SUMMER 2014 • VOLUME 7 • ISSUE 3 A PUBLICATION TO SUPPORT OUR NETWORK OF PHARMACY PROFESSIONALS

Burruano, Arquette and Olewine promotedIndependent Health’s Pharmacy Operations Department and pharmacy benefits management (PBM) affiliate, Pharmacy Benefit Dimensions®

(PBD), are pleased to announce the following individuals have recently earned promotions:

Martin Burruano has been promoted to vice president, pharmacy services. Burruano will lead the management and growth ofIndependent Health’s pharmacy benefit, by overseeing its strategic design, network and formulary development, as well as ensuring effective organizational resource alignment. He joined Independent Health in 2001 as manager, prior authorizationand most recently served as director, pharmacy services, since 2008. Burruano received his bachelor’s degree in biology fromCanisius College and is also a graduate of the University at Buffalo School of Pharmacy.

Sheila Arquette has been promoted to director, pharmacy services. In her new role, Arquette will provide strategic oversightfor many aspects of our pharmacy benefit, including our prior authorization program, quality management, network management and drug formularies. She joined Independent Health in 2003 as a clinical review pharmacist and was subsequently promoted in 2008 to manager, prior authorizations, and to her most recent position, assistant director, pharmacyservices, in 2010. Arquette earned her bachelor’s degree in pharmacy from the University at Buffalo.

Lynne Olewine has been promoted to vice president, pharmacy benefit management (PBM) operations. Olewine will developand actively support business strategy, plans and operational performance for all of PBD, overseeing PBD’s government programs and compliance, systems and data, communications, and employer group servicing. She joined PBD in 2005 as manager, pharmacy systems, and most recently served as director, pharmacy systems and pharmacy benefit management operations. Olewine received her bachelor’s degree in health care services and her master’s degree in business administrationwith a minor in information technology management from the University of Phoenix in Arizona.

PHARMACY HELP DESK

If you have questions regarding any of the information in this issue, please call our Pharmacy Help Desk at (716) 631-2927 or 1-800-993-9898, Monday through Friday from 8 a.m. to 11 p.m., and Saturday and Sundayfrom 8 a.m. to 8 p.m. Additional information regarding when the Help Desk is closed can be found on page 3.

Please complete 2014 Pharmacy Satisfaction Survey You may have already received, or will be receiving soon, our 2014 Pharmacy Satisfaction Survey in the mail. It is through feedback from these surveys that Independent Health pinpoints what we are doing well and opportunities for improvement.

When you receive this survey, please take the time to review, complete and return it to help us identify these opportunities for improvement. Youwill have two options to complete the survey:

1. Complete the paper survey questionnaire that is mailed to you, and return it in the self-addressed postage paid envelope; or

2. Complete the survey online.

Either survey method should be completed by September 5, 2014. If you are mailing the survey in, we ask that you mail it so we receive it prior tothe deadline date.

To show our appreciation, your name will be entered into a drawing to win one of four $100 prepaid credit cards. One drawing will be for those respondents who participate via the Internet and the other drawing will be for those who submit the paper questionnaire to us. The drawings willbe held on September 8, 2014.

The completed surveys will be reviewed and analyzed by our Marketing Research Department. Results will be published in an upcoming issue of Script.

Independent Health is a 4.5 Star Rated Medicare Plan for 2014

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For the fourth consecutive year, Independent Health has been recognized as a 4.5 StarRated Medicare Plan* by the Centers for Medicare and Medicaid Services (CMS). The StarRatings are designed to help Medicare beneficiaries choose a plan in their area that willmeet their needs and provide quality care and service.

The Medicare Star Ratings program was created in 2007 as a way for CMS and Medicarebeneficiaries to assess the quality of Medicare Advantage Plans throughout the country onan annual basis. However, it wasn’t until 2011 that CMS began to assign an overall rating.

Using a Five-Star Quality Rating System, with 5 being the highest rated plan and 1 beingthe lowest rated plan, the Medicare Star Ratings program rates the quality and performance of all Medicare Advantage health plans and Medicare Part D prescriptiondrug plans. The key components that plans are rated on include:

• Screenings, tests and vaccines

• Managing chronic (long-term) conditions

• Customer service

• Patient safety and accurate drug pricing

• Member experience

• Member complaints, access and improvement

Through our 4.5 Star Medicare Rating, Independent Health continues to demonstrate thevalue of our Medicare Advantage products and also provide assurance to our Medicaremembers on the quality and value of their coverage.

Independent Health is a Medicare Advantage organization with a Medicare contract offering HMO,HMO-SNP, HMO-POS and PPO plans. Independent Health’s Dual Difference is a HMO-SNP planwith a Medicare contract and a contract with the NY Medicaid program. Enrollment in IndependentHealth depends on contract renewal.

*Star Ratings are based on 5 Stars. Star Ratings are assessed each year and may change from oneyear to the next.

Fraud PreventionHealth care fraud can cost the government millions of dollars annuallyand increase the cost of health carenationwide. Examples of health carefraud range from an individual usingsomeone else’s coverage or insurancecard to a health care provider billingfor services that were not provided.

If you become aware of any potentiallyfraudulent or illegal activity, pleasecontact Independent Health’s IntegrityHelp Line toll-free at 1-877-229-4916.

Read Script on the InternetRead Script online at: independenthealth.com/providers. Accessible under the “News” tab in “Newsletters.”

Script is published quarterly for Independent Health’s network of pharmacy professionals

Director of Pharmacy:Martin Burruano

Editors of Script:Cheryl Paul, Jennifer Gallardo

Has Your Provider Information Changed?Independent Health is continuouslyupdating its pharmacy information to ensure the most accurate and complete information possible is available for published directory listings, as well as for service remittanceaddresses, phone and fax numbers,state identification, status and billing.

If any of the above listed or any relateditems should change in your pharmacy,please let us know in writing at:

Independent HealthAttn.:Pharmacy Department511 Farber Lakes DriveBuffalo, New York 14221

How to enroll in electronic funds transfer programWe have had several requests from pharmacies to switch from paper to electronic payments. If you presently receive paper checks directly from Independent Health and youwould like to begin taking advantage of electronic payments, you can do so by enrolling inEmdeon’s Electronic Transfer of Funds program. Simply visit www.emdeon.com/epayment/index.php and click on “enroll now.”

If you are interested in more information or would like to receive a tip sheet to assist youin the enrollment process, please call our pharmacy help desk at (716) 631-2927 or 1-800-993-9898, Monday through Friday from 8 a.m. to 11 p.m., and Saturday and Sunday from 8 a.m. to 8 p.m.

Update about fraud, waste and abuse training for 2014As a Network Pharmacy with whom Independent Health partners to provide Part D services to its members, you and your organization agreed tocomply with the terms and conditions specific to providing services to Medicare enrollees. Your cooperation and compliance with CMS regulations are implicit in your contract with Independent Health.

Contracted network pharmacies are required to comply with the Medicare Part D pharmacy benefit regulations including but not limited to; posting Medicare Prescription Drug Coverage and Your Rights; informing enrollees of lower priced AB-rated equivalent generics that are available at your pharmacy; appropriating transition process for current and new enrollees who are prescribed drugs not on the IndependentHealth formulary; maintaining signature and proof of delivery records, having and adhering to a code of conduct, and conflict of interest policies.

Additionally, The Centers for Medicare and Medicaid Services (CMS) requires Medicare Advantage Organizations (MAO) and Prescription DrugPlan (PDP) sponsors to apply fraud, waste and abuse (FWA) training to all entities with whom they partner to provide benefits or services in Part Cand D programs. This requirement also applies to your employees, contractors and subcontractors. This is an annual requirement as mandated by42 C.F.R. §§ 422.503 (b)(4)(vi) and 423.504(b)(4)(vi).

Over the next few weeks, your pharmacy should receive the following attestations:

• 2013 Fraud Waste and Abuse Training Attestation

• Participating Network Pharmacy Annual Medicare Compliance Attestation

In order to confirm compliance with the above requirements, it is imperative that you complete and sign both attestations. Please be sure that yousign and return both to Independent Health in the self-addressed postage-paid envelope that was provided in the mailing you received.

If you have any questions regarding the attestation forms or any other of these requirements, or if you need additional forms, envelopes or our address, please contact Mary Reed at (716) 250-4418 or Mary.Reed@independenthealth.com.

SUMMER 2014

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What to do when you get a rejection and the help desk is closedOur claim processing statistics indicate that our help desk is currently open when approximately 95 percent of Independent Health prescriptionsare filled. The normal hours of operation for our help desk are Monday through Friday from 8 a.m. to 11 p.m., and Saturday and Sunday from 8 a.m. to 8 p.m. Unfortunately, there will be some rejects occurring for medically necessary drugs when our help desk is not open.

Here’s what to do when:

1. A claim rejects because the drug is non-formulary, requires prior authorization, and

2. The prescription is urgent, and the patient cannot reasonably wait until the next time the help desk is open to obtain and begin taking the medication, and

3. You are confident of the member’s eligibility with Independent Health.

A. You can dispense up to a five-day supply of medication to Independent Health members with prescription coverage. You will need to call thenext time the help desk is open to obtain an override for the dispensed amount and to determine how to obtain coverage for the remainingamount. Independent Health will honor your decision for the five-day supply, provided you have made your best effort to confirm that themember is an active member (i.e., holding a valid Independent Health identification card).

OR

B. You can call our 24-Hour Medical Help Line at (716) 631-8701 or 1-800-501-3439, and press two. A nurse is available 24 hours a day, 7 days a week and will be able to page a staff pharmacist or medical director to determine if an override can be given. While you’re posting phonenumbers by your phone, our 24-Hour Medical Help Line number is a good one to add.

If a claim rejects for eligibility reasons, your best option is to have the member pay cash for part or all of the prescription and work out the eligibility issues with our Member Services Department and/or their employer. If they are later determined to have been eligible, they will be ableto submit their receipts for reimbursement.

Treatment considerations for Proton Pump InhibitorsTo better assist our prescribers on the proper usage of Proton Pump Inhibitors (PPIs), treatment considerations, duration of use and cost transparency,we recently provided the following information to area physicians and providers. Understanding Independent Health’s formulary placement and PPI treatment guidelines will help you guide and educate your patients at the pharmacy to pick the most efficacious and cost-effective treatment.

• Check for an indication!

- Discontinue outpatient use of a PPI that was started during a hospitalstay for stress ulcer prophylaxis

- NSAID induced ulcers & hypersecretory conditions usually warrantlong-term therapy

• Dose &duration of therapy

- Self medication with OTC PPIs: limited to 14 days/course, no morethan 3 courses/year

- Initiate once daily dosing, 30 minutes prior to the first meal of theday

- GERD, erosive esophagitis: - week course

- Ulcer healing: 4- to 8-week course

- PPI maintenance therapy can be used for patients who continue tohave symptoms after the PPI is discontinued and in patients with complications (erosive esophagitis, Barrett’s esophagus)

- Long-term PPI therapy should be administered in the lowest effective dose including on demand or intermittent therapy

• When to taper

- Anyone on PPI therapy for 2 months or longer should receive a tapered regimen

- Tapering is needed to avoid rebound symptoms

- Consider decreasing the dose and/or recommending QOD dosingover a 4- to 6-week period with the use of H2 blockers as needed

• Risks of long-term PPI use

- Increased risk of fracture

- Potential for drug-drug interactions

- Hypomagnesaemia

- Increased risk of infection (C. difficle, possibly pneumonia)

• Other considerations

- H2-receptor antagonists (H2RA) can be used as a maintenance option in patients without complications if patients experienceheartburn relief

- Bedtime H2RA therapy can be added to daytime PPI therapy in selected patients with objective evidence of nighttime reflux ifneeded, but may be associated with sudden decrease in response tothe medication after several weeks of use

• Drug selection

- No major difference in the efficacy & side effect profile betweenPPIs for the treatment of GERD, endoscopy-negative reflux disease and esophagitis

- Rabeprazole, generic Aciphex is now available as of November 2013

- Esomeprazole, generic Nexium, anticipated generic availability is May2014

• Cost considerations

- Commercial:

-NEW Tier 1 PPIs: no prior authorization required: omeprazole,pantoprazole, rabeprazole, lansoprazole

- As of January 1, 2015 all brand-name PPIs, whether a generic is available or not, will be removed from formulary, available byexception only. Existing members will be grandfathered if necessary

- Medicare:

- Brand-name Nexium Tier 4 (non-preferred), step therapy required

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Proton Pump Inhibitor Average Gross Cost per Rx for 30-Day Supply*

Omeprazole $7Pantoprazole $7Rabeprazole $25Lansoprazole $29

Dexilant (dexlansoprazole(Anticipated generic availability 2027)

$177

Protonix $230Nexium (esomeprazole) $265

Prilosec $292Prevacid Solutab $304

Prevacid $316Omeprazole/sodium bicarbonate $343

Aciphex $413Zegerid $417

Reference(s): Katz P, Gerson L, Vela M. Guidelines for the Diagnosis and Management of GERD. American Journal of Gastroenterology. 2013;108:308-28.

CATEGORY DRUG ACTION COMMENTS

Anticonvulsants

Other anticonvulsants levetiracetam IR/XR Addition – Tier 1 or preferred generic

Anti-Addiction/Substance Abuse Treatment Agents

Opioid Antagonists Zubsolv Addition – Tier 2 Change applies January 1, 2015

Antiemetics

Other antiemetics Diclegis Addition – Tier 2, Quantity Limit

SUMMER 2014

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Commercial formulary changes announced

The following medications were also reviewed and will remain non-preferred brand (NPB) on the commercial formulary at this time:

• Epanova – Tier 3; Step Therapy (ST)

• Tanzeum – Tier 3; ST

• Evzio – Tier 3; Prior Authorization (PA)

• Otezla – Tier 3; PA & Specialty Pharmacy (SP)

• Aveed – Tier 3; PA & Restricted to Males (RM)

• Hemangeol – Tier 3; PA

• Zykadia – Tier 3; PA & SP

• Impavido – Tier 3; PA

• Incruse Ellipta – Tier 3; Age Limit (AL)

• Zontivity – Tier 3; PA

• Ragwitek – Tier 3; PA

• Oralair – Tier 3; PA

• Grastek – Tier 3; PA

The following changes in coverage were approved:

• Vascepa – Add ST

• Lovaza – Move to Non-Formulary (NF) when ample generic supplies available

• Nexium – Move to NF as of January 1, 2015

• Suboxone/naltrexone;buprenorphine – Move to NF as of January 1, 2015

• V-go – Add as Tier 2

• Zovirax cream – Add PA

• fluocinonide 0.1% cream – Move to non-preferred generic

The following new generics are available:

• Evista (Tier 3) – raloxifene (Tier 1)

• Mycobutin (Tier 3, PA) – rifabutin (Tier 1, PA)

• Ortho Evra (Tier 3) – xulane (Tier 1)

• Lunesta (Tier 3, PA) – eszopiclone (Tier 3, PA)

• Astepro (Tier 3, ST) – azelastine spray (Tier 3)

• Lovaza (Tier 3) – omega-3-acid (Tier 1)

The following Injectable Drugs were reviewed and approved as follows:

• Vimizim (PA & SP)

• Cyramza (PA)

• Entyvio (PA)

• Sylvant (PA)

• Gelclair (PA)

• Faraheme (PA)

For updated versions of our drug formularies, please visit www.independenthealth.com/providers.

The Independent Health Pharmacy and Therapeutics (P&T) Committee, which is made up of 15 participating physicians and four network communitypharmacists, meets quarterly to review and make changes to the drug formulary. All drug tier decisions made by the committee are based on efficacyand safety first, and economics only after clinical effectiveness has been determined.

The following changes to Independent Health’s Commercial Drug Formulary were recommended by the P&T Committee at its June 2014 meeting:

The following medications were added to the formulary:

Recent FDA MedWatch updates on safety and efficacy issues

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The following represents are recent U.S. Food and Drug Administration (FDA) alerts or changes made to the package labeling of drugs, where patientsafety or efficacy are the primary concern:

Script does not publish all FDA alerts. For a complete summary of all alerts, please visit the FDA website at www.fda.gov/Safety/MedWatch.

Epidural Corticosteroid Injection: Drug Safety Communication – Riskof Rare but Serious Neurologic Problems: The FDA is warning that injection of corticosteroids into the epidural space of the spine may resultin rare but serious adverse events, including loss of vision, stroke, paralysis,and death. The injections are given to treat neck and back pain, and radiating pain in the arms and legs. The effectiveness and safety ofepidural administration of corticosteroids have not been established andthe FDA has not approved corticosteroids for this use.

The FDA will convene an advisory panel of experts in late 2014 to help define the techniques for such injections which would reduce preventableharm. The panel will discuss the benefits and risks of epidural corticosteroid injections and to determine if further FDA actions areneeded. Their recommendations will be released when they are finalized.

Pradaxa (dabigatran): Drug Safety Communication – Lower Risk forStroke and Death, but Higher Risk for GI Bleeding Compared to Warfarin: The FDA recently completed a new study in Medicare patientscomparing Pradaxa to Warfarin, for the risk of ischemic or clot-relatedstroke, bleeding in the brain, major GI bleeding, MI and death. The newstudy included information from more than 134,000 Medicare patients,65 years or older, and found that among new users of blood-thinningdrugs, Pradaxa was associated with a lower risk of clot-related strokes,bleeding in the brain, and death, than warfarin. The study also found an increased risk of major GI bleeding with use of Pradaxa as compared towarfarin. The MI risk was similar for the two drugs.

Importantly, the new study is based on a much larger and older patientpopulation than those used in the FDA’s earlier review of post-marketdata, and employed a more sophisticated analytical method to captureand analyze the events of concern. This study’s findings, except with regard to MI, are consistent with the clinical trial results that provided thebasis for Pradaxa’s approval. As a result of these latest findings, the FDAstill considers Pradaxa to have a favorable benefit to risk profile and havemade no changes to the current label or recommendations for use.

Eszopiclone (Lunesta) Containing Sleep Aids:Drug Safety Communication – Can Cause Next-Day Impairment: A recent study ofLunesta found that the previously recommended dose of 3 mg can causeimpairment to driving skills, memory, and coordination that can last morethan 11 hours after receiving an evening dose. Despite these driving andother problems, patients were often unaware they were impaired.

Based on this study a new warning has been added to the prescribing information and medication guide that Lunesta can cause next-day impairment of driving and other activities that require alertness. The FDAnow recommends a decreased starting dose of Lunesta to 1 mg at bedtime for both men and women. The drug labels for generic eszopiclone products will also be updated to include these changes.

Testosterone Products: FDA/CDER Statement – Risk of Venous BloodClots: The FDA added a general warning in the drug labeling of all approved testosterone products for the risk of venous thromboembolism(VTE), including deep vein thrombosis (DVT) and pulmonary embolism(PE).

Olmesartan: Drug Safety Communication – FDA Review Finds Cardiovascular Risks for Diabetics Not Conclusive: The FDA has completed its safety review and has found no clear evidence of increasedcardiovascular risks associated with use of the blood pressure medicationolmesartan in diabetic patients. The FDA believes the benefits of olmesartan in patients with high blood pressure continue to outweigh thepotential risks.

Over-the-Counter Topical Acne Products: Drug Safety Communication – Rare But Serious Hypersensitivity Reactions: TheFDA is warning that certain OTC topical acne products containing ben-zoyl peroxide or salicylic acid can cause rare but serious and potentially life-threatening allergic reactions or severe irritation. Consumers shouldstop using their topical acne product and seek emergency medical attention immediately if they experience hypersensitivity reactions such asthroat tightness; difficulty breathing; feeling faint; or swelling of the eyes,face, lips, or tongue. Consumers should also stop using the product if theydevelop hives or itching.

The hypersensitivity reactions may occur within minutes to a day orlonger after product use. These reactions differ from the local skin irritation that may occur at the product application site, such as redness,burning, dryness, itching, or slight swelling, that are already included in thedrug facts labels.

Lidocaine Viscous: Drug Safety Communication – Boxed Warning Required – Should Not Be Used to Treat Teething Pain: The FDA notified health professionals, their provider organizations and caregiversfor infants, that prescription oral viscous lidocaine 2% solution should notbe used to treat infants and children with teething pain. A Boxed Warningwill be added to the prescribing information to highlight this information.Oral viscous lidocaine solution is not approved to treat teething pain, anduse in infants and young children can cause serious harm, including death.

Topical pain relievers and medications that are rubbed on the gums arenot useful because they wash out of the baby’s mouth within minutes.When too much viscous lidocaine is given to infants and young childrenor they accidentally swallow too much, it can result in seizures, severebrain injury, and problems with the heart. Cases of overdose due towrong dosing or accidental ingestion have resulted in infants and childrenbeing hospitalized or dying.

Health care professionals should not prescribe or recommend this product for teething pain. Parents and caregivers should follow the American Academy of Pediatrics’ recommendations for treating teethingpain including using a chilled teething ring or gently rubbing the child’sgums with your finger to relieve symptoms.

Medical Supply Liquidators Injectable Vitamin Products With a "Sunshine Labs" Label: Warning – Products Not FDA Approved: TheFDA alerted health care professionals not to use injectable vitamin drugproducts distributed by Medical Supply Liquidators LLC in Clive, Iowa,with “Sunshine Labs” on the label. These products are manufactured by Compound Brothers Dominicana (also known as CB Inc.) in the Dominican Republic and sold as prescription injectable nutritional supplements. The FDA has not approved these products and cannot be assured of their safety, effectiveness, or quality.

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SUMMER 2014

Independent Health partnering with the Buffalo Bills to improve the health and wellness of Western New Yorkers

Russ Brandon, President and CEO of the Buffalo Bills, and Michael W. Cropp, M.D., President and CEO

of Independent Health

As you know, Independent Health has been transitioning our membership onto a new claims system. We are in the process of transitioning our membership to the new system on a monthly basis and will continue to do so throughout the

remainder of 2014.

It is important to remember that as members are transition to the new system, they will be issued new ID cards with new ID numbers. Many of our calls over the past few months have been related to claims rejecting for eligibility. In most of

those instances, the members had new ID numbers.

Please remember to ask your Independent Health customers if they have received new ID cards. We have been encouraging members to carry their new ID cards with them and to show them at provider offices and pharmacies.

MEMBERS CONTINUE TO BE TRANSITIONED TO NEW CLAIMS SYSTEM

Independent Health is always striving to expand its reach to provide wellness opportunities that strengthen the culture of health in Western New York. An excitinginitiative that we recently announced to help us accomplish that goal is a partnershipwith the Buffalo Bills.

Independent Health and the Buffalo Bills are teaming up to better the health and well-being of the Western New York community through a long-term partnership,centered on a community-wide fitness and nutrition initiative to encourage healthy living.

“We are confident this partnership will have a positive impact on the health and well-being of Western New Yorkers,” said Michael W. Cropp, M.D., president and CEOof Independent Health. “At Independent Health, we are committed to creating a culture of health through our member benefits and community-wide programs and partnerships. Our team is eager to work with the Bills to help tackle some of the mostimportant health challenges we face in this region.”

“This new partnership with Independent Health only strengthens our commitment to improving the Western New York community, especially the health and well-being ofour youth,” said Russ Brandon, president and CEO of the Buffalo Bills. “The Bills arelooking forward to making a difference by working in lock step with IndependentHealth to promote healthy living in schools and throughout our region.”

In a continued effort to make the next generation of youth active and healthy, the two organizations will work together to support the children of our community by encouraging physical activity and healthy eating in school and at home. The Independent Health Foundation’s Fitness for Kids Challenge and the Buffalo Bills Play60 Challenge will be offered in collaboration to thousands of local elementary schoolchildren from October 1, 2014 through May 31, 2015. This exciting initiative will include in-school programming and participation incentives for schools, teachers and students.

“Independent Health has a long history of partnering with community organizations to make access to health and fitness programs easier for WesternNew Yorkers. We’re excited to team up with the Bills to further enhance these efforts,” said Dr. Cropp.

Details on the community-wide fitness and nutrition initiative, including the establishment of a community advisory committee to help guide our efforts, will also be announced within the next few weeks.

updatePHARMACY PO L I C I E S

All of Independent Health’s policies and clinical

practice guidelines are available on our website.

To access these policies and guidelines:

1. Log in to the Independent Health Providers website

at independenthealth.com/providers using

“partners” as both the user name and password.

2. Click on “Policies.”

3. Click on the “Pharmacy Department Administrative

Policies & Drug Specific Policies” link.

The following drug specific policies are new:• Anoro Ellipta• Farxiga• Hetlioz• Orenitram

The following existing administrative policy hasbeen reviewed and revised:• Application of Closed/Tiered Formulary

The following drug specific policies have been

reviewed and revised:

The following existing administrative policy hasbeen reviewed without any changes made:• Experimental• Non-Par Prescribers of ER or Discharge Rxs • Pharmacy Audit

The following drug specific policies have been

reviewed without any changes made:

The following policies are being archived:• Spec Pharm Addendum• Testosterone topical solution• Testosterone gel

PRSRT STDU.S. POSTAGE

PAIDPERMIT NO. 757BUFFALO, NY

511 Farber Lakes Drive, Buffalo, New York 14221

• Boniva Inj

• Ilaris

• Inject-Hyaluronates

• IVIG

• Jakafi

• Kalydeco

• Lucentis

• Makena

• Modified Solid Food

Products

• Noxafil

• Olysio

• Oxytrol

• PPI

• PPI HD

• Risperdal Consta

• Sovaldi

• Tyvaso

• Velcade

• Ventavis

• Vivitrol

• Xiaflex

• Xolair

• Bydureon

• Cometriq

• Comtan

• Detrol/Detrol LA

• Direct Renin Inhibitor-

CCB step therapy

• Elidel

• Enablex

• Erivedge

• Fulyzaq

• Gattex

• Horizant

• Invega Sustenna

• Juxtapid

• Kadcyla

• Korlym

• Neupogen

• Pomalyst

• Protopic

• Provenge

• Samsca

• Solodyn

• Spiriva

• Tasmar

• Tykerb

• Uceris

• Vancomycin

• Zavesca

• Zelapar