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2019 Vertex Pharmaceuticals Incorporated July 31, 2019 Second-Quarter 2019 Financial Results 2019 Vertex Pharmaceuticals Incorporated Agenda Introduction Michael Partridge, Senior Vice President, Investor Relations Business Highlights Jeff Leiden, M.D., Ph.D., Chairman, President and Chief Executive Officer Clinical Update Reshma Kewalramani, M.D., Executive Vice President and Chief Medical Officer Financial Results Charlie Wagner, Executive Vice President and Chief Financial Officer Q VX-814 to advance into Phase 2 development; Clinical data in people with two Z mutations anticipated in 2020; Second molecule (VX-864) advanced into Phase 1 development Alpha-1 Antitrypsin Deficiency First patients dosed in Phase 1/2 study of CTX001 for severe sickle cell disease and beta- thalassemia Sickle Cell Disease / Beta Thalassemia APOL1-Mediated Kidney Diseases First molecule (VX-147) advanced into Phase 1 development; Potential to advance to Phase 2 POC study in 2020; Multiple other APOL1 inhibitors advancing through preclinical development Proof-of-concept for NaV1.8 inhibition in acute, musculoskeletal and neuropathic pain; Ongoing research to discover/develop additional NaV1.8 inhibitors and will choose best molecule(s) to advance into late-stage development; Initiating Phase 1 study of VX-961 Pain Duchenne Muscular Dystrophy / Myotonic Dystrophy Type 1 In July 2019, VRTX completed its acquisition of Exonics Therapeutics and expanded its collaboration with CRISPR Therapeutics with a goal of developing novel gene editing therapies for DMD and DM1 2019 Vertex Pharmaceuticals Incorporated REDUCING TOXIC POLYMER IN THE LIVER OF PIZ TRANSGENIC MICE RAISING CIRCULATING LEVELS OF AAT IN PIZ TRANSGENIC MOUSE 75% reduction in polymer (p0.001) Vehicle 12 weeksVX-864 12 weeks Potential to address pathology in the liverPotential to prevent disease progression in the lung Notes: Animal studies using PiZ transgenic mouse model that carries human Z-AAT gene Mouse baseline in this experiment corresponds well with approximate average human ZZ baseline (5uM) “Carrier range” corresponds to values above the “protective threshold” (11 uM) Carrier range Small Molecule Corrector for Alpha-1 Antitrypsin Deficiency Proof of Mechanism in Preclinical Studies over 12 Weeks Vehicle VX-864 10 2019 Vertex Pharmaceuticals Incorporated Severity of Disease FSGS is a severe kidney disease characterized by proteinuria and progressive loss of kidney function. 10,000 people in the U.S. have FSGS and are homozygous for APOL1 mutations Human Biology Precision medicine approach targeting APOL1 protein function in people with two APOL1 mutations a causal genetic factor in FSGS and other proteinuric kidney diseases Therapeutic Approach totals may not add due to rounding FY1H ($ in millions except per share data and percentages) Q2 182018Q1 19Q2 192019 Total CF product revenues $750$3.04

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