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33582-00633582 AMENDMENT NO. 6 This Amendment No. 6 ("Amendment"), effective January I, 2024, amends the Prescription Benefit Services Agreement between CaremarkPCS Health, L.L.C., ("Caremark") and City of Long Beach ("Client'') dated as of January I, 2014, as amended, (the "Agreement"). The parties agree to amend the Agreement as set forth in this Amendment. I. Section 2 (Caremark Services) of the Agreement is hereby amended by inserting the following as a new subsection 2.25: 2.25 Caremark Cost Saver™. Caremark shall provide, as part of the Services, its Caremark Cost Saver™ program to Client's eligible Plan(s) in accordance with the terms and conditions described in Exhibit H. 2. The first sentence of Section 9.1 (Tenn) of the Agreement is hereby amended by deleting such sentence in its entirety and inserting the following in its place: · · "The initial term of this Agreement shall commence on the Effective Date and expire on December 31, 2016 ("Initial Term"), with a first renewal tenn commencing on January 1, 2017, and expiring on December 31, 2019, a second renewal term commencing on January 1, 2020, and expiring on December 31, 2022 ("Renewal Term"), a third renewal term commencing on January I, 2023 and expiring on December 31, 2023, and a fourth renewal term commencing on January 1, 2024 and expiring on December 31, 2024 subject to earlier termination as hereinafter set forth." 3. Section 13.4 (Compliance with Law) of the Agreement is hereby amended by deleting such section in its entirety and inserting the following in its place: 13.4 Compliance with Law. (a) Each party shall comply with the provisions of all applicable laws relating to the performance of its obligations under thi~ Agreement. Each party is responsible for obtaining its own legal advice concerning its compliance with applicable laws. (b) Without limiting the generality of this Section, to the extent mandated by applicable law, the terms and conditions set forth in Schedule 1 (Regulatory Requirements) shall be incorporated herein, as applicable. 4. Section 14 (Exhibits) of the Agreement is hereby amended by deleting such section in its entirety and inserting the following in its place: 14. Exhibits and Schedules. The following Exhibits are hereby incorporated into and made a part of this Agreement: Exhibit A, including any attachments or Schedules to said Exhibit Description Financial Terms, including Attachment I (Specialty Fee Exhibit) 1 THIS AGREEMENT CONTAINS INFORMATION THAT IS CONFIDENTIAL, PROPRIETARY AND CONSTITUTES TRADE SECRETS OF CAREMARK. ANY THIRD-PARTY DISCLOSURE IS SUBJECT TO THE TERMS OF SECTION 10. B C D E F G H Schedule I Business Associate Obligations Audit Procedures Performance Guarantees Appeals Maintenance Choice Terms and Conditions Vaccine Master Addendum Caremark Cost SaverTM Program Description Regulatory Requirements 5. The pricing grid of Section 1 (Mail,.Retail, Rebates and Specialty) of Exhibit A (Financial Tenns) of the Agreement is hereby amended by deleting such pricing grid in its entirety and inserting the following in its place: NETWORK BRAND GENERIC DlSPENSING FEE DISPENSING FEE MC (84-90) CVS SPECIALTY AT RETAIL 2 National Network 01/01i2024-12/31/2024: AWP-20.00% Generic Effective Rate 01/01/2024 -12/31/2024: AWP·-83.50% {MAC & Non-MAC Combined) Brand & Generic 01/01/2024 -12/31/2024: $0.30 per Claim Brand & Generic 01/01/2024 -12/31/2024: $0.00 per Claim BRANDS 01/01/2024 -12/31/2024: AWP -16.00% GENERICS 01/01/2024-12/31/2024: AWP-16.00% Brand & Generic Dispensing Fee 01/01/2024-12/31/2024: $0.30 per Claim THIS AGREEMENT CONTAlNS lNFORMATlON THAT IS CONFIDENTIAL, PROPRIETARY AND CONSTITUTES TRADE SECRETS OF CAREMARK. ANY THIRD-PARTY DISCLOSURE IS SUBJECT TO THE TERMS OF SECTION 10. BRAND GENERIC DISPENSING FEE SPECIAL TY AT CVS SPECIAJ,. TY MAlL, INCLUDING SPECIALTY CONNECT OVERALL EFFECTIVE DISCOUNT (OED) ELECTRONIC CLAIM ADMINISTRATION FEE MANUAL CLAIMS ADMINISTRATION FEE MAIUMAINTENANCE CHOICE RETAIL SPECIALTY AT RETAIL SPECIAL TY AT CAREMARK SPECIAL TY 1 See Section.3.1 for Rebate conditions. 01/01/2024-12/31/2024: AWP -24.50% Generic Effective Rate. 01/01/2024-12/31/2024: AWP -88.00% (MAC & Non-MAC Combined) Brand.& Generic 01/01/2024-12/31/2024: $0,00 per Claim See Specialty Fee Schedule 01/01/2024-12/31/2024: AWP-22.00% 01/01/2024 ---12/31/2024: $1.50 per Claim 01/01/2024-12/31/2024: $856.47 per Brand Drug Claim 01/01/2024 -12/31/2024:·$322.71 per Brand Drug Claim 01/01/2024 -12/31/2024: $3;415.93 per specialty Brand Drug Claim 01/01/2024 -12/31/2024: $3,415.93 per specialty Brand Drug Claim 6.. Section 1 (Mail, Retail, Rebates and Specialty) of Exhibit A (Financial Terms) of the Agreement is hereby amended by inserting the following as~ riew subsection e.: e. When remitting and reconciling minimum Rebate guarantees, Caremark may add "Rebate Credit" value to the total Rebates remitted to Client for each respective Rebate component. "Rebate Credits" shall ~onsist of (i) the differential between the Wholesale Acquisition Cost (WAC) of any Biosimilar Claim processed and the WAC of the reference Brand Drug, subject to the below cap, and/or (ii) the value of price reductions for rebateable products that have experienced a WAC decrease, measured as the differential between the Baseline 3 THIS AGREEMENT CONTAINS INFORMA TrON THAT IS CONFIDENTIAL, PROPRIETARY AND CONSTITUTES TRADE SECRETS OF CAREM.ARK.· ANY THIRD-PARTY DISCLOSURE IS SUBJECT TO THE TERMS OF SECTION 10. WAC of the product and the WAC of the product when the Claim is adjudicated, subject to the below cap. The "Baseline WAC" will be the WAC of the product prior to a reduction in WAC or, as applicable, for Biosimilars the Baseline WAC will be the WAC of the reference Brand Drug at the time the Biosimilar is added to the Formulary. In no way will, !he Rebate Credit exceed the Baseline Rebate less the earned Rebates on either the"Biosimilar Claim or the rebateable product that has experienced a WAC decrease. "Baseline Rebate" is calculated as follows: in the year the price reduction occurred, Baseline Rebate will be the Rebate prior to the WAC reduction or, as applicable, for Biosimilars the Baseline Rebate will be the earned Rebate for the reference Brand Drug at the time the Biosimilar is added to the Formulary. In subsequent years, the Baseline Rebate will increase over the prior year Baseline Rebate at the WAC inflation rate of the GPI subclass (GPI-6) of the applicable product. Caremark will notify Client of any applicable product that qualities for Rebate Credits. Caremark shall provide reporting upon Client request demonstrating the net-cost impact in the therapeutic category. The pricing offer does not reflect any anticipated impacts from the Inflation Reduction Act (IRA) or the American Rescue Plan Act or change in formulary status of any preferred biologic drug, such as Humira (adalimumab) and Stelara (ustekinumab), through removal of preferred status or addition of preferred biosimilars. For example, rebate guarantees have not been adjusted to incorporate lower list prices for insulin products or other drugs. 7. Attachment 1 of Exhibit A (Specialty Drug Fee Schedule) of the Agreement is hereby amended by deleting such attachment in its entirety and replacing it with the attached Attachment I to Exhibit A. 8. The tenns and conditions of the Agreement remain in effect except as otherwise stated herein. With respect to the subject matter hereof, this Amendment constitutes the entire agreement between the parties, superseding all similar terms in any prior understandings, agreements, contracts or arrangements between the parties, whether oral or written. 9. All capitalized tenns used in this Amendment and not otherwise defined shall have the meanings set forth in the Agreement. In the event that any provision of this Amendment conflicts with any of the provisions set forth in the Agreement, the provisions of this Amendment shall govern and control. 10. If any provision of this Amendment is held to be void or unenforceable, the remaining provisions are considered to be severable and their enforceability is not affected or impaired in any way by reason of such law or holding. ***** 4 THIS AGREEMENT CONTAINS INFORMATION THAT IS CONFIDENTIAL, PROPRIETARY AND CONSTITUTES TRADE SECRETS OF CAREMARK. ANY THIRD-PARTY DISCLOSURE IS SUBJECT TO THE TERMS OF SECTION 10. IN WITNE.SS WHEREOF, the undersigned have duly executed thii; Amendment as of the date first wtitten above. CARE ·. · CS HEALTH,L.L.C. By: Title: Vice President, Employer Sales Date: 12/7/2023 5 THIS AGREEMENT CONTAINS IN FORMATION THAT IS CONFIDENTIAL, PROPRIETARY AND CONSTITUTES TRADE-SECRETS OF CAR~MARK; ANY THIRD-PART\' DISCLOSURE IS SUBJECT TO THE TERMS OF SECTION 10. Acromegaly Acromegaly Acromegaly Acromegaly Acromegaly Acromegaly Allergic Asthma Allergic Asthma Aller ic Asthma Aller ic Asthma Allergic Asthma Allergic Asthma Alpha-1 Antitrypsin Deficiency Alpha-1 Antitrypsin Deficiency Alpha-1 Antitrypsin Deficiency Amyloidosis Amyloidosis Amyloidosis Amyloidosis Anemia Anemia Anemia Anemia Anemia Anemia Atopic Dermatitis Atopic Dermatitis Atopic Dermatitis Bone Disorders -Other Cardiac Disorders Cardiac Disorders Ca.rdiac Disorders Coagulation Disorders ATTACHMENT 1 TO EXHIBIT A SPECIAL TY DRUG FEE SCHEDULE BYNFEZIA PEN LANREOTIDE ACETATE INJ OCTREOTIDE SANDOSTATIN SOMATULINE SOMAVERT CINQAIR DUPIXENT_ASTHMA FASENRA NUCAl:.A TEZSPIRE XOl.fl,IR, •'ARAL.AST NP GLASSiA ZEMAIRA AMVUTTRA ONPATTRO VYNDAMAX VYNDAQEL ARANESP ENJAYMO EPOGEN PROCRIT REBLOZYL RETACRIT ADBRY CIBiNQO DUPIXENT _ATOPIC DERMATITIS VOXZOGO CAMZYOS 12.00% 15.00% 15.00% 12.00% 7.00% 7.00% 7.00% 12.00% 7.00% 7.00% 7.00% 7.00% 7.00% 7.00% 7.00% 10.00% 10.00% 7.00% 7.00% 12.00% 7.00% 12.00% 12.00% 7.00% 12.00% 7.00% 7.00%. 15.00% 7.00% 10.00% Estimated MAC rate of DOFETILIDE AWP-55% TIKOSYN 12.00% CEPROTIN 7.00% 6 ** *-** *** THIS AGREEMENT CONTAINS INFORMATION THAT IS CONFIDENTIAL, PROPRlETARY AND CONSTITUTES TRADE SECRETS OF CAREMARK. ANY THIRD-PARTY DISCLOSURE IS SUBJECT TO THE TERMS OF SECTION 10. Cryopyrin Associated Periodic Syndromes Cryopyrin Associated Periodic Syndromes Cystic Fibrosis Cystic Fibrosis Cystic Fibrosis Cystic Fibrosis Cystic Fibrosis Cystic Fibrosis Cystic Fibrosis Cystic Fibrosis Dupuytren's Contracture Electrolyte Disorders Electrolyte Disorders Electrolyte Disorders Endocrine .Disorders Enzyme Deficiency Disorders -Other Enzy'me Deficiency Disorders -Other Gastrointestinal Gastrointestinal Gastrointestinal Gout Growth Hormone Growth Hormone Growth Hormone Growth l;-lormone Growth H9rmone Growth Hormone Growth Hormone Growth Hormone .Growth Hormone_ Growth Hormone Growth Hormone Growth Hormone Growth Hormone ARCALYST ILARIS BETHKIS BRONCHITOL CAYSTON KITABIS PAK PULMOZVME TOBI TOBI PODHALER TOBRAMVCIN XIAFLEX DICHLORPHENAMIDE SAMSCA TOLVAPTAN CORTROPHIN BETAINE ANHYDROUS NITISINONE GATTEX OCALIVA SOLESTA KRVSTEXXA EGR.IFTA GENOTROPIN HUMATROPE iNCRELEX NORDITROPIN NUTROl?IN OMNITROPE SAIZEN SEROSTIM SKYTROFA SQGROYA ZOMACTON ZORBTIVE 7 7.00% 7.00% 7.00% 7.00% 7.00% 7.00% 7.0Q>/4 7.00% 7.00% Estimated MAC rate of AWP~SS% 10.00% 15.00% 7.00% Estimated MAC rate of AWP-55% 7.00% 15.00% 12.00% 7.00% 7.00% 7.00% 7.00% 7.00% 12.00% 12.00% 7.00% 12.00% 7.00% 7.00% 7.00% 7.00% 7.00% 10.00% .12.00% 12.00% THIS.AGREEMENT CONTAINS INFORi\lATION THAT IS CONFIDENTIAL. PROPRIETARY AND CONSTITUTES TRADE SECRETS OF CAREMARK. ANY THlRD-PARTV .QISCLOSURE IS SUBJECT TO THE TERMS OF SECTION 10. Estimated MAC rate of HIV ABACAVIR AWP-55% ABACAVIR SULFATE-Estimated MAC rate of HIV LAMIVUDINE AWP-55% ABACAVIR SULFATE- HIV LAMIVUDINE-ZIDOVUDINE 12.00% HIV APRETUDE 7.00% HIV APTIVUS 12.00% Estimated MAC rate of HIV ATAZANAVIR SULFATE AWP-55% HIV ATRIPLA 12.00% HIV BIKTARVY 12.00% HIV CABENUVA 7.00% HIV CIMDUO 12.00% HIV COMBIVIR 12,00% HIV COMPLERA 12.00% HIV CRIXIVAN 12.00% HIV DELSTRIGO 12.00% HIV DESCOVY 16.00% HIV DIDANOSINE 12.00% HIV DOVATO 12.00% HIV EDURANT 12.00% Estimated MAC rate of HIV EFAVIRENZ AWP-55% EFAVIRENZ-EMTRICITABINE- TENOFOVIR DISOPROXIL Estimated MAC rate of HIV FUMARATE AWP-55% EFAVIRENZ/LAMIVUDINE/TE HIV NOFOVIR 15.00% HIV EMTRICITABINE 15.00% EMTRICITABIN E-TENOFOVIR Estimated MAC rate of HIV DISOPROXIL FUMARATE AWP-55% HIV EMTRIVA 12:00% HIV EPIVIR 12.00% HIV EPZICOM 12.00% Estimated MAC rate of HIV ETRAVIRINE AWP-55% HIV EVOTAZ 12.00% HIV FOSAMPRENAVIR 15.00% HIV FUZEON 7.00% HIV GENVOYA 12.00% 8 THIS AGREEMENT CONTAINS INFORMATION THAT IS CONFIDENTIAL, PROPRIETARY AND CONSTITUTES TRADE SECRETS OF CAREMARK. ANY THIRD-PARTY DISCLOSURE IS SUBJECT TO THE TERMS OF SECTION 10. HIV INTELENCE 12.00% HIV INVIRASE 12.00% HIV ISENTRESS 12.00% HIV JULUCA 12.00% HIV KALETRA 12.00% Estimated MAC rate of HIV LAMIVUDINl;/ZIDOVUDINE AWP-55% Estimated MAC rate of HIV LAMIVUDII\JE....:HIV AWP.:.ss% HIV LEXIVA 12.00% Estimated MAC rate of HIV LOPINAVIR/RITONAVIR AWP-55% HIV MARAVIROC 15.00% Estimated MAC rate.of HIV NEVIRAPINE AWP-55% HIV NORVIR 12.00% HIV ODEFSEY 12.00% HIV PIFELTRO 12.00% HIV PREZCOBIX 12.00% HIV PREZISTA 12.00% HIV RESCRIPTOR 12.00% HIV RETROVIR 12.00% HI\'/ REYATAZ 12.()0% Estimated MAC rate of HIV RITONAVIR AWP•SS% HIV RUKOBIA 12.00% "" HIV SEUENTRY 12.00% HIV STAVUDINE 12.00% HIV STRIBILD 12.00% HIV SUNLENCA 10.00% HIV SUNLENCA INJ 10.00% HIV SUSTIVA 12.00% HIV SYMFI 12.00% HIV SYMTUZA 12.00% HIV TEMIXYS 12.00% TENOFOVIR DISOPROXIL Estimated MAC rate of HIV F_UMA AWP-55% HIV TIVICAY 12.00% HIV TRIUMEQ 12.00% HIV TRIZIVIR 12.00% l'.IIV TROGARZO 7.00% 9 THIS AGREEMENT CONTAINS INFORMATION THAT IS CONFIDENTIAL, PROPRIETARY AND CONSTITUTES TRADE SECRETS OF CAREMARK .. ANY THIRD-PARTY DISCLOSURE IS SUBJECT TO THE TERMS OF SECTION 10. HIV TRUVADA 12.00% HIV TYBOST 12.00% HIV VIDEX 12.00% HIV VIRACEPT 12.00% HIV VIRAMUNE 12.00% HIV VIRAMUNEXR 12.00% HIV VIREAD 12.00% HIV ZERIT 15.00% HIV ZIAGEN 12.00% Estimated MAC rate of HIV ZIDOVUDINE AWP-55% Hematopoietics MOZOBIL 7.00% Hemophilia ADVATE 7.00% Hemophilia ADYNOVATE 7.00% Hernophilia AFSTYLA 7.00% Hemophilia ALPHANATE 7.00% Hemophilia ALPHANINE SD 7.00% Hemophilia ALPROLIX 7.00% Hemophilia ALTUVIIIO 10.00% Hemophilia BEBULIN 15.00% Hemophilia BENEFIX 7.00% Hemophilia COAGADEX 7.00% Hemophilia CORIFACT 7.00% Hemophilia ELOCTATE 7.00% Hemophilia ESPEROCT 7.00% Hemophilia FEIBA 7.00% Hemophilia FIBRYGA 7.00% Hemophilia HELIXATE 12.00% Hemophilia HEMGENIX 10.00% Hemophilia HEMLIBRA 18.00% Hemophilia HEMOFILM 7.00% Hemophilia HUMATE-P 7.00% Hemophilia IDELVION 7.00% Hemophilia IXINITY 7.00% Hemophilia JIVI 7.00% Hemophilia KOATE 7.00% Hemophilia KOGENATE 7.00% Hemophilia KOVALTRY 7.00% Hemophilia MONOCLATE 15.00% Hemophilia MONONINE 7.00% 10 THIS AGREEMENT CONTAINS INFORMATION THAT IS CONFIDENTIAL, PROPRIETARY AND CONSTITUTES TRADE SECRETS OF CAREMARK. ANY THIRD-PARTY DISCLOSURE IS SUBJECT TO THE TERMS OF SECTION 10. Hemophilia NOVOEIGHT Hemophilia NOVOSEVEN RT Hemophilia NUWIQ Hemophiiia OBIZUR Hemophilia PROFILNINE SD Hemophilia REBINYN Hemophilia RECOMBINATE Hemophilia RIASTAP Hemophilia RIXUBIS Hemophilia SEVENFACT Hemophilia STIMATE Hemophilia TRETTEN Hemophilia VONVENDI Hemophilia WILATE Hemophilia XYNTHA Hepatitis B ADEFOVIR DIPIVOXIL Hepatitis B BARACLUDE Hepatitis B ENTECAVIR Hepatitis B EPfVIR HBV Hepatitis B HEPSERA. H.epatitls B LAMIVUDINE_HEPB Hepatitis B VEMLIDY Hepatitis C DAKLINZA Hepatitis C EPC:lU~A Hepatitis C .HARVONI HepatitisC LEDIPASVIR/SOFOSBUVIR Hepatitis C MAVYRET HepatitisC MODERIBA Hepatitis C PEG-INTRON Hepatitis C PEGASYS Hepatitis C . REBETOL Hepatitis C RIBAPAK Hepatitis C RIBASPHERE Hepatitis t RIBAVIRIN HepatitisC SOFOSBUVIR/VELPATASVIR Hepatitis C SOVALDI 11 7.00% 7.00% 7.00% 7.00% 7.00% 7.00% 7.00% 7.00% . 7.00% 7.00% 12.00% 7.00% 7.00% 7.00% 7.00% Estima.ted MACrate of AWP 0 SS% 12.00% Estimated MAC rate of AWP-5.5% 12.00% Estfmated MAC rate of AWP-55% 12.00% 15.00% 12.00% 12.00% 12.00% 12.00% 1.5.00% 12.00% 12.00% 12.00% 12.00% Estimated MAC rate of AWP-55% 12.00% 12.00% THIS AGREEMENT CONTAINS INFORMATION THAT IS CONFIDENTIAL, PROPRIETARY AND CONSTITUTES TRADE SECRETS OF CAREMARK. ANY THIRD-PARTY DISCLOSURE IS SUBJECT TO THE TERl'VIS OF SECTION 10. Hepatitis C TECHNIVIE 15.00% Hepatitis.C VIEKIRA PAK 12.00% Hepatitis C VOSEVI 12.00% Hepc:ititis C ZEPATIER 12.00% Hereditary Angioedema BERINERT 7.00% Hereditary Angidedema CINRYZE 7.00% Hereditary Angioedema FIRA2YR 7.00% Hereditary Angioedema HAEGARDA 7.00% Estimated MACrnte of Hereditary Angioedema ICATIBANT ACETATE AWP-55% Hereditary Angioedema KALBITOR 10.00% Hereditary Angioedema RUCONEST 10.00% Hereditary Angioedema TAKHZYRO 7.00% H.ormonal Therapies AVEED 7.00% Hormonal Therapies ELIGARD 12;00% Hormonal Therapies FENSOLVI 7.00% Hormonal Therapies FIRMAGON 12.00% Estimated MAC rate of Hormonal Therapies LEUPROLIDE ACETATE AWP-55% LEUPROLIDE Hormonal Therapies ACETATE_BRAND 15.00% Hormonal Therapies LUPANETA PACK 12.00% Hormonal Therapies LUPRON DEPOT li00% Hormonal Therapies NATPARA 7.00% Hormonal Therapies SUPPRELIN 7.00% Hormonal Therapies TRELSTAR 12.00% Hormonal Therapies VANTAS 7.00% Hormonal Therapies ZOLADEX 12.00% I.V.I.G. ASCENIV 7.00% I.V.I.G. BIVIGAM 7.00% I.V.I.G. CARIMUNE 12.00% I.V.I.G. CUTAQUIG 7.00% I.V.I.G. CUVITRU 7.00% I.V.I.G. CYTOGAM 12.00% I.V.I.G; FLEBOGAMMA 7.00% I.V.I.G. GAMASTAN S/D 7.00% I.V.I.G. GAMMAGARD 7.00% I.V.I.G. GAMMAGARD LIQUID 7.00% I.V.I.G. GAMMAKED 7.00% I.V.I.G. GAMMAPLEX 7.00% 12 THIS AGREEMENT CONTAINS INFORMATION THAT IS CONFIDENTIAL, PROPRIETARY AND CONSTITUTES TRADE SECRETS OF CAREMARK. ANY THIRD-PARTY DISCLOSURE IS SUBJECT TO THE TERMS OF SECTION 10. I.V.I.G. GAMUN.EX I.VJ,G. HEPAGAM B 1.V.I.G. HIZENTRA I.V.I.G. HVPERHEP B !;V.I.G. HVPERRHO 5/D tV.I.G. HYQVIA I.VJ.G. MICRHOGAM. 1.V.I.G. NABI-HB I.V.1 .• G. OCTAGAM I.V.I.G. PANZVGA I.V.1.G. PRIVIGEN I.V.I.G. RHOGAM 1.V.1:G. RHOPHYLAC I.V.I.G. VARIZIG LV.l.G. WINRHO I.Y.I.G. XEMBIFV Infectious Disease ACTIMN.IUNE Infectious• Disease ALFERON N Infertility BRAVELLE Infertility CETRORELIX ACETATE Infertility CETROTIDE Infertility CHORION IC GONADOTROPIN Infertility FOLLISTIM AQ Infertility FVREMADEL I nf~rtility GANIRELIX ACETATE Infertility GANIRELIX ACETATE_BRAND Infertility GONAL-F Infertility MENOPUR Infertility NOVAREL Infertility OVIDREL Infertility PREGNYL Inflammatory Bowel Disease CIMZIA Inflammatory Bowel Disease CIMZIA POW lnflarnmatory Bowel Disease ENTYVIO Inflammatory Bowel Disease RENFLEXIS Iron Overload DEFERASIROX Iron Overload DEFERIPRONE 13 7.00% 12.00% 7.00% 7.00% 7.00% 12.00% 7.00% 7.00% 7.00% 7.00% 12.00% 7;00% 12.00% 12.00% 7.00% 7.00% 12.00% 15,00% 15.00% 12.00% 12.00% 12.00% Estimated MAC rate of AWP-55% Estimated MAC rate of AWP-55% 15.00% 12.00% 12.00% 12.00% 12.00% 12.00% 12,00% 15.00% 7.00% 7.00% Estimated MAC rate of AWP-55% 10.00% THIS AGREEMENT CONTAINS INFORMATION THAT IS CONFIDENTIAL, PROPRIETARY AND CONSTITUTES TRADE SECRETS OF CAREMARK. ANY THIRDsPARTY DISCLOSURE IS SUBJECT TO THE TERMS OF SECTION 10. Iron Overload DEFEROXAMINE 15.00% Iron Overload DESFERAL 1.2.00% Iron Overload EXJADE 7.00% Iron Overload JADENU 7.00% Lipid Disorcler KYNAMRO 15.00% Lysosomal Storage Diseases ALDURAZYME 7.00% *** Lysosomal Storage Diseases CERDELGA 7.00% Lysosomal Storage Diseases CEREZYME 7.00% *** Lysosomal Storage Diseases CYSTAGON 7.00% Lysosomal Storage· Diseases ELAPRASE 7.00% *** Lysosomal Storage Diseases ELELYSO 7.00% "'** Lysosomal StoragE! Diseases FABRAZVME 7.00% *** Lysosomal Storage Diseases KAN\,JMA 7.00% *** Lysosomal Storage Diseases LUMIZYME 7.00% *** Estimated MAC rate of Lysosomal Storage Diseases MIGLUSTAT AWP-55% Lysosomal Storage Diseases NAGLAZYME 7.00% *** Lysosomal Storage Diseases NEXVIAZYME 7.00% Lysosom.il Storage Diseases VIMIZIM 7.00% *** Lysosomal Stor.:ige Diseases VPRIV 7.00% *** Lysosomal Storage Diseases XENPOZYME 10.00% *** Mental Health Conditions ZULRESSO 7.00% * Movement Disorders APOKYN 7.00% APOMORPHINE Movement Disorders HYDROCHLORIDE INJ 15.00% Movement Disorders AUSTEDO 7.00% Estimated MAC rate,of Movement Disorders DROXIDOPA AWP-55% Movement Disorders DUOPA 7.00% Movement Disorders INGREZZA 7.00% Movement Disorders KVNMOBI 12.00% Movement Disorders NORTHERA 7.00% Movement Disorders NUPLAZID 7.00% Movement Disorders RADICAVA 10.00% Movement Disorders RADICAVA ORS 10.00% Movement Diso'rders RELYVRIO 10.00% Estimated MAC rate of Movement Disorders TETRABENAZINE AWP-55% Movement Disorders XENAZINE 7.00% Multiple Sclerosis AMPVRA 7.00% 14 THIS AGREEMENT CONTAINS INFORMATION THAT IS C:ONFIDENTIAL, PROPRIETARY AND CONSTITUTES TRADE SECRETS OF CAREMARK. ,ANY THIRD-PARTY DiSCLOSURE IS SUBjECT TO THE TERMS OF SECTION 10. · Muitiple Sclerosis AUBAGIO MultipleSderosis AVONEX Multiple Sclerosis BAFIERTAM Multiple Sclerosis BETASERON Multiple Sclerosis BRIUMVI Multiple Sclerosis COPAXONE20 Multiple Sclerosis COPAXONE40 Multiple Sclerosis DALFAMPRIDINE Multiple Sclerosis DIMETHYL FUMARATE Multiple Sclerosis EXTAVIA Multiple Sclerosis FINGOLIMOD MultipleSclerosis GILENYA Multiple Sclerosis GILENYA PED DOSE Multiple Sclerosis GLATIRAMER ACETATE 20 Multiple Sclerosis GLATIRAMER ACETATE 40 Multiple Sclerosis GLATOPA20 Multiple Sclerosis GLATOPA40 Multiple Sclerosis KESIMPTA Multiple Sclerosis LEMTRADA Multiple Sclerosis MAVENCLAD Multiple Sclerosis MAVZENT Multiple Sclerosis MITOXANTRONE Multiple Sclerosis OCREVUS Multiple Sclerosis PLEGRIOY Multiple Sclerosis PONVORY Multiple Sclerosis REBIF Multiple Sclerosis TECFIDERA Multiple Sclerosis TERIFLUNOMIDE Multiple Sclerosis TVSABRI Multiple Sclerosis VUMERllY Multiple Sclernsis ZEPOSIA Neurological .Disorders ADUHELM Neurological Disorders LEQEMBI Neuromuscular VYVGART Neutropenia FULPHILA Neutropenia FYLNETRA 15 7.00% 12.00% 7;00% 12.00% 10.00% 12.00% 12.00% Estimated MAC rate of AWP-55% Estimated MAC rate of AWP-55% 7.00% Estimated MAC rate of AWP-55% 12.00% 15.00% 15.00% 15.00% 15.00% 15.00% 7.00% 7.00% 7.00% 7.00% 12.00% 7.00% 7.00% 7.00% 12.00% 7.00% Estimated MAC rate of AWP-55% 7.00% 7.00% 7.00% 7.00% 10.00% 7.00% 12.00% 10.00% THIS AGREEMENT CONTAINS INFORi\tATION THAT IS CONFIDENTIAL, PROPRIETARY AND CONSTITUTES TRADE SECRETS OF CAREMARK. AN\' THIRD-PARTY DISCLOSURE IS SUBJECT TO THE TERMS OF SECTION 10. Neutropenia GRANIX i2.00% Neutropenia LEUKINE 12.00% Neutropenia NEULASTA 12.00% Neutropenia NEUPOGEN 12.00% Neutrope_nia NIVESTYM 12.00% Neutropenia NYVEPRIA 12.00% Neutropenia RELEUKO 10.00% Neutropenia ROLVEDON 10.00% Neutropenia STIMUFEND 15.00% Neutre>penia UDENYCA 12.00% Neutropenia ZARXIO 12.00% Neutropenia ZIEXTENZO 7:00% Ocular Disorders SUSVIMO 7.00% Ocular Disorders TEPEZZA 10.00% Oncology-injectable ABRAXANE 7.00% Oncology -Injectable ADCETRIS 7.00% Oncology-Injectable ALYMSYS 15.00% Oncology -Injectable ARZERRA 7.00% Oncology -Injectable ASPARlAS 7.00% Oncology-Injectable AVASTIN 7.00% Oncology-Injectable AZACITIDINE 15.00% Oncology -Injectable BAVENCIO 10.00% Oncology -Injectable BELEODAQ 7.00% Oncology -Injectable BELRAPZO 7.00% 13ENDAMUSTINE Oncology -Injectable HYDROCHLORID 12.00% BENDAMUSTINE Oncology-Injectable HYDROCHLORIDE ·1NJ 15.00% Oncology -Injectable BENDEKA 7.00% Oncology-Injectable BESPONSA 7.00% Oncology -Injectable BLINCYTO 7.00% *** Oncology -Injectable BORTEZOMIB 12.00% Oncology-Injectable BORTEZOMIB FORINJ 15.00% BORTEZOMIB FOR INJ Oncology -Injectable (BRAND) 15.00% BORTEZOMIRFOR Oncology -Injectable INJ_E,\RAND 15.00% Oncology -Injectable CYRAMZA 7.00% Oncology -Injectable DACOGEN 12.00% Oncology-Injectable DARZALEX 7.00% 16 THIS AGREEMENT CONTAINS INFORMATION-THAT IS CONFIDENTIAL, PROPRIETARY AND CONSTITUTES TRADE SECRETS OF CAREMARK. ANY THIRD-PARTY DISCLOSURE IS SUBJECT TO THE TERMS OF SECTION 10. Oncology-Injectable DECliABINE 12.00% Oncology -Injectable EMPLICITI 7.00% Oncology -Injectable ENHERTU 7.00% Oncology-Injectable ERBITUX 12.00% Oncology -Injectable ERWINAZE 7.00% Oncology-Injectable EVOMELA 7.00% Oncology -Injectable FOLOTYN 12;00% Oncology-Injectable FUSILEV 12.00% Oncology-Injectable GAZYVA 7.00% Oncology-Injectable HALAVEN 12.00% Oncology -lnjectc1ble HERCEPTIN 7.00% Oncology-Injectable HERCEPTIN HYLECTA 7.00% Oncology -Injectable HERZUMA 7.00% Oncology -Injectable IMFINZI 7.00% Oncology-Injectable IMJUDO 10.00% Oncology-Injectable INTRON A 7.00% Oncology-Injectable ISTODAX 7.00% Oncology -Injectable IXEMPRA 12.00% Oncology-Injectable JEMPERLI 7.00% Oncology -Injectable _JEVTANA 7.00% Oncology -lrijectc1ble KADCYLA 7.00% Oncology-Injectable KANJINTI 7.00% Oncology -Injectable KEYTRUDA 7.00% Onc::ology-Injectable KHAPZORY 7.00% Oncology -Injectable KYPROLIS 7.00% Oncology -lnjec:table LEVOLEUCOVORIN CALCIUM 12.00% Oncology-Injectable LUMOXITI 7.00% Oncology -Injectable LUNSUMIO 10.00% Oncolog'jl -Injectable MARGENZA 7.09% Oncology-Injectable MVASI 7.00% Oncology -lnjectc1ble MY_LOTARG 7.00% Oncology-Injectable OGIVRI 7.00% Onc:oiogy-Injectable ONCASPAR 12:00% Oncology -Injectable ONIVYDE 10.00% Oncology-Injectable ONTRUZANT 7.00% Onc9logy-Injectable QPDIVO 7.00% Oncology-: Injectable OPDUALA~ 10.00% Oncology• Injectable PACLITAXEL PRQTE!N°BOUND 15.QO% PACLITAXEL PROTEIN- Oncology-Injectable BOUND_BRAND 15.00% 17 THIS A_GREEMENT CONTAINS INFORMATION THAT IS CONFIDENTIAL, PROPRIETARY AND CONSTITUTES TRADE SECRETS OF.CAREMARK. ANY THIRD-PARTY DISCLOSURE IS.SUBJECT to THE TERMS OF SECTION 10. Oncology-"lhjectable PADCEV 7.00% Oncology-Injectable PERJETA 7.00% Oncology-Injectable PHESGO 7.00% Oncology -Injectable POLIVY 7.00% Oncology-'Injectable PORTRAZZA 7.00% Oncology-Injectable POTELIGEO 7.00% Ontology-Injectable PRALATREXATE 15.00% Oncolpgy-Injectable PROLEUKIN 12.00% Oncology-Injectable RIABNI 7.00% Ontology-Injectable RITUXAN 7.00% Oncology -Injectable RITUXAN HYCELA 7.00% Oncology-Injectable ROMIDEPSIN 12.00% Oncology-Injectable ROMIDEPSIN_BRAND 15.00% Oncolqgy -Injectable RUXIENCE 12.00% Oncology-Injectable RYBREVANT 7.00%. Oncology-Injectable RYLAZE 10.00% Oncology -Injectable SARCLISA 7.00% Oncology -Injectable SYLATRON 15.00% Oncology-lnjecta,ble SYLVANT 7.00% Oncology -Injectable SYNRIBO 10.00% Oncology-Injectable TECENTRIQ 7.00% Oncology -Injectable TEMODAR (INJECTABLE) 12,00% Oncology -injectable TEMSIROLIMUS 12.00% Oncology-Injectable TEPADINA 12.00% Oncology-Injectable THYROGEN 7.00% Oncology -Injectable TIVDAK 7,00% Oncology -Injectable TORISEL 12.00% Oncology -Injectable TRAZIMERA 12.00% Oncology -Injectable TREANDA 7.00% Oncology -Injectable TRUXIMA 12.00% Oncology-Injectable VALRUBICIN 12.00% Oncology-Injectable VALSTAR 7.00% Oncology-Injectable VECTIBIX 12.00% Oncology -Injectable VEGZELMA 15.00% Oncology-Injectable VELCADE 12.00% Oncology-Injectable VIDAZA 7.00% Oncology -Injectable VIVIMUSTA 10.00% Oncology-Injectable VYXEOS 7.00% Oncology-Injectable XGEVA 12.00% Oncology-Injectable YERVOY 7.00% 18 THIS AGREEMENT CONTAINS INFORMA TlON THAT IS CONFIDENTIAL, PROPRIETARY AND CONSTITUTES TRADE SECRETS OF CAREMARK. ANY THIRD-PART\' DISCLOSURE IS SUBJECT TO THE TERMS OF SECTION 10. Ontology-Injectable Oncology-Injectable Oncology-Injectable Oncology-Jnjectable Oncology -Injectable Oncology~ Injectable Oncology -Injectable Oncology -.lnjectabl~ Oncology -Oral Oncology ~ Oral Oncology -Oral Oncology -Oral Oncology'-Oral Oncology-Oral Oncology-Oral Oncology -Oral Oncology -Oral Oncology -Oral Oncology -OraJ Oncology -Oral . Ohcolpgy-Oral Onc(>logy -Oral Ontology -Oral Oncology-Oral Oncology -Orc1l Oncology-Oral Oncology -Oral Oncology -Oral Oncology-Oral Oncology -Oral Oncology-Oral Oncology-Oral Oncology -Oral Oncology -Oral YONDELiS ZALTRAP ZEPZELCA ZI_RABEV ZOLEDRONIC ACID_ONC ZOLEDRONIC ACID_ONC_BRAND ZOMETA . ZYNYZ ABIRATERONE ACETATE AFINITOR ALECENSA BALVERSA BEXAROTENE CAP BEX.A:ROTENE GEL BOSULIF BRAFTOVI CABOMETYX CAPECITABINE COMETRIQ .COPIKTRA COTELLIC DAURISMO ERIVEDGE ERLEADA ERLOTINIB HYD.ROCHLORIDE EVEROLIMUS_ONC FARYDAK GAVRETO GEFITINIB GLEEVEC GLEQSTINE HYCAMTIN IBRANCE IDHIFA 19 7.00% 7.00% 7.00% 15.00% 15.00% 15.00% 10.00% Estimated MAC rate of AWP-55% 12.00% 7.00% 10.00% Estimated MAC rate of AWP-55% Estimated MAC rate of AWP-55% 12.00% 7.00% 7.00% Estimated MAC rate of AWP-55% 7.00% 10.00% 7.00% 7.00% 7.00% 7.00% Estimated MAC rate of AWP-55% Estimated MAC rate of AWP-55% 7.00% 7.00% i5.Q0% .12.00% 15.00% 12.00% 7.00% 7.00% THIS AGREEMENT CONTAINS INFORMATION THAT IS CONFIDENTIAL, PROPRIETARY AND CONSTITUTES TRADE SECRETS OF CAREMARK. ANY THIRD-PARTY DISCLOSURE IS SUBJECT TO THE TERMS OF SECTION 10. Estimated MACrate of Oncology -Oral IMATINIB MESYLATE AWP-55% Oncology -Oral INLYTA 7.00% Oncology -Oral INQOVI 7.00% Oncology-Oral INREBIC 7.00% Oncology -Oral IRESSA 7.00% Oncology -Oral JAKAFI 7.00% Oncology -Oral JAYPIRCA 10.00% Oncology-Oral KISQALI 12.00% Oncology -Oral LAPATINIB DITOSYLATE 15.00% Oncology -Oral LENALIDOMIDE 10.00% Oncology -Oral LENVIMA 7.00% Oncology -Oral LONS.URF 7.00% Oncology -Oral LORBRENA 7,00% Oncology -Oral LUMAKRAS 7.00% Oncology -Oral LYNPARZA 7.00% Oncology -Oral MEKINIST 7.00% Oncology -Oral MEKTOVI 7.00% Oncology -Oral NERLYNX 7.00% Oncology -Oral NEXAVAR 7.00% Oncology -Oral NINLARO 7.00% Oncology -Oral NUBEQA 7;00% Oncology -Oral ODOMZO 7.00% Oncology -Oral ONUREG 7.00% Oncology -Oral PIQRAY 12.00% Oncology -Ora.I POMALYST 7.00% Oncology -Oral PURIXAN 7.00% Oncology -Oral RETEVMO 7.00% Oncology -Oral REVUl\lllD 7.00% Oncology-Oral ROZLYTREK 7.00% Oncology -Oral RUBRACA 7.00% Oncology -Oral RYDAPT 12.00% Oncology -Oral SCEMBLIX 7.00% Estimated MAC rate of Oncology -Oral SORAFENIB TOSYLATE AWP-55% Oncology -Oral SPRY(;El 12.00% Oncology -Oral STIVARGA 7.00% Estimated MAC rate of Oncology-Oral SUNITINIB MALATE AWP-55% Oncology -Oral SUTENT 7.00% 20 THIS AGREEMENT CONTAINS INFORMATION THAT IS CONFIDENTIAL, PROPRIETARY AND CONSTITUTES TRADE SECRETS OF CAREMARK. ANY THIRD-PARTY DISCLOSURE IS SUBJECT TO THE TERMS OF SECTION 10. Oncology -Oral TABRECTA 12.00% Oncology .. Oral TAFINLAR 7.00% Oncology-Oral TAGRI.SSO 7.00% Oncology-Oral TALZENNA 7.00% Oncology .. Oral TARCEVA 7.00% Oncology -Oral TARGRETIN -12.00% Oncology-Oral TASIGNA 12.00% Oncology -Oral TEMODAR (ORAL) 12.00% Estimated MAC rate of Oncology -Oral TEMOZOLOMIDE AWP-55% Oncology -Oral THALOMID 7.00% Oncology-Oral TRUSELTIQ 10.00% Oncology -Oral TYKERB 7.00% Oncology-Oral VERZENIO 7.00% Oncology -Oral VITRAKVI 7.00%- Oncology-Oral VIZIMPRO 7.00% Oncology -Oral VOTRIENT 7.00% Oncology -Oral XALKORI 7.00% Estimated MAC rate of Oncology-Oral XELODA AWP-55% Oncology -Oral XOSPATA 10.00% Oncology -Oral XTANDI 7.00% Oncology -Oral YONSA 7.00% Oncology -Oral ZEJULA 7.00% Oncology-· Oral ZELBORAF 7.00% Oncology -Oral ZOLINZA 12.00% Oncology -Oral ZVDELIG 7.00% Oncology -Oral ZVKADIA 7.00% Oncology -Oral ZVTIGA 7.QO% Osteoporosis EVENITY 12.00% Osteoporosis FO.RTEO 15.00% Osteoporosis PROLIA 12.00% Osteoporosis RECLAST 12.00% Oste·oporosis TERIPARATIDE 12.00% Osteoporosis TYMLOS 7.00% Estimated MAC rate of Osteoporosis ZO~EDRONIC ACID_OST AWP-55% Paroxysmal Nocturnal Hemoglobinoria SOURIS 7.00% 21 THIS AGREEMENT CONTAINS INFORMATION THAT IS CONFIDENTIAL, PROPRIETARY AND . CONSTITUTES TRADE SECRETS OF CARE!_\;iARK. -ANY THIRD-PARTY DISCLOSURE IS.SUBJECT TO THE TERMS OF SECTION 10. Paroxysmal Nocturnal Hemoglobinuria Phenylketonuria Phenylketonuria Phenylketonuria Pre-Term Birth Pre-Term Birth Psoriasis Psoriasis Psoriasis Psoriasis Psoriasis Psoriasis Psoriasis Psoriasis Psoriasis Psoriasis Psoriasis Pulmonary Arterial Hypertension Pulmonary Arterial Hypertension Pulmonary Arterial Hypertension Pulmonary Arterial Hypertension Pulmonary Arterial Hypertension Pulmonary Arterial Hypertension Pulmonary Arterial Hypertension Pulmonary Arterial Hypertension Pulmonary Arterial Hypertension Pulmonary Arterial Hypertension Pulmonary Arterial Hypertension ULTOMI.RIS KUVAN PALYNZIQ SAPROPTERIN DIHVDROCHLORIDE HYDROXYPROGESTERONE CAPRO MAKENA COSENTYX ILUMYA OTEZLA SILIQ SKYRIZI SOTYKTU STELARA STELARA (SOLN) STELARA IV TALTZ TREMFYA ADCIRCA ADEMPAS ALYQ AMBRISENTAN BOSENTAN EPOPROSTENOL FLOLAN LETAIRIS LIQREV OPSUMIT ORENITRAM 22 7.00% 7.00% 7.00% Estimated MAC rate of AWP-55% Estimated MAC rate of AWP--55% 7.00% 19.00% 7.00% 15.00% 12.00% 19.00% 10.00% 20.00% 15.00% 10.0()% 18.00% 12.00% 12.00% 7.00% Estimated MAC rate of AWP~ss% Estimated MAC rate of AWP-55% Estimated MAC rate of AWP-55% 10.00% * 7.00% * 7.00% 15.00% 7.00% 7.00% THIS AGREEMENT CONTAINS INFORMATION THAT IS CONFIDENTIAL, PROPRIETARY AND CONSTITUTES TRADE SECRETS OF CAREMARK. ANY THIRD-PARTY DISCLOSURE IS SUBJECT TO THE TERMS OF SECTION 10. Pulmonary Arterial Hypertension Pulmonary Arterial Hypertension Pulmonary Arterial Hypertension Puh:ne>nary Arterial Hypertension Pulmonary Arterial Hypertension Pulmonary Arterial Hypertension Pulmonary A.rterial Hypertension Pulmonary Arterial Hypertension Pulmom1ry Arterial Hypertension Pulmonary Arterial Hypertension Pulmonary Arterial Hypertension Pulmonary Disorders Pulmonary Disorders Pulmpnary Disorders RSV Rare Disorders Rare'Disorders Rare Disorders Rare Disorders Rare Disorders Rare Disorders Rare Disorders Renal Disease Renal Disease Renal Disease Renal Disease Renal Disease Retinal Disorders Retinal Disorders REMODULIN REVATIO SILDENAFIL CITRATE TADALAFIL TADLIQ TRACLEER TREPROSTINIL SODIUM TYVASO UPTRAVI VELETRI VEN.TAVIS ESBRIET OFEV PIRFENIDONE SYNAGIS CRYSVITA DOJOLVI ENSPRYI\IG GAMJFANT UPLIZNA VIJOICE ZOKINVY CINACALCETHCL FILSPARI PARSABIV SENSIPAR TIOPRONIN BEOVU BYOOVIZ 23 7.00% * 12.00% Estimated MAC .rate of AWP-55% Estimated MAC rate of AWP-55% 15.00% 7,00% 10.00% * 7.00% 7.00% 7.00% * 7.00% ** 7.00% Estimated MAC rate of AWP-55% 7.00% 7.00% 7.00% 10.00% 10.00% 10.00% 10.00% Estimated MAC rate of AWP-55% 1().00% 12:00% 12.Q0% .. 15.00% 10.00% THIS AGREEMENT CONTAINS INFO~MATION TQAT IS CONFIDENTIAL, PROPRIETARY AND CONSTIT()TES TRADE SECRETS OF CAREMARK. ANY THIRD-PARTY DISCLO~URE IS SUBJECT TO THE TERMS OF SECTION 10. Retinal Disorders CIMERLI 10.00%. Retinal Disorders EYLEA 7.00% Retinal Disorders ILUVIEN 7.00% Re.tin.al Disord.ers lUCENTIS 7.00% Retinal Disor:ders MACUGEN ];00% Retinal Disorders OZURDEX 7.00% Retinal Disorders RETISERT 7.00% Retinal Disorders VABYSMO 7.00% Retinal Disorders VISUDYNE 7.00% Rhe·umatoid Arthritis ACTl:MRA 7.00% Rheumatoid Arthritis AMJEVITA 15.00% Rheu.matoid Arthritis AMJEVITA_NS 15.00% Rheumatoid Arthritis AVSOLA 7.00% Rheumatoid Arthritis ENBREL 22.00% Rheumatoi~ Arthritis HUMIRA 20.00% Rheumatoid Arthritis INFLECTRA 7.00% Rheumatoid Arthritis INFLIXIMAB 7.00% Rhellmatoid Arthritis KEVZARA 7.00% Rheumatoid Arthritis OLUMIANT 7.00% Rheumatoid Arthritis ORENCIA 12.00% Rheumatoid Arthritis OTREXUP 12.00% Rheumatoid Arthritis RASUVO 12.00% Rheumatoid Arthritis REDITREX 15.00% Rheumatoid Arthritis REMICADE 7.00% Rheumatoid Arthritis RINVOQ 12.00% Rheun:iatoid Arthritis SIMPONI 12.00% Rheumatoid Arthritis XEUANZ 12.00% Seizure Disorders EPIDIOLEX 7.00% Seizure Disorders HP ACTHAR GEL 7.00% Seizure Disorders SABRIL 7.00% Estimated MAC rate of Seizure Disorders VIGABATRIN AWP-55% Sickle Cell Disease ADAKVEO 12.00% *** Sickle Cell Disease ENDARI 10.00% Sickle Cell Disease OXBRYTA 7.00% Sleep Disorder LUMRVZ 10.00% Sleep Disorder TASIMELTEON 15.00% Sleep Disorder WAKIX 7.00% Systemic Lupus Erythematosus BENLYSTA 7.00% 24 THIS AGREEMENT CONTAINS INFORMATION THAT IS CONFIDENTIAL, PROPRIETARY AND CONSTITUTES TRADE SECRETS OF CAREMARK. ANY THIRD-PARTY DISCLOSURE IS SUBJE~ TO THE TERMS OF SECTION 10. . Systemic Lupus . Eryttienu1tosus Thrombocytopenia Thrombocytopenia Thrombocytopenia Thrombocytopenia transplant Transplant Transplant Transplant Transplant Transplant Transplant transplant Transplant Transplant Transplant Transplant Transplant Transplant Transplant Transplant Transpl;mt Orea Cycle Disorders Urea Cycle Djsorders Urea Cycle .Disorders Urea Cycle Disorders Wilson's Disea~e Wilson's Disease· ·Wilson's.Disease Wilson's Disease Wilson's Diseclse. Wilson's Disease SAPHNELO DOPTELET • MULPLETA NPLATE PROMACTA ASTAGRAF XL CELLCEPT CYCLOSPORINE ENVARSUS XR 10:00% 7.00% 12.00% 12.00% 10.00% 12.00% 12.00% Estimated MAC rate of AWP-55% 12.00% Estimated MAC rate of EVEROLll\llUS_TRANSF!LANT AWP-55% Estimated MAC rate of GENG RAF AWP-55% Estimated MAC rate of MYCOPHENOLATE MOFETIL AWP-55% MYC::OPHENOLIC ACID MYFORTIC NEORAL NULOJIX; PROGRAF ... RAPAMUNE. SANDIMMUNE SIROLIMUS TACROLIMUS ZORTRESS ~UPHENYL CARGLUMIC ACID RAVICTI SODIUM PHENYLBUTYRATE CLOVIQUE CUPRIMINE · D~PENAMINE DEPEN TITRA PENICILLAIVIINE SYPRINE 25 Estimated MAC rate of AWP-55% 12.00% 12.00% 12.00% 12.00% 12.00% Estin,atecl MAC rate of AWP-5~% Estimated MAC rate of AWP-55% 12.00% 7.00% 15.00% 7.00% 15.00% 12,00% 12.00% 12;00% 12.00% Estimated MAC rate of AWP-55% 12.00% THIS AGREEMENT CONT:.\iNS INFORMA TlON THAT IS CONFIDENTIAL, PROPRIETARY AND CONSTITUTES TRADE SECRETS OF CAREMARK. ANY THIRD~PARTY DISCLOSURE IS SUBJECT TO THE .. . TERMS OF.SECTION 10. Wilson's Disease Default Rate Overall Effective Discount (OED) Dispensing Fee: NOTES: TRIENTINE HCL Estimated MAC rate of . AWP-55% 22.00% $0.00 The Overall Effective Discount ("OED") offer is conditioned on Caremark being the exclusive provider of Specialty Services with the exception of the HIV class and Client implementing and maintaining a generics first plan design for specialty. The rates quoted herein apply to specialty products dtspensed from CVS Specialty mail phannacies, includi11g through the Specialty Co.nnect program. C.aremark may am.end the individual Specialty Drug discounts from time to time to manage the financial guarantee. The financial guarantee is measured and reconciled annually across all Specialty Drugs dispensed from a CVS Specialty mail pharirtaey, including through the Specialty Connect program, with the exception of the following exclusions (in addition to the standard exclusions). -New to Market Brand Drugs -New to Market Limited and exclusive distribution Drugs For the items noted here, the following quoted rates shall apply. -New to Market Brand Drugs: A WP -15.00% -New to Market Generic Drugs; A WP -15.00% -New to Market Limited and exclusive distribution drugs: A WP -10.00% The exclusive specialty offer includes the provision by Caremark of nurse-based rare condition care management services for Engaged Members (defined below) with the following rare conditions pursuant to the AccordantCare Specialty program established by Caremark., as may be amended by Caremark from time to time: Crohn's Disease, Cystic Fibrosis, Gauchers Disease, Hemophilia, Lupus, Multiple Sclerosis, Rheumatoid Arthritis, Ulcerative Colitis, and Hereditary Angioedema (the "AccordantCare Specialty Program"). Pursuant to the AccordantCare Specialty Program, Client acknowledges that Caremark wiil utilize those Specialty Drug Claims that are filled by Caremark's specialty pharmacy; including Specialty Connect, to ident1fy and outreach to Members that Caremark detennines are likely to have one of the above listed rare conditions (each an "Eligible Member"), and Caremark may communicate.with medical and other healthcare providers and any health plans providing benefits to Engaged Members. Client acknowledges that the AccordantCare Specialty Program is intended solely to provide education of; and support to, Engaged Members in the diagnosis and treatment provided by their healthcate providers. "Engaged Member" means an Eligible Member who elects to receive and receives AccordantCate Specialty Program services. MAC: Certain dosage forms and strengths may not be. included on the MAC list and shall be priced at the specialty default rate. 26 THIS AGREEMENT CONTAINS INFORMATION THAT IS CONFIDENTIAL, PROPRIETARY AND CONSTITUTES TRADE SECRETS OF CAREMARK. ANY THIRD-PARTY DISCLOSURE IS SUB.JECT TO THE TERMS OF SECTION l 0. PER DIEMS, NURSING & EQUIPMENT: * Remodulin, Veletri, Flolan, Epoprostenol, Treprostinil Sodium, & Zulresso for Injection: $60 per day **Ventavis: Client acknowledges and agrees an I-Neb is necessary for the administration ofVentavis. For each I-Neb provided to Member, upon the initiation of therapy or in the event a replacement I-Neb is necessary, Client shall reimburse Caremark $1,811 for each I-Neb. *** Unless otherwise stated above: $75 per dose Nursing Charges: $225.00 per visit up to 2 hours, $110.00 for each hour thereafter. Alternatively, Caremark can refer any medically necessary nursing services to the Client's contracted nursing agency, in which case nursing services will be billed separately by those agencies. In further consideration of the fees and charges to be paid to Caremark under the Agreement, Caremark will .bill any applicable nursing and equipment charges and per diems to the Member's medical benefit. In the event it is not possible to bill such nursing and equipment charges and per diems to the Member's medical benefit or it is detennined there is no coverage, Caremark shall bill Client directly for any nursing and equipment charges and per diem associated with Specialty Drugs. Routine ancillary supplies (e.g., syringes, alcohol swabs, cotton balls) are included in the Specialty Drug prices set forth in this Specialty Fee Schedule, unless otherwise indicated in this Specialty Fee Schedule as being charged separately as part of an equipment fee or per diem. PRODUCT SHORTAGE: In the event of an industry-wide product shortage, Caremark reserves the right to adjust pricing upon notice to the Client. 27 THIS AGREEMENT CONTAINS INFORMATION THAT IS CONFIDENTIAL, PROPRIETARY AND CONSTITUTES TRADE SECRETS OF CAREMARK. ANY THIRD-PARTY DISCLOSURE IS SUBJECT TO THE TERMS OF SECTION 10. Exhibit H Caremark Cost Saver™ Program As part of the Services provided pursuant to the Agreement, Caremark shall provide its Caremark Cost Saver™ Program (the "Program"), which utilizes a third-party contracted Participating Pharmacy network to enable Plan Members to take advantage of lower discount card prices, when available, while retaining the benefit of the drug utilization and clinical programs provided under the Plan. There is no cost for Client's Plan(s) to participate in the Program. Below are the terms and conditions applicable to participation by Client's Plan(s) in the Program. 1. When the Member presents a prescription for an eligible Covered Product at a Participating Phannacy that participates in the Program, Caremark may compare the price available under the Caremark contracted network with the price available through a non-Caremark contracted network. If the price for the Covered Product is lower through a non-Caremark contracted network, the Claim will be processed through that network (a "Program Claim"). If the price for the Covered Product is lower through the Caremark contracted network, the Claim will process through the Caremark contracted network. The selection of the lowest cost option shall occur automatically and no enrollment or additional action is required by the Plan Member(s) beyond presenting their phannacy benefit identification card. Caremark shall perfonn all standard utilization review services with respect to Program Claims that it performs for other Claims pursuant to tJ1is Agreement. 2. Client acknowledges the following regarding the Program: a. Program Claims process through a third-party contracted retail pharmacy network. This network is not owned by Caremark and is contracted as a discount card network. Accordingly, Program Claims constitute discount card program claims and may not be subject to all pharmacy reimbursement price procedures and terms that apply to a Caremark contracted pharmacy network. b. The price for each Program Claim includes a fee that the Participating Pharmacy remits to the third-party that contracts for access to the pharmacy network. For avoidance of doubt, the total cost of the Program Claim, including such fee, must be lower than the total cost that would otherwise apply under the Caremark contracted network in order for the Claim to process as a Program Claim. The Member and/or Client will never pay a higher cost for a Program Claim than they would if the Program was not in place. c. If Client participates in Caremark's Maintenance Choice® Program, notwithstanding anything to the contrary elsewhere in the Agreement, Maintenance Choice Prescriptions that process as Program Claims will process at a price that is lower than the price at the Caremark mail service pharmacy. d. Even if Client is exempt from sales or use taxes, Program Claims may include a sales tax allocation where required by applicable law that cannot be removed or reported under the Program. e. Participating Pharmacies are not obligated to submit Program Claims to a secondary payor, when applicable, and even if submitted to a secondary payor, such secondary payor may refuse to make a coordination of benefit payment toward Program Claims. 3. Program Claims constitute Claims, as defined in the Agreement, and are included in the reconciliation of all financial guarantees under the Agreement in the same manner and to the same extent as other Claims. Program Claims will be included in all Claim reporting Caremark makes to Client or its designated vendor pursuant to the Agreement. For purposes of Claim reporting and reconciliation of 28 THIS AGREEMENT CONTAINS INFORMATION THAT IS CONFIDENTIAL, PROPRIETARY AND CONSTITUTES TRADE SECRETS OF CAREMARK. ANY THIRD-PARTY DISCLOSURE IS SUBJECT TO THE TERMS OF SECTION 10. financial guarantees, the Program shall allocate a portion of the total Program Claim cost as a dispensing fee, consistent with the maximum dispensing fee guarantees set forth in Exhibit A of this Agreement. Client acknowledges that the dispensing fee reported on the Program Claim may differ from the dispensing fee the Participating Pharmacy is entitled to under the third-party contracted pharmacy network, provided that Client and/or Member shall in no event be Hable for any differential in the dispensing fee. Consistent with the terms of Section 5 of the Agreement, Client's approved auditor may audit a sample of Caremark contracted Participating Pharmacy contracts. 4. Client acknowledges and agrees that Caremark is not guaranteeing savings for Members or Client through the Program. 5. The Plan is responsible for complying with all laws and regulations applicable to the Plan, for making any appropriate notifications to, Members concerning the Program and for making any appropriate changes to Plan documents to reflect Client's participation in the Program, ifnecessary. 6. Upon prior written notice to Client, Caremark may modify the Program. Either party may terminate Client's participation in the Program upon sixty (60) days' prior written notice to the other party. In the event that Client terminates its participation in the Program, Caremark may modify the financial guarantees in this Agreement that are impacted by such termination, but only to the extent reasonably necessary to account for the impact of such termination. 29 THIS AGREEMENT CONTAINS INFORMATION THAT IS CONFIDENTIAL, PROPRIETARY AND CONSTITUTES TRADE SECRETS OF CAREMARK. ANY THIRD-PARTY DISCLOSURE IS SUBJECT TO THE TERMS OF SECTION IO. Schedule 1 Regulatory Requirements This Schedule 1 (Regulatory Requirements) consists of one or more sub-schedules setting forth specific contractual provisions required to be included in the Agreement by a specific State, U.S. Territory or governmental agency that may have authority over (a) one or more of the Services provided by Caremark, (b) the Client's Plan, and/or (c) certain Members. Provisions of the sub-schedules are taken directly from the relevant statute or regulation in effect at the time the Agreement or Amendment to which this Schedule 1 is attached is executed. In the event of a change with respect to any Regulatory Requirements after a sub- schedule is effective, the applicable terms shall be considered amended as necessary to comply with any such change (as of the required compliance date). The contractual provisions set forth in the sub-schedules shall apply to the Services provided by Caremark to the extent mandated by their tenns and with respect to the specific elements of the Services provided or populations of Members (the "Subject Services and Members"), as mandated in the relevant provision. To the extent these provisions differ from the terms contained elsewhere in the Agreement, the following rules of interpretation shall apply: 1. If compliance with the tenns and conditions stated elsewhere in the Agreement with respect to the Subject Services and Members would comply with the applicable requirements of any sub-schedule of this Schedule 1, the tenns and conditions stated elsewhere in the Agreement shall prevail, and 2. If compliance with the tenns and conditions stated elsewhere in the Agreement with respect to the Subject Services and Members would not comply with the applicable requirements of any sub- schedule of this Schedule 1, the tenns and conditions of the applicable sub-schedule(s) of this Schedule 1 shall apply to the extent required by applicable law. The following sub-schedules are attached hereto: • Schedule 1-FL (State of Florida Regulatory Requirements) 30 THIS AGREEMENT CONTAINS INFORMATION THAT IS CONFIDENTIAL, PROPRIETARY AND CONSTITUTES TRADE SECRETS OF CAREMARK. ANY THIRD-PARTY DISCLOSURE IS SUBJECT TO THE TERMS OF SECTION JO. Schedule 1-FLA (State of Florida Regulatory Requirements) Florida Statutes §626.8825 Phannacy benefit manager transparency and accountability. {I) DEFINITIONS. As used in this section, the term: {a) "Adjudication transaction fee" means a fee charged by the pharmacy benefit manager to the pharmacy for electronic claim submissions. {b) "Affiliated pharmacy" means a pharmacy that, either directly or indirectly through one or more intermediaries: 1. Has an investment or ownership interest in a pharmacy benefit manager holding a certificate of.authority issued under this part; 2. Shares common ownership with a pharmacy benefit manager holding a certificate of authority issued under this part; or 3. Has an investor or a holder of an ownership interest which is ·a phannacy benefit manager holding a certificate of authority issued under this part. (c) "Brand name or generic effective rate" means the contractual rate set forth by a pharmacy benefit manager for the reimbursement of covered brand name or generic drugs, calculated using the total payments in the aggregate, by drug type, during the performance period. The effective rates are typically calculated as a discount from industry benchmarks, such as average wholesale price or wholesale acquisition cost. {d) "Covered person" means a person covered by, participating in, or receiving the benefit of a pharmacy benefits plan or program. {e) "Direct and indirect remuneration fees" means price concessions that are paid to the pharmacy benefit manager by the pharmacy retrospectively and that cannot be calculated at the point of sale. The tenn may also include discounts, chargebacks or rebates, cash discounts, free goods contingent on a purchase agreement, upfront payments, coupons, goods in kind, free or reduced-price services, grants, or other price concessions or similar benefits from manufacturers, pharmacies, or similar entities. (f) "Dispensing fee" means a fee intended to cover reasonable costs associated with providing the drug to a covered person. This cost includes the pharmacist's services and the overhead associated with maintainin~ the facility and equipment necessary to operate the pharmacy. . . {g) "Effective rate guarantee" means the minimum ingredient cost reimbursement a phannacy benefit manager guarantees it will pay for pharmacist services during the applicable measurement period. (h) "Erroneous claims" means pharmacy claims submitted in error, including, but not limited to, unintended, incorrect, fraudulent, or test claims. (i) "Group purchasing organization" means an entity affiliated with a pharmacy benefit manager or a pharmacy benefits plan or program which uses purchasing volume aggregates as leverage to negotiate discounts and rebates for covered prescription drugs with pharmaceutical manufacturers, distributors, and wholesale vendors. 31 THIS AGREEMENT CONTAINS INFORMATION THAT IS CONFIDENTIAL, PROPRIETARY AND CONSTITUTES TRADE SECRETS OF CAREMARK. ANY mIRD-PARTY DISCLOSURE IS SUBJECT TO THE TERMS OF SECTION 10. G) "Incentive payment" means a retrospective monetary payment made as a reward or recognition by the pharmacy benefits plan or program or pharmacy benefit manager to a pharmacy for meeting or exceeding predefined pharmacy performance metrics as related to quality measures, such as Healthcare Effectiveness Data and Information Set measures. (k) "Maximum allowable cost appeal pricing adjustment" means a retrospective positive payment adjustment made to a pharmacy by the pharmacy benefits plan or program or by the pharmacy benefit manager pursuant to an approved maximum allowable cost appeal request submitted by the same pharmacy to dispute the amount reimbursed, for a drug based on the pharmacy benefit manager's listed maximum allowable cost price. (l) "Monetary recoi.lpments" means rescinded or recouped payments from a pharmacy or provider by the pharmacy benefits plan or program or by the pharmacy benefit manager. (m) "Network" means a group of phannacies that agree to provide pharmacist services to coverc::d persons on behalf of a pharmacy benefits plan or program or a group of pharmacy benefits plans or programs in exchange for payment for such services. The term includes a pharmacy that generally dispenses outpatient prescription drugs to covered persons. (n) "Network reconciliation offsets" means a process during annual payment reconciliation between a phannacy benefit manager and a pharmacy which allows the pharmacy benefit manager to offset an amount for overperformance or underperformance of contractual guarantees across guaranteed line items, channels, networks, or payors, as applicable. (o) "Participation contract" means any agreement between a pharmacy benefit manager and pharmacy for the provision and reimbursement of pharmacist services and any exhibits, attachments, amendments, or addendums to such agreement. (p) "Pass-through pricing model'' means a payment model used by a pharmacy benefit manager in which the payments made by the pharmacy benefits plan or program to the pharmacy benefit manager for the covered outpatient drugs are: (q) (r) (s) (t) (u) 1. Equivalent to the payments the phannacy benefit manager makes to a dispensing pharmacy or provider for such drugs, including any contracted professional dispensing fee between the phannacy benefit manager and its network of pharmacies. Such dispensing fee would be paid if the pharmacy benefits plan or program was making the payments directly. 2. Passed through in their entirety by the pharmacy benefits plan or program or by the pharmacy benefit manager to the pharmacy or provider that dispenses the drugs, and the payments are made in a manner that is not offset by any reconciliation. "Pharmacist" has the same meaning as ins. 465.003. "Pharmacist services" means products, goods, and services or any combination of products, goods, and services provided as part of the practice of the profession of pharmacy as defined ins. 465.003 or otherwise covered by a pharmacy benefits plan or program. "Pharmacy" has the same meaning as ins. 465.003. "Pharmacy benefit manager" has the same meaning as in s. 626.88. "Pharmacy benefits plan or program" means a plan or program that pays for, reimburses, covers the cost of, or provides access to discounts on phannacist services provided by one or more pharmacies to covered persons who reside in, are employed by, or receive phannacist services from this state. 32 THIS AGREEMENT CONTAINS INFORMATION THAT IS CONFIDENTIAL, PROPRIETARY AND CONSTITUTES TRADE SECRETS OF CAREMARK. ANY THIRD-PARTY DISCLOSURE IS SUBJECT TO THE TERMS OF SECTION 10. 1. The tenn includes, but is not limited to, health maintenance organizations, health insurers, self.:insured employer health plans, discount card programs, and government-funded health plans, including the Statewide Medicaid Managed Care program established pursuant to part IV of chapter 409 and the state group insurance program pursuant to part I of chapter 110. 2. The term excludes such a plan or program under chapter 440. (v) "Rebate" means all payments that accrue to a pharmacy benefit manager or its pharmacy benefits plan or program client or an affiliated group purchasing organization, directly or indirectly, from a phannaceutical manufacturer, including, but not limited to, discounts, administration fees, credits, incentives, or penalties associated directly or indirectly in any way with claims administered on behalf of a phannacy benefits plan or program client. (w) "Spread pricing" is the practice in which a phannacy benefit manager charges a pharmacy benefits plan or program a different amount for pharmacist services than the amount the phannacy benefit manager reimburses a pharmacy for such pharmacist services. (x) "Usual and customary price" means the amount charged to cash customers for a pharmacist service exclusive of sales tax or other amounts claimed. (2) CONTRACTS BETWEEN A PHARMACY BENEFIT MANAGER AND A PHARMACY BENEFITS PLAN OR PROGRAM.-ln addition to any other requirements in the Florida Insurance Code, all contractual arrangements executed, amended, adjusted, or renewed on or after July 1, 2023, which are applicable to phannacy benefits covered on or after January 1, 2024, between a pharmacy benefit manager and a pharmacy benefits plan or program must include, in substantial fonn, terms that ensure compliance with all of the following requirements and that, except to the extent not allowed by law, shall supersede any contractual terms to the contrary: (a) Use a pass-through pricing model, remaining consistent with the prohibition in paragraph (3)(c). (b) Exclude terms that allow for the direct or indirect engagement in the practice of spread pricing unless the pharmacy benefit manager passes along the entire amount of such difference to the phannacy benefits plan or program as allowable under paragraph (a). ( c) Ensure that funds received in relation to providing services for a pharmacy benefits plan or program or a pharmacy are used or distributed only pursuant to the pharmacy benefit manager's contract with the pharmacy benefits plan or program or with the pharmacy or as otherwise required by applicable law. (d) Require the pharmacy benefit manager to pass 100 percent of all prescription drug manufacturer rebates, including nonresident prescription drug manufacturer rebates, received to the pharmacy benefits plan or program, if the contractual arrangement delegates the negotiation of rebates to the pharmacy benefit manager, for the sole purpose of offsetting defined cost sharing and reducing premiums of covered persons. Any excess rebate revenue after the pharmacy benefit manager and the pharmacy benefits plan or program have taken all actions required under this paragraph must be used for the sole purpose of offsetting copayments and deductibles of covered persons. This paragraph does not apply to contracts involving Medicaid managed care plans. (e) Include network adequacy requirements that meet or exceed Medicare Part D program standards for convenient access to the network pharmacies set forth in 42 C.F.R. s. 423.120(a)(l) and that: 33 THIS AGREEMENT CONTAINS INFORMATION THAT IS CONFIDENTIAL, PROPRIETARY AND CONSTITUTES TRADE SECRETS OF CAREMARK. ANY THIRD-PARTY DISCLOSURE IS SUBJECT TO THE TERMS OF SECTION 10. 1. Do not limit a networlc to solely include affiliated phannacies; 2. Require a phannacy benefit . manager to offer a provider contract to licensed pharmacies physically located on the physical site of providers that are: 1. Within the phannacy benefits plan's or program's geographic service area and that have been . specifically designated as essential providers by the Agency for Health Care Administration pursuant to s. 409.975(l)(a); 2. Designated as cancer centers of excellence under s. 381.925, regardless of the pharmacy benefits plan's or program's geographic service area; 3. Organ transplant hospitals, regardless of the phannacy benefits plan's or program's geographic service area; 4. Hospitals licensed as specialty children's hospitals as defined ins. 395.002; or 5. Regional perinatal intensive care· centers as defined in s. 383.16(2), regardless of the pharmacy benefits plan's or program's geographic service area. Such provider contracts must be solely for the administration or dispensing of covered prescription drugs, including biological products, which are administered through infusions, intravenously injected, or.inhaled during a surgical procedure or are covered parenteral drugs, as part of onsite outpatient care; 3. Do not require a covered person to receive a prescription drug by United States mail, common carrier, local courier, third-party company or delivery service, or phannacy direct delivery unless the prescription drug cannot be acquired at any retail pharmacy in the pharmacy benefit manager's networlc for the covered person's pharmacy benefits plan or program. This subparagraph does not prohibit a pharmacy benefit manager from operating mail order or delivery programs on an opt-in basis at the sole discretion of a covered person, provided that the covered person is not penalized through the imposition of any additional retail cost-sharing obligations or a lower allowed-quantity limit for choosing not to select the mail order or delivery programs; 4. For the in-person administration of covered prescription drugs, prohibit requiring a covered person to receive pharmacist services from an affiliated pharmacy or an affiliated health care provider; and 5. Prohibit offering or implementing pharmacy networks that require or provide a promotional item or an incentive, defined as anything other than a reduced cost- sharing amount or enhanced quantity limit allowed under the benefit design for a covered drug, to a covered person to use an affiliated pharmacy or an affiliated health care provider for the in-person administration of covered prescription drugs; or advertising, marketing, or promoting an affiliated pharmacy to covered persons. Subject to the foregoing, a pharmacy benefit manager may include an affiliated pharmacy in communications to covered persons regarding network pharmacies and prices, provided that the phannacy benefit manager includes information, such as links to all nonaffiliated network pharmacies, in such communications and that the information provided is accurate and of equal prominence. This subparagraph may not be construed to prohibit a pharmacy benefit manager from entering into an agreement with an affiliated pharmacy to provide pharmacist services to covered persons. 34 THIS AGREEMENT CONTAINS INFORMATION THAT IS CONFIDENTIAL, PROPRIETARY AND CONSTITUTES TRADE SECRETS OF CAREMARK. ANY THIRD-PARTY DISCLOSURE IS SUBJECT TO THE TERMS OF SECTION 10. (f) Prohibit the ability of a phannacy benefit manager to condition participation in one phannacy network on participation in any other phannacy network or penalize a phannacy for exercising its prerogative not to participate in a specific phannacy network. (g) Prohibit a phannacy benefit manager from instituting a network that requires a phannacy to meet accreditation standards inconsistent with or more stringent than applicable federal and state requirements for licensure and operation as a phannacy in this state. However, a pharmacy benefit manager may specify additional specialty networks that require enhanced standards related to the safety and competency necessary to meet the United States Food and Drug Administration's limited distribution requirements for dispensing any drug that, on a drug-by-drug basis, requires extraordinary special handling, provider coordination, or clinical care or monitoring when such extraordinary requirements cannot be met by a retail pharmacy. For purposes of this paragraph, drugs requiring extraordinary special handling are limited to drugs that are subject to a risk evaluation and mitigation strategy approved by the United States Food and Drug Administration and that: 1. Require special certification of a health care provider to prescribe, receive, dispense, or administer; or 2. Require special handling due to the molecular complexity or cytotoxic properties of the biologic or biosimilar product or drug. For participation in a specialty network, a pharmacy benefit manager may not require a pharmacy to meet requirements for participation beyond those necessary to demonstrate the pharmacy's ability to dispense the drug in accordance with the United States Food and Drug Administration's approved manufacturer labeling. (h) I. At a minimum, require the phannacy benefit manager or pharmacy benefits plan or program to, upon revising its fonnulary of covered prescription drugs during a plan year, provide a 60-day continuity-of-care period in which the covered prescription drug that is being revised from the formulary continues to be provided at the same cost for the patient for a period of 60 days. The 60-day continuity-of-care period commences upon notification to the patient. This requirement does not apply if the covered prescription drug: a. Has been approved and made available over the counter by the United States Food and Drug Administration and has entered the commercial market as such; b. Has been removed or withdrawn from the commercial market by the manufacturer; or c. Is subject to an involuntary recall by state or federal authorities and is no longer available on the commercial market. 2. Beginning January 1, 2024, and annually thereafter, the phannacy benefits plan or program shall submit to the office, under the penalty of perjury, a statement attesting to its · compliance with the requirements of this subsection. 35 THIS AGREEMENT CONTAINS INFORMATION THAT IS CONFIDENTIAL, PROPRIETARY AND CONSTITUTES TRADE SECRETS OF CAREMARK. ANY THIRD-PARTY DISCLOSURE IS SUBJECT TO THE TERMS OF SECTION 10 ..