© 2008 sanofi-aventis U.S. LLC HMO-PPO Digest 1

© 2008 sanofi-aventis U.S. LLC Overall enrollment in HMOs nationwide increased after seven consecutive years of decline, to 78.3 million in 2007 from 76.3 million in The total number of HMOs operating in the U.S. fell for the ninth straight year in 2007, to 443 from 448 in Nonsystem HMOs reported 1,525.7 hospital days per 1,000 Medicare members in 2007, 7.6% higher than the average for system plans (1,417.5). HMO Industry Overview 2

© 2008 sanofi-aventis U.S. LLC HMO Model Types Operating Plans (2007)HMO Members MODEL TYPE NumberPercentage Number (millions) Percentage IPA % % Network % % Group 347.7% % Staff 122.7%1.51.9% TOTAL % % 3

© 2008 sanofi-aventis U.S. LLC 2006 Total Enrollment 2007 Total Enrollment Enrollment Change (2006–2007) % Total Enrollment (78,280,933) Blue Cross/Blue Shield Association 18,698,25518,713,4710%23.9% UnitedHealthcare* 11,591,85615,547,547+34%19.9% Kaiser Foundation Health Plans 8,992,0308,924,782-1%11.4% Aetna Inc. 3,785,7103,653,566-3%4.7% Health Net 2,914,8212,779,709-5%3.6% Coventry Healthcare Corporation 2,295,4902,493,3090%3.2% CIGNA Healthcare 2,321,6611,959,954-16%2.5% TOTAL 50,599,82354,072, %69.1% The Seven Largest HMO Chains, by Enrollment * UnitedHealthcare is the health insurance subsidiary of UnitedHealth Group. 4

© 2008 sanofi-aventis U.S. LLC HMO Premiums and Revenue Average Monthly Revenue per Member Average Premium Rates per Month

© 2008 sanofi-aventis U.S. LLC The 25 Largest Individual HMO Plans Total EnrollmentNumber of Plans MODEL TYPE All HMOs (millions) 25 Largest HMOs (millions) All HMOs 25 Largest HMOs IPA Network Group Staff TOTAL

© 2008 sanofi-aventis U.S. LLC Point-of-Service (POS) Plans MODEL TYPE 2006 Percentage of HMOs Offering POS 2007 Percentage of HMOs Offering POS 2007 POS Enrollment (millions) Percentage of Total POS Enrollment IPA66.9%65.1%9,109, % Network52.5%51.6%3,655, % Group66.7%70.6%1,320,3469.3% Staff30.8%41.7%124,4760.1% TOTAL/AVG.60.7%60.0%14,210, % 7

© 2008 sanofi-aventis U.S. LLC HMO Utilization Utilization Rates for HMO Members Hospital Days per 1,000 Members Physician Encounters per Member Ambulatory Visits per Member PAYER TYPE Non-Medicare Medicare 1,529.11,

© 2008 sanofi-aventis U.S. LLC Physician Reimbursement, 2007 Percentage of HMOs Salary Profit Sharing Fee-For- Service Bonus Program Capitation 9

© 2008 sanofi-aventis U.S. LLC HMO Pharmacy Overview Slightly more than half (51.2%) of all HMO plans paid for their members’ over-the-counter drugs in 2007, down from 57.1% of plans in The share of HMOs that allowed members to choose branded over generic drugs at no additional charge grew notably in 2007, to 21.4% from 12.8% in Since the launch of Medicare Part D in January 2006, the average number of prescriptions dispensed per year to HMO members who receive Medicare benefits has increased roughly 12%. 10

© 2008 sanofi-aventis U.S. LLC Prescriptions Dispensed per Non-Medicare Member Prescriptions Dispensed per Medicare Member HMO Prescriptions and Drug Costs Average Ingredient Cost per Rx HMO Drug Costs as a Percentage of Operating Expenses $45.86 $ % 14.1% 11

© 2008 sanofi-aventis U.S. LLC HMO Use of Mail-Service Pharmacies Percentage of HMOs 75% 65% 55% 45% 85% 12

© 2008 sanofi-aventis U.S. LLC HMO Pharmacy Utilization, 2007 MODEL TYPE Proprietary Formulary PBM Formulary In-House Pharmacy Prior Authorization Practice Guidelines IPA 81.7%10.1%11.0%98.2%74.1% Network 71.4%12.8%24.8%97.4%68.2% Group 83.9%12.9%45.5%93.9%78.8% Staff 90.9%—75.0%91.7%75.0% Overall Average 78.6%11.0%20.4%97.4%72.4% 13

© 2008 sanofi-aventis U.S. LLC Third Party (Commercial) Payer Share of Total Prescriptions Dispensed, by Market*,** % of Total Prescriptions *Data are as of midyear 2008 and represent the percentages of prescriptions dispensed to all patients. **“Third party” refers to commercial HMOs and PPOs, and the PBMs that provide them with pharmacy services.

© 2008 sanofi-aventis U.S. LLC Percentage of Third Party (Commercial) RXs Filled with Generic Drugs, by Market*,** % of Total Prescriptions *Data are as of midyear 2008 and represent the percentages of prescriptions dispensed to all patients. **“Third party” refers to commercial HMOs and PPOs, and the PBMs that provide them with pharmacy services.

© 2008 sanofi-aventis U.S. LLC The total number of PPOs operating in the U.S. dropped in 2007, to 572 from 583 in Between 2006 (95.8 million) and 2007 (101.8 million), the number of eligible employees covered by PPO chains increased notably. For the first time in the history of this Digest, every PPO surveyed in 2007 reported having direct contracts with pharmacy providers, up from 98.0%. PPO Industry Overview 16

© 2008 sanofi-aventis U.S. LLC PPO Owner Types, 2007 TYPE OF OWNER Number of Eligible Employees (millions) Percentage of Eligible Employees Number of PPOs Employer/Employer Coalition 284,1720.3%3 HMO 2,560,2472.3%56 Hospital 233,2040.2%5 Hospital Alliance4,796,8664.4%62 Independent Investor37,473, %39 Insurance Company58,631, %356 Multiownership4,282,0473.9%24 Physician/Hosp. Joint Venture1,156,9551.1%14 Physician/Medical Group321,9040.3%6 Third-party Administrator255,7830.2%2 Other87,4840.1%5 TOTAL110,083, %572* 17 * Includes 30 specialty-only PPOs.

© 2008 sanofi-aventis U.S. LLC PPO Utilization Utilization Rates for PPO Members Average Length of Stay per Medical/Surgical Hospitalization Average Length of Stay per Psychiatric/ Substance Abuse Hospitalization Average Physician Visits per Eligible Employee per Year SIZE OF PPO –19, ,000–99, ,000–499, ,000–999, ,000, All PPOs

© 2008 sanofi-aventis U.S. LLC PPO Pharmacy Utilization Average Number of Prescriptions per Employee per Year Average Prescription Cost per Employee per Month SIZE OF PPO –19, $27.35$ ,000–99, $30.37$ ,000–499, $30.40$ ,000–999, $ ,000, $39.54$43.47 Overall Average $30.18$

© 2008 sanofi-aventis U.S. LLC Major Trends: HMO-PPO Digest Despite a decrease in the total number of plans (to 443 in 2007 from 448 in 2006), total HMO enrollment increased for the first time in seven years, to 78.3 million from 76.3 million. The number of government beneficiaries enrolled in HMOs climbed nearly 5% between 2006 (22,156) and 2007 (23,256). The PPO industry continued to consolidate in 2007, when a total of 572 PPOs were operating in the U.S., down from 583 in 2006, and substantially lower than the total of 988 in