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  1. Presenter Disclosure Information William Hawkins Chairman and CEO, Medtronic Inc. FINANCIAL DISCLOSURE: Chairman and CEO, Medtronic Inc. UNLABELED/UNAPPROVED USES DISCLOSURE: N/A

  2. Collaboration, Innovation and Restoring the Public Trust Bill Hawkins Chairman and CEO, Medtronic November 16, 2009

  3. Medical technology has enabled remarkable advances in the treatment of chronic diseases 60% reduction! External pacemaker DEATHS PER 100,000 Implantable cardiac pacemaker Heart valves Insulin pumps Balloon angioplasty Transvenous leads Implantable defibrillator Perfusion systems Cardiac resynchronization MRI & advanced imaging CAT scan Coronary stents Beating heart surgery YEAR

  4. Collaboration is vital to the medical technology “innovation ecosystem” Clinical Community Regulators Policymakers Hospitals Academia Industry Advocacy Medical Associations

  5. Invention and New Ideas Clinical Insights Product Improvement Selection Criteria and Indications Clinical Trials and Regulatory Support Physician collaboration Implantation Techniques and Technologies Long-term Performance Assessment Training and Education Physician-industry collaboration plays a critical role

  6. Many of today’s most important medical devices are the result of collaborative innovation with physicians

  7. Different from pharmaceuticals “Bedside to bench to bedside” Therapies are sophisticated and procedure-based Expert training optimizes therapy effectiveness Demanded for patient safety This is particularly true in the areas of education and training and essential to the well-being of patients

  8. TUESDAY, MAY 19, 2009 Senator Asks About Doctor Who Army Says Falsified G.I. Study By Barry Meier and Duff Wilson TUESDAY, AUGUST 18, 2009 Probing Doctors’ Ties to Industry By Ibby Caputo JAN. 27, 2009 Lawmakers Reintroduce Bill on Industry-Physician Gifts April 29, 2009 Senator Chuck Grassley News Release Report decries drug makers’ perksfor MDs; Providers of care are urged to shun financial benefits By Matthew Perrone JAN. 22, 2009 Grassley works to disclose financial ties between drug companies and doctors Trust in this model has been eroded as a result of highly publicized conflicts of interest JUNE 21, 2009 Side Effects Are Doctors’ Loyalties Divided? Faculty disclose outside payments Some UW doctors get 6-figure sums from drug, medical firms By John Fauber

  9. Medtronic has always been a leader in this area • Aligned with our mission • Defines our culture and values • Cornerstone of our ethics and compliance program • Provides clear policies and guidance for business practices, including our customer interactions • Required for all employees worldwide • Early champion: AdvaMed Code of Ethics

  10. As an industry we have made progress… Edwards Lifesciences to Disclose Financial Relationships with U.S. Physicians Medtronic to Voluntarily Disclose Payments to U.S. Physicians Eli Lilly to Launch Physician Payment Database Physician Payment Sunshine: Merck Joins the Act …but we can and MUST do better

  11. An important first step towards transparency Key component of healthcare reform Levels the playing field Provides a uniform standard Proprietary information must be protected The Physician Payments Sunshine Act

  12. Our evolving approach will continue to reinforce the benefits of collaboration while restoring the public trust [ [ REINFORCE REINFORCE 12

  13. We will continue to lead consistent with a set of principles that will guide our path forward

  14. It’s not just about “Public” trust, it’s about THEIR trust Angelina Henderson U.S. Cardiac Resynchronization Therapy to treat congestive heart failure Chima Miyaori Japan Microdebrider to remove tonsils causing sleep apnea Renan Altendorff Brazil Insulin pump to control diabetes David Mangram U.S. Intrathecal Baclofen Therapy to treat symptoms of stroke Lina Tedesco Italy InterStim Therapy to treat voiding dysfunctions Irene Chettiar India Activa DBS Therapy to treat Dystonia