Acacia Pharma : Presentation of Results for the Year Ended 31 Dec 2020

Acacia Pharma Group plc

2020 Year End Results Presentation

March 29, 2021

Delivering innovative products to enhance surgical patients' recovery

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Acacia Pharma Group - a transformational year in 2020

BARHEMSYS® - FDA approved for PONV, launched late 2020

• • Broad label for prevention and treatment of Post-Operative Nausea and Vomiting (PONV)

• • Only agent approved for 'Rescue' of ~16m patients p.a. in US with PONV after generic antiemetics fail1

• • PONV "rescue" is an estimated $2.7 billion annual total addressable market2

Commercialization began in 2H 2020 and showing good progress

• • Strong sales, marketing, medical affairs, commercial operations teams in place

• • Sales team deployed against ~900 initial targeted hospital accounts since mid-October

• • Drug shortages and surgery backlog creating pent-up demand (heightened by Covid)

BYFAVO™ - In-licensed, FDA approved for procedural sedation, launched Jan 2021

• • Indicated for procedural sedation in adults - launch benefitting from shared value proposition

• • Key target: 40m procedures a year in US, including 25m GI procedures3

• • Estimated >$1.5 billion annual total addressable market4

Strong corporate progress

• • Balance sheet strengthened with debt and equity financings

• • Gary Gemignani appointed CFO

• • Named BEL Small Company of the Year for second consecutive year

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 WAC price of $85 per 10mg dose. 3 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). 4 Based on the calculation in (4) multiplied by the number of doses per patient at a WAC price of $39 per dose.

We have been able to make significant progress in a very challenging operational environment caused by the global pandemic

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

• • Non-essential surgeries cancelled creating a significant backlog

• • Physical access to hospital decision-makers even more restricted

• • Surgeries and procedures are major contributors to hospital profits

• • Providers need to dramatically increase throughput to regain lost profits

• • BARHEMSYS and BYFAVO can help improve patient throughput - both are now even more relevant and of greater interest to customers due to COVID

• • Our strong relationships are helping us gain access to key decision-makers

1 How to rebuild surgical revenue after COVID-19,Becker's Hospital Review, accessed viahttps://www.beckershospitalreview.com/strategy/how-to-rebuild-surgical-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 is the only FDA-approved drug 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

• • Estimated ~65m eligible surgeries annually, ~49m patients receive preventative antiemetics4

• • Estimated ~16m patients still develop PONV and need rescue treatment3

• • Total addressable PONV rescue market estimated at ~$2.7 billion/year4

• • Estimated 80% of surgeries carried out in ~1,200 hospitals5

• • 30 sales territories address accounts with greatest immediate opportunity

• • Sales team began customer engagement in mid-October

• • Cost of goods ~10% of sale price

• • Substantial product inventory to minimize supply risk

• • Worldwide rights and exploring out-licensing opportunities in OUS markets

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 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 WAC price of $85 per 10mg rescue dose with, on average, 2 rescue doses per patient, and the above estimates. 5 Symphony Health, Source Non Retail, August 2017 - July 2018.

Total estimated addressable market in PONV rescue  $2.7B per year

Secondary market in combination prophylaxis in highest-risk patients, estimated to be worth $765M 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. Calculations based on available procedural data, applied Compound Annual Growth Rate and quantitative market research responses. 2 Based on WAC price of $85 per 10 mg rescue dose and average 2 rescue doses per patient; $42.50 per 5 mg prophylaxis dose.

BARHEMSYS® is the Only FDA-Approved Product for PONV Rescue

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%

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-minute reduction in PACU stay

• • 6-hour reduction in hospital stay

• • Offers significant economic savings to hospital vs current standard of care

Convenient, easy to use, high margin product

• • 5-year room 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 (recovery room) allows increased surgical throughput

• • Better efficacy and safety means better recovery and patient experience

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.

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

Field Force Design

• • 1 SVP of Field Commercial Teams

• • 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

BARHEMSYS - Robust Commercial Engagement Creating Traction

• • Robust WorseThanPain/ Disease state campaign highlighting unmet need in PONV (worsethanpain.com)

• • Medical congress engagements: ~ 400 symposia attendees and 550 leads generated

• • Peer-to-peer programs: 60+ programs with ~450 attendees (live, virtual and on demand) since launch

• • All promotional materials available both physically and digitally to meet customers needs

• • Digital brand engagements in the most trusted anesthesia publications with 89% readership (51K members)

Anaesthesia

PharmacyKey Surgeons

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

• • Surgery backlogs are major issues for US hospitals

• • Value of BARHEMSYS and BYFAVO in improving throughput facilitates our access to key decision-makers

Demonstrate unmet need, appropriate use & health economic benefit

• • Highlight current unmet needs with existing products

• • Educate on efficacy and safety data for our products

• • BARHEMSYS and BYFAVO can provide economic savings to hospital vs current standard of care

Formulary adoption and pull-through

• • P&T Committee approval typically takes 9-12 months on average

• • Protocols, standing orders and point-of-care supplies drive sales pull-through

Reviews assessment and votes to revise formulary

Pharmacy & Therapeutics Committee

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

120 accounts on formulary >85% win rate

141 additional accounts have scheduled a date for formulary review

>70 accounts have already ordered the product

38% of ordering accounts have placed repeat orders

BYFAVO™

(remimazolam) for injection

Rapid onset/offset procedural sedative with favorable safety profile

Total addressable market in procedural sedation >$1.5B/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

15 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 WAC price of $39 per dose.

• • Rapid onset and offset anesthetic with narrow therapeutic index1

• • Dose-related cardiorespiratory depression, pain at injection site1

• • Non-linear dosing effects due to individual variability4

• • Needs continuous monitoring by anesthesiologist, no reversal agent2

• • Lipid formulation susceptible to bacterial contamination4

Propofol

fast acting but significant safety issues1,2

• • 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

Midazolam

better safety profile but longer onset and recovery1,2

• • 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

BYFAVO

fast acting AND favorable safety profile1,2

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.

BYFAVO™ - Compelling Clinical and Commercial 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

BYFAVO - Launching the First New Sedative in the US for 20 years

• • On demand promotional programming available, featuring anesthesia, GI, and pulmonary investigators

• • Full congress plan across Anesthesia, Pharmacy, and including key GI and Pulm congresses

• • All promotional materials available in both digital and physical format

• • Non-personal promotional efforts, including direct mail are being initiated

- Direct email, banner ads, paid search and expanded web site

7 accounts on	36 additional	8 accounts have	38% of ordering
formulary in eight	accounts have	already ordered	accounts have
weeks of launch	scheduled a date	the product	placed repeat
for formulary	orders
review

Financials

2020 Operating Results

Loss after tax for the year ended 31 December 2020 of $33.5m (2019: $22.8m)

• • The operating loss increased by $8.5m to $30.9m (2019: $22.4m), reflecting the investment in our US commercial infrastructure and product launch preparations

• • R&D expenses $0.1m (2019: $3.9m) with the reduction reflecting lower R&D activities on completion of BARHEMSYS clinical program, together with a $1.4m credit on reversing certain inventory provisions on the approval of BARHEMSYS

• • Sales and marketing expenses $19.4m (2019: $14.0m) reflecting increased activities leading up to the planned launch of BARHEMSYS and BYFAVO

• • General and administrative expenses $11.6m (2019: $4.4m) with 2020 costs higher as a result of fundraising activities, personnel costs and amortisation of intangibles

2020 2019
$millions	Research and development expenses	Sales and marketing expenses	General and administrative expenses	Total	Research and development expenses	Sales and marketing expenses	General and administrative expenses	Total
OPEX As reported	$ (0.1)	$ (19.4)	$ (11.6)	$ (31.1)	$ (3.9)	$ (14.0)	$ (4.4)	$ (22.4)
Inventory provision reversal	(1.4)	-	-	(1.4)	1.4	-	-	1.4
Share based compensation	0.0	1.3	1.4	2.7	0.1	1.6	0.7	2.4
Amortization*	-	-	3.1	3.1	-	-	-	-
Adjusted OPEX	$ (1.5)	$ (18.1)	$ (7.1)	$ (26.7)	$ (2.4)	$ (12.4)	$ (3.7)	$ (18.6)
Operating Loss as Reported	$(30.9)	$(22.4)
Adjusted Operating Loss	$(26.5)	$(18.6)

1.4

* Relates to amortization of BYFAVO intangible asset

Strengthened Financial Position

Cash Runway Extended Through Q2 2022

• • Cash and cash equivalents as of 31 December 2020 of $46.7m (2019: $17.0m)

  • - €20m (~$22m) equity investment from Cosmo as part of BYFAVO license agreement

  • - €25m (~$31m) loan from Cosmo related to BYFAVO approval

  • - €25m (~$29m) equity financing in August 2020

• • Additional equity financing in February 2021 with gross proceeds of €27m (~$33m)

Summary

•	Our products address unmet medical needs in therapeutic areas with large total addressable market opportunities (~$2.7B in PONV rescue, >$1.5B in procedural sedation)

•	The team made tremendous progress in 2020 despite a very challenging operating environment due to the global pandemic

•	We have seen a great response from customers in the early stages of launch adding our products to formulary with positive customer feedback on both products so far

•	While the environment remains very dynamic, we believe we should be able to benefit from a relaxation of restrictions and a rebound in procedural volumes in the second half of this year

•	We believe we have the right team, with the right experience to continue to drive the successful commercial launch for both products this year

Q&A