A Prescription for Success …expanding your PBM know-how 2009 Retiree Symposium Making the Prescription Drug Benefit Work for You Presented by: Ashley Blevins Peter Orlaskey Judi Middleton

World Bank Catalyst Rx Team Ashley Blevins, Director of Client Services, 7 years of healthcare experience Judi Middleton, Sr. Client Services Manager, over 25 years of healthcare experience Peter Orlaskey, Pharm D., Clinical Manager, 5 years of pharmacy experience Erin Picariello, Client Services Representative, 6 years of healthcare experience 2 A Prescription for Success …expanding your PBM know-how

Catalyst Rx Corporate Overview Catalyst Rx is a full-service national pharmacy benefit management company providing benefits since th largest publicly traded PBM (NASDAQ: CHSI) Manage pharmacy benefits for 6 million members Our mission is to deliver unbiased pharmacy benefit management solutions that improve patient safety, achieve the highest standards of care, and effectively manage our clients’ drug costs 3 A Prescription for Success …expanding your PBM know-how

Catalyst Rx Customer Service Dedicated team of experienced Nationally Certified Pharmacy Technicians via fully integrated 24/7/365 service centers located in Las Vegas, NV, Ft. Lauderdale, FL, San Juan, PR, Avon Lake, OH, and Des Moines, IA Immediate access to benefit parameters, eligibility, retail and specialty data Q Service Level Validation – Consistently exceeding industry standards in all key categories Average speed to answer : <22 seconds Call abandonment rate: < 2.8% First call resolution: 99.7% Comprehensive prior authorization processing: < 24 hours 4 A Prescription for Success …expanding your PBM know-how

Mail Order Statistics January 1, 2009 – April 30, 2009 – 5,706 Total Scripts Filled – 1.32 Average Days in House – 96.41% 2-day Turn Around 5 A Prescription for Success …expanding your PBM know-how

Generic Medications Accounted for over 72% of all drugs filled in 2008 vs. 56% for World Bank Saved an estimated $121 billion for the healthcare system in 2008 Regulated by the Food & Drug Administration (FDA) Contain the same active ingredient as the Brand drug Manufactured in FDA approved facilities 6 A Prescription for Success …expanding your PBM know-how

Cholesterol Drugs Generics – Simvastatin, Pravastatin, Lovastatin – Average Yearly Cost: Member - $0, World Bank - $105 Preferred Brand Names – Lipitor, Crestor, Advicor, Simcor – Average Yearly Cost: Member - $228, World Bank - $913 Non-Preferred Brand Names – Lescol, Altocor, Vytorin, Altoprev – Average Yearly Cost: Member - $333, World Bank - $776 7 A Prescription for Success …expanding your PBM know-how

GERD/Heartburn Drugs Generics – Omeprazole, Pantoprazole – Average Yearly Cost: Member - $0, World Bank - $882 – Omeprazole: $407 – Pantoprazole : $ 1200 Preferred Brand Names – Nexium, Prevacid – Average Yearly Cost: Member - $413, World Bank - $1,700 Non-Preferred Brand Names – Aciphex, Protonix – Average Yearly Cost: Member - $632, World Bank - $1,500 8 A Prescription for Success …expanding your PBM know-how

Chronic Disease Non-Compliance What percentage of prescriptions written for chronic diseases are never picked up? – A. 25% – B. 50% – C. 75% – D. 100% 9 A Prescription for Success …expanding your PBM know-how

Non-Compliance leads to: Unnecessary disease progression Disease complications Reduced functional abilities Lower quality of life Increased medical costs Premature death 10 A Prescription for Success …expanding your PBM know-how

I forgot to take the drugs.64% I had no symptoms/symptoms went away.36% I wanted to save money.35% I didn’t believe the drugs were effective.33% I didn’t think I needed to take them.31% I had painful or frightening side effects.28% The drugs kept me from doing what I wanted to do.25% Nobody reminded me to keep taking them or to get refills.20% I had trouble getting the script filled.20% The drugs tasted or smelled unpleasant.19% I had trouble opening the bottle or swallowing the drug.16% I was confused by all the drugs I had to take.15% Reasons for Non-Compliance 11 A Prescription for Success …expanding your PBM know-how

How Catalyst Improves Compliance Education Generics Simplify the medication regimen Patient reminder aids – Auto-refill – Refill reminders – Behavioral support – Devices/Programs 12 A Prescription for Success …expanding your PBM know-how

Three Things to Remember! Share your Preferred Drug List with your Doctor Always ask for Generics when possible If you are prescribed a non-preferred drug, ask if a generic or preferred brand is available 13 A Prescription for Success …expanding your PBM know-how