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INITIATING COVERAGE                                                                                                              July 25, 2011

                                          VENTRUS BIOSCIENCES (VTUS)
                                                                                                                                                 22
                                      RATING:                    BUY                                                                             20
BIOPHARMA
                                      PRICE:                     $11.89                                                                          18
                                                                                                                                                 16
                                      PRICE TARGET:              $24
                                                                                                                                                 14
WILLIAM TANNER, PHD                   MARKET CAP:                $156.0 M                                                                        12
212-632-1512
william.tanner@lazardcap.com          S&P 500:                   1,345                                                                           10
                                                                                                                                                 8
COLLEEN MACKEY
                                      DRG:                       332
                                                                                                                                                 6
212-632-6413
colleen.mackey@lazardcap.com                                                                                                                     4
                                                                                 Dec               Feb            Apr            Jun
                                                                                 SOURCE: FactSet


                                          VTUS: Emerging player in large GI markets — initiating
                                          coverage with a BUY rating and $24 PT
                                             Small cap BioPharma targeting large unmet medical needs — success would
                                             make Ventrus big player in the space. In our opinion, Ventrus is uniquely
                                             positioned to develop treatments for large unmet GI disorders that lack effective
                                             prescription treatments, as they have been relatively ignored by large BioPharma
                                             companies. VEN 309 (iferanserin for hemorrhoids) and VEN 307 (diltiazem for
                                             anal fissures) could be important new therapies with little competition.
                                             Market cap belies stage of development and proof of concept of lead drug
                                             candidates. A market cap of $156M stands in contrast to the proof of concept
                                             and late stages of clinical testing of the company’s lead assets, in our opinion.
                                             Savvy investors may wish to take advantage of the obscure genesis of Ventrus
                                             and the inefficient manner in which the market may have valued the company.
                                             Ventrus could address markets alone or become an acquisition candidate
                                             for GI-focused market player. The unmet medical need for effective treatments
                                             should position VEN 309 and VEN 307 as drugs of substantial potential. We
                                             believe the commercial markets are addressable by a focused sales force that
                                             leverages the unmet medical need and the search for effective alternatives.
                                             Valuation and risks. Our $24 PT for VTUS shares is derived from the NPV for
                                             VEN 309 and VEN 307. Risks include successful clinical development of lead
                                             assets, regulatory approval and commercial market penetration.
 DECEMBER YEAR                    2010                                      2011E                                                      2012E
                                                  1Q11A         2Q11          3Q11                 4Q11           YEAR
Revenue (M)                       $0.0                $0.0       $0.0            $0.0               $0.0            $0.0                 $0.0
EBITDA (M)                         NM                   NM        NM              NM                NM               NM                   NM
EPS                            $(24.67)           $(0.38)      $(0.68)      $(0.44)           $(0.44)             $(1.94)              $(0.55)
FCF/S                              NM                   NM        NM              NM                NM               NM                   NM


 CAPITALIZATION                                                    VALUATION                               2010         2011E            2012E

Shares Outstanding (M)                           13.1             P/E                                       NM              NM              NM
Total Net Debt (M)                               NM               Rel. to S&P 500                           NM              NM              NM
Enterprise Value (M)                             106.1M           EV/EBITDA                                 NM              NM              NM
Total Debt / Capitalization                      NM               FCF Multiple                              NM              NM              NM




Effective May 10, 2005, Lazard Frères & Co. LLC (“LF&Co.”) transferred its capital markets business (which includes
equity research, syndicate, sales and trading) to a new privately-held company, Lazard Capital Markets LLC, which is
neither owned nor controlled by LF&Co. LF&Co., which is part of publicly-traded Lazard Ltd, has retained, among
other things, its investment banking business (including its mergers and acquisitions and financial restructuring
practices). Please see pages 22-23 for important disclosures and analyst certification.
KEY DRIVERS TO MONITOR                                                        TRADING / DIVIDEND DATA

1) Data from Phase III trial of VEN 309 in Q1 2012                             Range Since IPO on 12/17/10                     $20-$6
2) Data from European Phase III trial of VEN 307 in 2Q12                       Avg. Daily Trading Volume (000)                 125
3) VEN 307 NDA filing in 2013                                                  Dividend / Yield                                $0.00 / 0.0%




 KEY RISKS TO MONITOR                                                          BENCHMARKS

1) Successful completion of VEN 309 Phase III trial                             ROIC                                             NM
2) Successful completion of E.U. VEN 307 Phase III trial                        Book Value P/S *                                 NM
3) Uptake of Rectiv as a treatment for anal fissures (approved                  Price/Book *                                     NM
6/21/11)                                                                        Free Cash Flow Yield *                           NM
                                                                                Projected 3-year EPS Growth Rate                 -3%
                                                                                Institutional Ownership                          10%

                                                                                * Last actual quarter



FOREC AST PERCENT CH ANGE (Y/Y)
 DECEMBER YEAR        2010                                                     2011E                                              2012E
                                                   1Q11A            2Q11           3Q11             4Q11          YEAR
Revenue                             NM                 NM             NM               NM               NM           NM               NM
EBITDA                              NM                 NM             NM               NM               NM           NM               NM
EPS                                 NM                 NM             NM               NM               NM           NM               NM
FCF/S                               NM                 NM             NM               NM               NM           NM               NM




 COMPANY DESCRIPTION

 Ventrus is a specialty BioPharma company developing therapeutics to treat gastrointestinal disorders for which available treatments are
 relatively ineffective. VEN 309 (iferanserin) is a 5HT-2a receptor agonist for treating hemorrhoids. By modulating vasomotion, the drug
 could be effective for reducing swelling caused by blood vessel engorgement that is characteristic of hemorrhoids. If approved, VEN 309
 would be the only prescription treatment indicated for the condition and should fare well, in our opinion, as an alternative to topical creams.
 Proof of concept has been demonstrated in numerous Phase II trials, and commencement of Phase III testing is expected to commence in
 2H11. VEN 307 is a cream preparation of the calcium channel blocker diltiazem (originally approved as Cardizem for treating
 hypertension) and is being developed for treating anal fissures. Diltiazem is currently being used by some physicians (obtained from
 compounding pharmacies), so its effectiveness would appear to have been established in real-world settings. Availability of a prescription
 formulation would likely be more attractive to physicians unwilling to search for or rely upon drug obtained from compounding pharmacies.
 The focused nature of the markets could allow Ventrus to commercialize the products without the need for a commercial partner.




                                                                                                                                              2
INVESTMENT THESIS

Ventrus is a specialty BioPharma company developing therapeutics to treat
gastrointestinal disorders for which available treatments are relatively ineffective.
VEN 309 (iferanserin) is a 5HT-2a receptor antagonist for treating hemorrhoids.
By modulating vasomotion, the drug could be effective for reducing swelling
caused by blood vessel engorgement that is characteristic of hemorrhoids. If
approved, VEN 309 would be the only prescription treatment indicated for that
condition and should fare well, in our opinion, as an alternative to topical creams
and off-label treatments. Proof of concept has been demonstrated in numerous
Phase II trials, and commencement of Phase III testing is expected in 2H11. VEN
307 is a cream preparation of the calcium channel blocker diltiazem (originally
approved as Cardizem for treating hypertension) and is being developed for
treating anal fissures. Diltiazem is currently used by some physicians (obtained
from compounding pharmacies), so its effectiveness would appear to have been
established in a real-world setting. Availability of a prescription formulation
would likely be more attractive to physicians unwilling to search for or rely upon
drug obtained from compounding pharmacies. The focused nature of the markets
could allow Ventrus to commercialize the products without the need for a
commercial partner.

REASONS TO BUY

Valuation is compelling. As discussed in a subsequent section of this report, we
estimate the fair value of VTUS shares at $24, so we view the stock as being
significantly undervalued at the current price. By our analysis, either the market
views successful development of VEN 309 and/or 307 as of low probability or
our revenue estimates are too aggressive.

Meaningful catalysts lie ahead. Results from the Phase III trial of VEN 309 for
treating hemorrhoids could become available in 1Q12. Results from a Phase III
trial of VEN 307 being conducted in the E.U. in patients with anal fissures should
become available shortly thereafter.

Ventrus could develop the first FDA-approved prescription medication for
treating hemorrhoids. In the U.S., an estimated 4M prescriptions are written
each year for medications that are not approved as a treatment for the condition.
An estimated 22M units of over-the-counter (OTC) products are sold each year
for treating hemorrhoids as well. Most current treatments provide only temporary
symptom relief and do not address the underlying disease pathology. Patients
with persistent symptoms may progress to rubber band ligation, an invasive
procedure that involves banding the internal hemorrhoid for 4-7 days.

Product portfolio offers attractive blend of development and regulatory
risks. Our expert physician channel checks suggest that successful development
of VEN 309 is not without challenges given that a well-defined path to develop
treatments for the condition does not exist. Obviously, given the number of
prescriptions and OTC units dispensed each year, the demand for an effective
treatment could be robust. VEN 307, by contrast, may be easier to develop given
that abundant proof of concept exists in the real-world setting by virtue of the use



           Ventrus Biosciences (VTUS)                                             3
of compounded diltiazem. Our checks reveal that availability of prescription
diltiazem, FDA approved and marketed by a biopharma company, might still be
an attractive alternative in the face of more inexpensive compounded material.

Ventrus could be a natural acquisition candidate. We believe Ventrus could
be an attractive target for companies with business operations that focus on
gastrointestinal disorders or others that may be seeking to enter those markets.

RISKS

Development risks. As with practically any development-stage biopharma
company, the primary risk associated with investing in VTUS shares relates to
development and commercial activities. VEN 309 may blaze a trail with the FDA
as to how hemorrhoid treatments should be developed. The company attempted
to negotiate a Special Protocol Assessment (SPA) with the FDA but believed that
reaching an agreement would unnecessarily delay pivotal clinical testing. We
note that SPAs are by no means a binding contract with the Agency. We suspect
the company will, nevertheless, design the study to assess appropriate endpoints
that assess the drug’s safety and effectiveness.

Regulatory risks. VEN 309 has not been approved by the FDA, so there is an
obvious, albeit generic, risk that the Agency might not approve the drug. We see
less risk with VEN 307 given that the drug is essentially repurposed diltiazem.
Because the anal fissure indication will likely encompass a much smaller patient
population than the original hypertension one, we doubt the FDA will have
significant issues with approval.

Competition from Rectiv. Rectiv (nitroglycerin ointment) was approved on
June 21, 2011, as the first prescription drug for the treatment of pain associated
with chronic anal fissures. Consultants do not view it as a suitable alternative
given the side effects, especially when there exists substantial variability in blood
flow at the site of application, as would likely be the case with anal fissures.

Need for additional capital. We forecast Ventrus becoming profitable in 2015,
and our model contemplates a raise of $50M in 2013. Inability to raise capital
could negatively impact the commercial launch of the products.

FINANCIAL MODEL AND VALUATION

Probability-weighted NPV analysis yields a fair value of $24 per share. We
view the fair value of VTUS shares as being driven mainly by the successful
completion of Phase III testing and commercialization of VEN 309 for treating
hemorrhoids and VEN 307 for treating anal fissures. We have not included any
contribution from VEN 308 (phenylephrine gel for fecal intolerance) in our
financial model as the company is not actively developing it at this time. Based
on our revenue models, the value attributed to each drug is shown in the NPV
analysis in Exhibit 1. When additional proof of concept is provided, we would
likely be inclined to increase the probability of technical success (pTS) and that
would have the effect of increasing the value of each asset. For example, at a pTS




           Ventrus Biosciences (VTUS)                                              4
of 100%, the fair value per share would be $24 for VEN 309 and $23 for VEN
307.

    Exhibit 1. VTUS share valuation
                                VTUS NPV Valuation
                     NPV         pTS   Adjusted NPV            Fair Value/Share
     VEN 309           $314        50%                $157                  $12
     VEN 307           $305        50%                $153                  $12

     Shares (M), 2011E                                                      13.1
     Fair Value                                                              $24
    Source: LCM research; pTS = probability of Technical Success


The market model for VEN 309 is depicted in Exhibit 13 at the end of this report.
In brief, we use a prevalence of approximately 12.5M persons with hemorrhoids
in the U.S. and approximately 28M in the E.U. We assume the monthly cost to be
approximately $150 at launch with 4% annual price increases going forward.

Our financial model assumes that Ventrus sells VEN 309 in the U.S. and receives
royalties of 25% of gross sales from a partner in the E.U. We project that Ventrus
will pay royalties of 3.5% and 1.2% to Amer in the U.S. and E.U., respectively.
Projections assume FDA approval in 2014, with sales commencing in 2015.
Penetration of the hemorrhoid market grows from 1% after launch to a peak of
20% in the U.S. and 15% in the E.U. Each 5% market share translates into
approximately $250M in sales.

Based on the proof of concept data, we believe the probability that VEN 309 is
effective for treating hemorrhoids is relatively high. However, given that the
program is not without development risk, we applied a discount rate of 25% and
a probability of technical success (pTS) of 50% to the NPV estimate to arrive at
our per share estimate of $24.

Exhibit 2 provides details of our modeled future payments to Amer for VEN 309.




           Ventrus Biosciences (VTUS)                                              5
Exhibit 2. VEN 309 Modeled Payments to Amer




Source: LCM Research
                           The market model for VEN 307 is depicted in Exhibit 14 at the end of this report.
                           We model Ventrus selling VEN 307 in the U.S. and paying royalties of 8% to
                           S.L.A. Pharma. Projections assume FDA approval in 2014, with sales
                           commencing in 2015. Penetration of the anal fissure market grows from 1% after
                           launch to a peak of 20%. Each 5% market share translates into approximately
                           $240M in sales.

                           Exhibit 3 provides details of our modeled future payments to S.L.A. Pharma for
                           VEN 307.

Exhibit 3. VEN 307 Modeled Payments to S.L.A. Pharma




Source: LCM Research
                           Given that VEN 309 could address large markets and encounter little in the way
                           of meaningful competition, we believe it may be most helpful to conduct
                           sensitivity analyses around major variables such as pTS, pricing and market
                           penetration. In that way, investors can better assess the reasonableness of the
                           assumptions and the impact of deviation from them.

                           Exhibit 4 depicts a sensitivity analysis varying pTS for both assets and the
                           discount rate. As noted in Exhibit 1, we applied a pTS of 50% for both VEN 309
                           and VEN 307.




                                      Ventrus Biosciences (VTUS)                                          6
Exhibit 4. VTUS Discount Rate / pTS Sensitivity
                              VTUS Disc. Rate/pTS Sensitivity
                                      Discount Rate
              $    23.6        15%       20%      25%         30%        35%
                  30.0%   $   26.8 $ 19.4 $ 14.2 $ 10.5             $    7.8
                  40.0%   $   35.8 $ 25.8 $ 18.9 $ 14.0             $   10.4
   pTS            50.0%   $   44.7 $ 32.3 $ 23.6 $ 17.5             $   13.0
                  60.0%   $   53.6 $ 38.7 $ 28.3 $ 20.9             $   15.6
                  70.0%   $   62.6 $ 45.2 $ 33.0 $ 24.4             $   18.2
Source: LCM Research

We also wanted to examine the impact of pricing and market penetration on the
NPV of the assets. Exhibit 5 depicts sensitivity analyses varying monthly cost
and peak market penetration. As depicted in the VEN 309 market model in
Exhibit 13, we assume a cost of treatment of $150/month and peak market
penetration of 20%. Our revenue model has been set up such that market
penetration for years preceding peak penetration are derived by subtracting set
basis points of market share from the preceding year, specifically (working
backward from peak), 450bps, 450bps, 500bps, 250bps and 200bps.

Exhibit 5. VEN 309 Price (monthly)/Penetration Sensitivities




Source: LCM Research
Exhibit 6 depicts a similar analysis for VEN 307 for the U.S. market only.

Exhibit 6. VEN 307 Price (monthly)/Penetration Sensitivity




Source: LCM Research




             Ventrus Biosciences (VTUS)                                        7
VEN 309 — NOVEL APPLICATION OF A CNS DRUG

Iferanserin is a new chemical entity (NCE) that has been formulated as an
ointment for intra-anal application to treat hemorrhoids. The pharmacophore is a
highly selective, 5HT-2a receptor antagonist that was initially developed by
scientists at a major pharmaceutical company for treating various disorders of the
central nervous system (CNS). Beset by poor penetration of the blood-brain
barrier, development of the drug was directed toward use as a treatment of
vascular diseases.

Peripheral 5-HT2a receptors are believed to be involved in blood clotting and in
the contraction of arteries and veins, two events that are likely associated with the
formation of hemorrhoids. By reducing 5-HT2a receptor activity, it would be
predicted that VEN 309 might improve blood flow from the dilated veins that
comprise the hemorrhoid, thereby reducing bleeding, itchiness and pain.

On June 5, 2011, Ventrus entered into an Asset Purchase Agreement with Sam
Amer & Co., Inc. to acquire all rights, title and interest to VEN 309 for the
topical treatment of symptomatic hemorrhoids.

HEMORRHOIDS ARE SWOLLEN VEINS IN THE RECTUM OR ANUS

Hemorrhoids are described as swollen/inflamed veins in the rectum and anus, and
they often arise as a result of straining during defecation and heavy lifting.
Occurrence of hemorrhoids during pregnancy is also not uncommon. It has been
estimated that, by age 50, approximately half of adults have experienced
symptoms of hemorrhoids.

Physiologically, progressive occlusion of venous return vessels is believed to
induce stretching of the vessels that can lead to vascular stasis. Ultimately,
hemorrhoids can become swollen and inflamed and trapped blood leads to the
formation of piles (protruding skin folds that are filled with static and
thrombosed blood). Typical patient symptoms include bleeding, pain, itching,
swelling and difficulty defecating. Exhibit 7 depicts an illustration of
hemorrhoids.




           Ventrus Biosciences (VTUS)                                             8
Exhibit 7. Internal and External Hemorrhoids




Source: LCM Research
According to data from the National Institute of Diabetes and Digestive Kidney
Diseases, there are approximately 12.5M adults in the U.S. affected by
hemorrhoids. The significant size of the patient population notwithstanding, there
are currently no FDA-approved prescription drugs for treating the condition. As a
consequence, patients commonly resort to use of over-the-counter (OTC)
treatments, with the majority of them providing only temporary relief from the
symptoms and not addressing the underlying disease pathology, i.e., the vascular
dysfunction. Alternatively, prescription drugs (e.g., corticosteroids) are often
used in an off-label manner.

If those interventions do not provide adequate relief, ultimately surgical
procedures may be resorted to. External hemorrhoids can sometimes be dealt
with by a simple incision providing relief by draining pooled blood. More
invasive procedures can involve rubber band ligation that essentially chokes off
the blood supply at the base of the structure. Sclerotherapy (sometimes used for
treating varicose veins) involves injection of a chemical solution such as sodium
tetradecyl sulfate into the hemorrhoid. Logic suggests that treatments that avoid
the need for more aggressive intervention might be met by a receptive market.

PIVOTAL TESTING OF VEN 309 RESTS ON PREVIOUS WORK

Phase III testing of VEN 309 is expected to begin in 2H11, and the trial has been
designed to include approximately 600 patients in a double-blind, 3-arm design.
Iferanserin (0.5%) ointment will be compared with placebo ointment in the
following cohorts: 1) placebo as needed for 14 days, 2) iferanserin as needed for
14 days and 3) iferanserin as needed for 7 days followed by placebo as needed
for 7 days. Approximately 80 trial sites are expected to participate, and all
patients will be evaluated for follow-up at 28 days. All patients will roll over to
active treatment after 28 days with a 12 month follow-up to assess recurrence
(open label).

Inclusion criteria call for patients with symptomatic grade I to III internal
hemorrhoids who have experienced bleeding and pain or itching for two



             Ventrus Biosciences (VTUS)                                          9
consecutive days prior to randomization. These grades encompass hemorrhoids
that do not prolapse and those that prolapse upon defecation and spontaneously
reduce or must be manually reduced. Grade IV internal hemorrhoids, or those
that are prolapsed and cannot be manually reduced, will be excluded. The
primary endpoint is no bleeding on days 7-14, which is during the second week
of treatment. A secondary endpoint will consider no pain or itching during the
same period of time.

Questions have arisen as to why the trial was not designed to test VEN 309
against an active comparator. As it relates to pharmacologic treatment, because
there are no FDA-approved drugs with an indication for hemorrhoids, there is no
valid prescription comparison. Versus an OTC product such as Preparation H
(14% mineral oil, 71.9% petrolatum and 0.25% phenylephrine HCl), it could be
argued that the placebo being used in Phase III testing is not all that different.

According to the company, Phase IIb testing was conducted in Germany in 2003-
2004, in a trial that included 121 patients randomized to receive iferanserin 0.5%
(same as the Phase III dose) twice per day vs. placebo. Baseline and weekly visits
were conducted over the two week trial with follow-up at 45 days. A bleeding
scale of 1-10, with 1 indicating the absence of the symptom and 10 indicating the
worst symptom, was the primary endpoint, with itching and pain scales used as
secondary endpoints. Exhibit 8 depicts the mean daily bleeding scores, and
Exhibits 9 and 10 depict the mean daily itching and pain scores, respectively.

Exhibit 8. VEN 309 Phase IIb Mean Daily Bleeding Score (Germany)




Source: Company Presentation




             Ventrus Biosciences (VTUS)                                         10
Exhibit 9. VEN 309 Phase IIb Mean Daily Itching Score (Germany)




Source: Company Presentation




Exhibit 10.VEN 309 Phase IIb Mean Daily Pain Score (Germany)




Source: Company Presentation




The company modeled the potential performance of the primary and secondary
endpoints that will be used in the Phase III trial using data from the German
Phase IIb trial. The expected primary endpoint results based on this data are
shown in Exhibit 11 below.




             Ventrus Biosciences (VTUS)                                     11
Exhibit 11. Analysis of German Phase IIb study for Phase III Endpoint




Source: Company Presentation.




VEN 307 — A PRECRIPTION FORMULATION OF A
CURRENTLY USED DRUG

VEN 307 (diltiazem cream) is being developed as a topical treatment for
relief of pain associated with anal fissures. Anal fissures are small tears or cuts
in the lining of the anus or anal canal that cause bleeding and pain that is often
severe. Patients frequently resort to surgery for relief, although surgery itself can
lead to unsatisfactory outcomes such as fecal incontinence. It is estimated that
there are approximately 4M cases of anal fissures in the U.S. Verispan L.L.C., a
pharmaceutical market research firm, indicated that this population made about
1M office visits in the U.S. in 2003.




              Ventrus Biosciences (VTUS)                                          12
Exhibit 12. Anal Fissures




Source: VTUS Investor Presentation


VEN 307 is a pre-mixed and pre-packaged proprietary formulation of diltiazem
that is applied topically. It yields less than one-tenth the amount of diltiazem in
the blood from the lowest oral dose used for cardiovascular treatment, and yet
has a considerably greater effect on sphincter tone than diltiazem when taken
orally. Gastroenterologists’ existing familiarity with the use of diltiazem may
allow for accelerated market penetration if the drug is approved. Ventrus licensed
the exclusive North American rights to VEN 307 for the topical treatment of anal
fissures from S.L.A. Pharma, which completed early-stage clinical trials,
toxicology studies and manufacturing up to the end of Phase II.

S.L.A. Pharma commenced a Phase III clinical trial in the E.U. in November
2010 that is expected to be completed in the second quarter of 2012. The
company intends to develop the topical formulation as a Section 505(b)(2) NDA
filing due to previous approval of diltiazem as a systemic agent for hypertension
and angina. This, in combination with the Phase III trial being conducted by
S.L.A. Pharma and the planned Phase III U.S. trial, will form the basis of the
NDA application. If the U.S. trial is successful, the company intends to conduct
three short-term dermal toxicology studies and file an IND with the FDA for one
pivotal Phase III trial or two parallel pivotal Phase III trials. Depending on the
results of those trials, an NDA filing could be expected in 2013.

In June 2011, the FDA approved Rectiv, a nitroglycerin ointment, as the first
prescription product to treat anal fissures. However, a significant number of
patients experience headaches as a side effect of nitroglycerin. As mentioned
previously, consultants do not view nitroglycerin as a suitable alternative given
the side effects, especially when there exists substantial variability in blood flow
at the site of application, as would likely be the case with anal fissures.




              Ventrus Biosciences (VTUS)                                          13
VEN 308 FOR TREATING FECAL INCONTINENCE

Ventrus licensed the exclusive North American rights to VEN 308 from S.L.A.
Pharma, which developed the specific formulation of phenylephrine for the
topical use of fecal incontinence and developed the manufacturing method.

The company held a pre-IND meeting with the FDA in June 2007 concerning
VEN 308 for the treatment of fecal incontinence associated with ileal pouch anal
anastomosis. It was determined that the next clinical study should be a Phase IIb
trial with multiple doses assessed and that existing toxicology data are sufficient
to support the trial.

At this time, the company is focusing on continuing development of VEN 307
and 309 and is not pursuing development of VEN 308.

COMMERCIALIZATION POTENTIAL

We believe the commercial markets are addressable by a focused sales force of
approximately 100 sales representatives. Gastroenterologists, colorectal surgeons
and general practitioners would be the obvious prescribers for both VEN 307 and
309. A public relations effort, followed by direct-to-consumer marketing, would
presumably be required in order to achieve our sales estimates. Given the size of
the market and the extent of the unmet medical need (particularly for
hemorrhoids) if effective, we suspect the ability to persuade physicians and
patients to try the drug would not require an aggressive marketing campaign that
requires a significant and prolonged investment.

INTELLECTUAL PROPERTY

VEN 309 is licensed from Sam Amer & Co., Inc. (Amer), which had developed
the drug through Phase II trials and up to readiness for Phase III trials in the U.S.
and Europe. The license includes rights to all existing intellectual property and
any further improvements on VEN 309 owned by Amer related to the use of the
product for the topical treatment of anorectal disorders. VEN 309 is covered for
composition of matter in patents that will expire in August 2015 in the U.S. and
February 2018 elsewhere. If approved, VEN 309 will receive five years of data
exclusivity in the U.S. as an NCE under Hatch-Waxman and 10 years from the
date of approval in Europe. Ventrus filed a new concentration range patent in
August 2010 that, if issued, would grant patent protection until 2030 and prevent
substitutable generic competition.

On June 5, 2011, Ventrus entered into an agreement to purchase all rights, title
and interest to VEN 309 from Amer. The transaction is expected to be complete
by November 2011.

Ventrus has licensed the exclusive North American rights to VEN 307 for the
topical treatment of anal fissures from S.L.A. Pharma, which completed early-
stage clinical trials, toxicology studies and manufacturing for VEN 307 up to the
end of Phase II. Ventrus is using its own resources to pursue development. VEN



           Ventrus Biosciences (VTUS)                                              14
307 is covered by method of use in a patent that will expire in February 2018. If
approved, VEN 307 will receive three years of data exclusivity in the U.S. under
Hatch-Waxman.

Ventrus has licensed the exclusive North American rights to VEN 308 from
S.L.A. Pharma, which developed the specific formulation of phenylephrine for
topical use in fecal incontinence and developed the manufacturing method.
S.L.A. Pharma’s previous partner, Solvay, conducted pharmacokinetic studies.
Ventrus does not expect to continue developing VEN 308 in the short term. VEN
308 is covered by a patent that will expire in December 2017. If approved, VEN
308 will receive seven years of data exclusivity in the U.S. under the Orphan
Drug Act.

FINANCING HISTORY

Ventrus was incorporated in October 2005 (as South Island Biosciences, Inc.)
and began operations in April 2007.

In October 2005, Ventrus issued a promissory note payable to Paramount
BioSciences, LLC (Paramount), an affiliate of one of the company’s significant
stockholders. A second promissory note was issued in July 2007. In 2008, both
notes were voluntarily converted into shares of common stock and warrants to
purchase additional shares.

In April and July 2008, the company issued two additional promissory notes.
During 2007 and 2008, the company issued approximately $5.3M of senior
convertible notes in connection with a private placement. During 2009, Ventrus
issued four separate promissory notes to Paramount Credit Partners, LLC (whose
managing member is the same as Paramount BioSciences). The total principal
amount borrowed was approximately $1.6M. In February, April and May of
2010, the company issued approximately $5.6M of senior convertible notes that
provided funds to hire its management team and undertake an initial public
offering.

The company’s IPO was completed in December 2010 and raised approximately
$17.5M in net proceeds, including the underwriters’ over-allotment. The 2007,
2008, and 2010 convertible notes and 2008 promissory notes were converted into
shares at the close of the IPO. Retail investors were the primary participants of
the equity offering.

The company raised additional equity financing in a follow-on that priced in July
2011. For all intents and purposes, the transaction could be viewed as a “re-IPO,”
and institutional investors participated in the offering. Including the underwriters’
over-allotment, Ventrus raised net proceeds of $47.5M and issued 5.175M shares
of common stock. The company intends to use the capital to pay for the rights to
VEN 309, pay down the 2009 promissory notes to Paramount, continue
development of VEN 309, fund working capital requirements and other general
corporate purposes.




           Ventrus Biosciences (VTUS)                                             15
VENTRUS MANAGEMENT

Russell H. Ellison, M.D., M.Sc.

Dr. Ellison joined Ventrus as a director, Chief Executive Officer and Chief
Medical Officer in June 2010. He was elected Chairman of the Board in January
2011. Dr. Ellison’s prior experience includes positions at Paramount Biosciences
LLC, a global pharmaceutical development and healthcare investment firm;
Fibrogen, Inc., a privately held biotechnology company; Sanofi-Synthelabo,
USA, a pharmaceutical company; Roche Laboratories, Inc., USA, a
pharmaceutical company; and CorMedix, Inc. (NYSE Amex: CRMD), a
pharmaceutical company that went public in March 2010. He currently serves as
a director of several privately held development stage biotechnology companies.
Dr. Ellison holds an M.D. from the University of British Columbia and an M.Sc.
(with distinction) from The London School of Tropical Medicine and Hygiene.

David J. Barrett

Mr. Barrett joined Ventrus as Chief Financial Officer in July 2010. His prior
experience includes positions at Neuro-Hitech, Inc. (NHPI.PK), a publicly traded
company focused on developing, marketing and distributing branded and generic
pharmaceutical products; Overture Asset Managers and Overture Financial
Services, which, at the time, was a start-up asset management firm that
assembled investment products and platforms to distribute turnkey and
unbundled investment solutions to financial intermediaries and institutional
investors; and Deloitte & Touche, LLP. Mr. Barrett became a director of
Coronado BioSciences, Inc., a biopharmaceutical company, in May 2011. Mr.
Barrett received his B.S. in Accounting and Economics in May of 1998 and his
M.S. in Accounting in May of 1999 from the University of Florida. He is a
certified public accountant.




           Ventrus Biosciences (VTUS)                                         16
Exhibit 13. VEN 309 / Hemorrhoid Market Model, 2011E – 2020E




Source: LCM Research




                                                   Ventrus Biosciences (VTUS)   17
Exhibit 14. VEN 307 / Anal Fissure Market Model, 2011E – 2020E




Source: LCM Research




                                                     Ventrus Biosciences (VTUS)   18
Exhibit 15. Ventrus Income Statement, 2010 – 2015E




Source: LCM Research




                                       Ventrus Biosciences (VTUS)   19
Exhibit 16. Ventrus Balance Sheet, 2010A – 2015E




Source: LCM Research




                                       Ventrus Biosciences (VTUS)   20
Exhibit 17. Ventrus Cash Flow Statement, 2010 – 2015E




Source: LCM Research




                                       Ventrus Biosciences (VTUS)   21
ANALYST CERTIFICATION

All of the recommendations and views about the securities and companies in this report accurately reflect
the personal views of the research analyst named on the cover of this report. No part of this research
analyst’s compensation was, is, or will be directly or indirectly related to the specific recommendations or
views expressed by the research analyst in this research report.

IMPORTANT DISCLOSURES

Lazard Frères & Co. LLC has received compensation for investment banking services
from VTUS within the past twelve (12) months.
Lazard Capital Markets LLC has acted as manager or co-manager of a securities
offering on behalf of VTUS within the past twelve (12) months.
Lazard Capital Markets LLC makes a market in VTUS securities.


                                            VTUS - Current Rating: BUY, Price Target: $24


                  24


                  22


                  20


                  18


                  16


                  14


                  12


                  10


                  8


                  6


                  4
                 Nov 10         Dec 10         Jan 11         Feb 11          Mar 11         Apr 11         May 11          Jun 11            Jul 11

                                                                                Data source: FactSet prices / LCM ratings and target prices

                                DISTRIBUTION OF INVESTMENT RATINGS (AS OF 07/22/11)
                       OVERALL DISTRIBUTION                      BANKING CLIENT DISTRIBUTION*
          BUY               NEUTRAL            SELL           BUY           NEUTRAL         SELL
          60%                  38%              2%            22%               7%            0%
* Indicates the percentage of each category in the Overall Distribution that were banking clients of Lazard Frères in the previous 12 months.




RATING                     GUIDELINE          (return targets may be modified by risk or liquidity issues)
BUY                        Expected to produce a positive total return of more than 10% in the next 12 months.
NEUTRAL                    Fairly valued; expected to product a total return of ±10% in the next 12 months.
SELL                       Expected to product a negative total return of more than 10% in the next 12 months.




                                                        Ventrus Biosciences (VTUS)                                                                     22
DISCLAIMERS

This report has been prepared by Lazard Capital Markets LLC (“LCM”) in New York. It may not be
reproduced, redistributed or copied in whole or in part for any purpose. This report has been approved by, and
is being distributed in the US or to US persons, by LCM, which accepts responsibility for its contents in the US.
Transactions undertaken in the US in any security mentioned herein must be effected through LCM or another
US-registered broker-dealer, in conformity with SEC Rule 15a-6.

Neither this report nor any copy or part thereof may be distributed in any other jurisdictions where its
distribution may be restricted by law and persons into whose possession this report comes should inform
themselves about, and observe, any such restrictions. Distribution of this report in any such other jurisdictions
may constitute a violation of US securities laws, or the law of any such other jurisdictions.

This report does not constitute an offer or solicitation to buy or sell any securities referred to herein. It should
not be so construed, nor should it or any part of it form the basis of, or be relied on in connection with, any
contract or commitment whatsoever. The information in this report, or on which this report is based, has been
obtained from sources that LCM believes to be reliable and accurate. However, it has not been independently
verified and no representation or warranty, express or implied, is made as to the accuracy or completeness of
any information obtained from third parties. The information or opinions are provided as at the date of this
report and are subject to change without notice. The information and opinions provided in this report take no
account of the investors’ individual circumstances and should not be taken as specific advice on the merits of
any investment decision. Investors should consider this report as only a single factor in making any investment
decisions. Further information is available upon request. LCM may provide specialized research products or
services to certain customers focusing on the prospects for individual covered stocks as compared to other
covered stocks over varying time horizons or under differing market conditions. While the views expressed in
these situations may not always be directionally consistent with the long-term views expressed in the analyst's
published research, the analyst has a reasonable basis and any inconsistencies can be reasonably explained.
LCM does not accept any liability whatsoever for any direct or consequential loss howsoever arising, directly or
indirectly, from any use of this report or its contents.

By accepting this report you agree to be bound by the foregoing limitations.

Lazard Capital Markets LLC
30 Rockefeller Plaza, New York, NY 10020
Member NYSE and FINRA
Copyright 2011 Lazard Capital Markets LLC. All rights reserved.




                                        Ventrus Biosciences (VTUS)                                           23

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VTUS: Emerging player in large GI markets with $24 price target

  • 1. INITIATING COVERAGE July 25, 2011 VENTRUS BIOSCIENCES (VTUS) 22 RATING: BUY 20 BIOPHARMA PRICE: $11.89 18 16 PRICE TARGET: $24 14 WILLIAM TANNER, PHD MARKET CAP: $156.0 M 12 212-632-1512 william.tanner@lazardcap.com S&P 500: 1,345 10 8 COLLEEN MACKEY DRG: 332 6 212-632-6413 colleen.mackey@lazardcap.com 4 Dec Feb Apr Jun SOURCE: FactSet VTUS: Emerging player in large GI markets — initiating coverage with a BUY rating and $24 PT Small cap BioPharma targeting large unmet medical needs — success would make Ventrus big player in the space. In our opinion, Ventrus is uniquely positioned to develop treatments for large unmet GI disorders that lack effective prescription treatments, as they have been relatively ignored by large BioPharma companies. VEN 309 (iferanserin for hemorrhoids) and VEN 307 (diltiazem for anal fissures) could be important new therapies with little competition. Market cap belies stage of development and proof of concept of lead drug candidates. A market cap of $156M stands in contrast to the proof of concept and late stages of clinical testing of the company’s lead assets, in our opinion. Savvy investors may wish to take advantage of the obscure genesis of Ventrus and the inefficient manner in which the market may have valued the company. Ventrus could address markets alone or become an acquisition candidate for GI-focused market player. The unmet medical need for effective treatments should position VEN 309 and VEN 307 as drugs of substantial potential. We believe the commercial markets are addressable by a focused sales force that leverages the unmet medical need and the search for effective alternatives. Valuation and risks. Our $24 PT for VTUS shares is derived from the NPV for VEN 309 and VEN 307. Risks include successful clinical development of lead assets, regulatory approval and commercial market penetration. DECEMBER YEAR 2010 2011E 2012E 1Q11A 2Q11 3Q11 4Q11 YEAR Revenue (M) $0.0 $0.0 $0.0 $0.0 $0.0 $0.0 $0.0 EBITDA (M) NM NM NM NM NM NM NM EPS $(24.67) $(0.38) $(0.68) $(0.44) $(0.44) $(1.94) $(0.55) FCF/S NM NM NM NM NM NM NM CAPITALIZATION VALUATION 2010 2011E 2012E Shares Outstanding (M) 13.1 P/E NM NM NM Total Net Debt (M) NM Rel. to S&P 500 NM NM NM Enterprise Value (M) 106.1M EV/EBITDA NM NM NM Total Debt / Capitalization NM FCF Multiple NM NM NM Effective May 10, 2005, Lazard Frères & Co. LLC (“LF&Co.”) transferred its capital markets business (which includes equity research, syndicate, sales and trading) to a new privately-held company, Lazard Capital Markets LLC, which is neither owned nor controlled by LF&Co. LF&Co., which is part of publicly-traded Lazard Ltd, has retained, among other things, its investment banking business (including its mergers and acquisitions and financial restructuring practices). Please see pages 22-23 for important disclosures and analyst certification.
  • 2. KEY DRIVERS TO MONITOR TRADING / DIVIDEND DATA 1) Data from Phase III trial of VEN 309 in Q1 2012 Range Since IPO on 12/17/10 $20-$6 2) Data from European Phase III trial of VEN 307 in 2Q12 Avg. Daily Trading Volume (000) 125 3) VEN 307 NDA filing in 2013 Dividend / Yield $0.00 / 0.0% KEY RISKS TO MONITOR BENCHMARKS 1) Successful completion of VEN 309 Phase III trial ROIC NM 2) Successful completion of E.U. VEN 307 Phase III trial Book Value P/S * NM 3) Uptake of Rectiv as a treatment for anal fissures (approved Price/Book * NM 6/21/11) Free Cash Flow Yield * NM Projected 3-year EPS Growth Rate -3% Institutional Ownership 10% * Last actual quarter FOREC AST PERCENT CH ANGE (Y/Y) DECEMBER YEAR 2010 2011E 2012E 1Q11A 2Q11 3Q11 4Q11 YEAR Revenue NM NM NM NM NM NM NM EBITDA NM NM NM NM NM NM NM EPS NM NM NM NM NM NM NM FCF/S NM NM NM NM NM NM NM COMPANY DESCRIPTION Ventrus is a specialty BioPharma company developing therapeutics to treat gastrointestinal disorders for which available treatments are relatively ineffective. VEN 309 (iferanserin) is a 5HT-2a receptor agonist for treating hemorrhoids. By modulating vasomotion, the drug could be effective for reducing swelling caused by blood vessel engorgement that is characteristic of hemorrhoids. If approved, VEN 309 would be the only prescription treatment indicated for the condition and should fare well, in our opinion, as an alternative to topical creams. Proof of concept has been demonstrated in numerous Phase II trials, and commencement of Phase III testing is expected to commence in 2H11. VEN 307 is a cream preparation of the calcium channel blocker diltiazem (originally approved as Cardizem for treating hypertension) and is being developed for treating anal fissures. Diltiazem is currently being used by some physicians (obtained from compounding pharmacies), so its effectiveness would appear to have been established in real-world settings. Availability of a prescription formulation would likely be more attractive to physicians unwilling to search for or rely upon drug obtained from compounding pharmacies. The focused nature of the markets could allow Ventrus to commercialize the products without the need for a commercial partner. 2
  • 3. INVESTMENT THESIS Ventrus is a specialty BioPharma company developing therapeutics to treat gastrointestinal disorders for which available treatments are relatively ineffective. VEN 309 (iferanserin) is a 5HT-2a receptor antagonist for treating hemorrhoids. By modulating vasomotion, the drug could be effective for reducing swelling caused by blood vessel engorgement that is characteristic of hemorrhoids. If approved, VEN 309 would be the only prescription treatment indicated for that condition and should fare well, in our opinion, as an alternative to topical creams and off-label treatments. Proof of concept has been demonstrated in numerous Phase II trials, and commencement of Phase III testing is expected in 2H11. VEN 307 is a cream preparation of the calcium channel blocker diltiazem (originally approved as Cardizem for treating hypertension) and is being developed for treating anal fissures. Diltiazem is currently used by some physicians (obtained from compounding pharmacies), so its effectiveness would appear to have been established in a real-world setting. Availability of a prescription formulation would likely be more attractive to physicians unwilling to search for or rely upon drug obtained from compounding pharmacies. The focused nature of the markets could allow Ventrus to commercialize the products without the need for a commercial partner. REASONS TO BUY Valuation is compelling. As discussed in a subsequent section of this report, we estimate the fair value of VTUS shares at $24, so we view the stock as being significantly undervalued at the current price. By our analysis, either the market views successful development of VEN 309 and/or 307 as of low probability or our revenue estimates are too aggressive. Meaningful catalysts lie ahead. Results from the Phase III trial of VEN 309 for treating hemorrhoids could become available in 1Q12. Results from a Phase III trial of VEN 307 being conducted in the E.U. in patients with anal fissures should become available shortly thereafter. Ventrus could develop the first FDA-approved prescription medication for treating hemorrhoids. In the U.S., an estimated 4M prescriptions are written each year for medications that are not approved as a treatment for the condition. An estimated 22M units of over-the-counter (OTC) products are sold each year for treating hemorrhoids as well. Most current treatments provide only temporary symptom relief and do not address the underlying disease pathology. Patients with persistent symptoms may progress to rubber band ligation, an invasive procedure that involves banding the internal hemorrhoid for 4-7 days. Product portfolio offers attractive blend of development and regulatory risks. Our expert physician channel checks suggest that successful development of VEN 309 is not without challenges given that a well-defined path to develop treatments for the condition does not exist. Obviously, given the number of prescriptions and OTC units dispensed each year, the demand for an effective treatment could be robust. VEN 307, by contrast, may be easier to develop given that abundant proof of concept exists in the real-world setting by virtue of the use Ventrus Biosciences (VTUS) 3
  • 4. of compounded diltiazem. Our checks reveal that availability of prescription diltiazem, FDA approved and marketed by a biopharma company, might still be an attractive alternative in the face of more inexpensive compounded material. Ventrus could be a natural acquisition candidate. We believe Ventrus could be an attractive target for companies with business operations that focus on gastrointestinal disorders or others that may be seeking to enter those markets. RISKS Development risks. As with practically any development-stage biopharma company, the primary risk associated with investing in VTUS shares relates to development and commercial activities. VEN 309 may blaze a trail with the FDA as to how hemorrhoid treatments should be developed. The company attempted to negotiate a Special Protocol Assessment (SPA) with the FDA but believed that reaching an agreement would unnecessarily delay pivotal clinical testing. We note that SPAs are by no means a binding contract with the Agency. We suspect the company will, nevertheless, design the study to assess appropriate endpoints that assess the drug’s safety and effectiveness. Regulatory risks. VEN 309 has not been approved by the FDA, so there is an obvious, albeit generic, risk that the Agency might not approve the drug. We see less risk with VEN 307 given that the drug is essentially repurposed diltiazem. Because the anal fissure indication will likely encompass a much smaller patient population than the original hypertension one, we doubt the FDA will have significant issues with approval. Competition from Rectiv. Rectiv (nitroglycerin ointment) was approved on June 21, 2011, as the first prescription drug for the treatment of pain associated with chronic anal fissures. Consultants do not view it as a suitable alternative given the side effects, especially when there exists substantial variability in blood flow at the site of application, as would likely be the case with anal fissures. Need for additional capital. We forecast Ventrus becoming profitable in 2015, and our model contemplates a raise of $50M in 2013. Inability to raise capital could negatively impact the commercial launch of the products. FINANCIAL MODEL AND VALUATION Probability-weighted NPV analysis yields a fair value of $24 per share. We view the fair value of VTUS shares as being driven mainly by the successful completion of Phase III testing and commercialization of VEN 309 for treating hemorrhoids and VEN 307 for treating anal fissures. We have not included any contribution from VEN 308 (phenylephrine gel for fecal intolerance) in our financial model as the company is not actively developing it at this time. Based on our revenue models, the value attributed to each drug is shown in the NPV analysis in Exhibit 1. When additional proof of concept is provided, we would likely be inclined to increase the probability of technical success (pTS) and that would have the effect of increasing the value of each asset. For example, at a pTS Ventrus Biosciences (VTUS) 4
  • 5. of 100%, the fair value per share would be $24 for VEN 309 and $23 for VEN 307. Exhibit 1. VTUS share valuation VTUS NPV Valuation NPV pTS Adjusted NPV Fair Value/Share VEN 309 $314 50% $157 $12 VEN 307 $305 50% $153 $12 Shares (M), 2011E 13.1 Fair Value $24 Source: LCM research; pTS = probability of Technical Success The market model for VEN 309 is depicted in Exhibit 13 at the end of this report. In brief, we use a prevalence of approximately 12.5M persons with hemorrhoids in the U.S. and approximately 28M in the E.U. We assume the monthly cost to be approximately $150 at launch with 4% annual price increases going forward. Our financial model assumes that Ventrus sells VEN 309 in the U.S. and receives royalties of 25% of gross sales from a partner in the E.U. We project that Ventrus will pay royalties of 3.5% and 1.2% to Amer in the U.S. and E.U., respectively. Projections assume FDA approval in 2014, with sales commencing in 2015. Penetration of the hemorrhoid market grows from 1% after launch to a peak of 20% in the U.S. and 15% in the E.U. Each 5% market share translates into approximately $250M in sales. Based on the proof of concept data, we believe the probability that VEN 309 is effective for treating hemorrhoids is relatively high. However, given that the program is not without development risk, we applied a discount rate of 25% and a probability of technical success (pTS) of 50% to the NPV estimate to arrive at our per share estimate of $24. Exhibit 2 provides details of our modeled future payments to Amer for VEN 309. Ventrus Biosciences (VTUS) 5
  • 6. Exhibit 2. VEN 309 Modeled Payments to Amer Source: LCM Research The market model for VEN 307 is depicted in Exhibit 14 at the end of this report. We model Ventrus selling VEN 307 in the U.S. and paying royalties of 8% to S.L.A. Pharma. Projections assume FDA approval in 2014, with sales commencing in 2015. Penetration of the anal fissure market grows from 1% after launch to a peak of 20%. Each 5% market share translates into approximately $240M in sales. Exhibit 3 provides details of our modeled future payments to S.L.A. Pharma for VEN 307. Exhibit 3. VEN 307 Modeled Payments to S.L.A. Pharma Source: LCM Research Given that VEN 309 could address large markets and encounter little in the way of meaningful competition, we believe it may be most helpful to conduct sensitivity analyses around major variables such as pTS, pricing and market penetration. In that way, investors can better assess the reasonableness of the assumptions and the impact of deviation from them. Exhibit 4 depicts a sensitivity analysis varying pTS for both assets and the discount rate. As noted in Exhibit 1, we applied a pTS of 50% for both VEN 309 and VEN 307. Ventrus Biosciences (VTUS) 6
  • 7. Exhibit 4. VTUS Discount Rate / pTS Sensitivity VTUS Disc. Rate/pTS Sensitivity Discount Rate $ 23.6 15% 20% 25% 30% 35% 30.0% $ 26.8 $ 19.4 $ 14.2 $ 10.5 $ 7.8 40.0% $ 35.8 $ 25.8 $ 18.9 $ 14.0 $ 10.4 pTS 50.0% $ 44.7 $ 32.3 $ 23.6 $ 17.5 $ 13.0 60.0% $ 53.6 $ 38.7 $ 28.3 $ 20.9 $ 15.6 70.0% $ 62.6 $ 45.2 $ 33.0 $ 24.4 $ 18.2 Source: LCM Research We also wanted to examine the impact of pricing and market penetration on the NPV of the assets. Exhibit 5 depicts sensitivity analyses varying monthly cost and peak market penetration. As depicted in the VEN 309 market model in Exhibit 13, we assume a cost of treatment of $150/month and peak market penetration of 20%. Our revenue model has been set up such that market penetration for years preceding peak penetration are derived by subtracting set basis points of market share from the preceding year, specifically (working backward from peak), 450bps, 450bps, 500bps, 250bps and 200bps. Exhibit 5. VEN 309 Price (monthly)/Penetration Sensitivities Source: LCM Research Exhibit 6 depicts a similar analysis for VEN 307 for the U.S. market only. Exhibit 6. VEN 307 Price (monthly)/Penetration Sensitivity Source: LCM Research Ventrus Biosciences (VTUS) 7
  • 8. VEN 309 — NOVEL APPLICATION OF A CNS DRUG Iferanserin is a new chemical entity (NCE) that has been formulated as an ointment for intra-anal application to treat hemorrhoids. The pharmacophore is a highly selective, 5HT-2a receptor antagonist that was initially developed by scientists at a major pharmaceutical company for treating various disorders of the central nervous system (CNS). Beset by poor penetration of the blood-brain barrier, development of the drug was directed toward use as a treatment of vascular diseases. Peripheral 5-HT2a receptors are believed to be involved in blood clotting and in the contraction of arteries and veins, two events that are likely associated with the formation of hemorrhoids. By reducing 5-HT2a receptor activity, it would be predicted that VEN 309 might improve blood flow from the dilated veins that comprise the hemorrhoid, thereby reducing bleeding, itchiness and pain. On June 5, 2011, Ventrus entered into an Asset Purchase Agreement with Sam Amer & Co., Inc. to acquire all rights, title and interest to VEN 309 for the topical treatment of symptomatic hemorrhoids. HEMORRHOIDS ARE SWOLLEN VEINS IN THE RECTUM OR ANUS Hemorrhoids are described as swollen/inflamed veins in the rectum and anus, and they often arise as a result of straining during defecation and heavy lifting. Occurrence of hemorrhoids during pregnancy is also not uncommon. It has been estimated that, by age 50, approximately half of adults have experienced symptoms of hemorrhoids. Physiologically, progressive occlusion of venous return vessels is believed to induce stretching of the vessels that can lead to vascular stasis. Ultimately, hemorrhoids can become swollen and inflamed and trapped blood leads to the formation of piles (protruding skin folds that are filled with static and thrombosed blood). Typical patient symptoms include bleeding, pain, itching, swelling and difficulty defecating. Exhibit 7 depicts an illustration of hemorrhoids. Ventrus Biosciences (VTUS) 8
  • 9. Exhibit 7. Internal and External Hemorrhoids Source: LCM Research According to data from the National Institute of Diabetes and Digestive Kidney Diseases, there are approximately 12.5M adults in the U.S. affected by hemorrhoids. The significant size of the patient population notwithstanding, there are currently no FDA-approved prescription drugs for treating the condition. As a consequence, patients commonly resort to use of over-the-counter (OTC) treatments, with the majority of them providing only temporary relief from the symptoms and not addressing the underlying disease pathology, i.e., the vascular dysfunction. Alternatively, prescription drugs (e.g., corticosteroids) are often used in an off-label manner. If those interventions do not provide adequate relief, ultimately surgical procedures may be resorted to. External hemorrhoids can sometimes be dealt with by a simple incision providing relief by draining pooled blood. More invasive procedures can involve rubber band ligation that essentially chokes off the blood supply at the base of the structure. Sclerotherapy (sometimes used for treating varicose veins) involves injection of a chemical solution such as sodium tetradecyl sulfate into the hemorrhoid. Logic suggests that treatments that avoid the need for more aggressive intervention might be met by a receptive market. PIVOTAL TESTING OF VEN 309 RESTS ON PREVIOUS WORK Phase III testing of VEN 309 is expected to begin in 2H11, and the trial has been designed to include approximately 600 patients in a double-blind, 3-arm design. Iferanserin (0.5%) ointment will be compared with placebo ointment in the following cohorts: 1) placebo as needed for 14 days, 2) iferanserin as needed for 14 days and 3) iferanserin as needed for 7 days followed by placebo as needed for 7 days. Approximately 80 trial sites are expected to participate, and all patients will be evaluated for follow-up at 28 days. All patients will roll over to active treatment after 28 days with a 12 month follow-up to assess recurrence (open label). Inclusion criteria call for patients with symptomatic grade I to III internal hemorrhoids who have experienced bleeding and pain or itching for two Ventrus Biosciences (VTUS) 9
  • 10. consecutive days prior to randomization. These grades encompass hemorrhoids that do not prolapse and those that prolapse upon defecation and spontaneously reduce or must be manually reduced. Grade IV internal hemorrhoids, or those that are prolapsed and cannot be manually reduced, will be excluded. The primary endpoint is no bleeding on days 7-14, which is during the second week of treatment. A secondary endpoint will consider no pain or itching during the same period of time. Questions have arisen as to why the trial was not designed to test VEN 309 against an active comparator. As it relates to pharmacologic treatment, because there are no FDA-approved drugs with an indication for hemorrhoids, there is no valid prescription comparison. Versus an OTC product such as Preparation H (14% mineral oil, 71.9% petrolatum and 0.25% phenylephrine HCl), it could be argued that the placebo being used in Phase III testing is not all that different. According to the company, Phase IIb testing was conducted in Germany in 2003- 2004, in a trial that included 121 patients randomized to receive iferanserin 0.5% (same as the Phase III dose) twice per day vs. placebo. Baseline and weekly visits were conducted over the two week trial with follow-up at 45 days. A bleeding scale of 1-10, with 1 indicating the absence of the symptom and 10 indicating the worst symptom, was the primary endpoint, with itching and pain scales used as secondary endpoints. Exhibit 8 depicts the mean daily bleeding scores, and Exhibits 9 and 10 depict the mean daily itching and pain scores, respectively. Exhibit 8. VEN 309 Phase IIb Mean Daily Bleeding Score (Germany) Source: Company Presentation Ventrus Biosciences (VTUS) 10
  • 11. Exhibit 9. VEN 309 Phase IIb Mean Daily Itching Score (Germany) Source: Company Presentation Exhibit 10.VEN 309 Phase IIb Mean Daily Pain Score (Germany) Source: Company Presentation The company modeled the potential performance of the primary and secondary endpoints that will be used in the Phase III trial using data from the German Phase IIb trial. The expected primary endpoint results based on this data are shown in Exhibit 11 below. Ventrus Biosciences (VTUS) 11
  • 12. Exhibit 11. Analysis of German Phase IIb study for Phase III Endpoint Source: Company Presentation. VEN 307 — A PRECRIPTION FORMULATION OF A CURRENTLY USED DRUG VEN 307 (diltiazem cream) is being developed as a topical treatment for relief of pain associated with anal fissures. Anal fissures are small tears or cuts in the lining of the anus or anal canal that cause bleeding and pain that is often severe. Patients frequently resort to surgery for relief, although surgery itself can lead to unsatisfactory outcomes such as fecal incontinence. It is estimated that there are approximately 4M cases of anal fissures in the U.S. Verispan L.L.C., a pharmaceutical market research firm, indicated that this population made about 1M office visits in the U.S. in 2003. Ventrus Biosciences (VTUS) 12
  • 13. Exhibit 12. Anal Fissures Source: VTUS Investor Presentation VEN 307 is a pre-mixed and pre-packaged proprietary formulation of diltiazem that is applied topically. It yields less than one-tenth the amount of diltiazem in the blood from the lowest oral dose used for cardiovascular treatment, and yet has a considerably greater effect on sphincter tone than diltiazem when taken orally. Gastroenterologists’ existing familiarity with the use of diltiazem may allow for accelerated market penetration if the drug is approved. Ventrus licensed the exclusive North American rights to VEN 307 for the topical treatment of anal fissures from S.L.A. Pharma, which completed early-stage clinical trials, toxicology studies and manufacturing up to the end of Phase II. S.L.A. Pharma commenced a Phase III clinical trial in the E.U. in November 2010 that is expected to be completed in the second quarter of 2012. The company intends to develop the topical formulation as a Section 505(b)(2) NDA filing due to previous approval of diltiazem as a systemic agent for hypertension and angina. This, in combination with the Phase III trial being conducted by S.L.A. Pharma and the planned Phase III U.S. trial, will form the basis of the NDA application. If the U.S. trial is successful, the company intends to conduct three short-term dermal toxicology studies and file an IND with the FDA for one pivotal Phase III trial or two parallel pivotal Phase III trials. Depending on the results of those trials, an NDA filing could be expected in 2013. In June 2011, the FDA approved Rectiv, a nitroglycerin ointment, as the first prescription product to treat anal fissures. However, a significant number of patients experience headaches as a side effect of nitroglycerin. As mentioned previously, consultants do not view nitroglycerin as a suitable alternative given the side effects, especially when there exists substantial variability in blood flow at the site of application, as would likely be the case with anal fissures. Ventrus Biosciences (VTUS) 13
  • 14. VEN 308 FOR TREATING FECAL INCONTINENCE Ventrus licensed the exclusive North American rights to VEN 308 from S.L.A. Pharma, which developed the specific formulation of phenylephrine for the topical use of fecal incontinence and developed the manufacturing method. The company held a pre-IND meeting with the FDA in June 2007 concerning VEN 308 for the treatment of fecal incontinence associated with ileal pouch anal anastomosis. It was determined that the next clinical study should be a Phase IIb trial with multiple doses assessed and that existing toxicology data are sufficient to support the trial. At this time, the company is focusing on continuing development of VEN 307 and 309 and is not pursuing development of VEN 308. COMMERCIALIZATION POTENTIAL We believe the commercial markets are addressable by a focused sales force of approximately 100 sales representatives. Gastroenterologists, colorectal surgeons and general practitioners would be the obvious prescribers for both VEN 307 and 309. A public relations effort, followed by direct-to-consumer marketing, would presumably be required in order to achieve our sales estimates. Given the size of the market and the extent of the unmet medical need (particularly for hemorrhoids) if effective, we suspect the ability to persuade physicians and patients to try the drug would not require an aggressive marketing campaign that requires a significant and prolonged investment. INTELLECTUAL PROPERTY VEN 309 is licensed from Sam Amer & Co., Inc. (Amer), which had developed the drug through Phase II trials and up to readiness for Phase III trials in the U.S. and Europe. The license includes rights to all existing intellectual property and any further improvements on VEN 309 owned by Amer related to the use of the product for the topical treatment of anorectal disorders. VEN 309 is covered for composition of matter in patents that will expire in August 2015 in the U.S. and February 2018 elsewhere. If approved, VEN 309 will receive five years of data exclusivity in the U.S. as an NCE under Hatch-Waxman and 10 years from the date of approval in Europe. Ventrus filed a new concentration range patent in August 2010 that, if issued, would grant patent protection until 2030 and prevent substitutable generic competition. On June 5, 2011, Ventrus entered into an agreement to purchase all rights, title and interest to VEN 309 from Amer. The transaction is expected to be complete by November 2011. Ventrus has licensed the exclusive North American rights to VEN 307 for the topical treatment of anal fissures from S.L.A. Pharma, which completed early- stage clinical trials, toxicology studies and manufacturing for VEN 307 up to the end of Phase II. Ventrus is using its own resources to pursue development. VEN Ventrus Biosciences (VTUS) 14
  • 15. 307 is covered by method of use in a patent that will expire in February 2018. If approved, VEN 307 will receive three years of data exclusivity in the U.S. under Hatch-Waxman. Ventrus has licensed the exclusive North American rights to VEN 308 from S.L.A. Pharma, which developed the specific formulation of phenylephrine for topical use in fecal incontinence and developed the manufacturing method. S.L.A. Pharma’s previous partner, Solvay, conducted pharmacokinetic studies. Ventrus does not expect to continue developing VEN 308 in the short term. VEN 308 is covered by a patent that will expire in December 2017. If approved, VEN 308 will receive seven years of data exclusivity in the U.S. under the Orphan Drug Act. FINANCING HISTORY Ventrus was incorporated in October 2005 (as South Island Biosciences, Inc.) and began operations in April 2007. In October 2005, Ventrus issued a promissory note payable to Paramount BioSciences, LLC (Paramount), an affiliate of one of the company’s significant stockholders. A second promissory note was issued in July 2007. In 2008, both notes were voluntarily converted into shares of common stock and warrants to purchase additional shares. In April and July 2008, the company issued two additional promissory notes. During 2007 and 2008, the company issued approximately $5.3M of senior convertible notes in connection with a private placement. During 2009, Ventrus issued four separate promissory notes to Paramount Credit Partners, LLC (whose managing member is the same as Paramount BioSciences). The total principal amount borrowed was approximately $1.6M. In February, April and May of 2010, the company issued approximately $5.6M of senior convertible notes that provided funds to hire its management team and undertake an initial public offering. The company’s IPO was completed in December 2010 and raised approximately $17.5M in net proceeds, including the underwriters’ over-allotment. The 2007, 2008, and 2010 convertible notes and 2008 promissory notes were converted into shares at the close of the IPO. Retail investors were the primary participants of the equity offering. The company raised additional equity financing in a follow-on that priced in July 2011. For all intents and purposes, the transaction could be viewed as a “re-IPO,” and institutional investors participated in the offering. Including the underwriters’ over-allotment, Ventrus raised net proceeds of $47.5M and issued 5.175M shares of common stock. The company intends to use the capital to pay for the rights to VEN 309, pay down the 2009 promissory notes to Paramount, continue development of VEN 309, fund working capital requirements and other general corporate purposes. Ventrus Biosciences (VTUS) 15
  • 16. VENTRUS MANAGEMENT Russell H. Ellison, M.D., M.Sc. Dr. Ellison joined Ventrus as a director, Chief Executive Officer and Chief Medical Officer in June 2010. He was elected Chairman of the Board in January 2011. Dr. Ellison’s prior experience includes positions at Paramount Biosciences LLC, a global pharmaceutical development and healthcare investment firm; Fibrogen, Inc., a privately held biotechnology company; Sanofi-Synthelabo, USA, a pharmaceutical company; Roche Laboratories, Inc., USA, a pharmaceutical company; and CorMedix, Inc. (NYSE Amex: CRMD), a pharmaceutical company that went public in March 2010. He currently serves as a director of several privately held development stage biotechnology companies. Dr. Ellison holds an M.D. from the University of British Columbia and an M.Sc. (with distinction) from The London School of Tropical Medicine and Hygiene. David J. Barrett Mr. Barrett joined Ventrus as Chief Financial Officer in July 2010. His prior experience includes positions at Neuro-Hitech, Inc. (NHPI.PK), a publicly traded company focused on developing, marketing and distributing branded and generic pharmaceutical products; Overture Asset Managers and Overture Financial Services, which, at the time, was a start-up asset management firm that assembled investment products and platforms to distribute turnkey and unbundled investment solutions to financial intermediaries and institutional investors; and Deloitte & Touche, LLP. Mr. Barrett became a director of Coronado BioSciences, Inc., a biopharmaceutical company, in May 2011. Mr. Barrett received his B.S. in Accounting and Economics in May of 1998 and his M.S. in Accounting in May of 1999 from the University of Florida. He is a certified public accountant. Ventrus Biosciences (VTUS) 16
  • 17. Exhibit 13. VEN 309 / Hemorrhoid Market Model, 2011E – 2020E Source: LCM Research Ventrus Biosciences (VTUS) 17
  • 18. Exhibit 14. VEN 307 / Anal Fissure Market Model, 2011E – 2020E Source: LCM Research Ventrus Biosciences (VTUS) 18
  • 19. Exhibit 15. Ventrus Income Statement, 2010 – 2015E Source: LCM Research Ventrus Biosciences (VTUS) 19
  • 20. Exhibit 16. Ventrus Balance Sheet, 2010A – 2015E Source: LCM Research Ventrus Biosciences (VTUS) 20
  • 21. Exhibit 17. Ventrus Cash Flow Statement, 2010 – 2015E Source: LCM Research Ventrus Biosciences (VTUS) 21
  • 22. ANALYST CERTIFICATION All of the recommendations and views about the securities and companies in this report accurately reflect the personal views of the research analyst named on the cover of this report. No part of this research analyst’s compensation was, is, or will be directly or indirectly related to the specific recommendations or views expressed by the research analyst in this research report. IMPORTANT DISCLOSURES Lazard Frères & Co. LLC has received compensation for investment banking services from VTUS within the past twelve (12) months. Lazard Capital Markets LLC has acted as manager or co-manager of a securities offering on behalf of VTUS within the past twelve (12) months. Lazard Capital Markets LLC makes a market in VTUS securities. VTUS - Current Rating: BUY, Price Target: $24 24 22 20 18 16 14 12 10 8 6 4 Nov 10 Dec 10 Jan 11 Feb 11 Mar 11 Apr 11 May 11 Jun 11 Jul 11 Data source: FactSet prices / LCM ratings and target prices DISTRIBUTION OF INVESTMENT RATINGS (AS OF 07/22/11) OVERALL DISTRIBUTION BANKING CLIENT DISTRIBUTION* BUY NEUTRAL SELL BUY NEUTRAL SELL 60% 38% 2% 22% 7% 0% * Indicates the percentage of each category in the Overall Distribution that were banking clients of Lazard Frères in the previous 12 months. RATING GUIDELINE (return targets may be modified by risk or liquidity issues) BUY Expected to produce a positive total return of more than 10% in the next 12 months. NEUTRAL Fairly valued; expected to product a total return of ±10% in the next 12 months. SELL Expected to product a negative total return of more than 10% in the next 12 months. Ventrus Biosciences (VTUS) 22
  • 23. DISCLAIMERS This report has been prepared by Lazard Capital Markets LLC (“LCM”) in New York. It may not be reproduced, redistributed or copied in whole or in part for any purpose. This report has been approved by, and is being distributed in the US or to US persons, by LCM, which accepts responsibility for its contents in the US. Transactions undertaken in the US in any security mentioned herein must be effected through LCM or another US-registered broker-dealer, in conformity with SEC Rule 15a-6. Neither this report nor any copy or part thereof may be distributed in any other jurisdictions where its distribution may be restricted by law and persons into whose possession this report comes should inform themselves about, and observe, any such restrictions. Distribution of this report in any such other jurisdictions may constitute a violation of US securities laws, or the law of any such other jurisdictions. This report does not constitute an offer or solicitation to buy or sell any securities referred to herein. It should not be so construed, nor should it or any part of it form the basis of, or be relied on in connection with, any contract or commitment whatsoever. The information in this report, or on which this report is based, has been obtained from sources that LCM believes to be reliable and accurate. However, it has not been independently verified and no representation or warranty, express or implied, is made as to the accuracy or completeness of any information obtained from third parties. The information or opinions are provided as at the date of this report and are subject to change without notice. The information and opinions provided in this report take no account of the investors’ individual circumstances and should not be taken as specific advice on the merits of any investment decision. Investors should consider this report as only a single factor in making any investment decisions. Further information is available upon request. LCM may provide specialized research products or services to certain customers focusing on the prospects for individual covered stocks as compared to other covered stocks over varying time horizons or under differing market conditions. While the views expressed in these situations may not always be directionally consistent with the long-term views expressed in the analyst's published research, the analyst has a reasonable basis and any inconsistencies can be reasonably explained. LCM does not accept any liability whatsoever for any direct or consequential loss howsoever arising, directly or indirectly, from any use of this report or its contents. By accepting this report you agree to be bound by the foregoing limitations. Lazard Capital Markets LLC 30 Rockefeller Plaza, New York, NY 10020 Member NYSE and FINRA Copyright 2011 Lazard Capital Markets LLC. All rights reserved. Ventrus Biosciences (VTUS) 23