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DocuSign Envelope ID: 513185859-5943-4C41-90BF-OCE5E9OFDADD <br />(0112021 Version) <br />Therapeutic <br />;,d Name <br />Immune Deficiency <br />All Immune Deficiency Drugs requiring <br />$60.00 / Infusion <br />Per Diem <br />Enzyme Deficiency <br />All Enzyme Deficiency Drugs required <br />$60.00 / Infusion <br />Per Diem <br />Miscellaneous Specialty <br />Duopa <br />$65.00 / Day <br />Conditions <br />Miscellaneous Specialty <br />Solids <br />$60.00 Infusion <br />Conditions <br />PAH <br />Flolan, Veletri, Epoprostenol Sodium <br />$65.00 / Day <br />(generic-Flolan/Veletri), and Remodulin <br />PAH <br />Ventavis <br />$65.00 / Day <br />PAH <br />Tyvaso <br />$30.00 / Day <br />Inflammatory Conditions <br />Remicade <br />$60.00 / Infusion <br />Alpha 1 Deficiency <br />All Alpha I Deficiency Drugs requiring <br />$55.00/Infusion <br />Per Diem <br />Nursing Rates <br />All drugs / therapies requiring nursing <br />$150.00 per initial visit up to two <br />(2) hours/$75.00 per additional <br />hour or a fraction thereof <br />(c) Specialty Products will be excluded from the non -specialty price guarantees set forth in the <br />Agreement. In no event will the Mail Service Pharmacy or Participating Pharmacy pricing terms <br />specified in the Agreement, including, but not limited to, the annual average ingredient cost discount <br />guarantees, apply to Specialty Products. <br />(d) <br />SPECIALTY NET EFFECTIVE DISCOUNT GUARANTEE - Administrator guarantees that <br />the overall annual net effective discount for the products listed on the Specialty Products List will <br />be as follows for Client (excluding limited distribution products). <br />Within one hundred and eighty (180) days following the end of each Contract Year. Administrator <br />will calculate the actual net effective discount for the products listed on the Specialty Products List <br />to determine if the guarantee has been met. If the actual overall net effective discount is less than <br />the guaranteed net effective discount, Administrator will reimburse Client the full dollar amount of <br />the difference between the actual and guaranteed net effective discounts. Client will retain any <br />amount that the actual net effective discount exceeds the guaranteed net effective discount. The <br />calculation for the actual net effective discount will be as follows: ((Total Ingredient Cost for the <br />products listed on the Specialty Products List) divided by (Total AWP for the products listed on the <br />Specialty Products List)) minus 1. This guarantee is contingent on Client's participation in the <br />National Preferred Formulary or Basic Formulary and an exclusive specialty arrangement. <br />33 Vaccine Claims (NO VACCINE CLAIMS WILL BE INCLUDED IN ANY PRICING OR <br />REBATE GUARANTEE SET FORTH IN THE AGREEMENT). <br />(a) General Terms applicable to Vaccine Claims <br />"Vaccine Claim" means a claim for a Covered Drug which is a vaccine. <br />NOT FOR DISTRIBUTION. THE INFORNIATION CONTAINED HEREIN IS CONFIDENTIAL, PROPRIETARY <br />AND CONSTITUTES TRADE SECRETS OF EXPRESS SCRIPTS AND RXBENEFITS <br />52 <br />