One and Two Room Proton Therapy Solutions

1. One and Two Room Proton Therapy Solutions Addition to Current Radiation Facility Program Some features are under development and will be subject to review by competent authorities (FDA, Notified bodies, et al...)

2. Existing facilities are too large • Controversy reins within the radiation community on the best use of the particle • Once you announce you are interested everyone will come out of the woodwork to “pitch” protons • Often the information is wrongand self serving • Costs, proformas, business plans, and financing strategies are offered that are unrealistic • Often there is little to no experience involved with the group, even though they may say they have it. • There is no free lunch: • There is a better way • Protons are feasible • You need to lead with the clinical desire and focus • Match the financial and business terms as a result of the clinical needs and approach Proton Therapy Myths and Realities – What You Need To Know

3. Cost – Large expensive facilities require cash flows to repay the loans that are difficult achieve due to the large number of daily patients required to reach breakeven • Ownership and Control – Existing facilities often position the hospital and MDs as minority participants creating a program on campus that someone else controls • Reimbursement – Strong pressure on reimbursement for proton therapy and the use of the technology has implications for what you may treat and the resulting business plans. • Clinical Applications – Given the controversies how is the particle best used? Risk Factors - Learning From Experience

4. Build one or two room solutions under a cost structure and operational structure that can withstand reimbursement pressure • Match size to clinical demand and desires of the MD community and patient needs • Leverage experience and purchasing power • Be Smart, Understand and Include all costs, not just equipment and building as many will quote • Structure a financing solution that is low cost, long term, and does not demand unrealistic throughput assumptions • Above all own and control the project • Assure your clinical demands match your technology solution • Understand the various technology solutions to assure you are choosing wisely for your project The Solutions For A Viable Proton Facility

5. All In Project Costs Must Support Realistic Breakeven and Patient Throughput • Equipment • Building and Design • Financing Costs • Interest During Construction Period • Length of Time to First Patient (Most Important Driver of Cost) • Working Capital • Legal and Other Fees • PI, USA Can Provide Cost Effective Solutions That Can Tolerate Reimbursement Pressure: • Favorable Equipment Rates • Development Experience Multiple Centers • Less Expensive Financing Solutions • Reducing Time to First Patient • Full Turnkey Solutions For All Project Phases Proton International, USA Solutions – Cost

6. Maintain 100% ownership • Minimize capital invested (4M for One Room) • Structure in a financially efficient manner • Long Term Single Digit Debt • There is no need for an external partner Proton International, USA Solutions – Ownership and Control

7. Building One and Two Room Centers That Can Withstand Reimbursement Pressure • Minimize Cost • Establish Financing Strategies That Allow Reasonable Patient Numbers To Service the Debt • Stop The Madness – Focus On Reasonable Financial Returns For The Service. Why Are You Developing Protons? To Make Money Or To Have The Technology For Your Patients While Assuring Financial Viability? • Open A Center That Can Operate At Reduced PT Reimbursement • One Room Facilities That Can Work At Photon Rates!! Proton International, USA Solutions – Reimbursement

8. The Use Of Proton Therapy Should Be Driven Clinically Not Financially • Our Solutions Are Based On Effective Cost, Financing, and Equipment Strategies That Allow The Program To Focus On Clinical Applications Not “Filling” Rooms • Treat What You Want To Treat • Don’t Rely On One Diagnosis • Understand The Interplay Between Diagnosis, Fields, Throughput, Reimbursement and Project Viability. • There Are Viable Solutions That You Can Employ To Effectively Treat Your Patients In One and Two Room Facilities That Deliver Clinical Relevance With Financial Success Proton International, USA Solutions – Clinical Applications

9. Project Business Plan and Feasibility • Equipment Selection and Purchase • Financing Package • Long Term Debt • Single Digit Rates • Low Equity Requirements 4M For One Room • Building Design The Proton International, USA Turnkey Solution

10. Project Management of Key Elements • Experienced Team Assures On Time On Budget Project Based On Experience From 4 Projects All Completed Ahead of Schedule and Under Budget • Management of Construction • Management of Installation • Management of Commissioning and Physics Oversight • Complete Clinical Envelope • Clinical Treatment Protocols • Clinical Research and Registry Set Up • All Required Training • MDs • Physicists • Dosimetrists • Others As Needed The Proton International, USA Turnkey Solution

11. Operations Oversight • Guaranteed Equipment Uptime • On Site Trained Engineers and Operators • All Periodic Maintenance • Emergency Response • All Spare Parts • Emergency Response • Software and Hardware Upgrades • Throughput Management • Insurance and Reimbursement Support • Initial Contracting • Ongoing Support Proton International, USA Operations Services

12. Initial Meeting To Present Program And Financial Proforma and Sensitivity Analysis • Collection Of Data To Review Project Specific Plans • Financial evaluation and clinical review • Enhance model with hospital payer mix • Enhance model with clinical expectations of treatment mix • Enhance model with hospital expected staffing model • Enhance model with unique hospital assumptions • Follow Up Meeting • Presentation Of Proforma And Plans • Provide Term Sheet What Do We Do Next?