Half-year Report

LEI: 549300Q7EXQQH6KF7Z84

11 September 2025

RTW Biotech Opportunities Ltd

Half-Yearly Report for the six months ended 30 June 2025

Following a resilient period of performance, the Company is well positioned to capture value from a diversified portfolio of otherwise inaccessible opportunities.

RTW Biotech Opportunities Ltd (the "Group", "RTW Bio" or the "Company"), the London Stock Exchange-listed investment company focused on identifying transformative assets with high growth potential across the life sciences sector, is pleased to announce its Half Year Results for the six months ended 30 June 2025.

Roderick Wong, MD, Managing Partner and Chief Investment Officer of RTW Investments, LP (the "Investment Manager") commented:

"The first half of 2025 saw one of the most volatile periods for the biotech sector since the Company's launch. Despite the headwinds which led to the NAV falling during the period, the Company continues to outperform its reference benchmarks and the wider peer group over the long term. Following period end, we were pleased to see that RTW Bio will be included in the FTSE All Share from 22 September.

"With new FDA leadership and the launch of the 'Make American Biotech Accelerate' initiative, the policy backdrop has turned increasingly supportive for innovation. We see these changes as a tailwind that could meaningfully accelerate the path from scientific breakthrough to patient benefit.

"While macro headlines around tariffs and drug pricing have stirred market volatility, the practical impact on most biotech companies remains limited. Tariff risks are muted given the sector's domestic focus, and the re-emergence of the Most Favoured Nation drug pricing concept is primarily a large pharma issue. In parallel, public market valuations remain at historically attractive levels, with nearly half of U.S. biotech companies trading below their cash balance. This dislocation - the fifth consecutive year of XBI underperformance versus the S&P 500 - in our view, represents a compelling opportunity for long term investors.

"Large pharma's looming patent cliffs are adding urgency to the M&A cycle, with $49 billion in announced deals for the first half already surpassing the full-year 2024 total. Cash-rich acquirors are actively seeking late-stage, high-impact assets, and the current valuation environment is fertile ground for strategic transactions. We expect deal activity to accelerate in the second half as political uncertainty subsides and the need for pipeline replenishment intensifies.

"In short, the biotech industry is navigating a complex but increasingly constructive environment. Policy momentum is leaning pro-innovation, valuations are at multi-year lows, and strategic buyers are stepping in with unprecedented balance sheet firepower. For investors able to look through the short-term noise, the combination of regulatory support, scientific progress, and strategic demand points to a potentially powerful re-rating as we look ahead to the second half and beyond."

Financial Highlights

Portfolio highlights

As of 30 June 2025, 70% of NAV was invested in public companies1 (2024: 65%), 32% was invested in private holdings (2024: 30%) and 3% of NAV was royalty exposure (2024: 3%).

1. In prior periods exposure was presented as fair market value +/- accruals as a percentage of NAV, summing to 100%. Beginning with this report, exposure will be shown as economic exposure as a percentage of NAV, the result of which could be more or less than 100%.

2. Development stage exposures apply to portfolio companies with 1% or greater exposure. Exposures have been converted to sum to 100%. In prior periods, development stage exposures were presented as the number of companies vs % of NAV, and on what was previously referred to as the "core" portfolio.

Public Investments

Private Investments

Royalty Investments:

Post Period-End Events

Company Updates

Enquiries:

About Biotech Opportunities Ltd:

RTW Biotech Opportunities Ltd (LSE: RTW) is an investment fund focused on identifying transformative assets with high growth potential across the biopharmaceutical and medical technology sectors. Driven by a long-term approach to support innovative businesses, RTW Biotech Opportunities Ltd invests in companies developing next-generation therapies and technologies that can significantly improve patients' lives. RTW Biotech Opportunities Ltd is managed by RTW Investments, LP, a leading healthcare-focused entrepreneurial investment firm with deep scientific expertise and a strong track record of supporting companies developing life-changing therapies.

Visit the website at www.rtwfunds.com/rtw-biotech-opportunities-ltd for more information.

Highlights

30 June 2025 Financial Highlights

1 The share price was $1.51 at 9 September 2025.

2 Leverage is calculated per the Commitment Method of the AIFMD. Real economic exposure at the fund and position level (1.0x) is ultimately what impacts NAV as some positions are partially or fully hedged.

3 The NAV per Ordinary Share at IPO was $1.04.

Portfolio Highlights in the period

1 In prior periods exposure was presented as fair market value +/- accruals as a percentage of NAV, summing to 100%. Beginning with this report, exposure will be shown as economic exposure as a percentage of NAV, the result of which could be more or less than 100%.

2 Development stage exposures apply to portfolio companies with 1% or greater exposure. Exposures have been converted to sum to 100%. In prior periods, development stage exposures were presented as the number of companies vs % of NAV, and on what was previously referred to as the "core" portfolio.

RTW Bio's Purpose and Long-Term Strategy

Transforming the lives of millions

RTW Bio's long-term strategy is anchored in identifying sources of transformational innovations with significant commercial potential by engaging in deep scientific research and a rigorous idea generation process, which is complemented by years of investment, company building, and both transactional and legal expertise.

Why Invest?

RTW Bio offers shareholders the benefit of exposure to a wide swath of investments in private and public companies in a sector requiring specialist expertise that would typically be a barrier to entry for most. As a publicly traded investment company, RTW Bio democratises investing beyond the private fund universe. The following investment platforms (not a comprehensive list) provide direct access to buying shares:

Chair's Statement

Dear Shareholders

On behalf of the Board, I am pleased to provide the Group's Interim Report and Accounts for the six-month period to 30 June 2025.

Performance

The first half of 2025 has been volatile for global markets and the biotech sector was not immune from this. The Group's NAV per Ordinary Share continues to outperform its reference indices and peer group over the long-term, although the NAV per Ordinary Share fell during the period. Over the six months to 30 June 2025, the Group delivered a NAV per Ordinary Share return of -6.0%, ahead of the Russell 2000 Biotechnology Index (-11.4%) and behind the Nasdaq Biotechnology Index (-1.9%). The Russell 2000 Biotechnology Index is heavily tilted towards smaller market cap companies, which aligns closely with RTW Bio's approach, while the Nasdaq Biotechnology Index provides broader exposure and includes larger companies.

Since IPO in October 2019, the Group's NAV per Ordinary Share has grown by 63.4%, materially ahead of the Russell 2000 Biotechnology Index (-4.8%), the Nasdaq Biotechnology Index (+25.2%), and the AIC Biotechnology & Healthcare Sector (+8.8%). The Group's performance is also ahead of both indices and the peer group over three-year (RTW Bio +35.9%, Russell 2000 Biotech -3.0%, Nasdaq Biotech +12.8%, AIC +3.6%) and five-year (RTW Bio +27.2%, Russell 2000 Biotech

-31.3%, Nasdaq Biotech -1.6%, AIC +3.6%) time periods.

Public Investments

Over the first half of the year, public investments contributed -2.9% to the NAV per Ordinary Share return. At the period end, 70.2% of the Group's portfolio was in public securities.

The largest contributor was Akero, where the share price rose by 91.8% over the period and delivered 3.8% to the NAV per Ordinary Share return. This followed promising data from its drug to reverse liver cirrhosis with Akero later rumoured to be exploring a potential sale. Rocket was the main detractor over the period, contributing -4.4% to the NAV per Ordinary Share return, after a young man treated with its gene therapy trial for Danon disease tragically died. Rocket actively engaged with the FDA and the clinical hold was subsequently released in August. Phase 2 trials were restarted with a recalibrated dose and a revised immunomodulatory regimen. We remain hopeful there is a path forward given the benefits seen in earlier patients.

Private Investments

The Company's private investments contributed -2.3% to the NAV per Ordinary Share return. At the period end, 32.4% of the Group's portfolio was in private assets.

Corxel announced major developments for its lead candidate, CX11, an oral GLP-1 receptor agonist for obesity and overweight: Corxel began enrolling patients in a U.S. Phase 2 trial following the release of positive results from a China Phase 2 trial, where CX11 demonstrated significant weight reduction across all doses. Corxel delivered a 1.1% contribution to performance over the period. Artios contributed -3.0% to returns. Encouraging clinical trial data from its lead oncology candidate hit multiple indications, meaning that development costs were forecast to be higher than expected. We remain positive on the company and its candidate, ART0380, which offers the potential to transform outcomes for individuals with hard-to-treat cancers, an area of high unmet need.

Royalties

Royalty financing, a growing non-dilutive capital source for life sciences companies launching first- or best-in-class therapies, involves an upfront payment in exchange for a percentage of future revenues, typically paid quarterly. RTW Bio accesses this model through its investment in 4010 Royalty Fund, managed by RTW Investments, which leverages its full life cycle platform to identify and structure deals with strong downside protection. RTW Bio's royalty exposure contributed modestly to NAV over the first half, with assets like Lumryz (Avadel) and Jelmyto (UroGen) performing well - both showing strong sales and regulatory progress. Looking ahead, 4010 has a promising pipeline with several term sheets in negotiation, supported by favourable market conditions for non-dilutive funding.

Discount and capital allocation

Discounts across the investment companies sector remain wide on a historical basis, driven by both structural and sentiment-related factors, particularly for the biotech space, which is impacted by ongoing political volatility. The Board recognises that the current share price discount to NAV remains wider than shareholders would wish and remains committed to taking steps to narrow it materially over time.

In response, the Company has actively repurchased 5,650,000 shares in the first half of 2025, representing 15% of all shares traded during the period. Together with the 8,500,000 shares bought back in 2024, these repurchases have been accretive to NAV per share and increased secondary market liquidity. Importantly, this also demonstrates the Board's strong conviction in the Investment Manager's capabilities, the portfolio valuation, and the exceptional opportunity to invest in innovative biotech today.

Buybacks are evaluated through a capital allocation lens, always anchored in our core objective: long-term capital growth. Given that our portfolio companies typically consume capital to advance through clinical development or early commercialisation, maintaining sufficient liquidity is critical to protect and grow value over time. This is especially relevant in today's market for small- and mid-cap biotech, where capital scarcity creates opportunity for those able to act swiftly. We continue to believe this is a once-in-a-generation moment to invest in public and private biotech.

Therefore, when allocating your capital, the Board carefully considers both the prevailing level of discount in the Company's shares and the opportunity to deploy capital at attractive valuations to deliver outsized long-term capital growth, whether by supporting existing investments or funding new opportunities. However, should the Group receive a significant cash inflow (e.g. through a portfolio position being acquired), it remains the Board's intention to consider the return of a portion of the realised gain to shareholders through buybacks.

Following period end, the Board was pleased to note the 3 September announcement from FTSE Russell that, following the quarterly review of the FTSE Russell UK Index Series and the resulting decision to allow the inclusion of non-GBP shares, RTW Bio's Ordinary Shares will be included in the FTSE All Share Index with effect from market open on 22 September. Inclusion in the FTSE All Share Index is likely to enhance our exposure to investors, develop greater UK and international awareness of RTW Bio and provide increased long-term access to capital. In due course, we expect index trackers and other passive strategies to initiate and build positions within RTW Bio, which should be positive for the Group's share price and its rating.

Simplification of portfolio breakdown

Historically, the Group's public investments have been split into "core public" and "other public" pools. Core public largely comprises positions originally held privately and represents the primary driver of long-term performance, while other public originally served as a capital-efficient way to deploy excess cash (typically reflecting RTW's private fund exposures).

As a matter of good corporate governance, we regularly garner feedback on how we can improve aspects of our delivery to shareholders. We understand that the distinction between core public and other public has become less meaningful to investors and separating the pools can obscure the fact that RTW Bio is predominantly publicly invested, particularly in a market where the valuation of private assets is under scrutiny. Going forward, listed holdings will be reported under a single public category, alongside private and royalties. This presentational change does not impact how the portfolio is constructed or managed.

Outlook

2025 began with renewed optimism for biotech, driven by a resurgence in M&A activity. The acquisition of Intra-Cellular Therapies by Johnson & Johnson in January served as a high-profile signal of strategic interest returning to the space, helping to lift sentiment and catalyse a rally in biotech indices. Innovation remained robust across key therapeutic areas, including obesity, oncology, and rare diseases, while the FDA maintained a strong pace of drug approvals. However, this early momentum was tempered by macroeconomic and political uncertainty around "Liberation Day". These factors contributed to persistent volatility, especially among small- and mid-cap biotech names.

Despite these headwinds, companies with differentiated pipelines and near-term catalysts have continued to attract capital, and the valuation reset of recent years created compelling entry points for long-term investors. The combination of scientific progress, strategic interest from large pharma, and a stabilising macro backdrop laid the foundation for a more constructive second quarter.

Looking ahead, the outlook for the remainder of 2025 is encouraging. Policy clarity is improving, with new FDA leadership reaffirming its commitment to innovation and regulatory flexibility. Initiatives such as "Make American Biotech Accelerate" (MABA) underscore the strategic importance of biotech to the U.S. economy. The risk of impact from tariffs is receding given the large on-shoring commitments made by big pharma and we are also seeing a potential resolution to the debate around drug pricing in the U.S. Further details on policy evolution is contained in the Investment Manager's report. Capital markets activity is beginning to reawaken, and a pipeline of upcoming clinical readouts and potential M&A catalysts is expected to drive renewed investor engagement. The sector is also benefiting from easing inflationary pressures and a more stable interest rate environment, which should support risk appetite and capital flows.

RTW Bio continues to provide investors with access to the most innovative and high-growth areas of the healthcare sector through a diversified portfolio spanning public, private, and royalty investments. Leveraging the access and strategic approach of its Investment Manager, RTW Investments, the Company's full life cycle strategy provides shareholders with exposure to often otherwise inaccessible opportunities and the opportunity to capitalise on emerging innovation, be that next-generation obesity therapies or the groundbreaking use of psychedelic medicine for patients with severe forms of depression. With a well-capitalised, liquid balance sheet and a high-conviction investment strategy, the Company is well-positioned to capture value as sentiment improves. The Board believes the second half of 2025 presents a compelling environment for biotech investing, defined by innovation, strategic momentum, and the potential for meaningful long-term returns.

William Simpson

Chair

10 September 2025

Report of the Investment Manager

Sector overview

The first half of 2025 has been marked by significant policy shifts and regulatory recalibrations in the U.S. healthcare landscape. RTW's Policy and Government Affairs team is actively engaging with policymakers on the administration's priorities, and we are thinking about political and regulatory risk within three buckets:

FDA

The appointment of Dr Marty Makary as FDA commissioner brought renewed support for regulatory flexibility and a proactive stance on accelerating innovation. Dr Vinay Prasad stepped down as head of CBER in July but rejoined the agency in August. His return as head of CBER at the FDA has not triggered volatility in rare disease or gene therapy stocks, suggesting that the market is now more familiar with his views and less reactive to leadership changes. This momentum extended to the Department of Health and Human Services, where RFK Jr launched the "Make American Biotech Accelerate" (MABA) initiative, stating in a social media post that 'We know the power of U.S. biotech. It's time to let it flourish…we're clearing the path to transform great science into real cures, at lower costs, and better health for the American people.' This is a signal of the sector's strategic importance to the U.S. and aligns with the National Security Commission on Emerging Biotechnology's push to position biotechnology as a national security priority through six pillars:

We are already seeing signs of increased responsiveness in regulatory interactions and believe these reforms will accelerate the path to market for high-impact therapies. Overall, we believe that changes at the FDA may become a potential tailwind for biotech as the agency becomes more efficient and transparent while maintaining its pro innovation leaning.

Tariffs

President Trump announced "Liberation Day" on 2 April, when a raft of tariffs were imposed on imports into the U.S., although it is notable that pharma companies were initially excluded. After an initial sell-off, the market has recovered and the tariff risk for biotech appears to be largely behind us given the pharma sector's swift response. Over half of multinational pharmaceutical companies have already committed to 're-shore' nearly $300 billion in manufacturing in the US, including $55 billion by J&J, $50 billion by Roche, and $40 billion by Bristol Myers Squibb. We believe this swift industry response will likely soften the eventual impact of any manufacturing-related tariffs, potentially through exemptions or phased implementations.

Importantly, even in a worst-case scenario, we believe that the financial impact on biotech companies would be minimal. Unlike big pharma companies, biotech firms are less exposed to global supply chain dynamics as most are focused on or based in the U.S. and either out-licence or forgo ex-U.S. commercialisation altogether. With policy momentum shifting toward innovation and domestic investment, the tariff narrative has faded into the background, replaced by a more constructive dialogue around biotech as a national strategic asset.

Drug pricing

Most Favoured Nation (MFN) drug pricing is a policy concept aimed at aligning U.S. drug prices with those in lower-cost countries, particularly those in Europe. It re-emerged under the Trump administration as part of a broader effort to address what the White House views as "free riding" by foreign governments on American pharmaceutical innovation. The White House is considering various approaches to lower U.S. drug prices and we are cautiously optimistic that reasonable deals can get done. What's more, the Trump administration has made it clear that it is also interested in direct-to-consumer solutions to lower prices for U.S. patients, and we saw validation of that approach shortly after the period end on 17 July when Bristol Myers Squibb and Pfizer announced a "direct-to-patient" option for their blood thinning drug, Eliquis. We are also hearing progress on the European side that could mitigate MFN policies put in place in the U.S. In the worst-case scenario where no deal is reached, MFN is largely a pharma rather than a biotech problem, for similar reasons as outlined above with regard to tariffs.

Market overview

Public market valuations in biotech continued to be challenged in the first half, although with a notable divergence between the small-cap focused Russell 2000 Biotech Index (-11.4%) and the large-cap skewed Nasdaq Biotech Index (-1.9%). Given the policy uncertainty that has dominated the year so far, it is not surprising that the more defensive large-cap, commercial-stage names have outperformed.

Figure 1. Annual XBI vs S&P Performance

The first half of 2025 continues the underperformance of the XBI (S&P Biotech ETF) against the broader S&P 500. We are now in the fifth consecutive year of underperformance, which is remarkable as the XBI has never underperformed the S&P 500 for more than one consecutive year in the last 15 years. We believe this signals the compelling value potential of small- and mid-cap biotech. A parallel can be drawn with the flourishing biotech ecosystem in Hong Kong, where the Hang Seng Biotech Index fell 20% in 2024 yet rebounded 59% in the year to June and is up 115% for the year to date.

At 30 June, almost half of publicly-traded US biotech companies had market capitalisations lower than the level of cash on their balance sheets, an increase on the prior two years. The Nasdaq Biotech Index continues to trade at low EV/EBITDA and Price/Sales ratios. We believe that these levels represent an attractive point to put new money to work, particularly in late-stage biotech companies, and are favourable for M&A.

Figure 2: Percentage of US, small- and midcap biotech companies trading at less than cash on their balance sheets at 30 June 2025

Patent cliffs and loss of exclusivity (LOE) remain a critical strategic concern for large pharma companies, with significant revenue at risk over the coming years as drugs 'go generic'. Ten blockbuster drugs (meaning those with >$1 billion sales per annum) face LOE issues in the near term and together these drugs generated a combined $164 billion in global sales in 2024. The most acute revenue erosion is expected in 2028, when multiple high-revenue products are set to lose exclusivity. This looming cliff is prompting large pharma companies to intensify their pipeline replenishment efforts, often through M&A and strategic collaborations; indeed, pharma and large-cap biotech have c. $1 trillion in 'dry powder' (cash and moderate debt capacity) to deploy in acquisitions. M&A accelerated in the first half of 2025, with $49 billion of deals announced, already ahead of the $44 billion seen in the whole of 2024. Marquee deals included J&J's $14.7 billion acquisition of Intra-Cellular Therapies in January, Sanofi's $9.9 billion acquisition of Blueprint Medicines in June, and Merck's $3.4 billion acquisition of SpringWorks Therapeutics in April. Strategic collaborations are also on the rise, such as the $11.1 billion deal between BioNTech and Bristol Myers Squibb announced in June. We expect M&A to accelerate in the second half of the year as volatility and political uncertainty subside, given the compelling valuations at which public biotechs trade and the imperative for large pharma to replace lost revenues.

Figure 3: US biotech M&A deal volumes and value

Biotech IPO activity remained subdued over the first half, constrained by persistent macroeconomic headwinds. Although a few high-quality, clinical-stage companies managed to go public, broader market conditions and mixed aftermarket performance of early 2025 IPOs continued to dampen broader issuance. Historically, the sector averaged around 50 IPOs annually from 2014-24, however, recent years have seen a sharp decline, with only 24 IPOs in 2024 and just 7 in 2025 so far. Notably, the 2025 IPO cohort has skewed toward later-stage companies (Phase 2 and beyond), a shift from the preclinical-heavy wave of 2020-21, reflecting investor preference for more de-risked assets in the current environment. We note the January IPO of obesity-focused Metsera, which has performed strongly since launch (+7.4%) which bodes well for RTW Bio's investments in the space. Private placement activity continued, with $10.4 billion raised across 148 deals, in-line with the $12.4 billion across 168 deals raised in the first half of 2024. The market remained bifurcated: while megarounds (>$100 million) accounted for over half of the capital raised, their frequency declined, and most were structured as tranched financings. Series A and B rounds saw robust step-ups, while Series C valuations remained volatile. Similar to the IPO market, investor appetite within private fundraises shifted towards later-stage opportunities.

The follow-on financing environment for biotech remained highly selective, with 37 secondary offerings raising approximately $7 billion, down sharply from 83 offerings and $18 billion in proceeds during the same period in 2024. Investor support was largely reserved for companies with clear value-driving catalysts, such as positive clinical data. Nonetheless, companies demonstrating fundamental success, particularly through clinical milestones, have continued to access capital markets effectively.

Figure 4: US Biopharma Financing Market - IPOs and Follow-Ons

In the first half of 2025, the FDA approved 16 new drugs, reflecting a measured but steady pace of regulatory activity. While the approval count is lower than in recent years, it includes several first-in-class therapies and drugs developed using novel modalities such as gene editing and RNA-based platforms. Our sentiment toward the FDA remains cautiously optimistic: most companies report no disruption in interactions, and many continue to benefit from expedited pathways like Breakthrough Therapy and Priority Review. Indeed, the FDA leadership continues to express support for innovation, especially in rare diseases and cell and gene therapies.

From a therapeutic area perspective, rare disease, cardiovascular/metabolic, and oncology remain core focuses. We have spoken previously about our excitement around next-generation drugs to fight obesity, with consensus estimates of over $100 billion per year in peak sales. We are also increasingly excited about the opportunity within neuropsychology, particularly addressing hard-to-treat conditions with psychedelic medicine - more on that can be found in our "Strategy in Action" section later in this report.

Financial Highlights, Performance Drivers and Significant Events

Table 1. Financial Highlights in the period

Figure 5. Historical performance characteristics

RTW Investments, LP, a leading global healthcare-focused investment firm with a strong track record of supporting companies developing life-changing therapies, created the Group as an investment fund focused on identifying transformative assets with high growth potential across the biopharmaceutical and medical technology sectors. Driven by deep scientific expertise and a long-term approach to building and supporting innovative businesses, we invest in companies developing transformative next-generation therapies and technologies that can significantly improve patients' lives while creating significant value for our shareholders.

RTW Bio delivered a NAV per Ordinary Share return of -6.0% during the period under review, outperforming the -11.4% from the Russell 2000 Biotech Index and underperforming the -1.9% for the Nasdaq Biotech Index. On a longer-term basis, RTW Bio continues to deliver performance ahead of the indices and peer group, with the NAV per Ordinary Share compounding at 8.8% per annum since launch.

In the first half of the year, public investments contributed -2.9%, private investments contributed -2.3%, and Royalties contributed 0.2%. Further commentary on the performance of each part of the portfolio is provided below, with specific commentary for the top contributors / detractors where the impact on NAV per Ordinary Share was >1%.

Public Investments

The Group's public investments represent the largest portion of the portfolio by design. Biotech companies typically require significant capital to fund development through key clinical milestones, and accessing the public markets is often the only viable route to secure funding at the necessary scale. While RTW is a full life cycle investor, capable of investing at any stage of a company's development, we believe that the majority of value creation in biotech occurs in the public markets. Many of our public holdings started as private positions, which we have retained in the public markets to capture as much value as possible.

Akero and UroGen were the largest contributors amongst the public positions: Akero was the strongest contributor, with its share price rising 91.8% and adding 3.8% to NAV per Ordinary Share. The company reported positive clinical data for its lead asset, efruxifermin (EFX), in MASH, a progressive liver disease with limited treatment options. Shortly after, market speculation emerged around a potential strategic acquisition, further boosting investor sentiment.

UroGen also performed well, contributing 1.5% to NAV. The company secured FDA approval for ZUSDURITM, a non-surgical treatment for a common form of bladder cancer, complementing its existing commercial product, Jelmyto®. This regulatory milestone helped drive a 28.6% increase in the share price over the period.

Rocket and Dyne were the largest detractors amongst the public positions: Rocket was the largest detractor, with its share price falling 80.5% and reducing NAV per Ordinary Share by -4.4%. The decline followed a Serious Adverse Event (SAE) and subsequent death of a patient in its pivotal Phase 2 trial for RP-A501 in Danon disease. Rocket actively engaged with the FDA and the clinical hold was subsequently released in post period end. Phase 2 trials were restarted with a recalibrated dose and a revised immunomodulatory regimen. Rocket also continues to advance a broader pipeline targeting rare genetic cardiomyopathies and haematologic disorders.

In January Dyne's shares fell after the release of updated data from its Phase 1/2 ACHIEVE trial for DYNE-101, a treatment for myotonic dystrophy type 1 (DM1). While the data were positive, investors reacted negatively to the magnitude of the improvements. Additionally in June, Dyne's revised accelerated approval strategy for DM1 drove a delay in its regulatory timeline, also contributing to negative sentiment, and reducing NAV per Ordinary Share during the period by -2.0%. 

Private Investments

We primarily focus on mid-to-late-stage venture and crossover rounds, where we anticipate a company will go public within 6 to 18 months of our initial investment. As a leading crossover investor, RTW is frequently approached by high-quality private biotech companies preparing for public market entry. A smaller portion of the portfolio is allocated to early-stage ventures and RTW-founded companies, where we expect a public listing within three to five years. This balanced approach allows us to support innovation across the development lifecycle while maintaining a clear path to liquidity and value capture.

Among the Company's private investments, Corxel was the top contributor, adding 1.1% to the NAV per Ordinary Share. Corxel is an RTW company creation that is developing CX11, an oral, once-daily GLP-1 receptor agonist for obesity. In June, it enrolled the first patient in its U.S. Phase 2 trial, following positive results from a China Phase 2 trial conducted by partner Vincentage, where CX11 showed strong weight loss efficacy and a favourable safety profile. Topline data from the U.S. trial is expected in H1 2026. During the period, Corxel also received a dividend distribution linked to the sale of Aficamten to Sanofi, of which RTW Bio received its pro rata share.

Artios was the largest detractor at -3.0%. In May, Artios announced encouraging Phase 1/2a data from its lead clinical oncology candidate, ART0380. Importantly, this data hits multiple indications, meaning that development costs (and therefore capital requirements) will likely be higher than expected. We remain positive on the promising clinical trial data from ART0380, which offers the potential to transform outcomes for individuals with hard-to-treat cancers, an area of high unmet need.

Since admission, the Group has made 73 private investments. At 30 June 2025, 33 of these positions had had liquidity events (i.e., go-public or acquisition). The average holding period as private was 17 months and the average MOIC to the liquidity event was 1.7x. 23 of these positions have either concurrently or subsequently been exited in full at an average MOIC of 2.3x.

Royalty Investments

Royalty financing is a growing source of capital for life sciences companies, particularly those launching first-in-class or best-in-class therapies. It involves providing an upfront payment in exchange for a pre-determined percentage of future revenues from a specified product or asset, typically paid out as quarterly cash flows. This structure offers companies a bespoke, non-dilutive alternative to traditional debt, while aligning investor and company interests through revenue participation. RTW Bio mostly gains exposure to royalty financing through the RTW Investments-managed 4010 Royalty Fund (4010). RTW Investments' full life cycle platform and in-house transactional capabilities allow it to identify royalty opportunities early, underwrite with deep insight, and structure deals that offer robust downside protection for investors.

The Group's royalty positions, representing 2.8% of NAV, added a modest amount to the NAV per Ordinary Share. These positions comprise direct royalty investments and the Group's investment in 4010. The underlying assets have performed well in the first half of 2025. Sales of Lumryz, marketed by Avadel Pharmaceuticals, have continued to perform well and revenue guidance has been increased. Avadel also reported that the United States Court of Appeals for the Federal Circuit ruled in favor of Avadel, overturning important parts of a prior injunction, allowing Lumryz to seek approval for the treatment of indications beyond the narcolepsy model.

The Jelmyto royalty asset, marketed by UroGen Pharma, also continues to perform well. UroGen maintained its 2025 sales growth guidance for Jelmyto at 8-12% growth. The company reported long-term follow-up from the OLYMPUS trial that showed Jelmyto's median duration of response to be 48 months, adding positive long-term validation to Jelmyto's already strong clinical profile. On 12 June UroGen's UGN-102 asset received approval from the FDA and began to be marketed as Zusduri from 1 July. The RTW royalty contract with UroGen receives payments from the sales of both drugs. 

Looking forward, RTW Bio is exposed to an exciting pipeline of opportunities including with Milestone Pharmaceuticals, centred on future royalty streams of its lead asset, Cardamyst, a nasal spray medication to treat a type of arrhythmia (paroxysmal supraventricular tachycardia, PSVT). Funding of the royalty is contingent on FDA approval, which is expected in the second half of the year. At the top of the sourcing funnel, we have been actively building out our pipeline by leveraging our strong network. We have several term sheets outstanding and are active in negotiations with a number of promising opportunities. We believe the current complex macro environment and elevated volatility provide an additional tailwind for the royalty value proposition as companies seek new non-dilutive capital to fund their commercial launch activities.

Figure 6. Performance breakdown in H1 2025

Portfolio Breakdown and New Investments

Our investment approach is defined as full life cycle and, therefore, involves retaining private investments beyond their IPOs; hence the portfolio consists of both privately-held and publicly-listed companies and royalty investments.

As discussed in the Chair's statement, going forward, all listed holdings will be reported under a single public category, alongside private and royalties. As of 30 June 2025, the number of holdings in each of the Group's portfolio buckets was as follows:

Figure 7. NAV capital breakdown as of 30 June 2025 compared to 30 June 2024

In prior periods exposures were presented as fair market value as a % of NAV and summed to 100%. In the current period they are presented as exposure as a % of NAV.

Private investments accounted for 32.4% of NAV across 36 investments. The increase in exposure from 30.3% (as at 31 December 2024) reflects five new investments over the period. These included American Laboratories (1.4% of NAV), which specialises in the production of enzymes, proteins, and flavours used across several industries, and Prolium Bioscience (1.3% of NAV), a new RTW company creation focused on autoimmune diseases.

Public investments accounted for 70.2% of NAV. The increase in exposure from 64.6% (as at 31 December 2024) reflects two privately-held positions going public. In January, Beta Bionics went public and raised gross proceeds of $204 million, trading under the ticker "BBNX". In April, Jade Biosciences completed a reverse merger with Aerovate Therapeutics and now trades on the NASDAQ under ticker "JBIO".

Royalties accounted for 2.8% of NAV across 2 investments: 4010 Royalty Fund (an RTW-managed private fund) and RTW Royalty 2 (a royalty based on the revenues of UroGen's Jelmyto and ZUSDURI).

Our "full life cycle" portfolio is diversified across clinical stages, capital position (i.e., equity and royalty), treatment modalities, and therapeutic focus giving it multiple, differentiated return levers and horizons. By constructing the portfolio in such a way, investors get exposure to the most innovative parts of a highly specialised sector with the explosive potential of companies that successfully navigate clinical, regulatory or commercial inflection points.

Looking forward, we expect the total portfolio sector allocation to remain close to 80% biopharmaceutical assets and 20% medical technology assets. In line with prospectus guidance, we anticipate two-thirds of new private investments will be made in mid- to later-stage venture companies and one-third focused on active company building around the discovery and development or licensing and distribution of promising assets. Royalty investments will be limited to approximately 15% of NAV. 

Table 2. Top ten positions as of 30 June 2025

1 Positions are shown on a net basis. Any differences with the Schedule of Investments are due to short holdings and warrants.

Table 3. Private investments greater than 1% exposure added to the portfolio in the first half of 2025

Figure 8. Breakdown of portfolio positions greater than 1% exposure as a percentage of NAV, adjusted to be out of 100%, by (A) Therapeutic Focus, (B) Modality, (C) Clinical Stage and (D) Geography as of 30 June 2025. Therapeutic Focus, Modality and Geography do not include royalty vehicles.

Table 4. Private positions greater than 1% exposure as of 30 June 2025 and 31 December 2024

1 Positions are shown on a net basis. Any differences with the Schedule of Investments are due to short holdings and warrants.

Table 5. Public positions greater than 1% exposure as of 30 June 2025 and 31 December 2024

1 Positions are shown on a net basis. Any differences with the Schedule of Investments are due to short holdings and warrants.

2 Consists primarily of common stock and pre-funded warrants.

Table 6. Royalty positions greater than 1% exposure as of 30 June 2025 and 31 December 2024

Private Portfolio Valuations and Cash Runway Analysis

Private investments remain a core component of the Group's strategy, built on our disciplined, bottom-up approach to identifying high-quality opportunities. While we continue to maintain a selective and well-funded private portfolio, the recent dislocation in public markets has shifted the relative attractiveness of deploying new capital, as depressed public valuations create a compelling entry point for new investments. This dynamic is informing our capital allocation decisions, even as we remain committed to supporting our private companies through clinical development and strategic growth.

As of 30 June 2025, the average cash runway across our private companies was slightly over 18 months, providing sufficient time to advance clinical development plans. Around one-fifth of the portfolio had less than six months of runway; three of these are RTW Investments company creations, where the Investment Manager has the flexibility to inject capital when needed. The remainder are actively pursuing capital raising solutions.

We value our private investments at 'fair value' in accordance with US GAAP, using techniques aligned with the International Private Equity and Venture Capital ("IPEV") Guidelines. RTW Investments' Valuation Committee updates valuations on a monthly basis and in response to trigger events, aiming to ensure both timeliness and accuracy. At least twice per annum, the Valuation Committee receives the advice of an independent third-party valuation firm. Oversight is provided by the Board's Audit Committee, which reviews the Investment Manager's valuation policies and procedures semi-annually and as needed.

As at 30 June, RTW Bio held 38 private investments and royalty positions. During the first half of 2025, 30 private or royalty positions saw a total of 42 valuation adjustments, with an average of one adjustment per position:

· 13 positions were marked up by an average of 7.8%

· 17 positions were marked lower by an average of 21.7%

· The balance remained unchanged

The average valuation change was -6.4%. 53% of the mark-downs were primarily driven by changes to relative comparables or market-based inputs. 15% of the mark-ups were primarily driven by comparables, and 85% were primarily driven by idiosyncratic company performance, a financing round or transaction. At period end, the average time since the last third-party valuation was four weeks and an average of 14 months had elapsed since the last financing round.

Figure 9. Average Multiple of Invested Capital (MOIC) by vintage on 1) privates to liquidity event, 2) fully exited positions and 3) privates with no liquidity event

1 Liquidity event = IPO, SPAC merger, reverse merger, acquisition from private

2 Multiple of Invested Capital ("MOIC") represents the ratio of total value to the corresponding amount of total capital invested, expressed

as a multiple. Gross MOIC is utilised, which is calculated before giving effect to management fees, carried interest, taxes and other

expenses, which would reduce performance and the rate of return.

3 Certain legacy investments acquired in the 2024 Arix transaction are not included in the MOIC and IRR statistics above.

Figure 10. Private portfolio cash runway as of 30 June 2025

Table 7. Private Valuation Statistics for H1 2025

1 Includes one reverse merger and one IPO.

Post period-end updates and other key portfolio company events

RTW Investments, LP

10 September 2025

Strategy in Action

Impact Focus: The emergence of psychedelics as a transformative therapy for treatment-resistant depression.

Three million patients in the U.S. alone suffer from treatment-resistant depression (TRD). TRD refers to when a patient either doesn't respond to selective serotonin reuptake inhibitors (SSRIs, the primary approach to depression treatment) or experiences adverse events on them. If you fail two adequate lines of antidepressants, you are said to be treatment-resistant, and your odds of getting better go down significantly.

The interest in psychedelics as a potential treatment for TRD began as the war on drugs of the 1980s started to die down, and certain academics in the U.S., UK and elsewhere started studying magic mushrooms. They found in these early studies that the effects on depression (particularly of psilocybin) were profound. Academic research increased and the idea that previously "scheduled" drugs (controlled substances) could become approved medicines became more widespread. From this sprouted new biotech companies founded around new psychedelic compounds. With the emergence of more and more positive data from clinical trials, psychedelics continue to become destigmatised.

The current standard of care for TRD is Johnson & Johnson's drug, Spravato, which is esketamine in a nasal spray form that is delivered to patients in a clinic. Spravato's regimen is first given twice a week for four weeks and then once a week for four more weeks, with a maintenance dose of typically once a week. Spravato is trending to be a multi-billion dollar product, indicating a huge potential market. Psychedelics currently being studied look significantly more promising - they can be dosed less frequently (potentially once-a-month or even less frequently), and the response rates appear to be more durable.

The new White House administration has demonstrated its support for psychedelics. RFK Jr, FDA Commissioner Marty Makary and Trump's pick for Surgeon General, Casey Means have all made positive statements. The FDA is really leaning in, and they've even produced guidance documents for biotech companies to help them design a development program that the FDA is more likely to approve.

RTW Bio's portfolio has 2.7% exposure to psychedelics as of period end. GH Research, based in Dublin, is aiming to transform the treatment of psychiatric and neurological disorders and is pursuing therapies that have the potential to be highly effective, rapid acting, durable, well-tolerated, and conveniently administered for their target indications. Its lead product candidate is an inhaled version of mebufotenin for Treatment-Resistant Depression. Compass Pathways is a biotechnology company dedicated to accelerating patient access to evidence-based innovation in mental health. Its first major initiative is developing an investigational psilocybin treatment through a global phase 3 program for people living with treatment-resistant depression.

Impact Focus: Obesity developments in 2025 from Kailera Therapeutics and Corxel Pharmaceuticals

Kailera Therapeutics

5.0% of NAV (31 December 2024: 3.4%)

After launching in 2024, Kailera Therapeutics announced positive topline data from Hengrui Pharmaceutical's Phase 2 clinical trial of HRS9531, a GLP-1/GIP receptor dual agonist, in individuals with obesity or overweight. The clinical trial results showed that a once-weekly subcutaneous injection of the 8 mg dose of HRS9531 demonstrated a statistically significant 21.1% (p

Shortly after period-end, Kailera and Hengrui announced positive topline data from the China Phase 3 clinical trial of HRS9531 in individuals living with obesity or overweight. The trial met both primary endpoints, demonstrating superior weight loss and a greater percentage of participants achieving at least 5% body weight reduction compared to placebo. The safety profile was favourable and consistent with other GLP-1-based treatments, with most treatment-emergent adverse events being mild to moderate and gastrointestinal-related. Hengrui plans to submit a New Drug Application (NDA) for chronic weight management in China. Kailera is advancing KAI-9531 to global clinical trials.

Corxel Pharmaceuticals

9.4% of NAV (31 December 2024: 8.5%)

At the end of 2024 Corxel announced its acquisition of worldwide rights (excluding greater China) to CX11, an oral small molecule for obesity and diabetes. In June, Corxel announced the enrolment of the first patient in its U.S. Phase 2 trial of CX11, which will evaluate the efficacy and safety of CX11 in a U.S. population with a high proportion of obesity and diabetes. In a previous China Phase 2 trial conducted by its partner, Vincentage, CX11 had demonstrated competitive weight loss with favourable safety and tolerability in Chinese patients. The U.S. Phase 2 trial aims to minimise gastrointestinal side effects and will also evaluate a higher dose to achieve better weight reduction results. Topline data from this trial is expected in H1 2026.

Also in June, Corxel announced the positive China Phase 2 clinical results for CX11. In the China Phase 2 trial, weight reduction was significantly greater at all doses compared to the placebo. A weight reduction of at least 5% by week 16 occurred in 55% to 90% of the participants who received CX11, as compared to the 13% who received the placebo. Treatment with CX11 was associated with improvement in all weight-related and cardiometabolic metrics that were measured. Of reported adverse events, most were gastrointestinal and mild to moderate in severity. No liver toxicity safety signal was identified, nor were any drug-related serious adverse events reported.

Responsible Investment

The Group aims to achieve superior long-term capital appreciation, focusing on forming, building, and supporting world-class life sciences, biopharmaceutical, and medical technology companies. The Group's primary consideration is to support companies that promote health and well-being by bringing drugs and devices to market that are expected to save or extend life, improve quality of life, or revolutionise the course of treatment for diseases and conditions that afflict people.

The Group (via the Investment Manager) seeks to meet regularly with the management teams of portfolio companies to foster long-term relationships. This ongoing dialogue enables open discussions on issues that could affect long-term returns. The decision to engage with a portfolio company depends on both the materiality of the issue and the size of the holding.

The Group is committed to investing in and building companies that adopt and integrate sound practices that are proportionate to the scale of the business, including established industry best practices related to clinical trials and animal testing, contract research organization (CRO) oversight, anti-bribery and corruption and the development of a governance framework. On an ongoing basis, the Investment Manager's IR team engages with portfolio companies to collect information on sustainability data and policies where they exist.

The Group's Board of Directors has established a Sustainability Committee which meets with the Investment Manager bi-annually where they are briefed on updates to process, policy, and portfolio engagement. The Sustainability Committee provides oversight on behalf of and advice to the Board in relation to the Company's Responsible Investment strategy and ensures that all stakeholders receive appropriate related information. The Committee assists the Board in overseeing the development of the Responsible Investment Policy and reviews relevant matters to be presented in this half-yearly financial report, maintaining oversight of and making recommendations. 

Statement of Principal Risks and Uncertainties for the Remaining Six Months of the year to 31 December 2025

As described in the Group's annual consolidated financial statements for the year ended 31 December 2024, the Group's principal and emerging risks and uncertainties include the following:

- Failure to achieve investment objective;

- Unfavourable tax exposure;

- Counterparty risk;

- The Investment Manager relies on key personnel;

- Portfolio companies may be subject to litigation;

- Exposure to global political and economic risks;

- Clinical development and regulatory risks;

- Imposition of pricing controls for clinical products and services;

- Inflation;

- Availability of capital; and

- Sustainability reporting.

The Board believes that these risks are unchanged in respect of the remaining six months of the year to 31 December 2025.

Further information in relation to these principal risks and uncertainties may be found on pages 38 to 40 of the Group's annual report and audited consolidated financial statements for the year ended 31 December 2024.

These inherent risks associated with investments in the biotech and pharmaceutical sector could result in a material adverse effect on the Group's performance and value of the Ordinary Shares.

Risks are mitigated and managed by the Board through continual review, policy setting and regular reviews of the Group's risk matrix by the Audit Committee to ensure that procedures are in place with the intention of minimising the impact of the above-mentioned risks. The Board carried out a formal review of the risk matrix at the Audit Committee meeting held on 31 July 2025. The Board relies on periodic reports provided by the Investment Manager and Administrator regarding risks that the Group faces. When required, experts will be employed to gather information and/or provide expert advice, including tax and legal advisers.

Statement of Directors' Responsibilities

The Directors confirm to the best of their knowledge that:

- the unaudited interim consolidated financial statements have been prepared in conformity with US generally accepted accounting principles and give a true and fair view of the assets, liabilities, financial position and profit or loss of the Group; and

- the interim management report (which includes the Chair's Statement, Report of the Investment Manager and Statement of Principal Risks and Uncertainties) together with the unaudited interim consolidated financial statements include a fair review of the information required by:

a. DTR 4.2.7R of the Disclosure Guidance and Transparency Rules, being an indication of important events that have occurred during the first six months of the financial year and their impact on the unaudited interim consolidated financial statements; and a description of the principal risks and uncertainties for the remaining six months of the financial year; and

b. DTR 4.2.8R of the Disclosure Guidance and Transparency Rules, being related party transactions that have taken place during the first six months of the financial year and that have materially affected the financial position or performance of the Group during that period; and any changes in the related party transactions described in the last annual report that could do so.

The Directors are responsible for the maintenance and integrity of the corporate and financial information included on the Group's website (https://www.rtwbio.com). Legislation in Guernsey governing the preparation and dissemination of financial statements may differ from legislation in other jurisdictions.

By order of the Board

Independent Review Report to RTW Biotech Opportunities Ltd

Conclusion

We have been engaged by RTW Biotech Opportunities Ltd (the "Company") to review the consolidated financial statements in the half-yearly financial report for the six months ended 30 June 2025 of the Company and its subsidiaries (together, the "Group"), which comprises the unaudited interim consolidated statement of assets and liabilities including the unaudited interim consolidated condensed schedule of investments, the unaudited interim consolidated statements of operations, changes in net assets and cash flows and the related explanatory notes.

Based on our review, nothing has come to our attention that causes us to believe that the consolidated financial statements in the half-yearly financial report for the period ended 30 June 2025 do not give a true and fair view of the financial position of the Group as at 30 June 2025 and of its financial performance and its cash flows for the six month period then ended, in accordance with U.S. generally accepted accounting principles and the Disclosure Guidance and Transparency Rules ("the DTR") of the UK's Financial Conduct Authority ("the UK FCA").

Scope of review

We conducted our review in accordance with International Standard on Review Engagements (UK) 2410 Review of Interim Financial Information Performed by the Independent Auditor of the Entity ("ISRE (UK) 2410") issued by the Financial Reporting Council for use in the UK. A review of interim financial information consists of making enquiries, primarily of persons responsible for financial and accounting matters, and applying analytical and other review procedures. We read the other information contained in the half-yearly financial report and consider whether it contains any apparent misstatements or material inconsistencies with the information in the consolidated financial statements. 

A review is substantially less in scope than an audit conducted in accordance with International Standards on Auditing (UK) and consequently does not enable us to obtain assurance that we would become aware of all significant matters that might be identified in an audit. Accordingly, we do not express an audit opinion.

Conclusions relating to going concern

Based on our review procedures, which are less extensive than those performed in an audit as described in the Scope of review section of this report, nothing has come to our attention to suggest that the directors have inappropriately adopted the going concern basis of accounting or that the directors have identified material uncertainties relating to going concern that are not appropriately disclosed.

This conclusion is based on the review procedures performed in accordance with ISRE (UK) 2410. However future events or conditions may cause the Group and the Company to cease to continue as a going concern, and the above conclusions are not a guarantee that the Group and the Company will continue in operation.

Directors' responsibilities

The half-yearly financial report is the responsibility of, and has been approved by, the directors. The directors are responsible for preparing the interim financial report in accordance with the DTR of the UK FCA.

The consolidated financial statements included in this interim report have been prepared in accordance with U.S. generally accepted accounting principles.

In preparing the half-yearly financial report, the directors are responsible for assessing the Group and the Company's ability to continue as a going concern, disclosing, as applicable, matters related to going concern and using the going concern basis of accounting unless liquidation is imminent.

Our responsibility

Our responsibility is to express to the Company a conclusion on the consolidated financial statements in the half-yearly financial report based on our review. Our conclusion, including our conclusions relating to going concern, are based on procedures that are less extensive than audit procedures, as described in the scope of review paragraph of this report.

The purpose of our review work and to whom we owe our responsibilities

This report is made solely to the Company in accordance with the terms of our engagement letter to assist the Company in meeting the requirements of the DTR of the UK FCA. Our review has been undertaken so that we might state to the Company those matters we are required to state to it in this report and for no other purpose. To the fullest extent permitted by law, we do not accept or assume responsibility to anyone other than the Company for our review work, for this report, or for the conclusions we have reached. 

Andrew J. Salisbury

For and on behalf of KPMG Channel Islands Limited

Chartered Accountants

Guernsey

10 September 2025

Unaudited Interim Consolidated Statement of Assets and Liabilities

as at 30 June 2025 and 31 December 2024

(Expressed in United States Dollars)

The unaudited interim consolidated financial statements of the Group were approved and authorised for issue by the Board of Directors on 10 September 2025 and signed on its behalf by:

William Simpson Paul Le Page

Chair Director

See accompanying notes to the unaudited interim consolidated financial statements.

 Unaudited Interim Consolidated Condensed Schedule of Investments

as at 30 June 2025

(Expressed in United States Dollars)

See accompanying notes to the unaudited interim consolidated financial statements.

See accompanying notes to the unaudited interim consolidated financial statements.