INSTITUTIONAL RESEARCH Biotechnology COMPANY UPDATE Member FINRA/SIPC

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1 INSTITUTIONAL RESEARCH Biotechnology COMPANY UPDATE Member FINRA/SIPC Toll Free: North Federal Highway - Suite 500 Boca Raton, FL Acasti Pharma (Nasdaq/ACST) BUY Investment Highlights TRILOGY trial advancing Acasti Pharma is a biopharmaceutical innovator focusing on the research, development and commercialization of prescription drugs using omega-3 fatty acids derived from krill oil 1) Acasti is making solid progress on its keystone cardiovascular product program, CaPre, with its two TRILOGY Phase 3 studies on track to complete enrollment this year. TRILOGY has surpassed 90% of the planned 500 patient enrollment with greater than 50% of patients randomized at its more than 150 clinical sites across North America, as of October 31. Acasti is projecting that that the two trials will be completed (on schedule) in H2/2019, with reporting of topline results targeted before the end of next year. And thanks to two separate equity offerings competed, one each in the US and Canada, the Company estimates that it is now fully funded to complete the TRILOGY Phase 3 trials. Furthermore, Acasti estimates it has sufficient funding to initiate certain CaPre prelaunch marketing programs in the US and even begin work on the CaPre New Drug Application (NDA) with the US FDA. 2) For its most recent quarter (ending September 2018), Acasti reported a net operating loss of $10.4 million, as compared to a net operating loss of $4.4 million in the prior year period. The increased loss for this year s period is primarily due to higher R&D spend as the Company advanced its two Phase 3 trials for CaPre. At the end of the quarter, the Company had $6.0 million in cash on hand, which was augmented post-quarter end by approximately $48 million added by the two October equity offerings. The Company has also been active this year in the personnel area, including bringing in a new Vice President of Finance, Jean-François Boily, a CPA with prior experience at Teva Canada (TEVA, Not Rated) and Innovaderm Research, as well as Brian Groch as Chief Commercial Officer. He was previously with Veru (VERU, Buy), Telesta Therapeutics, and Horizon Therapeutics. The chart below depicts the Company s current CaPre development timeline and key milestones expected: November 26, 2018 Robert M. Wasserman Senior Research Analyst rwasserman@dawsonjames.com Current Price $0.70 Price Target $2.40 Estimates F2017A F2018A F2019E Revenues($000s) $0 $0 $0 E 1Q June A 2Q September A 3Q December 1 0 4Q March 0 0 EPS (diluted) ($0.97) ($1.23) ($0.71) E 1Q June (0.29) (0.19) (0.23) A 2Q September (0.22) (0.31) (0.62) A 3Q December (0.22) (0.40) 4Q March (0.24) (0.32) EBITDA/Share ($0.67) ($1.00) ($0.64) EV/EBITDA (x) N/A N/A N/A Stock Data 52-Week Range $0.43-$1.90 Shares Outstanding (mil.) 77.5 Market Capitalization (mil.) $54.3 Enterprise Value (mil.) $48.3 Debt to Capital (9/18) N/A Book Value/Share (9/17) N/A Price/Book N/A Average Trading Volume (3-month) (Mill) 1.37 Insider Ownership 8.5% Institutional Ownership 0.7% Short interest (Mill) 1.04 Dividend / Yield $0.00/0.0% Price target and ratings changes over the past 3 yrs: Initiated - January 26, Buy - Price Target $2.40 Please find Important Disclosures beginning on Page 5. Page 1 of 6

2 Source: Acasti Pharma Conclusion Possibly due to its recent spin-off as a public company just a few years ago, the share price performance of Acasti Pharma has lagged others in the well-performing cardiovascular therapeutic area. In addition, recent gyrations of Amarin s (AMRN, NR) shares following presentation of data from the large Vascepa REDUCE-IT trial followed by additional color provided by Company management and the possibility of European approval and partnership for the drug have confused many investors regarding the potential of this leading component of the cardiovascular market. However, with an innovative therapeutic well-advanced into Phase 3 clinical trials in a large medical market, a recently-strengthened balance sheet, an experienced management and advisory team on board, and a number of developmental milestones and catalysts expected in the near-term, Acasti shares may soon attract both growthoriented and value-investors. Thus we believe ACST shares may soon follow those of other cardio stocks (many of which have $1 + billion market capitalizations) which have exhibited strong price appreciation this year, and thus we are maintaining our BUY rating on Acasti shares and month price target of $2.40 per share. (For a full explanation of our stock valuation on Acasti shares please see our Initiation Report dated January 26, 2018) Risk Factors In addition to normal economic and market risk factors that impact most equities and the common risks shared by Acasti Pharma with other companies in the industry, we believe an investment in ACST involves the following risks: Reliance on key management At present, ACST relies on several key members of its management team who have been in key executive positions for an extended period of time. Should one or more of these key executives leave the Company, ACST could find it difficult to replace their long-standing knowledge of operations and industry expertise. Acasti Pharma 11/26/2018 Page 2 of 6

3 Reliance on future partnerships To date, ACST has not formally signed major development partnerships for its product candidates although one such partnership is currently under due diligence. In the future, however, the Company may sign such agreements, and as such certain factors related to product marketing and/or new product development may be determined by third parties and out of the control of Company management. Limited stock liquidity Trading volume in ACST stock is comparatively light and these shares have a relatively limited history of trading compared with other healthcare stocks. As such, news regarding ACST, its target market, partners and/or competitors could lead to significant volatility in the stock price. Competitive markets The Company and its potential partners are expected to compete in its target cardiovascular pharmaceutical markets with a number of companies, many of which are considerably larger than the Company. There can be no assurance that the Company and its partners will be able to successfully compete and launch new products into these competitive markets in the future. FDA and regulatory risks ACST and its potential partners are subject to regulatory review for ongoing product research and development, principally approval and review processes of the US Food and Drug Administration and other non-domestic regulatory agencies. In addition, the quality assurance and manufacture of the Company's products will be subject to ongoing oversight and regulation, and any negative correspondence from the FDA or other regulatory agencies in the future could have an adverse effect on the ongoing operations of the Company. Lack of historic profitability ACST has not achieved operating profitability since its founding, and according to our forecasts may not be expected to do so in the near future. Although the Company maintains adequate cash reserves at the present time, there can be no assurance the Company will not need to raise additional working capital in the future should operating losses continue. Need to defend patents and other intellectual property ACST currently has issued patents and patent applications pending in the US on its pharmaceutical products, some of which may expire in the near future. The Company may be required to defend its patents in the US and overseas in the future, and there can be no assurance these defenses will be successful. Acasti Pharma 11/26/2018 Page 3 of 6

4 Source: Dawson James Securities, Inc. estimates; Company documents Acasti Pharma 11/26/2018 Page 4 of 6

5 Important Disclosures: Price Chart: Price target and ratings changes over the past 3 years: Initiated Buy - January 26, 2018 Price Target $2.40 Dawson James Securities, Inc. (the Firm ) is a member of the Financial Industry Regulatory Authority ( FINRA ) and the Securities Investor Protection Corporation ( SIPC ). The Firm does not make a market in the securities of the subject company (s). The Firm has engaged in investment banking relationships with ACST in the prior twelve months, as a manager or co-manager of a public offering and has received compensation resulting from those relationships. The Firm may seek compensation for investment banking services in the future from the subject company(s). The Firm has not received any other compensation from the subject company(s) in the last 12 months for services unrelated to the managing or co-managing of a public offering. Neither the research analyst(s) whose name appears on this report nor any member of his (their) household is an officer, director or advisory board member of these companies. The Firm and/or its directors and employees may own securities of the company(s) in this report and may increase or decrease holdings in the future. As of October 31, 2018, the Firm as a whole did not beneficially own 1% or more of any class of common equity securities of the subject company (s) of this report. The Firm, its officers, directors, analysts or employees may effect transactions in and have long or short positions in the securities (or options or warrants related to those securities) of the company(s) subject to this report. The Firm may effect transactions as principal or agent in those securities. Analysts receive no direct compensation in connection with the Firm's investment banking business. All Firm employees, including the analyst(s) responsible for preparing this report, may be eligible to receive non-product or service specific monetary bonus compensation that is based upon various factors, including total revenues of the Firm and its affiliates as well as a portion of the proceeds from a broad pool of investment vehicles consisting of components of the compensation generated by investment banking activities, including but not limited to shares of stock and/or warrants, which may or may not include the securities referenced in this report. Although the statements in this report have been obtained from and are based upon recognized statistical services, issuer reports or communications, or other sources that the Firm believes to be reliable, we cannot guarantee their accuracy. All opinions and estimates included in this report constitute the analyst s judgment as of the date of this report and are subject to change without notice. Information about valuation methods and risks can be found in the STOCK VALUATION and RISK FACTORS sections of this report. Acasti Pharma 11/26/2018 Page 5 of 6

6 The securities of the company discussed in this report may be unsuitable for investors depending on their specific investment objectives and financial position. This report is offered for informational purposes only, and does not constitute an offer or solicitation to buy or sell any securities discussed herein in any jurisdiction where such would be prohibited. Additional information is available upon request. Ratings Definitions: 1) Buy: the analyst believes the price of the stock will appreciate and produce a total return of at least 20% over the next months; 2) Neutral: the analyst believes the price of the stock is fairly valued for the next months; 3) Sell: the analyst believes the price of the stock will decline by at least 20% over the next months and should be sold. The following chart reflects the range of current research report ratings for all companies followed by the analysts of the Firm. The chart also reflects the research report ratings relating to those companies for which the Firm has performed investment banking services in the last twelve months. Analyst Certification: The analyst(s) whose name appears on this research report certifies that 1) all of the views expressed in this report accurately reflect his (their) personal views about any and all of the subject securities or issuers discussed; and 2) no part of the research analyst s compensation was, is, or will be directly or indirectly related to the specific recommendations or views expressed by the research analyst in this research report; and 3) all Dawson James employees, including the analyst(s) responsible for preparing this research report, may be eligible to receive non-product or service specific monetary bonus compensation that is based upon various factors, including total revenues of Dawson James and its affiliates as well as a portion of the proceeds from a broad pool of investment vehicles consisting of components of the compensation generated by investment banking activities, including but not limited to shares of stock and/or warrants, which may or may not include the securities referenced in this report. Acasti Pharma 11/26/2018 Page 6 of 6