#1AstraZeneca B What science can do Q1 2021 results Conference call and webcast for investors and analysts 30 April 2021#2Forward-looking statements In order, among other things, to utilise the 'safe harbour' provisions of the US Private Securities Litigation Reform Act of 1995, AstraZeneca (hereafter 'the Group') provides the following cautionary statement: this document contains certain forward-looking statements with respect to the operations, performance and financial condition of the Group, including, among other things, statements about expected revenues, margins, earnings per share or other financial or other measures. Although the Group believes its expectations are based on reasonable assumptions, any forward-looking statements, by their very nature, involve risks and uncertainties and may be influenced by factors that could cause actual outcomes and results to be materially different from those predicted. The forward-looking statements reflect knowledge and information available at the date of preparation of this document and the Group undertakes no obligation to update these forward-looking statements. The Group identifies the forward-looking statements by using the words 'anticipates', 'believes', 'expects', 'intends' and similar expressions in such statements. Important factors that could cause actual results to differ materially from those contained in forward-looking statements, certain of which are beyond the Group's control, include, among other things: the risk of failure or delay in delivery of pipeline or launch of new medicines; the risk of failure to meet regulatory or ethical requirements for medicine development or approval; the risk of failure to obtain, defend and enforce effective IP protection and IP challenges by third parties; the impact of competitive pressures including expiry or loss of IP rights, and generic competition; the impact of price controls and reductions; the impact of economic, regulatory and political pressures; the impact of uncertainty and volatility in relation to the UK's exit from the EU; the risk of failures or delays in the quality or execution of the Group's commercial strategies; the risk of failure to maintain supply of compliant, quality medicines; the risk of illegal trade in the Group's medicines; the impact of reliance on third-party goods and services; the risk of failure in information technology, data protection or cybercrime; the risk of failure of critical processes; any expected gains from productivity initiatives are uncertain; the risk of failure to attract, develop, engage and retain a diverse, talented and capable workforce, including following completion of the Alexion Pharmaceuticals, Inc. (Alexion) transaction; the risk of failure to adhere to applicable laws, rules and regulations; the risk of the safety and efficacy of marketed medicines being questioned; the risk of adverse outcome of litigation and/or governmental investigations, including relating to the Alexion transaction; the risk of failure to adhere to increasingly stringent anti-bribery and anti-corruption legislation; the risk of failure to achieve strategic plans or meet targets or expectations; the risk of failure in financial control or the occurrence of fraud; the risk of unexpected deterioration in the Group's financial position; the impact that the COVID-19 global pandemic may have or continue to have on these risks, on the Group's ability to continue to mitigate these risks, and on the Group's operations, financial results or financial condition; the risk that a condition to the closing of the transaction with Alexion may not be satisfied, or that a regulatory approval that may be required for the transaction is delayed or is obtained subject to conditions that are not anticipated; the risk that AstraZeneca is unable to achieve the synergies and value creation contemplated by the Alexion transaction, or that AstraZeneca is unable to promptly and effectively integrate Alexion's businesses; and the risk that management's time and attention are diverted on transaction-related issues or that disruption from the Alexion transaction makes it more difficult to maintain business, contractual and operational relationships. Nothing in this document, or any related presentation/webcast, should be construed as a profit forecast. B 2#3Forward-looking statements, proposed acquisition of Alexion Important additional information In connection with the proposed transaction, the Group filed a registration statement on Form F-4 (the Registration Statement), which has been declared effective by the United States Securities and Exchange Commission (SEC), and which includes a document that serves as a prospectus of the Group and a proxy statement of Alexion (the proxy statement/prospectus). Alexion filed the proxy statement/prospectus as a proxy statement and the Group filed the proxy statement/prospectus as a prospectus with the SEC on 12 April 2021, and each party will file other documents regarding the proposed transaction with the SEC. Investors and security holders of Alexion are urged to carefully read the entire registration statement and proxy statement/prospectus and other relevant documents filed with the SEC when they become available, because they will contain important information. A definitive proxy statement will be sent to Alexion's shareholders. Investors and security holders will be able to obtain the Registration Statement and the proxy statement/prospectus free of charge from the SEC's website or from the Group or Alexion as described in the paragraphs below. 3 The documents filed by the Group with the SEC may be obtained free of charge at the SEC's website at www.sec.gov. These documents may also be obtained free of charge on the Group's website at http://www.astrazeneca.com under the tab "Investors". The documents filed by Alexion with the SEC may be obtained free of charge at the SEC's website at www.sec.gov. These documents may also be obtained free of charge on Alexion's website at http://www.alexion.com under the tab, "Investors" and under the heading "SEC Filings" or by contacting Alexion's Investor Relations Department at [email protected]. Participants in the solicitation Alexion, the Group and certain of their directors, executive officers and employees may be deemed participants in the solicitation of proxies from Alexion shareholders in connection with the proposed transaction. Information regarding the persons who may, under the rules of the SEC, be deemed participants in the solicitation of the shareholders of Alexion in connection with the proposed transaction, including a description of their direct or indirect interests, by security holdings or otherwise, is set forth in the proxy statement/prospectus filed with the SEC on 12 April 2021. Information about the directors and executive officers of Alexion and their ownership of Alexion shares is set forth in Alexion's Annual Report on Form 10-K/A, as previously filed with the SEC on 16 February 2021. Free copies of these documents may be obtained as described in the paragraphs above. B#44 Speakers Pascal Soriot Executive Director and Chief Executive Officer Marc Dunoyer Executive Director and Chief Financial Officer Dave Fredrickson Executive Vice President, Oncology Business Unit Pam Cheng Executive Vice President, Operations & IT (for Q&A) Ruud Dobber Executive Vice President, BioPharmaceuticals Business Unit Leon Wang Executive Vice President, International and China President (for Q&A) Mene Pangalos Executive Vice President, BioPharmaceuticals R&D 4#5Agenda Overview Oncology 5 BioPharmaceuticals, Emerging markets Finance Pipeline update, news flow Closing and Q&A B#6Q1 2021: solid start to the year Key highlights Total revenue +11%, incl. 4% from the pandemic COVID-19¹ vaccine. Total revenue excl. vaccine +7% Growth: Oncology +16% and New CVRM² +15%. Respiratory & Immunology -4%, impacted by stocking in Q1 2020. Emerging markets +10% Core operating profit +34%, supported by core 001³ (+146%) Core EPS4 $1.63 (+53%), incl. 8% tax rate. Impact of pandemic vaccine $(0.03) Pipeline progress underpins double-digit revenue growth ESG5: COVID-19 vaccine supplies increasing Proposed Alexion acquisition passed several competition clearances; shareholder vote 11 May 2021 2021 guidance reiterated: total revenue increase by a low teens percentage, accompanied by faster growth in core EPS to $4.75 to $5.00 Absolute values at actual exchange rates; changes at constant exchange rates (CER) and for first-quarter (Q1) 2021, unless stated otherwise. Guidance at CER and excludes the COVID-19 vaccine and Alexion. 1. Coronavirus disease; an infectious disease caused by a newly discovered coronavirus 2. New Cardiovascular, Renal and Metabolism comprising Farxiga, Brilinta, Diabetes and Renal 3. Other operating income 4. Earnings per share 5. Environmental, social and (corporate) governance (topics). 3 6#7Progress in the late-stage pipeline Milestones since the last results update Regulatory approval or other regulatory action Regulatory submission acceptance and/or submission Major Phase III data readout or other significant development Medicine Tagrisso Imfinzi Koselugo Lynparza Brilique Lynparza Farxiga roxadustat nirsevimab COVID-19 vaccine Indication (geography) adjuvant NSCLC¹ (EGFRm2): approval (CN) adjuvant NSCLC (EGFRm): positive opinion (EU) bladder cancer (2nd line³): indication voluntarily withdrawn (US) NF14: positive opinion (EU) breast cancer (BRCAm5): submission voluntarily withdrawn (CN) CAD/T2D7 CVOT8: submission voluntarily withdrawn (EU, CN) adjuvant breast cancer (BRCAm): Phase III primary endpoint met COVID-19: Phase III primary endpoint not met anaemia in CKDº: delay in regulatory decision due to convening of advisory committee (US) RSV10: Phase III primary endpoint met COVID-19: Phase III primary endpoint met (US trial) 1. Non-small cell lung cancer 2. Epidermal growth factor receptor mutation 3. 2nd treatment in the metastatic setting; 1st/2nd/3rd line used across this presentation 4. Neurofibromatosis type 1 5. Breast cancer susceptibility gene 1/2 mutation 6. Coronary artery disease 7. Type-2 diabetes 8. Cardiovascular outcomes trial 9. Chronic kidney disease 10. Respiratory syncytial virus. Status as of 30 April 2021. 7 4#88 Q1 2021: total revenue +11% Vaccine contributed 4% of growth Total revenue growth, per cent FY 2015 T FY 2016 FY 2017 Total revenue excluding vaccine increased by 7% Q1 2018 Q2 2018 Q3 2018 14% 11% 18% Q4 2018 Q1 2019 Q2 2019 22% Q3 2019 5% 17% Q4 2019 Q1 2020 11% Q2 2020 Total revenue excluding vaccine (with negative growth in dark grey) Pandemic COVID-19 vaccine Changes at CER. 3% Q3 2020 10% Q4 2020 4% 7% Q1 2021 Brilinta Bevespi Koselugo Breztri New medicines the major contributor +$0.8bn incremental revenue of the new medicines compared to Q1 2020¹ Lokelma Enhertu Fasenra roxadustat Imfinzi Tagrisso Calquence Lynparza Farxiga Oncology New CVRM Respiratory & Immunology Absolute values at CER. 1. Total revenue for Farxiga, Lynparza, Tagrisso, Calquence, Imfinzi, Fasenra, roxadustat, Enhertu, Lokelma, Breztri, Koselugo, Bevespi and Brilinta. $m 200 150 100 50 0 -50 3#9Q1 2021: solid start to the year Oncology and New CVRM drove growth Oncology New CVRM Respiratory & Immunology Other medicines Total revenue excl. vaccine Pandemic COVID-19 vaccine Total revenue Growth across disease areas Total revenue at actual exchange rates; changes at CER. 9 Q1 2021 $m 3,024 1,306 1,546 1,169 7,045 275 7,320 growth % 16 15 (4) (4) 7 11 ratio % 41 18 21 16 96 100 EMs¹ - EMS ex China - China US Europe Established rest of world Total revenue Growth across geographies Q1 2021 $m 2,592 913 1,679 2,310 1,546 872 7,320 Total revenue at actual exchange rates; changes at CER. 1. Emerging markets. growth % 10 11 10 10 18 5 11 ratio % 35 12 23 32 21 12 100 B#10Accelerating the expansion into immunology Good progress made with FTC¹ and other clearances AstraZeneca & 1. US Federal Trade Commission. 10 Compelling scientific complementarity and synergy Combination of two science- and patient-centric organisations Further-sustained, industry-leading double-digit revenue growth Improved profitability and strengthened cash flow ALEXION Alexion, the AstraZeneca rare disease unit B#11Agenda Overview Oncology BioPharmaceuticals, Emerging markets Finance Pipeline update, news flow Closing and Q&A 11 B#12Tagrisso and Imfinzi Global growth boosted by Europe, Rest of World Tagrisso: 13% growth to $1.1bn $m Approvals 17 (adjuvant), 89 (1st line), 91 (2nd line)¹ 1,200 1,000 800 600 400 200 0+ Q1 2018 Q2 2018 Q3 2018 Q4 2018 Q1 2019 Q2 2019 Q3 2019 Q4 2019 Q1 2020 Q2 2020 Q3 2020 US Europe Established Rest of World (EROW) EMS Total revenue at actual exchange rates; changes at CER and for Q1 2021, unless stated otherwise. 12 Q4 2020 Q1 2021 ● ● ● ● US +12% (36% of total) Growth reduced from high penetration, fewer diagnoses. Europe +26% 1st-line adoption rates increased in key countries EROW +14% Japan: +7%; >80% 1st-line penetration maintained² EMs +5% China -5%. 1st-line NRDL³ stock compensation; underlying solid growth 1. Reimbursement in four, 43 and 67 countries, respectively. 2. Market research, Q1 2021. 3. National Reimbursement Drug List. $m 600 500 400 300 200 100 Q1 2018 Q2 2018 Q3 Imfinzi: 17% growth to $0.6bn Approvals 714 (NSCLC5), 534 (ES-SCLC6) 2018 Q4 2018 Q1 2019 Q2 2019 Q3 2019 Q4 2019 Q1 2020 Q2 2020 US Europe EROW EMS Total revenue at actual rates; changes exchange at CER and for Q1 2021, unless stated otherwise. Q3 2020 Q4 2020 Q1 2021 ● ● ● US +2% (53% of total) COVID-19 reduced overall diagnoses; use in SCLC grew Europe +32% Emerging SCLC use drove growth EROW +35% Japan: +39%; fewer diagnoses; increased SCLC uptake EMS +69% China NSCLC launch continued 4. Reimbursement in 34 and eight countries, respectively. 5. Unresectable, Stage III NSCLC. 6. Extensive-stage small cell lung cancer. 3#13Lynparza The globally-leading PARP¹ inhibitor $m 13 600 500 400 300 200 100 - Lynparza 33% sales growth to $0.5bn Q1 2018 Q2 2018 Q3 2018 Q4 2018 Q1 2019 Q2 2019 Fur Q3 2019 Product sales at actual exchange rates; changes at CER and for Q1 2021, unless stated otherwise. 1. Poly ADP ribose polymerase. Q4 2019 Lynnarza Q1 2020 Q2 2020 Q3 2020 Q4 2020 Q1 2021 As ● E Approvals 81 (ovarian), 79 (breast), 59 (pancreatic) and 55 (prostate cancer) AstraZeneca US +28% (47% of total) Growth driven by use in prostate cancer Europe +33% Growth from 1st-line OC2, prostate EMs +54% Expanded China NRDL supported OC 2. Ovarian cancer. EROW +22% Japan: +17%. c.14% Q2 2020 price cut. OC uptake; emerging in other cancers $ Q3 2017 Lynparza collaboration revenue da Q4 2017 Q1 2018 2018 Q4 2018 Q2 2018 Q3 Q1 2019 US-28859 4/19 Q2 2019 Q3 2019 Q4 2019 Q1 2020 Q2 2020 Q3 2020 Q4 2020 Q1 2021 Collaboration exchange rates. revenue at actual Collaboration with Merck & Co., Inc., Kenilworth, NJ, US, known side the US and Canada. $3.1bn revenue recorded; $4.6bn future potential. $m as MSD out- 1,000 800 600 400 200 0 $ THE TRE FOR P#14Calquence and Enhertu Launches continued well Calquence $m Approvals: 61 (CLL¹) and 28 countries (MCL²)³ 250 200 150 100 50 0 Q1 2018 Q2 2018 Q3 2018 Q4 2018 Q1 2019 Q2 2019 Q3 2019 Q4 2019 Q1 2020 Q2 2020 Q3 2020 Q4 2020 Q1 2021 ● ● ● Global $209m; US $195m US CLL Use moved earlier; share of new patients now: Front line c.40% of BTKI4 class and c.15% overall R/R5 c.40% of BTKi class and c.15% overall6 Global CLL Worldwide launch ongoing US Europe EROW EMs Total revenue at actual exchange rates. 1. Chronic lymphocytic leukaemia 2. Mantle cell lymphoma (R/R) 3. Reimbursement in up to 13 (2nd line) and eight countries, respectively 4. Bruton tyrosine kinase inhibitor 5. Relapsed/refractory 6. IQVIA. 14 $m 50 40 30 20 10 0 Q1 2020 Enhertu Approvals: US, EU, JP (mBC7); US, JP (mGC³) Q2 2020 Q3 2020 Q4 2020 Q1 2021 ● Global $40m; US $35m $73m total US in-market sales by Daiichi Sankyo France early access and sporadic launch sales elsewhere 00-406-41 ENHERTU -rastrual dedica nection B 100 mg per vial nu insion Onl and Dute pro to Cytotec Age NDC 65597-406-01 Rx only ENHERTUⓇ (fam-trastuzumab deruxtecan-nxki) For Injection 100 mg per vial For Intravenous Infusion Only Dispense the enclosed Medication Guide to each patient. Reconstitute and Dilute prior to administration Single-Dose Vial Discard Unused Portion CAUTION: Cytotoxic Agent KEEP REFRIGERATED 1 vial Daiichi-Sankyo AstraZeneca US Europe EMS Total revenue at actual exchange rates, including $1m of sales. 7. Metastatic breast cancer (3rd line, HER2+) 8. Metastatic gastric cancer (3rd line/2n line+, HER2+). 4#15BioPharmaceuticals: New CVRM 15% growth boosted by Farxiga and EMS $m 1,500 1,250 1,000 750 500 250 Q1 2018 Q2 2018 Q3 2018 New CVRM 15% growth Q4 2018 Q1 2019 Q2 2019 Q3 2019 Farxiga Brilinta Diabetes Renal Total revenue at actual exchange rates; changes at CER and for Q1 2021, unless stated otherwise. 15 Q4 2019 Q1 2020 Q2 2020 Q3 2020 Q4 2020 Q1 2021 $m 750 500 250 Q1 2018 Q2 2018 Q3 2018 Q4 2018 Farxiga 50% growth - the fastest-growing SGLT2i¹ globally Q1 2019 Q2 2019 Q3 2019 US Europe EROW EMS Total revenue at actual exchange rates; changes at CER and for Q1 2021, unless stated otherwise. Q4 2019 Q1 2020 Q2 2020 Q3 2020 Q4 2020 Q1 2021 US +16% Strong volume growth including HFrEF2 indication, but offset by price impact Europe +36% Solid volume growth boosted by initial launch of HFrEF indication EMs +85% Benefit from NRDL inclusion in China and also strong growth elsewhere 1. Sodium-glucose co-transporter 2 inhibitor 2. Heart failure with reduced ejection fraction. Ą#16BioPharmaceuticals: Respiratory & Immunology Recovery continued, but offset by Q1 2020 stocking effect Respiratory down 4% from $m high stocking base in 2020 2,000 1,500 1,000 500 - Q1 2018 Q2 2018 Q3 2018 Q4 2018 Q1 2019 Q2 2019 Q3 2019 Fasenra Symbicort Other Pulmicort Total revenue at actual exchange rates; changes at CER and for Q1 2021, unless stated otherwise. 16 Q4 2019 Q1 2020 Q2 2020 Q3 2020 Q4 2020 Q1 2021 Impact from stocking in Q1 2020 Comparison to ease in Q2 2021 US +8% Symbicort (-14%); slowing market growth. Fasenra (+30%) Europe -15% Symbicort (-21%) ; partial offset by Fasenra (+25%) EROW -22% Japan: -26%; increasing Symbicort competition. Fasenra (+33%) EMS -4% Pulmicort ($286m, -14%); continued impact from COVID-19 and generics. 3rd generic now approved Maintenance use with Symbicort ($165m, +3%) partly offset Pulmicort 11-2018 PBHE PULMICORT 1 mg/2m W Pulmicort 1mg in 2 mL restules Sterle single-dose un user uspersion 5 x 2mL อาชนทราย ยาเฉพาะ AstraZeneca. Fasenra Pen 30 mg/mL (benvallzumab Pjection p Symbicort 3#17BioPharmaceuticals: new launch medicines Portfolio of new medicines across uses and markets Europe $63m (+25%); Japan $26m (+19%) US, total patient share Leading new biologic medicine in many markets¹ US $156m (+30%) Leading novel biologic¹ 100% 80% 60% Fasenra Severe asthma 40% 20% 0% Q4 2017 Q2 201 SQ4 2018 tan Q2 2019 Q4 2019 Con Q2 2020 52% 48% etit Q4 2020 Total revenue at actual exchange rates. 1. Market shares are total patient share in severe, uncontrolled asthma; specialty pharmacies and 'buy and bill' market, IQVIA market research. 17 Breztri COPD US $12m Achieved 20%+ share of new patients² EMs $9m Continued launch in China; NRDL inclusion in place. Japan $5m Achieved 25%+ share of new patients² 2. IQVIA market research. ストリエアロスフィア ピレーズトリ エアロスフィア 56双入 FASUDAAN GHASKA TS $m 40 30 20 10 0 Lokelma Hyperkalaemia Global $33m; US $24m US market leadership³; COVID-19 reduced growth Global launch continued Q1 2019 Q2 2019 Q3 2019 Q4 2019 2020 Q1 Q2 2020 Q3 2020 Q4 2020 Q1 2021 T₁ US Europe EROW EMS Total revenue at actual exchange rates. 3. Market leadership in both total and new-to-medicine patients, IQVIA market research. $m 50 40 30 10 20- 0 EMs $41m Now recording sales in China. Increased hospital listings and patients roxadustat Anaemia in CKD US Regulatory decision H2 '21 Q1 2020 Q2 2020 Q3 2020 Q4 2020 EMS Total revenue at actual exchange rates. Q1 2021 3#18Emerging markets Diverse and solid growth $m 3,000 2,500 2,000 1,500 1,000 500 Q1 2018 Q2 2018 Q3 2018 Emerging markets +10% EMs ex China +11%; China +10% Q4 2018 Q1 2019 Q2 2019 Q3 2019 China EMs ex China Total revenue at actual exchange rates; changes at CER and for Q1 2021, unless stated otherwise. 18 Q4 2019 Q1 2020 Q2 2020 Q3 2020 Q4 2020 Q1 2021 Performance driven by new medicines up 30% (34% of total revenue; $0.9bn¹) Oncology +4%: Tagrisso (+5%) ; March 2021 NRDL inclusion. New CVRM +41% : Forxiga (+85%); roxadustat ($41m) Respiratory & Immunology -4%: Pulmicort ($286m, -14%), but Symbicort continued up ($165m, +3%) Diversified growth: AP2 stable, MEA³ +26%, LA4 +10%, Russia +7% 2021 China patient access: major NRDL inclusion Tagrisso 1st line and VBP5 impact to Brilinta, Nexium, other tail medicines Revenue anticipated to continue growing ahead of the long-term ambition of mid to high single-digit growth Total revenue at actual exchange rates; changes at CER and for Q1 2021, unless stated otherwise. 1. Total revenue at CER 2. Asia Pacific 3. Middle East, Africa and other 4. Latin America 5. Volume-based procurement. 3#19Agenda Overview Oncology BioPharmaceuticals, Emerging markets Finance Pipeline update, news flow Closing and Q&A 19 B#20Reported profit and loss Total revenue - product sales - collaboration revenue Gross margin Operating expenses¹ - R&D² expenses - SG&A³ expenses Other operating income Operating profit Tax rate EPS Q1 2021 $m 7,320 7,257 63 74.3% 4,741 1,713 2,929 1,180 1,895 2.9% $1.19 change % 11 11 42 (2.7) pp4 9 19 4 145 54 97 % total revenue 100 99 1 65 23 40 16 26 Absolute values at actual exchange rates; changes at CER. Gross margin excludes the impact of collaboration revenue and any associated costs, thereby reflecting the underlying performance of product sales. 1. Includes distribution expenses 2. Research and development 3. Sales, general and administration 4. Percentage points. 20 B#21Core profit and loss Total revenue - product sales - collaboration revenue Gross margin Operating expenses - R&D expenses - SG&A expenses Other operating income Operating profit Tax rate EPS Impact of pandemic vaccine Q1 2021 $m 7,320 7,257 63 74.6% 4,136 1,638 2,399 1,180 2,524 8.1% 1.63 $(0.03) change % 11 11 42 (3.0) pp 11 18 7 146 34 53 % total revenue 100 99 1 57 22 33 16 34 Absolute values at actual exchange rates; changes at CER. Gross margin excludes the impact of collaboration revenue and any associated costs, thereby reflecting the underlying performance of product sales. 21 B#22Analysis: core operating profit and net debt Increasing core operating profit; net debt was stable $m 22 2,750 2,500 2,250 2,000 1,750 1,500 1,250 1,000 750 500 250 0 Q3 2017 Core operating profit reached $2,524m Sources of profit continued to progress Q4 2017 Q1 2018 Q2 2018 Return Return to to sales revenue growth growth Q3 2018 Residual Collaboration revenue (CR) Core O01 Absolute values at actual exchange rates. Q4 2018 Q1 2019 Q2 2019 Q3 2019 Q4 2019 Q1 2020 Q2 2020 Q3 2020 Q4 2020 Q1 2021 $bn 12.1 Net debt end 2020 2.7 EBITDA Net debt broadly stable from improved EBITDA¹ 1.2 Working capital, short-term provisions 0.8 Other operating cash, disposals 0.2 Capex 0.4 Contingent and intangible assets and non-current asset investments Net debt: $12,205m EBITDA: $8,942m 2.5 Dividends 0.1 Other AstraZeneca credit ratings: 1. Earnings before interest, tax, depreciation and amortisation; last four quarters ($8,942m vs. $6,974m one year ago) Moody's: short-term rating P-2, long-term rating A3, outlook negative. Standard & Poor's: short-term rating A-2, long-term rating BBB+, CreditWatch positive. 12.2 Net debt end March 2021 3#23Financial priorities Q1 2021 results underpinned the strategic journey Deleveraging/dividend growth As cash flow improves, deleveraging and progressive dividend policy ● Unchanged priorities for capital allocation. Cash-flow growth 28% growth in reported EBITDA and continued improvement in working capital management ● • 2021: anticipate further improvement in cash flow, cash- flow metrics and dividend cover Changes at CER except last four quarters (used for EBITDA). 23 ● Revenue growth +7% growth in total revenue in Q1 2021 excluding the pan- demic COVID-19 vaccine Operating leverage 57% ratio of core operating expenses to total revenue (stable) ● • 34% growth in core operating profit • 34% core operating profit margin including contribution from 001 B#242021 guidance reiterated Total revenue increase by a low teens percentage Core EPS faster growth to $4.75 to $5.00 Guidance is at CER. The guidance does not incorporate any revenue or profit impact from sales of the pandemic COVID-19 vaccine. Similarly, the guidance excludes the proposed acquisition of Alexion which is intended to become AstraZeneca's rare disease unit and area of expertise. The acquisition is anticipated to close in Q3 2021. AstraZeneca recognises the heightened risks and uncertainties from the impact of COVID-19. Variations in performance between quarters can be expected to continue. B 24#25Alexion: recent US FTC clearance milestone Acquisition logic, rationale and highlights unchanged Compelling scientific complementarity and synergy, e.g. Pipeline boosted with 11 molecules across 20+ programmes Combination of two science- and patient-centric organisations Further-sustained, industry-leading revenue growth, e.g. Double-digit average annual revenue growth through 2025 25 ● ● Improved profitability and strengthened cash flow Core operating margin significantly enhanced in the short term, and with continued margin expansion thereafter Synergies c.$500m per year by the end of the third year following completion ● ● ● ALEXION ● TRANSITION PLANNING TEAM — Double-digit percentage core EPS accretion anticipated in the first three years following completion Strong cash flow, rapid debt deleveraging with an ambition to increase the dividend Strong, investment-grade credit rating to provide strategic and financial flexibility ASTRAZENECA Significant regulatory progress; several important competition clearances obtained Shareholder vote 11 May 2021 Source: 12 December 2020 webinar and conference call for investors and analysts on the proposed Alexion acquisition. Targets provided above are aspirational only and should not be considered formal guidance. For details, including legal disclaimer, please visit: https://www.astrazeneca.com/investor-relations/astrazeneca-to-acquire-alexion.html. For a complete list of competition authority clearances, please visit: https://www.astrazeneca.com/investor-relations/astrazeneca-to-acquire-alexion.html#table. B#26Agenda Overview Oncology BioPharmaceuticals, Emerging markets Finance Pipeline update, news flow Closing and Q&A 26 B#27Continuing response to COVID-19 Status on vaccine and anti-viral antibody COVID-19 vaccine clinical and real-world data US Phase III met the primary endpoint with 76% vaccine efficacy Real-world data from UK rollout showing >80% protection against hospitalisation¹ 73% effective 35 days after first dose in older adults² Potential to play a significant role in defeating the pandemic 1. Bernal JL et al., preprint published online, The Lancet. 2021 2. Hyams C et al., preprint published online, The Lancet. 2021. 27 COVID-19 vaccine rollout 68m doses invoiced globally COVAX initiative has reached 100 countries Supply continuing to ramp with production yields improving Work on new variants begun Granted conditional approval or emergency use in c.80 countries AZD7442 long-acting antibody combo Potential to offer immediate protection Late-stage trials in both prophylaxis and treatment. US Government agreements for potential supply of 700,000 doses First data in H1 2021 3#28CVRM: treating underlying conditions Broad portfolio of next-generation medicines Cardiovascular AZD8233 (PCSK9¹) hypercholesterolaemia. MEDI6570 (LOX-1²) CV disease AZD8601 (VEGF-A³) CV disease Heart failure No AZD4831 (MPO4) HFPEF5 Farxiga + AZD9977 (MCR6) HF, CKD ● Renal G₁S Farxiga (SGLT2) CKD Farxiga + zibotentan (ERA) CKD AZD5718 (FLAP8) CAD/CKD Metabolism Liver disease Q cotadutide (GLP-19/glucagon) NASH ¹0, DKD¹1 AZD2693 (PNPLA3¹²) NASH Visit astrazeneca.com for a replay of the 'Meet AZN management: BioPharmaceuticals' event 1. Proprotein convertase subtilisin/kexin type 9 2. Lectin-like oxidized low-density lipoprotein receptor-1 3. Vascular endothelial growth factor A 4. Myeloperoxidase 5. Heart failure with preserved ejection fraction 6. Mineralocorticoid receptor 7. Endothelin receptor antagonist 8. 5-Lipoxygenase-activating protein 9. Glucagon-like peptide-1 10. Non-alcoholic steatohepatitis 11. Diabetic kidney disease 12. Patatin-like phospholipase domain-containing protein. 28 3#29Respiratory & Immunology: nirsevimab First immunisation to show benefit in a general infant population Synagis is the only antibody approved for prevention in high- risk infants¹ with RSV² RSV-related hospitalisations (%) 15% 10% 5% Building on Synagis launched in 1998 0% 10.6% placebo ↓55% reduction 4.8% SYNAGIS 8 PALIVIZUMAB Over 20 years of experience in RSV prevention with Synagis 1. Children of premature birth (less than or equal to 35 weeks) or bronchopulmonary dysplasia 2. Respiratory syncytial (virus). Source: Pediatrics, 1998, 102(3):531-537. 29 nirsevimab Phase IIb trial had strong results³ 70% lower rate of medically- attended RSV-associated lower respiratory tract infection 78% lower rate of hospitalisation RSV-related hospitalisations (%) 5% 0% 4.1% placebo ↓78% reduction 0.8% nirsevimab c.30 million infant lower respiratory tract infections per year, globally 3. Population: healthy infants born early (29 weeks, 0 days to 34 weeks 6 days of gestation). Sources: The New England Journal of Medicine, 13 August 2020, 13;383(7):698 and AstraZeneca epidemiology estimate. In collaboration with Sanofi. nirsevimab MELODY Phase III trial showed positive data Positive efficacy readout in general infant population. Protection across the entire RSV season with one dose Trial continues for safety MEDLEY Phase II/III trial also anticipated to read out early First regulatory submission anticipated in 2022 3#30BioPharmaceuticals: 'What's next' Expanding pipeline, including immunology What's next Phase I/II new medicines, selected MEDI3506 (IL33¹ mAb²) DKD cotadutide (GLP-1/glucagon co-agonist) NASH, DKD AZD4831 (MPO inhibitor) HFpEF AZD5718 (FLAP inhibitor) CKD, CAD AZD9977 + Farxiga (MCR modulator + SGLT2) HF with CKD zibotentan + Farxiga (ETR³ antagonist + SGLT2) CKD CAD Plla available ✓ MEDI3506 (IL33 mAb) asthma, COPD, AD4, COVID-19 AZD1402 (IL4Ra5 antagonist) asthma AZD0449, AZD4604 (inhaled JAK6 inhibitors) asthma MEDI7352 (NGF7 TNF8 bispecific fusion protein) - pain AZD2693 (PNPLA3 inhibitor) NASH AZD8233 (PCSK9 ASO⁹) hypercholesterolaemia Phase II started ✓ AZD4604 Phase I started ✓ Phase II started ✓ 1. Interleukin-33 2. Monoclonal antibody 3. Endothelin receptor 4. Atopic dermatitis (eczema) 5. Interleukin-4 receptor alpha 6. Janus kinase 7. Nerve growth factor 8. Tumour necrosis factor 9. Antisense oligonucleotide 10. Trial technically classified as Phase II. 30 What's now Phase III new medicines roxadustat anaemia in CKD nirsevimab RSV brazikumab inflammatory bowel disease¹0 PT027 asthma Farxiga multiple indications tezepelumab severe asthma anifrolumab lupus (SLE) Phase III lifecycle management, major New Phase III started ✓ Fasenra multiple indications Breztri/Trixeo asthma#31In memory of José Baselga (1959-2021) 31 30M Ⓡ ● José Baselga tragically passed away on 21 March 2021 José joined AstraZeneca in early 2019 as Executive Vice President and Head of Oncology R&D, but had been supporting AstraZeneca in various advisory capacities for a number of years José has left a lasting legacy on AstraZeneca, including: Collaborations on Enhertu and datopotamab deruxtecan ● Ⓡ Strategy for breast cancer and other cancer areas Extensive use of novel biomarkers in development A number of other key initiatives Relentless focus on patients and their care B#32Breast cancer Progressing pipeline across multiple modalities Lynparza adjuvant breast cancer Phase III OlympiA trial unblinded IDMC¹ recommended trial move. to primary analysis and reporting based on planned interim analysis of primary endpoint iDFS² Anticipated to become new standard of care in the treatment of BRCAm high-risk HER2- negative early breast cancer First PARPI to demonstrate benefit in BRCAm adjuvant breast cancer 1. Independent Data Monitoring Committee 2. Invasive disease-free survival. 32 PARP1-selective inhibitor Five abstracts at AACR³ Selective PARP1-DNA trapper More potent and efficacious than first-generation PARP inhibitors Relative Tumour Volume 14.0 10.0 5.0- 30- 2.0- 1.0 0.5- 0.2- AZD5305 01. → Vehicle 0 HBCX-9 Carboplatin 50mg/kg QW AZD5305-006 1mg/kg QD Combination 14 21 Days of Treatment Strong 72% TGI Combination 88% TGI *** 87% reg *** 28 activity with carboplatin (non-BRCA -setting) AZD5305 now in Phase I trials 3. Abstract ND05, American Association for Cancer Research, 2021. Upcoming Enhertu breast cancer data readouts H2 2021 DESTINY-Breast03 (2L, HER2+) 2022 DESTINY-Breast02 (3L, HER2+) DESTINY-Breast04 (HER2 low) 2022+ Multiple trials across HER2+, HER2 low and earlier disease Multiple Phase III trials underway 3#33Breast cancer: well-positioned with at least five medicines Potential to cover most patients across settings and lines of treatment HER2+ c.20% of patients Hormone- receptor positive (HR+) c.65% of patients Triple-negative (TNBC) c.15% of patients Illustrative; includes trials planned. 33 Early/curative setting Neo-adjuvant Enhertu monotherapy and potential combos HER low c.55% of patients that are not HER2+ Adjuvant ADC² +/- 10³ camizestrant capivasertib Lynparza (BRCAm) ADC after neo-adjuvant 1st line camizestrant capivasertib combinations ADC +/- 10 capivasertib + CTX4 Metastatic setting 2nd line Enhertu monotherapy and potential combos camizestrant capivasertib combinations Enhertu Lynparza (BRCAm) datopotamab 3rd line Enhertu Enhertu datopotamab deruxtecan 3rd line+ datopotamab deruxtecan 1. HER2-low prevalence is anticipated to be c.35-40% in TNBC 2. Antibody drug conjugates (Enhertu and datopo- tamab deruxtecan) 3. Immunotherapy 4. Chemotherapy. 3#34Oncology: 'What's next' Solid pipeline moving forward What's next Phase I/II new medicines, selected adavosertib (WEE1¹ inhibitor) uterine, ovarian cancer oleclumab (CD73² mAb) solid tumours AZD5305 (PARP1 inhibitor) solid tumours AZD4573 (CDK9³ inhibitor) blood cancers AZD5991 (MCL14 inhibitor) blood cancers Now Phase I ✓ ceralasertib (ATR5 inhibitor) solid tumours, blood cancers AZD4635 (A2AR6 inhibitor) solid tumours MEDI5752 (PD-17/CTLA48 mAb) solid tumours AZD2811 (Aurora B inhibitor) solid tumours, blood cancers AZD0466 (Bcl-29/XL) solid tumours, blood cancers 1. Tyrosine kinase WEE1 2.5'-nucleotidase 3. Cyclin-dependent kinase 9 4. Induced myeloid leukaemia cell differentiation protein 5. Ataxia telangiectasia and rad3-related kinase 6. Adenosine A2A receptor 7. Programmed cell death protein 1 8. Cytotoxic T-lymphocyte-associated protein 4 9. B-cell lymphoma 2 10. Potentially pivotal Phase II. 34 What's now datopotamab deruxtecan lung cancer monalizumab head & neck cancer savolitinib NSCLC10 Tagrisso NSCLC Phase III new medicines camizestrant (AZD9833) breast cancer Imfinzi multiple cancers capivasertib breast, prostate cancer Phase III lifecycle management, major tremelimumab multiple cancers Lynparza multiple cancers New Phase III Enhertu multiple cancers Calquence multiple cancers#35Late-stage pipeline events in the 2021-2022 timeframe Busy news flow continues; Phase III readouts increase into 2021 Regulatory decision Regulatory submission acceptance and/or submission Key Phase III data readout H1 2021 Tagrisso-adjuvant NSCLC (EGFRM) (EU) Koselugo - NF1 (EU) Farxiga - CKD (US) Symbicort - mild asthma (EU) Calquence - CLL (R/R) (ELEVATE R/R) Fasenra - nasal polyps tezepelumab - severe asthma COVID-19 vaccine - COVID-19 (US, JP) AZD7442 - SARS-CoV-2 Imfinzi +/-treme - NSCLC (1L) (POSEIDON) (OS) AZD7442 - SARS-CoV-2 Status as of 30 April 2021. 1. Based on a planned interim analysis as communicated by Daiichi Sankyo in Q2 of their fiscal year 2021. 35 H2 2021 Lynparza - prostate cancer (2L) (CN) Forxiga - CKD (EU, JP, CN) Brilique - stroke (THALES) (EU, CN) roxadustat - anaemia in CKD (US) anifrolumab - lupus (SLE) (US, EU, JP) Imfinzi - unresectable, Stage III NSCLC (PACIFIC-2) Imfinzi +/-treme - NSCLC (1L) (POSEIDON) Imfinzi +/-treme - liver cancer (1L) Lynparza - adjuvant breast cancer Lynparza - prostate cancer (1L, castration-resistant) Enhertu - breast cancer (2L, HER2+) Imfinzi - unresectable, Stage III NSCLC (PACIFIC-2) Imfinzi - NSCLC (1L) (PEARL) Imfinzi +/- treme - liver cancer (1L) Lynparza - prostate cancer (1L, castration-resistant) Enhertu - breast cancer (2L, HER2+)¹ Farxiga - HF (HFpEF) PT027- asthma nirsevimab - RSV (MEDLEY) 2022 Imfinzi - ES-SCLC (CN) Imfinzi - NSCLC (1L) (PEARL) Imfinzi - limited-stage SCLC Imfinzi - liver cancer (locoregional) Imfinzi - biliary tract cancer Lynparza - ovarian cancer (3L, BRCAM) Enhertu - breast cancer (3L, HER2+) (Phase III) Enhertu - breast cancer (HER2 low) Calquence - CLL (CN) Koselugo - NF1 (JP, CN) Farxiga - HF (HFpEF) roxadustat - anaemia in myelodysplastic syndrome PT027 - asthma nirsevimab - RSV Imfinzi - limited-stage SCLC Imfinzi - liver cancer (locoregional) Imfinzi - biliary tract cancer Enhertu - breast cancer (3L, HER2+) (Phase III) Enhertu - breast cancer (HER2 low) roxadustat - anaemia in myelodysplastic syndrome 3#36Agenda Overview Oncology BioPharmaceuticals, Emerging markets Finance Pipeline update, news flow Closing and Q&A 36 B#37AstraZeneca in summary Pipeline-driven transformation Global presence Balanced specialty and primary-care franchises¹ Leading emerging markets presence with R&D base Strong pipeline 22 Phase III medicines and significant lifecycle projects Advancing early- and mid-stage pipeline Improving financials Nine blockbuster medicines² Returned to durable revenue and earnings growth Focus on operating leverage and cash flow Innovative medicines in Oncology, BioPharmaceuticals³ and rare diseases4 Experienced and proven team 1. In Q1 2021, speciality-care medicines (Oncology, Brilinta, Lokelma, roxadustat and Fasenra) comprised 51% of total revenue 2. Last four quarters 3. Cardiovascular, Renal & Metabolism and Respiratory & Immunology 4. Subject to the Alexion acquisition. 37 4#3825 Questions & Answers 38 Recently launched: AIR As part of ongoing efforts to make sustainability data transparent and accessible, the new Analyst Interactive Reporting (AIR) centre provides sustainability data in a single platform, covering global information from key performance indicators for Access to healthcare, Environmental protection and Ethics and transparency astrazeneca.com/investors/air#39Appendix: 'What's next' Next key milestone by project Oncology Project adavosertib ceralasertib oleclumab AZD4635 AZD5305 MEDI5752 AZD4573 AZD2811 AZD5991 AZD0466 Status as of 30 April 2021. 39 Target WEE1 ATR CD73 A2AR PARP1 PD-1/ CTLA4 CDK9 Aurora B MCL1 Bcl-2/xL Phase || || || || I | || I I | Indication uterine, ovarian cancer solid tumours blood cancers solid tumours solid tumours solid tumours solid tumours blood cancers solid tumours blood cancers blood cancers solid tumours blood cancers Next milestone Phase III start Phase II data Phase II data Phase II data Phase I data 2021 Phase II start 2021 Phase II data Phase II start 2021 Phase II start 2021 Phase I data 2021 Phase I start 2021 BioPharmaceuticals: CVRM Target GLP-1/ glucagon Project cotadutide AZD4831 AZD5718 AZD9977 + Farxiga zibotentan + Farxiga AZD2693 AZD8233 MEDI3506 AZD1402 AZD0449 AZD4604 MPO MEDI7352 FLAP MCR + SGLT2 ETR + SGLT2 PNPLA3 PCSK9 IL33 IL4Ra JAK Phase NGF TNF || || || I I || BioPharmaceuticals: Respiratory & Immunology I || || Indication | || NASH DKD HFpEF CKD CAD HF with CKD CKD NASH hypercholesterolaemia COPD asthma, AD, COVID-19, DKD asthma asthma Pain Pain, osteoarthritis Next milestone Phase IIb data H2 2021 Phase II data 2022 Phase IIb start H1 2021 Phase IIb data 2022 Phase II start H1 2021 Phase II start H1 2021 Phase I data H2 2021 Phase II data H2 2021 Phase I data 2021 Phase II data 2021/22 Phase II data 2022 Phase II start H1 2021 Phase I data 2022 Phase II start Phase II data 3#4040 Use of AstraZeneca conference call, webcast and presentation slides The AstraZeneca webcast, conference call and presentation slides (together the 'AstraZeneca materials') are for your personal, non-commercial use only. 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