1. Results of Quality Interventions For A Multi-Company Coalition Quality Management Program™ Craig Stern, RPh, PharmD, MBA Pro Pharma Pharmaceutical Consultants, Inc. October 2009 AMCP

2. KEY MESSAGES AND SUCCESSES 2007 All Coalition Trend = -3% (cf. 8.3% national, and 16% quoted for coalition industry) Trend was based on improving the performance of the mean for the target physicians who controlled 85% of drug spend The PP-QMP is focused on managing the mean of patient costs and is not applicable to each and every physician Best-in-Class (BIC) doctors cost approximately 1/5 of non-BIC and use 1/2 as many prescriptions. BIC physicians used the same drugs and treat the same conditions as non- BIC, but they are more judicious in their choice of drugs and use less expensive alternatives.

5. CCG

6. PRESCRIBING GUIDE

8. CLINICAL VARIANCE QUALITY GAPS

13. UTILIZATION VARIANCE

20. GROUPS & VARIANCE

22. BEST IN CLASS

27. Multi-Company Coalition Best in Class Stats 2007 5-StarRatingPPPMRx PPPM ***** $ 54.72 1.63 **** $ 63.46 1.62 *** $ 84.95 1.90 ** $ 164.06 2.79 * $ 218.36 3.09 0 Star $ 278.19 3.32 % of Total IC Total100.0% Target MD85.3% BIC MD5.1% KEY: PPPM = Cost / patient / month Rx PPPM = Number of prescriptions / patient / month IC = ingredient cost BIC = best-in-class