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an ASD Healthcare publication Volume 1 • 2013InsideOutinform+connect+improveCountdown to the Affordable Care Act24SEE WHAT’S NEW!OUR UPDATEDCATA LOGIS ON PAGE 45.Facts. Stats. Stories.Get the latest in The Medical Minute18Making History TogetherASD Healthcare celebrates 20 years28Under PressurePreserving the community oncology practice36

Grifols: A Leading Manufacturer of Plasma Protein TherapiesVertical integration with geographic diversity helps ensure continuous production of therapies• The largest network of source plasma donor centers in the industry 1 provides Grifolswith a dependable supply of the plasma needed to produce our therapies• Two Grifols-owned state-of-the-art plasma testing facilities• The largest plasma protein fractionation capacity in the world 1• Three global plasma protein manufacturing facilitiesGrifols Fractionation Facility, Los Angeles, CAState-of-the-Art Production ProcessesA Broad Range of Plasma Protein TherapiesAlbumin (Human), marketed as Albutein ® 5%, Albutein ® 25%, Plasbumin ® -5 and Plasbumin ® -25Alpha 1- Proteinase Inhibitor (Human), marketed as Prolastin ® -CAntihemophilic Factor/von Willebrand Factor Complex (Human), marketed as Alphanate ®Antithrombin III (Human), marketed as Thrombate III ®Coagulation Factor IX (Human), marketed as AlphaNine ® SDFactor IX Complex, marketed as Profilnine ® SDImmune Globulin Intravenous (Human) or IVIGImmune Globulin Injection (Human)Hyperimmune Globulin Therapy Products, marketed as Hypermunes :- Rabies Immune Globulin (Human), marketed as HyperRAB ® S/D- Tetanus Immune Globulin (Human), marketed as HyperTET ® S/D- Rh o(D) Immune Globulin (Human), marketed as HyperRHO ® S/D- Hepatitis B Immune Globulin (Human), marketed as HyperHEP B ® S/DGrifols also provides operational solutions for compounding areas in pharmacy and diagnostic instrumentation,reagents, software and related products for the clinical laboratory.Learn more about how Grifols can meet your hospital’s needs at www.grifols.com1. Marketing Research Bureau data, June 2012© 2012 Grifols Biologicals Inc. All rights reserved. Printed in USA. June 2012 CO19-0612

If you thInk they deliver the same benefits –take a closer look at Cubixx ® .yes, 340B* inventory can be ordered on consignment. and yes, itlooks the same as your inventory. But, compare the two, and youwill see how cubixx consignment gives you more – like the same fullcontrol you want but with less effort and more savings in costs, timeand resources.along with 340B accessibility, the cubixx system also frees up themoney your pharmacy has tied up in factor inventory, leaving thosefunds available to benefit your staff in better ways. that’s becausecubixx only bills you for the products you use – when you use them –while giving you instant access to the vital medications you need,when you need them.that’s just one of the many benefits you will discover when you take acloser look at cubixx. the chart to the right shows you more.CUBIXX SAVINGSYour EstimatedAnnual Factor Purchases $1M $5M $10MCost-of-Capital Savings(8% @ 8 turns)Freight (0.1%) andExpiration Savings (2%)Administration Savings(0.25%)Total EstimatedAnnual SavingsEstimated inventory and savings$10,000 $50,000 $100,000$21,000 $105,000 $210,000$2,500 $12,500 $25,000$33,500 $167,500 $335,000Want to know more about the benefits of Cubixx, now?Call 877.900.7352 oremail BusinessInnovation@asdhealthcare.comwww.asdhealthcare.com* 340B pricing is limited to eligible participating covered entity members as listed and defined on thefederal 340B hrsa-oPa website, http://www.hrsa.gov/opa/.ASD Healthcare 1

The future of your practicebegins here and now.It’s time to demonstrate the real, measurablevalue of community oncology.Share your voice with legislators atCommunityCountsAdvocacy.orgTo ensure the future of community oncology, we must communicate its value today.Community Counts is a physician-led movement that puts the power in your hands.Simply register at ourcommunitycounts.org and gain access to information and toolsto help you learn how to navigate this new healthcare environment, and operatemore efficiently in it.So join the cause and make your voice count. Go to ourcommunitycounts.org today.2 InsideOut

Insideinform+connect+improveOutin the newsin the spotlightin the communityin our catalogin the works1028364575The Medical MinuteFacts, stats and stories makingthe headlines in health.18Making History TogetherASD Healthcare celebrates our first 20 years.28The Road to ACA implementation24Community BenefitsPreserving access to communityoncology practices.36Editorial StaffMarketing managerTeri BurgessEditor / WriterChristina McFarlandContributing WritersDale DirksDane ChristiansenGraphic DesignerWes GeigerAdvertising salesBernadette RospigliosiAdvertising CoordinatorEva KypraiouArticle and Advertising SubmissionsArticle submissions and suggestions, as wellas advertising inquiries may be sent to:ASD Healthcareattn: InsideOut Marketing3101 Gaylord ParkwayFrisco, Texas 75034or by email:Eva.Kypraiou@asdhealthcare.comPUBLICATION DESIGNA W A R DASD Healthcare is committed to providing our customers with timely, relevant information. In thecoming months, InsideOut will include articles and sections that are important to you and yourbusiness. As we move forward, we are reaching out to you, our valued customers, for ideas andinput on topics you would like to see covered.2 0 1 2Please send your thoughts, ideas and suggestions for making this a dynamic and interestingpublication to ASD Healthcare’s marketing department (marketing@asdhealthcare.com).Information presented in this publication is not intended as a substitute for the personalized advice given by a healthcare provider. Although ASD Healthcare strives to present only current and accurate information, readers should not considerit as professional advice or endorsement of any position. Although great care has been taken in compiling and checking the information given in this publication to ensure accuracy, the authors, ASD Healthcare, and its employees or agentsshall not be responsible or in any way liable for the continued currency of the information or for any errors, omissions, or inaccuracies in this publication, whether arising from negligence or otherwise or for any consequence arising therefrom.ASD Healthcare 3

Involved In thecommunItIes we serve.From hemophilia to kidney disease to immunedeficiency communities and more, ASD Healthcaresupports the advocacy foundations that dedicatetheir efforts to improving healthcare and publicpolicy for their communities. It’s our privilege toprovide financial support, as well as volunteersupport through our associates who counsel atcamps, cycle in fundraising tours and join in eventsthat raise awareness.Our involvement gives us one way to give back.But, it also keeps us connected to the people weserve and the ever-changing challenges they face.And, on occasion, it puts us in the right place at theright time to create new and innovative solutionsthat help us serve these communities even more.www.asdhealthcare.com4 InsideOut

The ACA countdown has begun. On January 1, 2014the Patient Protection and Affordable Care Act(ACA) goes into full effect. Are you ready? It’s thequestion we are all asking. While we’ve had threeyears to get ready, few of us feel prepared.As healthcare professionals, we know we’re inthis together, along with businesses and citizensthroughout the nation. That’s why ASD Healthcarewill feature a special series of articles on the ACAimplementation throughout the year. We start theseries in this issue by giving you all the basics aboutthe Act in COUNTDOWN TO 2014 on page 24.At 2,700 pages, the healthcare bill feels daunting.But we give you some simple ways to understandthe Act and what goals it attempts to achieve.We’ve written this series to help you separate thefacts you’ll be dealing with in healthcare from thefiction that has created so much confusion aboutthe ACA. Our coverage takes you from the big pictureinto the small details, so you have what youneed to help your patients, your community andyour facility make the transition.In this issue, we’ll also take a closer look at thechallenges community oncology practices facetoday. Community Benefits on page 36 covers theissues – like increased costs, falling reimbursementsand closing rates that are rising and threateningthis important healthcare resource.Community oncology practices provide manyvital benefits. The article shows you why preservingaccess to these providers is important. It alsointroduces the Community Counts campaign, aphysician-led movement that is helping keep thesevital resources alive.As one of the pioneers in specialty pharmaceuticaldistribution, I’m really excited to announce a bigmilestone in ASD Healthcare’s history. In 2013, wecelebrate our 20th anniversary. We are very excitedto share it with you in Making History Togetheron page 28 by taking a trip down memory lane tohighlight some of the key moments in our historyand the history of specialty pharmaceuticals.And as always, this issue of InsideOut helps youcatch up on all the news you might have missedwith The Medical Minute on page 18 andWashington Update on page 10.I’m sure this will be an interesting year as the ACAimplementation continues to unfold. We will keepyou updated. I hope our ACA series and the otherstories in this issue help keep you in touch withyour healthcare world – inside and out.Thank you for your commitment in healthcare,Neil Herson, Presidenton behalf of ASD HealthcareASD Healthcare 5

Kogenate® FS:The brand you know withKogenate® FS with BIO-SET® offers:Grab & Go packaging contains materialsnecessary for safe and fast reconstitutionBIO-SET® reconstitution system with user-friendly featuresWide range of vial sizes for flexibility in preparing your doseSmall diluent volumes make reconstitution fast and easy250 IU 500 IU 1000 IU 2000 IU 3000 IU2.5-mL Diluent5.0-mL DiluentAsk your doctor if Kogenate® FS is right for you. INDICATIONSKogenate® FS, antihemophilic factor (recombinant), is a recombinant factor VIIItreatment indicated for the control and prevention of bleeding episodes andperi-operative management in adults and children (0-16 years) with hemophilia A.Kogenate® FS is also indicated for routine prophylaxis to reduce the frequency ofbleeding episodes and the risk of joint damage in children with hemophilia A withno preexisting joint damage.BAYER, the Bayer Cross, and KOGENATE are registered trademarks of Bayer.BIO-SET is a registered trademark of Biodome SAS.©2011 Bayer HealthCare Pharmaceuticals Inc. All rights reserved 06/11 KN100002116 InsideOut

KOGENATE FS [Antihemophilic Factor (Recombinant), Formulated with Sucrose]For Intravenous Use, Lyophilized Powder for Reconstitution with BIO-SET, a needlelessself-contained reconstitution systemInitial U.S. Approval: 1993BRIEF SUMMARY - CONSULT PACKAGE INSERT FOR FULL PRESCRIBINGINFORMATION1 INDICATIONS AND USAGE1.1 Control and Prevention of Bleeding EpisodesKogenate ® FS is an antihemophilic factor that is indicated for the control and preventionof bleeding episodes in adults and children (0-16 years) with hemophilia A.1.2 Peri-operative ManagementKogenate FS is indicated for surgical prophylaxis in adults and children with hemophiliaA.1.3 Routine Prophylaxis in Children with Hemophilia A with No Pre-existing JointDamageKogenate FS is indicated for routine prophylactic treatment to reduce the frequency ofbleeding episodes and the risk of joint damage in children with no pre-existing jointdamage.Kogenate FS is not indicated for the treatment of von Willebrand’s disease.4 CONTRAINDICATIONSKogenate FS is contraindicated in patients who have manifested life-threateningimmediate hypersensitivity reactions, including anaphylaxis, to the product or itscomponents, including mouse or hamster proteins.5 WARNINGS AND PRECAUTIONS5.1 GeneralThe clinical response to Kogenate FS may vary. If bleeding is not controlled with therecommended dose, the plasma level of factor VIII should be determined and a sufficientdose of Kogenate FS should be administered to achieve a satisfactory clinical response.If the patient’s plasma factor VIII level fails to increase as expected or if bleedingis not controlled after the expected dose, the presence of an inhibitor (neutralizingantibodies) should be suspected and appropriate testing performed. [See Warningsand Precautions (5.4).]5.2 Anaphylaxis and Severe Hypersensitivity ReactionsAllergic-type hypersensitivity reactions including anaphylaxis have been reported withKogenate FS and have manifested as pruritus, rash, urticaria, hives, facial swelling,dizziness, hypotension, nausea, chest discomfort, cough, dyspnea, wheezing, flushing,discomfort (generalized) and fatigue. Discontinue Kogenate FS if symptoms occurand seek immediate emergency treatment.Kogenate FS contains trace amounts of mouse immunoglobulin G (MuIgG) andhamster (BHK) proteins. Patients treated with this product may develop hypersensitivityto these non-human mammalian proteins.5.3 Neutralizing AntibodiesPatients treated with antihemophilic factor (AHF) products should be carefully monitoredfor the development of factor VIII inhibitors by appropriate clinical observations andlaboratory tests. 6 Inhibitors have been reported following administration of KogenateFS predominantly in previously untreated patients. If expected plasma factor VIII activitylevels are not attained, or if bleeding is not controlled with an expected dose, an assaythat measures factor VIII inhibitor concentration should be performed. [See Warningsand Precautions (5.4).]5.4 Monitoring Laboratory Tests• Monitor plasma factor VIII activity levels by the one-stage clotting assay to confirmthe adequate factor VIII levels have been achieved and maintained, when clinicallyindicated. [See Dosage and Administration (2).]• Monitor for development of factor VIII inhibitors. Perform assay to determine if factorVIII inhibitor is present. If expected factor VIII activity plasma levels are not attained, orif bleeding is not controlled with the expected dose of Kogenate FS. Use Bethesda Units(BU) to titer inhibitors.• If the inhibitor is less than 10 BU per mL, the administration of additional Kogenate FSconcentrate may neutralize the inhibitor, and may permit an appropriate hemostaticresponse.Adequate hemostasis may not be achieved if inhibitor titers are above 10 BU permL. The inhibitor titer may rise following Kogenate FS infusion as a result of ananamnestic response to factor VIII. The treatment or prevention of bleeding in suchpatients requires the use of alternative therapeutic approaches and agents.6 ADVERSE REACTIONSThe most serious adverse reactions are systemic hypersensitivity reactions includingbronchospastic reactions and/or hypotension and anaphylaxis and the developmentof high-titer inhibitors necessitating alternative treatments to AHF.The most common adverse reactions observed in clinical trials (frequency ≥ 4% ofpatients) are inhibitor formation in previously untreated patients (PUPs) and minimallytreated patients (MTPs), skin-related hypersensitivity reactions (e.g., rash, pruritus),infusion site reactions (e.g., inflammation, pain), and central venous access device(CVAD) line-associated infections in patients requiring a CVAD for intravenousadministration.6.1 Clinical Trials ExperienceBecause clinical trials are conducted under widely varying conditions, adverse reactionrates observed in the clinical trials of a drug cannot be directly compared to rates inclinical trials of another drug and may not reflect the rates observed in clinical practice.Previously Treated Patients (PTPs)During the clinical studies conducted in PTPs, there were 24 adverse reactions reportedin the course of 24,936 infusions.Adverse reactions reported by ≥ 4% of the patients are listed in Table 3 below.Table 3 Adverse Reactions (AR) in Previously Treated Patients (PTPs) with Frequencyof ≥ 4%MedDRA Primary SOC Preferred Term Total No. of Total No. ofPatients: 73 Infusions: 24,936No. of Patients AR per Infusion (%)with AR (%)Skin and Subcutaneous Rash, pruritus 6 (8.2%) 0.02Tissue DisordersGeneral Disorders and Infusion site 3 (4.1%) 0.01Administration Site reactionsConditionsSOC = System Organ ClassPreviously Untreated Patients (PUPs) and Minimally Treated Patients (MTPs)In clinical studies with pediatric PUPs and MTPs, there were 29 adverse reactionsreported in the course of 9,389 infusions.Adverse reactions reported by ≥ 4% of the patients are listed in Table 4 below.Table 4 Adverse Reactions (AR) in Previously Untreated Patients (PUPs) and MinimallyTreated Patients (MTPs) with Frequency of ≥ 4% (Age Range 2-27 months)MedDRA Primary SOC Preferred Term Total No. of Total No. ofpatients: 61 Infusions: 9,389No. of Patients AR per Infusionwith AR (%) (%)Skin and Subcutaneous Rash, pruritus, 10 (16.4) 0.01Tissue DisordersurticariaBlood and Lymphatic System Factor VIII 9 (15) 1 N/ADisordersinhibitionGeneral Disorders and Infusion site 4 (6.6) 0.04Administration Site reactionsConditionsSOC = System Organ Class1. Denominator for de novo inhibitors is N=60, since one patient had a pre-existinginhibitor.Minimally Treated Patients (MTPs) in the Joint Outcome StudyIn the Joint Outcome Study with pediatric MTPs treated with routine prophylaxis orepisodic enhanced treatment for 5.5 years, 46 of the 65 randomized patients experiencedadverse events over the study duration. Adverse events were not assessed for theirrelationship with Kogenate FS.Table 5 Adverse Events (AE) in MTPs in the Joint Outcome Study (Age Range 0-6years)MedDRA Primary SOC Preferred Term Total No. of Total No. ofProphylaxis Arm EnhancedPatients: 32 Episodic ArmNo. of Patients Patients: 33with AE (%) No. of Patientswith AE (%)Surgical and Central venous 19 (59) 18 1 (55)Medical Procedures catheterization,Catheter removalInfections and Infestations Central line infection 6 (19) 6 (18)General Disorders and Pyrexia 1 (3) 4 (12)Administration Site ConditionsSOC = System Organ Class1. Three patients from the enhanced episodic arm had catheter removal.ImmunogenicityIn clinical studies with 73 PTPs (defined as having more than 100 exposure days), onepatient had a pre-existing inhibitor. In the other 72 patients, followed over 4 years, node novo inhibitors were observed.In clinical studies with pediatric PUPs and MTPs, inhibitor development was observedin 9 out of 60 patients (15%), 6 were high titer1 (> 5BU) and 3 were low-titer inhibitors.Inhibitors were detected at a median number of 7 exposure days (range 2 to 16exposure days).In the Joint Outcome Study with Kogenate FS,5 de novo inhibitor developmentwas observed in 8 of 64 patients with negative baseline values (12.5%), 2 patientsdeveloped high titer1 (> 5 BU) and were withdrawn from the study. Six patientsdeveloped low-titer inhibitors. Inhibitors were detected at a median number of44 exposure days (range 5 to 151 exposure days).6.2 Post-Marketing ExperienceThe following adverse reactions have been identified during post approval use ofKogenate FS. Because these reactions are reported voluntarily from a population ofuncertain size, it is not always possible to reliably estimate their frequency or establisha causal relationship to drug exposure.Among patients treated with Kogenate FS, cases of serious allergic/hypersensitivity8 InsideOut

Control costs, streamlineyour business and enhancequality care with theintegrated nephrology networkIntegrated Nephrology Network (INN) is the largest specialty grouppurchasing organization (GPO) dedicated exclusively to nephrologistsand dialysis providers. INN provides valuable contract information,resources and savings opportunities on products you purchase everyday. Visit us at www.inn-online.com or call 800.372.4002 to learnabout the immediate benefits of joining INN.To learn how ASD Healthcare and INN can save you time and resources,call 888.642.6999 today and speak to a renal sales specialist.ASD Healthcare 9

★ ★ ★★ ★ ★★ ★ ★in the newsSince the 113th Congressconvened at the beginningof the year, lawmakers havespent the lion’s share of theirtime confronting many ofthe same issues that occupiedthe attention of the previous 112thCongress. Legislative activity on CapitolHill has focused almost exclusively onitems related to federal spending – namely,deficit reduction and sequestration, thebudget, and the annual appropriations process.Legislators continue to show generalconcern that funding cuts will underminefederal healthcare programs, but despitethis consensus Congress has yet to advanceany proposal to ensure critical programsare adequately supported and patientshave ongoing, unhindered access to careand treatment options.UPDATE$$WASHINGTONPrepared by Dale P. Dirks and Dane R. Christiansen,ASD Healthcare’s representatives in Washington10 InsideOut

Budget andAppropriationsWhen FY 2013 began last October, the previousCongress had done little work on the12 annual appropriations bills that fundall federal programs. In order to keep thegovernment operating, lawmakers passeda continuing resolution (CR) that fundedfederal programs near their FY 2012 levelsuntil March 27.In mid March, with the temporary CR setto expire, the new Congress completedwork on FY 2013 appropriations by passingan omnibus appropriations packagethat included a year-long CR for somefederal programs while substituting completedappropriations bills for others. Programsfunded through the Labor-Healthand Human Services (HHS)-EducationAppropriations bill will continue to befunded near their FY 2012 levels (minus5.1% for sequestration).Cuts from sequestration also impactmany of the programs funded throughthe omnibus package’s completed appropriationsbills, which includes theFY 2013 Agriculture-Food and DrugAdministration (FDA) appropriationsbill. While Congress did provide someincreased budgetary support to the FDA,prescription drug user fees are subjectto sequestration. It remains to be seenhow budgetary challenges at the FDAmight impact the review of innovativetreatment options.Protracted work on FY 2013 appropriationsdelayed the release of the President’sFY 2014 budget requestto Congress until April.The President’s budget ★request is traditionallyreleased in February andserves as the ceremonial★beginning of the annualbudget and appropriations★process on Capitol Hill.Rather than wait for theAdministration’s guidance, both the Houseand Senate decided to move ahead withcrafting their FY 2014 budget resolutionsand appropriations bills.SequestrationAt the beginning of March, automatic across-the-board funding cuts known as“sequestration” went into effect. These cuts are a self-imposed penalty that lawmakersplaced on the federal government for their inability to reach consensus on adeficit-reduction strategy. Sequestration generally indiscriminately reduces fundingfor defense and social programs in equal measure.The consequences of sequestration will be felt most directly by patients who dependon the Medicare program. The sequester reduced reimbursement for items and servicesfurnished to Medicare program beneficiaries by 2 percent. As just one exampleof how this cut is applied, physician-administered biologics formerly reimbursedat Average Sales Price (ASP) +6 percent are now reimbursed at ASP +4.3 percent.In the coming months, the tangible impact of this cut on patient access to care andtherapies will become more apparent.Because both parties tend to view draconian cuts to medical research and patientcare activities in a negative light, Congressional leaders continue to negotiate witheach other and the Administration on a deficit-reduction strategy that could potentiallyreplace sequestration.ASD Healthcare 11

★ ★ ★★ ★ ★★ ★ ★WASHINGTONUPDATELegislativeUpdateSpecialty Tiers Legislation – CongressmanDavid McKinley (R-W. Va.-1st) andCongresswoman Lois Capps (D-Calif.-24th) have reintroduced the PatientsAccess to Treatments Act (H.R. 460).This bill was relatively popular in the lastCongress and seeks to restrict specialtydrug tiers used by private insurance plans.Under some co-insurance requirementsof certain specialty tiers, out-of-pocketexpenses for patients relying on biologicproducts can create a cost-driven barrierto access. Patient organizations continueto work together to advocate for passageof H.R. 460 through the Coalition forAccessible Treatments.IVIG Legislation – One of the major achievementsof the last Congress was the enactmentof the Medicare IVIG Access Act.Since this legislation was passed in lateDecember, the Department of Health andHuman Services (HHS) has been workingto put together a project to study Medicarecoverage of the items and services necessaryto facilitate home infusion for patientswith Primary ImmunodeficiencyDiseases (PIDD). When the study begins,it will follow up to 4,000 PIDD patients forthree years. The data gathered throughthis study should ultimately inform HHSof how to establish a more completebenefit for Medicare home infusion byPIDD patients. The Immune DeficiencyFoundation and other stakeholders continueto work with HHS to ensure the IVIGstudy is a success.Track-and-Trace Legislation – Late into thelast Congress, legislators in the House andSenate were working to reach an agreementon a national drug pedigree trackingsystem known as “track and trace.” Due tothe condensed timetable at the end of theyear, lawmakers were unable to resolvetheir differences on some core issues.Therefore, track-and-trace negotiationshave continued into the new Congress.A coalition of manufacturers, distributorsand other stakeholders continues toadvocate for the establishment of an appropriatenational drug pedigree trackingsystem through the PharmaceuticalDistribution Security Alliance.12 InsideOut

Medicare Cuts to Neurologists – Late lastyear, the Centers for Medicare andMedicaid Services (CMS) announcedthat the 2013 reimbursement rates toneurologists for certain diagnostic testswould be cut by nearly 50%. This drasticreduction came as a surprise to theneurology community and caused alarmto patients who rely on the screening servicesfor an accurate diagnosis and earlyintervention with a biologic treatmentregimen. Organizations like the Guillain-Barré Syndrome/Chronic InflammatoryDemyelinating Polyneuropathy FoundationInternational and their congressionalchampions have begun calling on CMSto reverse or mitigate this cut for 2014 toensure that patient access to quality careand treatments is not jeopardized.AgencyUpdate340B Program Review – Key members ofCongress continue to hold a watchfuleye on the Health Resources andServices Administration’s (HRSA) 340BDrug Discount Program. In February,a handful of legislators sent a letter toHRSA that requests transparency in theongoing audit and recertification of coveredentities participating in the 340Bprogram. The letter specifically asks forinformation on the standards and decision-makingcriteria used to removeentities from the program. The letteralso asks if legal action will be pursuedagainst entities that have been removedfrom the program for the time they spentparticipating without meeting the program’scriteria.Part B and Durable Medical Equipment – InFebruary, HHS issued a report entitled,“Part B Payments for Drugs Infusedthrough Durable Medical Equipment.”Medicare currently reimburses infusiondrugs administered through DurableMedical Equipment (DME) at 95 percentof Average Wholesale Price (AWP).HHS found that Medicare spending onDME infusion drugs could be meaningfullyreduced if payment was based onAverage Sales Price rather than AWP.ASD Healthcare 13

Fluzone High-Dose vaccine—Because her immune systemisn’t 30 anymore.As patients reach 65 years of age and older, their immuneresponse to standard-dose influenza vaccines weakens, whichmay leave them at increased risk for infection. 1,2 In addition, 90%of influenza-related deaths occur in this age group. 3Only Fluzone High-Dose vaccine is specifically designed togive her a more robust immune response for this time in her life. 3,4SANOFI PASTEUR. Discovery Drive. Swiftwater, Pennsylvania 18370. www.sanofipasteur.usMKT25743 © 2012 Sanofi Pasteur Inc. 10/12 Printed in USA14 InsideOut

Covered underMedicarePart BIMPORTANT SAFETY INFORMATIONINDICATIONFluzone High-Dose vaccine is an inactivated infl uenza virus vaccine indicated for activeimmunization of persons 65 years of age and older against infl uenza disease caused byinfl uenza virus subtypes A and type B contained in the vaccine. Approval of Fluzone High-Dosevaccine is based on superior immune response relative to Fluzone vaccine. Data demonstratinga decrease in infl uenza disease after vaccination with Fluzone High-Dose vaccine relative toFluzone vaccine are not available.SAFETY INFORMATIONThe most common local and systemic adverse reactions to Fluzone High-Dose vaccine includepain, erythema, and swelling at the vaccination site; fever, headache, malaise, and myalgia. Otheradverse reactions may occur. Fluzone High-Dose vaccine should not be administered to anyonewith a severe allergic reaction (eg, anaphylaxis) to any vaccine component, including egg protein,or to a previous dose of any infl uenza vaccine.The decision to give Fluzone High-Dose vaccine should be based on the potential benefi tsand risks, especially if Guillain-Barré syndrome has occurred within 6 weeks of receipt of a priorinfl uenza vaccine. Vaccination with Fluzone High-Dose vaccine may not protect all individuals.Before administering Fluzone High-Dose vaccine, please see brief summary of full PrescribingInformation on next page.CPT ®a Code: 90662aCPT = Current Procedural Terminology is a registered trademark of the American Medical Association.Fluzone High-Dose vaccine is manufactured and distributed by Sanofi Pasteur Inc.To order Fluzone High-Dose vaccine or learn more about the Fluzone Partners Program,please visit VaccineShoppe.com ® or call 1-800-VACCINE (1-800-822-2463).References: 1. Monto AS, Ansaldi F, Aspinall R, et al. Infl uenza control in the 21st century: optimizing protection of older adults. Vaccine. 2009;27:5043-5053. 2. Goodwin K, Viboud C,Simonsen L. Antibody response to infl uenza vaccination in the elderly: a quantitative review. Vaccine. 2006;24:1159-1169. 3. Centers for Disease Control and Prevention. Prevention and controlof infl uenza with vaccines: recommendations of the Advisory Committee on Immunization Practices (ACIP), 2010. MMWR. 2010;59(RR-8):1-61. 4. Fluzone High-Dose vaccine [PrescribingInformation]. Swiftwater, PA: Sanofi Pasteur Inc.; 2012.Senior StrengthASD Healthcare 15

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PREORDER PROGRAMPROTECT YOURSELF THISFLU SEASONReduce your risks with theASD Healthcare advantage:> > Price protection> > Best return policy> > Most favorable delivery schedulesT:11”S:10.5”Let’s face it. Flu season is risky – especially for pharmacyprofessionals, like you. That’s why ASD Healthcare is helpingyou protect your community while protecting your facility’sB:11.5”bottom line. Order from the largest range of vaccine options,plus get the ASD Healthcare advantage on price, returnsand deliveries. It’s going the extra mile to keep your vaccineprograms on-time and on-budget, so everyone gets theprotection they need – including you. That’s an example of ourTrue Blue customer support.Protection’s just a call away. Start reducing your fluseason risks by calling ASD Healthcare at 866.281.4FLU(4358) today and visit www.asdhealthcare.com.ASD Healthcare 17

in the newsThe MedicalMinuteStay in the know on the latest healthcare news with The MedicalMinute. It brings you the latest facts, stats and stories that havebeen making the headlines in health.$30 billionEstimated reduction in U.S. healthcare costsusing Microsoft Kinect gaming systemKinect: A Healthcare Game-Changer?According to research outlined in the International Journal of Electronic Finance,Kinect’s motion-sensing controller could save billions in U.S. medical costs by preventingthe risk of infection and reducing travel costs associated with hospital visits.The 3-D system enables doctors to connect and interact remotely, which allows themto maintain a sterile environment by controlling the system through hand gesturesand voice commands.Kinect ® copyright Microsoft ©2013Fast Track for Breakthrough DrugsU.S. Food and Drug Administration(FDA) director Janet Woodcockspoke recently about a newagency program to speed certaindrugs to market by assigning them“breakthrough” status. The goalof the designation is to bring drugsfor deadly diseases to patientsfaster. While new drugs currentlyundergo three phases of clinicaltesting, breakthrough drugs couldbe granted FDA approval after justone expanded Phase 1 trial.So far, three drugs have beenawarded this status: Kalydeco andVX-809, both cystic fibrosis drugsfrom Vertex ® Pharmaceuticals Inc.,and a third drug that has not yetbeen made public. Eighteen moredrugs, most of which are cancerrelated,have applied for the newdesignation.The breakthrough classificationrepresents a radical change to thedrug approval process, giving pharmaceuticalcompanies an opportunityto reach the market muchfaster, and helping patients withserious conditions get the treatmentsthey need much sooner.18 InsideOut

“It’s [a] sweet, nondescript,not quite cherry-flavor,”– Kathleen Neville, Cancer DrugResearcher at Children’s MercyHospital, describing the liquidversion of a cancer drug intendedfor childrenFor young patients, large cancer treatmentpills are hard to swallow. That’s whyresearchers at Children’s Mercy Hospitaland the University of Kansas MedicalCenter are reformulating cancer drugsinto liquid versions with sweet flavorsthat are easier to administer to children.NSAIDs Linked to Kidney Damage in KidsAfter assessing more than a decade of data, researchers at Indiana University Schoolof Medicine in Indianapolis concluded that exposure to nonsteroidal anti-inflammatorydrugs (NSAIDs) is a common cause of acute kidney injury in children and teens.Ibuprofen was the most frequently used treatment, accounting for 67 percent of thereported cases. Seventy-five percent of patients in the study were given doses withinthe recommended limits. Study authors suggested that, for inpatient settings, ascertainmentof renal function may be indicated before administering NSAIDs to avoidkidney damage.Greatest Generation Beats Boomers in Health39% vs. 29%Obesity43% vs. 36%Hypertension74% vs. 34%HypercholesterolemiaDisease rates for baby boomers aged 46 to 64, compared with their parents’ generation within the same age rangeBaby Boomers aren’t as healthy as theirparents’ generation, according to a studysupported in part by National Institutes ofHealth (NIH) grants. The study analyzesNational Health and Nutrition ExaminationSurvey (NHANES) data comparing thetwo generations at ages 46 to 64.Results indicated that while life expectancyis higher for boomers than forthe previous generation, boomers havehigher rates of chronic disease, more disabilityand lower self-rated health. Sevenpercent of boomers used a walkingdevice, versus 3 percent of the previousgeneration, and boomers experienced4 percent more limits in work-related activities.Fourteen percent had functionallimitations, compared with 9 percent forthe Greatest Generation.Boomers don’t feel as healthy either.Only 13 percent rated their health as “excellent,”compared to the other group.Boomers were 10 percent more likely tobe obese, and 52 percent said they gotno physical activity at all, compared withonly 17 percent from the previous generation.However, boomers were 7 percentless likely to smoke. The results confirmfindings that healthcare costs will rise asindividuals born in the post-war boomcontinue to age. Researchers say morepolicies aimed at prevention are neededfor boomers.ASD Healthcare 19

in the newsBottle Safest Betfor Some BabiesAccording to a recent policy statementfrom the American Academy ofPediatrics (AAP), American women withHIV should not breastfeed their babies,even if they are receiving antiretroviraltherapy. As reported in Antiviral Therapy,studies in Africa showed thatsix months of antiretroviralprophylaxis could reduce therisk of transmission from fiveto one percent. However, theAAP argues that in a settingwhere mothers can accessclean water and affordableinfant formula, any transmissionrisk outweighs thebenefits of breastfeeding.New AIDS-like Diseasein Asians not ContagiousResearchers at The National Institutesof Health (NIH) discovered a new adultonsetdisease in Southeast Asia thatcauses symptoms similar to AIDS, but isnot contagious. Nearly all the individualswith the disease were Asian or Asianborn,suggesting it may be caused bygenetic or environmental factors.Trouble in the WaterCatfish on anti-depressants. Trout on antibiotics. Bass on steroids. Studies acrossthe U.S., Europe and Canada have found drugs in fish that swim in municipal watersources, making groundwater contamination a growing environmental concern. It’sunknown whether the pharmaceuticals showing up in our water are causing a neurologicaleffect on these animals – or on humans. However, it is clear that drugs gettinginto the water through improper disposal, like flushing them down the toilet, arehaving an effect on our ecosystems.As reported by The New York Times, a new law in Alameda County,California will require drug manufacturers to create and pay for disposalprograms for unused medications. Supporters of the law say take-backprograms would help keep drugs out of the water supply, and would alsoprevent unused drugs from being taken accidentally by children, used recreationallyby teens or stolen.Detractors point out that the new law does not address issues of water contaminatedthrough effluent, which may be the greater source of pharmaceutical content.The Pharmaceutical Research and Manufacturers of America (PhRMA), which representsbrand-name drug companies, the Generic Pharmaceutical Association and theBiotechnology Industry Organization are joining forces in filing a lawsuit against theAlameda County ordinance.Keeping water sources drug-free will involve cooperation between communities,pharmaceutical companies, law enforcement agencies and patients. As yet, acomprehensive solution has not been proposed – but ultimately, we’ll need to worktogether to clear the water.20 InsideOut

41%Increase in U.S. diabetes costs since 2007The cost of diabetes in the U.S. has risen 41 percentsince 2007, reaching $245 billion, according to a 2012study commissioned by the American Diabetes Association. The study calculateddirect costs, as well as indirect costs like absenteeism, reduced productivity and unemployment.The main reason for the increase is the rising number of Americans withthe disease, currently calculated at 26 million adults and children. The per-patientcost for treatment remains roughly the same.Glowing Mice Spotlight Tumors42% to12%Drop in clot rates for DaVita patientsdue to company’s CathAway programGlow-in-the-dark mice may sound like something out of a science fictionnovel – but for cancer patients, they offer real potential for a brighterfuture. A new strain of mice created by researchers from the University ofNorth Carolina Lineberger Comprehensive Cancer Center literally glowswhen tumors begin to form, helping scientists study tumors at their earlieststages. Researchers added a gene from fireflies to the mice, and enabled itto “turn on” when P9, an important gene in aging and cancer suppression,is activated.DaVita Receives NationalAward for Patient SafetyThe Renal Physician Association (RPA)recently awarded its Patient SafetyImprovement Award to DaVita ® , a divisionof DaVita HealthCare Partners Inc.,for its innovative CathAway program.Designed to replace central venouscatheters (CVCs) with functioning arteriovenous(AV) fistulas or grafts,CathAway has helped improve clinicalcare and quality of life for patients andalso reduced healthcare costs, accordingto BusinessWire.ASD Healthcare 21

AFLURIA ® (Influenza Virus Vaccine)BRIEF SUMMARY (For full Prescribing Information, see Package Insert)INDICATIONS AND USAGEAFLURIA is an inactivated influenza virus vaccine indicated for active immunization against influenza disease causedby influenza virus subtypes A and type B present in the vaccine. AFLURIA is approved for use in persons 5 years of ageand older.DOSAGE AND ADMINISTRATIONFor intramuscular (IM) injection only (0.5 mL).Dose and ScheduleChildrenChildren 5 years through 8 years of age not previously vaccinated with an influenza vaccine, or vaccinated for the firsttime last season with only one dose: Administer two 0.5 mL doses, one on Day 1 and another approximately 4 weeks later.Children 5 years through 8 years of age given two doses last season, or at least one dose two or more years ago:Administer a single 0.5 mL dose.Children 9 years of age and older: Administer a single 0.5 mL dose.AdultsAdminister a single 0.5 mL dose.AdministrationThe preferred site for intramuscular injection is the deltoid muscle of the upper arm.CONTRAINDICATIONSAFLURIA is contraindicated in individuals with known severe allergic reactions (e.g., anaphylaxis), to any component ofthe vaccine including egg protein, or to a previous dose of any influenza vaccine (see Description [11]).WARNINGS AND PRECAUTIONSFever and Febrile SeizuresAdministration of CSL’s 2010 Southern Hemisphere influenza vaccine was associated with postmarketing reports ofincreased rates of fever and febrile seizures in children predominantly below the age of 5 years as compared to previousyears; these increased rates were confirmed by postmarketing studies. Febrile events were also observed in children 5to less than 9 years of age.Guillain-Barré Syndrome (GBS)Guillain-Barré Syndrome (GBS) has occurred following vaccination with AFLURIA. If GBS has occurred within 6 weeks ofprevious influenza vaccination, the decision to give AFLURIA should be based on careful consideration of the potentialbenefits and risks.Preventing and Managing Allergic ReactionsAppropriate medical treatment and supervision must be available to manage possible anaphylactic reactions followingadministration of the vaccine.Altered ImmunocompetenceIf AFLURIA is administered to immunocompromised persons, including those receiving immunosuppressive therapy, theimmune response may be diminished.Limitations of Vaccine EffectivenessVaccination with AFLURIA may not protect all individuals.ADVERSE REACTIONSIn children 5 through 17 years of age, the most common injection-site reactions observed in clinical studies with AFLURIAwere pain (≥60%), redness (≥20%) and swelling (≥10%). The most common systemic adverse events were headache,myalgia (≥20%), malaise and fever (≥10%).In adults 18 through 64 years of age, the most common injection-site adverse reactions observed in clinical studieswith AFLURIA were tenderness (≥60%) and pain (≥40%). The most common systemic adverse events observed wereheadache, malaise, and muscle aches (≥20%).In adults 65 years of age and older, the most common injection-site adverse reactions observed in clinical studies withAFLURIA were tenderness (≥30%) and pain (≥10%).Clinical Trials ExperienceBecause clinical studies are conducted under widely varying conditions, adverse reaction rates observed in the clinicalstudies of a vaccine cannot be directly compared to rates in the clinical studies of another vaccine and may not reflectthe rates observed in clinical practice.ChildrenIn clinical studies, AFLURIA has been administered to, and safety information collected for, 3,009 children ages 6 monthsto less than 18 years. Clinical safety data for AFLURIA in children is presented from three clinical studies (Studies 1, 2, and3). Data from a comparator-controlled trial (Study 1) are presented, followed by pooled data from two open label studies(Studies 2 and 3). Subjects 6 months through 8 years of age received one or two vaccinations as determined by previousvaccination history (for further details on clinical study design, dosing and demographics see Clinical Studies [14]).Study 1 included 1,468 subjects for safety analysis, ages 6 months to less than 18 years, randomized to receive AFLURIA(735 subjects) or another U.S.-licensed trivalent inactivated influenza vaccine (manufactured by Sanofi Pasteur, Inc.)(733 subjects).Study 2 included 1,976 subjects for safety analysis, ages 6 months to less than 18 years. All subjects received AFLURIA.Study 3 included 298 subjects for safety analysis, ages 6 months to less than 9 years. All subjects received AFLURIA.The safety assessment was similar for the three pediatric studies. Local (injection site) and systemic adverse eventswere solicited for 7 days post-vaccination (Tables 1 and 2 in the Prescribing Information). Unsolicited adverse eventswere collected for 30 days post-vaccination. All adverse events are presented regardless of any treatment causalityassigned by study investigators.Among the pediatric studies, there were no vaccine-related deaths or vaccine-related serious adverse events reportedin children 5 years of age and older.In the comparator-controlled trial (Study 1), the rate of fever after the first dose of AFLURIA in subjects aged 5 to lessthan 9 years was 16% as compared to 8% in subjects who received the comparator. The rate of fever in subjects aged9 to less than 18 years following a single dose of AFLURIA was 6% as compared to 4% in subjects who received thecomparator. In all three pediatric studies, the rates of fever in subjects aged 5 to less than 9 years who received AFLURIAwere lower after dose 2 than dose 1.The data below are presented for children 5 years and older.Proportion of Subjects 5 Through 17 Years of Age With Solicited Local or Systemic Adverse Events Within 7 DaysAfter First or Second Dose of AFLURIA, Irrespective of Causality (Study 1)The most common solicited adverse reactions (>20%) in Study 1 were pain, redness, myalgia, malaise, and headache(subjects aged 5 years to less than 9 years of age) and pain, myalgia, malaise, and headache (subjects aged 9 yearsto less than 18 years).Proportion of Subjects 5 Through 17 Years of Age With Unsolicited Adverse Events (Study 1)In Study 1, unsolicited adverse events that occurred in ≥5% of subjects who received AFLURIA in ages 5 years to lessthan 9 years following the first or second dose included cough (15%) and pyrexia (9%). Unsolicited adverse events thatoccurred in ≥5% of subjects who received AFLURIA in ages 9 years to less than 18 years following the first dose includedcough (7%), oropharyngeal pain (7%), headache (7%), and nasal congestion (6%).Proportion of Subjects 5 Through 17 Years of Age With Solicited Local or Systemic Adverse Events Within 7 DaysAfter Administration of AFLURIA, Irrespective of Causality (Studies 2 and 3)The most common solicited adverse reactions (>20%) in Studies 2 and 3 were pain and erythema (subjects aged 5 yearsto less than 9 years of age) and pain, headache, and general muscle ache (subjects aged 9 years to less than 18 years).Proportion of Subjects 5 Through 17 Years of Age With Unsolicited Adverse Events (Studies 2 and 3)In Studies 2 and 3, unsolicited adverse events that occurred in ≥5% of subjects ages 5 years to less than 9 years afterthe first or second dose included the following: upper respiratory tract infection (13%), cough (10%), rhinorrhea (7%),headache (5%), nasopharyngitis (5%) and pyrexia (5%). Unsolicited adverse events that occurred in ≥5% of subjectswho received AFLURIA in ages 9 years to less than 18 years following the first dose included upper respiratory tractinfection (9%) and headache (8%).AdultsIn clinical studies, a single dose of AFLURIA was administered to, and safety information collected for, 11,104subjects ages 18 to less than 65 years and 836 subjects ages 65 years and older. Clinical safety data for AFLURIAin adults are presented from three clinical studies (Studies 4 through 6). In all adult studies, there were novaccine-related deaths or vaccine-related serious adverse events reported.Study 4 included 1,357 subjects for safety analysis, ages 18 to less than 65 years, randomized to receive AFLURIA(1,089 subjects) or placebo (268 subjects) (see Clinical Studies [14]).Study 5 included 15,020 subjects for safety analysis, ages 18 to less than 65 years, randomized to receive AFLURIA(10,015 subjects) or placebo (5,005 subjects) (see Clinical Studies [14]).Study 6 included 1,266 subjects for safety analysis, ages 65 years and older, randomized to receive AFLURIA(630 subjects) or another U.S.-licensed trivalent inactivated influenza vaccine (manufactured by Sanofi PasteurSA) as an active control (636 subjects) (see Clinical Studies [14]).The safety assessment was identical for the three adult studies. Local (injection-site) and systemic adverseevents were solicited for 5 days post-vaccination (Table 3). Unsolicited adverse events were collected for 21days post-vaccination. All adverse events are presented regardless of any treatment causality assigned by studyinvestigators.Proportion of Subjects 18 Years of Age and Older With Solicited Local or Systemic Adverse Events Within 5Days After Administration of AFLURIA or Placebo, Irrespective of Causality (Studies 4, 5, and 6)In Studies 4, 5, and 6, the solicited local or systemic adverse events that occurred in ≥20% of subjects who receivedAFLURIA (regardless of causality) were as follows:Study 4: tenderness (pain on touching), pain without touching, headache, malaise.Study 5: tenderness (pain on touching), pain without touching, headache, malaise, muscle aches.Study 6: tenderness (pain on touching).Proportion of Adult Subjects With Unsolicited Adverse Events (Studies 4, 5, and 6)In Study 4, headache was the only unsolicited adverse event that occurred in ≥5% of subjects who received AFLURIAor placebo (8% versus 6%, respectively).In Study 5, headache was the only unsolicited adverse event that occurred in ≥5% of subjects who received AFLURIAor placebo (12% versus 11%, respectively).In Study 6, unsolicited adverse events that occurred in ≥5% of subjects who received AFLURIA included headache(8%), nasal congestion (7%), cough (5%), rhinorrhea (5%), and pharyngolaryngeal pain (5%).Postmarketing ExperienceBecause postmarketing reporting of adverse reactions is voluntary and from a population of uncertain size, it is notalways possible to reliably estimate their frequency or establish a causal relationship to vaccine exposure. The adversereactions described have been included in this section because they: 1) represent reactions that are known to occurfollowing immunizations generally or influenza immunizations specifically; 2) are potentially serious; or 3) have beenreported frequently. These adverse reactions reflect experience in both children and adults and include those identifiedduring post-approval use of AFLURIA outside the US since 1985.Blood and lymphatic system disordersTransient thrombocytopeniaImmune system disordersAllergic reactions including anaphylactic shock and serum sicknessNervous system disordersNeuralgia, paresthesia, and convulsions (including febrile seizures); encephalopathy, neuritis or neuropathy, transversemyelitis, and GBSVascular disordersVasculitis with transient renal involvementSkin and subcutaneous tissue disordersPruritus, urticaria, and rashAdverse Reactions Associated With Influenza VaccinationAnaphylaxis has been reported after administration of AFLURIA. Egg protein can induce immediate hypersensitivityreactions among persons who have severe egg allergy. Allergic reactions include hives, angioedema, asthma, andsystemic anaphylaxis (see Contraindications [4]).The 1976 swine influenza vaccine was associated with an increased frequency of GBS. Evidence for a causal relation ofGBS with subsequent vaccines prepared from other influenza viruses is unclear. If influenza vaccine does pose a risk, itis probably slightly more than one additional case per 1 million persons vaccinated.Neurological disorders temporally associated with influenza vaccination, such as encephalopathy, optic neuritis/neuropathy, partial facial paralysis, and brachial plexus neuropathy, have been reported.Microscopic polyangiitis (vasculitis) has been reported temporally associated with influenza vaccination.DRUG INTERACTIONSConcurrent Use With Other VaccinesThere are no data to assess the concomitant administration of AFLURIA with other vaccines. If AFLURIA is to be givenat the same time as another injectable vaccine(s), the vaccine(s) should be administered at different injection sites.AFLURIA should not be mixed with any other vaccine in the same syringe or vial.Concurrent Use With Immunosuppressive TherapiesThe immunological response to AFLURIA may be diminished in individuals receiving corticosteroid or immunosuppressivetherapies.USE IN SPECIFIC POPULATIONSPregnancyPregnancy Category B: A reproductive and developmental toxicity study has been performed in female rats at a doseapproximately 265 times the human dose (on a mg/kg basis) and revealed no evidence of impaired female fertility orharm to the fetus due to AFLURIA. There are, however, no adequate and well-controlled studies in pregnant women.Because animal reproduction studies are not always predictive of human response, AFLURIA should be given to apregnant woman only if clearly needed.In the reproductive and developmental toxicity study, the effect of AFLURIA on embryo-fetal and pre-weaningdevelopment was evaluated in pregnant rats. Animals were administered AFLURIA by intramuscular injection twiceprior to gestation, once during the period of organogenesis (gestation day 6), and once later in pregnancy (gestationday 20), 0.5 mL/rat/occasion (approximately a 265-fold excess relative to the projected human dose on a body weightbasis). No adverse effects on mating, female fertility, pregnancy, parturition, lactation parameters, and embryo-fetalor pre-weaning development were observed. There were no vaccine-related fetal malformations or other evidence ofteratogenesis.Nursing MothersAFLURIA has not been evaluated in nursing mothers. It is not known whether AFLURIA is excreted in human milk. Becausemany drugs are excreted in human milk, caution should be exercised when AFLURIA is administered to a nursing woman.Pediatric UseAFLURIA is not approved for use in children less than 5 years of age. In a clinical study in which children received AFLURIAor a US-licensed comparator vaccine (Study 1, see Clinical Trials Experience, [6.1]), the incidence of fever in children 6months to less than 3 years of age following the first and second doses of AFLURIA were 37% and 15%, respectively,as compared to 14% following each dose in the comparator group. Among children 3 years to less than 5 years of age,the incidence of fever following the first and second doses of AFLURIA were 32% and 14%, respectively, as comparedto 11% and 16% in the comparator. In an open-label study (Study 2), fever, irritability, loss of appetite, and vomiting/diarrhea occurred more frequently in children 6 months to less than 3 years of age as compared to older children. Acrossthree pediatric studies of AFLURIA (Studies 1, 2, and 3), 1.2% of eligible children (n=1,764) were discontinued from thesecond vaccination because of severe fever (≥104°F) within 48 hours of the first vaccination. Across the three pediatricstudies, two children, a 7-month old and a 3-year old, experienced vaccine-related febrile seizures (rate of 0.07% acrossstudies), one of which was serious.Administration of CSL’s 2010 Southern Hemisphere influenza vaccine was associated with increased rates of fever andfebrile seizures, predominantly in children below the age of 5 years as compared to previous years, in postmarketingreports confirmed by postmarketing studies (see Warnings and Precautions [5.1]).Geriatric UseIn clinical studies, AFLURIA has been administered to, and safety information collected for, 836 subjects ages 65 yearsand older (see Clinical Trials Experience [6.1]). After administration of AFLURIA, hemagglutination-inhibiting antibodyresponses in persons 65 years of age and older were lower as compared to younger adult subjects (see Clinical Studies [14]).HOW SUPPLIED/STORAGE AND HANDLINGPresentation: Carton NDC Number ComponentsPre-Filled Syringe 33332-012-01 Ten 0.5 mL single-dose syringes without needles [NDC 33332-012-02]Multi-Dose Vial 33332-112-10 One 5 mL vial, which contains ten 0.5 mL doses [NDC 33332-112-11]Store refrigerated at 2–8°C (36–46°F). Do not freeze. Discard if product has been frozen. Protect from light. Do not useAFLURIA beyond the expiration date printed on the label. Once the stopper of the multi-dose vial has been pierced, thevial must be discarded within 28 days.Manufactured by: CSL Limited, Parkville, Victoria, 3052, Australia, US License No. 1764Distributed by: Merck Sharp & Dohme Corp., a subsidiary of MERCK & CO., INC., Whitehouse Station, NJ 08889, USAAFLURIA is a registered trademark of CSL Limited. CSL Biotherapies is a division of CSL Limited.Copyright © 2012 Merck Sharp & Dohme Corp., a subsidiary of Merck & Co., Inc. All rights reserved.Updated as of 10/1222 InsideOut

PRebookNow FoR THe2013–2014 FLUSeASoNGET connected wITH AFLURIA ® (Influenza Virus Vaccine)Help meet your seasonal flu vaccination needs● Available in 2 presentations– Single-dose, pre-filledLuer-Lok syringes (preservative free)– Multi-dose vials● Latex free● Peel-off labels● To learn more, visit AFLURIA.comAbout AFLURIAAFLURIA is an inactivated influenza virus vaccine indicated for active immunization against influenza diseasecaused by influenza virus subtypes A and type B present in the vaccine. AFLURIA is approved for use inpersons 5 years of age and older.Select Safety InformationAFLURIA is contraindicated in individuals with known severe allergic reactions (eg, anaphylaxis) to anycomponent of the vaccine including egg protein, or to a previous dose of any influenza vaccine.Administration of CSL’s 2010 Southern Hemisphere influenza vaccine was associated with postmarketingreports of increased rates of fever and febrile seizures in children predominantly below the age of 5 yearsas compared to previous years; these increased rates were confirmed by postmarketing studies. Febrileevents were also observed in children 5 to less than 9 years of age.Guillain-Barré Syndrome (GBS) has occurred following vaccination with AFLURIA. If GBS has occurredwithin 6 weeks of previous influenza vaccination, the decision to give AFLURIA should be based on carefulconsideration of the potential benefits and risks.If AFLURIA is administered to immunocompromised persons, including those receivingimmunosuppressive therapy, the immune response may be diminished.Antibody responses in persons 65 years of age and older were lower after administration of AFLURIA ascompared to younger adult subjects.In children 5 through 17 years of age, the most common injection-site reactions observed in clinicalstudies with AFLURIA were pain, redness, and swelling. The most common systemic adverse events wereheadache, myalgia, malaise, and fever.In adults 18 through 64 years of age, the most common injection-site adverse reactions observed in clinicalstudies with AFLURIA were tenderness and pain. The most common systemic adverse reactions observedwere headache, malaise, and muscle aches.In adults 65 years of age and older, the most common injection-site adverse reactions observed in clinicalstudies with AFLURIA were tenderness and pain.Vaccination with AFLURIA may not protect all individuals.Please see the adjacent Brief Summaryof the Prescribing Information.AFLURIA is a registered trademark of CSL Limited.Copyright © 2012 Merck Sharp & Dohme Corp., a subsidiary of Merck & Co., Inc.All rights reserved. VACC-1050731-0001 11/12AFLURIA.COMASD Healthcare 23

in the spotlightOn January 1, 2014, the Patient Protection and Affordable Care Act goesinto full effect. While many of the provisions in the law are still unfolding, onething is certain – the Affordable Care Act (ACA) will touch all Americans. Itwill, however, touch us all in different ways.For approximately 30 million citizens, it means insurance coverage andaccess to preventative healthcare. For insurance providers, while it couldpotentially deliver some 30 million new customers to them; it also deliverednew policy regulations they have been implementing over the past threeyears. And for the nation, the ACA means one giant step toward slowing therapidly escalating growth in the cost of healthcare.Healthcare professionals stand at the center where these groups intersect– responsible for patient care, for incorporating payer changes, andfor the cost and care of the service they deliver. In the year ahead, InsideOutwill feature articles about the ACA implementation. These articles will coverthe big picture, as well as small details to help you better understand what’schanging, who it impacts and how you can help your patients and facilitymake the transition.24 InsideOut

57%A Health Tracking Poll conducted in March 2013 bythe Kaiser Family Foundation found that 57 percentof people surveyed believe they do not have sufficientinformation about the ACA to understand howit will impact them.Understanding the ACAThe ACA became a law for many reasons.Looking at those reasons gives us a wayto understand what the Act includes andwhy it does what it does.While insuring the uninsured wasa hotly debated talking point in theACA debate, the rapidly rising cost ofhealthcare, along with the recessionAmericans faced, may have been thebiggest motivators and reason the lawwas passed this time. Healthcare in theUnited States accounts for almost 20percent of our gross domestic productaccording to Forbes magazine. As anation, we pay twice as much as otherdeveloped countries. But as high as thecost is, the fact that those costs aregrowing at a faster rate than inflation,the increase in national income andthe economy has caused the greatestalarm. 1 The basic provisions of the lawseek to address these economic andnational issues – lowering healthcarecosts and slowing its growth while improvinghealthcare outcomes.The Basic BillThe complete ACA takes up 2,700 pages.But knowing what’s in those pages canbe simplified by looking at the 10 Titlesof the law shown here and how they connectto these key objectives: increasinghealthcare access, reducing healthcarecost and improving healthcare outcomes.1. Quality, affordable healthcare forall Americans (access)2. The role of public programs(access, cost and quality)3. Improving the quality and efficiencyof healthcare (quality)4. Prevention of chronic disease andimproving public health (cost and quality)5. Healthcare workforce (access)6. Transparency and program integrity(cost and quality)7. Improving access to innovative medicaltherapies (access, cost and quality)8. Community Living Assistance Servicesand Support Act (CLASS ACT, abandonedOct. 2011)9. Revenue provisions (cost)10. Reauthorization of the Indian Health CareImprovement Act (access, cost and quality)The RolloutSince its signing, different aspects of theACA have gone into effect – most of whichhave impacted insurance companies andbenefited citizens. Each implementationrepresents a part of a careful rolloutleading up to the implementation of themajority of the law in January 2014. Thefollowing timeline shows how the Act hasunfolded over the last three years.To read the full law, visit www.healthcare.gov/law/full/index.html.ASD Healthcare 25

85%With the ACA, 85 percent of each health insurance dollar mustbe spent on healthcare services and quality improvements.2010 The first provisionsimplemented in the ACA expanded accessto Medicaid coverage for low-income individualsand families who previouslyhad not qualified for the program. Otherprovisions were outlined in the Patient’sBill of Rights. The Bill works to give consumersthe control they need over theirown healthcare. This was achieved bystipulating the coverage insurance companieswould need to change or include in thepolicies they offer. These key changeswent into effect September 23, 2010 in thePatient’s Bill of Rights.»»Coverage for Americans with pre-existingconditions»»Coverage for free preventative care withno copayment»»Coverage for young adults on their parent’spolicy until age 26»»The end of lifetime limits on coverage,pre-existing conditions exclusions forchildren and arbitrary cancelation ofcoverageYou can go to http://www.healthcare.gov/law/features/rights/bill-of-rights/index.html to read all of the provisions in thePatient’s Bill of Rights.Once the ACA was passed, tax incentivesfor small businesses went into effect tohelp employers provide health insuranceto their employees in 2014. Work alsobegan on the creation of healthcare exchangesand new incentives were addedto expand the number of doctors, nursesand physician’s assistants in the primarycare workforce to serve the needs of themillions of new healthcare patients. Thisprovision includes scholarship fundingand loan repayment or forgivenessto increase the number of primary careprofessionals and encourage service inunderserved areas. Funding to supportand expand services at community healthcenters also went into effect to help meetthe needs of the newly insured.Stakeholders began building the foundationsfor several initiatives designed toimprove the health of Americans and ourhealthcare outcomes. The Prevention andPublic Health Fund was launched with$15 billion to invest in keeping Americanshealthy through programs aimed atpreventing health problems caused bylifestyle, such as smoking and obesity.Included in the ACA is a plan to reducecost and improve outcomes throughAccountable Care Organizations (ACO).The Department of Health and HumanServices (HHS) began drafting guidelinesfor the creation of these organizationswhen the ACA was passed. The goal isto coordinate the care of Medicare andMedicaid patients and to encouragehealthcare improvements by linking costto outcomes. According to the Centers forMedicare and Medicaid Services (CMS)two out of three Americans over 65 havemultiple chronic conditions. Coordinatingthe care for these patients could potentiallysave about $960 million over athree-year period. 2“New incentives were addedto expand the number ofdoctors, nurses and physician’sassistants in the primary careworkforce. This provisionincludes scholarship fundingand loan repayment orforgiveness to increase thenumber of professionalsand encourage service inunderserved areas.”Where are we now?What’s ahead throughout 2013? Plenty. Thiswill be the year of final approvals, checks anddouble-checks before millions of Americanssign up for health insurance for the first time inOctober. Here’s a preview of the year leadingup to the final implementation of the ACA inJanuary 2014.January»»Medicaid payment rates for primary careno less than 100% of Medicare 2013 and2014 rates»»Deduction for cost of retiree drug coverageoffset by Medicare Part D subsidy eliminated»»State-based Health Exchanges (SBE) approvedor conditionally approved by HHS»»Employers must notify employees of thehealth insurance exchanges and availablecoverage optionsFebruary»»Administrative simplification begins»»Final deadline for states to submit their federalpartnership plans to HHS for ExchangesApril»»Final regulations for Medicaid and premiumtax credit eligibility, appeals, cost sharingand premium support requirements andbenchmark benefit plan requirements»»Final rules from the Department of Treasuryoutlining individual mandate requirements26 InsideOut

NavigatorsHow does a nation get millions of Americans signed up for health coverage?You enlist the help of Navigators. That’s what the ACA calls the non-profitorganizations that received grants in June to help make enrollment a success.2011 The big implementationfocus in 2011 was on provisions that couldimprove the quality of healthcare whilelowering the costs for enrollees in governmenthealthcare programs – Medicare,Medicaid and CHIP (Children’s HealthInsurance Program). Most of these provisionswent into effect in January 2011.»»Additional prescription drug discounts tohelp seniors cover the gap in MedicarePart D coverage»»Free services to seniors for preventive care,wellness care and prevention plans»»Community Care Transition Program implementedto help high-risk Medicare recipientsavoid unnecessary hospital readmission»»Greater access to home-care servicesthrough the Community First Choice Option,which allows states to offer communityservices to disabled individuals insteadof institutional care in nursing homes(effective October 1, 2011)»»Center for Medicare & Medicaid Innovationestablished to start testing new ways toimprove healthcare and reduce costs ingovernment healthcare programsIn the private sector, the 85 percent rulewent into effect on January 1, 2011 requiringprivate insurance companies to spendthat percentage of premium dollars onhealthcare services or initiatives that improvehealthcare quality.There was an additional provision toaddress overpayment to insurance companiesfor Medicare Advantage plans.Originally, the plan was to cut 2.2 percentfrom these programs. According to CMS,that plan has been amended and will nowprovide a 3.3 percent increase to MedicareAdvantage.2012 While the list of implementationsfor 2012 is shorter, themeasures it put into place bring the ACAcloser to its goal of linking payment toquality healthcare outcomes in governmentprograms.»»ACO incentives to physicians to encourageintegrated health systems (January 1, 2012)»»Hospital Value-Based Purchasing program(VBP) established for Traditional Medicareto offer financial incentives for improvedquality of care in hospitals (October 1, 2012)»»Paperwork and administrative cost reductionthrough electronic health records. Whilemost businesses were moving into thedigital age in the late 1980s, the healthcarebusiness continued to rely on paper records.By moving the healthcare industry intothe electronic age, this provision aims tostreamline administrative tasks, lower costsand reduce errors. (October 1, 2012)2014What’s next? Implementation 2014»»Medicaid expansion»»State exchanges established»»Individual mandate and subsidies»»Employer requirements»»Small business subsidies»»Insurance market reforms fully implemented»»Medicaid 100 percent federal match to statesNext in InsideOutWhat’s in? What’s out? Find out the changesthe ACA could bring to healthcare. Watch forour next feature in the next InsideOut.Summer»»Health Insurance Exchange websitesoperational»»HHS and State Exchanges review QualifiedHealth Plan (QHP) ratesJune»»Navigator grants awardedJuly»»Consumer Operated and Oriented Plannon-profit, member-run health insurancecompanies beginOctober»»Open enrollment for plans in health insuranceexchanges (October 1, 2013 – March31, 2014)References:1. Cost and Spending, the Kaiser Family Foundation athttp://www.kaiseredu.org/Topics/Costs-and-Spending.aspx?p=12. Need for and Benefits of Coordinated, Accountable Care FactSheet, HealthCare.gov at3. http://www.healthcare.gov/news/factsheets/2011/03/accountablecare03312011a.htmlSources:1. Health Reform Source, the Kaiser Family Foundation athttp://healthreform.kff.org/timeline.aspx2. Key Features of the Affordable Care Act, by Year, HealthCare.gov at http://healthcare.gov/law/full/index.html3. Hixon, Todd, The U.S. Does Not Have a Debt Problem … It hasa Health Care Cost Problem, Forbes magazine at http://www.forbes.com/sites/toddhixon/2012/02/09/the-u-s-does-nothave-a-debt-problem-it-has-a-health-care-cost-problem/print/4. Health Care that Works for Americans, White House website athttp://whitehouse.gov/healthcare-overview5. CMS Ensures Greater Value for People in Medicare Drug andHealth Plan, Center for Medicare and Medicaid Services athttp://www.cms.gove/apps/media/press/release.asp?ASD Healthcare 27

in the spotlightMaking History TogetherASD Healthcare celebrates our first 20 years.With breakthroughs every day, things can change pretty fast in healthcare.That’s one reason it’s hard to believe specialty distributors didn’t evenexist twenty years ago. Today, they’re a well-developed resource healthcarefacilities depend on. But when Bergen Brunswig Drug Company carved out a cornerof space in its warehouse to office Alternate Site Distributors (ASD), the businessof specialty distribution was nothing more than a vision.That was 20 years ago. ASD Healthcare is now one of the largest specialty pharmaceuticaldistributors of plasma derivatives and nephrology products. We’d like tocelebrate this milestone with you by taking a moment to look back on the commonhistory those of us in healthcare all share. See if you recognize some of the manychanges we have been fortunate to experience together.“Our markets were so new,so undefined, that we feltthere was a chance for usto have a greater role inhealthcare than just beinga traditional distributor.”- Steve Collis, President of AmerisourceBergenCorporation, Executive Vice President of AlternateSite Distributors in 19931993 December 2, ASD makes its first sale as thenewly formed subsidiary of Bergen Brunswig DrugCompany. Its mission? Make specialty purchasingeasier for oncology and renal communities.1995 ASD establishes a plasma division to helphealthcare providers secure albumin during theshortage created by the first Gulf War.1996 ASD makes same-day emergency and dailydeliveries a new option for customers by moving itsdistribution center to Louisville, Kentucky, closer tocourier hubs.Oncology Supply, an industry expert in servingindependent oncology practices, is acquiredby ASD.1997 The Company expands its customer baseto include health systems. As a result, the meaningof ASD is changed from Alternate Site Distributors toAdvanced Specialty Distribution to reflect the company’sproduct line and customers.1998 ASD expands its services and options withthe acquisition of Besse Medical, a vaccine distributionspecialist with expertise in distribution to physicianpractices.ASD launches its first practice-management system,Converge, to provide integrated clinical services andinformation technology to oncology practices.ASD creates ASD Direct, to deliver specialty pharmaceuticalsstraight to patients.2000 ASD enters the new millennium with thenext generation in computer enterprise systems.The design goes beyond state-of-the-art, makingASD the first distributor with the ability to track bylot number and retrieve data per customer needs.2001 Bergen Brunswig Drug Company mergeswith AmeriSource Health Company to formAmerisourceBergen and the AmerisourceBergenSpecialty Group comprised of a family of specialtycompanies, including ASD Healthcare.ASD Healthcare immediately dispatches trucksstocked with albumin to relief staging sites afterseeing the news of the 9 / 11 attacks.2003 ASD Healthcare adds flu vaccine distributionservices, giving health systems greater options andselection.2004 To protect the supply chain and customersfrom counterfeit drugs, ASD Healthcare takes thelead by developing a web-based pedigree trackand-tracesystem.2005 Brooks, Kentucky distribution center opens,expanding ASD Healthcare’s warehouse space by102,000 square feet.In the wake of Hurricane Katrina, ASD Healthcaresends life-saving medications to relief staging sites.2006 Reno, Nevada distribution center opensclose to major shipping hubs, adding a 43,500square foot redundant facility and enhancing servicesto customers in the Western United States.2007 ASD Healthcare innovates the new Cubixxfactor consignment system, launching it to healthcareand hemophilia centers.2009 Nucleus Inventory Management Systemintroduced to automate the dispensing and drugtracking process throughout an oncology practice.2010 ASD Healthcare launches True Blue to reflectthe company’s high level of service commitmentto our customers and the patients they serve.2011 ASD Healthcare introduces the Depot Modelto give patients on-demand access to high-cost,high-risk medications, while giving manufacturerscritical, real-time usage data they need.2012 As with all natural disasters, ASD Healthcareand our associates come together to support victimsof Hurricane Sandy, including our coworkers inthe northeast.ASD Healthcare receives a patent for Cubixx ® andapplies for a patent for myCubixx ® , an in-home factorsolution that helps improve compliance, tracking andoutcomes for hemophilia patients.2013 ASD Healthcare celebrates 20 years ofservice with a tagline that captures our unwaveringfocus – Your patients. Your purpose. Our priority.28 InsideOut

Specialty ThenSpecialty NOWProduct deliveries only four days a week Emergency orders delivered in hours – any dayPhone orders during business hours only Online ordering 24/7/365what’s in a name?1993Launched as Alternate Site Distributors, the namereflected the type of healthcare customer servedby this new distribution idea.Multiple manufacturers to order fromMultiple suppliers – multiple billsData reporting available after 30 daysHow True Blue Comes ThroughFrom the beginning, ASD Healthcare heldthe highest standards in the service wedelivered and the commitment we madeto our customers and their patients.In 2010, ASD Healthcare gave thisenduring culture a name – True Blue. It’sa name we all understand as loyal, dedicated,someone you can always depend onto come through. ASD Healthcare demonstratesthis culture in the level of servicewe deliver, in our support of the advocacygroups that serve our patient communitiesand in the role we play in shaping healthcarelegislation, like the Medicare IVIGAccess Act.While much has changed in thelast 20 years, one thing is certain – ASDHealthcare’s True Blue culture will remainthe same and will continue to comethrough for the communities we serve.One-stop shop for all specialty needsOne company – one billData reporting available in real timeA Victory for PIDDNeil Herson, ASD Healthcare President,with Carol Ann Demaret, the motherof the immune deficiency patient whobecame known as The Boy in the Bubblein the mid-70s. Both were on CapitolHill to celebrate the successful passingof the Medicare IVIG Access Act theysupported.ALTERNATE SITE DISTRIBUTORSA Subsidiary of Bergen Brunswig Drug Company1996The second ASD logo with the caduceus helpedto strengthen and communicate the company’shealthcare branding.A Subsidiary of Bergen Brunswig Drug Company1997As the company’s customer base expands to healthsystems, ASD is given a new meaning – AdvancedSpecialty Distribution – and Specialty Healthcare isadded to the acronym to better reflect the company’sdistribution expertise.1999The logo is given a fresher look.Share Your HistoryDo you have any stories about ASD Healthcare or about how things have changed in specialty healthcare inthe past 20 years? We’d love to hear them and create a history to share with our readers. Just email yourmemories to marketing@asdhealthcare.com.2005With the formation of AmerisourceBergen Corporationand the creation of AmerisourceBergen Specialty Group,ASD Healthcare adopts a new logo that simplifies itsname and includes the new corporate branding.ASD Healthcare 29

30 InsideOut

Be aLifesaver.24-hour on-call accessTrue Blue customer serviceInnovative solutionsMore product options from one sourceDedicated, knowledgeable account managersTwenty years ago, asD Healthcare made a choice. Because our business woulddeliver medications that saved lives, we set our standards high – for the optionswe offered, the products we provided and the service we delivered. We knewevery detail of our business had to go above and beyond expectation so we couldbe the lifesaving support our customers and their patients needed. Be a lifesaver.it was an easy choice to make – one asD Healthcare plans to follow into our next20 years of service to the healthcare community.ASD Healthcare – making your patients and your purpose our priority for 20 years.3101 Gaylord ParkwayFrisco, Texas 750341.800.746.6273www.asdhealthcare.comASD Healthcare 31

in the spotlightAdvocacyConnectionTheEvery day, nonprofit organizations work to improve patients’ lives. ASD Healthcaresupports a range of these advocacy groups, including the ones featured here.We hope this list helps you discover and connect with the ones that can makea difference to you and the patients you serve.alpha-1foundation.orgtheevanfoundation.orgThe Alpha-1 Foundation is dedicated to providing theleadership and resources that will result in increasedresearch, improved health, worldwide detection and acure for Alpha-1.2937 SW 27th Ave, Suite 302Miami, FL 33133877.228.7321The Evan’s Victory Against Neuroblastoma (EVAN)Foundation supports research that will foster newtherapeutic options for kids currently in treatment for thisunderfunded cancer.19308 Penrod TerraceGermantown, MD 20874jmfworld.comneuropathyaction.orgThe Jeffery Model Foundation dedicates its efforts tothe early diagnosis, treatments and, ultimately, curesfor primary immunodeficiency diseases.780 Third AvenueNew York, NY 10017212.819.0200The Neuropathy Action Foundation helps neuropathypatients obtain the resources, information and toolsneeded to access individualized treatment that canimprove their quality of life.1304 S. Roxbury Drive, #303Los Angeles, CA 90035877.512.7262neuropathy.orgsaveonelife.netThe Neuropathy Association provides patient support andeducation, advocates for patients, and supports criticalresearch. It has a nationwide network of 135 support groupsand 15 neuropathy centers at prominent medical institutions.60 E 42nd Street, Suite 942New York, NY 10165212.692.0662Save One Life offers a bridge of hope for hemophiliapatients in developing countries by providing peoplein developed countries sponsorship opportunities foras little as $20 a month.68 East Main Street, Suite 204Georgetown, MA 01833978.352.765232 InsideOut

The Power of FVIII/VWF ComplexConvenient Room Temperature StorageFirst FVIII/VWF product in the US stable for 3 years, up to the expiration date printed,when stored at or below 77°F (25°C). Do not freeze.Please see brief summary of Alphanate ® Full Prescribing Information below.HIGHLIGHTS OF PRESCRIBING INFORMATIONThese highlights do not include all the information needed to use Alphanate AntihemophilicFactor/von Willebrand Factor Complex (Human) safely and effectively. See FullPrescribing Information for Alphanate.ALPHANATE (ANTIHEMOPHILIC FACTOR/VON WILLEBRAND FACTOR COMPLEX [HUMAN])Sterile, lyophilized powder for injectionFor Intravenous Use OnlyInitial U.S. Approval: 1978INDICATIONS AND USAGEAlphanate is an Antihemophilic Factor/von Willebrand Factor Complex (Human) indicatedfor:• Control and prevention of bleeding in patients with hemophilia A.• Surgical and/or invasive procedures in adult and pediatric patients with vonWillebrand Disease in whom desmopressin (DDAVP) is either ineffective orcontraindicated. It is not indicated for patients with severe VWD (Type 3) undergoingmajor surgery.CONTRAINDICATIONS• Patients who have manifested life-threatening immediate hypersensitivity reactions,including anaphylaxis, to the product or its components.WARNINGS AND PRECAUTIONS• Anaphylaxis and severe hypersensitivity reactions are possible. Should symptomsoccur, treatment with Alphanate should be discontinued, and emergency treatmentshould be sought.• Development of activity-neutralizing antibodies has been detected in patients receivingFVIII containing products. Development of alloantibodies to VWF in Type 3 VWD patientshave been occasionally reported in the literature.• Thromboembolic events may be associated with AHF/VWF Complex (Human) in VWDpatients, especially in the setting of known risk factors.• Intravascular hemolysis may be associated with infusion of massive doses of AHF/VWFComplex (Human).• Rapid administration of a FVIII concentrate may result in vasomotor reactions.• Plasma products carry a risk of transmitting infectious agents, such as viruses, andtheoretically, the Creutzfeldt-Jakob disease (CJD) agent, despite steps designed toreduce this risk.ADVERSE REACTIONSThe most frequent adverse events reported with Alphanate in > 5% of patients arerespiratory distress, pruritus, rash, urticaria, face edema, paresthesia, pain, fever, chills,joint pain and fatigue.To report SUSPECTED ADVERSE REACTIONS, contact Grifols Biologicals Inc. at1-888-GRIFOLS (1-888-474-3657) or FDA at 1-800-FDA-1088 or www.fda.gov/medwatch.USE IN SPECIFIC POPULATIONS• Pregnancy: No human or animal data. Use only if clearly needed.• Labor and Delivery: No human or animal data. Use only if clearly needed.• Nursing Mothers: No human or animal data. Use only if clearly needed.• Pediatric Use: Clinical trials for safety and effectiveness in pediatric hemophilia Apatients have not been conducted. The hemostatic efficacy of Alphanate has beenstudied in 20 pediatric subjects with VWD 18 years of age and under. Based on the datafrom a subset of these subjects, age had no effect on the pharmacokinetics of VWF:RCo.• Geriatric Use: No human or animal data. Use only if clearly needed.For more information: Grifols Inc.Customer Service: 888 325 8579 Fax: 323 441 7968© 2012 Grifols Biologicals Inc. All rights reserved. Printed in USA. January 2012 A803-0911Grifols Biologicals Inc.5555 Valley Boulevard, Los Angeles, 90032 CA - USA Tel. 888-GRIFOLS (888 474 3657)www.grifolsusa.comASD Healthcare 33

Privigen ®Immune Globulin Intravenous (Human),10% LiquidInitial U.S. Approval: 2007BRIEF SUMMARY OF PRESCRIBING INFORMATIONThese highlights do not include all the information needed to use Privigensafely and effectively. See full prescribing information for Privigen.WARNING: ACUTE RENAL DYSFUNCTION/FAILURESee full prescribing information for complete boxed warning.• Renal dysfunction, acute renal failure, osmotic nephropathy, and deathmay occur with the administration of human immune globulin intravenous(IGIV) products.• Renal dysfunction and acute renal failure occur more commonly in patientsreceiving IGIV products that contain sucrose. Privigen does not containsucrose.• For patients at risk of renal dysfunction or renal failure, administerPrivigen at the minimum infusion rate practicable.------------------------------------INDICATIONS AND USAGE----------------------------------Privigen is an Immune Globulin Intravenous (Human), 10% Liquid indicated for thetreatment of:• Primary humoral immunodefi ciency (PI)• Chronic immune thrombocytopenic purpura (ITP)-------------------------------DOSAGE AND ADMINISTRATION-----------------------------Intravenous Use OnlyIndication Dose Initial InfusionRateMaintenance InfusionRate (if tolerated)PIITP200-800 mg/kg(2-8 mL/kg)every 3-4 weeks1 g/kg (10 mL/kg) for2 consecutive days0.5 mg/kg/min(0.005 mL/kg/min)0.5 mg/kg/min(0.005 mL/kg/min)Increase to 8 mg/kg/min(0.08 mL/kg/min)Increase to 4 mg/kg/min(0.04 mL/kg/min)• Ensure that patients with pre-existing renal insuffi ciency are not volume depleted, anddiscontinue Privigen if renal function deteriorates.• For patients at risk of renal dysfunction or thrombotic events, administer Privigen atthe minimum infusion rate practicable.--------------------------------DOSAGE FORMS AND STRENGTHS-------------------------Privigen is a liquid solution containing 10% IgG (0.1 g/mL).---------------------------------------CONTRAINDICATIONS -----------------------------------• History of anaphylactic or severe systemic reaction to human immune globulin• Hyperprolinemia (Privigen contains the stabilizer L-proline)• IgA-defi cient patients with antibodies to IgA and a history of hypersensitivity------------------------------WARNINGS AND PRECAUTIONS-------------------------------• IgA-defi cient patients with antibodies to IgA are at greater risk of developing severehypersensitivity and anaphylactic reactions.• Monitor renal function, including blood urea nitrogen and serum creatinine, and urineoutput in patients at risk of developing acute renal failure.• Thrombotic events may occur. Monitor patients with known risk factors forthrombotic events; consider baseline assessment of blood viscosity for those at risk ofhyperviscosity.• Hyperproteinemia, increased serum viscosity, and hyponatremia may occur.• Aseptic meningitis syndrome (AMS) may occur, especially with high doses or rapidinfusion.• Hemolysis that is either intravascular or due to enhanced red blood cell sequestrationcan develop subsequent to Privigen treatments. Risk factors for hemolysis include highdoses and non-O blood group. Closely monitor patients for hemolysis and hemolyticanemia.• Monitor patients for pulmonary adverse reactions (transfusion-related acute lung injury[TRALI]).• Carefully consider the relative risks and benefi ts before prescribing the high doseregimen (for chronic ITP) in patients at increased risk of thrombosis, hemolysis, acutekidney injury, or volume overload.• Privigen is made from human blood and may contain infectious agents, e.g., virusesand, theoretically, the Creutzfeldt-Jakob disease (CJD) agent.------------------------------------ADVERSE REACTIONS-------------------------------------• PI – The most common adverse reactions, observed in >5% of study subjects, wereheadache, pain, nausea, fatigue, chills, vomiting, joint swelling/effusion, pyrexia, andurticaria. Serious adverse reactions were hypersensitivity, chills, fatigue, dizziness, andincreased body temperature.• Chronic ITP – The most common adverse reactions, observed in >5% of studysubjects, were headache, pyrexia/hyperthermia, positive direct antiglobulin test (DAT),anemia, vomiting, nausea, bilirubin conjugated increased, bilirubin unconjugatedincreased, hyperbilirubinemia, and blood lactate dehydrogenase increased. A seriousadverse reaction was aseptic meningitis.To report SUSPECTED ADVERSE REACTIONS, contact CSL BehringPharmacovigilance at 1-866-915-6958 or FDA at 1-800-FDA-1088 orwww.fda.gov/medwatch.----------------------------------DRUG INTERACTIONS---------------------------------------The passive transfer of antibodies may:• Lead to misinterpretation of the results of serological testing.• Interfere with the response to live virus vaccines.----------------------------USE IN SPECIFIC POPULATIONS---------------------------------• Pregnancy: No human or animal data. Use only if clearly needed.• In patients over age 65 or in any patient at risk of developing renal insuffi ciency,do not exceed the recommended dose, and infuse Privigen at the minimum ratepracticable.Based on February 2013 revision.34 InsideOut

LargestVial SizeAvailable!40 gA new measure ofconvenience in IVIg therapyPrivigen 40 gReady-to-use 10% IVIg liquidSimple choice• Provides the largest vial size of IVIg availableSimple storage• Provides more grams in less space…for more efficient storageSimple administration• Reduces the number of vials to open and handle for infusions of 40 g or moreTo order Privigen 40 g,contact your distributor orCSL Behring representative.NDC 44206-439-40Important Safety InformationPrivigen is indicated as replacement therapy for patients with primary immunodeficiency (PI) associated with defects in humoral immunity, including but not limited to common variable immunodeficiency(CVID), X-linked agammaglobulinemia, congenital agammaglobulinemia, Wiskott-Aldrich syndrome, and severe combined immunodeficiencies. Privigen is also indicated to raise platelet counts in patientswith chronic immune thrombocytopenic purpura (ITP).WARNING: Use of Immune Globulin Intravenous (IVIg) products, particularly those containing sucrose, have been associated with renal dysfunction, acute renal failure, osmoticnephropathy, and death. Privigen does not contain sucrose. Administer Privigen at minimum rate practicable in patients at risk of renal dysfunction or acute renal failure.At-risk patients include those with preexisting renal insufficiency, diabetes mellitus, volume depletion, sepsis, or paraproteinemia; over 65 years of age; or receiving knownnephrotoxic drugs. See full prescribing information for complete boxed warning.Privigen is contraindicated in patients with history of anaphylactic or severe systemic reaction to human immune globulin, in patients with hyperprolinemia, and in IgA-deficient patients with antibodies toIgA and history of hypersensitivity.Monitor patient vital signs throughout infusion of Privigen. In cases of severe hypersensitivity or anaphylactic reactions, discontinue administration and institute appropriate medical treatment. In patientsat risk for developing renal failure, monitor urine output and renal function, including blood urea nitrogen and serum creatinine. Thrombotic events have occurred in patients with risk factors; considerbaseline assessment of blood viscosity for those at risk of hyperviscosity.Patients could experience increased serum viscosity, hyperproteinemia or hyponatremia; infrequently, aseptic meningitis syndrome (AMS) may occur (most often with high doses and/or rapid IVIg infusion).Hemolysis that is either intravascular or due to enhanced red blood cell sequestration can develop subsequent to treatment with Privigen. Closely monitor patients for hemolysis and hemolytic anemia. Riskfactors for hemolysis include non-O blood group, underlying inflammation, and high doses. Carefully consider relative risks and benefits before prescribing high-dose regimen for chronic ITP in patients atincreased risk of thrombosis, hemolysis, acute kidney injury or volume overload.Monitor patients for pulmonary adverse reactions and signs of transfusion-related acute lung injury (TRALI).Privigen is derived from human plasma. The risk of transmission of infectious agents, including viruses and, theoretically, the Creutzfeldt-Jakob disease (CJD) agent, cannot be completely eliminated.In clinical studies of patients being treated with Privigen for PI, the most serious adverse reaction was hypersensitivity (one subject). Adverse reactions observed in >5% of subjects with PI were headache,pain, nausea, fatigue, chills, vomiting, joint swelling/effusion, pyrexia, and urticaria.In clinical studies of patients being treated with Privigen for chronic ITP, the most serious adverse reactions were AMS (one subject) and hemolysis (eight subjects). Adverse reactions seen in >5% ofsubjects with chronic ITP were headache, pyrexia/hyperthermia, positive DAT, anemia, vomiting, nausea, increases in conjugated and unconjugated bilirubin, hyperbilirubinemia, and increased bloodlactate dehydrogenase.Treatment with Privigen might interfere with a patient’s response to live virus vaccines and could lead to misinterpretation of serologic testing.Please see brief summary of prescribing information for Privigen on adjacent page.Privigen is manufactured by CSL Behring AG and distributed by CSL Behring LLC.Privigen is a registered trademark of CSL Behring AG.©2013 CSL Behring LLC1020 First Avenue, PO Box 61501, King of Prussia, PA 19406-0901 USAwww.CSLBehring-us.com www.Privigen.com PVG13-04-0018 4/2013ASD Healthcare 35

CommunityBenefitsPreserving Access toCommunity Oncology Practices36 InsideOut

As early as the 1970s, outpatientoncology practices have been thecornerstone of oncology care, providingstate-of-the-art facilities andmultidisciplinary approaches to oncologypatient management and clinical research. 1Often designed as a comprehensive healthcareunit, these centers provide a largevolume of cancer care. Today, nearly84 percent of all cancer patients are treatedin community cancer settings. Across thecountry, however, those community-basedpractices are facing challenges that impactpatient access to care – and potentiallyclinical outcomes.Outpatient oncology practices providebenefits to patients, and to the entirehealthcare system, by delivering a safeand cost-effective alternative to hospitalcare. These community oncology centersgrant patients easy access to sites ofcare and individualized treatment plansthat maximize convenience to patientsat a lower cost to the healthcare system.“Nearly 84 percent of allcancer patients are treated incommunity cancer settings.Across the country, however,those community-based practicesare dealing with a numberof challenges that impact patientaccess to care – and potentiallyclinical outcomes.”In practice, the benefit of community oncologycenters is increasingly understoodas a conduit to provide efficient, patientcenteredoncology care at lower costs topatients, health plans and communityphysicians. The advantages of communityoutpatient chemotherapy are significantand include: 2»»Safe, easy drug administration»»Respect for patient’s wish to avoidhospitalization»»Familiar facility that enhancespatient’s comfort and psychologicalwell-being»»Oncologist has direct and immediatecontrol of administration ofchemotherapy»»Overnight stays and expenses avoided»»Simplified tracking and control oftreatment costs»»Treatment administration at patient’sconvenienceThere are two primary entities drivingoncology care today: hospital outpatientcenters and private community clinics.According to the American Society ofClinical Oncology’s definition of privatecommunity clinics, these are privatelyowned,community-based oncology centersthat specifically have office space asa direct cost to the physician (paid, leasedor rented) and not typically in a hospitaloutpatient department (HOPD) area.Within private community oncology centers,nurses who administer care are employedby physicians. Supplies and equipmentalso represent a direct cost to thephysician. 3,4Conversely, a hospital-based outpatientdepartment or HOPD is defined as aclinic providing oncology outpatient servicesunder the hospital’s general acutecarelicense as issued by the respective“Since 2004, Medicarereimbursement in this settinghas fallen by 35 percent.In addition, the Medicaresustainable growth ratepayment system has createdadditional pressures oncommunity practices.”state. The clinic may be located on or offthe main grounds of a hospital but mustbe owned and operated by a hospital orsystem.Although essential to the oncologycommunity, the private community clinicmodel has faced many challenges due tothe Centers for Medicare and MedicaidServices (CMS) implementing significantcuts in reimbursement to private communitycenters. Since 2004, Medicarereimbursement in this setting has fallenby 35 percent. 5 In addition, the Medicaresustainable growth rate (SGR) paymentsystem has created additional pressureson community practices.Other concerns to private communitypractices are the new CMS quality andperformance requirements. In addition,340B drug pricing policies allow hospitalclinics full reimbursement for pharmaceuticalsacquired at 340B-discountedprices. 6Due to these changes, the communityoncology landscape is shifting. Privatepractices are closing or entering into jointventures or ownership models with hospitals.7,8 A 2010 Community OncologyAlliance study of 1,254 clinics and practicesdemonstrated significant changesin the financial performance of communityphysician-based oncology clinics andthe resulting impact on the marketplace.There has been a 21 percent increase inthe number of physician-owned clinicsclosing and a 20 percent increase in thenumber of practices that are strugglingfinancially.ASD Healthcare 37

21% numberincreasein theof physician-owned communityoncology clinics thatare closing.And consolidation of practice sitescontinues; of the 1,254 private communityoncology practices in the study, 392 practiceswere purchased by hospitals and 132practices had merged or were acquired bya corporate entity. 9 It is documented thatoncology consolidation will increase costsand create treatment access problemsfor cancer patients – especially in ruralareas. 7,9,10Although the provider landscape inoncology is rapidly changing, payers putthe cost of other aspects of oncology carebefore the movement from communitybasedcare to hospital-affiliated practices.However, the priorities for payers are stillcost drivers, such as the cost of hospitalizationsor the cost of high-priced productsas shown in Figure 1-1. 11Considering the increased focusby payers on the high price of new drugproducts and the cost of hospitalizationsshown in Figure 1-1, several independentresearchers have assessed the impact ofcare in hospital-owned outpatient clinicsversus private community outpatientpractices. An analysis of three years ofcommercial health-plan data revealed thatoncology patients treated in an HOPDare more costly to manage, regardless ofepisode length, and patients have higherhospitalization rates. The average cost foroffice-managed chemotherapy episodeslasting one month or more was $7,350versus $9,903 for HOPD-managed chemotherapy.A chemotherapy episode was definedas the duration between the first andlast date of chemotherapy being administeredto a patient. Compared with patientsmanaged in a community office-based setting,the average cost per chemotherapyepisode was 24 percent higher for HOPDpatients across the most common types ofcancer. 9When hospitalization rates and thesite of chemotherapy delivery were considered,14 out of 100 patients had at leastone hospitalization during their chemotherapyepisode in the hospital outpatientsetting versus 11 out of 100 patients whoreceived treatment in the office-managedsetting. 9When reviewing the overall distributionof office-managed patients receivingchemotherapy versus HOPD-managedPercentage of Payers Per Priority LevelP100%90%80%70%60%50%40%30%20%10%Payer Priorities in OncologyPriority #1High-pricednew productsPriority #2Cost ofhospitalizationsSelected Payer Prioritieschemotherapy episodes, over 78 percentof chemotherapy episodes for men wereoffice-managed compared to 70 percentof episodes for women. Patients 70 yearsof age and older utilized outpatient office-managedchemotherapy services at ahigher rate than patients 49 years of ageand younger. In Medicare patients, reportsdemonstrated that fewer patients receivechemotherapy in both hospital outpatientand physician offices, but rather select aspecific setting (n=7,128; 9.0 percent forboth settings). Primarily, Medicare patientsreceived treatment in office-basedchemotherapy centers (n=53,087; 66.9percent) versus HOPD chemotherapy(n=19,161; 24.1 percent). 10Total costs per year were higherfor Medicare patients receiving chemotherapyin hospital outpatient settings at$54,000, compared to $47,500 in the communitysetting. Similarly, patient out-ofpocketamounts were 10 percent higherfor patients receiving chemotherapy inhospital outpatient settings. 10Although existing data indicate thatthe cost of care may be higher in the outpatienthospital setting, there are limi-Priority #10Movement ofcommunity-basedcare to hospitalaffiliated practicesExtremely high priorityHigh priorityModerate priorityNeutralSomewhat priorityLow priorityNot at all a priority38 InsideOut

tations to these analyses that attenuatehow these findings should be interpreted.Patients treated in an outpatient hospitalsetting were younger. Therefore, it ispossible more aggressive chemotherapyregimens could have been used, whichmay have resulted in higher costs at thesesites. These studies failed to evaluate differencesin the comorbidities of these patients,which again could have skewed differencesin costs.A recent survey of healthcare plansindicated that the shift of oncology fromthe community setting to the hospital settingwas not a major concern at this time. 11However, if payers are interested in reducingor effectively slowing the increasein oncology-related healthcare costs, thistrend should be more closely evaluated.While this shift in care can substantiallyimpact payers, patients may be impactedthe most. Previous studies indicatethat out-of-pocket costs for Medicarepatients receiving chemotherapy for thetreatment of breast cancer were calculatedat $759 for care in the office-managedsetting versus $814 in the hospitaloutpatient setting. 10 It has been reportedthat private community practices offeredlower out-of-pocket costs for Medicarepatients or patients without supplementalinsurance, and greater accessibility forpatients in varying geographical regionsand rural areas. 10,12,13Given the increased costs and higherinpatient hospitalizations associated withthe delivery of chemotherapy in a hospitaloutpatient environment, and given thedrive in healthcare reform to lower costswhile improving care, it seems the trendof providers, payers and patients shouldbe toward the community oncology centers.It isn’t – and the diminishing numberof community practices reveals this unfortunatereality. To change this reality, itbecomes critical to recognize and communicatethe advantages of community oncologycare to ensure the ongoing sustainabilityof these practices and the benefitsthey deliver.Recently, the Community Countscampaign was launched to help demonstratethis value and communicate thereal, measurable benefits of communityoncology. This physician-led movementgives community practices the tools theyneed to build a unified voice and maketheir value known. A broader knowledgeof this value would provide payers, oncologypractitioners and stakeholders realworldinsight they could use to give physiciansmore choices in where they delivercare and give patients greater options andability to receive that care from a communityprovider.You can download a complimentarycopy of The Value of CommunityOncology: Site of Care Cost Analysis, fromwhich this article was excerpted. Thisstudy fills in the gaps in current cost-analysisof community and hospital oncologyutilization and cost benefits. To downloadthe study now and learn more about theCommunity Count campaigns, visit www.OurCommunityCounts.org and see the adon page 2.Top 10 Payer Priorities in Oncology1. High-priced new products2. Cost of hospitalizations3. Ability to compare and analyzepharmacy and medical benefit4. Need to increase use of generics5. Appropriate use of biomarkers6. Pathway implementation7. Appropriate use of hospice8. Compliance and persistency withoncology drugs9. Cost of emergency room visits10. Movement of community-basedcare to hospital-affiliated practicesReferences:1. Association of Community Cancer Centers. The changing face of oncology. 2012. http://www.accc-cancer.org/association/History.asp. Accessed September 1, 2012.2. Dollinger, M. Guidelines for hospitalization for chemotherapy. Oncologist. 1996;1(1,2):107-111.3. American Society of Clinical Oncologists. ASCO Statement on Medicare Drug Reimbursement. June 2, 2000. http://www.asco.org/ASCOv2/Press+Center/ Latest+News+Releases/ASCO+Statement+on+Medicare+Drug+Reimbursement. Accessed September 20, 2012.4. Goldstein, M. Systems perspective: the community-based oncology practice. Ensuring quality cancer care through the oncology workforce: sustaining research and care in the 21st century. Presentation at: ASCO NationalCare Policy Forum Workshop. October 20-21, 2008.5. Kuznar, W. Community oncology clinics under increasing financial pressure. Association for Value-Based Cancer. http://www.valuebasedcancer.com/article/community-oncolo-gy-clinics-under-increasing-financial-pressure.Accessed September 18, 2012.6. Guy, GP Jr, Richardson, LC. Visit duration for outpatient physician office visits among patients with cancer. Am J Manag Care. 2012 May;18(5 Spec No. 2):SP49-56.7. Community Oncology Alliance. Practice Impact Report. April 4, 2012. http://www.communityoncology.org/pdfs/community-oncology-practice-impact-report.pdf Accessed August 23, 2012.8. Goins, R. The Oncology Landscape: Complexity, Cost, Care, and Coordination. Pharmacy Times. May 18, 2011. http://www.pharmacytimes.com/publications/specialty- pt/2011/May2011/The-Oncology-Landscape-Complexity-Cost-Care-and-Coordination. Accessed September 18, 2012.9. Avalere Health, LLC. Avalere Health Analysis Report of National Association of Managed Care Physicians member data. Total cost of cancer care by site of service: physician office vs outpatient hospital. March 2012.http://www.avalerehealth.net/news/2012-04-03_COA/Cost_of_Care.pdf. Accessed August 20, 2012.10. Fitch K, Pyenson B. Milliman Client Report: Site of service cost differences for Medicare patients receiving chemotherapy. October 19, 2011. http://publications.milliman.com/publications/health-published/pdfs/site-of-service-cost-differences.pdf. Accessed August 20, 2012.11. Xcenda. Managed Care Network. PayerPulse June 2012.12. Shea AM, Curtis LH, Hammill BG, et al. Association between the Medicare Modernization Act of 2003 and patient wait times and travel distance for chemotherapy. JAMA.2008;300(2):189-196.13. Neuss MN, Guidi T. Commentary: when it comes to chemotherapy, location matters. J Oncol Pract. 2010 Sep;6(5):235-237.ASD Healthcare 39

Be creative.“We develop some pretty special skillsdelivering True Blue service at ASD Healthcare.My name is Shannon Commander and here’swhy being creative is one of them.Last winter, one of our sister companiesasked me to check our emergency warehousefor a life-saving specialty drug. They neededit for a patient who lived abroad. Withoutthe medication, he had only days to live. Thepatient’s son lived in the U.S. and was waiting tofly the medication to his father.The product wasn’t in stock at ASD Healthcare.I quickly started checking other distributioncenters. First I tried the AmerisourceBergenfacility closest to the son. No luck. I knew I neededto think outside our traditional network. That’swhen I started reviewing the inventory we hadin our Cubixx storage solutions in healthcarefacilities across the nation. Success! A hospitalin Dallas had the product. Once I got permissionto pull it, I had the product couriered to me,then walked it over to our sister company forshipment.A little creative thinking made a big differencein a person’s life that day. It’s not like writing anovel, but the True Blue drive to keeptrying new ideas until you succeedsure made for a happier ending”for this father and his son.www.asdhealthcare.com

Albumin-free 1Demonstrated bleed control 2Zero transfer step 2It’s the factor VIII with state-of-the-art purification. 1,3It comes with all-in-one reconstitution. 2When your patients turn to you, consider XYNTHA.XynThA® Antihemophilic Factor (Recombinant),Plasma/Albumin-Free is indicated for the controland prevention of bleeding episodes in patients withhemophilia A (congenital factor VIII deficiency or classichemophilia) and for surgical prophylaxis in patients withhemophilia A.XynThA does not contain von Willebrand factor and,therefore, is not indicated in von Willebrand’s disease.Important Safety Information for XYNTHA• Do not use in patients who have manifested lifethreateningimmediate hypersensitivity reactions,including anaphylaxis, to the product or its components,including hamster proteins.Save on XYNTHA **Terms and conditions can be found42 InsideOut at XynThA.com.• Allergic type hypersensitivity reactions arepossible. Inform patients of the early signs orsymptoms (including hives, generalized urticaria,chest tight-ness, wheezing, and hypotension) andanaphylaxis. If these symptoms occur, advisepatients to discontinue use of the product andcontact their physician. XynThA contains traceamounts of hamster proteins. Patients may develophypersensitivity to these proteins.• Patients using coagulation factor VIII productsshould be monitored for inhibitors, which have beenreported in patients receiving XynThA.Need help accessing Pfizer medicines? Pfizer’s RSVPprogram may be able to help. Call 1-888-327-RSVP(7787) or visit www.HemophiliaVillage.com/RSVP.

FREE TRIAL Help your eligible patients get a1-month supply up to 20,000 IU* One-time offer.FreeTrialPfizerFactor.comSee your local hemophilia representative today to request a form.If you are unable to reach your representative, please try 888-999-2349.*Offer applies to patients covered by a private commercial insurance plan only.*Terms and conditions apply.• Clinical response to XYNTHA may vary. If bleeding isnot controlled with the recommended dose of factor,determine the plasma level and administer a dose ofXynThA sufficient to achieve clinical response. If thefactor level does not increase or there is no response,suspect an inhibitor and perform appropriate testing.• The most common adverse reaction in the safety andefficacy study is headache (24% of subjects) and in thesurgery study is fever (43% of subjects). Overall, themost common adverse reactions (≥5% of subjects) inclinical studies were headache, fever, nausea, vomiting,diarrhea, and weakness.• XYNTHA is an injectable medicine administered byintravenous (IV) infusion. Patients should be advisedthat local irritation may occur when infusing XynThAafter reconstitution in XynThA® SOlOFUSe®.Please see accompanying full Prescribing Information on next page.1. Kelley B, Jankowski M, Booth J. An improved manufacturing process for XynthA/ReFacto AF. Haemophilia. 2009;1-9.doi:10.1111/j.1365-2516.2009.02160.x. 2. XynthA ®SOLOFUSE ® Antihemophilic Factor (Recombinant), Plasma/Albumin-Free PrescribingInformation, Wyeth Pharmaceuticals Inc. 3. XynthA ® Antihemophilic Factor (Recombinant),Plasma/Albumin-Free Prescribing Information, Wyeth Pharmaceuticals Inc.*terms and conditions apply. your patients must be currently covered by a private[commercial] insurance plan. For questions about the XynthA trial Prescription Program,please call 1.800.710.1379 or write us at XynthA trial Prescription Program Administrator,MedVantx, PO Box 5736, Sioux Falls, SD 57117-5736 If your patients are not eligible forthe trial prescription program, they may find help accessing Pfizer medicines by contactingPfizer’s RSVP program at 1-888-327-RSVP (7787).Manufactured by Wyeth Pharmaceuticals Inc.Marketed by Pfizer Inc.RUS473303-01 © 2012 Pfizer Inc. All rights reserved. Printed in the USA/July 2012ASD Healthcare 43

Brief SummarySee package insert for full Prescribing Information. For further product information and currentpackage insert, please visit XYNTHA.com or call Wyeth Pharmaceuticals toll-free at 1-800-438-1985.INDICATIONS AND USAGEControl and Prevention of Bleeding Episodes in Patients with Hemophilia AXYNTHA is indicated for the control and prevention of bleeding episodes in patients withhemophilia A (congenital factor VIII deficiency or classic hemophilia).Surgical Prophylaxis in Patients with Hemophilia AXYNTHA is indicated for surgical prophylaxis in patients with hemophilia A.XYNTHA does not contain von Willebrand factor, and therefore is not indicated in patients withvon Willebrand’s disease.DOSAGE FORMS AND STRENGTHSXYNTHA is available as a white to off-white lyophilized powder in the following nominal dosages:- 250 International Units- 500 International Units- 1000 International Units- 2000 International Units- 3000 International UnitsEach XYNTHA vial has the actual recombinant factor VIII (rFVIII) potency in International Unitsstated on the label.CONTRAINDICATIONSDo not use in patients who have manifested life-threatening immediate hypersensitivityreactions, including anaphylaxis, to the product or its components, including hamster proteins.WARNINGS AND PRECAUTIONSAnaphylaxis and Hypersensitivity Reactions—Allergic type hypersensitivity reactions arepossible. Inform patients of the early signs or symptoms of hypersensitivity reactions (includinghives [rash with itching], generalized urticaria, chest tightness, wheezing, and hypotension) andanaphylaxis. Advise patients to discontinue use of the product and to contact their physician ifthese symptoms occur.XYNTHA contains trace amounts of hamster proteins. Patients treated with this product maydevelop hypersensitivity to these non-human mammalian proteins.Neutralizing Antibodies—Patients using coagulation factor VIII products, including XYNTHA,should be monitored for the development of factor VIII inhibitors by appropriate clinical observationsand laboratory tests. Inhibitors have been reported following administration of XYNTHA. Ifexpected factor VIII activity plasma levels are not attained, or if bleeding is not controlled with anappropriate dose, an assay should be performed to determine if a factor VIII inhibitor is present.Monitoring: Laboratory Tests—The clinical response to XYNTHA may vary. If bleeding is notcontrolled with the recommended dose, determine the plasma level of factor VIII and administera sufficient dose of XYNTHA to achieve a satisfactory clinical response. If the patient’s plasmafactor VIII level fails to increase as expected or if bleeding is not controlled after the expected dose,suspect the presence of an inhibitor (neutralizing antibodies) and perform appropriate testingas follows:• Use individual factor VIII values for recovery and, if clinically indicated, otherpharmacokinetic characteristics to guide dosing and administration.• Monitor plasma factor VIII activity levels by the one-stage clotting assay to confirm thatadequate factor VIII levels have been achieved and are maintained, when clinically indicated.• Monitor for development of factor VIII inhibitors. Perform assay to determine if factor VIIIinhibitor is present when expected factor VIII activity plasma levels are not attained, or whenbleeding is not controlled with the expected dose of XYNTHA. Use Bethesda Units (BU) totiter inhibitors.ADVERSE REACTIONSOverall, the most common adverse reactions (≥ 5%) with XYNTHA were headache, pyrexia,nausea, vomiting, diarrhea, and asthenia.Clinical Trials Experience—Because clinical trials are conducted under widely varyingconditions, adverse reaction rates observed in the clinical trials of a drug cannot be directlycompared to rates in the clinical trials of another drug and may not reflect the rates observedin clinical practice.XYNTHA was evaluated in two clinical studies (N=124). In the first study (n=94), safety andefficacy were examined in previously treated patients (PTPs) with hemophilia A (factor VIII activityin plasma [FVIII:C] ≤ 2%] who received XYNTHA for routine prophylaxis and on-demand treatment.Ninety-four patients received at least one dose of XYNTHA, resulting in a total of 6,775 infusions.The second study (n=30) examined the use of XYNTHA for surgical prophylaxis in previouslytreated patients with severe or moderately severe hemophilia A ( [FVIII:C] ≤ 2%) who requiredelective major surgery and were expected to receive XYNTHA replacement therapy for at least6 days post-surgery. All patients received at least one dose of XYNTHA, resulting in 1161 infusions.One patient received XYNTHA for a pre-surgery pharmacokinetic assessment only and did notundergo surgery.The most frequently reported adverse reaction in PTP patients was headache (24% of subjects).Other adverse reactions reported in ≥ 5% of patients were: nausea (6%), diarrhea (5%), asthenia(5%), and pyrexia (5%).The most frequently reported adverse reaction in surgical patients was pyrexia (43%). Otheradverse reactions reported in ≥ 5% of patients were: headache (13%), nausea (13%), andvomiting (7%).Immunogenicity Information—There is a potential for immunogenicity with therapeutic proteins.The clinical studies for XYNTHA examined 94 patients who had previously been treated withfactor VIII (PTPs) and 30 surgical patients. In the safety and efficacy study, two subjects with inhibitorswere observed in 89 subjects (2.2%) who completed ≥ 50 exposure days. In a Bayesian statisticalanalysis, results from this study were used to update PTP results from a prior supporting studyusing XYNTHA manufactured at the initial facility (with one de novo and two recurrent inhibitorsobserved in 110 patients) and the experience with predecessor product (with one inhibitorobserved in 113 subjects). The Bayesian analysis indicated that the population inhibitor rate forXYNTHA, an estimate of the 95% upper limit of the true inhibitor rate, was 4.17%.None of the PTPs developed anti-CHO (Chinese hamster ovary) or anti-TN8.2 antibodies. One PTPdeveloped anti-FVIII antibodies; but, this patient did not develop an inhibitor.In the surgery study, one low titer persistent inhibitor and one transient false-positive inhibitorwere reported. In this study, one surgical patient developed anti-CHO cell antibodies with noassociated allergic reaction. One patient developed anti-FVIII antibodies; but, this patient did notdevelop an inhibitor.Overall, no allergic manifestation to any immune response was observed during the study.The detection of antibody formation is highly dependent on the sensitivity and specificity of theassay. Additionally, the observed incidence of antibody, including neutralizing antibody, positivityin an assay may be influenced by several factors, including assay methodology, sample handling,timing of sample collection, concomitant medications, and underlying disease. For these reasons,comparisons of the incidence of antibodies to XYNTHA with the incidence of antibodies to otherproducts may be misleading.Postmarketing Experience—Because these reactions are reported voluntarily from a populationof uncertain size, it is not always possible to reliably estimate their frequency or establish a causalrelationship to drug exposure.The following postmarketing adverse reactions have been reported for XYNTHA:Hypersensitivity ReactionsAnaphylaxisInhibitor DevelopmentInadequate Therapeutic ResponseDRUG INTERACTIONSNone known.USE IN SPECIFIC POPULATIONSPregnancyPregnancy Category C - Animal reproduction studies have not been conducted with XYNTHA.It is not known whether XYNTHA can cause fetal harm when administered to a pregnantwoman or can affect reproduction capacity. XYNTHA should be given to a pregnant woman onlyif clinically indicated.Labor and Delivery—There is no information available on the effect of factor VIII replacementtherapy on labor and delivery. XYNTHA should be used only if clinically indicated.Nursing Mothers—It is not known whether this drug is excreted into human milk. Because manydrugs are excreted into human milk, caution should be exercised if XYNTHA is administered tonursing mothers. XYNTHA should be given to nursing mothers only if clinically indicated.Pediatric Use—Pharmacokinetics of XYNTHA was studied in 7 previously treated patients 12-16years of age. Pharmacokinetic parameters in these patients were similar to those obtained foradults after a dose of 50 IU/kg. For these 7 patients, the mean (± SD) C maxand AUC ∞were 1.09 ±0.21 IU/mL and 11.5 ± 5.2 IU·h/mL, respectively. The mean clearance and plasma half-life valueswere 5.23 ± 2.36 mL/h/kg and 8.03 ± 2.44 hours (range 3.52 – 10.6 hours), respectively. The meanK-value and in vivo recoveries were 2.18 ± 0.41 IU/dL per IU/kg and 112 ± 23%, respectively.Geriatric Use—Clinical studies of XYNTHA did not include subjects aged 65 and over. In general,dose selection for an elderly patient should be individualized.STORAGE AND HANDLINGXYNTHA VialsProduct as Packaged for Sale:• Store XYNTHA under refrigeration at a temperature of 2° to 8°C (36° to 46°F) for up to36 months from the date of manufacture until the expiration date stated on the label. Withinthe expiration date, XYNTHA also may be stored at room temperature not to exceed 25°C(77°F) for up to 3 months. After room temperature storage, XYNTHA can be returned to therefrigerator until the expiration date. Do not store XYNTHA at room temperature and return itto the refrigerator more than once.• Clearly record the starting date at room temperature storage in the space provided on the outercarton. At the end of the 3-month period, immediately use, discard, or return the product torefrigerated storage. The diluent syringe may be stored at 2° to 25°C (36° to 77°F).• Do not use XYNTHA after the expiration date.• Do not freeze. (Freezing may damage the prefilled diluent syringe.)• During storage, avoid prolonged exposure of XYNTHA vial to light.Product After Reconstitution:• Store the reconstituted solution at room temperature prior to administration. Remember toadminister XYNTHA within 3 hours after reconstitution.XYNTHA SOLOFUSEProduct as Packaged for Sale:• Store XYNTHA SOLOFUSE under refrigeration at a temperature of 2° to 8°C (36° to 46°F) forup to 36 months from the date of manufacture until the expiration date stated on the label.Within the expiration date, XYNTHA SOLOFUSE also may be stored at room temperature notto exceed 25°C (77°F) for up to 3 months.• Clearly record the starting date at room temperature storage in the space provided on the outercarton. At the end of the 3-month period, immediately use or discard the product. Do not putthe product back into the refrigerator.• Do not use XYNTHA SOLOFUSE after the expiration date stated on the label or after 3 monthswhen stored at room temperature, whichever is earlier.• Do not freeze. (Freezing may damage the XYNTHA SOLOFUSE.)• During storage, avoid prolonged exposure of XYNTHA SOLOFUSE to light.Product After Reconstitution:• Store the reconstituted solution at room temperature prior to administration. Remember toadminister XYNTHA SOLOFUSE within 3 hours after reconstitution or after removal of the greyrubber tip cap from the product.This brief summary is based on the Xyntha ® [Antihemophilic Factor (Recombinant), Plasma/Albumin-Free] Prescribing Information LAB-0516-3.0, revised 01/12, and LAB-0500-7.0, revised 01/12.Manufactured by Wyeth Pharmaceuticals Inc.Marketed by Pfizer Inc.RUS483904-01 © 2012 Pfizer Inc. All rights reserved. Printed in USA/September 201244 InsideOut

in our catalogASD Healthcare Product CatalogWe’ve got you covered!Need a product code? NDC number? Or product sizing? This ASD Healthcare catalogis for you – the way you work and order specialty products. It includes the product codes,NDC numbers and sizing information you need every day. And you get an updated versioneach quarter in InsideOut in print and online. In it, you’ll find the most popular plasmaproducts, pharmaceuticals, contrast media, nephrology and more – all color coded for quickreference.Don’t see a product you need? That’s easy – our product offering includes even more.Just call us today for personalized service at 800.746.6273.Or order online at www.asdhealthcare.com.ASD Healthcare –making your patientsand your purpose ourpriority for 20 years.Plasma DerivativesAlbumin 46Antihemophelic 46Immunologic 49Hyper-Immune Globulin 50PharmaceuticalsVaccines 52Specialty 52Biosurgery 54Contrast MediaAstellas Pharma US 56Bayer 56Bracco 57Coeur 60Covidien 60GE 64Get the product information you need in our online catalog atwww.asdhealthcare.comNephrologyNephrology Rx 66Medical / Surgical 69ASD Healthcare 45

Product availability subject to change.contrast plasma derivatives mediaAlbuminCODE PRODUCT SIZE EQ. UNIT MFR. NDC # PK/CSP9047 Albuked 25% 50 ml 1 KED 76125-0784-25 vialP9047 Albuked 25% 100 ml 1 KED 76125-0784-10 vialP9045 Albuked 5% 250 ml 1 KED 76125-0785-25 vialP9045 Albumin 5% 250 ml 1 OCT 67467-0623-02 vialP9045 Albumin 5% 500 ml 1 OCT 68209-0623-03 vialP9047 Albumin 25% 50 ml 1 OCT 67467-0643-01 vialP9047 Albumin 25% 100 ml 1 OCT 67467-0643-02 vialP9047 Albuminar ® 5% 250 ml 1 CSL 00053-7670-31 vialP9047 Albuminar ® 5% 500 ml 1 CSL 00053-7670-32 vialP9047 Albuminar ® 25% 50 ml 1 CSL 00053-7680-32 vialP9047 Albuminar ® 25% 100 ml 2 CSL 00053-7680-33 vialP9045 Albutein ® 5% (Albumin) 250 ml 1 GFS 68516-5211-01 vialP9045 Albutein ® 5% (Albumin) 500 ml 2 GFS 68516-5271-02 vialP9047 Albutein ® 25% (Albumin) 50 ml 1 GFS 68516-5213-02 vialP9047 Albutein ® 25% (Albumin) 100 ml 2 GFS 61953-0002-02 vialP9047 AlbuRx ® 25% 50 ml 1 CSL 44206-0251-05 vialP9047 AlbuRx ® 25% 100 ml 2 CSL 44206-0251-10 vialP9045 AlbuRx ® 5% 250 ml 1 CSL 44206-0310-25 vialP9045 AlbuRx ® 5% 500 ml 2 CSL 44206-0310-50 vialJ3490 Buminate 5% (Albumin) 6 x 250 ml 1 BAX 00944-0491-01 caseJ3490 Buminate 5% (Albumin) 6 x 500 ml 2 BAX 00944-0491-02 caseJ3490 Buminate 25% (Albumin) 10 x 20 ml 0.4 BAX 00944-0490-01 caseJ3490 Flexbumin 25% 24 x 50 ml 1 BAX 00944-0493-01 caseJ3490 Flexbumin 25% 12 x 100 ml 2 BAX 00944-0493-02 caseP9041 Plasbumin ® 5% (Albumin) 50 ml 0.2 GFS 13533-0685-20 vialP9045 Plasbumin ® 5% (Albumin) 250 ml 1 GFS 13533-0685-25 vialP9046 Plasbumin ® 25% (Albumin) 20 ml 0.4 GFS 13533-0684-16 vialP9047 Plasbumin ® 25% (Albumin) 50 ml 1 GFS 13533-0684-20 vialP9047 Plasbumin ® 25% (Albumin) 100 ml 2 GFS 13533-0684-71 vialP9043 Plasmanate ® 5% (PPF) 50 ml 0.2 GFS 13533-0613-20 vialP9048 Plasmanate ® 5% (PPF) 250 ml 1 GFS 13533-0613-25 vialAntihemophilicCode PRODUCT SIZE MFR. NDC # PK/CSFactor VIIa (Recombinant)J7189 NovoSeven ® RT 1000 mcg NOVO 00169-7010-01 vialJ7189 NovoSeven ® RT 2000 mcg NOVO 00169-7020-01 vialJ7189 NovoSeven ® RT 5000 mcg NOVO 00169-7040-01 vialJ7189 NovoSeven ® RT 8000 mcg NOVO 00169-7050-01 vialFactor VIII (Recombinant)J7192 Advate ® w/Baxject II 250 iu BAX 00944-2941-10 vialJ7192 Advate ® w/Baxject II 500 iu BAX 00944-2942-10 vialJ7192 Advate ® w/Baxject II 1000 iu BAX 00944-2943-10 vial46 InsideOut

Go to www.asdhealthcare.com for pricing, ordering and moreProduct availability subject to change.Code PRODUCT SIZE MFR. NDC # PK/CSJ7192 Advate ® w/Baxject II 1500 iu BAX 00944-2944-10 vialJ7192 Advate ® w/Baxject II 2000 iu BAX 00944-2945-10 vialJ7192 Advate ® w/Baxject II 3000 iu BAX 00944-2946-10 vialJ7192 Advate ® w/Baxject II 4000 iu BAX 00944-2948-10 vialJ7192 Helixate ® FS 250 iu CSL 00053-8131-02 vialJ7192 Helixate ® FS 500 iu CSL 00053-8132-02 vialJ7192 Helixate ® FS 1000 iu CSL 00053-8133-02 vialJ7192 Helixate ® FS 2000 iu CSL 00053-8134-02 vialJ7192 Helixate ® FS 3000 iu CSL 00053-8135-02 vialJ7192 Kogenate ® FS 250 iu BYR 00026-3782-20 vialJ7192 Kogenate ® FS 500 iu BYR 00026-3783-30 vialJ7192 Kogenate ® FS 1000 iu BYR 00026-3785-50 vialJ7192 Kogenate ® FS 2000 iu BYR 00026-3786-60 vialJ7192 Kogenate ® FS 3000 iu BYR 00026-3787-70 vialJ7192 Kogenate ® FS w/BIO-SET ® 250 iu BYR 00026-3792-20 vialJ7192 Kogenate ® FS w/BIO-SET ® 500 iu BYR 00026-3793-30 vialJ7192 Kogenate ® FS w/BIO-SET ® 1000 iu BYR 00026-3795-50 vialJ7192 Kogenate ® FS w/BIO-SET ® 2000 iu BYR 00026-3796-60 vialJ7192 Kogenate ® FS w/BIO-SET ® 3000 iu BYR 00026-3797-70 vialJ7192 Recombinate ® 250 iu BAX 00944-2831-10 vialJ7192 Recombinate ® 500 iu BAX 00944-2832-10 vialJ7192 Recombinate ® 1000 iu BAX 00944-2833-10 vialJ7185 Xyntha ® Solofuse 250 iu PFZ 58394-022-03 PFSJ7185 Xyntha ® Solofuse 500 iu PFZ 58394-023-03 PFSJ7185 Xyntha ® Solofuse 1000 iu PFZ 58394-024-03 PFSJ7185 Xyntha ® Solofuse 2000 iu PFZ 58394-025-03 PFSJ7185 Xyntha ® Solofuse 3000 iu PFZ 58394-016-03 PFSJ7185 Xyntha ® 250 iu PFZ 58394-0012-01 vialJ7185 Xyntha ® 500 iu PFZ 58394-0013-01 vialJ7185 Xyntha ® 1000 iu PFZ 58394-0014-01 vialJ7185 Xyntha ® 2000 iu PFZ 58394-0015-01 vialFactor VIII (Immunoaffinity Purified. Derived from Human Plasma.)J7190 Hemofil ® M 250 iu BAX 00944-2930-01 vialJ7190 Hemofil ® M 500 iu BAX 00944-2931-01 vialJ7190 Hemofil ® M 1000 iu BAX 00944-2932-01 vialJ7190 Hemofil ® M 1700 iu BAX 00944-2933-01 vialJ7190 Monoclate-P ® 250 iu CSL 00053-7656-01 vialJ7190 Monoclate-P ® 500 iu CSL 00053-7656-02 vialJ7190 Monoclate-P ® 1000 iu CSL 00053-7656-04 vialJ7190 Monoclate-P ® 1500 iu CSL 00053-7656-05 vialFactor VIII (Derived from Human Plasma. Contains von Willebrand Factor.)J7186 Alphanate ® 250 iu GFS 68516-4601-01 vialJ7186 Alphanate ® 500 iu GFS 68516-4602-01 vialJ7186 Alphanate ® 1000 iu GFS 68516-4603-02 vialJ7186 Alphanate ® 1500 iu GFS 68516-4604-02 vialplasma contrast derivatives mediaASD Healthcare 47

Product availability subject to change.CODE PRODUCT SIZE MFR. NDC # PK/CSJ7187 Humate-P ® 250 RCoF CSL 00053-7615-05 vialJ7187 Humate-P ® 500 RCoF CSL 00053-7615-10 vialJ7187 Humate-P ® 1000 RCoF CSL 00053-7615-20 vialJ7190 Koate ® -DVI PDS 250 iu KED 13533-0665-20 vialJ7190 Koate ® -DVI PDS 500 iu KED 13533-0665-30 vialJ7190 Koate ® -DVI PDS 1000 iu KED 13533-0665-50 vialJ3590 Wilate ® 450 iu RCo/5ml OCT 67467-181-01 vialJ3590 Wilate ® 900 iu RCo/10ml OCT 67467-181-02 vialFactor IX (Recombinant)J7195 BeneFIX ® -rt 250 iu PFZ 58394-633-03 vialJ7195 BeneFIX ® -rt 500 iu PFZ 58394-634-03 vialJ7195 BeneFIX ® -rt 1000 iu PFZ 58394-635-03 vialJ7195 BeneFIX ® -rt 2000 iu PFZ 58394-636-03 vialFactor IX (Prothrombin Concentrates. Derived from Human Plasma. Contains Factor II, VII, IX and X.)J7194 Bebulin ® VH 500 iu BAX 64193-0244-02 vialJ7194 Bebulin ® VH 700 iu BAX 64193-0445-02 vialJ7194 Profilnine ® SD 500 iu GFS 68516-3201-01 vialJ7194 Profilnine ® SD 1000 iu GFS 68516-3202-02 vialJ7194 Profilnine ® SD 1500 iu GFS 68516-3203-02 vialFactor IX (Derived from Human Plasma)J7193 AlphaNine ® SD 500 iu GFS 68516-3601-02 vialJ7193 AlphaNine ® SD 1000 iu GFS 68516-3602-02 vialJ7193 AlphaNine ® SD 1500 iu GFS 68516-3603-02 vialJ7193 Mononine ® 500 iu CSL 00053-7668-02 vialJ7193 Mononine ® 1000 iu CSL 00053-7668-04 vialFactor XIII (Derived from Human Plasma)J7199 Corifact PDS 1380 iu CSL 63833-518-02 vialFibrinogen ConcentrateJ1680 RiaSTAP 900-1300 gm CSL 63833-8915-01 vialcontrast plasma derivatives mediaAnti-Inhibitor Coagulation Complexes (Derived from Human Plasma)J7198 Feiba ® NF 500 iu BAX 64193-0223-02 vialJ7198 Feiba ® NF 1000 iu BAX 64193-0224-02 vialJ7198 Feiba ® NF 2500 iu BAX 64193-0225-02 vialAntithrombin III (Derived from Human Plasma)J7197 Thrombate III ® 500 iu GFS 13533-0603-20 vialAntithrombin (Recombinant)J3590 ATryn ® 1750 iu GTC 67386-521-51 vialDesmopressin Acetate (Useful in Disorders of Hemostasis)J2597 Stimate ® (Nasal Spray) 2.5 ml CSL 00053-2453-00 vial48 InsideOut

Go to www.asdhealthcare.com for pricing, ordering and moreProduct availability subject to change.ImmunologicCODE PRODUCT SIZE MFR. NDC # PK/CSImmune Globulin Intravenous (Human) LyophilizedJ1566 Carimune ® NF 3 gm CSL 44206-0416-03 vialJ1566 Carimune ® NF 6 gm CSL 44206-0417-06 vialJ1566 Carimune ® NF 12 gm CSL 44206-0418-12 vialJ1566 Gammagard Low IgA 5 gm BAX 00944-26200-03 vialJ1566 Gammagard Low IgA 10 gm BAX 00944-26200-04 vialImmune Globulin Intravenous (Human) LiquidJ3590 Bivigam 10% 50 mL 5 gm Biotest 59730-6502-01 vialJ3590 Bivigam 10% 100 mL 10 gm Biotest 59730-6503-01 vialJ1572 Flebogamma ® DIF 5% 2.5 gm GFS 61953-0004-02 vialJ1572 Flebogamma ® DIF 5% 5 gm GFS 61953-0004-03 vialJ1572 Flebogamma ® DIF 5% 10 gm GFS 61953-0004-04 vialJ1572 Flebogamma ® DIF 5% 20 gm GFS 61953-0004-05 vialJ1572 Flebogamma ® DIF 10% 5 gm GFS 61953-0005-01 vialJ1572 Flebogamma ® DIF 10% 10 gm GFS 61953-0005-02 vialJ1572 Flebogamma ® DIF 10% 20 gm GFS 61953-0005-03 vialJ1569 Gammagard Liquid 1 gm BAX 00944-2700-02 vialJ1569 Gammagard Liquid 2.5 gm BAX 00944-2700-03 vialJ1569 Gammagard Liquid 5 gm BAX 00944-2700-04 vialJ1569 Gammagard Liquid 10 gm BAX 00944-2700-05 vialJ1569 Gammagard Liquid 20 gm BAX 00944-2700-06 vialJ1561 Gammaked 10% 1 gm KED 76125-0900-01 vialJ1561 Gammaked 10% 2.5 gm KED 76125-0900-25 vialJ1561 Gammaked 10% 5 gm KED 76125-0900-50 vialJ1561 Gammaked 10% 10 gm KED 76125-0900-10 vialJ1561 Gammaked 10% 20 gm KED 76125-0900-20 vialJ1557 Gammaplex ® 5% 2.5 gm BPL 64208-8234-01 vialJ1557 Gammaplex ® 5% 5 gm BPL 64208-8234-02 vialJ1557 Gammaplex ® 5% 10 gm BPL 64208-8234-03 vialJ1561 Gamunex ® -C 1 gm GFS 13533-0800-12 vialJ1561 Gamunex ® -C 2.5 gm GFS 13533-0800-15 vialJ1561 Gamunex ® -C 5 gm GFS 13533-0800-20 vialJ1561 Gamunex ® -C 10 gm GFS 13533-0800-71 vialJ1561 Gamunex ® -C 20 gm GFS 13533-0800-24 vialJ1568 Octagam ® 5% 100 mL 5 gm OCT 67467-0843-03 vialJ1568 Octagam ® 5% 200 mL 10 gm OCT 67467-0843-04 vialJ1459 Privigen ® 10% 5 gm CSL 44206-0436-05 vialJ1459 Privigen ® 10% 10 gm CSL 44206-0437-10 vialJ1459 Privigen ® 10% 20 gm CSL 44206-0438-20 vialImmune Globulin Subcutaneous (Human) LiquidJ1559 Hizentra 1 gm CSL 44206-451-01 vialJ1559 Hizentra 2 gm CSL 44206-452-02 vialJ1559 Hizentra 4 gm CSL 44206-454-04 vialplasma contrast derivatives mediaASD Healthcare 49

Product availability subject to change.Hyper-Immune GlobulinHepatitis B Immune GlobulinCode PRODUCT SIZE MFR. NDC # PK/CSIntramuscular Immune Globulins (Human)J1470 GamaSTAN ® S/D 2 ml GFS 13533-0635-04 vialJ1550 GamaSTAN ® S/D 10 ml GFS 13533-0635-12 vialNEWNEWNEWNEWNEWNEWRho(D) Immune GlobulinJ2788 HyperRHO ® S/D mini-dose 50 mcg GFS 13533-0631-06 10/pkJ2790 HyperRHO ® S/D 300 mcg GFS 13533-0631-02 syringeMICRhoGAM ® UF Plus 1 x 50 mcg KED 00562-7806-01 syringeMICRhoGAM ® UF Plus 5 x 50 mcg KED 00562-7806-05 syringeMICRhoGAM ® UF Plus 25 x 50 mcg KED 00562-7806-25 syringeJ2790 RhoGAM ® UF Plus 1 x 300 ug KED 00562-7805-01 syringeJ2790 RhoGAM ® UF Plus 5 x 300 ug KED 00562-7805-05 syringeJ2790 RhoGAM ® UF Plus 25 x 300 ug KED 00562-7805-25 syringeJ2791 Rhophylac ® 300 mcg CSL 44206-0300-01 syringeJ2791 Rhophylac ® 300 mcg CSL 44206-0300-10 10/pkJ2792 WinRho ® SDF Liguid 1500 iu 300 mcg CAN 53270-3300-01 vialJ2792 WinRho ® SDF Liguid 2500 iu 500 mcg CAN 53270-3500-01 vialJ2792 WinRho ® SDF Liguid 5000 iu 1000 mcg CAN 53270-3100-01 vialJ2792 WinRho ® SDF Liguid 15000 iu 3000 mcg CAN 53270-3000-01 vial*Not sold in state of Florida.Hepatitis B Immune GlobulinJ1573 HepaGam B ® 1 ml APO 60505-6071-00 vialJ1573 HepaGam B ® 5 ml APO 60505-6072-00 vialCPT-90371 HyperHEP B ® S/D 0.5 ml GFS 13533-0636-03 syringeCPT-90371 HyperHEP B ® S/D 1 ml GFS 13533-0636-02 syringeCPT-90371 HyperHEP B ® S/D 1 ml GFS 13533-0636-01 vialCPT-90371 HyperHEP B ® S/D 5 ml GFS 13533-0636-05 vialC9105 Nabi-HB ® 1 ml BIOTEST 59730-4202-01 vialC9105 Nabi-HB ® 5 ml BIOTEST 59730-4203-01 vialcontrast plasma derivatives mediaRabies Immune GlobulinCPT-90375 HyperRAB ® S/D 2 ml GFS 13533-0618-02 vialCPT-90375 HyperRAB ® S/D 10 ml GFS 13533-0618-10 vialCPT-90376 IMOGAM ® Rabies-HT 300 iu/2 ml SAN 49281-0190-20 vialCPT-90376 IMOGAM ® Rabies-HT 1500 iu/10 ml SAN 49281-0190-10 vialTetanus Immune GlobulinJ1670 HyperTET ® S/D 1 ml GFS 13533-0634-02 syringeCytomegalovirus Immune Globulin Intravenous (Human)J0850 CytoGam ® 2.5 gm/50 ml CSL 44206-3101-01 vial50 InsideOut

Go to www.asdhealthcare.com for pricing, ordering and moreProduct availability subject to change.Get your flu programheaded for successwith FluFirstAID.AIDThis free and easy-to-use online calculator helps you loweryour facility’s risks this flu season. Make FluFirstAID your firststep in planning a vaccine inventory that minimizes yourproduct returns to maximize your success.Visit FluFirstAID now to get started.Just scan this code, or go to www.flufirst.com.Want the personal touch? You’ve got it.Just call an ASD Healthcare representativeat 866.281.4FLU (4358).www.flufirst.comASD Healthcare ASD Healthcare 51 51

Product availability subject to change.VaccinesCode PRODUCT SIZE MFR. NDC # PK/CSFluQ2035 Afluria ® 10 x 0.5 ml MER 33332-011-01 syringeQ2035 Afluria ® 5 ml MER 33332-111-10 syringeCPT 90661 Flucelvax ® 10 x 0.5 ml NOV 63851-612-01 syringeCPT 90660 FluMist ® 10 x 0.2 ml MEDI 66019-0109-10 sprayerQ2037 Fluvirin ® 5 ml NOV 66521-114-10 vialQ2037 Fluvirin ® 10 x 0.5 ml NOV 66521-114-02 syringeQ2038 Fluzone ® 5 ml SAN 49281-011-50 vialCPT 90656 Fluzone ® PF 10 x 0.5 ml SAN 49281-111-25 syringeCPT 90656 Fluzone ® SDV PF 10 x 0.5 ml SAN 49281-011-10 pkCPT 90654Fluzone ® IntradermalMicroinjection PF10 x 0.1 ml SAN 49281-387-65 pkCPT 90655 Fluzone ® Pediatric PF 10 x 0.25 ml SAN 49281-010-25 syringeCPT 90662 Fluzone ® HD PF 10 x 0.5 ml SAN 49281-389-65 syringeTuberculosisJ3490 Aplisol ® 5TU 1 ml KING 42023-0104-01 vialJ3490 Aplisol ® 5TU 5 ml KING 42023-0104-05 vialCPT-86580 Tubersol ® 5TU 1 ml SAN 49281-0752-21 pkCPT-86580 Tubersol ® 5TU 5 ml SAN 49281-0752-22 pkSpecialtycontrast pharmaceuticals mediaNEWNEWNEWCode PRODUCT SIZE MFR. NDC # PK/CSJ2997 Activase ® Cathflo 2 mg GNT 50242-0041-64 vialJ8999 Afinitor ® 2.5/28 tabs mg NOV 00078-0594-51 pkJ8999 Afinitor ® 5 mg/28 tabs NOV 00078-0566-51 pkJ8999 Afinitor ® 7.5 mg/28 tabs NOV 00078-0620-51 pkJ8999 Afinitor ® 10 mg/28 tabs NOV 00078-0567-51 pkAfinitor Disperz ® 2 mg/28 tabs NOV 00078-0626-51 pkAfinitor Disperz ® 3 mg/28 tabs NOV 00078-0627-51 pkAfinitor Disperz ® 4 mg/28 tabs NOV 00078-0628-51 pkAmmonul ® 50 ml MEDI 62592-0720-50 vialJ3490 Berinert ® 500 unit vial CSL 63833-825-02 kitBuphenyl ® 500 mg tabs MEDI 62592-0496-03 btlBuphenyl ® 250 g MEDI 62592-0188-64 btlC9274 CroFab ® 2 x 2 ml BTG 50633-0110-12 vialJ9878 Cubicin ® 500 mg CUB 67919-0011-01 10/pkJ0894 Dacogen ® 50 mg MGI 62856-0600-01 vialJ1162 DigiFab 40 mg BTG 50633-0120-11 vialErivedge ® 150 mg/28 caps GNT 50242-0140-01 eaJ8499 Exjade ® 125 mg/30 tabs NOV 00078-0468-15 btlJ8499 Exjade ® 250 mg/30 tabs NOV 00078-0469-15 btlJ8499 Exjade ® 500 mg/30 tabs NOV 00078-0470-15 btlJ9999 Folotyn 20 mg ALLOS 48818-0001-01 vialJ9999 Folotyn 40 mg ALLOS 48818-0001-02 vialGattex ® 5 mg SDV NPS 68875-0103-01 vial52 InsideOut

Go to www.asdhealthcare.com for pricing, ordering and moreProduct availability subject to change.NEWNEWCode PRODUCT SIZE MFR. NDC # PK/CSGattex ® 30 mg vial kit NPS 68875-0102-01 vial kitJ9999 Halaven 1 mg/2 ml SDV EISAI 62856-0389-01 vialJ8999 Iclusig ® 15 mg/60 tabs ARIAD 76189-535-60 btlJ8999 Iclusig ® 45 mg/30 tabs ARIAD 76189-534-30 btlKadcyla ® 100 mg/15 ml SDV GNT 50242-0088-01 vialKadcyla ® 160 mg/20 ml SDV GNT 50242-0087-01 vialJ0598 Kalbitor ® 10 mg DYAX 47783-0101-01 vialKorlym ® 300 mg/28 tabs COR 76346-0073-01 btlKyprolis ® 60 mg Powder SDV ONXX 76075-0101-01J8999 Nexavar ® 200 mg/120 tabs BYR 00026-8488-58 btlNutropin ® 10 mg GNT 50242-0018-21 eaNutropin AQ ® 5 mg/2 ml Nuspin Inj GNT 50242-0075-01 eaNutropin AQ ® 10 mg/2 ml Nuspin Inj GNT 50242-0074-01 eaNutropin AQ ® 20 mg/2 ml Nuspin Inj GNT 50242-0076-01 eaNutropin AQ ® 2 ml pen cartridge GNT 50242-0043-14 eaNutropin AQ ® 20 mg/2 ml pen cartridge GNT 50242-0073-01 eaOstene Bone Hemostasis Material 1 gm BAX 94922814418 csOstene Bone Hemostasis Material 2.5 gm BAX 94922814418 csOstene Bone Hemostasis Material 3.5 gm BAX 94922814418 csJ1640 Panhematin ® 100 ml OVA 67386-0701-54 vialPanretin ® 0.1% Gel 60 g EISAI 64365-501-01 tubePerjeta ® 420 mg/14 ml SDV GNT 50242-0145-01 eaQ2043 Provenge ® 250 ml DEND 30237-8900-6 vialJ7335 Qutenza ® 1 patch/50 g gel NEURO 49685-928-01 kitJ7335 Qutenza ® 2 patch/50 g gel NEURO 49685-928-02 kitRavicti ® 25 ml HYP 76325-0100-25 vialJ1300 Soliris ® 300 mg/30 ml ALX 25682-0001-01 vialSodium Phenylbutyrate Powder 250 gm SIG 42794-0086-14 eaStivarga ® 40 mg tabs BYR 50419-0171-03 btlJ8999 Tasigna ® 150 mg/28 caps NOV 00078-0592-51 pkJ8999 Tasigna ® 200 mg/28 caps NOV 00078-0526-51 pkJ2323 Tysabri ® 300 mg (15 ml) ELAN 59075-0730-15 vialJ9025 Vidaza ® 100 mg PhM 59572-0102-01 vialC9293 Voraxaze ® 1000 units/vial BTG 50633-210-11 1 vial/cartonJ2357 Xolair ® 150 mg GNT 50242-0040-62 vialJ9228 Yervoy ® 50 mg/10 ml BMS 0003-2327-11 vialJ9228 Yervoy ® 200 mg/40 ml BMS 0003-2328-01 vialZaltrap ® 200 mg/ml SAN 0024-5841-01 vialZelboraf ® 240 mg/120 tabs GNT 50242-0090-01 eapharmaceuticalscontrast mediaASD Healthcare 53

Product availability subject to change.Biosurgery Productscontrast pharmaceuticals mediaNEWCode PRODUCT SIZE MFR. NDC # PK/CS600041 Adept ADH Reduction Sol BAX 5/csAfectair Neonatal Airway Connector DIS 10/pk600036 Cannula DuploTip 20 g x 10 cm BAX 10/cs600037 Cannula DuploTip 20 g x 26 cm BAX 10/cs600038 Cannula DuploTip 20 g x 32 cm BAX 10/cs934070 CoSeal 2 ml BAX vial934071 CoSeal 4 ml BAX vial934072 CoSeal 8 ml BAX vial934033 CoSeal Applicator tips BAX 5/cs934034 CoSeal Extended Applicator BAX 10/cs934500 CoSeal Spray Accessory Kit BAX 5/cs600021 CoSeal Spray Set BAX 10/cs921023 DuoFlo Dispenser Kit BAX ea921020 Duplocath 35 M.I.S. BAX ea921021 Duplocath 180 BAX ea921022 Duplocath 25 BAX ea921050 Duploreach 35 Extended Spray Applicator BAX 6/cs921134 DuploGrip Accessory Grip 6 x 2 ml BAX cs921135 DuploGrip Accessory Grip 6 x 5 ml BAX cs600029 DuploSpray MIS Applicators 30 cm BAX 5/cs600030 DuploSpray MIS Applicators 40 cm BAX 5/cs600033 DuploSpray MIS Applicators 20 cm BAX 5/cs600031 DuploSpray MIS Replacement Tips BAX 10/cs921063 Easy Prep 6 x 1 ml BAX cs921064 Easy Prep 6 x 2 ml BAX cs921065 Easy Prep 6 x 5 ml BAX cs600012 EasySpray Pressure Regulator BAX ea600013 EasySpray Set BAX 10/cs921042 FibriJet 57 Duplotip BAX ea921043 FibriJet 83 Duplotip BAX ea921044 FibriJet 51 Duplotip BAX ea921045 FibriJet 102 Duplotip BAX ea921046 FibriJet 267 Duplotip BAX ea921047 FibriJet 318 Duplotip BAX ea934057 FloSeal Matrix Hemostatic Sealant 6 x 5 ml BAX cs934050 FloSeal NT Matrix Hemostatic Sealant 6 x 5 ml BAX cs934055 FloSeal Reusable Endoscopic Applicator BAX ea1500181 FloSeal Endoscopic Applicator BAX 6/cs934208 FloSeal Curved Applicator Tip 8 cm BAX ea934210 FloSeal Curved Applicator Tip 10 cm BAX ea921031 Spray Set for the Tissomat Spray Device BAX 10/cs54 InsideOut

Go to www.asdhealthcare.com for pricing, ordering and moreProduct availability subject to change.Code PRODUCT SIZE MFR. NDC # PK/CS921028 Tisseel VH 2 ml BAX 00944-4201-04 vial921029 Tisseel VH 4 ml BAX 00944-4201-08 vial921030 Tisseel VH 10 ml BAX 00944-4201-12 vial921051VP921052VP921053VPValuPak 2 ml(1 cs TISSEEL Biologic-Only and 1 cs DUPLOJECT EASY PREP)ValuPak 4 ml(1 cs TISSEEL Biologic-Only and 1 cs DUPLOJECT EASY PREP)ValuPak 10 ml(1 cs TISSEEL Biologic-Only and 1 cs DUPLOJECT EASY PREP)6 x 1 ml BAX 00944-4201-03 cs6 x 2 ml BAX 00944-4201-07 cs6 x 5 ml BAX 00944-4201-11 cspharmaceuticalscontrast mediaASD Healthcare 55

Product availability subject to change.Astellas Pharma USASD # mFR # description size NDC # PK/CSMR33195 6501-89 Lexiscan 0.4 mg/ 5 ml syr 5 ml 00469-6501-89 1 eachBayer *ASD # mFR # description size NDC # PK/CSMR36563 3278959 Eovist Vial 181.43 mg/ml 10 ml 5041932005 5 vl/cs37941 1658772 Gadavist 7.5 ml vial 7.5 ml 50419032511 20 vl/cs37942 1641851 Gadavist 10 ml vial 10 ml 50419032512 20 vl/cs37943 1665637 Gadavist 15 ml vial 15 ml 50419032513 20 vl/cs37944 1684950 Gadavist 65 ml vial 65 ml 50419032515 10 vl/cs38411 1650787 Gadavist 7.5 ml SD PFS 7.5 ml 50419032527 5 syr/cs38412 1655026 Gadavist 10 ml SD PFS 10 ml 50419032528 5 syr/cs38413 1656826 Gadavist 15 ml SD PFS 15 ml 50419032529 5 syr/cs31349 1213321 Magnevist Inj syr 10 ml 5041918836 5 syr/cs30512 1213347 Magnevist Inj syr 15 ml 5041918837 5 syr/cs30513 1213727 Magnevist Inj syr 20 ml 5041918838 5 syr/cs31350 1973676 Magnevist Vial 5 ml 5041918805 20 vl/cs31351 1311935 Magnevist Vial 10 ml 5041918801 20 vl/cs35324 1311745 Magnevist Vial 15 ml 5041918815 20 vl/cs35323 3218450 Magnevist Vial 20 ml 5041918802 20 vl/cs31352 1242668 Magnevist Vial pbp 50 ml 5041918858 10 vl/cs31353 1240340 Magnevist Vial pbp 100 ml 5041918811 10 vl/cscontrast mediaCT36896 1712603 Ultravist Vial 240 mg/ml 100 ml 5041934210 10 vl/cs36897 1333343 Ultravist Vial 240 mg/ml pbp 200 ml 5041934221 10 vl/cs36553 1731355 Ultravist Vial 300 mg/ml 50 ml 5041934405 10 vl/cs32054 1732957 Ultravist Vial 300 mg/ml 100 ml 5041934410 10 vl/cs36554 1288075 Ultravist Vial 300 mg/ml 125 ml 5041934412 10 vl/cs36555 1737550 Ultravist Vial 300 mg/ml 150 ml 5041934415 10 vl/cs36556 1288802 Ultravist Vial 300 mg/ml pbp 200 ml 5041934421 10 vl/cs36898 1289578 Ultravist Vial 300 mg/ml pbp 500 ml 5041934458 8 vl/cs36557 1761378 Ultravist Vial 370 mg/ml 50 ml 5041934605 10 vl/cs36558 1761600 Ultravist Vial 370 mg/ml 100 ml 5041934610 10 vl/cs36559 1761808 Ultravist Vial 370 mg/ml 150 ml 5041934615 10 vl/cs36560 1762293 Ultravist Vial 370 mg/ml 200 ml 5041934620 10 vl/cs36561 1292630 Ultravist Vial 370 mg/ml pbp 250 ml 5041934625 10 vl/cs36562 1332535 Ultravist Vial 370 mg/ml pbp 500 ml 5041934658 8 vl/cs* No Bayer products shipped to Florida, Arizona or Nevada.56 InsideOut

Go to www.asdhealthcare.com for pricing, ordering and moreProduct availability subject to change.BraccoASD # mFR # description size NDC # PK/CSCT / X-Ray21146 1411-11 Isovue M 200 41% vl 10 x 10 ml 10 ml 00270-1411-11 10/cs26183 1411-25 Isovue M 200 41% 10 x 20 ml 20 ml 00270-1411-25 10/cs21961 1412-15 Isovue M 300 61% 10 x 15 ml 15 ml 00270-1412-15 10/cs17752 1314-30 Isovue 200 vl 10 x 50 ml 50 ml 00270-1314-30 10/cs36668 1314-15 Isovue 200 vl 10 x 200 ml 200 ml 00270-1314-15 10/cs36669 1317-05 Isovue 250 vl 10 x 50 ml 50 ml 00270-1317-05 10/cs36670 1317-02 Isovue 250 btl 10 x 100 ml 100 ml 00270-1317-02 10/cs36671 1317-09 Isovue 250 btl 10 x 150 ml 150 ml 00270-1317-09 10/cs36672 1317-41 Isovue multi 250 10 x 200 ml 200 ml 00270-1317-41 10/cs36673 1315-25 Isovue 300 61% 10 x 30 ml 30 ml 00270-1315-25 10/cs21881 1315-30 Isovue 300 61% 10 x 50 ml 50 ml 00270-1315-30 10/cs36614 1315-47 Isovue 300 61% btl 10 x 75 ml 75 ml 00270-1315-47 10/cs32427 1315-35 Isovue 300 61% btl 10 x 100 ml 100 ml 00270-1315-35 10/cs36615 1315-50 Isovue 300 61% btl 10 x 150 ml 150 ml 00270-1315-50 10/cs36677 1315-41 Isovue multi 300 btl 10 x 200 ml 200 ml 00270-1315-41 10/cs36678 1315-98 Isovue multi 300 btl 6 x 500 ml 500 ml 00270-1315-98 6/cs36679 1316-01 Isovue 370 btl 10 x 50 ml 50 ml 00270-1316-01 10/cs36680 1316-52 Isovue 370 btl 10 x 75 ml 75 ml 00270-1316-52 10/cs36681 1316-35 Isovue 370 btl 10 x 100 ml 100 ml 00270-1316-35 10/cs36682 1316-04 Isovue 370 btl 10 x 125 ml 125 ml 00270-1316-04 10/cs36683 1316-37 Isovue 370 btl 10 x 150 ml 150 ml 00270-1316-37 10/cs36688 1316-41 Isovue multi 370 10 x 200 ml 200 ml 00270-1316-41 10/cs36689 1316-98 Isovue multi 370 6 x 500 ml 500 ml 00270-1316-98 6/csCT / X-Ray36690 0265-20 Cholografin 52% vl 1 x 20 ml 20 ml 00270-0265-20 1/cs31844 1410-30 Cystografin 18% btl 10 x 300 ml 300 ml 00270-1410-30 10/cs36691 0149-60 Cystografin 30% 10 x 100 ml 100 ml 30270-0149-60 10/cs36692 0523-30 Sinografin 10 ml 10/pk 10 ml 30270-0523-30 10/csAdministration Sets and Transfer Devices36693 0004-75 Fluid Admin Set - Large Bore 00270-0004-75 10/cs36694 0051-10 Solution Transfer Device 00270-0051-10 10/csContrast Media Products - MR32442 5164-13 Multihance 529 mg 5 x 10 ml 10 ml 00270-5164-13 5/cs32441 5164-14 Multihance 529 mg 5 x 15 ml 15 ml 00270-5164-14 5/cs36622 5164-15 Multihance 529 mg/ml vl 5 x 20 ml 20 ml 00270-5164-15 5/cs36621 5164-12 Multihance 529 mg/ml vl 5 x 5 ml 5 ml 00270-5164-12 5/cs36623 5264-16 Multihance MP 529 mg/ml btl 5 x 50 ml 50 ml 00270-5264-16 5/cs36624 5264-17 Multihance MP 529 mg/ml btl 5 x 100 ml 100 ml 00270-5264-17 5/cscontrast mediaASD Healthcare 57

Product availability subject to change.ASD # mFR # description size NDC # PK/CS36617 1111-01 Prohance 279.3 mg/ml vl 5 x 10 ml 10 ml 00270-1111-01 5/cs36616 1111-04 Prohance 279.3 mg/ml vl 5 x 5 ml 5 ml 00270-1111-04 5/cs36276 1111-03 Prohance 279.3 mg/ml 5 x 20 ml 20 ml 00270-1111-03 5/cs22820 1111-02 Prohance 279.3 mg/ml vl 5 x 15 ml 15 ml 00270-1111-02 5/cs36620 1111-70 Prohance MP 279.3 mg/ml btl 5 x 50 ml 50 ml 00270-1111-70 5/csOral Contrast Agents22242 0455-40 Gastrografin 37% sol 120 ml 12/cs 120 ml 00270-0445-40 12/cs35353 44535 Gastrografin Lemon sol 24 x 30 ml 30 ml 00270-0445-35 24/csOral Contrast Agents - CT Barium35356 7350 Readi-Cat Apple 24 x 450 ml 450 ml 32909-0735-03 24/cs35355 7250 Readi-Cat Banana 24 x 250 ml 250 ml 32909-0725-07 24/cs35357 7450 Readi-Cat Banana 24 x 450 ml 450 ml 32909-0725-03 24/cs35366 721 Readi-Cat Barium 1.3% 12 x 900 ml 900 ml 32909-4501-03 12/cs35364 728 Readi-Cat Barium 1.3% 24 x 450 ml 450 ml 32909-0728-01 24/cs35365 724 Readi-Cat Barium 1.3% 4 x 1900 ml 1900 ml 32909-4501-05 4/cs35354 7150 Readi-Cat Berry 24 x 450 ml 450 ml 32909-0715-03 24/cs35359 7650 Readi-Cat Creamy Van 24 x 250 ml 250 ml 32909-0755-07 24/cs35358 7550 Readi-Cat Creamy Van 24 x 450 ml 450 ml 32909-0755-03 24/cs35360 4503-07 Readi-Cat Mochaccino 24 x 450 ml 450 ml 32909-0775-03 24/cs35363 729 Readi-Cat2 Barium 2.1% 12 x 900 ml 900 ml 32909-0723-03 12/cs35361 723 Readi-Cat2 Barium 2.1% 24 x 450 ml 450 ml 32909-0723-01 24/cs35362 726 Readi-Cat2 Barium 2.1% 4 x 1900 ml 1900 ml 32909-0723-02 4/cs35370 4501-01 E-Z Cat Barium Conc 24 x 225 ml 225 ml 32909-0720-01 24/cs35371 4501-07 E-Z Cat Barium Dry 50 x 23 gm 23 gm 32909-0727-01 50/cs35372 4501-11 Esopho-Cat Barium 24 x 30 gm 30 gm 32909-0738-01 24/cs35369 4507-01 Volumen 0.1% 24 x 450 ml 450 ml 32909-0945-03 24/cs35373 4500-02 CT Enema Kit 00270-4500-02 12/csFluoroscopy - Routine Filled Colon Examination36270 AP14 Polibar ACB Barium lq 14 oz 14 oz 00270-9005-04 24/cs36271 AP16 Polibar ACB Barium lq 16 oz 16 oz 00270-9005-06 24/cs36701 920 Empty Enema Bag 00270-9003-02 48/cs36702 935 Empty Enema Exacta Bag 00270-9003-04 4/cscontrast mediaDouble Contrast Colon Examination36513 9012-03 Super XL Empty Enema Kit 00270-9012-03 24/cs36375 9001-01 E-Z Dose Polibar Kit 650 ml 650 ml 32909-0652-02 6/cs36269 L164 Polibar Liq 100% w/v 1900 ml 1900 ml 32909-0164-01 4/cs36703 L168 Polibar Liq 105% w/v 1900 ml 1900 ml 32909-0168-02 4/csASD # mFR # description size NDC # PK/CSRoutine Upper GI Examination36061 9019-01 E-Z paque 6.2 oz 6.2 oz 32909-0750-03 24/cs36062 9028-01 E-Z Paque 12 oz 12 oz 32909-0186-02 24/cs36716 9030-01 E-Z Paque 10 kg 10 kg 32909-0750-05 1/cs58 InsideOut

Go to www.asdhealthcare.com for pricing, ordering and moreProduct availability subject to change.ASD # mFR # description size NDC # PK/CS36056 9026-01 E-Z Paque 1200 g 1200 g 32909-0750-01 8/cs36060 9029-01 E-Z Paque 1900 ml 1900 ml 32909-0186-01 4/cs35700 9019-02 Ultra-R UD cups 24 x 6 oz 6 oz 32909-0753-01 24/cs36915 9031-02 Flexible plastic straws 00270-9031-02 144/cs36063 9021-01 E-Z Paste 16 oz 1 lb 32909-0770-01 12/csDouble Contrast Examination of Esophagus, Stomach and Duodenum35699 9017-02 E-Z HD 250% w/v susp 24 x 12 oz 12 oz 32909-0764-01 24/cs36059 9018-01 E-Z HD Pail 25 lb 25 lb 00270-9018-01 1/csFluoroscopy36305 2700 Digibar 190 susp 232 gm 33609-0270-19 24/cs36377 9027-01 Maxibar Suspension 120 ml 32909-0150-08 24/cs35997 9020-01 E-Z Gas II Granules 10361-0793-0138939 9021-02 E-Z Disc 10 Grain Tabs 10361-0778-31 100/csModified Barium Swallowing Studies36719 9000-01 Varibar Barium Thin liquid 148 g 32909-0105-10 24/cs36720 9000-02 Varibar Barium Nectar 240 ml 32909-0115-00 24/cs36721 9000-04 Varibar Barium Thin Honey 250 ml 32909-0121-07 12/cs36722 9000-05 Varibar Barium Honey 250 ml 32909-0122-07 12/cs36723 9000-06 Varibar Barium Pudding 230 ml 32909-0125-22 12/csSmall Bowel/Enteroclysis Studies36724 9014-01 Entero Vu 13% 100 g Packets 100 g 32909-0754-01 12/cs36725 9014-03 Enteroclysis Admin Kit 00270-9014-03 12/cs36374 9014-06 Liquid Entero Vu 13% 600 ml 32909-0140-06 12/cs36734 9014-07 Entero Vu 24% 600 ml 32909-0145-06 12/csVirtual Colonoscopy - Patient Prepping and Laxatives36613 3902-01 Loso Prep Cleansing Kit 10361-0306-44 24/cs36738 3902-02 Loso Prep Bowel Cleansing System 10361-0376-40 50/csUltrasound Gels and Disinfecting Towelettes36307 6010-01 E-Z Gel 8 oz 8 oz 00270-6010-01 12/cs36150 6010-04 E-Z Gel in 5 L Container 00270-6010-04 4/cs36762 6010-02 E-Z Scan 0.25 L Bottle 00270-6010-02 12/cs36763 6010-03 E-Z Scan in 5 L Container 00270-6010-03 12/cs36764 Q89072 Sani-Coth Plus Towelettes 160 count 12/cscontrast mediaASD Healthcare 59

Product availability subject to change.CoeurASD # mFR # description size NDC # PK/CSConnector Tubing and Transfer Sets39061 C405-0060 Tubing LP 60" Coiled 100/cs 100/cs39244 C403-0720 Tube HP 72" Line/Fixed Leur 50/cs39245 C403-0600 Tube HP 60" Line/Fixed Leur 50/cs39343 C405-2604 Y-Tube 60" Coiled 1ck val 100/cs 100/cs39344 C405-3208 Transfer set 20" val & spike 100/cs 100/cs39365 C405-2155 Y-Tube 60" Coiled 2ck val 100/cs 100/cs39987 C853-0125 Syringe Empty 125 ml 50/csCovidienMR (Gadolinium)ASD # mFR # description size NDC # PK/CSOptimark Bottles31116 117702 OptiMARK ® 5 ml 00019-1177-02 10 vl/cs31117 117704 OptiMARK ® 10 ml 00019-1177-04 10 vl/cs31118 117706 OptiMARK ® 15 ml 00019-1177-06 10 vl/cs31119 117708 OptiMARK ® 20 ml 00019-1177-08 10 vl/cs31124 117750 OptiMARK ® 50 ml 00019-1177-50 5 vl/csOptimark Syringes39610 117711 OptiMARK ® Syringe 10 cc 00019-1177-11 10 syr/cs39611 117716 OptiMARK ® Syringe 15 cc 00019-1177-16 10 syr/cs39612 117721 OptiMARK ® Syringe 20 cc 00019-1177-21 10 syr/cs39613 117731 OptiMARK ® Syringe 30 cc 00019-1177-31 10 syr/cscontrast mediaTubing / Syringes31485 801018 Optistar MR ® Mpak 2 x 60 ml Y 60" 50/cs31486 801019 Optistar MR ® Mpak 2 x 60 ml Y 90" 50/cs31483 801020 Optistar MR ® Mpak 60 ml/25 ml Y 60" 50/cs31484 801021 Optistar MR ® Mpak 60 ml/25 ml Y 90" 50/cs31481 801103 Optistar MR ® Syringe 25 ml 100 syr/cs31482 801104 Optistar MR ® Syringe 60 ml 50 syr/csDisposable Tubing31488 801106 Optistar MR ® Coiled Y-Tubing 60" 100/cs31489 801107 Optistar MR ® Coiled Y-Tubing 90" 100/csDisposable Syringes31487 801800 Optistar ® LE Multipak 2 x 60 ml/90” Y 90" 50/cs31497 801801 Optistar ® LE Syringe 60 ml 50 syr/csPrefilled Sodium Chloride31436 118875 Sodium Chloride Inj, USP 0.9% 50 ml 00019-1188-75 10 syr/csMiscellaneous31266 1550CW Ready-Box Media Warmer LF MDL 1 each60 InsideOut

Go to www.asdhealthcare.com for pricing, ordering and moreProduct availability subject to change.CT (Iodine)ASD # mFR # description size NDC # PK/CSOptiray 350 (Glass)31157 133311 Optiray 350 100 ml 00019-1333-11 12 btl/cs31158 133316 Optiray 350 150 ml 00019-1333-16 12 btl/cs31159 133321 Optiray 350 200 ml 00019-1333-21 12 btl/cs31160 133341 Optiray 350 75 ml 00019-1333-41 12 btl/cs31156 133306 Optiray 350 50 ml 00019-1333-06 25 vl/csOptiray 350 (Plastic)39618 133375 Optiray 350 Hand-held Syringe 50 ml 00019-1333-75 20 syr/cs31161 133351 Optiray 350 Pharmacy Bulk Pkg 250 ml 00019-1333-51 12 btl/cs31162 133361 Optiray 350 Pharmacy Bulk Pkg 500 ml 00019-1333-61 6 btl/cs39256 133377 Optiray 350 Power Injector Syringe 50 ml 00019-1333-77 20 syr/cs39257 133387 Optiray 350 Power Injector Syringe 125 ml 00019-1333-87 20 syr/cs39258 133390 Optiray 350 Power Injector Syringe 100 ml 00019-1333-90 20 syr/cs39259 133395 Optiray 350 Power Injector Syringe 75 ml 00019-1333-95 20 syr/csOptiray 350 (RFID)32237 133355 Optiray 350 Power Injector RFID 50 ml 00019-1333-55 20 syr/cs32238 133327 Optiray 350 Power Injector RFID 125 ml 00019-1333-27 20 syr/cs32239 133300 Optiray 350 Power Injector RFID 100 ml 00019-1333-00 20 syr/cs32240 133385 Optiray 350 Power Injector RFID 75 ml 00019-1333-85 20 syr/csOptiray 320 (Glass)31131 132311 Optiray 320 100 ml 00019-1323-11 12 btl/cs31132 132316 Optiray 320 150 ml 0019-1323-16 12 btl/cs31133 132321 Optiray 320 200 ml 00019-1323-21 12 btl/cs31134 132341 Optiray 320 75 ml 00019-1323-41 12 btl/cs31128 132302 Optiray 320 20 ml 00019-1323-02 25 vl/cs31129 132304 Optiray 320 30 ml 00019-1323-04 25 vl/cs31130 132306 Optiray 320 50 ml 00019-1323-06 25 vl/csOptiray 320 (Plastic)39615 132375 Optiray 320 Hand-held Syringe 50 ml 00019-1323-75 20 syr/cs31135 132361 Optiray 320 Pharmacy Bulk Pkg 500 ml 00019-1323-61 6 syr/cs39250 132352 Optiray 320 Power Injector Syr 50 ml 00019-1323-52 20 syr/cs39251 132387 Optiray 320 Power Injector Syr 125 ml 00019-1323-87 20 syr/cs39252 132390 Optiray 320 Power Injector Syr 100 ml 00019-1323-90 20 syr/cs39253 132395 Optiray 320 Power Injector Syr 75 ml 00019-1323-95 20 syr/csOptiray 320 (RFID)32231 132355 Optiray 320 Power Injector RFID 50 ml 00019-1323-55 20 syr/cs32232 132327 Optiray 320 Power Injector RFID 125 ml 00019-1323-27 20 syr/cs32233 132300 Optiray 320 Power Injector RFID 100 ml 00019-1323-00 20 syr/cs32234 132385 Optiray 320 Power Injector RFID 75 ml 00019-1323-85 20 syr/csOptiray 300 (Glass)31150 133211 Optiray 300 100 ml 00019-1332-11 12 btl/cs31151 133216 Optiray 300 150 ml 00019-1332-16 12 btl/cs31152 133221 Optiray 300 200 ml 00019-1332-21 12 btl/cs31149 133206 Optiray 300 50 ml 00019-1332-06 25 btl/cscontrast mediaASD Healthcare 61

Product availability subject to change.ASD # mFR # description size NDC # PK/CSOptiray 300 (Plastic)31153 133261 Optiray 300 Pharmacy Bulk Pkg 500 ml 00019-1332-61 6 btl/cs39617 133278 Optiray 300 Hand-held Syringe 50 ml 00019-1332-78 20 syr/cs39255 133290 Optiray 300 Pl Syringe 100 ml 00019-1332-90 20 syr/csOptiray 300 (RFID)32236 133200 Optiray 300 Power Injector RFID 100 ml 00019-1332-00 20 syr/csOptiray 240 (Glass)31143 132411 Optiray 240 100 ml 00019-1324-11 12 btl/cs31144 132416 Optiray 240 150 ml 00019-1324-16 12 btl/cs31145 132421 Optiray 240 200 ml 00019-1324-21 12 btl/cs31142 132406 Optiray 240 50 ml 00019-1324-06 25 vl/csOptiray 240 (Plastic)39616 132478 Optiray 240 Hand-held Syr 50 ml 00019-1324-78 20 syr/cs39254 132487 Optiray 240 Power Injector Syr 125 ml 00019-1324-87 20 syr/csOptiray 240 (RFID)32235 132427 Optiray 240 Power Injector RFID 125 ml 00019-1324-27 20 syr/csPrefilled Sodium Chloride32290 118827 Sodium Chloride Inj, RFID 0.9% 125 ml 00019-1188-27 20 syr/cs31435 118881 Sodium Chloride Inj, USP 0.9% 125 ml 00019-1188-81 20 syr/csDisposable Syringes, Single Head Procedures31507 800099 CT MPAK FL Syr HF 200 ml 00019-8000-99 50/cs31508 800096 Frontload Syr w/hand 200 ml 00019-8000-96 50/cs31467 601195 Connector Tubing 00019-6011-95 100/csDisposable Tubing31263 844012 Y-Tube w/Dual chk vlv OptiVantage 60" 50/cs31366 844010 Y-Tube w/No chk vlv OptiVantage 60" 50/cs31264 844011 Y-Tubing w/Sgl chk vlv OptiVantage 60" 50/cs31467 601195 Low Pressure Coiled Connector Tube 60" 00019-6011-95 100/cs31376 810551 Transfer Set OptiVantage 50/cscontrast media62 InsideOut

Go to www.asdhealthcare.com for pricing, ordering and moreProduct availability subject to change.Conventional CMASD # mFR # description size NDC # PK/CSConray 3031110 95211 Conray 30 150 ml 00019-0952-11 12 btl/csConray 4331169 318309 Conray 43 250 ml 00019-3183-09 12 btl/cs31170 318315 Conray 43 50 ml 00019-3183-15 50 vl/csConray 6031111 95309 Conray 100 ml 00019-0953-09 12 btl/cs31112 95311 Conray 150 ml 00019-0953-11 12 btl/cs31113 95313 Conray 30 ml 00019-0953-13 50 vl/cs31114 95315 Conray 50 ml 00019-0953-15 50 vl/csCysto Conray31108 86207 Cysto-Contray II 250 ml 00019-0862-07 12 btl/csMD Gastroview31238 481604 MD-Gastroview 30 ml 00019-4816-04 25 btl/csMD-76R31125 131707 MD-76R 100 ml 00019-1317-07 12 btl/cs31126 131709 MD-76R 200 ml 00019-1317-09 12 btl/cs31127 131715 MD-76R 50 ml 00019-1317-15 50 vl/csHexabrix31172 550508 Hexabrix 100 ml 00019-5505-08 12 btl/cs31173 550521 Hexabrix 200 ml 00019-5505-21 12 btl/cs31174 550551 Hexabrix 20 ml 00019-5505-51 10 vl/cs31171 550506 Hexabrix 50 ml 00019-5505-06 25 vl/csMiscellaneous31542 14403 Fluid Admin Set, Large Bore 12 pk31544 265703 Sol Admin RX Burron Set 00019-2657-03 12 pkMiscellaneousASD # mFR # description size NDC # PK/CSMiscellaneous Syringes31491 302100 Syringe w/Handifil 100 ml 50 syr/cs31492 600172 Syringe w/Handifil 130 ml 50 syr/cs31493 600269 Syringe w/Handifil 150 ml 50 syr/cs31494 601360 Syringe w/Handifil for Medrad Inj 150 ml 50 syr/cs31495 601350 Syringe w/Handifil for Medrad Inj 200 ml 50 syr/cs31496 600169 Syringe w/Handifil 260 ml 50 syr/cs31498 900105 Illumena Syringe w/Handifil Disp 200 ml 50 syr/cs31499 601590 Tripack Syringe 200 ml 50 syr/cscontrast mediaASD Healthcare 63

Product availability subject to change.GEASD # mFR # description size NDC # PK/CSMR36780 J068 Omniscan 287 mg/ml vl 10 x 5 ml 5 ml 00407-0690-05 10/cs36781 J100 Omniscan 287 mg/ml vl 10 x 10 ml 10 ml 00407-0690-10 10/cs36782 J160 Omniscan 287 mg/ml pfs 10 x 10 ml 10 ml 00407-0690-12 10/cs30563 J120 Omniscan 287 mg/ml vl 10 x 15 ml 15 ml 00407-0690-15 10/cs36783 J170 Omniscan 287 mg/ml pfs 10 x 15 ml 15 ml 00407-0690-17 10/cs36784 J140 Omniscan 287 mg/ml vl 10 x 20 ml 20 ml 00407-0690-20 10/cs36785 J180 Omniscan 287 mg/ml pfs 10 x 20 ml 20 ml 00407-0690-22 10/cs36787 J800 Omniscan 287 mg/ml 10 x 100 ml 100 ml 00407-0690-70 10/cs36788 J640 Omniscan 287 mg/ml pfs 10 x 15 ml 15 ml 00407-0691-62 10/cs36789 J650 Omniscan 287 mg/ml pfs 10 x 20 ml 20 ml 00407-0691-63 10/cscontrast mediaCT36790 Y510 Omnipaque +140 mg/ml 10 x 50 ml 50 ml 00407-1401-52 10/cs19648 Y101 Omnipaque 180 mg/ml vl 10 x 10 ml 10 ml 00407-1411-10 10/cs21201 Y102 Omnipaque 180 mg/ml 10 x 20 ml 20 ml 00407-1411-20 10/cs21202 Y203 Omnipaque 240 mg/vl 10 x 10 ml 10 ml 00407-1412-10 10/cs30114 Y220 Omnipaque 240 mg/ml vl 10 x 20 ml 20 ml 00407-1412-20 10/cs36795 Y520 Omnipaque +240 mg/ml btl 10 x 50 ml 50 ml 00407-1412-30 10/cs36796 Y522 Omnipaque +240 mg/ml btl 10 x 100 ml 100 ml 00407-1412-33 10/cs28889 Y524 Omnipaque +240 mg/ml btl 10 x 150 ml 150 ml 00407-1412-34 10/cs36797 Y526 Omnipaque +240 mg/ml btl 10 x 200 ml 200 ml 00407-1412-35 10/cs28495 Y250 Omnipaque 240 mg/ml vl 10 x 50 ml 50 ml 00407-1412-50 10/cs22823 Y306 Omnipaque 300 mg/ml vl 10 x 10 ml 10 ml 00407-1413-10 10/cs20225 Y308 Omnipaque 300 mg/ml vl 10 x 50 ml 50 ml 00407-1413-50 10/cs36803 Y530 Omnipaque +300 mg/ml btl 10 x 50 ml 50 ml 00407-1413-61 10/cs36804 Y531 Omnipaque +300 mg/ml btl 10 x 75 ml 75 ml 00407-1413-62 10/cs36805 Y532 Omnipaque +300 mg/ml btl 10 x 100 ml 100 ml 00407-1413-63 10/cs36806 Y534 Omnipaque +300 mg/ml btl 10 x 150 ml 150 ml 00407-1413-65 10/cs36807 Y536 Omnipaque +300 mg/ml btl 10 x 200 ml 200 ml 00407-1413-66 10/cs36808 Y538B Omnipaque +300 mg/ml btl 10 x 500 ml 500 ml 00407-1413-68 10/cs36816 Y416 Omnipaque 350 mg/ml btl 10 x 200 ml 200 ml 00407-1414-04 10/cs36829 Y420 Omnipaque 350 mg/ml btl 10 x 125 ml 125 ml 00407-1414-76 10/cs32944 Y540 Omnipaque +350 mg/ml btl 10 x 50 ml 50 ml 00407-1414-89 10/cs36831 Y541 Omnipaque 350 mg/ml btl 10 x 75 ml 75 ml 00407-1414-90 10/cs36832 Y542 Omnipaque +350 mg/ml btl 10 x 100 ml 100 ml 00407-1414-91 10/cs36833 Y544 Omnipaque +350 mg/ml btl 10 x 150 ml 150 ml 00407-1414-93 10/cs36834 Y546 Omnipaque +350 mg/ml btl 10 x 200 ml 200 ml 00407-1414-94 10/cs36835 Y548B Omnipaque +350 mg/ml btl 10 x 500 ml 500 ml 00407-1414-98 10/cs26548 V020 Visipaque 270 mg/ml btl 10 x 50 ml 50 ml 00407-2222-01 10/cs36838 V550 Visipaque +270 mg/ml btl 10 x 50 ml 50 ml 00407-2222-16 10/cs64 InsideOut

Go to www.asdhealthcare.com for pricing, ordering and moreProduct availability subject to change.ASD # mFR # description size NDC # PK/CS36839 V552 Visipaque +270 mg/ml btl 10 x 100 ml 100 ml 00407-2222-17 10/cs36840 V554 Visipaque +270 mg/ml btl 10 x 150 ml 150 ml 00407-2222-19 10/cs36841 V556 Visipaque +270 mg/ml btl 10 x 200 ml 200 ml 00407-2222-21 10/cs36842 V558B Visipaque +270 mg/ml btl 10 x 500 ml 500 ml 00407-2222-23 10/cs36849 V560 Visipaque +320 mg/ml btl 10 x 50 ml 50 ml 00407-2223-16 10/cs36850 V562 Visipaque +320 mg/ml btl 10 x 100 ml 100 ml 00407-2223-17 10/cs36851 V564 Visipaque +320 mg/ml btl 10 x 150 ml 150 ml 00407-2223-19 10/cs36852 V566 Visipaque +320 mg/ml btl 10 x 200 ml 200 ml 00407-2223-21 10/cs36853 V568B Visipaque +320 mg/ml btl 10 x 500 ml 500 ml 00407-2223-23 10/cscontrast mediaASD Healthcare 65

Product availability subject to change.Nephrology RxASD # Description NDC # ManufacturerAntibiotics24330 Amikacin Sulfate 250 mg 4 ml 00703-9040-03 Teva Pharmaceuticals USA34185 Cefazolin 1 gm SDV 25/10 ml 00409-0805-01 Hospira Worldwide Inc.37505 Ceftazidime 1 gm 20 ml 25021-0127-20 Sagent Pharmaceuticals37506 Ceftazidime 2 gm 50 ml 25021-0128-50 Sagent Pharmaceuticals26591 Ceftriaxone 1 gm 00409-7332-01 Hospira Worldwide Inc.26408 Ceftriaxone 2 gm 10019-0688-04 Westward/Baxter28516 Ciprofloxacin 400 mg SDV 40 ml each 00409-4778-86 Hospira Worldwide Inc.32428 Cubicin Daptomycin 500 mg vl 67919-0011-01 Cubist Pharmaceutical24631 Cubicin Daptomycin 500 mg 10/pk 67919-0011-01 Cubist Pharmaceutical26086 Fortaz 1 gm vl pwd 10 x 25 ml 00173-0378-10 Covis Pharmaceutical26087 Fortaz 500 mg 00173-0377-10 Covis Pharmaceutical10117 Gentamicin 40 mg/ml FTV 25 x 2 ml 63323-0010-02 Fresenius Kabi USA, LLC23421 Gentamicin Top 0.1% crm 15 gm 00168-0071-15 Fougera E and Co.38513 Levofloxacin 500 mg 20 ml SDV 17478-0107-20 Akorn Inc.14181 Rocephin 1 gm vl each 00004-1964-04 Genentech USA27620 Tazicef ® 1 gm 25 x 2 ml 00409-5082-16 Hospira Worldwide Inc.38521 Tobramycin 80 mg 25 x 2 ml 63323-0306-02 Fresenius Kabi USA, LLC38575 Vancomycin 500 mg FTV 10/box 00069-2587-10 Pfizer38574 Vancomycin 1 gm FTV 10/box 00069-2589-10 Pfizercontrast nephrology mediaESAs28198 Aranesp 25 mcg SDV 4 x 1 ml 55513-0002-04 Amgen Inc.28199 Aranesp 40 mcg SDV 4 x 1 ml 55513-0003-04 Amgen Inc.28200 Aranesp 60 mcg SDV 4 x 1 ml 55513-0004-04 Amgen Inc.28201 Aranesp 100 mcg SDV 4 x 1 ml 55513-0005-04 Amgen Inc.28202 Aranesp 150 mcg SDV 4 x 0.75 ml 55513-0053-04 Amgen Inc.28203 Aranesp 200 mcg SDV 1 ml 55513-0006-01 Amgen Inc.28204 Aranesp 300 mcg SDV 1 ml 55513-0110-01 Amgen Inc.28191 Aranesp 25 mcg PFS 4 x 0.42 ml 55513-0057-04 Amgen Inc.28192 Aranesp 40 mcg PFS 4 x 0.4 ml 55513-0021-04 Amgen Inc.28193 Aranesp 60 mcg PFS 4 x 0.3 ml 55513-0023-04 Amgen Inc.28194 Aranesp 100 mcg PFS 4 x 0.5 ml 55513-0025-04 Amgen Inc.28195 Aranesp 150 mcg PFS 4 x 0.3 ml 55513-0027-04 Amgen Inc.28196 Aranesp 200 mcg PFS 0.4 ml 55513-0028-01 Amgen Inc.28197 Aranesp 300 mcg PFS 0.6 ml 55513-0111-01 Amgen Inc.28140 Aranesp 500 mcg PFS 1 ml 55513-0032-01 Amgen Inc.11230 Epogen S3 3 M un/ml vl 10 x 1 ml 55513-0267-10 Amgen Inc.11295 Epogen S4 4 M un/ml vl 10 x 1 ml 55513-0148-10 Amgen Inc.11294 Epogen S2 2 M un/ml vl 10 x 1 ml 55513-0126-10 Amgen Inc.11296 Epogen S10 10 M un/ml vl 10 x 1 ml 55513-0144-10 Amgen Inc.11177 Epogen M10 20 M un/2ml MDV 10 x 2 ml 55513-0283-10 Amgen Inc.11508 Epogen M20 20 M un/ml MDV 10 x 1 ml 55513-0478-10 Amgen Inc.66 InsideOut

Go to www.asdhealthcare.com for pricing, ordering and moreProduct availability subject to change.ASD # Description NDC # Manufacturer30696 Procrit 20 m un/ml MDV 4 x 1 ml 59676-0320-04 Ortho Biotech Products, LP10982 Procrit 40 m un/ml vl 4 x 1 ml 59676-0340-01 Ortho Biotech Products, LP31310 Procrit 10 m un/ml 2 ml MDV 4/pk 59676-0312-04 Ortho Biotech Products, LP10510 Procrit 10 m un/ml vl 6 x 1 ml 59676-0310-01 Ortho Biotech Products, LP11190 Procrit 10 M un/ml 1 ml 25/pk 59676-0310-02 Ortho Biotech Products, LPVaccines30326 Engerix B Hep/Vaccine 20 mcg (Vials) 58160-0821-11 Glaxosmithkline Vaccines30218 Engerix B Hep/Vaccine 10 mcg (Pediatric) 58160-0820-11 Glaxosmithkline Vaccines36945 Engerix B Hep/Vaccine 20 mcg (PFS Tiplok) 58160-0821-52 Glaxosmithkline Vaccines10486 Pneumovax 23 5 dose 2.5 ml 00006-4739-00 Merck & Co.10355 Pneumovax 23 vl 0.5 ml 10/pk 00006-4943-00 Merck & Co.22353 Recombivax HB 40 mcg 1 ml 00006-4992-00 Merck & Co.22719 Recombivax 10 mcg 1 ml (Pediatric) 00006-4995-00 Merck & Co.Heparin36901 Heparin 1000 u/ml MDV 25 x 30 ml 25021-0400-30 Sagent Pharmaceuticals36906 Heparin sod 5 m MDV vl 25 x 10 ml 25021-0402-10 Sagent Pharmaceuticals37216 Heparin sod 10 m un MDV 25 x 1 ml 25021-0403-01 Sagent Pharmaceuticals37217 Heparin sod 1 m un/ml MDV 25 x 10 ml 25021-0400-10 Sagent Pharmaceuticals37215 Heparin sod 5 ml un MDV 25 x 10 ml 25021-0400-10 Sagent Pharmaceuticals37218 Heparin sod 10 m un MDV 25 x 4 ml 25021-0403-04 Sagent PharmaceuticalsIron37769 Ferrlecit 62.5 mg/5 ml vl 10 x 5 ml 00024-2792-10 Sanofi Renal34408 Feraheme 510 mg/17 ml SDV 59338-0775-01 AMAG34409 Feraheme 510 mg/17 ml SDV 10/pk 59338-0775-10 Amag22668 Infed 50 mg/ml vl 10 x 2 ml 52544-0931-02 Watson Pharm39476 Sodium Ferric Gluconate Sucrose Injection 00591-0149-87 Watson Pharm20686 Venofer 20 mg/ml vl 10 x 5 ml (CKD) 00517-2340-10 Amer Regent Lab29962 Venofer 20 mg/ml SDV 2 x 5 ml (CKD) 00517-2340-25 Amer Regent Lab37214 Venofer 50 mg SDV 10 x 2.5 ml (Dialysis) 49230-0530-10 Fresenius USA Marketing33100 Venofer 100 mg SDV 10 x 5 ml (Dialysis) 49230-0534-10 Fresenius USA MarketingVitamin D37547 Calcitriol 0.25 mcg caps 100/btl 63304-0239-01 Ranbaxy37548 Calcitriol 0.5 mcg caps 100/btl 63304-240-01 Ranbaxy37813 Calcitriol Oral Solution 1 mcg 15 ml 00054-3120-41 Roxanne38711 Calcitriol 1 mcg/ml amp 10 x 1 ml 17478-0931-01 Akorn Inc.29151 Hectorol 0.5 mcg caps 50/btl 58468-0120-01 Sanofi Renal37234 Hectorol 1 mcg caps 50/btl 58468-0124-01 Sanofi Renal37299 Hectorol 2 mcg SDV 50 x 1 ml 58468-0126-01 Sanofi Renal33635 Hectorol 2.5 mcg caps 50 58468-0121-01 Sanofi Renal33705 Hectorol 4 mcg 50 x 2 ml 58468-0123-01 Sanofi Renal37232 Zemplar 1 mcg caps 30/btl 00074-4317-30 AbbViecontrast media nephrologyASD Healthcare 67

Product availability subject to change.ASD # Description NDC # Manufacturer37233 Zemplar 2 mcg caps 30/btl 00074-4314-30 AbbVie20967 Zemplar 2 mcg/ml vl 25 x 1 ml 00074-4637-01 AbbVie32194 Zemplar 4 mcg caps 30/btl 00074-4315-30 AbbVie10001 Zemplar 5 mcg/ml 25 x 1 ml FTV 00074-1658-01 AbbVie37381 Zemplar 10 mcg/2 ml mdv 25 x 2 ml 00074-1658-05 AbbViecontrast nephrology mediaOther / Ancillary Rx28520 Acetaminophen 325 mg tab UD 100 00904-1982-61 Major Pharm20363 Activase Cathflo 2 mg SDV 50242-0041-64 Genentech USA31843 Aplisol 5TU 50 test vl 5 ml 42023-0104-05 JHP Pharmaceuticals31842 Aplisol 5tu 10 test vl 1 ml 42023-0104-01 JHP Pharmaceuticals32464 Atropine lfs syr 10 ml 0.1 mg/ml 00409-4911-34 Hospira Worldwide Inc.19920 Cal Gluc 10% SDV 10 ml each 63323-0311-10 Fresenius Kabi USA, LLC27616 Calcium Chloride 10% syringe 00409-1631-10 Hospira Worldwide Inc.20490 Carnitor 1 gm/5 ml SDV 5 x 5 ml 54482-0147-01 Sigma-Tau Pharmaceuticals10093 Clonidine 0.1 mg tab 100/btl 00228-2127-10 Actavis27537 Dextrose 25 gm ansyr 50 ml each 00409-7517-16 Hospira Worldwide Inc.26223 Dextrose 50% vl 25 x 50 ml 00409-6648-02 Hospira Worldwide Inc.10704 Diphenhydramin 25 mg cap 100/btl 00185-0648-01 Sandoz38759 Diphenhydramine 25 mg UD 100/pk 00904-5306-61 Major Pharm22253 Diphenhydramne 50 mg vl 25 x 1 ml 63323-0664-01 Fresenius Kabi USA, LLC27730 Epinep lfshld syg 10 ml nondl 00409-4921-34 Hospira Worldwide Inc.27229 Epinep 1:10000 18 g abjct 10 ml 00409-4901-18 Hospira Worldwide Inc.27906 Gelfoam 12-7 mm spg 12/pk 00009-0315-08 Pfizer Pharm34930 Glucose tab orange 10/pk 38396-0543-64 Amerisourcebergen Drug Corporation40021 Hydrogen Peroxide 3% Liq 16 oz each 00869-0871-43 Amerisourcebergen Drug Corporation29417 Imodium Liq 4 oz 50580-0134-04 Johnson & Johnson10063 Insulin Hum R 100 u/ml vl 10 ml 00002-8215-01 Eli Lilly & Co32794 Lido 0.5% FTV 50 ml each 00409-4275-01 Hospira Worldwide Inc.27029 Lidocaine 1% ansyr syg 5 ml each 00409-9137-05 Hospira Worldwide Inc.26662 Lidocaine 1% FTV 50 ml each 00409-4276-02 Hospira Worldwide Inc.20078 Loperamide 2 mg cap 100/btl 00093-0311-01 Teva Pharmaceuticals USA36031 Mannitol 25% FTV 25 x 50 ml 00409-4031-01 Hospira Worldwide Inc.11474 Mannitol 25% SDV 25 x 50 ml 63323-0024-25 Fresenius Kabi USA, LLC40755 Maxipime 1 gm FTV PWD 10/pk 00409-0219-01 Hospira Worldwide Inc.40756 Maxipime 2 gm FTV PWD 10/pk 00409-0220-01 Hospira Worldwide Inc.32324 Metoclopram 10 mg/2ml FTV 2 00409-3414-01 Hospira Worldwide Inc.32320 Pain Ease Spray mist 3 oz 00386-0008-02 Gebauer Company26843 Pain ease 3.5 oz spray 00386-0008-03 Gebauer Company39202 Phenergan 25 mg 1 ml 25/pk 00641-6082-25 Westward/Baxter32546 Phenytoin Sod 250 mg 5 ml vl 00641-2555-41 Westward/Baxter11151 Promethazine 25 mg/ml amp 25 x 1 ml 00641-1495-35 Westward/Baxter18779 Sod Chl. 0.9% 100/150 cc bags 64/cs 00264-1800-32 B. Braun Medical18782 Sod Chl 0.9% 1000 cc bag 12/case 00264-7800-00 B. Braun Medical10032 Sod Chl 0.9% Excl 24 x 500 ml sol 00264-7800-10 B.Braun Medical11484 Sod Chl Conc 23.4% SDV 25 x 30 ml 63323-0187-30 Fresenius Kabi USA, LLC27615 Sod Bic 8.4% Ls syg 50 ml each 00409-6637-34 Hospira Worldwide Inc.68 InsideOut

Go to www.asdhealthcare.com for pricing, ordering and moreProduct availability subject to change.ASD # Description NDC # Manufacturer37007 Triple Anti Oint Foil 144 x 0.9 gm Dynarex Corp20609 Tubersol 5tu 10 test vl 1 ml 49281-0752-21 Sanofi Pasteur19969 Tubersol 5TU 50 test vl 5 ml 49281-0752-22 Sanofi Pasteur11062 Tums e-x x/s fruit tab 96/pk 00766-0739-66 Glaxosmithkline26656 Water Sterile FTV 25 x 10 ml 00409-4887-10 Hospira Worldwide Inc.26552 Water Sterile FTV 25 x 20 ml 00409-4887-20 Hospira Worldwide Inc.38566 Xylocaine 2% MDV 20 ml 25/pk 63323-0486-27 Fresenius Kabi USA, LLCNephrology Medical / SurgicalASD # description manufacturer pk/csTop Disposable Products35009 Alcohol Prep Pad Med. (sterile) Dynarex 200/box27969 Alcohol Swabsticks 3'S Dynarex 25/box32474 Apron Gowns Disposable 28" x 46" (Plastic) Busse 144/case32710 Catheter Cap (injectable) Latex Free Molded 100/box18784 Catheter Cap (dead end /non-injectable) B. Braun 100/box26860 Chloraprep Single Swabstick Tacy Med 48/box32787 Cotton Tip Applicators 6" Sterile 2’s Harwood 100/boxDialysis Recliner – 6 Position Winco 1/ea.32475 Drape Sheet 18" x 26" (other sizes available) Busse 50/box26857 Drape Sheet 40" x 48" 2 ply Tidi 100/case36048 Drape Sheet 40" x 90" 3 ply Tidi 50/case34089 Emesis Basin 9" Medline 250/case32618 Fistula Pressure Clamps (Plastic) Molded 1/ea.35908 Hemastix Test Strips Siemens 50/box32709 Hemoband (non-sterile) Hemoband 1/ea.32761 Luer Lock End Caps – Blue Molded 100/box18534 Mask (Ear Loop) Blue Dynarex 50/box14837 Mask (Molded) Blue Dynarex 50/box18318 Medicine Cups 1 oz Dynarex 100/box32538 Oxygen Mask Rebreather – Adult Allied 1/ea.15184 Oxygen Nasal Cannula – Adult Allied 1/ea.14844 Povidone/Iodine Prep Pads (PVP Pads) Dynarex 100/box14840 Povidone/Iodine Swabsticks (1 per pack) Dynarex 50/box28053 Povidone/Iodine Swabsticks (3 per pack) Dynarex 75/box32754 Recirculating Connector (Male to Male) Molded 100/box32414 Shoe Covers – Blue (one size fits all) Dynarex 150/pairs26355 Skin Staple Remover Kits Busse 1/ea.20941 Suture Removal Kits Busse 1/ea.15598 Table Paper 21" x 225' Smooth Tidi 12/case20568 Towel 3 ply 13.5" x 18" White 500/case Graham 500/casecontrast nephrology mediaASD Healthcare 69

Product availability subject to change.ASD # Description Manufacturer pk/cs14815 Tape Remover Pads (Sterile) Dynarex 100/box32643 Transducer Protector (w/luer lock) Molded 100/case32755 Tube Occluding Clamp (hemostats) Blue Molded 100/bag25875 Underpad 17" x 24" (blue) Chux Dynarex 300/case32605 Urinals w/Cover – Plastic (disposable) Perigon 50/case33864 Urinals w/Cover – Plastic (disposable) Medline 1/ea.15601 Wash Cloths 10" x 13.5" (blue/disposable) Graham 500/caseGloves39657 Gloves PF Latex Small Tradex 100/box39658 Gloves PF Latex Medium Tradex 100/box39659 Gloves PF Latex Large Tradex 100/box39660 Gloves PF Latex X-Large Tradex 100/box39653 Gloves PF Vinyl Small Tradex 100/box39654 Gloves PF Vinyl Medium Tradex 100/box39655 Gloves PF Vinyl Large Tradex 100/box39656 Gloves PF Vinyl X-Large Tradex 100/box32407 Gloves Sterile Latex (Medium) Sm and Lg Avail. Tradex 50/pairs39661 Gloves PF Nitrile Small Tradex 100/box39662 Gloves PF Nitrile Medium Tradex 100/box39663 Gloves PF Nitrile Large Tradex 100/box39664 Gloves PF Nitrile X-Large Tradex 100/boxLab Coats39797 Lab Coat White No Pkt Small Dynarex 30/case39795 Lab Coat White No Pkt Medium Dynarex 30/case39794 Lab Coat White No Pkt Large Dynarex 30/case39796 Lab Coat White No Pkt X-Large Dynarex 30/case39836 Lab Coat White No Pkt XX-Large Dynarex 30/caseSharps containers17710 Sharps Container 2 gallon - Red (# 8961) Kendall 20/case22352 Sharps Container 2 gallon - Red (# 8970) Square Kendall 20/case36603 Sharps Container 3 gallon - Red (# 852221) Square Kendall 10/case32727 Sharps Container 3 gallon - Red (# 8964) Kendall 20/case23163 Sharps Container 8 gallon - Red (# 8980) Square Kendall 10/case32042 Sharps Container 8 gallon - Red (# 8980S) Slide Lid Kendall 10/case11973 Sharps Container 18 gallon - Red Kendall 1/ea.32623 Sharps Container – Brackets 2 and 3 gallon Kendall 1/ea.contrast nephrology mediaThermometers13281 Filac Probe Covers Kendall 500/box32742 Genius Probe Covers Kendall 2100/case14167 Tempa Dot Thermometers (Oral and Axil) 3M 100/box24456 Thermoscan Sure Temp Plus 690 Welch Allyn 1/ea.32765 Thermoscan Sure Temp Probe Covers Welch Allyn 1000/case25572 Thermoscan Probe Covers Welch Allyn 800/box70 InsideOut

Go to www.asdhealthcare.com for pricing, ordering and moreProduct availability subject to change.ASD # Description Manufacturer pk/csTape14137 Durapore Tape 1" x 10 yards (Cloth/Silk) 3M 12/rolls14138 Durapore Tape 2" x 10 yards (Cloth/Silk) 3M 6/rolls33234 Durapore/Single Use 1" x 1.5 yards (Cloth/Silk) 3M 100/rolls32338 Hypo-Pore Tape 1" x 10 yards (Paper) Dukal 12/rolls32577 Hypo-Silk Cloth Tape 1" x 10 yards Dukal 12/rolls19140 Micropore Tape 1" x 10 yards (Paper) 3M 12/rolls32535 Micropore/Single Use 1" x 1.5 yards (Paper) 3M 100/rolls32536 Transpore Tape 1" x 1.5 yards (Clear Plastic) 3M 500/rolls14151 Transpore Tape 1" x 10 yards (Clear Plastic) 3M 12/rollsBandages34440 Bandage Strip 1" x 3" (plastic) Dukal 100/box32553 Bandage Strip 3/4" x 3" (plastic) Dukal 100/box19216 Bandage Flex Strip 1" x 3" Dynarex 100/box19204 Bandage Sheer Strip 1" x 3" Dynarex 100/box32594 Gauze 2" x 2" (non-sterile) 8 Ply Dukal 5000/case32595 Gauze Pads 2" x 2" 8 Ply (sterile) 2's Dukal 1500/case32597 Gauze 4" x 4" 12 ply N/S 2000/case Dukal 2000/case32693 Gauze 4" x 4" 12 ply (sterile) Dukal 100/box32796 Gauze 4" x 4" 8 Ply (sterile) 2's Dukal 1200/box24274 Gauze 2" x 2" 8 Ply (sterile) 2's Dynarex 100/box13275 Telfa Pads 2" x 3" Sterile Kendall 100/box32578 Tegaderm 2 3/8" x 2 3/4" (compare to 3M brand) Dukal 100/box32741 Tegaderm 4" x 4 3/4" (compare to 3M brand) Dukal 50/box14163 Tegaderm 2 3/8" x 2 3/4" 3M Brand 3M 100/box18528 Tegaderm 4" x 4 3/4" 3M Brand 3M 50/box32743 Topper Sponge Sterile 4" x 3" Dukal 50/box32357 Zorband (Large) 1" x 2 3/4" (compare to Sureseal) Exel 100/box32358 Zorband (XL) 1 1/4" x 2 3/4" (compare to Sureseal) Exel 100/boxFace masks and shields34204 Face Shield – Full Length (no visor) Precept 1/ea.18534 Mask (ear loop) Blue Dynarex 50/box14837 Mask (molded) Blue Dynarex 50/box18544 Mask (ear loop) w/Face Shield Blue Dynarex 50/boxTest strips11262 Accuchek Comfort Curve Test Strip Roche 100 strips11265 Accuchek Comfort Curve Control Solution Roche 1/box32328 Ascensia Breeze Gluc. Blood Strips Bayer 50 strips34128 Bicarb PH II Test Strips (100 per bottle) SerimResearch 5/btls34124 Chlorine Test Strips (100 per bottle) SerimResearch 6/btls21204 One Touch Ultra Test Strips Lifescan 100 strips23596 One Touch Ultra Control Solution 4 ml Lifescan 2/v37537 Total Chlorine Hisense Test Kit Serim Research 1/kit34131 Total Chlorine Hisense Refills 5 x 100 Serim Research 1/kitcontrast nephrology mediaASD Healthcare 71

Product availability subject to change.ASD # Description Manufacturer pk/cs34127 Peracetic Acid Reagant Strips (100 per bottle) Serim Research 6/btls34126 Residual Peroxide Reagant Strips (100 per bottle) Serim Research 6/btls34130 Water Hardness Reagent Strips (50 per bottle) SerimResearch 6/btlsNeedles10993 Needles 18g x 1" Terumo 100/box18984 Needles 18g x 1.5" Terumo 100/box11072 Needles 20g x 1" Terumo 100/box18985 Needles 21g x 1.5" Terumo 100/box11065 Needles 23g x 1" Terumo 100/box11058 Needles 25g x 5/8" Terumo 100/boxFistula needles32361 Fistula Needles 15g x 1" w/Back Eye 12" TB Exel 50/box32362 Fistula Needles 16g x 1" w/Back Eye 12" TB Exel 50/box32360 Fistula Needles 17g x 1" w/Back Eye 12" TB Exel 50/box32560 Fistula Needles 17g x 1.25" w/Back Eye 12" TB Exel 50/box32359 Fistula Needles 15g x 1" w/o Back Eye 12" TB Exel 50/boxDuopross syringes32575 3cc 21g x 1.5" Low Dead Space safety syringe Duopross 100/box32571 1cc 22g x 1 x 1.5" Renal Max Duopross 100/box32570 1cc 22g x 1.5" Renal Safe safety syringe Duopross 100/box32576 1cc 25g x 5/8" Safety TB Syringe Duopross 100/box34418 Insulin Syringe 1cc 29g x 1/2" Duopross 100/box34915 Safety Syringe 3cc 23g x 1" Duopross 100/boxcontrast nephrology mediaSyringes32680 Insulin Syringe 1cc 27g x 1/2" Terumo 100/box32562 Insulin Syringe 1cc 29g x 1/2" Terumo 100/box22686 Syringe 1cc 27g x 1/2" Allergy (Low Dead Space) Terumo 100/box18993 TB Syringe 1cc 25g x 5/8" Terumo 100/box32352 TB Syringe 1cc 25g x 5/8" (Zero Dead Space) Exel 100/box11033 Syringe 1cc w/Luer Lock Terumo 100/box18995 Syringe 3cc w/Luer Lock Terumo 100/box18996 Syringe 3cc 20g x 1" w/Luer Lock Terumo 100/box18997 Syringe 3cc 21g x 1" w/Luer Lock Terumo 100/box18998 Syringe 3cc 22g x 1" w/Luer Lock Terumo 100/box32367 Safety Syringe 3cc 22g x 1" Exel 100/box11053 Syringe 3cc 23g x 1" Terumo 100/box11049 Syringe 3cc 25g x 5/8" Terumo 100/box19000 Syringe 5cc w/Luer Lock Terumo 100/box11031 Syringe 10cc w/Luer Lock Terumo 100/box19003 Syringe 10cc 21g x 1" Terumo 100/box33579 Syringe 20cc w/Luer Lock Terumo 50/box11403 Syringe 30cc w/Luer Lock Terumo 25/box11407 Syringe 60cc w/Luer Lock Terumo 25/box72 InsideOut

Go to www.asdhealthcare.com for pricing, ordering and moreProduct availability subject to change.ASD # Description Manufacturer pk/csB/D – Syringes12786 TB Syringe 1cc 25g x 5/8" (BD# 309626) B/D 100/box10645 Syringe 10cc Luer Lock (BD# 309604) B/D 100/box10638 Syringe 10cc 21g x 1" (BD# 309642) B/D 100/box37116 Syringe 3cc Luer Lock (BD# 309657) B/D 200/box12791 Syringe 3cc 20g x 1.5" (BD# 309579) B/D 100/box12792 Syringe 3cc 20g x 1" (BD# 309578) B/D 100/box12794 Syringe 3cc 21g x 1" (BD# 309575) B/D 100/box12795 Syringe 3cc 22g x 1.5" (BD# 309574) B/D 100/box12796 Syringe 3cc 22g x 1" (BD# 309572) B/D 100/box12797 Syringe 3cc 23g x 1" (BD# 309571) B/D 100/box12799 Syringe 3cc 25g x 1" (BD# 309581) B/D 100/box12882 Syringe 30cc Luer Lock (BD# 309650) B/D 40/box12814 Syringe 5cc 21g x 1.5" (BD# 309633) B/D 100/boxB/D – Safety syringes23970 BD Integra 3cc 22g x 1.5" Low Dead Space B/D 100/box23969 BD Integra 3cc 23g x 1" Low Dead Space B/D 100/box12782 Insulin Safety Syringe 1cc 29g x 1.5" (BD# 329464) B/D 500/case18735 Safety Syringe 10cc Luer Lock (BD# 305559) B/D 50/box19562 Safety Syringe 10cc 21g x 1.5" (BD# 305564) B/D 50/box12884 Safety Syringe 3cc Luer Lock (BD# 309606) B/D 100/box12808 Safety Syringe 3cc 21g x 1.5" (BD# 309595) B/D 100/box12789 Safety Syringe 3cc 22g x 1.5" (BD# 309593) B/D 100/box12811 Safety Syringe 3cc 25g x 5/8" (BD# 309592) B/D 100/box18734 Safety Syringe 5cc Luer Lock (BD# 305558) B/D 50/box19561 Safety Syringe 5cc 21g x 1.5" (BD# 305561) B/D 50/box12784 TB Safety Syringe 1cc 25g x 5/8" (BD#305554) B/D 100/box12785 TB Safety Syringe 1cc 27g x 1/2" (BD# 305553) B/D 100/boxKendall – Safety syringes19521 Safety Syringe 1cc Insulin 29g x 1.5" Kendall 100/box19519 Safety Syringe 1cc 28g x 1/2" Kendall 100/box19518 Safety Syringe 1cc 25g x 5/8" Kendall 100/box19525 Safety Syringe 3cc 20g x 1 x 1.5" Kendall 100/box19302 Safety Syringe 3cc 21g x 1" Kendall 100/box19303 Safety Syringe 3cc 21g x 1 x 1.5" Kendall 100/box19528 Safety Syringe 3cc 22g x 1.5" Kendall 100/box19304 Safety Syringe 3cc 23g x 1" Kendall 100/box19530 Safety Syringe 3cc 25g x 5/8" Kendall 100/box19536 Safety Syringe 6cc 20g x 1.5" Kendall 50/box19308 Safety Syringe 6cc 21g x 1 x 1.5" Kendall 50/box19531 Safety Syringe 6cc Luer Lock Kendall 50/box19300 Safety Syringe 12cc 20g x 1 x 1.5" Kendall 50/box19301 Safety Syringe 12cc 21g x 1 x 1.5" Kendall 50/box19535 Safety Syringe 12cc Luer Lock Kendall 50/boxcontrast nephrology mediaASD Healthcare 73

Our Customer ServiceRepresentativesare here for you.During our regular business hours or during an after-hoursemergency, you can count on ASD Healthcare to provide youthe products and the service you need, when you need them.Call ASD Healthcare today to experience our superior service,get connected with a dedicated Account Manager, and startenjoying the benefits of working with ASD Healthcare.For more information, please visit www.asdhealthcare.comor call us at 800.746.6273.Customer Service800.746.6273Monday – Thursday7:00 am – 6:30 pm CSTFriday7:00 am – 6:00 pm CST24 hour emergency on-call74 InsideOut

in the worksClinicalTrialsPatients with Primary Immunodeficiency Diseases(PIDD) are prone to infectious disease, autoimmunedisorders and malignancy. This can result in recurringand/or chronic infections that lead to organ damage.ADMA Biologics is currently recruiting participantsfor a Phase-III, open label study to evaluate the pharmacokinetics,efficacy and safety of RI-002 (IGIV) insubjects with PIDD. This study will recruit both maleand female participants between the ages of 2 and 75.Relypsa Inc. is conducting a study to evaluatePatiromer in the treatment of hyperkalemia. Males andfemales ages 18-80 with Chronic Kidney Disease(CKD) at stage 3a, 3b or 4 or with hyperkalemia areeligible to participate. The study is now recruiting inmultiple centers across the United States, as well asother countries. An estimated 240 participants will beenrolled with a completion date of September 2013.Influenza infection in solid organ transplant recipientswhile on maintenance immunosuppressant therapyis associated with increased morbidity and mortality.An exploratory, open label, observer blinded study isbeing sponsored by Inova Health Care Services todetermine the safety and immunogenicity of Fluzone ®and Fluzone ® High-Dose influenza vaccine in thesehigh-risk patients. A second objective of this study isto determine the tolerability and efficacy of two differentstrengths of trivalent influenza vaccine. Male andfemale recipients of kidney, lung and heart transplantsaged 18 to 70 years are eligible to participate. Thisstudy is estimated to start in September 2013.A study to evaluate the safety, tolerability and immunogenicityof ipilimumab (Yervoy ® ) in combination withNY-ESO-1 vaccine in patients with unresectable ormetastatic melanoma began in March 2013. Patientsfor whom treatment with ipilimumab has been indicatedare eligible to participate in this Phase-I study sponsoredby Ludwig Institute for Cancer Research andin collaboration with the Cancer Research Institute.Only 18 participants are estimated to enroll in thisstudy that is not yet open for participant recruitment.In patients who previously underwent a stem celltransplant, carfilzomib or Kyprolis ® may stop thegrowth of cancer cells, while dexamethasone mayimprove bone marrow function and increase bloodcell counts. The Mayo Clinic is sponsoring a Phase-IIstudy to determine if administering carfilzomib togetherwith dexamethasone may be an effective treatmentfor multiple myeloma in patients who previouslyunderwent stem cell transplant. Males and femalesaged 18 and older are eligible to participate in thisstudy that will begin in June 2013.Source: ClinicalTrials.gov, 17 April 2013ASD Healthcare 75

Why stock coagulation factor product and specialty pharmaceutical inventory?Cubixx gives you a better way.Now you can transform your coagulation product inventory into a consignmentsystem that helps you save lives while saving your facility’s bottom line.Save Money while Saving Lives.With secure, on-site storage, the exclusive Cubixx consignment system gives your healthcarefacility critical access to life-saving coagulation factor product and specialty pharmaceuticalproducts – without the cost of stocking inventory. Expenses from lost, stolen or expired factorare eliminated.Streamline Management with Real-Time Data.Cubixx also revolutionizes inventory tracking and accountability. Its radio-frequency technologyprovides Web access to real-time product tracking that meets your business needs and improvesyour supply-chain efficiencies.877.4CUBIXX877.428.2499www.asdhealthcare.comLearn more about the cost and healthcare benefits of Cubixx, plus 340B pricing forqualifying facilities. Call ASD Healthcare and talk to a Cubixx innovator at 877.4CUBIXX.76 InsideOut

HyperRHO® S/DFull DoseRho(D) Immune Globulin (Human)Solvent /Detergent TreatedBRIEF SUMMARYCONSULT PACKAGE INSERT FOR FULL PRESCRIBINGINFORMATIONFOR INTRAMUSCULAR INJECTION ONLYINDICATIONS AND USAGEPregnancy and Other Obstetric ConditionsRho(D) Immune Globulin (Human) — HyperRHO® S/D Full Doseis recommended for the prevention of Rh hemolytic disease of thenewborn by its administration to the Rho(D) negative mother within72 hours after birth of an Rho(D) positive infant, providing thefollowing criteria are met:1. The mother must be Rho(D) negative and must not already besensitized to the Rho(D) factor.2. Her child must be Rho(D) positive, and should have a negativedirect antiglobulin test (see PRECAUTIONS).If HyperRHO S/D Full Dose is administered antepartum, it isessential that the mother receive another dose of HyperRHO S/DFull Dose after delivery of an Rho(D) positive infant.If the father can be determined to be Rho(D) negative,HyperRHO S/D Full Dose need not be given.HyperRHO S/D Full Dose should be administered within 72 hoursto all nonimmunized Rho(D) negative women who have undergonespontaneous or induced abortion, follow ing ruptured tubalpregnancy, amniocentesis or abdominal trauma unless the bloodgroup of the fetus or the father is known to be Rho(D) negative. Ifthe fetal blood group cannot be determined, one must assumethat it is Rho(D) positive, and HyperRHO S/D Full Dose should beadministered to the mother.TransfusionHyperRHO S/D Full Dose may be used to prevent isoimmuni -zation in Rho(D) negative individuals who have been transfusedwith Rho(D) positive red blood cells or blood componentscontaining red blood cells.CONTRAINDICATIONSNone known.WARNINGSHyperRHO S/D Full Dose is made from human plasma.Products made from human plasma may contain infectiousagents, such as viruses, and, theoretically, the Creutzfeldt-Jakob Disease (CJD) agent that can cause disease. The riskthat such products will transmit an infectious agent has beenreduced by screening plasma donors for prior exposure tocertain viruses, by testing for the presence of certain currentvirus infections, and by inactivating and/or removing certainviruses. Despite these measures, such products can stillpotentially transmit disease. There is also the possibility thatunknown infectious agents may be present in such products.Individuals who receive infusions of blood or plasma productsmay develop signs and/or symptoms of some viral infections,particularly hepatitis C. ALL infections thought by a physicianpossibly to have been transmitted by this product should bereported by the physician or other healthcare provider toGrifols Therapeutics Inc. [1-800-520-2807].The physician should discuss the risks and benefits of thisproduct with the patient, before prescribing or administering itto the patient.NEVER ADMINISTER HYPERRHO S/D FULL DOSEINTRAVENOUSLY. INJECT ONLY INTRAMUSCULARLY. NEVERADMINISTER TO THE NEONATE.Rho(D) Immune Globulin (Human) should be given with caution topatients with a history of prior systemic allergic reactions followingthe administration of human immunoglobulin preparations.The attending physician who wishes to administer Rho(D)Immune Globulin (Human) to persons with isolated immuno -globulin A (IgA) deficiency must weigh the benefits of immuni -zation against the potential risks of hypersensitivity reactions.Such persons have increased potential for developing antibodiesto IgA and could have anaphylactic reactions to subsequentadministration of blood products that contain IgA.As with all preparations administered by the intramuscular route,bleeding complications may be encountered in patients withthrombocytopenia or other bleeding disorders.PRECAUTIONSGeneralA large fetomaternal hemorrhage late in pregnancy or followingdelivery may cause a weak mixed field positive D u test result. Ifthere is any doubt about the mother’s Rh type, she should begiven Rho(D) Immune Globulin (Human). A screening test todetect fetal red blood cells may be helpful in such cases.If more than 15 mL of D-positive fetal red blood cells are presentin the mother’s circulation, more than a single dose ofHyperRHO S/D Full Dose is required. Failure to recognize thismay result in the administration of an inadequate dose.Although systemic reactions to human immunoglobulinpreparations are rare, epinephrine should be available fortreatment of acute anaphylactic reactions.Drug InteractionsOther antibodies in the Rho(D) Immune Globulin (Human)preparation may interfere with the response to live vaccines suchas measles, mumps, polio or rubella. Therefore, immunizationwith live vaccines should not be given within 3 months afterRho(D) Immune Globulin (Human) administration.Drug/Laboratory InteractionsBabies born of women given Rho(D) Immune Globulin (Human)ante partum may have a weakly positive direct antiglobulin test atbirth.Passively acquired anti-Rho(D) may be detected in maternalserum if antibody screening tests are performed subsequent toantepartum or postpartum administration of Rho(D) ImmuneGlobulin (Human).Pregnancy Category CAnimal reproduction studies have not been conducted withHyperRHO S/D Full Dose. It is also not known whetherHyperRHO S/D Full Dose can cause fetal harm whenadministered to a pregnant woman or can affect reproductioncapacity. HyperRHO S/D Full Dose should be given to a pregnantwoman only if clearly needed.Pediatric UseSafety and effectiveness in the pediatric population have not beenestablished.ADVERSE REACTIONSReactions to Rho(D) Immune Globulin (Human) are infrequent inRho(D) negative individuals and consist primarily of slightsoreness at the site of injection and slight temperature elevation.While sensitization to repeated injections of human immuneglobulin is extremely rare, it has occurred. Elevated bilirubin levelshave been reported in some individuals receiving multiple dosesof Rho(D) Immune Globulin (Human) following mismatchedtransfusions. This is believed to be due to a relatively rapid rate offoreign red cell destruction.Grifols Therapeutics Inc.Research Triangle Park, NC 27709 USAU.S. License No. 187108941119-BS

3101 Gaylord ParkwayFrisco, Texas 75034www.asdhealthcare.comFor life’s sensitive moments…Grifols is committed to the prevention ofRh hemolytic disease of the newborn (HDN)by providing HyperRHO ® S/D Full Dose(Rh O [D] immune globulin [human])HyperRHO S/D Full Dose provides the critical protection needed 1• It contains high titers of Rh O (D) immune globulin antibodies to optimize protection and reduce thepotentially life-threatening risk of HDN 1• Received first FDA labeling for removal of pathogenic prions that may cause TSE* in humans 1Partnering with healthcare professionalsat this sensitive time of your patients’ livesIn fulfilling our commitment to you and your patients, we at Grifols are proud to deliverexceptional customer service and ensure product availability when your patients need it most.Product information 1Product NDC# Description SizeHyperRHO S/DFull DoseFor intramuscular administration only.13533-631-02 Single-dosePrefilled Syringe1500 IU• Rh-negative, first-time mother-to-beTo learn more, visit www.hypermunes.com.with an Rh-positive babyImportant Safety Information• Mother needs immediate protectionHyperRHO ® S/D Full Dose (Rh O [D] immune globulin [human]) is indicated for prevention of Rh hemolytic disease• Mother received HyperRHO S/D at week 28of the newborn (HDN) and the prevention of isoimmunization in Rh O (D) negative individuals who have been transfusedand later within 72 hours of full-term deliverywith Rh O (D) positive red blood cells.HyperRHO S/D Full Dose is made from human plasma. Because this product is made from human plasma, it maycarry a risk of transmitting infectious agents, e.g., viruses, and theoretically, the Creutzfeldt-Jakob (CJD) agent.Never administer HyperRHO S/D Full Doses intravenously. Inject only intramuscularly. Never administer to the neonate.Rh O (D) Immune Globulin (Human) should be given with caution to patients with a history of prior systemic allergic reactions following the administration of human immunoglobulinpreparations. Such persons have increased potential for developing antibodies to IgA and could have anaphylactic reactions to subsequent administration of blood products that contain IgA.As with all preparations administered by the intramuscular route, bleeding complications may be encountered in patients with thrombocytopenia or other bleeding disorders.A large fetomaternal hemorrhage late in pregnancy or following delivery may cause a weak mixed field positive DU test result. If there is any doubt about the mother’s Rh type,she should be given Rh O (D) Immune Globulin (Human). A screening test to detect fetal red blood cells may be helpful in such cases.If more than 15 mL of D-positive red blood cells are present in the mother’s circulation, more than a single dose of HyperRHO S/D Full Dose is required. Failure to recognize thismay result in the administration of an inadequate dose.Although systemic reactions to human immunoglobulin preparations are rare, epinephrine should be available for treatment of acute anaphylactic symptoms.Administration of live virus vaccines (eg, MMR) should be deferred for approximately 3 months after Rh O (D) Immune Globulin (Human) administration.HyperRHO S/D Full Doses should be given in pregnant women only if clearly needed because animal reproduction studies have not been conducted.Reactions to Rh O (D) Immune Globulin (Human) are infrequent in Rh O (D)-negative individuals and consist primarily of slight soreness at the siteof injection and slight temperature elevation. While sensitization to repeated injections of human immunoglobulin is extremely rare, it has occurred.Elevated bilirubin levels have been reported in some individuals receiving multiple doses of Rh O (D) Immune Globulin (Human) following mismatchedtransfusions. This is believed to be due to a relatively rapid rate of foreign red cell destruction.Please see brief summary of HyperRHO S/D Full Dose complete Prescribing Information on adjacent page.®*Human TSEs (transmissible spongiform encephalopathies) are a group of neurodegenerative diseases related to mad cow disease.†Not an actual patient.Reference: 1. HyperRHO ® S/D Full Dose (Rh O [D] immune globulin [human]) [package insert]. Research Triangle Park, NC: Grifols Inc; 2012.© 2013 Grifols Inc. All rights reserved. January 2013 HY04-0113Grifols Therapeutics Inc.8368 US 70 West. Clayton NC 27520-USA www.grifols.comGrifols Customer Service 1.800.243.4153Meet Kim † and baby.