From: o. a; E.COM] Sent: Thursday, January 11, 2018 6:10 PM To: Kaw, Kristine Subject: Re: [EXTERNAL] Injectable medication Hi Kristine. Thank you for this! I actually sent jeffrey a note about this earlier but still ha e not heard back from him. He is been in consta rit mectin gs himself A will ask him again howev er and use your EFTA_R1_01016239 EFTA02242618

much more well versed paragr aph tomotr ow mornin g early! Hope to have an answer soon. Thanks and have a great evenin • Sent from my iPhone On Jan 11, 2018, at 6:03 PM, Kaw, Kristine <kristi nc.kaw ail escill ntsinai. !Az> wrote: Sorry for the late response. Just finished with patients. -Looking a labs sent from early this month, Lipids done was calculated as opposed to direct LDL. Insurance companies look for the direct LDL when approving medications because this is a more accurate count, therefore, representing a more accurate cardiovascular risk equivalent. When the triglycerides is high, such as in the case of Mr. Epstein, the lab cannot provide an accurate LDL count. As you can see there was no LDL value given EFTA_R1_01016240 EFTA02242619

-If you want to proceed with insurance approval, he will need to re-take labs with direct 101. He cannot start Repatha prior to rechecking labs because it will not be an accurate reflection of his baseline without medications. -If he wants to self pay, Century Specialty Pharmacy is willing to give him a 10% discount if he purchases minimum of 6 months. They will ship the medication over as soon as it's ordered and have it virtually the next day. -Here is the breakdown of cost: For the once a month injection $1,250/month (with 10% discount if he buys minimum of 6 months) For the twice a month injection $1,150/month (with 10% discount if he buys minimum of 6 months) Hope that answers all your questions. I will be available tomorrow if you have any questions. Please let me know what his decision is prescription to the pharmacy is pending his ok. Thanks KK From: [mailto:lesleyjeeegmaitcom] Sent: Thursday, January 11, 2018 12:34 PM To: Kew, Kristine Subject: Re: [EXTERNAL] Injectable medication Hello Kristine! I wanted to let you know I DID get Jeffrey's approval confirmed with Repatha and have been able to speak with a nurse on Jeffrey's behalf! A registered nurse EFTA_R1_01016241 EFTA02242620

is to call me within 1-2 business days to set up his training...truly hoping for next We, Th or Fri! I will be sure to let you know. Some more questions: -I understood from Dr. Shimony you will be contacting Jeffrey's insurance to find out about coverage and getting the $5 co-pay card? -Once insurance approves the medication, when will Jeffrey receive his meds? Hoping he can get 3 months of the medication at a time....let me know if his insurance approves this or how many months we can receive at a time...maybe it is more!? -will you order Jeffrey a Sharps Container? The nurse was asking me with type of injection he will be getting and I do not know...she said there are 3 different ones... I know you are busy and will sack to me when you can!! Thank you! On Jan 10, 2018, at 4:08 PM, Kaw, Kristine wrote: I am so sorry if I can't respond right away since I am seeing patients with Dr. Shimony. I am on the now with Repatha. It must have been a misunderstanding, they need the patient, Mr. Epstein, to give permission for you to set up his appointment. Repatha needs to be called again and choose EFTA_R1_01016242 EFTA02242621