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340B Prime Vendor Program - An Update 340B Coalition Winter Conference February 1, 2008

Program Transition: HPPI to Apexus. June 2007

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340B Prime Vendor Program - An Update 340B Coalition Winter Conference February 1, 2008

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    1. 340B Prime Vendor Program - An Update 340B Coalition Winter Conference February 1, 2008 Christopher A. Hatwig, MS, RPh, FASHP Senior Director 340B Prime Vendor Program/Apexus

    3. Apexus/PVP Organizational Chart

    4. PVP Mission/Goals Improve access to affordable medications for covered entities and their patients Primary goals: Lower participants’ supply costs by expanding the current PVP portfolio of sub-340B priced products Provide covered entities with access to efficient drug distribution solutions to meet their patients’ needs Provide access to other value added products and services meeting covered entities’ unique needs

    5. Program Highlights Over 5,700 participants Over 50 suppliers 2,800 products and services Participant councils providing program guidance DSH CHC’s Title X Family Planning Clinics Average sub-ceiling savings of 16% across all participants for outpatient covered drugs Conservative - excludes savings from vaccines and other value added services

    6. Participants Benefits Ease of enrollment and activation of pricing by wholesaler No cost to participate – federal benefit Savings on outpatient covered drugs and other value added outpatient products and services Access to secure website to validate PVP pricing and 340B ceiling pricing with wholesalers Reports and other resources available to assist with procurement and budgeting decisions Top 200 Reports - price increases/decrease by quarter Best price by therapeutic class report Women’s health care portfolio Participant communications Support of 340B education programs focused on compliance and providing networking opportunities for participants

    7. PVP Participants by Entity Type (as of 1/9/08– 5734 participants)

    8. Authorized Distributors Regional Distributors Capital Wholesale Drug Co. H.D. Smith Drug Co. Kinray, Inc. McQueary Bros. Morris & Dickson, Co., LTD Mutual Drug Co. Rochester Drug Cooperative

    9. Supplier Agreements Allendale Pharmaceutical Alliant Pharmaceuticals AMO (pending) Astra-Zeneca Pharmaceuticals Abraxis Pharmaceutical Akorn Inc. ASD (flu vaccine) Bayer Diagnostics Bedford Labs Can-am Care LLC Caraco Pharmaceutical Labs Dabur Pharmaceuticals FFF (flu vaccine) G&W Laboratories Geritrex Corporation GlaxoSmithKline Hawthorne Pharmaceuticals, Inc Home Diagnostics Inc. Early Detect Lilly & Company Major Pharmaceuticals Medicure Morton Grove Pharm Inc. NitroMed Inc. Novartis Vaccines Novo Nordisk Okomoto USA Inc. Organon USA, Inc. Paddock Labs RD Plastics Co Inc. Rx Elite Holdings, Inc. Sandoz Pharmaceutical Teva Health Systems Total Pharmacy Supply Tri State Distribution Stratus Pharmaceuticals Trinity Biotech X-Gen Pharmaceuticals Watson Pharma Inc. Wyeth Pharmaceuticals

    10. Recent PVP Contract News AstraZeneca – Symbicort® Bayer Diagnostics – Breeze® 2 Meter (no coding technology) Novartis – Fluvirin® (direct purchase) Lilly – Cymbalta® Wyeth – Protonix® nominal - expanded dosage forms Organon/SP – Implanon® GSK – Fluarix® , Coreg CR®, Flovent® Advair® and Ventolin® Ista Pharmaceuticals – Xibrom® Dabur Pharmaceuticals – injectable oncology products Kerr - full product line of prescription vials New generics from Sandoz, Teva, Watson, & Caraco

    11. Ongoing Supplier Discussions for New Products Abbott AMO - Healon Astra-Zeneca Bayer GSK Hospira Lilly Merck Schering Plough Novartis Drug Assistant –Indigent Drug Recovery Software

    12. Women’s Health Products

    13. Other Products and Services Vaccines (flu, hep A, hep B) – GSK, Novartis, ASD and FFF PAP software – MedData, M&D Cares Split bill software – eAudit, D-21/ABC, Talyst, Auditing/overcharge recovery services – eAudit, ST Health Repackaging services – Dispensing Solutions Inc. Labels/printer cartridges - Tristate Distribution Vials – Kerr, Tristate Diabetic meters and supplies – Bayer, HDI PBM services – Global Pharmaceutical Solutions (GPS) OTC diagnostic test kits – Early Detect Syringes – Can Am (Kendall) Pharmacy automation – AutoMed Technologies, ScriptPro HIV rapid test kits – Trinity Biotech, Iverness Medical

    14. Cost Savings Analysis – FQHC, Spokane , WA

    15. Systems and Customer Support Enhancements Newsletter – expanded and improved New reports available on secure website Top 200 price increases/decreases from quarter to quarter Therapeutic class report Women’s health care portfolio PVP participant database enhancements Interface with OPA database to capture updates Addition of key identifiers to improve timely and accurate processing of charge-backs Transition from annual to quarterly customer satisfaction survey

    16. PVP Pharmacy Flash Newsletter

    17. 340B Program Integrity Initiatives Improving pricing transparency Establishment of secure website for posting of ceiling prices Quarterly comparison of four largest wholesalers’ PHS selling prices Supporting and fulfilling key role in HRSA’s pilot project with industry Recruitment of suppliers to participate Distribution of OPA verified price file to wholesalers Coordination and support of meetings with industry stakeholders

    18. PVP Roles in Supporting HRSA’s Patient Safety Initiative Leadership role in supporting patient safety initiative with other national organizations (APHA, ASHP, ORHP, JCAHO, etc.) Continue current contracting role to generate savings which can be re-invested by participants to support patient safety initiatives Contract for specific products and services supporting patient safety in the outpatient pharmacy arena ISMP Ambulatory Care Newsletter Assist PVP participants identified as “champions” in attending HRSA meetings to share successes

    19. 340B Prime Vendor Program Contact Information Web site: www.340bpvp.com Toll Free Number: 1-888-340B PVP Chris Hatwig, Senior Director (972)910-6646, chatwig@340bpvp.com

    20. Mechanisms to Increase Value (Savings) of the PVP Growth in participants Expand value of portfolio without cannibalizing current value provided by existing suppliers New suppliers Expand contracted products of existing suppliers Steeper discounts on existing products Improve utilization of PVP contracts by existing participants

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