1. ViewRay Renaissance Business Case UWHC Authority Board November 3, 2010

2. Introduction
Our vision is to provide the cancer patient with cutting edge technology that improves patient care and increases research opportunities
With Healthcare Reform on the horizon, it will be critical to differentiate ourselves from the competition in providing the most comprehensive treatment options for our patients as an accountable care organization
UWHC will be one of the first three facilities to receive the new equipment nationally. This new technology enhances UW Health’s position as a quaternary care provider
Our Radiation Oncologists and physics staff have been involved in this technology development, increasing our credibility as a global research partner
UW Health has already invested $450,000 into the Renaissance project to position ourselves as a technology leader

3. Renaissance Technology
Image Guided Radiation Therapy (IGRT) system
Provides external beam radiation from three gamma (cobalt) sources with real-time motion tracking by the Magnetic Resonance Imaging (MRI)
Used in tumors that may move over the course of a treatment due to breathing, internal movement, and changes in size of tumor
Provides automatic gating so beam turns off if target moves out of range
Most advantageous use in lung, liver, and prostate cancer

4. The RenaissanceTM System 1000

5. Targeting a Moving Tumorb) c) d)
a) imaging of a lung tumor that is off target; b) motion of the tumor; c) treatment while the tumor is on target; and d) MRI data that enable the real-time imaging of the patient anatomy and targets.

6. University of Wisconsin Technology Assessment Committee—February 2010
Pending Food and Drug Administration (FDA) approval, the Technology Assessment committee recommended the acquisition of the Renaissance due to:
reduction in patient radiation dose to healthy tissues
gain in market share from being a first mover with this new technology
enhanced research capabilities
positive financial outlook

7. Timeline of Future Events
Construction bid process: November/December 2010
Start of Vault Construction: January 2011
ViewRay expects to have final FDA approval March/April 2011
Earliest expected Delivery of Equipment: August 2011
Start of Validation Process: September 2011
First patient treatment: December 2011

8. Business Case
Anticipates new market capture by year 3 of radiotherapy volumes of 8% over current (increase is modeled based on experience being the market leader introducing Tomotherapy), then tapering as technology is more widely adopted
Shifts appropriate volume from Computed Tomography (CT) guidance to ViewRay MRI guidance to maximize use of new technology for patient safety
Estimates that it will take two years for all payors to adopt coverage for new Current Procedural Terminology (CPT) Codes required for new technology and revenue will not be maximized until codes are established

9. Conclusion
Our vision is to provide the cancer patient with cutting edge technology that improves patient care as well as increases research opportunities
With Healthcare Reform on the horizon, it will be critical to differentiate ourselves from the competition in providing the most comprehensive treatment options for our patients as an accountable care organization. UWHC will be one of the first three facilities to receive the new equipment nationally
Baseline projections show a positive Internal Rate of Return (IRR) for most-likely scenarios
Purchase would enhance the positive image of University of Wisconsin Health and the Carbone Cancer Center to the community, patients, and referring physicians
Board Resolution