1. Community pharmacy flu vaccination services- preparing for 2014/15

2. Novartis Flu and Travel Health Partnership Programme 2

3. Marketing the flu vaccination service to commissioners and patients Lara Mapp, Novartis Vaccines Key Account Manager London, April 1 st 2014 Confidential Information Vaccines Prescribing Information available at the end of this presentation

4. Principal Objective Improving patient access to flu vaccination through pharmacies Increasing awareness Improving access Novartis Vaccines is committed to the fight against flu 4 UK/FLU/13-0046 – Nov 2013 Confidential Information

5. Flu Vaccination– Unmet need 5 Million ‘NHS at-risk’ patients not protected against flu  ~5 million people eligible for the NHS free flu jab are not being vaccinated in England alone 1  Flu Vaccination Uptake rates of <65yrs ‘at-risk’ in the GP practices remain flat at ~ 50% 2  Private Flu Market: ~30% of pharmacy customers eligible for a NHS free flu jab – decide to pay out of their pockets 3  Convenience and personal preference being the key reason for 90% of NHS customers choosing the pharmacy for their flu jab 4  NHS commissioning of flu service: Potential to capture 5M at risk people in the pharmacy 1- Flu-vaccine-uptake-A-Z_SHA-PCT_2012_acc, Data source: DH and HPA Jan 2012 2- Chief Medical Officer. The Influenza Immunisation Programme 2012/2013 3- Pharmoutcomes, Flu Private service, Hampshire, Greater Manchester, Herefordshire & Worcestershire, Coventry & Warwickshire – accessed December 2013 4- Pharmoutcomes, Flu NHS service, Herefordshire & Worcestershire, Coventry & Warwickshire - accessed December 2013 5. European Scientific Working Group on Influenza (ESWI) Flu Centre. Seasonal flu, Economic impact. http://www.flucentre.net/knowledge-centre/seasonal-flu/economic- impact (accessed Dec 2013)http://www.flucentre.net/knowledge-centre/seasonal-flu/economic- impact 5 UK/FLU/13-0046 – Nov 2013 Confidential Information

6. Novartis Vaccines’ proven track record of success  2003 - Supported the development of the UK’s first pharmacist flu vaccination Xprogramme (NHS Grampian) Leading to the development of the successful City & Hackney PCT service  10 years successful experience creating, developing and supporting award- winning UK pharmacist-led vaccination partnerships. 1  Actively supporting PCTs, CCGs and Scottish HBs to deliver NHS flu vaccination Xservices through pharmacy during the Flu season 1 - Pf Awards 2013 _ 2012 Winners, Finalists & Commendations UK/FLU/13-0046 – Nov 2013 Confidential Information6

7.  >10,000 UK pharmacists trained  >3,000 UK pharmacies participating  >1 Million vaccines administered Data on file, Novartis Vaccines and Diagnostics Limited, Dec 2013. Cumulated figures since programme launch. Includes: 7 Novartis In-Pharmacy Flu Vaccination Programme Programme results since launch UK/FLU/13-0046 – Nov 2013 Confidential Information  Independent Pharmacies - private and NHS flu service  National Retail Groups  National Pharmacy Groups

8. NHS commissioning 2013: Overview Map Novartis actively supporting and partnering directly and indirectly with 102 CCGs 8 UK/FLU/13-0046 – Nov 2013 Confidential Information

9. NHS commissioning of the Flu Service >5M NHS ‘at-risk’ patients remain unprotected in England alone 9  18 PCTs partnering with NVD in 2012, 102 CCGs partnering directly & indirectly with NVD in 2013 1  ~1,500 pharmacies trained by NVD in 2013 offering the flu service to NHS patients  Top pharmacies achieving more than 250 NHS patients / pharmacy in first 4 weeks of the flu season 2  MUR patients as potential to enhance uptake in “at risk” patients  Flu service linking to all other healthy living services  NHS commissioning capturing patients at risk across all ages with 30% of patients under 65 years of age 3  In non-NHS commissioned areas, 30% of private patients choosing the pharmacy are eligible for a NHS free jab 3 1- NVD Data on file, 102 CCGs partnering with NVD including CCGs with NVD training and CCGs trained locally. 2- Pharmoutcomes, Flu NHS service, Herefordshire & Worcestershire, Coventry & Warwickshire, December 2013 3 -Pharmoutcomes, NVD Flu Private Service, Hampshire, Greater Manchester, Herefordshire & Worcestershire, Coventry & Warwickshire December 2013 UK/FLU/13-0046 – Nov 2013 Confidential Information

10. Novartis Vaccines & Pharmoutcomes Piloting Pharmoutcomes in 2013/14: Private and NHS service 10 Source: Pharmoutcomes, Flu NHS service, Herefordshire & Worcestershire, Coventry & Warwickshire, accessed December 2013; Pharmoutcomes, NVD Flu Private Service, Hampshire, Greater Manchester, Herefordshire & Worcestershire, Coventry & Warwickshire accessed December 2013 Total number of private and NHS flu jabs in the sample: 11,000, ~150 pharmacies. Private Service  88% under 65 years – confirming the pharmacy as the best place to target this patient group  30% NHS eligible  90% convenience/pharmacy preference  11% of the jab have been administered by the pharmacist at the work place NHS Flu Service in the Pharmacy:  33% under 65 years  45% respiratory disease & 20% diabetes And last but not Least:  1 st time jab: between 9% and 21% in pilot areas UK/FLU/13-0046 – Nov 2013 Confidential Information

11. NHS commissioning of the Flu Service 90% of customers chose the pharmacy for convenience & preference 11 *Pharmoutcomes, Flu NHS service, Herefordshire & Worcestershire, Coventry & Warwickshire, accessed December 2013 UK/FLU/13-0046 – Nov 2013 Confidential Information

12. 2013/14 Training Programme – pharmacist feedback 4 Online training 1 - Data on file. Novartis Vaccines and Diagnostics Limited, In-Pharmacy Vaccination Programme training report, January 2014 All aspects of the online training were scored as 4 (very good) and above data from 2578 pharmacists “An excellent and well constructed learning programme” “Thank you - I am thoroughly enthused & can't wait to get started” “Excellent resource - had all my staff viewing CPR sections!!” 1=poor; 2=fair; 3=good; 4=very good; 5=excellent 12 UK/FLU/13-0046 – Nov 2013 Confidential Information

13. 2013/14 Training Programme – pharmacist feedback 4 Online training – NHS Commissioned areas independent pharmacists 1 - Data on file. Novartis Vaccines and Diagnostics Limited, In-Pharmacy Vaccination Programme training report, January 2014 88% of scores: Excellent-Very good data from 714 pharmacists 1=poor; 2=fair; 3=good; 4=very good; 5=excellent 13 UK/FLU/13-0046 – Nov 2013 Confidential Information

14. 2013/14 Training Programme – pharmacist feedback 4 Practical live training 1- Data on file. Novartis Vaccines and Diagnostics Limited, In-Pharmacy Vaccination Programme training report, January 2014 “This was one of the best training events I have been to in the last few years” “Really enjoyed the day, a wonderful way to learn” 14 UK/FLU/13-0046 – Nov 2013 Confidential Information

15. Novartis Flu and Travel Health Partnership Programme 15 UK/FLU/13-0046 – Nov 2013 Confidential Information

16. Novartis Vaccines support – NHS Commissioning Toolkit provided by Novartis Vaccines for interested LPCs/CCGs 16 UK/FLU/13-0046 – Nov 2013 Confidential Information

17. Novartis Vaccines case studies building the evidence and business case for ‘commissioning’ 17 UK/FLU/13-0046 – Nov 2013 Confidential Information

18. Supporting NHS commissioned programmes to get started Business case-gauging interest-pharmacist training-SLA-service launch 18 UK/FLU/13-0046 – Nov 2013 Confidential Information

19. Comprehensive training and support programme provided by Novartis Vaccines for NHS commissioned pharmacies 19 UK/FLU/13-0046 – Nov 2013 Confidential Information

20. 20 The high quality and efficiency of an award winning programme:  Interactive and focused training consisting of online learning (~3 hrs) and Live Training (3.5 hrs)  Online-Only training after 1 year live training and at least 50 jabs  Ability to vaccinate 2 years and above customers under the private PGD NEW  Ability to vaccinate pregnant women also within the private PGD to achieve consistency with NHS PGD NEW  Medical support line  Clinical governance support material  Point of Sale material  B2B support – flu jab vouchers  Website www.dontforgetaboutflu.co.uk store locatorwww.dontforgetaboutflu.co.uk  Best sharing practice and uptake support through e- newsletters - NEW Flu Vaccination Programme Made Simple Maximise the opportunity in a simple and convenient way UK/FLU/13-0046 – Nov 2013 Confidential Information

21. Novartis Flu and Travel Health Partnership Programme 21

22. Promoting your private and NHS flu service Why it’s so important...  Flu vaccination opens the door to other services such as healthy living initiatives  In NHS commissioned areas, the pharmacy is an alternative venue to the GP surgery, for patients who look for convenience and cannot attend the GP surgery flu clinic “The flu vaccination service is the single most important service that has helped us move forward in community pharmacy” Pharmacist in Chorlton - more than 1,000 people have been vaccinated against flu in this pharmacy in the last 5 years Reference: M.K., Chorlton, Flu and Meningococcal (ACWY) Vaccination Services Case Study, Novartis Vaccines and Diagnostics Limited, September 2012 22 22 | UK/FLU/13-0031 Vaccination Training Presentation – GENERIC May 2013 | Confidential

23. What is the key to the success of your vaccination service? Approach it as a team venture – engage all your pharmacy staff  Approach it as a pharmacy team venture  Ensure all of the team undertake the online learning  Discuss Point of Sale (PoS) materials  Allocate clear roles and objectives  Appoint a “Vaccination Service Champion”  Undertake customer engagement role plays 23 | UK/FLU/13-0031 Vaccination Training Presentation – GENERIC May 2013 | Confidential

24. Promoting the flu vaccination service: PoS materials Key to success: create a visible pathway using ALL materials  Ensure ALL PoS materials are used: posters, leaflets, shelf wobblers  Position the materials at eye level and in visible places  Create a “pathway” from the entrance to the counter with the flu service materials 24 | UK/FLU/13-0031 Vaccination Training Presentation – GENERIC May 2013 | Confidential

25. Promoting your flu vaccination service: whom to target Key to success: talking to everyone entering your pharmacy  Identify whom you want to target  Speak with every customer about your flu vaccination service  Create a buzz!  If in an NHS commissioned area: Target Medicines Use Review (MUR)patients Target patients included in your healthy living services  Encourage customers to have the jab  Every gained customer will return! 98% of people vaccinated in the pharmacy said they would return next year for their flu vaccination in the pharmacy 1. Reference: Data on file, IPFI Post Vaccination Feedback for 2011/12 influenza season In Pharmacy, Novartis Vaccines and Diagnostics Limited, July 2012 25 | UK/FLU/13-0031 Vaccination Training Presentation – GENERIC May 2013 | Confidential

26. Promoting your flu vaccination service in & out of your pharmacy Key to success: have a clear plan on how and whom to target  Promote your flu vaccination service via the media and in the local community  Inform your local GPs  Identify whom you want to target with your flu service, e.g.: Private & NHS patients Practice nurses Dentist practices Social workers Teachers and more  Target local businesses 26 | UK/FLU/13-0031 Vaccination Training Presentation – GENERIC May 2013 | Confidential

27. Promoting your NHS service Increase your flu vaccination uptake  Establish relationships with GPs who may refer NHS or non-NHS patients Patients unable to attend their GP flu clinic will be referred to you Fully booked GP clinics: Patients referred to you  Target MUR, healthy living and smoking cessations patients 27 | UK/FLU/13-0031 Vaccination Training Presentation – GENERIC May 2013 | Confidential

28. Promoting your flu vaccination service: Your pharmacy details on the Novartis flu website  Your pharmacy details will be included in the store locator on www.dontforgetaboutflu.co.uk  All elements of the online and practical training must be completed before a pharmacy details are added to the website 28 | UK/FLU/13-0031 Vaccination Training Presentation – GENERIC May 2013 | Confidential

29. Novartis Flu and Travel Health Partnership Programme 29

30. Conclusion and Key Learning How to maximise the NHS service in the pharmacy  LPCs to start early to engage with Area Teams and subsequently start earlier inviting pharmacists  NHS PGD to include all at-risk patients. The pharmacy convenience is key driver at any age  Start the flu service in October to maximise the opportunity to capture the patients at risk not presenting at the GP practice  Invite pharmacists to attend live training sessions and complete their online learning at latest by end of August to allow enough time to promote the service and book appointments  Make sure that a representative of the Immunisation Screening Team attend the practical training sessions to cover the NHS PGD and the peripherals  The most successful pharmacies in the NHS service are the ones very strong in offering the private service UK/FLU/13-0046 – Nov 2013 Confidential Information 30

31. Optaflu ® ▼prescribing information 31 UK/Flu/13-0004 - Jan 2013 Confidential Information

32. Fluvirin ® prescribing information 32 UK/Flu/13-0004 - Jan 2013 Confidential Information

33. Agrippal ® prescribing information 33 UK/Flu/13-0004 - Jan 2013 Confidential Information

34. Your questions…