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© 2010 Medco Health Solutions, Inc. All rights reserved. C T AAT C G C G C G 2 Today’s Agenda Your Medco Prescription Drug Plan Benefit Description Specialized Care Therapeutic Resource Centers: Specialist Pharmacists Personalized Medicine Program Tools to Help Manage the Prescription Benefit My Rx Choices ® The importance of generic utilization Other Available Resources

© 2010 Medco Health Solutions, Inc. All rights reserved. C T AAT C G C G C G 3 Your Medco Prescription Drug Plan Medco administers your prescription drug plans on behalf of the A&M Care plan. Benefit includes both a retail and mail component Medco has its own mail-order pharmacy – Medco By Mail – where specialist pharmacist focus on compliance and lower cost options for the patient, and the automated filling system ensures the prescription is filled accurately.* Medco’s mail-order pharmacies fill about 2 million prescriptions per week through a highly automated process that is % accurate and is 23 times more accurate than a retail pharmacy “Dispensing Error Rate in a Highly Automated Mail-Service Pharmacy Practice”; Nov. 2007, Pharmacology, a peer-reviewed journal of the American College of Clinical Pharmacy

© 2010 Medco Health Solutions, Inc. All rights reserved. C T AAT C G C G C G 4 Prescription Drug Benefits * If you obtain a brand-name drug when a generic equivalent is available, you are responsible for the generic copayment plus the cost difference between the brand-name drug and the generic drug. Chart illustrates benefits when network pharmacies are used. Non-network benefits are also available; see Enrollment Guide for more information. Annual Deductible $50 per person per year / $150 per family per year (Deductible does not apply to medical plan deductible) Access Options Generic Drug Copayment Preferred Drug Copayment Non-Preferred Drug Copayment Retail – 30 Day Supply: Refills allowed as prescribed. (Good option for new prescriptions) $10$35$60 Retail – 90 Day Supply: Refills allowed as prescribed $30$105$180 Medco By Mail Pharmacy: Up to a 90-day supply*. Refills allowed as prescribed (Best option for maintenance medication) $20$70$120

© 2010 Medco Health Solutions, Inc. All rights reserved. C T AAT C G C G C G 5 Rx Benefit Information Specifics Retail pharmacies are ideal for acute (short-term) and new medication you may be trying for the first time. If you are taking a long-term medication, filling your prescriptions through Medco’s mail-order pharmacy provides several benefits. You have access to specialist pharmacists whether you fill your prescription at a retail pharmacy or at Medco By Mail

© 2010 Medco Health Solutions, Inc. All rights reserved. C T AAT C G C G C G 6 Specialty Medications Medco provides specialty pharmacy services through our wholly owned subsidiary Accredo Health Group, Inc. What are specialty medications? High cost infused, injectable, and oral drugs that typically require added supervision of patient therapy With Accredo, at no extra cost, you’ll benefit from: Personalized Care Safe, prompt delivery 24 hour support Refill reminders Drug safety monitoring

© 2010 Medco Health Solutions, Inc. All rights reserved. C T AAT C G C G C G 7 Patient Stratification: Patient’s needs vary… Patient Care Needs Wrinkles, Baldness, Impotence, Contraception, Vitamins Well Colds & Flu, Strep Throat, Ear Infection, Headache, Sprains Acute Heart Disease, Diabetes, Arthritis, High Blood Pressure, High Cholesterol, Dementia, Back Pain Chronic Multiple Chronic Conditions such as Heart Failure & Diabetes, Cancer, AIDS, Multiple Sclerosis, Metabolic Syndrome Complex Medco’s specialist pharmacists create a patient experience which improves the quality of member care and increases savings for our clients

© 2010 Medco Health Solutions, Inc. All rights reserved. C T AAT C G C G C G 8 A&M Care patient stratification 817 patients 4.9% Rx cost Oncology Immunology Neurology Psychiatry Pulmonary Rare & Specialty Cardio-vascular Women’s Health Diabetes 216 patients 796 patients 2,621 patients 7,756 patients 3,726 patients 5,186 patients 1,476 patients 1Q FY10 A&M Care data Complex & Chronic patients Medco’s Therapeutic Resource Centers focus on Gaps in Care and ensure medication safety

© 2010 Medco Health Solutions, Inc. All rights reserved. C T AAT C G C G C G 9 Getting the right drug to the right person at the right time Specialization and member engagement are critical components to controlling healthcare costs and driving quality clinical outcomes: Specialist Pharmacists Personalized Medicine offering Research Driven Protocols My Rx Choices ® Worry-free Fills™

© 2010 Medco Health Solutions, Inc. All rights reserved. C T AAT C G C G C G 10 Personalized Medicine What is it? A science that examines the inherited variations in genes that dictate drug response (whether a drug will be effective or safe) Personalizing drug therapy based on each patient's genetic variability TAMUS provides this service to new patients if both the doctor and patient wish to take the test Tests are currently available for new users of warfarin and Tamoxifen How patients metabolize drugs can have significant impacts on both medication choice and dosage Testing consists of a cheek swab…what do you have to lose?

© 2010 Medco Health Solutions, Inc. All rights reserved. C T AAT C G C G C G 11 How Does it Work?? Identification  Prescription comes in for a pharmacy claim for a product with an associated test through the prescription. Fill the prescription, then… Intervention  Cheek swab completed by patient and mailed to lab  Lab processes test, sends results and interpretation to physician and Medco TRC pharmacist  Therapy change made if applicable Communication  Contact physician for approval to test patient  Contact patient to discuss program and test kit mailing  800 number provided for questions Follow-up  Monitor lab outcomes and follow-up as needed

© 2010 Medco Health Solutions, Inc. All rights reserved. C T AAT C G C G C G 12 My Rx Choices ® Your online savings tool Lower your cost for prescriptions with My Rx Choices Simply visit You’ll need to take a moment to register before using this service. You can also call You have to shop your benefit. Prices can vary at different retail pharmacies

© 2010 Medco Health Solutions, Inc. All rights reserved. C T AAT C G C G C G 13 My Rx Choices Available through Customer Service or on

© 2010 Medco Health Solutions, Inc. All rights reserved. C T AAT C G C G C G 14 Generic medications save… My Rx Choices Approximately 2,000 web hits per month Savings For every 1% increase in generic dispensing, A&M Care and its members could save millions of dollars Average cost of generic prescription is just over $15 as compared to $151 for a brand Cost Difference Generic Copay Waiver Program First phase June through August 2010

© 2010 Medco Health Solutions, Inc. All rights reserved. C T AAT C G C G C G 15 Worry-free Fills™ Worry-free Fills™ is an automatic refill program available to A&M Care members who utilize the Medco Pharmacy. Members enroll for the program at the drug level. If a member chooses to enroll a particular medication, a reminder letter is either mailed or ed to the member approximately three weeks before the prescription is filled.

© 2010 Medco Health Solutions, Inc. All rights reserved. C T AAT C G C G C G 16 Information Resources A&M Benefits Web site – Pharmacy Benefit Highlights List of participating retail pharmacies Download forms Medco Member Web site – Formulary Information Locate a Participating Pharmacy Health and Wellness Information My Rx Choices ® / Price a Medication Online Ordering Order Medco By Mail Refills Download forms Medco widget Customer Service Number Annual Enrollment Book