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

2. Subcutaneous Pipeline April 2016

3. 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)

4. Albumin

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

6. 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%
UNIVERSITY OF ALBERTA HOSPITAL
27,886
25,819
-7.4%
24,533
26,763
3.7%
FOOTHILLS HOSPITAL
8,625
8,690
0.7%
7,280
7,941
-8.6%
RED DEER REGIONAL HOSPITAL CENTRE
1,865
1,732
-7.1%
1,813
1,978
14.2%
PETER LOUGHEED CENTRE
1,822
1,565
-14.1%
1,374
1,499
-4.2%
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

7. 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%
VANCOUVER GENERAL HOSPITAL
17,048
18,537
8.7%
16,525
18,027
-2.8%
ROYAL JUBILEE HOSPITAL, VICTORIA
4,626
5,388
16.5%
5,697
6,215
15.4%
ROYAL COLUMBIAN HOSPITAL
3,787
4,326
14.2%
4,073
4,443
2.7%
KELOWNA GENERAL HOSPITAL
3,325
4,049
21.8%
4,242
4,628
14.3%
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

8. 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%
HEALTH SCIENCES CENTRE WINNIPEG
5,108
5,904
15.6%
5,243
5,720
-3.1%
ST. BONIFACE GENERAL HOSPITAL
4,506
4,277
-5.1%
4,166
4,545
6.3%
BRANDON REGIONAL HEALTH CENTRE
1,167
1,098
-5.9%
1,216
1,326
20.8%
GRACE GENERAL HOSPITAL (WINNIPEG)
592
513
-13.3%
381
416
-19.0%
SEVEN OAKS GENERAL HOSPITAL
541
441
-18.5%
280
305
-30.7%
*2015 Is based on 11 months of data

9. 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%
SAINT JOHN REGIONAL HOSPITAL
4,013
3,821
-4.8%
3,434
3,746
-1.9%
THE MONCTON HOSPITAL
1,222
1,191
-2.5%
1,107
1,207
1.4%
MIRAMICHI REGIONAL HOSPITAL
719
539
-25.0%
450
491
-8.9%
DR. GEORGES-L-DUMONT UNIVERSITY CEN
653
1,082
65.8%
830
905
-16.3%
CHALEUR REGIONAL HOSPITAL
575
257
-55.4%
155
169
-34.1%
*2015 Is based on 11 months of data

10. 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%
HEALTH SCIENCES CENTRE - GEN HOSPIT
2,668
3,533
32.4%
2,937
3,203
-9.3%
ST. CLARE'S MERCY HOSPITAL
1,298
1,045
-19.5%
987
1,076
2.9%
JAMES PATON MEMORIAL REGIONAL HC
361
181
-50.0%
371
405
124.2%
WESTERN MEMORIAL HOSPITAL
273
572
109.9%
498
543
-5.0%
CENTRAL NEWFOUNDLAND REGIONAL HC
155
186
20.0%
247
269
44.9%
*2015 Is based on 11 months of data

11. 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%
QEII HEALTH SCIENCES CENTRE, VG SIT
5,125
6,015
4,522
4,933
-18.0%
QEII HEALTH SCIENCES CENTRE, HI SIT
3,253
3,715
14.2%
3,745
4,085
10.0%
IWK HEALTH CARE CENTRE
664
1,001
50.7%
922
1,006
0.5%
CAPE BRETON REGIONAL HOSPITAL
429
389
-9.4%
421
459
18.2%
CUMBERLAND REGIONAL HEALTH CARE CEN
418
516
23.4%
568
620
20.1%
*2015 Is based on 11 months of data

12. 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%
UHN - TORONTO GENERAL SITE
22,342
21,477
-3.9%
23,158
25,263
17.6%
HAMILTON HS - HAMILTON GENERAL HOSP
10,706
9,667
-9.7%
8,998
9,816
1.5%
ST. JOSEPH'S HEALTHCARE HAMILTON
10,247
6,812
-33.5%
6,697
7,305
7.2%
LONDON HSC - UNIVERSITY HOSPITAL
9,249
7,889
-14.7%
6,868
7,492
-5.0%
KINGSTON GENERAL HOSPITAL
8,274
7,461
-9.8%
6,636
7,239
THE OTTAWA HOSPITAL - GENERAL CAMPU
7,656
9,192
20.1%
7,884
8,601
-6.4%
LONDON HSC - VICTORIA HOSPITAL
7,459
5,901
-20.9%
5,119
5,584
-5.4%
THE OTTAWA HOSPITAL - CIVIC CAMPUS
6,488
7,066
8.9%
7,838
8,550
21.0%
HAMILTON HS - JURAVINSKI HOSPITAL
5,958
6,238
4.7%
6,257
6,826
9.4%
TRILLIUM HEALTH PARTNERS - MISSISSA
5,646
5,055
-10.5%
4,918
5,365
6.1%
GRAND RIVER HOSPITAL
4,274
5,416
26.7%
6,484
7,073
30.6%
*2015 Is based on 11 months of data

13. 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
QUEEN ELIZABETH HOSPITAL, CHARLOTTE
67.4%
-57.6%
*2015 Is based on 11 months of data

14. 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%
REGINA GENERAL HOSPITAL
3,641
4,508
23.8%
4,501
4,910
8.9%
ROYAL UNIVERSITY HOSPITAL
2,724
3,214
18.0%
2,953
3,221
0.2%
ST. PAUL'S HOSPITAL, SASKATOON
2,207
2,298
4.1%
2,339
2,551
11.0%
PASQUA HOSPITAL
1,534
1,184
-22.8%
924
1,007
-14.9%
DR FH WIGMORE REGIONAL HOSPITAL
334
323
-3.3%
193
211
-34.8%
CYPRESS REGIONAL HOSPITAL
225
288
28.0%
377
411
42.8%
VICTORIA HOSPITAL, PRINCE ALBERT
191
265
38.7%
299
326
22.9%
*2015 Is based on 11 months of data

15. Ordering CMV Negative Products

16. Order Form
The order form still has Anti-CMV on the form. The link is below
F/CDI.nsf/OpenDocumentLinks/id96E A986E85257A2C006 5B4DF/$FILE/F ( ).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.

17. Cryo/RiaSTAP

18. 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

19. 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