Kristine wrote: Good morning. Just following up regarding Mr. Epstein's decision on how to proceed. I believe the nurse is scheduled to come in this week for teaching and ideally it would be great if she can teach and observe his first medication administration. Please let me know so I can prescribe accordingly. KK From: 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 constant meetings himself. I will ask him again however and use your much more well versed paragraph tomorrow morning early! Hope to have an answer EFTA_R1_0 1000786 EFTA02236882

soon. Thanks and have a great evening. Sent from my iPhone On Jan II, 2018, at 6:03 PM, Kaw, Kristine wrote: Sorry for the late respons e. Just finished with patient s. Looking a labs sent from early this month, Lipids done was calculat ed as oppose d to direct LDL. Insuran ce compan ies look for the direct LDL when approvi EFTA_R1_01000787 EFTA02236883

ng medica tions becaus e this is a more accurat e count, therefo re, represe nting a more accurat e cardiov ascular risk equival ent. When the triglyce rides is high, such as in the case of Mr. Epstein, the lab cannot provide an accurat e LDL count. As you can see there was no LDL value given -If you want to procee d with EFTA_R1_01000788 EFTA02236884

insuran ce approv al, he will need to re-take labs with direct 101. He cannot start Repath a prior to recheck ing labs becaus e it will not be an accurat e reflecti on of his baselin e without medica tions. -If he wants to self Pay, Century Specialt V Pharma cV-■is willing to give him a 10% discoun EFTA_R1_01000789 EFTA02236885

t if he purchas es minimu m of 6 months . They will ship the medica tion over as soon as it's ordered and have it virtuall y the next day. -Here is the breakd own of cost: For the once a month injectio n $1,250/ month with 10% discoun t if he buys minimu m of 6 months For the twice a month injectio n $1,150/ EFTA_R1_01000790 EFTA02236886

month with 10% discoun t if he buys minimu m of 6 months Hope that answer s all your questio ns. I will be availabl e tomorr ow if you have any questio ns. Please let me know what his decisio n is prescri ption to the pharma cy is pendin g his ok. Thanks KK From: EFTA_R1_01000791 EFTA02236887

Sent: Thursday, January 11, 2018 12:34 PM To: Kaw, Kristine Subject: Re: [EXTERNAL] Injectable medication Hello Kristin e! I wanted to let you know I DID get Jeffrey' approv al confir med with Repath a and have been able to speak with a nurse on Jeffrey' $ behalf! A register ed nurse is to call me within 1-2 busines EFTA_R1_0 1000792 EFTA02236888

s days to set up his trainin g...trul y hoping for next We, Th or Fri! I will be sure to let you know. Some MOM questio ns: -I underst ood from Dr. Shimo ny you will be contact ing Jeffrey' insuran cc to find out about coven ge and getting the $5 co-pay card? -Once insuran EFTA_R1_01000793 EFTA02236889

ce approv cs the medica tion, when will Jeffrey receive his meds? Hopin g he can get 3 months of the medica tion at a time.... let me know if his inuran ce approv es this or how many months we can receive at a time... maybe it is more!? -will you order Jeffrey a Sharps Contai ner? EFTA_R1_01000794 EFTA02236890

The nurse was asking me with type of injectio n he will be getting and I do not know ...she said there arc 3 differe nt ones... I know you are busy and will get back 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 phone 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 reimbursement services for Mr. EFTA_R1_01000795 EFTA02236891