Quarterlytics / Healthcare / Medical - Instruments & Supplies / NovoCure Limited

NovoCure Limited

nvcr · NASDAQ Healthcare
Claim this profile
Ticker nvcr
Exchange NASDAQ
Sector Healthcare
Industry Medical - Instruments & Supplies
Employees 1488
← All annual reports
FY2018 Annual Report · NovoCure Limited
Sign in to download
Loading PDF…
from day one forward 

N O V O C U R E   2 0 1 8   A N N U A L   R E P O R T

1

For an interactive version of our annual report,  
please visit 2018.novocure.com.

NOVOCURE 2018 ANNUAL REPORT

a global oncology company 
with a proprietary platform

2

5

FDA-APPROVED
INDICATIONS

INDICATIONS 
IN LATE-STAGE PIPELINE

140+

ISSUED PATENTS   
GLOBALLY

$248M

NET REVENUES
FY 2018

40%

$246M

REVENUE GROWTH
2018 COMPARED TO 2017

CASH, CASH EQUIVALENTS AND 
SHORT-TERM INVESTMENTS

In 2018, we made a commitment to put 
into words our vision, mission and values. 
Our 2018 report focuses on our  
mission and values that support our 
overarching patient-forward vision  
to make a difference in cancer. The  
words are new, but the sentiments – 
who we are as a company and the 
mission we are striving to achieve – 
have been the foundation of Novocure 
from day one and will continue to  
unify us as we move forward. 

Together with our patients, we strive  
to extend survival in some of the  
most aggressive forms of cancer by 
developing and commercializing  
our innovative therapy.

333

 
NOVOCURE 2018 ANNUAL REPORT

TOTAL PERSCRIPTIONS

23%

2018 VS. 2017

2,808

5,060

2,383

$248,069

4,119

1,834

$177,026

1,091

2016

2017

2018

(USD in thousands)

$82,888

2017

2016

2018

In the United States, total prescriptions grew more than  
20 percent in 2018 compared to the prior year. We 
continue to focus the tremendous efforts of our sales and 
marketing teams on increasing oncologists’ confidence 
and comfort describing our clinical benefits to patients and 
on increasing adoption in the community setting, 
particularly among radiation oncologists. In the U.S., we 
also rolled out several direct-to-patient initiatives, 
including groundbreaking Facebook Live programs, an 
expanded patient ambassador program, and an updated 
direct-to-patient campaign highlighting Optune’s long-
term survival and quality-of-life data.

2016

2017

2018

We are grateful for the trust and confidence of our 
patients, prescribers and shareholders. I am particularly 
grateful for the dedication and hard work of my Novocure 
colleagues who make our progress possible.

Driving commercial adoption of Optune

Optune is proven to provide quality, long-term survival for 
patients with newly diagnosed GBM. Since our first FDA 
approval, we have made significant investments to 
establish our commercial infrastructure around the world. 
To date, we have treated more than 10,000 GBM patients 
and have posted 16 consecutive quarters of active patient 
growth since the initial presentation of our EF-14  
trial data in newly diagnosed GBM. In 2018, prescriptions 
for patients with newly diagnosed GBM grew 40  
percent year-over-year. 

4,119

2,808

“Today, we are a global 
oncology company with two 
FDA-approved indications, 
a third indication under FDA 
review and four additional 
phase 3 clinical programs.”

2016

2017

TOTAL ACTIVE PATIENTS

5,060

2,383

$248,069

4,119

30%

2018 VS. 2017

2,808

1,834

1,091

$177,026

In EMEA, we focused primarily on the German market. We 
were also active in Austria, Switzerland and Israel. Total 
prescriptions grew 14 percent in 2018 compared to the 
prior year. Notably, net revenues grew more than 70 
percent year-over-year, driven by a meaningful 
improvement in the reimbursement approval rate of 
individual claims in Germany and by national 
reimbursement in Austria. In January 2019, we announced 
receipt of national reimbursement in Sweden. Our 
commercial launch in Sweden is underway. 

$82,888

2016

2017

2018

2016

2017

2018

2016

2017

2018

(USD in thousands)

5,060

TOTAL OPERATING REVENUE

2,383

$248,069

1,834

40%

2018 VS. 2017

1,091

$177,026

$82,888

2018

2016

2017

2018

2016

2017

2018

(USD in thousands)

2018 was our first full year of commercial activity in Japan. 
We signed contracts with more than 100 hospitals to 
provide Optune; we filled 162 prescriptions and delivered 
more than $6.3 million in net revenues. We remain 
enthusiastic about the opportunity to grow adoption of 
Optune in this key market.

In September 2018, we announced a strategic 
collaboration with Zai Lab including a license agreement 
for Tumor Treating Fields in Greater China and a clinical 
development cooperation agreement. Zai Lab shares our 
patient-forward vision and our business values. Zai hit the 
ground running and already has begun to treat GBM 
patients in Hong Kong.

As we enter 2019, we believe there is significant 
opportunity for further growth in our GBM business across 
geographies. Our teams continue to focus on driving 
adoption through physician education, clinical research 
and, where permitted, direct-to-patient outreach. We 
know there are many more patients who can benefit from 
Optune than are currently on therapy. 

5

dear fellow  
shareholders,

Bill Doyle, Executive Chairman

Cancer, the second leading cause of death worldwide, 
presents one of the principal healthcare challenges of our 
time. Novocure was founded in 2000 to develop Tumor 
Treating Fields, a new approach to treating cancer that 
targets the electrical properties of proteins to kill dividing 
cancer cells. Today, we are a global oncology company 
with two FDA-approved indications, a third indication 
under FDA review and four additional phase 3 clinical 
programs. At Novocure, delivering better outcomes for 
patients with some of the most aggressive forms of cancer 
drives our work each day.

2018 was a particularly productive year 

We entered 2018 with two clear priorities: first, to drive 
commercial adoption of Optune for the treatment of 
glioblastoma (GBM); and second, to advance our clinical 
pipeline. We finished the year with growth in our GBM 
business globally and tangible progress in our clinical 
development programs. Highlights included presenting  
our STELLAR data in malignant pleural mesothelioma 
(MPM), enrolling the first patient in our phase 3 pivotal 
PANOVA-3 trial for pancreatic cancer, signing our 
collaboration agreement with Zai Labs to bring Tumor 
Treating Fields to China, receiving national reimbursement 
in Sweden, and finishing the year with almost $250 million 
in annual revenue.

4

phase 2 pilot 
milestones

PANOVA data 
(1st cohort)

2016

PANOVA data 
(2nd cohort)

INNOVATE
data

HEPANOVA
data

gastric trial
data

STELLAR 
data

TODAY

LUNAR 
interim analysis

FDA approval
for MPM

METIS 
data

final EF-14 
data

Phase 3 pivotal or 
registration milestones

anticipated milestones

2022

INNOVATE-3
interim analysis

LUNAR 
final data

PANOVA-3
interim analysis

potential to significantly expand total addressable market

= 5,000 cases diagnosed annually in the U.S.

Glioblastoma (GBM)

Non-small cell lung cancer

Mesothelioma (MPM)

Pancreatic cancer

Brain metastases from
non-small cell lung cancer 

Ovarian cancer

GBM 
Today

~1 
Year

~3
Years

~5
Years

NOVOCURE 2018 ANNUAL REPORT

Advancing the pipeline

Tumor Treating Fields is a physics-based therapy that is 
broadly applicable to solid tumor cancers. The application 
of electric fields to attract and repel charged proteins 
during cell division has demonstrated an effect in every 
cancer cell line tested. The mechanism of action is 
independent of genotype, phenotype or micro-
environment. It only requires the appropriate placement of 
transducer arrays to create electric fields tuned to specific 
frequencies within targeted cancer cells. 

Since our initial public offering in 2015, we have presented 
successful phase 2 pilot data in multiple solid tumor 
indications. These clinical milestones have created the 
foundation for a drumbeat of late-stage clinical and 
regulatory milestones expected over the next three years. 

In 2018, we presented data from our STELLAR registration 
trial studying Tumor Treating Fields in unresectable MPM. 
Patients who received Tumor Treating Fields with 
pemetrexed and cisplatin or carboplatin experienced a 
median overall survival of 18.2 months. As expected,  
there was no increase in systemic toxicity when Tumor 
Treating Fields was added to the standard of care 
chemotherapy regimen.

MPM is one of the most aggressive forms of cancer.  
There has not been significant progress in treating MPM 
since the approval of pemetrexed more than 15 years ago. 

Our STELLAR data have been submitted to the FDA for 
marketing approval under the Humanitarian Device 
Exemption (HDE) pathway provided by our Humanitarian 
Use Device (HUD) designation. We are in constructive, 
ongoing discussions with the FDA and hope to receive 
approval for MPM in 2019.

We continue to enroll patients in our phase 3 pivotal  
trials in brain metastases, non-small cell lung cancer and 
pancreatic cancer, and initiated our phase 3 pivotal trial in 
ovarian cancer in March 2019. We are also recruiting a 
phase 2 pilot trial in liver cancer and are working with  
Zai Lab to initiate a phase 2 pilot trial in gastric cancer  
in China.

We continue to perform basic research on Tumor Treating 
Fields as do members of the independent scientific 
community. In 2018, we developed significant new insights 
that may enable us to further improve efficacy beyond 
what we have seen in our trials, to date. 

A post-hoc analysis of the EF-14 data showed that more 
time on Optune predicted increased survival of GBM 
patients. In 2018, a separate post-hoc analysis showed  
that higher levels of energy (mW/cm3) at the tumor bed 
predicted increased survival of GBM patients, independent 
of time on therapy. For Optune, dose density can now be 
defined as time on therapy times the energy delivered, the 
cumulative energy delivered.

With this knowledge, our engineering efforts are now 
geared toward Optune system improvements to improve 
efficacy and extend survival. We have developed novel 
mapping algorithms to optimize treatment planning and 
our teams are working to incorporate these algorithms 
into a second generation NovoTAL system. We are also 
working to develop second generation transducer arrays 
to improve patient comfort and convenience and to 
maximize the energy delivered to the tumor bed and 
surrounding tissues.

Creating shareholder value

Novocure is a high-growth oncology company with 
significant growth opportunities remaining in GBM and in 
much more prevalent cancers. Our balance sheet is strong. 
We ended 2018 with $246 million cash, cash equivalents 
and short-term investments on hand, and largely have 
been able to fund our investments in additional indications 
and Optune system technology improvements with cash 
flow from the GBM business. 

While GBM alone provides an important opportunity for 
Novocure to improve patient outcomes and grow  
revenue, it represents the tip of iceberg for the company. 
We believe the total potential addressable market for 

Optune in additional cancer indications is exponentially 
larger than the opportunity we see today in GBM. We 
believe our extensive IP portfolio and our extended cash 
runway provide the stability and flexibility to execute  
our core strategies.

Investing in our people and culture

From the day Professor Yoram Palti founded Novocure in 
2000, we have maintained an encompassing effort to 
ensure every employee shares his patient-forward vision. 
Now, as a 600-plus-person organization, we have 
recommitted to ensure a shared focus on our core mission 
to extend survival in some of the most aggressive forms of 
cancer by developing and commercializing Tumor Treating 
Fields – to extend life without interfering with quality of 
life. Looking ahead, I am enthusiastic and energized about 
our opportunities as we work to accomplish our mission.

Thank you for your continued support.

Bill Doyle,  
Executive Chairman

6

7

 
from  
day one 
f rward 

NOVOCURE 2018 ANNUAL REPORT

– innovation

Our founders created a different way to fight cancer. We 
channel that founding spirit into our science, business 
and patient relationships to deliver innovative and proven 
solutions designed to advance cancer care. 

– focus

We dream big. But we also know that in order to achieve 
our aspirations, we must be intentional every day in how 
we spend our time, energy and resources. 

– drive

Patients and their families are the heart of our mission. 
Our passion for making a difference in the lives of cancer 
patients fuels us in our day-to-day work and guides us in 
our decision-making. 

– courage

It takes courage to innovate. We stand alongside  
our patients and stand up for them by challenging  
the status quo. 

– trust

Our patients trust us as an integral part of their cancer 
care team. We trust ourselves and our colleagues to act 
with integrity and accountability as we use our individual 
strengths to work together efficiently and effectively in 
pursuit of our patient-forward mission.

– empathy

Confronting cancer is physically, mentally and 
emotionally challenging. We put ourselves in the shoes  
of our patients, their families, health care providers, 
researchers and our colleagues as we strive to change  
the way cancer is treated. 

8

9

 
 
 
 
 
 
“Innovation plays a role 
in the work we do here 
daily. It plays a role in 
every single aspect of 
the business.”

NOVOCURE 2018 ANNUAL REPORT

“Innovation plays a role in the work we do here daily,” she 
said. “It plays a role in every single aspect of the business. 
Being stagnant is not an option.”

For Katia, innovation begins with an idea and then 
develops by including others and incorporating their 
feedback. 

“I really value the input of the team, even when we 
disagree on the approach,” she said. “We always try to do 
what’s best for our patients. For me, innovation and 
creativity has a lot to do with the conversations with the 
team and including people in the decision-making.”

A big-picture thinker, Katia also uses innovation in her 
personal life as a mother of three sons. For example, she 
said, as her children grow, she finds new ways to spend 
quality time together and thinks deeply about how to 
effectively communicate. Her son, Matt, 22, likes to talk 
while riding in the car, so Katia uses that time to connect. 
With her stepson, Kyle, 24, she had to learn how to 
understand him and help him learn how to express himself. 
When he was younger, she would play games with him or 
buy his favorite food and they would prepare it together. 
Today, she makes a point to ask him about things that 
interest him. Katia and her youngest son, Lukas, 14, go to 
the gym together and once a week to his favorite coffee 
shop. During that time, she asks about his life, what he’s 
learning at school, and what teachers he likes or dislikes. 

“I cannot approach a subject in the same way twice,” she 
said of being a parent. “I have to approach it differently and 
creatively.” 

When it comes to innovating at Novocure, she said she 
feels comfortable expressing her ideas partly because 
Novocure’s leadership team encourages employees to do 
so. She also feels that her management team trusts her to 
follow through on her commitments and knows that if she 
needs help, she will ask for it. 

Since adjusting to her new role within Novocure, Katia 
feels excited about the positive impact her projects can 
have on her colleagues and on the company. She also 
looks forward to Novocure’s future. 

“All of us want to be a part of these next chapters of 
Novocure,” she said.

Katia Felix, Associate Director of  
Global Strategic Development

innovation

Katia Felix is not afraid to share her ideas. 

Throughout her career, she has paved a way for herself 
often by bringing her ideas to the table. Recently, she 
expressed to some members of Novocure’s management 
team that she felt there was a need to develop career 
paths for employees and to strengthen Novocure’s training 
program to ensure that the company is retaining the 
talented people it attracts. 

“I think that our employees are our greatest assets,”  
Katia said. “If we treat them well, they will treat our  
patients well, and we all gain with that. That has always 
been my mantra.” 

The sharing of that idea contributed to a promotion for 
Katia in 2018 – she’s now Novocure’s Associate Director  
of Global Strategic Development. Novocure’s management 
team created the role for Katia to better utilize her  
skills and strengths. One of her current initiatives is the 
development of career paths and training programs  
for employees who work in Revenue Operations and 
Health Policy. 

“I’m not afraid of presenting ideas, even if it means I am 
going to have to improve … if it means that I am the one 
that has to change so that other changes can happen, so 
be it,” she said.

With her latest promotion, came a big change. Katia went 
from managing a large team to managing no one and 
collaborating more with people from other departments. 
Along with being excited about her new role, she said, it 
was also difficult to let go of her former responsibilities. It 
took her time to decompress and refocus in her new 
position. 

“I felt lost for about a month,” she said, adding that she 
questioned whether she made the right decision. “But then 
I started focusing on the difference I could make in the 
lives of my colleagues if I worked very hard on the projects 
that we identified.” 

Katia said interacting with her colleagues is one of her 
favorite aspects of working at Novocure. She also enjoys 
breaking ground as an innovative company. Since joining 
the company in 2013, she has seen the company grow  
and change in many ways. 

10

11

focus

From a young age, Dario Garcia-Carrecedo has 
understood the importance of the parts that equal  
the whole. 

As a 12-year-old boy growing up in Oviedo, Spain, he 
would often checkout animal books from the library and 
visit his grandmother in the countryside to identify 
creatures and observe them in their natural habitats. In 
high school, he became interested in molecular biology 
and was fascinated by how the cell works. 

When settling on a career path in college, Dario wanted to 
do something that he could apply to society, so he chose 
oncology. Upon completing his doctorate in Molecular 
Biology and Biochemistry from the University of Oviedo, 
he moved to the United States in 2008 after receiving a 
grant to work as an associate research scientist studying 
head and neck and pancreatic cancers at Columbia 
University in New York. In 2015, he received a Medical 
Affairs Fellowship at Novocure. 

As a fellow, he learned about the business and supported 
the Medical Affairs department, which reviews materials for 
medical and scientific accuracy, creates medical and 
scientific content, and monitors the competitive 
landscape. After his one-year contract, he was hired as a 
Manager, and has since been promoted to Senior Manager 
and Associate Director of Medical Affairs. 

In Dario’s role today, focus is essential to doing his  
job well. 

“Focus to me means to direct the attention at what is 
important, and what’s important, are our patients,”  
Dario said. 

The Medical Affairs team supports other parts of the 
business and receives a high volume of requests to review 
materials, many of which are time sensitive. In order to 
focus effectively, Dario said, he also has to prioritize.

“It’s almost like making a to-do list and just having 
everything organized. Keeping the focus on the things that 
need priority, but without forgetting about other things 
you have on your to-do list, getting to them when the time 
is necessary,” Dario said of his strategy for focus. 

His experience of working in laboratories has translated to 
his work at Novocure. Focus is also important in his role 
because he often reviews or creates materials that are 
distributed to patients and health care providers or at 
scientific congresses, and those materials need to be 
accurate. 

“Focus to me means 
to direct the attention  
at what is important, 
and what’s important, 
are our patients.”

NOVOCURE 2018 ANNUAL REPORT

Dario Garcia-Carrecedo,  
Associate Director of Medical Affairs

“In the laboratory, you have to be very meticulous,  
focused and organized,” Dario said, adding that a lack  
of focus in a lab could result in having to repeat an 
experiment. “In order to be scientifically accurate,  
prioritize and meet all of your deadlines, you have to 
be able to direct your attention.” 

In his current role, Dario leads a team and often imparts his 
approach of focus and prioritization to his colleagues. 

“I enjoy the fact that I can influence others on my team by 
sharing the ways I see things,” he said. “I think that’s very 
powerful, and I feel very lucky.” 

Growing with the organization has helped Dario to 
prioritize his workflow. 

“I’ve been more involved in conversations that are cross-
functional,” he said. “I’m able to see a bigger picture than 
when I first arrived here. I am able to see which things 
need to get out first.”

Dario also sees how his work plays a role in the bigger 
picture of Novocure’s mission. For example, during the first 
few months of his fellowship, he helped develop the 
materials that are used to train physicians to become 
certified prescribers of Novocure’s cancer treatment. 
Those materials have been used to certify hundreds of 
physicians who have prescribed Novocure’s therapy to 
thousands of patients. 

“It always feels good,” he said of making a difference at 
Novocure. “The moment I joined Novocure, I realized that 
everything we do has an impact on our patients.”

12

13

drive

In 2008, Roman Pass moved from his home Finland to 
Switzerland for an opportunity to play floorball with 
only his sport bag and hockey sticks. He knew no one 
in Switzerland, nor did he speak German.

He had played floorball – a type of indoor hockey – for 
more than 10 years at the time, and had an opportunity 
to play in Switzerland and to live somewhere new. He 
always foresaw himself moving away from Finland, 
where he emigrated to from Estonia with his mother 
and brother as a young child. 

Playing the sport provided only a small amount of 
money, and he needed a full-time job. Without 
knowing the local language, finding employment 
proved to be a challenge. He recalled being paid 1,000 
Swiss francs when he arrived by the team, spending the 
money within several days, and eating pasta with 
tomato sauce for two weeks straight. 

“First year I was totally without a job,” Roman said. “I 
was just getting paid from the club, just pocket money 
every month. It was kind of a dark time.” 

Roman felt a world away from home – isolated and 
lonely, as he embarked on this new chapter of his life. 
Many times, he thought about giving up.

“I think the most horrible part is the loneliness,” he said. 
“It’s easier to give up. It’s harder to say ‘I will not give 
up. I will fight for it.’” 

Roman reminded himself that it would get better with 
every day that passed. A year after moving, he secured 
a job working as a warehouse operator for a sporting 
goods company. He started to make friends. Over the 
course of three years, he learned German and began to 
feel confident enough to speak it. 

Then he felt ready to grow professionally. In 2013, he 
learned about an open position as a warehouse 
operator at Novocure in Root, Switzerland, and became 
intrigued by the company’s story. Roman saw the 
position as an opportunity to build something from the 
ground up. His first task was to design the inside of the 
warehouse. He traveled to Novocure’s U.S. Operations 

NOVOCURE 2018 ANNUAL REPORT

“For me, it’s not just a 
job. I want to do my best 
every day, to show my 
managers and everybody 
else that I want to grow 
with the company. So I’m 
still not done. I have a  
lot to reach.”

Center in Portsmouth, New Hampshire, to see how the 
warehouse was structured there and to learn from his 
colleagues. After two years, Roman transitioned to a new 
role as an Order Administrator to try something new.

“I am a person who sets goals,” he said. “And I want to be 
there in two years and in five years. I definitely want to 
build a career and go as far as I can.”

In Roman’s current role, he manages patient-related 
shipments to and from the warehouse in Root. He 
coordinates with Novocure’s Device Support Specialists in 
Europe to ensure that patients receive the therapy on time. 

“For me, it’s not just a job,” he said. “I want to do my best 
every day, to show my managers and everybody else that I 
want to grow with the company. So I’m still not done. I 
have a lot to reach.”

He aims to motivate his colleagues and build connection 
by keeping a positive attitude and making a point to 
connect with people face to face or over the phone,  

when possible, instead of via email. He finds meaning  
in the work he does at Novocure and feels that he is  
making a difference along with the company. 

“I have never regretted it,” he said of his decision to  
join Novocure. 

Roman has lived in Switzerland for more than 10 years. He 
still plays and coaches floorball for the same team, and 
teaches fitness classes at a local gym. The struggle of his 
early days in Switzerland is somewhat a distant memory, 
yet still fresh as a reminder of the drive he exemplified to 
create this life for himself. He recalled the moment he 
knew he had made it through the hardest days of his 
journey of starting over somewhere new.

“It starts to feel like home,” Roman said. “Then you know 
you are in the right place.”

14

Roman Pass, Order Administrator

15

courage

For Noam Zaradez, courage means many things.

He has his master’s degree in Philosophy and is pursuing a 
doctorate in Qualitative Research. When he speaks  
about courage, his thoughts are refreshingly complex yet 
still somehow light. In 2007, Noam joined Novocure as a 
Device Support Specialist (DSS), a role that provides 
technical support and a face-to-face relationship with 
glioblastoma patients who receive Novocure’s cancer 
treatment. Noam said interacting with patients who face  
a life-threatening disease can evoke emotions of  
sadness, fear and grief in DSSs. 

“For me, courage as a DSS is to be able to handle tough 
and complex situations regarding our patients, and also 
within our team, to be able to communicate those 
experiences – to be able to talk freely about our feelings, 
fears and stress,” he said. “As a team, we need to share 
those experiences.” 

Noam realized the importance of processing and sharing 
challenging emotions when his team grew and he became 
a manager. In 2016, he was promoted to a DSS Regional 
Manager and Care Coordinator. Prior to becoming a 
manager, he dealt with difficult emotions and stress on his 
own, mostly by finding comfort in being with his family at 
the end of the day and learning to appreciate every day. 

“Then I realized that it’s not only me anymore,” he said. “I 
also have responsibility to the others, to my team.” 

In 2018, he initiated a mental health program for DSSs in 
Israel – a monthly, two-hour group therapy session. 
During the sessions, he said, his team starts to open up and 
share before even sitting down. They move the table and 
face each other, seated in a circle so there are no barriers 
between. 

NOVOCURE 2018 ANNUAL REPORT

“We have to have 
courage to do  
things that have  
never been  
done before.”

Bringing the idea to management took courage on Noam’s 
part. The program is the first of its kind at Novocure. Noam 
also suggested to leadership for the group’s therapist to 
conduct workshops at a DSS conference in Rome last year. 
The workshops were well-received, and a DSS manager in 
Germany initiated a therapy program for her team as well 
after attending. 

“We have to have courage to do things that have never 
been done before,” Noam said. 

Participating in group therapy together has helped to unify 
his team, creating a sense of team spirit. They are more 
willing to volunteer and help each other when a team 
member needs it. As a manager of a team, Noam aims to 
create an open, sincere and free working relationship  
with his colleagues. 

“It’s really empowering us,” Noam said. “In this way, we can 
work on our strength as employees, on our resilience, to 
be able to keep the dynamic relationships with our 
patients. I am so proud of my team.” 

Noam also uses physical activity as a way to alleviate stress 
and process his emotions. He enjoys long-distance 
running, cycling, swimming, surfing and dancing. 

“Running long distances is like taking out all of the things 
that stay inside your soul and dealing with it,” he said. “For 
me, it’s like meditation.” 

Noam also views courage as being flexible and having the 
ability to work through the unknown. In group therapy, he 
and his team learn about accepting oneself and emotions 
as they come and noticing when they are reacting to those 
emotions. They learn how to watch their emotions and let 
them pass. 

Noam said it is important that DSSs take care of their 
mental health because of the ongoing interactions they 
have with patients and caregivers. DSSs have to be 
compassionate, positive and sensitive when they work with 
patients, who are confronting a devastating diagnosis. 

“There is a lot of responsibility on our shoulders,” he  
said. “It is our responsibility to go with them through this 
path and to give them a hand and to guide them during 
this process.”

16
16

17

Noam Zaradez, DSS Regional Manager 

and Care Coordinator

trust

DeEtta Ard-McDonald has learned the importance  
of trust throughout her 30-year marriage to her 
husband, Everett. 

DeEtta and Everett met when she was 15 and he was 16 
at a festival in East Chicago, Indiana. They had a mutual 
friend and Everett asked for DeEtta’s phone number. 
She wasn’t allowed to date until she turned 16, so they 
spoke on the phone every day for a few months, 
developing a friendship first. She liked that he was 
smart, funny, thoughtful and easy to talk to. When they 
began dating, he’d drive to her home from a 
neighboring town about 30 minutes away and they 
would spend time together a few hours a week. 

Together, they attended Indiana University. They 
married when she was 27 and had two children, Maxx, 
29, and Jade, 27. DeEtta said Everett has never given 
her a reason not to trust him. Having trust with Everett 
makes her feel secure. 

“In my marriage, I had to trust that my husband was 
doing the best thing for our family to move us forward 
and reach our goals, and he had to trust me to do the 
same,” she said. 

DeEtta views trust as the foundation of all relationships. 

“To me, trust means transparency, open 
communication, support, encouragement and just 
wanting to be the best for the other person in that 
relationship,” she said. 

NOVOCURE 2018 ANNUAL REPORT

Earlier in her career, DeEtta worked as a pharmacy 
technician. She transitioned to a career in sales when her 
two children were young after Everett, who also works in 
sales, suggested it. Her first sales role was a flexible, part-
time position that enabled her to spend more time with 
her kids. As her children grew older, she moved back into 
full-time work. She enjoys sales because of the flexibility 
and because she has the chance to interact with different 
people every day. 

DeEtta considers trust to be important to the work she 
does at Novocure. She joined Novocure in 2015 as a 
Territory Manager on the U.S. Business Team. In her role, 
she is responsible for sales and account management-
related activities in South Chicago. Her job entails 
establishing and maintaining relationships with health care 
providers. In order to do that effectively, she has to earn 
their trust. 

“Trust with providers is built by being reliable, by being 
resourceful, and just by letting my providers know that I 
am there to support them so they can better support their 
patients,” she said. 

When establishing a relationship with a new provider, 
DeEtta focuses on the data supporting Novocure’s cancer 
treatment in glioblastoma. If they have prior 
misperceptions regarding the treatment, she does her best 

to educate them and gives them time to trust that she is 
providing them with accurate information. She knows that 
she’s earned a provider’s trust when they become more 
open and begin reaching out.

“That’s a great feeling,” she said. “That’s what keeps me 
going.”

DeEtta also finds trust to be an important part of her 
interactions with her teammates. They confide in each 
other regarding their challenges and know that the 
information will not be shared outside of the conversation 
without permission. She also feels that Novocure’s 
leadership team is transparent with its colleagues. 

“We have to let each segment of the organization do what 
they do, and we have to trust that they’re doing what’s best 
for the organization as a whole,” she said. “We have to trust 
that leadership is going to take us in the direction we need 
to go.”

Ultimately, for DeEtta, valuing trust goes back to the 
patients who are the heart of Novocure’s mission. 

“I value trust because we’re providing a therapy for patients 
with a devastating diagnosis,” DeEtta said. “They need to 
know we are doing the best we can to help them.”

DeEtta Ard-McDonald, Territory Manager,  

South Chicago

18
18

“Trust with providers is 
built by being reliable, 
by being resourceful, 
and just by letting my 
providers know that I am 
there to support them  
so they can better 
support their patients.”

19

NOVOCURE 2018 ANNUAL REPORT

“This is not just a number,” he said. “This is a person who 
has a family, they have feelings, they have friends, and they 
have brain cancer. When you have a reason for your 
argument and you feel strongly about it, it’s really hard to 
stop someone like that.”

Syed has felt a strong connection to Novocure’s patient-
forward mission since joining the company in 2015. In 
order to empathize with patients, he said, one has to try to 
understand what they are going through. 

“I think that’s probably the most important factor of the 
whole business, to really empathize with the patient,”  
he said. 

Syed also practices empathy with his colleagues, health 
care providers and insurers. 

“Empathy is one of those things that you don’t just pick 
and choose when you want to use it,” he said. “You have it 
and use it. You have to be respectful to whoever you’re 
talking to and that goes a long way.” 

For Syed, his job is much more than a paycheck. He loves 
having the opportunity to help patients gain access to 
Novocure’s cancer treatment. 

“Not every patient’s case is going to go that way, but they 
all have the possibility of turning out that way,” he said. 
“The opportunity I have to help somebody else is what 
keeps me motivated.”

“I think that’s probably 
the most important 
factor of the whole 
business, to really 
empathize with the 
patient.”

empathy

In 2012, Syed Ali was leading his college baseball team  
as pitcher in a matchup against one of their rivals in 
Florida when he tore two muscles in the rotator cuff of 
his shoulder. In what may have been one throw, he lost 
his ability to play the game he loved and what had 
become a large part of his identity. 

“It kind of felt like everything that I cared about, everything 
that had led me to that point, was gone,” he said.

Recovering from his injury was a physical and mental 
challenge. Physically, he had to do basic exercises every 
day to help the injury heal and to regain his strength. 
Mentally, he couldn’t play the sport that had become such 
a big part of his life. He missed the rest of the season and 
postponed graduation by one year so that he could finish 
his collegiate baseball career. Many of his friends were 
graduating that year, and he was supposed to be on the 
stage with them. 

As Syed recovered from his injury, he refocused on his 
academics. He also turned his attention toward other areas 
of his life where he could improve, like being a good 
teammate and being a good listener. He realized during 
this time that baseball was a small part of who he was and 
that he had much more to offer. He returned to play for a 
fifth year of college with a new perspective and had one of 
his best seasons, breaking all of his personal records and 
making all-conference teams.

“I look back on it, and it was one of the best things that 
ever happened to me,” he said. 

During his fifth year, Syed recalled a time when a friend 
and teammate was struggling with baseball and his 
personal life. Syed listened and shared his story and 
feelings from his journey the year prior. His friend went on 
to turn around his season and improve his grades.

“That was empathy right there, just being able to come 
down to my friend’s level and talk to him about a similar 
situation that I went through,” he said. “It made me feel 
good to help him, and it made him feel like there was not 
only hope for him, but that there was plenty of light in the 
tunnel.” 

Empathy is one of Syed’s greatest strengths. A Case 
Manager at Novocure in Portsmouth, New Hampshire, 
Syed works with insurers to help facilitate coverage 
approvals for patients prescribed Novocure’s cancer 
treatment. Syed keeps the patient at heart during his 
interactions with insurers. 

20

21
21

Syed Ali, Case Manager

 
selected financials

Cash flow from the glioblastoma business is  
funding increased investments in R&D

global net revenues (USD in millions)

$300,000

IN USD MILLIONS

$248,017  

$177,026  

$248M 

FULL YE AR  2018 
NET REVENUES  

$248M

$82,888  

$10,359  

$15,490  

$33,087  

NET REVENUES 
FY 2018

>40%

REVENUE GROWTH 
2018 COMPARED TO  2017 

2013

2014

2015

2016

2017

2018

U.S. net revenues 

EMEA net revenues 

Japan net revenues 

China upfront licensing fee 

See Novocure’s Form 8-K filed on or around 
Jan. 7, 2019 for additional detail 

2016

2017

2018

$250
$250,000

$200,000

$200
$150,000

$100,000
$150

$50,000

$100

$0

$50

0

($50)

($100)

($150)

($2)

98% NET CASH USED IN 
OPERATING ACTIVITIES
A 98% DECREASE FROM 2016

INCLUDING

$51M

INVESTMENT IN RESEARCH  
AND DEVELOPMENT

CASH, CASH EQUIVALENTS AND 
SHORT-TERM INVESTMENTS

269.4

245.9

219.6

183.3

Our balance sheet is strong 

global net revenues (USD in millions)

2015

2016

22

$300,000

$250,000

$200,000

$150,000

$100,000

$50,000

$0

2017

2018

$248,017  

$248M 

FULL YE AR  2018 
NET REVENUES  

$177,026  

$82,888  

$10,359  

$15,490  

$33,087  

>40%

REVENUE GROWTH 

2018 COMPARED TO  2017 

2013

2014

2015

2016

2017

2018

U.S. net revenues 

EMEA net revenues 

Japan net revenues 

China upfront licensing fee 

See Novocure’s Form 8-K filed on or around 

Jan. 7, 2019 for additional detail 

NOVOCURE 2018 ANNUAL REPORT

Year ended December 31,

2018

2017

2016

2015

$

248,069

$

177,026

$

82,888

$

33,087

80,048

–

168,021

50,574

77,663

73,456

201,693

(33,672)

(12,270)

(45,942)

(17,617)

(63,559)

(0.69)

$

$

55,609

–

121,417

38,103

63,528

59,114

160,745

(39,328)

(9,169)

(48,497)

(13,165)

(61,662)

(0.70)

$

$

39,870

6,412

36,606

41,467

59,449

51,007

151,923

(115,317)

(6,147)

(121,464)

(10,381)

(131,845)

(1.54)

$

$

20,610

–

12,477

43,748

38,861

33,864

116,473

(103,996)

(3,151)

(107,147)

4,434

(111,581)

(3.67)

$

$

December 31,

2018

2017

2016

2015

$

140,622

$

78,592

$

99,780

$

119,423

105,256

339,793

256,809

64,560

162,974

112,259

104,719

265,298

194,932

50,202

101,532

113,564

119,854

282,081

224,991

36,882

102,854

142,345

150,001

307,336

265,277

28,627

27,889

250,820

consolidated statement  
of operations

U.S. dollars in thousands
Net revenues 

Cost of revenues 

Impairment of field equipment

Gross profit 

Research, development and clinical trials 

Sales and marketing 

General and administrative 

Total Operating expenses 

Operating income (loss)

Financial income (expenses), net 

Income (loss) before income taxes 

Income taxes 

Net income (loss) 

Basic and diluted net income  
(loss) per ordinary share

consolidated balance sheet

U.S. dollars in thousands

Cash and cash equivalents

Short-term investments

Total assets

Working capital

Current liabilities

Long - term liabilities

Total shareholders' equity

condensed cash flow

U.S. dollars in thousands

2018

2017

2016

2015

Net cash provided by (used in)  
operating activities

Net cash provided by (used in)  

investing activities

Net cash provided by (used in)  

financing activities

Effect of exchange rate differences on  
cash and cash equivalents

Net increase (decrease) in cash,  
cash equivalents and restricted cash

$

(1,865)

$

(33,134)

$

(107,592)

$

(99,884)

(5,493)

69,369

27

8,628

5,168

8

12,996

(115,269)

75,124

276,989

10

–

62,038

(19,330)

(19,462)

 (61,836)

23

 
 
”With annual revenues 
appoaching $250  
million, five indications  
in our late-stage pipeline  
and a strong balance  
sheet, we believe  
we are well-positioned  
to deliver significant long-
term shareholder value.”

— Wilco Groenhuysen,  
Chief Financial Officer

leadership

corporate officers and 
executive leadership

William F. Doyle 
Executive Chairman

Asaf Danziger 
Chief Executive Officer

Mike Ambrogi 
Chief Operating Officer

Wilco Groenhuysen 
Chief Financial Officer

Eilon Kirson, M.D., Ph.D. 
Chief Science Officer and  
Head of Research and Development

Todd Longsworth 
General Counsel

Yoram Palti, M.D., Ph.D. 
Founder

Pritesh Shah 
Chief Commercial Officer

2424
24

board of directors

William F. Doyle 
Executive Chairman

Asaf Danziger 
Chief Executive Officer

William Burkoth

Jeryl Hilleman

David T. Hung

Kinyip Gabriel Leung

Martin J. Madden

Sherilyn D. McCoy

Charles G. Phillips III

William A. Vernon

NOVOCURE 2018 ANNUAL REPORT

market price of and dividends on the registrants’ 
common equity and related stockholder matters
The following performance graph is being furnished as part of this annual 
report and shall not be deemed “filed” with the SEC or incorporated by 
reference into any of our filings under the Securities Act of 1933, as amended 
(the “Securities Act”), or the Exchange Act, whether made before or after the 
date hereof and irrespective of any general incorporation language in any 
such filing.

The following graph shows the total shareholder return of an investment 
of $100 in cash at market close on October 2, 2015 (the first day of trading 

of our ordinary shares) through December 31, 2018 for (1) our ordinary 
shares, (2) the Russell 2000 Index, and (3) the Nasdaq Biotechnology Index. 
Pursuant to applicable SEC rules, all values assume reinvestment of the full 
amount of all dividends; however, no dividends have been declared on our 
ordinary shares to date. The shareholder return shown on the graph below 
is not necessarily indicative of future performance, and we do not make or 
endorse any predictions as to future stockholder returns.

comparison of 39 month cumulative total return
COMPARISON OF CUMULATIVE TOTAL RETURN
Among NovoCure Ltd, the Russell 2000 Index, and the NASDAQ Biotechnology Index

$ 140
$ 120
$ 100
$ 80
$ 60
$ 40
$ 20
$ 0
10/2/2015

NovoCure Ltd

$ 350

$ 300

$ 250

$ 200

$ 150

$ 100

$ 50

12/31/2015

03/31/2016

06/30/2016

09/30/2016

12/31/2016

$ 0
10/2/15

NASDAQ Biotechnology Index
6/16

12/15

3/16

9/16

Russell 2000 Index
3/17

12/16

6/17

NovoCure Ltd

Russell 2000

NASDAQ Biotechnology

12/17

9/17
3/18
Assumes $100 invested on October 2, 2015
Assumes dividend reinvested
Fiscal year ending December 31, 2015

6/18

9/18

12/18

*100 invested on 10/2/15 in stock or 9/30/15 in index, including reinvestment of dividends. Fiscal year ending December 31.

Copyright© 2019 Russell Investment Group. All rights reserved.

COMPARISON OF CUMULATIVE TOTAL RETURN
cumulative total return summary
Among Novocure Ltd, the Russell 2000 Index, and the Nasdaq Biotechnology Index

NovoCure Ltd

Russell 2000

$ 140
$ 120
$ 100
$ 80
$ 60
$ 40
$ 20
$ 0
10/2/2015

NASDAQ 
Biotechnology

10/2/15

12/15

3/16

6/16

9/16

12/16

3/17

6/17

9/17

12/17

3/18

6/18

9/18

12/18

100.00

122.32

79.21

63.84

46.72

42.94

44.31

94.64

108.59

110.50

119.26

171.23

286.65

183.15

100.00

103.59

102.02

105.89

115.47

125.67

128.77

131.94

139.42

144.07

143.95

155.11

160.66

128.21

100.00

111.62
10/31/2015

89.57

86.95

95.87

89.13

97.75
11/30/2015

103.18

112.36

106.14

104.85

107.67

119.92

96.28

12/31/2015

Novocure Limited

NASDAQ Biotechnology Index

Russell 2000 Index

Assumes $100 invested on October 2, 2015
Assumes dividend reinvested
Fiscal year ending December 31, 2015

Indications For Use
Optune is intended as a treatment for adult patients (22 years of age or older) 
with histologically-confirmed glioblastoma multiforme (GBM).

Optune with temozolomide is indicated for the treatment of adult patients 
with newly diagnosed, supratentorial glioblastoma following maximal 
debulking surgery and completion of radiation therapy together with 
concomitant standard of care chemotherapy.

For the treatment of recurrent GBM, Optune is indicated following 
histologically-or radiologically-confirmed recurrence in the supratentorial 
region of the brain after receiving chemotherapy. The device is intended to be 
used as a monotherapy, and is intended as an alternative to standard medical 
therapy for GBM after surgical and radiation options have been exhausted.

Summary of Important Safety Information 

Contraindications 
Do not use Optune if you have an active implanted medical device, a skull 
defect (such as, missing bone with no replacement), or bullet fragments. Use 
of Optune together with implanted electronic devices has not been tested 
and may theoretically lead to malfunctioning of the implanted device. Use of 
Optune together with skull defects or bullet fragments has not been tested 
and may possibly lead to tissue damage or render Optune ineffective.

Do not use Optune if you are known to be sensitive to conductive hydrogels. 
In this case, skin contact with the gel used with Optune may commonly 
cause increased redness and itching, and rarely may even lead to severe 
allergic reactions such as shock and respiratory failure. 

Warnings and Precautions 
Use Optune only after receiving training from qualified personnel, such as 
your doctor, a nurse, or other medical personnel who have completed a 
training course given by Novocure (the device manufacturer).

Do not use Optune if you are pregnant, you think you might be pregnant 
or are trying to get pregnant. It is not known if Optune is safe or effective in 
these populations.

The most common (≥10%) adverse events involving Optune in combination 
with temozolomide were low blood platelet count, nausea, constipation, 
vomiting, fatigue, scalp irritation from device use, headache, convulsions, 
and depression.

All servicing procedures must be performed by qualified and trained 
personnel.

Do not use any parts that do not come with the Optune Treatment Kit, or 
that were not sent to you by the device manufacturer or given to you by 
your doctor.

Do not wet the device or transducer arrays.

If you have an underlying serious skin condition on the scalp, discuss  
with your doctor whether this may prevent or temporarily interfere with 
Optune treatment.

Please visit www.optune.com/safety to see the Optune Instructions for 
Use (IFU), for complete information regarding the device’s indications, 
contraindications, warnings, and precautions.

25

 
NOVOCURE 2018 ANNUAL REPORT

looking
ahead

living our mission and values

Since the early days of Novocure, when Tumor Treating Fields was a theory not yet a  
therapy, our mission has been clear. We are striving to improve survival in some of the  
most aggressive forms of cancer by developing and commercializing our innovative  
therapy. At Novocure, the patient has been at the center of what we do, from day one. 

Developing and commercializing Tumor Treating Fields required that we create an innovative 
and evolving business that supports the patient, from device support specialists to care 
coordinators to shipping clerks. When we receive a prescription, it triggers this system, and 
our important work of supporting our patients begins. We support thousands of patients in 
the same way around the globe. We have the potential to support hundreds of thousands of 
patients as we continue to develop our therapy in indications outside of glioblastoma.

Some companies need to remind employees why they work there. That is not the case  
at Novocure. Our mission is understood. Our values define who we are – as people first – 
then as a company. As we grow across countries and continents, we will ensure that our 
commitment to our mission and our values remains strong. We believe our values, the  
core traits that we share, will help us to achieve our mission.

As we look toward the future, it can be helpful at times to reflect on where we came from. 
Novocure began with an idea that led to a culture of innovation. Bringing the idea to fruition 
required a microscopic level of focus, focus that becomes more and more intricate and 
important as we grow. We needed the drive to fight a fight that no one else would fight for 
us, and the courage to get up again and stand up for what we believe in after getting knocked 
down. As we began to grow across the world, we had to trust our colleagues to have our 
patients’ best interest at heart. From day one, we had to have empathy for our patients – who 
may be facing the greatest challenge of their lives – empathy for our colleagues and health 
care providers, and even empathy for those who disagree with us.

I am proud to say that as a part of Novocure, this is who I am. I am proud to lead a company 
of employees with outstanding character who do the most challenging work, who create 
their own path rather than following one that already exists. As we grow, there may be times 
of uncertainty on the best way forward. In those moments, we will use our vision, mission 
and values as a compass to help chart our way. Thank you for being a part of our journey.

Asaf Danziger, CEO

2626

27

  
Second Floor 
No. 4 The Forum 
Grenville Street 
St. Helier, Jersey, JE2 4UF

www.novocure.com