Extension of Commercial Fill/Finish Services Agreement between Insmed Incorporated and Ajinomoto Althea, Inc., dated as of December 18, 2018

December 18, 2018

Craig Logan

VP of Finance and Chief Financial Officer

Ajinomoto Althea, Inc.

11040 Roselle Street

San Diego, CA 92121

RE: Extension of Commercial Fill/Finish Services Agreement

Dear Mr. Logan,

As you know, Ajinomoto Althea, Inc. (“Althea”) and Insmed Incorporated (“Insmed”) are parties to the Commercial Fill/Finish Supply Agreement, dated January 1, 2015 (the “Agreement”). Per Section 7.1 of the Agreement, the Initial Term (as defined in the Agreement) of the Agreement was extended to, and now expires on, December 31, 2019 and the parties may mutually agree to extend the Agreement for an additional two (2) year period at least one (1) year prior to the expiration. Insmed kindly requests that Althea acknowledge and agree to a two (2) year extension of the Agreement until December 31, 2021 by signing below.

We appreciate all of the efforts made to date by Althea and look forward to continuing our relationship. Please contact me at ###-###-#### with any questions.

Sincerely,

/s/ Don Nociolo

Don Nociolo

Vice President, Technical Operations

AGREED AND ACKNOWLEDGED:

Ajinomoto Althea, Inc.

By: /s/ Craig W. Logan                

Name: Craig W. Logan

Title: VP of Finance and Chief Financial Officer