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Executive Chairman Dr. John Climax President Corporate Development Bill Taaffe CEO Peter Gray Chief Financial Officer Ciaran Murray ICON Development Solutions.

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Presentation on theme: "Executive Chairman Dr. John Climax President Corporate Development Bill Taaffe CEO Peter Gray Chief Financial Officer Ciaran Murray ICON Development Solutions."— Presentation transcript:

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2 Executive Chairman Dr. John Climax President Corporate Development Bill Taaffe CEO Peter Gray Chief Financial Officer Ciaran Murray ICON Development Solutions President Dr Thomas Frey ICON Medical Imaging Chief Executive Dr Ted Gastineau ICON Central Laboratories President Bob Scott-Edwards VP Corporate QA Jo Coyle VP Global IT Mike McGrath VP Corporate Training & Development Anne Wesler VP Strategic HR Eimear Kenny VP Market Development Simon Holmes ICON Clinical Research Global President Dr John Hubbard Commercial VP Brian O’Dwyer COO US Malcolm Burgess Snr VP Global BD Elizabeth Thiele Snr VP Global Medical Suzanne Gagnon VP Global Data Management Tom O’Leary ICON Contracting Solutions President Sean Leech

3 Executive Chairman Dr. John Climax President Corporate Development Bill Taaffe CEO Peter Gray Chief Financial Officer Ciaran Murray ICON Development Solutions President Dr Thomas Frey ICON Medical Imaging Chief Executive Dr Ted Gastineau ICON Central Laboratories President Bob Scott-Edwards VP Corporate QA Jo Coyle VP Global IT Mike McGrath VP Corporate Training & Development Anne Wesler VP Strategic HR Eimear Kenny VP Market Development Simon Holmes ICON Clinical Research Global President Dr John Hubbard Commercial VP Brian O’Dwyer COO US Malcolm Burgess Snr VP Global BD Elizabeth Thiele Snr VP Global Medical Suzanne Gagnon VP Global Data Management Tom O’Leary ICON Contracting Solutions President Sean Leech

4 Certain statements contained herein including, without limitation, statements containing the words “believes,” “anticipates,” “intends,” “expects” and words of similar import, constitute forward-looking statements concerning the Company's operations, performance, financial condition and prospects. Because such statements involve known and unknown risks and uncertainties, actual results may differ materially from those expressed or implied by such forward-looking statements. Given these uncertainties, prospective investors are cautioned not to place undue reliance on such forward-looking statements. The Company undertakes no obligation to publicly update or revise any forward-looking statements, whether as a result of new information, future events or otherwise. Forward Looking Statements

5 Global Full Service Clinical Development US 53% EU 38% ROW 9% Q4 Revenue by Region Global Clinical

6 North America 2 Countries 17 Offices >1,900 Staff Western Europe / Africa 10 Countries 13 Offices >1,600 Staff Asia Pacific 8 Countries 10 Offices >450 Staff Latin America 5 Countries 5 Offices >170 Staff Projects in 60+ Countries Eastern Europe / Russia 8 Countries 9 Offices > 350 Staff Japan 1 Country 2 Offices >80 Staff ICON’s Global Clinical Footprint

7 Market Environment

8 Continued R&D Spending Growth. –Phase II / III pipelines strengthening Increased Outsourcing –Being accelerated by activity & funding in Biotech / Speciality –Globalisation of clinical research –New strategic thinking / cost containment Increasing Regulation –More patients/ more studies –Post marketing surveillance 5 Strong Market Environment with...

9 Source: Pharmaprojects Up ≈ 23% The Pipeline continued to fill in 2007 Preclinical Compounds in Development

10 Source: Pharmaprojects Up ≈ 22% Phase I Compounds in Development The Pipeline continued to fill in 2007

11 Source: Pharmaprojects The Pipeline continued to fill in 2007 Up ≈ 14% Phase II/III Compounds in Development

12 $Billion Biotech fundraising (excluding debt financing) Source: Burrill and Company US Biotech Funding Environment continued to grow

13 ICON in this Market Environment

14 14 RFP Value by Market Segment 2007 Value  54% Increase / PY Size of Projects  41 > 20 Million  168 > 5 Million  959 < 5 Million Gross RFP Value by Market Segment (Including RFPs that never progress to award)

15 Strong RFP volume growth, with increasing average proposal value…

16 …which has led to increasing numbers of awards greater then $5 million.

17 ICON Gross Business Wins - Last 10 Quarters ($ millions) Overall, Strong Gross Business wins has led to…

18 Net Business WinsBook to Bill Ratio.. excellent Net New Business wins and very strong book to bill ratios…

19 Up 38% YoY Up 49% YoY …leading to record Total Backlog levels. ($ millions)

20 Value of backlog forecast to be earned in next 4 quarters % coverage of next 4 quarters forecast revenues From this backlog, coverage of next 4 quarters revenues is robust……..

21 Client Diversity 2005, 2006, New Business by Customer Segment This has led to a diversified customer base……

22 ….and broad therapeutic expertise. Revenue by Therapeutic Area 2007

23 Strategy

24 ICON’s Core Strategy is Organic Growth, with acquisitions made to add new services or scale. Capitalise on market fundamentals to drive organic growth in all business units. Pursue acquisitions to enhance depth and scale of current operations and to add additional complementary services e.g. Phase I - US Bioanalytical / Biomarkers Therapeutic specialists Safety / Phase IV Patient Recruitment Staffing Cross-sell services to grow sales and margin Acquisitions to date - 11 Revenues acquired $114m Staff acquired – 1,100 => Organic growth >80%

25 Key Strategic Trends Strategic v Tactical Outsourcing –More large companies are seeking to use outsourcing strategically rather than tactically. –ICON fully engaged. Globalisation –Growth in Eastern Europe, Latin America and Asia as a venue. –ICON growing rapidly in these regions Greater Scientific Involvement –Customers seeking greater scientific input from CROs –ICON has added TAGS, IDS, Imaging, new Lab technologies etc. to respond. EDC –Estimated that over 40% of clinical trials now use EDC –49% of ICON’s Data Management activity in 2007 was EDC

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27 Executive Chairman Dr. John Climax President Corporate Development Bill Taaffe CEO Peter Gray Chief Financial Officer Ciaran Murray ICON Development Solutions President Dr Thomas Frey ICON Medical Imaging Chief Executive Dr Ted Gastineau ICON Central Laboratories President Bob Scott-Edwards VP Corporate QA Jo Coyle VP Global IT Mike McGrath VP Corporate Training & Development Anne Wesler VP Strategic HR Eimear Kenny VP Market Development Simon Holmes ICON Clinical Research Global President Dr John Hubbard Commercial VP Brian O’Dwyer COO US Malcolm Burgess Snr VP Global BD Elizabeth Thiele Snr VP Global Medical Suzanne Gagnon VP Global Data Management Tom O’Leary ICON Contracting Solutions President Sean Leech

28 CAGR 32% * Mid Point of 2008 Guidance issued December, 2007 Net Revenue CAGR of over 30% since % Forecast for ‘08

29 CAGR 26% (E) * Mid Point of 2008 Guidance issued December 2007 Earnings Per Share Growth

30 Q4 ’07Q4 ’06% Increase Net Revenue % Direct Costs % SG & A553845% D & A5437% _____ Operating Income201443% Operating Margin11%10.7% Net Income161140% _____ EPS (Inc SFAS123R)53c39c36% Weighted Average no. of Shares (Inc SFAS123R) 29.9m29.1m2.7% Recent Financial Performance ($ millions, except EPS; includes stock option expense)

31 FY2007FY2006% Increase Net Revenue % Direct Costs % SG & A % D & A191527% _____ Operating Income694845% Operating Margin11%10.5% Net Income563846% _____ EPS (Inc SFAS 123R)188c133c41% Weighted Average no. of Shares (Inc SFAS123R) 29.7m28.7m3.5% Recent Financial Performance ($ millions)

32 Approx. 25% of ICON’s business is generating single digit margins –Further margin growth in Lab –Improve performance from Phase I and Consultancy businesses –Bring Japan to higher profitability Expand margins in Phase II – IV through leverage as growth moderates. Currency Movements creating some “Headwinds” 5 Margin improvement is a key focus

33 May 31, 05 (Year) Dec 31, 05 (7 mths) Dec 31, 06 (Year) Dec 31, 07 (Year) Net Cash$78.4$82.3$98$23.8 Total assets$347.6$349.1$476.3$693.1 Shareholder’s equity$233.1$241.6$302.7$388.4 Cashflow from operations$23.8$11.7$51.5$42.9 Capital expenditures$15.6$12.1$31.5$75.4 CAPEX Excl. Dublin Extn.$15.6$12.1$20.4$36.8 Shares outstanding Summary Balance Sheet and Cash Flow ($ millions)

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35 Executive Chairman Dr. John Climax President Corporate Development Bill Taaffe CEO Peter Gray Chief Financial Officer Ciaran Murray ICON Development Solutions President Dr Thomas Frey ICON Medical Imaging Chief Executive Dr Ted Gastineau ICON Central Laboratories President Bob Scott-Edwards VP Corporate QA Jo Coyle VP Global IT Mike McGrath VP Corporate Training & Development Anne Wesler VP Strategic HR Eimear Kenny VP Market Development Simon Holmes ICON Clinical Research Global President Dr John Hubbard Commercial VP Brian O’Dwyer COO US Malcolm Burgess Snr VP Global BD Elizabeth Thiele Snr VP Global Medical Suzanne Gagnon VP Global Data Management Tom O’Leary ICON Contracting Solutions President Sean Leech

36 The Globalisation of Clinical Research: Challenges and Opportunities in Argentina, Brazil, Russia, China and India John W. Hubbard, Ph.D., FCP Global President, ICON Clinical Research

37 Products in Development by Therapeutic Area Source – BioPharmInsight.com, 2007

38 Global trend for higher costs, more patients and experienced clinical investigators! Cost per patient Cost per investigator Complexity of protocols Treatment naïve patients Qualified investigators Number of procedures, and type of inclusion/ exclusion criteria TrendDriver Cost per trial Cost of clinical development Infrastructure cost Number and size of trials Regulatory requirements Pharma & Device Industry Challenges Source McKinsey 2004

39 Access to treatment naïve patients, or patients who have only been treated with older medications Emergent disease populations, e.g., Type II diabetes, treatment resistant infections such as HIV, tuberculosis, hepatitis B & C, and various forms of cancer, and cardiovascular disease Cost and time benefits: Faster patient recruitment and lower cost base Since 1990, global clinical research has grown from 28 to 79 countries and the amount of FDA regulated research has increased 16-fold ICH E5 regulations allow the use of foreign data in new drug submissions Why Conduct Global Clinical Trials? PharmafocusAsia, 2005

40 Drivers of Country Selection Medical practice Regulatory process Commercial and post-marketing value Cost of the trial Disease demographics Speed of enrollment Quality, quality, quality Quality is the key driver: If a country cannot deliver quality, all other benefits are irrelevant

41 North America 2 Countries 17 Offices 1896 Staff Western Europe / Africa 10 Countries 13 Offices 1554 Staff Asia Pacific 8 Countries 10 Offices 448 Staff Latin America 5 Countries 5 Offices 166 Staff Projects in 60+ Countries ICON’s Global Clinical Footprint Eastern Europe / Russia 8 Countries 9 Offices 339 Staff Japan 1 Country 2 Offices 72 Staff

42 Key Countries for Clinical Trials Based on the Overall Country Attractiveness Index 1 1 A.T. Kearney Attractiveness Index, Pharmaceutical Executive Supplement,

43 Clinical Research in Russia, Argentina, Brazil, China and India: Opportunities and Challenges

44 ICON’s Clinical Trial Experience in Russia Country Office Locations Services Current Staff Staff by 2010 Number of Ongoing Studies RussiaMoscow / Novosibirsk Clinical Operations, Regulatory/EC/submissions, > ~50

45 Russia: Opportunities and Challenges Opportunities –Population of more than 142 million, with only 274 ongoing multi-national clinical trials (only 5% of the clinical research potential) –Large urban hospitals and medical centers –768 Clinical sites registered by the Federal Service for Healthcare and Social Development in the Russian Federation –High average patient enrollment rates of 4.7 patients/site/month –FDA has conducted 36 audits since 1995 and ranks #1 in quality amongst other E7 countries –Low cost relative to Western EU and the US –Relatively straight forward regulatory and clinical site contracting process Challenges –New regulatory requirements regarding the shipment of blood, DNA, and tissue samples –Rapidly maturing marketplace Sources: UBC International Clinical Trials, 2007

46 Russia versus U.S. in Clinical Research Key Features of a Clinical TrialU.S.Russia No. of patients across urban life style diseasesMediumHigh No. of patients with tropical diseasesLow Speed of recruiting patients for trialLow-MediumVery High Speed of conducting a trialMediumHigh Follow-up rate of patientsMediumHigh Number of qualified doctors and cliniciansVery HighHigh Heterogeneous populationsHighMedium-High Awareness of ICH GCP guidelinesVery HighHigh Availability of technology to streamline trialsVery HighMedium-High Regulatory & ethical issues and barriersLowLow-Medium Key: Red color = An area of development or current limitation.

47 ICON’s Clinical Trial Experience in Latin America Country Office Locations Services Current Staff Staff by 2010 Number of Ongoing Studies Argentina Buenos Aires Clinical Monitoring / Project Management / Regulatory Submissions / Pharmacovigilance BrazilSao Paulo Clinical Monitoring / Project Management / Regulatory Submissions Mexico / Chile / Peru Capital Cities Clinical Monitoring / Project Management / Regulatory Submissions 60150>40

48 Latin America: Opportunities and Challenges Opportunities –The seven main Latin American markets add up to 448 million people with a GDP of US $2.5 trillion in Highly concentrated: 70% urban / mega-cities Only two main languages Counter-season enrollment in Southern Hemisphere –Led by Mexico, Brazil and Argentina, they are expected to represent a market value of US $52 billion at retail prices by Sources: Espicom / PWC

49 Latin America: Opportunities and Challenges –Between 1995 & 2000, the number of clinical trials executed in the region rose by a factor of ten. High quality of medical practice and experienced clinical investigators Growing clinical trails sector – Development of dedicated CT sites, ERBs, SMOs – Expansion of CROs and Pharma clinical operations – Availability of GCP/CRA/SC training Courses – Support services: central labs, CTM logistics, QA consultants Challenges –Regulatory agencies are “stretched” due to lack of resources to meet the clinical trial demand –Longer regulatory start-up in some countries (e.g., Brazil) –Evolving regulatory environment – Some agencies are recognizing the need to adapt their regulations harmonization initiatives, which could enhance the attractiveness of the region Sources: Espicom / PWC

50 Latin America versus U.S. in Clinical Research Key Features of a Clinical TrialU.S.Latam No. of patients across urban life style diseasesMedium No. of patients with tropical diseasesLowHigh Speed of recruiting patients for trialLow-MediumHigh Speed of conducting a trialMedium Follow-up rate of patientsMediumHigh Number of qualified doctors and cliniciansVery HighMedium Heterogeneous populationsHighMedium Awareness of ICH GCP guidelinesVery HighHigh Availability of technology to streamline trialsVery HighMedium Regulatory & ethical issues and barriersLowMedium Key: Red color = An area of development or current limitation.

51 ICON’s Experience in India and China Country Office Locations Services Current Staff Projected Staff by 2010 Number of Ongoing Studies China Beijing / Hong Kong Clinical Operations, Regulatory, Consulting India Chennai Bangalore Clinical Operations, Data Management, Biostatistics, IVRS, Pharmacovigilance, Medical Imaging

52 China: Opportunities and Challenges Opportunities –Homogenous population of 1.3 billion –Increasing incidence and prevalence of infectious diseases, cancer, and metabolic disorders –History of pharmaceutical usage –Clinical Trial Site Management Regulation enacted in 2004 Only GCP-certified sites were approved to conduct clinical trials –Centralized medicine: 80% of medical resources are in large cities –Strong commercial pharmaceutical market approaching $75 billion by 2010

53 China: Opportunities and Challenges Challenges –Slow to accept ICH/GCP requirements –High demand for limited resources –Inexperienced clinical investigators may under report AEs/SAEs –Long regulatory approval to initiate clinical trials (6-12 months) –All regulatory documents must be translated into Chinese and local dialects may be a challenge –Restricted export of whole blood – Lab analysis and clinical chemistries need to be conducted in the country –Logistical challenges: Time and costs may be higher than other locations

54 China versus U.S. in Clinical Research Key Features of a Clinical TrialU.S.China No. of patients across urban life style diseasesMediumVery High No. of patients with tropical diseasesLowVery High Speed of recruiting patients for trialLow - MediumVery. High Speed of conducting a trialMedium Follow-up rate of patientsMediumMedium - High Number of qualified doctors and cliniciansVery HighLow - Medium Heterogeneous populationsHighLow Awareness of ICH GCP guidelinesVery HighLow Availability of technology to streamline trialsVery HighMedium Regulatory & ethical issues and barriersLowHigh Key: Red color = An area of development or current limitation.

55 India: Opportunities and Challenges Intellectual Property Changes –India Patent Act (1970) did not recognize pharmaceutical patents –India agreed to uphold the Trade-Related Intellectual Property Rights (TRIPS) agreement in 1995 and committed to enforcement by 2005 –Significant expansion of local pharmaceutical and bulk chemical manufacturing Source: Pharmaceutical Manufacturing and Packing Sourcer, 2006

56 India: Opportunities and Challenges Opportunities –Large English speaking Caucasian population (> 1.1 billion) –Educated and cost-effective workforce –Nearly 700,000 hospital beds –221 Medical colleges –Robust IT infrastructure –FDA has accepted data from India in large pivotal trials –Improving regulatory approval times for study start-up (12-18 weeks) –$100 million market in 2007 for clinical trials outsourced to India growing to $1.1 - $1.5 billion by 2010 Source: Pharmaceutical Manufacturing and Packing Sourcer, 2006

57 India: Opportunities and Challenges Challenges –Concerns over quality of patient data –High demand for limited resources and experienced clinical investigators –Large patient populations are dispersed throughout the country –Infrastructure across the country is under developed –Less desirable market place for pharmaceutical companies to commercialize products Low health insurance coverage Limited consumer purchasing power Controlled drug-pricing Entrenched generic market

58 India versus U.S. in Clinical Research Key Features of a Clinical TrialU.S.India No. of patients across urban life style diseasesMediumVery High No. of patients with tropical diseasesLowVery High Speed of recruiting patients for trialLow-MediumVery High Speed of conducting a trialMediumVery High Follow-up rate of patientsMediumVery High Number of qualified doctors and cliniciansVery HighMedium – High Heterogeneous populationsHigh Awareness of ICH GCP guidelinesVery HighLow – Medium Availability of technology to streamline trialsVery HighLow - Medium Regulatory & ethical issues and barriersLowMedium - High Key: Red color = An area of development or current limitation.

59 Case Study: Study No 2: Phase II/III study Type 2 Diabetes-1 protocol

60 Diabetes Estimates in Emerging Countries Source: World Health Organization & Contract Pharma, May 2007

61 Regional Performance USIsraelArgentinaIndiaTotal Screened Run-In Randomized Completed

62 Globalization of clinical trials is accelerating and will continue to develop in regions such as Eastern Europe, Latin America, and Asia- Pacific (India, and China) There are many challenges and opportunities that must be addressed as the market matures in these regions This represents a huge opportunity for CROs who have a global structure and capability to conduct trials in these regions ICON is well positioned in these locations and will continue to expand its global clinical development capabilities to meet our client’s needs In Conclusion….

63 Executive Chairman Dr. John Climax President Corporate Development Bill Taaffe CEO Peter Gray Chief Financial Officer Ciaran Murray ICON Development Solutions President Dr Thomas Frey ICON Medical Imaging Chief Executive Dr Ted Gastineau ICON Central Laboratories President Bob Scott-Edwards VP Corporate QA Jo Coyle VP Global IT Mike McGrath VP Corporate Training & Development Anne Wesler VP Strategic HR Eimear Kenny VP Market Development Simon Holmes ICON Clinical Research Global President Dr John Hubbard Commercial VP Brian O’Dwyer COO US Malcolm Burgess Snr VP Global BD Elizabeth Thiele Snr VP Global Medical Suzanne Gagnon VP Global Data Management Tom O’Leary ICON Contracting Solutions President Sean Leech

64 CRO Marketplace Dynamics Elizabeth Thiele Sr. Vice President Global Business Development ICON Clinical Research

65 Increased Number of Strategic Outsourcing Initiatives –Reduced Oversight Models –Use of Low Cost Regions for Process Rich Services –Implementation of Alternative Study Execution Methodologies –Integration of Technology Based Information Management Systems Growing Number of Global Projects Across All Market Segments Why is Growth so High for CROs… “Large Pharma & Biotech are Searching for Ways to Stretch R&D Funds & Small Biotech/Emerging Pharma are Holding onto the their Assets Longer”

66 66 RFP Flow by Market Segment 2007 Volume  500+ RFIs  RFPs - 38% Increase / PY - Program vs. Project - 32% Multi-Region

67 67 RFP Value by Market Segment 2007 Value  54% Increase / PY Size of Projects  41 > 20 Million  168 > 5 Million  959 < 5 Million

68 68 RFP Flow by Participating Region

69 69 RFP Value by Participating Region

70 Increased Number of Strategic Outsourcing Initiatives –Reduced Oversight Models –Use of Low Cost Regions for Process Rich Services –Implementation of Alternative Study Execution Methodologies –Integration of Technology Based Information Management Systems Growing Number of Global Projects Across All Market Segments Incremental Number of Requests for Feasibility Related to Study Design and/or Available Patients Greater Demand for Regulatory Support Services Overall Demand for “Scientific” Input Why is Growth so High for CROs… “With Large Pharma & Biotech Searching for Ways to Stretch R&D Funds & Small Biotech/Emerging Pharma Holding on the their Assests Longer”

71 Three-fold Increase in the Number of RFIs Overall & a Specific Interest in the Universe of Post-approval Services at ICON Emerging RFIs Related to “Risk Minimization Action Plan” Development (starting approximately 1Q07) Increased Number of RFIs & 75% Increase in RFPs for 2007 Related to Stand-alone Safety & Pharmacovigilance Work Increase in the Number of RFIs & RFPs for Assistance with Epidemiological Design & Analysis Increase in the Number of RFPs for Registries, Particularly Originating in Europe Observations in the Post Approval Arena…

72 Executive Chairman Dr. John Climax President Corporate Development Bill Taaffe CEO Peter Gray Chief Financial Officer Ciaran Murray ICON Development Solutions President Dr Thomas Frey ICON Medical Imaging Chief Executive Dr Ted Gastineau ICON Central Laboratories President Bob Scott-Edwards VP Corporate QA Jo Coyle VP Global IT Mike McGrath VP Corporate Training & Development Anne Wesler VP Strategic HR Eimear Kenny VP Market Development Simon Holmes ICON Clinical Research Global President Dr John Hubbard Commercial VP Brian O’Dwyer COO US Malcolm Burgess Snr VP Global BD Elizabeth Thiele Snr VP Global Medical Suzanne Gagnon VP Global Data Management Tom O’Leary ICON Contracting Solutions President Sean Leech

73 Global Data Management and EDC Thomas O’Leary Vice President Global Head of Data Management ICON Clinical Research

74 What is driving Electronic Data Capture (EDC) Adoption –Number of clinical procedures quadrupled in last 20 years –Data more complex, speed of availability is critical –Paper based processes not scalable –2005: Watershed year for EDC Market Two Enterprise-level leaders emerge in the market place –2006: Crossing the Chasm Industry switched their concerns about not being first to not being last Where is EDC headed ( ) –Spending expected to exceed $3.1 billion –Average time to deploy study will be halved EDC Adoption in the Market Place

75 Medidata Rave™ (February 2005) –Non-exclusive agreement Phase Forward Inform™ (January 2007) –Rave™ and Inform™ dominated 2007 (about 40% of market each) –Allows us to cover the majority of our EDC committed client base Oracle Clinical OC RDC™ (Dec 2007) –Oracle have invested heavily in order to establish market share –Specific clients committed due to heritage Niche products emerging (eg Phase I, Late Phase/registry trials) –Medidata and Phase Forward specific products for early and late phase requirements. –ICON has agreed partnerships with two niche providers –ICON extends clinical reach with such providers Recognised as CRO who understands optimal use of technology EDC Capabilities at ICON

76 EDC Adoption Metrics In the last 4 years –ICON has won 6 times as many EDC projects than pre 2003 –EDC Wins have more than doubled year on year 8 wins in 2004, 17 wins in 2005, 38 wins in 2006, 79 wins 2007 –Requests for proposals featuring EDC comprised about 52% of our portfolio at the end of 2007 (<1% in 2003) –Currently over 33% of our projects are using EDC, this is projected to reach 45-50% by the end of 2008, 85-90% by 2010 Current EDC project portfolio –116 ongoing EDC studies (plus 37 completed studies) 77 studies in Medidata Rave™ 22 studies using Phase Forward Inform™ 17 studies using other EDC systems (client mandated)

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78 Data Management Locations Dublin Edinburgh Marlow Chennai Hong Kong Philadelphia North Carolina San Francisco

79 PositionEast Coast West Coast EuropeIndiaSupport Offices Global Total DM Project Managers Data Coordinators /EDC Analysts Data Entry Specialists / EDC Testers Medical Coders DBAs / EDC Study Builders Total Staff Data Management Headcount

80 Databases set up – 96 (EDC = 29%) Edit checks programmed – 89,504 CRF pages processed – 3,189,323 (EDC = 49%) DM Queries processed – 352,169 All Queries processed – 472,206 Medical terms coded – 437,111 Databases closed (final) – 67 Audits Performed – 30 Data Management Metrics 2007

81 Electronic Data Capture –Medidata Rave™ (v5.6.1) –Phase Forward InForm™ (v4.5) –Oracle Clinical RDC ® (v4.5.2) Oracle Clinical® (v4.0.3, 4.5.1) DataFax™(v3.7) Clintrial™ (v4.4) OptICON (Integic) - CRF Scanning & Workflow Manager ICONet – Web Portal Application ICOSaurus – coding application SAS (8.2, 9.1.3) FrameMaker (v8.0) - CRF design,  structured (XML) E-Diaries (CRF Inc & PHT & Invivodata ) Technology & Capabilities

82 Integration with other ICON systems

83 Executive Chairman Dr. John Climax President Corporate Development Bill Taaffe CEO Peter Gray Chief Financial Officer Ciaran Murray ICON Development Solutions President Dr Thomas Frey ICON Medical Imaging Chief Executive Dr Ted Gastineau ICON Central Laboratories President Bob Scott-Edwards VP Corporate QA Jo Coyle VP Global IT Mike McGrath VP Corporate Training & Development Anne Wesler VP Strategic HR Eimear Kenny VP Market Development Simon Holmes ICON Clinical Research Global President Dr John Hubbard Commercial VP Brian O’Dwyer COO US Malcolm Burgess Snr VP Global BD Elizabeth Thiele Snr VP Global Medical Suzanne Gagnon VP Global Data Management Tom O’Leary ICON Contracting Solutions President Sean Leech

84 IVR in Clinical Trials & the impact of technology on CR Malcolm Burgess Chief Operating Officer, U.S. Operations ICON Clinical Research

85 Interactive Voice Response (IVR) –Interactive Web Response (IWR) Utilizes telephone to collect data –Mobile or landline Technology used in many different industries –Banking, IT support, etc IVR usage in Clinical trials –Been around for 25 years –IWR more recently adopted Modern IVR systems integrated with IWR –Allows users to select interface that works best for them IVR/IWR Defined

86 Low cost solution for simple data entry Enrollment and Randomization –Prevents over recruitment –Can also be used to recruit patients Dispensing pharmaceuticals drugs –according to need or type of clinical trial Used to record complete clinical trial data about the recruitment of subjects Can be integrated with other tools to manage the clinical study data (CTMS, EDC, etc) Maintain a record of drug accountability –Dispensed, used, returned, etc Patient Reported Outcomes –Improves Quality and Integrity of data IVR/IWR in Clinical Trials

87 Enrollment –Reduced costs due to over-enrollment of patients Randomization –Supports complex randomization and Adaptive trials Drug Management –Reduce costs of drug due to less waste Patient Report Outcomes –Improve quality and integrity of the data collected IVR/IWR Cost Saving Advantages

88 IVR can be used for Electronic Patient Report Outcomes (ePRO) –FDA mandates and guidance will drive the number trials requiring ePRO up significantly None of the implementation costs associated with handheld ePRO solution PRO can be submitted using the IVR or IWR concurrently Low cost, Global, Multilingual solution Electronic Patient Report Outcomes

89 ICON IVR Metrics Current IVR project portfolio –325 active IVR projects –>650 projects launched since inception in March 2000 Growth since 2006 –90% increase in per study revenue –105% increase in total awards Staff –235 global staff –35 staff in Chennai providing back end support

90 “200+ ICOPhone dedicated staff worldwide" ICON Global Reach DublinMarlow Chennai Philadelphia Raleigh Chicago Houston

91 ICON solution (ICOPhone) has been in place for 8 years Utilized in over 650 clinical trials Integrates with all major CTMS and EDC platforms Combines IVR and IWR in a seamless package All data is available real-time for decision making New technology release –EDGE –Reduce timelines for setup by 50% ICON Advantage

92 Changing the paradigm of Clinical Research –Site Monitors more focused on … Site Management Representing the client rather than monitoring the data –Data Flow accelerated Direct data collection from site/patient (eg EDC, ePRO) On-line (instead of on-site) data review Majority of query & study management done remotely Real time data access and decisions (adaptive designs) –Reduced classical Data Management No data entry, minimal manual queries – reduced workload More focus on holistic ‘clinical management’ of the study More focus on technology, less of a commodity But slowly – many still think in the paper paradigm So where is the technology taking us ……

93 Executive Chairman Dr. John Climax President Corporate Development Bill Taaffe CEO Peter Gray Chief Financial Officer Ciaran Murray ICON Development Solutions President Dr Thomas Frey ICON Medical Imaging Chief Executive Dr Ted Gastineau ICON Central Laboratories President Bob Scott-Edwards VP Corporate QA Jo Coyle VP Global IT Mike McGrath VP Corporate Training & Development Anne Wesler VP Strategic HR Eimear Kenny VP Market Development Simon Holmes ICON Clinical Research Global President Dr John Hubbard Commercial VP Brian O’Dwyer COO US Malcolm Burgess Snr VP Global BD Elizabeth Thiele Snr VP Global Medical Suzanne Gagnon VP Global Data Management Tom O’Leary ICON Contracting Solutions President Sean Leech

94 Developments in Pharmacovigilance Suzanne Gagnon Snr VP Global Medical Affairs & Drug Safety ICON Clinical Research

95 Since 2004: Increased emphasis on monitoring safety throughout the product life cycle –Recent withdrawals of several marketed products –Increased scrutiny of Regulatory Agencies –Lack of enforcement of Phase IV commitments –Impression that FDA was not adequately protecting the public health –Need to respond Developments in Pharmacovigilance (PV)

96 Regulatory Agencies’ Response FDA’s –Office of Drug Safety –Office of Surveillance and Epidemiology Task Forces –IOM’s 2006 Report on the Future of Drug Safety – Promoting and Protecting the Health of the Public Guidance Documents Risk Management European Directive on Pharmacovigilance Increased Safety Audits

97 Pharmaceutical Companies’ Response Phase IV clinical trials, observational studies, safety registries Data basing of legacy cases Risk Minimization Plans (RiskMAPs) –Increased outsourcing –FSP model for safety –Total product safety support Case processing Signal detection and analysis Drug Information and product complaints Regulatory report writing

98 ICON’s Response 2004… Global Headcount:68 Safety Management: 10 Safety Centers WW: 3 Stand Alone Projects 3 Value Largest Project $350K 2008… Global Headcount: 392 Safety Management: 28 Safety Centers WW: 5 Stand Alone Projects: 16 Value Largest Project: $ >30M

99 ICON Global Safety Portfolio 2004

100 ICON Global Safety Portfolio 2007

101 ICON’s 2008 Plan for Drug Safety Safety Alliance within ICON –Medical Affairs and Drug Safety (Case Processing) –Lifecycle Sciences Group (Registries) –Development Solutions (Consulting) –Medical Imaging (Endpoints) –Biostatistics (Signal Detection and Analysis, DSMBs) –Call Center (Safety Reporting, Drug Information, Product Complaints) –Regulatory Affairs Global Safety Marketing Campaign Total Product Safety Solution

102 Off-shoring to Low Cost Markets 2008 Only certain clients want low cost options off-shore for PV Services to be off-shored vary –Case processing –Safety Narratives –Call Center activities Not all PV services off-shored easily Technology enables seamless interaction between ICON Safety Centers Training within the cultural framework is key Currently 48 Medical Affairs and Drug Safety staff in Chennai, India Plan to increase to > 100 by end of 2008 as workload increases

103 Executive Chairman Dr. John Climax President Corporate Development Bill Taaffe CEO Peter Gray Chief Financial Officer Ciaran Murray ICON Development Solutions President Dr Thomas Frey ICON Medical Imaging Chief Executive Dr Ted Gastineau ICON Central Laboratories President Bob Scott-Edwards VP Corporate QA Jo Coyle VP Global IT Mike McGrath VP Corp Training & Development Anne Wesler VP Strategic HR Eimear Kenny VP Market Development Simon Holmes ICON Clinical Research Global President Dr John Hubbard Commercial VP Brian O’Dwyer COO US Malcolm Burgess Snr VP Global BD Elizabeth Thiele Snr VP Global Medical Suzanne Gagnon VP Global Data Management Tom O’Leary ICON Contracting Solutions President Sean Leech

104 Jo Coyle VP Quality Assurance ICON plc

105 Agenda  ICON’s quality framework and philosophy  Internal QA Program  Client and Regulatory focus  The year ahead

106 Quality is our Focus

107 External assessment of ICON’s Global Quality System Group registration for the whole company  Annual random surveillance audits across regional offices to monitor compliance - audit frequency is based on office size and number of services  All new offices independently audited to attain registration 2007 audit program  USA: PA, FL, NC, CA-Irvine, CA-Redwood City  Europe: IRL, GER, SWE, RUS, HUN,  ROW: South Africa, CAN, MEX*, ARG (*new offices registration audit) The following accreditations are maintained by ICON Laboratories  ISO  CAP accreditation  CLIA (New York facility only) ISO 9001:2000 Registered

108 Quality is our focus… ICON Internal QA Audits – 2007 DivisionUSEUROWTotal ICR ICL IDS IMI2300 Corporate system audits

109 DivisionSponsor ICR148 ICL41 IDS31 IMI Client, Regulatory and ISO Audits – 2007 …Clients check it…

110 OfficeDateRegionAuditing AuthorityOutcome Redwood City, CAOct 2003USFDANo findings (no FDA 483) New York City, NYMar/Apr 2005USFDANo findings (no FDA 483) North Wales, PAMay 2005USFDANo findings (no FDA 483) Nashville, TNOct/Nov 2005USFDANo findings (no FDA 483) North Wales, PADec 2005USFDANo findings (no FDA 483) Nashville, TNJan 2006USFDANo findings (no FDA 483) Eastleigh, UKOct 2004EUMHRANo critical findings Dublin, IrelandApr 2005 EU IMBNo critical findings Eastleign/Marlow, UKSept 2007EUMHRANo critical findings Frankfurt. GermanySept 2007EU Local regulatory authority: RP Darmstadt No critical findings SingaporeOct 2005ROW HSA - Health Services Authority of Singapore No critical findings …Regulatory Agents inspect it…

111 SurveyYearComments William Blair / PharmaMediation 2004Top CRO for quality and execution. CenterWatch Survey of Investigative Sites 2005 Top 3 CRO for Investigator relationships and site management. Frost Sullivan2006 Top 3 CRO for timely database lock and key attributes of overall quality, personnel expertise, therapeutic expertise, and project turnaround. Frost Sullivan2007North American Service Provider of the Year Thomson CenterWatch and William Blair 2007 Vendor you most prefer working with based on quality. Lehman Brothers2007Top CRO for quality of global execution. SGS – ISO AuditAnnualPassed without significant comments since 1992 …and Third Parties validate it…

112 Integration of new US Phase I facility into Quality System Development of the Quality System in new ICON offices New ISO registrations in IMI, Brazil, Bangalore and Italy Acquire new MHRA Supplementary accreditation for Phase 1 units (UK) Implementation of electronic QA system - improve efficiency in internal audit process Expansion of audit program in ROW region Quality plans for the year ahead…

113 Executive Chairman Dr. John Climax President Corporate Development Bill Taaffe CEO Peter Gray Chief Financial Officer Ciaran Murray ICON Development Solutions President Dr Thomas Frey ICON Medical Imaging Chief Executive Dr Ted Gastineau ICON Central Laboratories President Bob Scott-Edwards VP Corporate QA Jo Coyle VP Global IT Mike McGrath VP Corporate Training & Development Anne Wesler VP Strategic HR Eimear Kenny Group Director Market Development Simon Holmes ICON Clinical Research Global President Dr John Hubbard Commercial VP Brian O’Dwyer COO US Malcolm Burgess Snr VP Global BD Elizabeth Thiele Snr VP Global Medical Suzanne Gagnon VP Global Data Management Tom O’Leary ICON Contracting Solutions President Sean Leech

114 Thomas Frey President ICON Development Solutions

115 Regulatory Strategy Development Plan IND/CTA Clinical Pharmacology Proof Of Concept Expeditious Drug Development – Enhanced Decision Making

116 Regulatory Strategy Scientific Consulting Pre-clinical CMC Formulation Development Target Product Profile Expeditious Drug Development – Enhanced Decision Making

117 Development Plan Scientific Consulting Phase I Development Plan & Protocol Design Proof Of Concept Study Design Outline Of Phase II & III Non-Clinical Development Plan Cost Of Development Expeditious Drug Development – Enhanced Decision Making

118 IND/CTA Regulatory Affairs Pre-IND Meeting/Regulatory Advice IND Compilation Paper & Electronic Submissions Annual Updates Expeditious Drug Development – Enhanced Decision Making

119 Clinical Pharmacology Phase I Full Range of Regulatory Pharmacokinetic Special Populations Studies PK/PD Studies – Pharmacodynamic Models Bioanalytical & Immunoassay Analysis PK/PD Analysis, Modeling & Simulations Data Management, Statistics, Medical Writing Expeditious Drug Development – Enhanced Decision Making

120 Proof Of Concept Phase IIa Planning, Management & Execution Of Targeted Proof of Concept Studies Bioanalytical & Immunoassay Analysis PK/PD Analysis, Modeling & Simulations Data Management, Statistics, Medical Writing Expeditious Drug Development – Enhanced Decision Making

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122 NONMEM - NONlinear Mixed Effects Model-base analyses –Developed at the University of California, San Francisco –Licensed to end-users by ICON Development Solutions –Used worldwide in drug development to quantify exposure (PK) - response (PD) relations in support of internal decision-making and to provide evidence of safety and efficacy for regulatory evaluation. ICON Development Solutions provides a proprietary interface program, PDx-POP, that runs the NONMEM Software Package in a Windows-like environment. Expeditious Drug Development – Enhanced Decision Making

123 Anticipated Added Value For Users: To improve numerical stability & computational efficiency To ease code maintenance To add more modern, robust estimation methods Anticipated Added Value For ICON: Intellectual property Enhanced pricing Visibility and scientific reputation throughout the industry Expeditious Drug Development – Enhanced Decision Making

124 Global Publishing System GPS is a validated, 21 CFR Part 11 compliant, centralized system for the organization, assembly, and dispatch of navigable electronic & paper documents to regulatory agencies Changing Regulatory Environment –eCTD “requirement” with FDA (January 2008) and EMEA (2009) –The UK, NL & Belgian authorities are already requesting electronic submissions Expeditious Drug Development – Enhanced Decision Making

125 Submission Source Documents Document Management System (Documentum) Publishing Systems (CoreDossier, Insight Publisher) Submission Sent To Regulatory Authorities (e-Gateway) Expeditious Drug Development – Enhanced Decision Making

126 Executive Chairman Dr. John Climax President Corporate Development Bill Taaffe CEO Peter Gray Chief Financial Officer Ciaran Murray ICON Development Solutions President Dr Thomas Frey ICON Medical Imaging Chief Executive Dr Ted Gastineau ICON Central Laboratories President Bob Scott-Edwards VP Corporate QA Jo Coyle VP Global IT Mike McGrath VP Corporate Training & Development Anne Wesler VP Strategic HR Eimear Kenny Group Director Market Development Simon Holmes ICON Clinical Research Global President Dr John Hubbard Commercial VP Phase I Brian O’Dwyer COO US Malcolm Burgess Snr VP Global BD Elizabeth Thiele Snr VP Global Medical Suzanne Gagnon VP Global Data Management Tom O’Leary ICON Contracting Solutions President Sean Leech

127 Phase I Developments Brian O’Dwyer, General Manager & Vice President

128 Manchester Phase I Clinical Research Unit Clinical Trial Directive Implementation in 2004 negatively impacted most of UK based CPUs Inadequate business development contributed to the sluggish business High value and high risk studies combined with significant cancellations aggravated the situation Imbalance between high science and low business acumen

129 Manchester Phase I Clinical Research Unit Way to Success Maintained scientific strengths complemented by commercial and operational management –Focus on biomarker models incl. imaging techniques, e.g. CNS, diabetes, CV –Improved volunteer recruitment & study delivery Strengthened business development significantly Re-branded to ICON Development Solutions and creating the “quality” brand image with sponsors Increased substantially bed utilization and backlog

130 MEU Collaboration Access to hospital based beds for FIM & complex studies Enhanced flexibility through additional bed capacity For MEU access to support services e.g. bioanalysis, DM, PK etc. Access to respiratory patients Proof of Concept capability MEU is quality unit, close proximity to existing facility & strong reputation in respiratory internationally

131 85 bed clinical research unit in San Antonio, TX Experienced team with excellent market reputation Clinical pharmacology platform in the US to complement the UK CPU Highly synergistic to our existing Development Solutions business and service offering Healthy client base, RFP flow and new business wins Phase I Acquisition In The US

132 Full spectrum of services to support early drug development from compound selection to proof of concept (and beyond – RA, PK/PD Clients may wish to choose individual functional services or the integrated IDS package: regulatory strategy, development planning, operational execution, evaluation and reporting The IDS business model is unique in our industry. The competition offers a similar “shopping list”, but lacks the early phase drug development integration Development Solutions - Key Differentiators

133 Executive Chairman Dr. John Climax President Corporate Development Bill Taaffe CEO Peter Gray Chief Financial Officer Ciaran Murray ICON Development Solutions President Dr Thomas Frey ICON Medical Imaging Chief Executive Dr Ted Gastineau ICON Central Laboratories President Bob Scott- Edwards ICON Clinical Research Global President Dr John Hubbard VP Corporate QA Jo Coyle VP Global IT Mike McGrath VP Corporate Training & Development Anne Wesler VP Strategic HR Eimear Kenny Group Director Market Development Simon Holmes Commercial VP Brian O’Dwyer COO US Malcolm Burgess Snr VP Global BD Elizabeth Thiele Snr VP Global Medical Suzanne Gagnon VP Global Data Management Tom O’Leary ICON Contracting Solutions President Sean Leech

134 Robert Scott - Edwards President ICON Central Laboratory

135 ICON Central Laboratories - Quick Facts: 425 staff in 4 Labs – NY, NJ, Dublin, Singapore 528 active studiesBacklog >$126m Won 284 studies in 2007 (Strike rate = 48%) Built >600,000 kits in 2007 Resulted >8,000,000 tests in % of New Business is repeat 70% Clients say we are the best CL! (26%=same!)

136 Drivers of the Business: The search for subjects… –USA remains strong –Classic Europeremains steady –New Europestill growing very strongly –Asia/Pacific showing good growth/high interest More complex testing required… –More than just “safety testing” –Biomarkers and esoteric testing

137 Our Challenges: LOGISTICS –Getting a sample into a Laboratory; TIME/COST BROADENING MENU of TESTING –New technology, investment, having scale & mass FLEXIBLE IT system to support global activity –Data is what we deliver –From a global platform –Serviced & supported 24/7

138 STRATEGY: Expand Network to support market growth –Additional testing in Singapore:June 2008 –New Laboratory in India:September 2008 –Strengthen partnership in China:Ongoing Expand technology base to meet market demand –Ongoing:Example: Flow Cytometry network Upgrade IT systems to support business –Ongoing:Pilot phase successful

139 Global Flow Cytometry: Standardized analyzers (BD) Custom reagents from central source Link all cytometers to central hub for analysis/gating Build EDC system and give Client access FC is key for Oncology, Immunology, Cell Signaling NY, Dublin, Singapore, Japan, Argentina, India

140 The challenge in meeting Client demand for more complex testing is simple: VOLUME! Unlike Bioanalytical work in the phase I arena, CL testing is not batch-oriented. Margin comes from being adept at managing volume. Volume, Informatics, Agility Volume Margin

141 Critical Success Factors: Global Coverage is essential… –USA, Europe, China, India, Asia/Pacific –Strong Logistics skills Broad Test Menu is essential… –65% of testing is esoteric –Rapid deployment of technology on global scale Flexible IT system is essential… –Information to support proactive management –Global data & 24/7 Customer Support

142 Executive Chairman Dr. John Climax President Corporate Development Bill Taaffe CEO Peter Gray Chief Financial Officer Ciaran Murray ICON Development Solutions President Dr Thomas Frey ICON Medical Imaging Chief Executive Dr Ted Gastineau ICON Central Laboratories President Bob Scott-Edwards VP Corporate QA Jo Coyle VP Global IT Mike McGrath VP Corporate Training & Development Anne Wesler VP Strategic HR Eimear Kenny Group Director Market Development Simon Holmes ICON Clinical Research Global President Dr John Hubbard Commercial VP Brian O’Dwyer COO US Malcolm Burgess Snr VP Global BD Elizabeth Thiele Snr VP Global Medical Suzanne Gagnon VP Global Data Management Tom O’Leary ICON Contracting Solutions President Sean Leech

143 Ted Gastineau CEO ICON Medical Imaging

144 Medical Imaging ICON Medical Imaging is focused on medical imaging endpoints for the development of pharmaceutical, biotech, and medical device products. Our industry leading technology enables clients through digital asset management, real time information access, and knowledge management.

145 Medical Imaging X-Ray, MRI, CT, Nuclear Medicine, PET, Ultrasound, Video, Photography Imaging shows how drugs work inside the body Medical Imaging in clinical trials is growing across Phase I, II, III and IV PET Movie

146 Medical Imaging Why? –See and measure structure and function –Dose effects, target effects, side effects –Better information faster –Phase I: Internal decision making/ Compound screening –Phase II: Dose, Safety, Efficacy, Accelerated Approval –Phase III: Surrogate Endpoint, Disease Modifying Effect, Safety, Efficacy

147 Medical Imaging FDA Continues to Accept and Promote Imaging Critical Path: Janet Woodcock, MD Deputy Director, CMO FDA –“Imaging technologies are currently very important, and will become even more crucial to therapeutic development” –“FDA, under its critical path initiative, is seeking to advance development of these imaging biomarkers in an organized fashion” Oncology Guidance Document: updated May 2007 –Supports the use of Objective Response Rate and Progression Free Survival…all are imaging based endpoints –“When the study endpoint is based on tumor measurements (e.g., PFS or ORR), tumor endpoint assessments should be verified by central reviewers blinded to study treatments”

148 Medical Imaging Genentech Clears Hurdle On Cancer Drug Avastin By MARILYN CHASE and ANNA WILDE MATHEW Wall St Journal February 23, 2008; Page A3 –Accelerated approval based on Progression Free Survival –Independent Review of Imaging data was key –"We are very confident of the effect of this drug on progression-free survival." said Richard Pazdur, director of the FDA's office of oncology-drug products.” –“Dr. Pazdur said the Avastin decision didn't represent a shift for the agency, which has considered progression-free survival in a number of other approvals. "We're not boxed in to a survival-only mentality," he said. "We have to demonstrate regulatory flexibility."

149 Medical Imaging Therapeutic Initiatives –Oncology: 40% - 70% –Cardiovascular 40% –CNS: 10%-20% –Musculoskeletal: –Gastrointestinal: –Dermatology:

150 Medical Imaging Cardiac Safety –Cardiovascular function with CT, MR, Nuclear Med, US, Angio –Echo growing as measure of cardiac function –Integrated offering differentiates ICON –Adjudication of Cardiac Events powered by IMI technology (MIRA) –Key academic relationships: Harvard, Duke, Cleveland Clinic, UCSF, Oxford (UK)

151 Medical Imaging

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153 Technology –MIRA ™ IMI’s leading image management/project tracking platform Complete workflow 24/7 access to images and information Real time data –SpeedTrial™ IMI’s validated cancer review application Image display and analysis Linked in electronic case report form Ready to Read in as little as 2 weeks –Image Knowledge Expert (IKE™) Image based Educational/Information Portal Built for Major Pharma Available for clients and projects

154 Meta Data Image Storage Computational Platform: HW-OS Algorithms Image Data Standardization Common Back-plane Query Identify Retrieve Process Project Management Clinical DB Legacy Data Sales and Marketing User PET User MRI User Remote User Query Retrieve Images or Information

155 Browser Interface SERIES STUDIES PROTOCOLS SITES CASESCODES

156 Task Lists (Work Flows) PROTOCOLS FILTERS TASK LISTS SERIES FOR PROCESSING CODES FOR PROCESSING

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166 Sean Leech President ICON Contracting Solutions

167 MARKET DEVELOPMENTS & DEFINITION

168 Staffing Industry Definition The staffing industry can be broadly defined as a collection of business that provides organisations and individuals with a range of employment related services. The industry has evolved from what was once very discreet types of businesses, for example temporary hire, retained search, permanent placement, contract project staffing and professional employer organizations (PEO) into one industry with many sectors with the lines of demarcation blurring as the industry develops further. DEFINITION

169 Shift in Business Models –Temporary to Permanent –Contract Teams –FSP –VMS –Unique Projects A Move to Full Service Global Positioning Fewer Vendors Consolidation(i3, KForce, Kelly, RPS, Inventiv) Candidate Acceptance Move to scale & flexible solutions MARKET DEVELOPMENTS

170 MARKET SCALE

171 WORLD STAFFING MARKET CountryUS$B USA119.9 Europe UK47.8 France25.3 Germany10.6 Netherlands10.2 Switzerland5.1 Sweden1.6 Denmark1.0 Norway0.9 Finland0.9 ROW Japan26.2 China2.7 South Africa2.2

172 Source: CenterwWatch October 2005 CLINICAL STAFFING MARKET

173 MARKET SPLIT Regional Clinical Staffing MarketBreakdown of Market ROW 12% EU 44% US 44% 75% Temporary Help 15% Place and Search 9% Insourcing 1% Staff leasing

174 TEMPORARY STAFF PENATRATION RATES ICS COVERAGE

175 INDUSTRY SECTOR GROWTH US 2005

176 OUR GROWTH Growth EUROPE$30m€45m 50% USA$16m€20m 25% TOTAL ICS$46m€65m 41%

177 Leverage centralised cost/management infrastructure. Project/Multiple assignment focus = reduced business/candidate acquisition cost. Layered in permanent placement revenue. Value added service – More $ same client. Candidate market therefore pricing is favourable. Average Operating Margin excess 15% within 2 years OUR MARGIN OPPORTUNITY

178 STRATEGY

179 Full Range of Staffing Services Global Infrastructure –Greater scale required in the US; acquisition a possibility Flexible Solutions STRATEGY

180 ICON CONTRACTING SOLUTIONS – INTERNATIONAL, NOT YET GLOBAL Sweden Denmark Finland Netherlands Poland Germany x2 Belgium France UK x3 New York North Carolina Tampa

181 PERMANENT PLACEMENT CONTRACT PLACEMENT FLEXIBILITY TRAINING FROM ONE ASSIGNMENT TO INTEGRATED STRATEGIC INSOURCING Permanent Placement - Executive Search - Search and Selection - Basic Search - Advertising - Assessments Contract Placement - Project based - Project or functional teams - Vacancy Management - Interim Management - Administration Training - Traineeships - Coaching - Training and Education STRATEGIC STAFFING SOLUTION

182 ICS is the staffing arm of ICON, providing flexible staffing solution to the Pharma Industry on an International basis SUMMARY


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