NAC Action Item Updates Rick Trifunov Director, Supply Chain Operations April 28/29, 2016

Subcutaneous Pipeline April 2016

Special Access Program   Product Supplier HC Submission HC Approval CBS Review Yes/No Immune Globulin (Subcutaneous) Hizentra, 20% (subcutaneous) SubQ Approved for PID, SID only Prefilled syringes CSL December 2015 August 2016 Gamunex, 10% (subcutaneous) Grifols December 2014 Gammanorm, 16.5% Subcutaneous/Intramusclar Immunglobuin (SQ/IMIg) SubQ indicated for PID Octapharma Special Access Program CUVITRU, normal Immune Globulin (Human), 20% Solution for Subcutaneous Infusion Indicated for primary humoral immunodeficiency & Secondary humoral immunodeficiency Baxalta February 26, 2016 Q1 2017 HyQvia (Immune Globulin Infusion (Human), 10% (IGI, 10%) with recombinant Human Hyaluronidase 9rHuPH20) (IGI, 10% with rHuPH20) Subcutaneous Immunglobulins Indicated for PID Currently in Phase III Testing for CIPD US and EU approved, Canada - TBD Octanorm, 16.5% Subcutaneous Immunoglobin Similar to octagam, next generation of Gammanorm Currently in Phase III Testing for PID Q2 2017 Q2 2018 New Norm, 20% new high yield subcutaneous In development with an ideal pump solution To be indicated for PID 2020/2021 We are keeping our eyes on the pipeline As SCIG usage grows, we will bring on another brand (assuming cost effectiveness)

Albumin

Albumin Usage How uniform is usage across the country Are certain regions/hospitals driving demand? National growth rate in 2015-16 was 4.9%

Alberta Albumin – Top Hospitals by Province 2013.FY 2014.FY % increase   2013.FY 2014.FY % increase 2015.FY * forecast 2015 FY Customers All 46,385 44,996 -3.0% 41,992 45,809 1.8% 500097 - UNIVERSITY OF ALBERTA HOSPITAL 27,886 25,819 -7.4% 24,533 26,763 3.7% 500104 - FOOTHILLS HOSPITAL 8,625 8,690 0.7% 7,280 7,941 -8.6% 500838 - RED DEER REGIONAL HOSPITAL CENTRE 1,865 1,732 -7.1% 1,813 1,978 14.2% 500122 - PETER LOUGHEED CENTRE 1,822 1,565 -14.1% 1,374 1,499 -4.2% 500149 - CHINOOK REGION LABORATORY, MAIN SIT 1,447 1,966 35.8% 1,578 1,721 -12.4% *2015 Is based on 11 months of data

BCY Albumin – Top Hospitals by Province 2013.FY 2014.FY % increase   2013.FY 2014.FY % increase 2015.FY* forecast 2015 FY Customers All 45,807 48,916 6.8% 48,604 53,022 8.4% 500082 - VANCOUVER GENERAL HOSPITAL 17,048 18,537 8.7% 16,525 18,027 -2.8% 500186 - ROYAL JUBILEE HOSPITAL, VICTORIA 4,626 5,388 16.5% 5,697 6,215 15.4% 500113 - ROYAL COLUMBIAN HOSPITAL 3,787 4,326 14.2% 4,073 4,443 2.7% 500338 - KELOWNA GENERAL HOSPITAL 3,325 4,049 21.8% 4,242 4,628 14.3% 500197 - ST. PAUL'S HOSPITAL, VANCOUVER 3,128 2,703 -13.6% 3,517 3,837 41.9% *2015 Is based on 11 months of data

Manitoba Albumin – Top Hospitals by Province 2013.FY 2014.FY   2013.FY 2014.FY % increase 2015.FY* forecast 2015 FY Customers All 13,010 13,461 3.5% 12,257 13,371 -0.7% 500183 - HEALTH SCIENCES CENTRE WINNIPEG 5,108 5,904 15.6% 5,243 5,720 -3.1% 500184 - ST. BONIFACE GENERAL HOSPITAL 4,506 4,277 -5.1% 4,166 4,545 6.3% 500191 - BRANDON REGIONAL HEALTH CENTRE 1,167 1,098 -5.9% 1,216 1,326 20.8% 500667 - GRACE GENERAL HOSPITAL (WINNIPEG) 592 513 -13.3% 381 416 -19.0% 500678 - SEVEN OAKS GENERAL HOSPITAL 541 441 -18.5% 280 305 -30.7% *2015 Is based on 11 months of data

New Brunswick Albumin – Top Hospitals by Province 2013.FY 2014.FY   2013.FY 2014.FY % increase 2015.FY* forecast 2015 FY Customers All 7,845 7,612 -3.0% 6,422 7,006 -8.0% 500188 - SAINT JOHN REGIONAL HOSPITAL 4,013 3,821 -4.8% 3,434 3,746 -1.9% 500096 - THE MONCTON HOSPITAL 1,222 1,191 -2.5% 1,107 1,207 1.4% 500037 - MIRAMICHI REGIONAL HOSPITAL 719 539 -25.0% 450 491 -8.9% 500103 - DR. GEORGES-L-DUMONT UNIVERSITY CEN 653 1,082 65.8% 830 905 -16.3% 500341 - CHALEUR REGIONAL HOSPITAL 575 257 -55.4% 155 169 -34.1% *2015 Is based on 11 months of data

Newfoundland Albumin – Top Hospitals by Province 2013.FY 2014.FY   2013.FY 2014.FY % increase 2015.FY* forecast 2015 FY Customers All 5,086 6,064 19.2% 5,456 5,951 -1.9% 500109 - HEALTH SCIENCES CENTRE - GEN HOSPIT 2,668 3,533 32.4% 2,937 3,203 -9.3% 500281 - ST. CLARE'S MERCY HOSPITAL 1,298 1,045 -19.5% 987 1,076 2.9% 500277 - JAMES PATON MEMORIAL REGIONAL HC 361 181 -50.0% 371 405 124.2% 500295 - WESTERN MEMORIAL HOSPITAL 273 572 109.9% 498 543 -5.0% 500297 - CENTRAL NEWFOUNDLAND REGIONAL HC 155 186 20.0% 247 269 44.9% *2015 Is based on 11 months of data

Nova Scotia Albumin – Top Hospitals by Province 2013.FY 2014.FY   2013.FY 2014.FY % increase 2015.FY* forecast 2015 FY Customers All 11,047 12,967 17.4% 11,698 12,761 -1.6% 500800 - QEII HEALTH SCIENCES CENTRE, VG SIT 5,125 6,015 4,522 4,933 -18.0% 500842 - QEII HEALTH SCIENCES CENTRE, HI SIT 3,253 3,715 14.2% 3,745 4,085 10.0% 500853 - IWK HEALTH CARE CENTRE 664 1,001 50.7% 922 1,006 0.5% 500764 - CAPE BRETON REGIONAL HOSPITAL 429 389 -9.4% 421 459 18.2% 500026 - CUMBERLAND REGIONAL HEALTH CARE CEN 418 516 23.4% 568 620 20.1% *2015 Is based on 11 months of data

Ontario Albumin – Top Hospitals by Province 2013.FY 2014.FY % increase   2013.FY 2014.FY % increase 2015.FY* forecast 2015 FY Customers All 177,148 171,814 -3.0% 165,190 180,207 4.9% 500089 - UHN - TORONTO GENERAL SITE 22,342 21,477 -3.9% 23,158 25,263 17.6% 500315 - HAMILTON HS - HAMILTON GENERAL HOSP 10,706 9,667 -9.7% 8,998 9,816 1.5% 500317 - ST. JOSEPH'S HEALTHCARE HAMILTON 10,247 6,812 -33.5% 6,697 7,305 7.2% 500506 - LONDON HSC - UNIVERSITY HOSPITAL 9,249 7,889 -14.7% 6,868 7,492 -5.0% 500143 - KINGSTON GENERAL HOSPITAL 8,274 7,461 -9.8% 6,636 7,239 500165 - THE OTTAWA HOSPITAL - GENERAL CAMPU 7,656 9,192 20.1% 7,884 8,601 -6.4% 500112 - LONDON HSC - VICTORIA HOSPITAL 7,459 5,901 -20.9% 5,119 5,584 -5.4% 500102 - THE OTTAWA HOSPITAL - CIVIC CAMPUS 6,488 7,066 8.9% 7,838 8,550 21.0% 500316 - HAMILTON HS - JURAVINSKI HOSPITAL 5,958 6,238 4.7% 6,257 6,826 9.4% 500626 - TRILLIUM HEALTH PARTNERS - MISSISSA 5,646 5,055 -10.5% 4,918 5,365 6.1% 500208 - GRAND RIVER HOSPITAL 4,274 5,416 26.7% 6,484 7,073 30.6% *2015 Is based on 11 months of data

Prince Edward Island Albumin – Top Hospitals by Province 2013.FY   2013.FY 2014.FY % increase 2015.FY* forecast 2015 FY Customers All 189 316 123 134 500364 - QUEEN ELIZABETH HOSPITAL, CHARLOTTE 67.4% -57.6% *2015 Is based on 11 months of data

Saskatchewan Albumin – Top Hospitals by Province 2013.FY 2014.FY   2013.FY 2014.FY % increase 2015.FY* forecast 2015 FY Customers All 11,597 12,957 11.7% 12,308 13,427 3.6% 500210 - REGINA GENERAL HOSPITAL 3,641 4,508 23.8% 4,501 4,910 8.9% 500100 - ROYAL UNIVERSITY HOSPITAL 2,724 3,214 18.0% 2,953 3,221 0.2% 500581 - ST. PAUL'S HOSPITAL, SASKATOON 2,207 2,298 4.1% 2,339 2,551 11.0% 500209 - PASQUA HOSPITAL 1,534 1,184 -22.8% 924 1,007 -14.9% 500259 - DR FH WIGMORE REGIONAL HOSPITAL 334 323 -3.3% 193 211 -34.8% 500212 - CYPRESS REGIONAL HOSPITAL 225 288 28.0% 377 411 42.8% 500574 - VICTORIA HOSPITAL, PRINCE ALBERT 191 265 38.7% 299 326 22.9% *2015 Is based on 11 months of data

Ordering CMV Negative Products

Order Form The order form still has Anti-CMV on the form. The link is below http://cbsapp002/Production/Notes/A- F/CDI.nsf/OpenDocumentLinks/id96E41276539A986E85257A2C006 5B4DF/$FILE/F040547 (2012-06-12).pdf We would not want to change the form as a means to control demand/issues until “transfusion guidelines” have been revised or reviewed in all regions.

Cryo/RiaSTAP

Cryo/RiaSTAP With the introduction of licensed Fibrinogen concentrate (RiaSTAP) in Jan 2013, we expected to see reduced demand for cryo, and increased demand for the concentrate This has occurred in some regions and not others, and generally not overall We are seeking to understand what is driving demand differences

Of note… When RiaSTAP was approved, its treatment cost was compared to cryo and was expected to be only slightly more costly. Production of RiaSTAP from Canadian plasma is now being implemented This will result in treatment costs with concentrate being cheaper than with cryo Treatment choices are up to physicians, we merely want to provide the cost comparison update