The Project Team

1. Particle Therapy Investment The Project Team • ACCEL / VARIAN • Ion Boston (Holding exclusivity in Germany in regards to) • Massachusetts General Hospital, academic training hospital of Harvard University • Johnson Controls • State Government of NRW • Operating Company under Harvard Leadership • additionally consisting of the universities in Cologne, Bonn and Aachen. • Particle Therapy Investments, currently being used as • Development Company and initiated to the project, so far investing into the work.

2. Particle Therapy Investment The Links to NRW Government Dr. Kals is working with the public private partnership taskforce of the Ministry of Finance as external expert and is advising Government within this field as well as within the field of international know-how transfer and investments with international partners. In close cooperation with Dr. Frank Littwin, president of the taskforce and Ministerialrätin Angelika Weihnacht, chief of new organization structures within the Ministry of Finance, a close coordination structure has been developed. The concept reflects also the interests of the Ministry of Innovation (formerly Ministry of Science). Angelika Weihnacht, Frank Littwin, and Dr. Kals have been jointly working on this project since roughly two years meanwhile. Dr. Christian Schmidt, project coordinator for the Particle Therapy Center in Kiel, Schleswig-Holstein, is consulting the group momentarily. Dr. Schmidt is clinical director at Mühlenkreis Kliniken in the northern part of NRW. Dr. Schmidt’s knowledge is highly respected with State Government in NRW because of his experience with the very similar project up in the north of Germany.

3. Particle Therapy Investment Technology Background I Photons (=x-rays) are electromagnetic waves, which are alleviated through matter Protons are particles with limited range

4. Particle Therapy Investment Technology Background II

5. Dose % Particle Therapy Investment Technology Background III Conventional Carbon Courtesy of Prof. Debus, University Clinic of Heidelberg

6. Particle Therapy Investment Technology – Gantry I

7. Particle Therapy Investment Technology – Gantry II

8. Particle Therapy Investment Technology – Fixed beam

9. Particle Therapy Investment Procurement rules and USP I It is either a unique selling point or alternatively private financing.  Ion Boston, using MGH and Harvard knowledge, refers to the uniqueness of the Harvard operation in Boston.  MGH as training hospital of Harvard University is the only university worldwide that owns and operates a PTC.  Harvard can also provide practical experience in this fields and presents a highly attractive cooperation party for the fields education and research, both being duties by constitution of State Governments in Germany. 

10. Particle Therapy Investment Procurement rules and USP II Establishing such a facility consequently means that, if you want to have financial participations by State Government, you are to give Government authorities, in this regard clinics, the chance to use this facility to fulfill their constitutional duties.  The other fact to avoid procurement is that we are looking at a privately structured and financed project, having State Government as a user in it for constitutional duties.  The structure demonstrated, is developed and presented in a way, that we fulfill both points to avoid procurement.  If procurement will be done, it will be by the investment company within the fields of technical vendors, contractors or subcontractors for these parties.

11. Particle Therapy Investment The Links to NRW Government I • Dr. Kals has been working for the Government already for a few years and • Dr. Kals has been working for the European Union for five years and understands the techniques to get European Union structures involved into various projects. 

12. Particle Therapy Investment • Dr. Schmidt, with his experience in public service and coordination officer between Kiel University and Schleswig- Holstein Government, do not only have the advantage of practical experience but also the contacts for many years.  • Government at any time has been involved into the development of the structures of our project.  In so far the public authorities in Düsseldorf had a chance to verify the legal integrity of the proposed structure The Links to NRW Government II

13. Particle Therapy Investment • our proposal is the only solution to State Government to get second PTC in NRW. • This project is extremely important for State Government, because it shall also include a heavy ion sector. • you cannot have any additional income by heavy ion technology • the decision of State Government to have heavy ions implemented in NRW II was a clear decision for research and education.  The Links to NRW Government III

14. Particle Therapy Investment • both are constitutional duties of State Government, so to fulfill their constitutional duties, Government is willing to pay for 25 years into NRW II a yearly amount to cover the investment, teaching and finally research.  • Our willingness to cooperate with the government allows them to accomplish their academic and political targets.  • Minister, science and finance, are aware of our development and highly welcome our activities.  The Links to NRW Government IV

15. Particle Therapy Investment • our proposal is the only solution to State Government to get second PTC in NRW. • This project is extremely important for State Government, because it shall also include a heavy ion sector.  • you cannot have any additional income by heavy ion technology • the decision of State Government to have heavy ions implemented in NRW II was a clear decision for research and education.  • both are constitutional duties of State Government, so to fulfill their constitutional duties, Government is willing to pay for 25 years into NRW II a yearly amount to cover the investment, teaching and finally research.  • Our willingness to cooperate with the government allows them to accomplish their academic and political targets.  • Minister, science and finance, are aware of our development and highly welcome our activities.  The Links to NRW Government III

16. Equity MGH / PTC Rental contract 30yrs Loan ION Boston PT – Know-How PTC NRW II GmbH PTI GmbH € Funding Guarantees EU Dr.Schmidt +Team procurement consulting 3yrs Rent Credit during construction „FM Company“ Planning/ Design/ Construction 30 years hard services FM-Soft-Services Contract 30 years Accel Cyclotron Owners Representative JCI Management JCI Particle Therapy Investment Project structure and major contracts Consulting

17. Particle Therapy Investment Sources of revenue – potential in Germany UK S-H Kiel In use: GSI Darmstadt Hahn-Meitner-Institut Berlin (closes in 2006) Under construction: RTPC München (Rinecker Protonen Center/ProHealth AG) WPE Essen Universität Heidelberg Planned: UK S-H Kiel (advanced) Universität Leipzig (advanced) Universität Mannheim (Vision) Hahn-Meitner-Institut Berlin Berlin-Charité WPE Essen Leipzigg Aachen Bonn Darmstadt Mannheim Heidelberg RTPC München

18. Particle Therapy Investment Sources of revenue – catchment area Basis: Indications by DEGRO and Incidences in catchment area (50% of all potential cases – very conservative approach)

19. Particle Therapy Investment Sources of revenue – competition Competitors will be able to recruit out of a catchment area of more than 14 Mio. Patients !

20. Particle Therapy Investment Sources of revenue – Income • Donation of NRW 6.5 m€ per Year for 25 yrs indexed • Average 20.670 € per patient • 2160 patients per Year  • 44,6 m€ income due to normal treatments • Boost treatments are not calculated

21. Particle Therapy Investment Costs Proton Facility 56.170.000 Heavy Ion Facility 65.000.000 Building 50.000.000 Total 171.170.000 Maintenance and Operation per year 8.680.000 Personnel (depends on business model) 3.900.000 Others (Land leasehold, Marketing,Training 2.100.000 NOT included medical staff, energy and other media

22. Particle Therapy Investment Timeline

23. Particle Therapy Investment Finance required • Amount required • Equity contributions • Overview of suggested sale / leasebacvk

24. Particle Therapy Investment Comparison Kiel I

25. Particle Therapy Investment Comparison Kiel II Cooperations with: Odensee DK Aarhus DK Oslo N Kaunas Lt Capio S Hannover D Rostock D Greifswald D

26. Particle Therapy Investment Comparison Kiel III

27. Particle Therapy Investment Comparison Kiel IV