovery

Important Notice

The information contained in this presentation (this "presentation") has been prepared by Acacia Pharma Group plc ("the Company") as at the date of this presentation and is subject to updating, completion, revision, further verification and amendment without notice. This presentation is for general information only and is the property of the Company. Making this presentation available in no circumstances whatsoever implies the existence of a commitment or contract by or with the Company, or any of its affiliated entities, or any of its or their respective subsidiaries, directors, officers, representatives, employees, advisers or agents for any purpose.

This presentation has not been approved by the United Kingdom Listing Authority under the Prospectus Rules (made under Part VI of the Financial Services and Markets Act 2000 ("FSMA")), by the Belgian Financial Services and Markets Authority or otherwise, by the regulated market of Euronext Brussels. This presentation does not constitute or form part of any offer for sale or solicitation of any offer to buy or subscribe for any securities nor shall it or any part of it form the basis of or be relied on in connection with, or act as any inducement to enter into, any contract or commitment whatsoever. No reliance may be placed for any purpose whatsoever on the information or opinions contained in this presentation or on the completeness, accuracy or fairness thereof.

No undertaking, representation, warranty or other assurance, express or implied, is made or given by or on behalf of the Company or its directors, officers, partners, employees, agents or advisers or any other person as to the accuracy or completeness of the information or opinions contained in this presentation and no responsibility or liability is accepted by any of them for any such information or opinions or for any errors, omissions, misstatements, negligence or otherwise for any other communication written or otherwise. In addition, in issuing this presentation, the Company undertakes no obligation to update or to correct any inaccuracies which may become apparent in this presentation. Notwithstanding the aforesaid, nothing in this paragraph shall exclude liability for any undertaking, representation, warranty or other assurance made fraudulently.

The statements contained in this presentation may include "forward looking statements" that express expectations of future events or results. All statements based on future expectations rather than on historical facts are forward looking statements that involve a number of risks and uncertainties and the Company cannot give assurance that such statements will prove to be correct. Any forward-looking statements made by or on behalf of the Company speak only as of the date they are made. The Company gives no undertaking to update forward looking statements to reflect any changes in expectations, events, conditions or circumstances upon which such statements are made.

The presentation should not be considered a recommendation by the Company or any of its affiliated entities, or any of its or their respective subsidiaries, directors, officers, representatives, employees, advisers or agents in connection with any purchase of or subscription for securities of the Company.

This presentation is not directed to, or intended for distribution to or use by, any person or entity that is a citizen or resident or located in any locality, state, country or other jurisdiction where such distribution or use would be contrary to law or regulation or which would require any registration or licensing within such jurisdiction. In particular, this presentation should not be copied or distributed by recipients and should not be distributed by any means including electronic transmission, to persons with addresses in the United States of America, Canada, Australia, South Africa or Japan their possessions or territories or to any citizens thereof, or to any corporation, partnership or such entity created or organised under the laws thereof. Any such distribution contrary to the above could result in a violation of the laws of such countries.

2

Acacia Pharma Group - in Summary

Acacia Pharma Group plc: an integrated specialty pharma company entering commercial phase

• IPO 2018 on Euronext Brussels (ticker: ACPH)
• Key focus: surgeries, procedures, cancer therapy
• Products to increase procedural throughput in even greater demand due to COVID-19

BARHEMSYS® - now FDA approved

• Broad label for prevention and treatment of Post-Operative Nausea and Vomiting (PONV)
• Key target: estimated 16 million patients a year in US with PONV after failure of generic antiemetics1
• Estimated $2.6 billion annual total addressable market2

BYFAVO™ - now FDA approved3

• Indicated for procedural sedation in adults, supported by strong clinical data package
• Key target: 40 million procedures a year in US, including 25 million GI procedures4
• Estimated >$1 billion annual total addressable market5

Core commercial organization in place ready for product launches in 2H 2020

• Key sales, marketing, medical affairs, commercial operations leadership in place
• Sales representatives onboard late September
• Drug shortages and surgery backlog creating pent-up demand

1 Calculations based on available procedural data, applied Compound Annual Growth Rate and quantitative market research responses as follows: National Hospital Discharge Survey, 2006; National Survey of Ambulatory Surgery, 2006 (as revised in 2009); Source Healthcare; NCHS 2005; Life Science Strategy Group, LLC Market Research; Apfel et al.,2004. 2 Based on the calculations in (1) multiplied by the number of doses per patient at a selling price of $80 per 10mg dose. 3 Subject to scheduling by DEA

3 4 iData Research, US Market Report Procedure Numbers for Gastrointestinal Endoscopic Devices February 2019; American Society of Anesthesiologists, Practice Guidelines for Moderate Procedural Sedation and Analgesia 2018; and Quantitative Market Research prepared by The Link Group for Cosmo Technologies (March 2019). 5 Based on the calculation in (4) multiplied by the number of doses per patient at a selling price of $25-35 per dose.

Leadership Team with Experience to Deliver the Vision

Mike Bolinder

CEO

Gary Gemignani

CFO

Dr Gabriel Fox

CMO

• Joined 2015, became CEO 1 August 2019
• 18+ years in pharma sales & marketing
• Relevant commercial experience with OFIRMEV® at Cadence/Mallinckrodt
• Joined as CFO January 2020
• 30+ years finance experience in healthcare
• Relevant CFO experience in early commercial stage pharma
• Joined as CMO 2008
• 23+ years in pharmaceutical medicine
• Relevant development and medical- marketing experience in repurposed drugs

4

Late Stage Commercial Product Pipeline

Product

Indication

Preclinical Phase 1

Phase 2

Phase 3

Filing

Approval

Postoperative

BARHEMSYS® Nausea &

Vomiting (PONV)

BYFAVO™ Procedural

Sedation

Chemotherapy

APD403 Induced Nausea

& Vomiting

5

Patent Terms and Commercial Rights

BARHEMSYS	• Orange Book listed, current patent term to 2031,
	expected ability to extend1
	• IP protection in all major pharmaceutical markets:
	• Intend to directly commercialize in the US
	• Exploring partnership opportunities OUS
	• Approved for PONV, developing for CINV

BYFAVO	• Orange Book listing expected soon, current patent
	term to 2031, expected ability to extend1

• In-licensed commercial rights for US (largest pharmaceutical market)

• Approved for procedural sedation, can develop for ICU sedation and general anesthesia

6	1 Patent extension currently under review by US Patent and Trademark Office for BARHEMSYS and request is expected to be made for BYFAVO. Management believes the
patent terms will be extended to 2034 for both BARHEMSYS and BYFAVO.

COVID-19 Situation and Impact

• The OR accounts for up to 65% of hospital profit margin, so this missing volume is cutting deeply into cash flow and net income.❞

		-Becker's Hospital Review1
	COVID-19 impact on	• Non-essential surgeries cancelled creating a significant backlog
	hospitals and surgical	• Physical access to hospital decision-makers even more restricted
	centers
	Hospital profits have	• Surgeries and procedures are major contributors to hospital profits
	suffered and need to be
	• Providers need to dramatically increase throughput to regain lost profits
	restored quickly

We believe our products and team are ideally positioned to help

• BARHEMSYS and BYFAVO can help improve patient throughput - both now even more relevant and of greater interest to customers
• Our strong relationships will help us gain access to key decision-makers

1 How to rebuild surgical revenue after COVID-19,Becker's Hospital Review, accessed via https://www.beckershospitalreview.com/strategy/how-to-rebuild-surgical-7 revenue-after-covid-19-even-if-you-just-lost-60-of-your-or-volume.html

BARHEMSYS®

(amisulpride for injection)

The first and only FDA-approved product for PONV rescue treatment1

1 FDA labels for other recommended treatments do not include treatment after failed prophylaxis. Treatment agents recommended by Society for Ambulatory Anesthesiology Consensus Guidelines (2014). Habib et al (2019): no agent has previously been shown in a prospective trial to be more effective than a placebo for treating PONV for patients who have failed prophylaxis.

BARHEMSYS® and the US Opportunity in PONV

BARHEMSYS

A new option in PONV

• BARHEMSYS is the only FDA-approveddrug for PONV rescue after failed prophylaxis1
• Dopamine D2/D3 antagonist with broad, differentiated label
• Offers significant economic savings to hospital vs current standard of care

High gross profit and secure supply chain

• Cost of goods ~10% of sale price
• Five-yearroom temperature shelf-life
• Substantial product inventory to minimize supply risk

		•	Estimated ~65m eligible surgeries annually, ~49m patients receive preventative antiemetics4
	Large US market
	•	Estimated ~16m patients still develop PONV and need rescue treatment3
	opportunity in PONV2
		•	Total addressable PONV rescue market estimated at ~$2.6 billion/year4

Concentrated market, addressable by small direct sales force

• Estimated 80% of surgeries carried out in ~1,600 hospitals5
• 30 sales territories address accounts with greatest immediate opportunity
• Product in US supply chain as of late August

1 FDA labels for other recommended treatments do not include treatment after failed prophylaxis, 2 This is the belief of the Company. 3 Company market size estimates based upon: 2006 National Hospital Discharge Survey; National

9 Survey of Ambulatory Surgery, 2006 (as revised in 2009); LSSG Quantitative Research November 2014; Apfel, NEJM 2004. Calculations based on available procedural data, applied Compound Annual Growth Rate and quantitative market research responses. 4 Based upon price of $80 per 10mg rescue dose with, on average, 2 rescue doese per patient, and the above estimates. 5 Symphony Health, Source Non Retail, August 2017 - July 2018.

Nausea and Vomiting is a Complex Process

Managed by combinations of antiemetics targeting multiple mechanisms

Fear, anxiety, memory	Bloodstream emetogens

GI tract			Vestibular system
	D2	5HT3
	NK1
		H1	Inflammation?
Multiple pathways, including:	Current standard of care for
Despite this >30% of
• Serotonin (5-HT3)	PONV prophylaxis1:
• Dopamine (D2)	5-HT3 antagonist	surgical patients still
• Histamine	(e.g. ondansetron)	get PONV2
• NK1	± corticosteroid

10 1 Gan et al, 2020. 2 Apfel et al, 2004; Habib et al, 2019.

Targeting PONV Rescue Market

~65m invasive	~49m receive	~32% fail	~16m patients
surgical	per year require
antiemetic	prophylaxis and
procedures per	PONV rescue
prophylaxis1	get PONV1
year (US)1	treatment

~18m high-risk patients per year eligible for combination prophylaxis1

Total estimated addressable market in PONV rescue ≈ $2.6B per year

Secondary market in combination prophylaxis in highest-risk patients, estimated to be worth $720M per year2

1 Company market size estimates based upon: 2006 National Hospital Discharge Survey; National Survey of Ambulatory Surgery, 2006 (as revised in 2009); LSSG Quantitative Research November 2014; Apfel et al, 2004.

11 Calculations based on available procedural data, applied Compound Annual Growth Rate and quantitative market research responses. 2 Based on selling price of $80 per 10 mg rescue dose and average 2 rescue doses per patient; $40 per 5 mg prophylaxis dose.

Generic Options for Rescue Treatment are Problematic

• When PONV prophylaxis has failed, patients should receive antiemetic treatment from a different pharmacological class to the PONV prophylaxis❞
• • Consensus Guidelines1

Antiemetic	Can't redose	Efficacy issues	Safety issues	Current share of
rescue patients4
Ondansetron	✘1			69%
Dexamethasone	✘1	✘2		19%
Metoclopramide		✘1	✘1	19%
Promethazine			✘1	11%
BARHEMSYS	3	3	3	INTENT TO PRESCRIBE4
61%

12	1 Fourth Consensus Guidelines for the Management of Postoperative Nausea and Vomiting. 2 Wang et al (2000). 3 BARHEMSYS label prescribing information. 4 LSSG quantitative market research among 152
anesthesiologists and general surgeons. Question referred to "Product X" with a description matching the profile of BARHEMSYS. Note: current shares totals > 100% as responses included some combination therapy.

BARHEMSYS® - Compelling Clinical and Commercial Proposition

Only FDA-approved product for PONV rescue1

• Only drug proven in randomized clinical trial to work in PONV rescue2
• Excellent safety profile demonstrated in clinical studies
• Also demonstrated to be effective for prevention

Throughput and health economic benefits

• 35-minutereduction in PACU stay
• 6-hourreduction in hospital stay
• Offers significant economic savings to hospital vs current standard of care

Convenient, easy to use, high margin product

• 5-yearroom temperature shelf-life
• Fits in auto-dispensing (Pyxis™) machines
• Cost of goods ~10% of sale price

Helps post-COVID pressure to get through surgical backlog

• Shorter time in PACU allows increased surgical throughput
• Better efficacy and safety means better recovery and patient experience

13	1 FDA labels for other recommended treatments do not include treatment after failed prophylaxis. Treatment agents recommended by Society for Ambulatory Anesthesiology Consensus Guidelines (2014). Habib et al (2019): no agent has previously been
	shown in a prospective trial to be more effective than a placebo for treating PONV for patients who have failed prophylaxis. 2 FDA labels for other recommended treatments do not include treatment after failed prophylaxis.

Highly Experienced Commercial Team in Hospital Space

Midwest

Northeast

West

Mid-Atlantic

South-Central

Southeast

Commercial Leadership TeamSales Leadership Team

28+	60+	22	18+
Years avg	Launches	Years avg	Years
industry		industry	hospital

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Team has direct experience successfully launching OFIRMEV into same market to same key customers

Field Force Design

• 1 VP of Sales
• 1 National Accounts Group Leader
• 1 National MSL Group Leader
• 6 Sales Regions each with:
• • 1 RBD
  • 1 MSL
  • 1 National Account Director
  • 5 Hospital Territory Managers

National Accounts TeamMedical Science Liaison Team

24	21+	22	10+
Years avg	Years	Years avg	Years as
industry	hospital	industry	MSL

Commercial Roll-out Underway

Manufacturing and distribution networks in place

• Substantial API and finished product manufactured to de-risk supply chain1
• Service agreements in place with 3rd party logistics provider and key wholesalers
• Contracting discussions underway with top Group Purchasing Organizations and Integrated Delivery Networks

PONV and	•	Presence at major congresses
BARHEMSYS education	•	Print and online advertising
campaigns ongoing	•	F2F and virtual meetings in key centers
	•	Leading PONV experts involved in
Strong KOL and
	BARHEMSYS clinical development trials
advocate support	•	Additional anesthesia, surgery and
		pharmacy KOLs being educated

Early adopting sites and formulary champions identified

• Extensive institution profiling already undertaken
• Key clinical champions identified in hundreds of hospitals

15	1 This is the belief of the Directors of the company.

Formulary Review Phase to Begin 2H 2020

Post-COVID pressures improve our access to key decision-makers

• Surgery backlogs are major issues for US hospitals
• Value of BARHEMSYS in improving throughput facilitates our access to key decision-makers

Demonstrate unmet need, appropriate use & health economic benefit

• Existing products unsuitable for rescue
• BARHEMSYS is only FDA-approved product for rescue
• Offers significant economic savings to hospital vs current standard of care

Formulary adoption and pull-through will build sales

• P&T Committee approval typically takes 9-12 months on average2
• Protocols, standing orders and point-of-care supplies drive sales pull-through

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Anaesthesia

Pharmacy

Key Surgeons

Reviews assessment and votes to revise formulary

Pharmacy &

Therapeutics Committee

Appropriate Use Standing Orders	Point-of-Care
and Protocols	Stocking

Major Follow-on Opportunity in Chemotherapy Induced Nausea & Vomiting (CINV) for APD403

		•	~4 million cycles of highly emetogenic
	CINV market opportunity		chemotherapy (HEC) every year in US1
	is similar to PONV	•	Preventive anti-emetics
			recommended for 4 days per cycle2
		•	Despite use of three-antiemetic
	Significant unmet need		cocktail, 50% of patients still suffer
	remains in delayed phase		with delayed CINV3
	CINV	•	Oncologists target zero tolerance of
			CINV2
		•	Positive data in one randomized trial:
	One further pivotal trial
		significant reduction in incidence of
	required to support new
		delayed CINV3
	indication
	•	Further trial to be conducted by 2022

>90%		Two phases
	of CINV4:
patients get CINV when		Acute
receiving HEC4		(Day 1)
		Delayed
		(Day 2-5)
Delayed
CINV
	NDA submission:
		Potential
is the unmet medical		2023
need

32%

relative risk reduction of delayed CINV3

17	1	Morgan Stanley analyst note on Tesaro, 2012, Deutsche Bank analyst note on Tesaro, 2013, Edison analyst note on Tesaro, 2014, NCCN Guidelines for antiemesis, 2017.
2	NCCN Guidelines 2017. 3 Calculated from DN10016 study report. 4 Roila et al (2010) , Hesketh (2011).

BYFAVO™

(remimazolam) for injection

Rapid onset/offset procedural sedative with favorable safety profile

Procedural Sedation Market Opportunity

~40 million1	~25 million	>80%
procedures each year	GI procedures performed	GI procedures have sedation administered
requiring sedation	each year2	by an anesthesia provider3

>6 million	~4 million	~1 million	~1.5 million
Interventional	Ophthalmic	Bronchoscopy6	Cosmetic/
Radiology4	Procedures5		Plastic Surgery7

Total addressable market in procedural sedation ~$1B/year8

1 Calculations based on available procedural data, applied Compound Annual Growth Rate and quantitative market research responses. 40 million includes other opportunities: CC (MHA National) EP (dicardiology), Dental (areadentist), Plastic Surgery (American Society of Plastic Surgeons), ECT (MHA National). 2 iData Research, US Market Report Procedure Numbers for Gastrointestinal Endoscopies Nov 2016; CDC website. 3 Quantitative Market Research prepared by The Link Group for Cosmo Technologies (March 2019). 4 Report on interventional Radiology November/December 2007. 5 American Medical Association 2011. 6 iData Bronchoscopy 2019 report. 7 American Society of Plastic Surgeons 2018. 8 Based on the calculation in iData

19 Research, US Market Report Procedure Numbers for Gastrointestinal Endoscopic Devices February 2019; American Society of Anesthesiologists, Practice Guidelines for Moderate Procedural Sedation and Analgesia 2018; and Quantitative Market Research prepared by The Link Group for Cosmo Technologies (March 2019) multiplied by the number of doses per patient at a selling price of $25-35 per dose.

BYFAVO Addresses Unmet Need in Procedural Sedation

Propofol

fast acting but

significant safety issues1,2

• Rapid onset and offset anesthetic with narrow therapeutic index1
• Dose-relatedcardiorespiratory depression, pain at injection site1
• Non-lineardosing effects due to individual variability4
• Needs continuous monitoring by anesthesiologist, no reversal agent2
• Lipid formulation susceptible to bacterial contamination4

Midazolam

better safety profile but

longer onset and recovery1,2

• Benzodiazepine sedative, reversible by flumazenil1
• Slower onset and offset2,3
• Metabolized by cytochrome system; individual variability affects sedation1
• Active metabolite can accumulate and cause prolonged sedation2
• Risk of respiratory depression1

BYFAVO

fast acting AND favorable

safety profile1,2

• Rapid onset/offset1,2,3 benzodiazepine
• Rapid biotransformation into inactive metabolites via non- specific tissue esterases - not dependent on liver enzymes1
• Predictable behavior, no pharmacokinetic drug interactions5
• Reliable sedation, reliable safety profile1
• Reversible by flumazenil1

20	1	Colao J, et al. J Anesth Clin Res. 2016; 7:690. 2 Whizar-Lugo V, et al. J Anesth Crit Care. 2016; 4(6): 00166. 3 Rex DK et al. Gastrointest Endosc. 2018 Sep;88(3):427-437.
4	Prescribing label for Propofol. 5 Prescribing label for BYFAVO.

Rapid Onset/Offset with a Favorable Safety Profile1

40

30

Average Procedure Timings1

Key Adverse Events1

	BYFAVO	Midazolam
Any adverse event	74%	91%

20

10

0

6

4

13

19

Vascular disorders	62%	81%
Cardiac disorders	18%	26%
Respiratory disorders	4%	6%

BYFAVOMidazolam

Minutes to fully alert after procedure Minutes to procedure start

21 1 Rex DK et al. Gastrointest Endosc. 2018 Sep;88(3):427-437.

BYFAVO™ - Compelling Clinical Proposition

Approved with a broad label

• Indicated for procedural sedation in adults in procedures lasting 30 mins or less
• Substantial clinical data package shows compelling efficacy and safety in colonoscopies and bronchoscopies, including least fit patients

Throughput and health economic benefits

• Rapid onset/offset enables shorter procedure times and greater patient throughput for hospitals and surgical centers compared to other recommended treatments

Commercial synergy with BARHEMSYS

• Target prescribers: anesthesiologists and proceduralists in hospitals and ambulatory surgery centers

Helps post-COVID pressure to alleviate procedural backlog

• Shorter procedure times allow increased procedural volumes
• Both midazolam and propofol currently on FDA drug shortages list

22

Acacia Pharma Group - Financial Summary

Listed on Euronext	•	IPO in March 2018	Key Shareholders1
•	~85m shares outstanding
Brussels exchange
•	~80% free float
			23%	24%
Cash position	• Cash balance at June 30, 2020 was ~$24.6m	4%
•	Raised $30m August 2020
			4%
			5%	23%
	• Hercules ~$8.6m outstanding as of June 30, 2020
Debt facilities	17%
•	Additional ~$27m loan facility available from
		Cosmo (~$16.5m already drawn upon)	Cosmo Technologies Ltd
			Gilde Healthcare
			Lundbeckfonden Invest
Current milestone	•	€5m in ACPH shares due upon first commercial sale	F-Prime Capital Partners
KBC Bank
obligations		of BYFAVO
	AXA Investment Management
			Other

23	1:Shareholder data as of July 22, 2020.

Acacia Pharma Group - in Summary

Acacia Pharma Group plc: an integrated specialty pharma company entering commercial phase

• IPO 2018 on Euronext Brussels (ticker: ACPH)
• Key focus: surgeries, procedures, cancer therapy
• Products to increase procedural throughput in even greater demand due to COVID-19

BARHEMSYS® - now FDA approved

• Broad label for prevention and treatment of Post-Operative Nausea and Vomiting (PONV)
• Key target: estimated 16 million patients a year in US with PONV after failure of generic antiemetics1
• Estimated $2.6 billion annual total addressable market2

BYFAVO™ - now FDA approved3

• Indicated for procedural sedation in adults, supported by strong clinical data package
• Key target: 40 million procedures a year in US, including 25 million GI procedures4
• Estimated >$1 billion annual total addressable market5

Core commercial organization in place ready for product launches in 2H 2020

• Key sales, marketing, medical affairs, commercial operations leadership in place
• Sales representatives onboard late September
• Drug shortages and surgery backlog creating pent-up demand

1 Calculations based on available procedural data, applied Compound Annual Growth Rate and quantitative market research responses as follows: National Hospital Discharge Survey, 2006; National Survey of Ambulatory Surgery, 2006 (as revised in 2009); Source Healthcare; NCHS 2005; Life Science Strategy Group, LLC Market Research; Apfel et al.,2004. 2 Based on the calculations in (1) multiplied by the number of doses per patient at a selling price of $80 per 10mg dose. 3 Subject to scheduling by DEA

24 4 iData Research, US Market Report Procedure Numbers for Gastrointestinal Endoscopic Devices February 2019; American Society of Anesthesiologists, Practice Guidelines for Moderate Procedural Sedation and Analgesia 2018; and Quantitative Market Research prepared by The Link Group for Cosmo Technologies (March 2019). 5 Based on the calculation in (4) multiplied by the number of doses per patient at a selling price of $25-35 per dose.