North American Neuromodulation Society

Investor Update
January 12, 2018

Maulik Nanavaty
Senior Vice President and President, Neuromodulation
Jim Cassidy
Vice President and Franchise Lead, Pain Management
Milad Girgis
Vice President and Franchise Lead, Deep Brain Stimulation
1
 Safe Harbor for Forward-Looking Statements
and Regulatory Disclaimers

This presentation contains forward-looking statements within the meaning of Section 27A of the
Securities Act of 1933 and Section 21E of the Securities Exchange Act of 1934. Forward-looking
statements may be identified by words like “anticipate,” “expect,” “project,” “believe,” “plan,”
“estimate,” “intend” and similar words. These forward-looking statements are based on our beliefs,
assumptions and estimates using information available to us at the time and are not intended to be
guarantees of future events or performance. If our underlying assumptions turn out to be incorrect, or
if certain risks or uncertainties materialize, actual results could differ materially from the expectations
and projections expressed or implied by our forward-looking statements.

Factors that may cause such differences can be found in our most recent Form 10-K and Forms 10-Q
filed or to be filed with the Securities and Exchange Commission under the headings “Risk Factors”
and “Safe Harbor for Forward-Looking Statements.” Accordingly, you are cautioned not to place
undue reliance on any of our forward-looking statements. We disclaim any intention or obligation to
publicly update or revise any forward-looking statements to reflect any change in our expectations
or in events, conditions, or circumstances on which they may be based, or that may affect the
likelihood that actual results will differ from those contained in the forward-looking statements.

Market Estimates:
Unless noted otherwise, all references to market sizes, market share positions, and market growth
rates are BSX internal estimates.
Regulatory Disclaimers:
Vercise™ PC Deep Brain Stimulation System/Vercise™ Directional System - CE Marked. US:
“Caution: Investigational Device. Limited by Federal (or US) law to investigational use only. Not
available for sale.”
Vercise Gevia™ Deep Brain Stimulation System - CE Marked. Not available for use or sale in the U.S.
2 2
Next Gen DBS System: Device under development. Not for sale or use worldwide.
Positioned for Leadership
in Two Fast-Growth Markets

Overview BSX Growth Drivers

Market • Spectra Wavewriter ™ SCS System

Size ~$2.5B
First & only system FDA approved to simultaneously
(2017E)
provide paresthesia and sub-perception therapy
• Comprehensive SCS Platform with Illumina 3D™
Market
Personalized therapy with neural targeting algorithm
Growth +14%
across broad IPG* and lead portfolio
(2017E)
• Cosman RF Ablation
Early stage treatment options for pain patients
2017-2020
est. Market +10%-15% • Vercise™ Deep Brain Stimulation Platform
CAGR First & only MICC*-based directional system
• International expansion
Preliminary
Under-penetrated market opportunity in both pain and
BSX 20171 +14% brain
Revenue
Growth
3 3*IPG: Implantable Pulse Generator; MICC: Multiple Independent Current Control
Pain: Expanding a Winning Pain Portfolio and
Leading with Rigorous Clinical Research

Spectra™ SCS Infinion CX™

Illumina 3D™ Systems Multiwave™ Cosman

Options for Patients Broadest Coverage of Personalized Therapy

Precision with Neural (32 contacts, MRI RF Ablation:
compatibility2, Non- the Spine for Multi Through Multiple
Targeting Algorithm Denervation
Rechargeable) Therapy Targeting Waveform Options

15+ ongoing clinical research studies & RCTs3 to help prove personalized therapy is the future of pain relief:

• PROCO4 (Q2:17): Double-blind crossover RCT to evaluate the role of frequency on SCS patient outcomes
• WHISPER5 (Q1:18): Crossover RCT to evaluate the safety and effectiveness at sub-perception amplitudes
• ACCELERATE6 (H2:18): Crossover RCT to evaluate the safety and effectiveness at high-rate SCS
• VERITAS7 (2019): Prospective, multicenter study to evaluate the effectiveness of multiple modalities with
Spectra WaveWriter

Strong
4 cadence of technology with 2 new platforms expected to launch over next 24 months
Challenges and Opportunities in SCS

Longevity of Therapy Variation in Response

Opportunity to improve therapy

longevity
• 3 - 6% annual explant rate due to
inadequate pain relief8
Multiple recent studies (PROCO4,
SUNBURST9) show patients respond
variably to different therapies –

Recently launched modalities • Non-responders to one modality

may be responders to another
haven’t resolved loss of therapy
modality
issue
• 10 kHz: 5% annual explant rate due
to inadequate pain relief8
• Burst: 5% of patients with diminished
or loss of symptom relief after 24
weeks9
Expect multiple mechanisms of
• DRG*: 9% of patients experience loss 11
of stimulation after one year10 action involved

5 *DRG: Dorsal Root Ganglion

Spectra WaveWriter™ SCS System:
Multiple Therapies. One Device.

Spectra WaveWriter System Early Clinical Data – NANS 2018

Q1:18 US Launch Multi-site observational outcomes collection12

Change in Overall Pain Scores

(NRS*) at Last Follow-up
10

NRS Score (0-10)

8
D = 6.0 (p < 0.0001)
6

4 7.7
Maximize Responders:
2
• First system approved to simultaneously 2.0 1.7
provide paresthesia and sub-perception 0
therapies Baseline End of Trial Last F/u Visit
(N=79) (N=69) (n=79)
Simplify Personalization:
∆ 6.0 reduction in NRS
• Real-time patient rating and data on
~30 Day Follow Up
waveform usage

The Power of Combination Therapy with Significant Pain Reduction

the Simplicity of Waveform Automation in Early Follow-Up
6
*Numeric Rating Scale
Spectra WaveWriter™ SCS System:
Multiple Therapies. One Device.

New Sub-perception Algorithms

Combination Therapy
+ Waveform Automation

+
Designed for deeper, lasting relief by layering Designed to easily find and keep the optimal
waveforms simultaneously or sequentially target with a personalized stimulation field

Paresthesia Sub-perception
T10T10

T9 T9

T8 T8

T7 T7

T10T10

T9 T9

T10T10

T8 T8

T9 T9

T7 T7

T8 T8
Responders Responders
Infinion Infinion Infinion
Infinion Infinion Infinion
Infinion Infinion Infinion
Infinion Infinion Infinion

WaveWriter vs Competition
Multiple Therapies Infinon CX (16 contacts) 8-contact leads +
~15% responder + Contour Conventional Bi-Pole
increase13
Multiple Vertebral Level Limited Coverage
Coverage

7
WHISPER & PROCO: Foundational Studies
for Spectra WaveWriter™

PROCO RCT4 WHISPER RCT5

(de novo patients) (previously implanted patients,
average ~4 years on therapy)

Key Takeaways Key Takeaways

• Similar pain relief across 1, 4, 7 & 10 kHz
• 1/3 charge burden with 1kHz
• Neural dosing algorithms are critical
• <1.2 kHz delivered significant, long term,
sub-perception pain relief in a real world
population
• Multiple therapies provide superior
outcomes when patients are able to
choose most effective therapy

Spectra WaveWriter™

Next gen sub-perception technologies

• Contour™Algorithm
• Therapy Rater and Waveform Automation
Impactful clinical outcomes
• Exciting new data at NANS: WaveWriter
Observational Outcomes
8 • VERITAS Study (2019E)
 WHISPER RCT5: Multiple Therapies Provide
Superior Outcomes

Challenging Patient Positive Outcomes in Superior Outcomes with

Population Paresthesia Responders Waveform Options
Study n=20 n=70
WHISPER SENZA 8 50% 47%
Aspects 7.2 62% increase
45%
Previously 7
implanted De-novo 39%
40%
Patients 6
Precision patients NRS Score (0-10) 35%
patients 5 29%

Responder Rate
Mean 30%
duration of 4 +/- 1.9 yrs. 0 yrs. 4
25%
implant 3 2.5 20%
Duration of
18.3 yrs. 13 yrs. 2
chronic pain 15%
Disability per
1 10%
Oswestry 69.4 54
Disability (Crippling) (Severe) 0 5%

Index Baseline Best Option 0%

Yes No (sub or supra) Supra-perception Sub-perception Best option
only only (supra or sub)
CRPS (19%) (0%)
• Subgroup : ≥50%
• WHISPER results improvement with supra- • Met primary endpoint
showed clinical value perception during • Superiority demonstrated
of SCS in challenging, crossover phase • 62% increase in responder rate
long-term, implanted • Outcomes consistent with when patients are able to
choose between multiple
patients de novo PROCO RCT
waveform options
patients
9 9
 Our History in Neuromodulation:
A Different Path to Deep Brain Stimulation

Advanced Bionics A heritage in cochlear vs pacemaker

2004 technology, acquired by
•Utilization of multi-channel stimulation
Boston Scientific in 2004
•Precise control
SCS Precision Plus (WW)
1st and only MICC ,
1st Rechargeable Platform Applying cochlear technology to
neurological disorders
•Focus on stimulation modality
SCS Spectra Platform (WW) • Multiple Independent Current Control
1st 32 Channel •Focus on patient centric technology
Rechargeable Platform
2012 • Wireless
DBS Vercise
RC System (EU)
• Rechargeable
1st DBS system with 16 • Ease-of-use
independent sources of • Size
current
• Precision

1010
 Path to Leadership in Brain Modulation:
Differentiated Technology, Strong Clinical Evidence

Next Generation
System
Vercise™ - U.S. launch with Vercise™ PC – First Directional System with Therapy
first and only MICC powered, integrated Clinical Effects Map Expansion
rechargeable system, 8 level
Vercise™ Gevia™ – First MRI conditional MRI and
leads, and 5 years of proven personalized
Rechargeable Directional System
therapy in Europe visualization

U.S. expected
launch timeline 2018 2019 2020+

Anticipate 18+3 ongoing clinical research studies will drive Brain Modulation to be a meaningful contributor:

• INTREPID14 (Q4:17) : First & only prospective, double-blind, sham-controlled, multi-center RCT;
evaluating Vercise™ DBS system for U.S. entry
• DBS Directional15 (2019): Evaluating therapeutic advantages of Cartesia™ Directional Lead with
Vercise™ PC DBS System
• DBS Registry16 (on-going): Comprehensive registry of real world outcomes to establish improvement
in quality of life
• Investments in indication expansion studies: Stroke rehabilitation, Alzheimer’s disease, depression,
others
1111
Revolutionizing Brain Modulation Therapy

Vercise™ DBS Systems Brainlab Visualization Smart Programming

Precision Control of Advanced Surgical Personalizes Programming

Captures Outcomes
Directionality with MICC Planning for Patients

BSX best-in-class system solution to meet market needs:

• High-growth, underpenetrated market
• ~$600M worldwide opportunity shifting away from a single player market
• BSX entering U.S. with compelling new technology
• System capabilities with potential to treat other neurological disorders

12
Boston Scientific NANS 2018
RCTs
WHISPER: A Multicenter, Prospective
Randomized Controlled Trial
Evaluating Sub-perception SCS at ≤
1.2 kHz
Friday, January 12
7:35AM - 7:45AM
Forum Ballroom 14, 15, and 16
James North, MD
Effects of Rate on Analgesia in
Kilohertz Spinal Cord Stimulation:
Final Results of the PROCO RCT
Saturday, January 13
3:45PM - 3:55PM
Octavius Ballroom 7, 8, and 9
Simon Thomson, MBBS FRCA FIPP
FFPMRCA
13
Basic Science and Mechanism Of Action
No Effects of High-Rate (Multi-kHz) Dependence of c-Fos Expression on
Electric Fields on Brain Slice on Amplitude of High-Frequency Spinal
Excitability Cord Stimulation
Friday, January 12 in an Animal Model
7:15AM - 7:25AM Friday, January 12
Octavius Ballroom 5 and 6 4:45PM - 4:55PM
Marom Bikson, PhD Octavius Ballroom 7, 8, and 9
Robert Foreman, PhD
Artifactual Hyperpolarization During A Computational Study of Dorsal
Extracellular Electrical Stimulation: Column Versus Dorsal Horn Modulation
Proposed Mechanism of High-Rate Using Higher Rate (≥250 Hz) Spinal Cord
Neuromodulation Disproved Stimulation
Friday, January 12 Saturday, January 13
7:25AM - 7:35AM 7:25AM - 7:35AM
Octavius Ballroom 5 and 6 Forum Ballroom 14, 15, and 16
Steven A. Prescott, MD PhD Tianhe Zhang, PhD
DBS
DBS Registry: Outcomes and Safety DBS Registry: Outcomes and Safety
E-Poster using the Directional Lead
Deuschl, Vesper E-Poster
Deuschl, Vesper
 Neuromodulation: Strong Growth Driven by
Leading Innovation

• Exciting, large, underpenetrated and high-growth markets: SCS and DBS

• Strong start to 2018 with significant new FDA product approvals

– Spectra WaveWriter™ SCS System
– WHISPER RCT sub-perception labeling
– Vercise™ DBS System

• Pain: Defining the future of SCS through personalized therapy

– Broadest portfolio: neural targeting algorithms &waveforms, MRI, primary cell, 32 contacts, RF
– Commitment to rigorous clinical and pre-clinical research: LUMINA17, PROCO4 , WHISPER5,
ACCELERATE6
– Significant international expansion momentum and opportunity

• Brain: Poised for share gains with the most innovative platforms and U.S. market entry
– INTREPID14, VANTAGE18, CUSTOM19 data
– Differentiated directional system supported by extensive clinical data
– Integrated offering: Directional System, visualization, MRI, Brainlab partnership

• Convergence of technology and clinical insights unlocking new treatments for

neurological disorders (stroke rehabilitation, Alzheimer’s disease, depression and others)

14
 References

1) Neuromodulation reported revenue growth based on preliminary, unaudited sales results issued January 9,
2018. Results are preliminary and subject to completion of year end financial reporting processes, reviews and
audit.
2) 1.5 Tesla MRI conditional when all conditions of use are met
3) Includes company and investigator-sponsored research studies
4) Effects of Rate on Analgesia in Kilohertz Frequency Spinal Cord Stimulation: Results of the PROCO Randomized
Controlled Trial. Simon J. Thomson, MBBS, et al. Neuromodulation, November 2017
5) North, J., et. al. WHISPER: A Multicenter, Prospective Randomized Controlled Trial Evaluating Sub-perception
SCS at ≤ 1.2 kHz. NANS 2018, Las Vegas
6) Safety and Effectiveness Study of the Precision SCS System Adapted for High-Rate Spinal Cord Stimulation
(ACCELERATE) NCT02093793
7) Value of Multiple Modalities Using the Spectra WaveWriter Spinal Cord Stimulator System (VERITAS)
NCT03251937
8) Therapy-Related Explants After Spinal Cord Stimulation: Results of an International Retrospective Chart Review
Study. Dr. Jean-Pierre Van Buyten, MD; et al Neuromodulation, October 2017
9) Proclaim™ Implantable Pulse Generator CLINICIANS MANUAL, 2016-04 ARTEN100125494B
10) PREDICT: A prospective post-market trial to evaluate DRG stimulation for the management of chronic
intractable pain. S. Eldabe,, MD; et al. INS 2017
11) Rauck, R. PET Study. NANS 2015, Las Vegas
12)Metzger, C., et. al. Outcomes Using an SCS Device Capable of Delivering Combination Therapy (Simultaneous
or Sequential) and advanced waveforms/field shapes. NANS 2018, Las Vegas
13)Thomson et al., PROCO RCT, INS 2017

1515
 References

14) Deep Brain Stimulation (DBS) for the Treatment of Parkinson's Disease (INTREPID) NCT01839396
15) Directional Data:
• Steigerwald et al. “Directional deep brain stimulation of the subthalamic nucleus: a pilot study using a
novel neurostimulation device.” Movement Disorders. 2016;

• Reker et al, “Directional deep brain stimulation: A case of avoiding dysarthria with bipolar directional
current steering: Parkinsonism and Related Disorders 2016 Aug

• “Scientists Test Next Generation Deep Brain Stimulation Leads to Improve Targeting the Subthalamic
Nucleus with Fewer Adverse Effects” NEUROLOGY TODAY | Jul 2016
16) Registry of Deep Brain Stimulation With the VERCISE™ System: Vercise DBS Registry NCT02071134
17) Veizi et al, “SCS with Anatomically Guided (3D) Neural Targeting Shows Superior Chronic Axial Low Back Pain
Relief Compared to Traditional SCS.” Pain Medicine Jan 2017.
18) Vantage:
• 1 Year: Timmermann et al., Multiple-source current steering in subthalamic nucleus deep brain
stimulation for Parkinson’s disease (the VANTAGE study): a non-randomised, prospective, multicentre,
open-label study Lancet Neurology 2015; 14: 693–701

• 3 Years: Timmerman et al, “Three-Year Outcomes of a Prospective, Multi-center Trial Evaluating Deep
Brain Stimulation With a New Multiple-Source, Constant-Current Rechargeable System in Parkinson
Disease.” Neurosurgery. Aug 2016.
19) CUSTOM-DBS: Volkmann et al., Presented at 2014 Annual Meeting of the International Parkinson and
Movement Disorders Society, June 2014

1616