mckesson. From state governments to labor unions and from
patient groups and health plans to the federal government, the PBM industry is
under tremendous pressure and scrutiny to prove its value in light of
prescription costs that have skyrocketed over the last decade under its
'management. "For more than three years, NCPA and our independent pharmacist
members have worked diligently to shine a light on unregulated PBM practices
that are detrimental to patients, payers, and pharmacists. And,
according to the 2004 survey, "Pharmacists are rated more highly now than at
any time" since Gallup started measuring their image more than 20 years ago . "The desperation of the PBM industry is
understandable given this intense scrutiny.

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MDS can be deadly, even if it does
not progress to leukemia.

pharmacies resources

McKesson Specialty delivers the services manufacturers , payors
and providers need to ensure pharmaceutical products, coordinated
reimbursement, and clinical services are available to patients with complex
diseases.

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, executive vice president and CEO of the National
Community Pharmacists Association (NCPA), "so we can certainly understand the
anxiety of the PBM industry.

medicinal which

'"
For example, the nation's largest PBMs are facing litigation relating to
the federal false claims act, antitrust and unfair competition, deceptive
practices, and their roles as fiduciaries.

Preparation and dispensing of medicinal drugs must be offered.

pharmacies pharmacy

McKesson Specialty pharmacists
have completed required training and are registered with the RevAssist
program, which allows them to dispense REVLIMID.

About McKesson
McKesson Corporation (NYSE: MCK) , is a Fortune 15 healthcare services and
information technology company dedicated to helping its customers deliver
high-quality healthcare by reducing costs, streamlining processes and
improving the quality and safety of patient care.com., Facing intense public and
private scrutiny of their financial and business practices, the pharmacy
benefit management (PBM) industry lashed out at one of the nation's most
trusted health care professions -- independent community pharmacists.
"Community pharmacists deal with patients in dire situations every day,"
said Bruce Roberts, R. "Independent pharmacists/owners are in the
unique position of being health care professionals and small business owners.
They support both the physical and financial health of the communities where
they are located," Roberts said.

A pharmacist shop or dispensary which offers online ordering.

pharmacies resources

To encourage treatment regimen adherence, McKesson
Specialty will contact the patient to provide counseling , and a pharmacist or
nurse will be available 24/7 to answer questions and address patient concerns .
"This relationship represents another landmark for our specialty pharmacy
oncology portfolio ," states Brian Tyler, president of McKesson Specialty.

Under Intense Scrutiny PBM Industry Lashes Out at Nation's Small Business Independent Pharmacists

pharmacy dispensing

mckessonspecialty.
In addition, four states -- Georgia, Maine, Maryland, and South Dakota --
and the District of Columbia have enacted laws regulating PBM operations. Why else would they choose to
assault the 4 percent before tax profits of small business, independent
pharmacies? Especially in light of the fact that once you adjust for their
accounting gimmicks, such as including pharmacy inventory on their balance
sheets, their 31 to 54 percent pre-tax profits are among the highest in
corporate America and are definitely the highest in health care.

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Clinical data from a Phase II trial of 148 patients
demonstrated that REVLIMID can reduce or even eliminate the need for blood
transfusions.

About McKesson Specialty
McKesson Specialty (http://www. The October 2003 Consumer Reports survey of 32,000 readers found
that, "more than 85 percent of customers at independent drugstores were very
satisfied or completely satisfied with their experience.

be offers

For more
information, visit http://www. Over the course of its
170-year history, McKesson has grown by providing pharmaceutical and
medical-surgical supply management across the spectrum of care; healthcare
information technology for hospitals, physicians, homecare and payors;
hospital and retail pharmacy automation; and services for manufacturers and
payors designed to improve outcomes for patients.

dispensers must

, McKesson Specialty, a subsidiary of
McKesson Corporation , has been certified by Celgene Corporation as one of a
select group of RevAssist(SM) Program contract pharmacies to launch
REVLIMID(R) (lenalidomide). To reduce fetal exposure to the drug, REVLIMID is
available only through RevAssist, a unique distribution network employing only
certified, contracted specialty pharmacies.com.
Nationwide, independent pharmacies employ nearly a quarter million full-
time equivalent employees and contribute more than $10 billion in employee
wages to their local economies. The nation's independent pharmacies, independent pharmacy
franchises, and independent chains represent an $84 billion marketplace,
dispensing nearly half of the nation's retail prescription medicines.

preparation drugs

ALEXANDRIA, Va.

pharmacy or

"
McKesson Specialty assists leading pharmaceutical and biotech
manufacturers launch and maximize growth in their specialty pharmaceutical
products through an integrated array of distribution, reimbursement, clinical
and marketing services.

About Celgene
Celgene Corporation, headquartered in Summit, N.

medicinal ordering

pharmacies medicinal

Similar legislation passed the North Dakota Legislature and is awaiting the
governor's signature; and 14 other states have introduced PBM regulation
legislation this year."

The National Community Pharmacists Association (NCPA) represents the
nation's community pharmacists, including the owners of more than 24,000
pharmacies .

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Patients with this type of MDS, which can lead to
leukemia, may suffer from low red blood cell counts that require treatment
with blood transfusions, sometimes weekly. These strengths help ensure that qualified patients will have
access to REVLIMID, as well as the knowledge they need to motivate them to
follow the treatment guidelines. For more information, visit
us at http://www.

ordering dispensing

As for the attacks on independent pharmacists, Roberts said they were to
be expected.

be resources

REVLIMID is an oral medication for the treatment of patients with
transfusion-dependent anemia due to low - or intermediate-1-risk
myelodysplastic syndromes (MDS) associated with a missing part of chromosome 5
(known as deletion 5q MDS).
REVLIMID can be prescribed only by RevAssist-registered prescribers to
RevAssist-registered patients who agree to comply with the program
requirements., is an integrated
global pharmaceutical company engaged primarily in the discovery, development
and commercialization of innovative therapies for the treatment of cancer and
inflammatory diseases through gene and protein regulation.

or shopping

McKesson Specialty will also verify insurance, deductibles and eligibility.J.

must or

McKesson Specialty provides unequaled nationwide dispensing capabilities
and an ability to provide outstanding patient outreach and reimbursement
assistance.com) is a subsidiary of McKesson
Corporation."
Despite attempts to mischaracterize independent pharmacists, the American
public's trust in them continues to grow and they prefer to patronize their
practices .

medicinal preparation

Physicians will send prescriptions to Celgene, which will then
forward them to an approved contract pharmacy that has fulfilled all RevAssist
program requirements.
"REVLIMID is the first drug to reach the market to treat patients with
myelodysplastic syndromes, and we are proud to help launch it.
"With all these organizations, including state and federal governments,
suing over, investigating , and/or regulating PBM activities, I think we have
to ask the question, 'Who is wrong? Could they all be wrong?'" said Roberts.
"Again, I think the question has to be asked, "Can all these consumers be
wrong? Community pharmacists work every day to provide excellent care to the
patients they serve and in turn they have earned the trust and respect of
their patients and their communities ," Roberts said.

dispensary pharmacies

Celgene Selects McKesson Specialty as a RevAssist Program Pharmacy Vendor to Launch REVLIMID

Some of those who have sued the
PBMs include:

* 20 state attorneys general -- Arizona , California, Connecticut,
Delaware, Florida, Illinois, Iowa, Louisiana, Maine, Maryland,
Massachusetts, Nevada, New York, North Carolina, Oregon, Pennsylvania,
Texas, Vermont , Virginia, and Washington

* The State of Florida

* American Federation of State , County + Municipal Employees

* National Community Pharmacists Association and the Pharmacy Freedom Fund

* Peabody Energy Corporation

* Northwest Airlines Health Plans

* United States Attorney, Eastern District, Pennsylvania

* The State Teachers Retirement System of Ohio

* Chicago District Council of Carpenters Welfare Plan

They are also facing investigation by the Vermont State Auditor.

pharmacist pharmacy

McKesson Specialty to Provide Dispensing, Reimbursement and Clinical Services

HARAHAN, La.celgene.Ph." No preference was
found for PBM mail order .
Pharmacists/druggists rate at or near the top of the Gallup Organization's
annual poll of honesty and ethics among professions every year.

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